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https://www.readbyqxmd.com/read/29455437/live-donor-liver-transplantation-for-acute-liver-failure-a-single-center-experience
#1
Siddharth Mehrotra, Naimish Mehta, Prashantha S Rao, Shailendra Lalwani, Vivek Mangla, Samiran Nundy
INTRODUCTION: Acute liver failure (ALF) is an indication for emergency liver transplantation (LT). Although centers performing only deceased donor liver transplants (DDLT) have shown improved outcomes in this situation, they still have relatively long waiting lists. An alternative would be living donor liver transplantation (LDLT), which has shown equivalent outcomes in the elective situation but there is limited evidence of its results in ALF. AIM: The purpose of this study was to assess the outcomes in patients with ALF undergoing emergency LDLT in our center in Delhi, India...
February 17, 2018: Indian Journal of Gastroenterology: Official Journal of the Indian Society of Gastroenterology
https://www.readbyqxmd.com/read/29453515/micro-fragmented-adipose-tissue-injection-for-the-treatment-of-complex-anal-fistula-a-pilot-study-accessing-safety-and-feasibility
#2
G Naldini, A Sturiale, B Fabiani, I Giani, C Menconi
BACKGROUND: The aim of the present study was to evaluate the safety and efficacy of autologous, micro-fragmented and minimally manipulated adipose tissue injection associated closure of the internal opening in promoting healing of complex anal fistula. METHODS: A pilot study was conducted on patients referred to our center with anal fistula, from April 2015-December 2016. Inclusion criteria were age over 16 years old and a diagnosis of complex anal fistula according to the American Gastroenterological Association classification The patients were divided into 2 groups; the "first time group" (Group I) in which micro-fragmented adipose tissue injection with closure of the internal opening was the first sphincter-saving procedure, and the "recurrent group" (Group II) consisting of patients who had failed prior sphincter-saving procedures...
February 16, 2018: Techniques in Coloproctology
https://www.readbyqxmd.com/read/29447854/risk-factors-associated-complications-for-postoperative-urinary-retention-after-lumbar-surgery-for-lumbar-spinal-stenosis
#3
Joshua L Golubovsky, Haariss Ilyas, Jinxiao Chen, Joseph E Tanenbaum, Thomas E Mroz, Michael P Steinmetz
BACKGROUND CONTEXT: Postoperative Urinary Retention (POUR) is a very common post-operative complication of all surgeries (5 - 70%) that may lead to complications such as urinary tract infection (UTI), bladder over-distention, autonomic dysregulation, and increased postoperative length of stay (LOS). Within the field of spine surgery, the reported incidence of POUR is highly variable (5.6 - 38%). Lack of clear stratification of surgical level, spinal pathology, and inadequate sample size is a major limitation of available studies concerning POUR following spine surgery that may lead to inconsistency in the incidence of POUR and the ability to model its occurrence and consequences...
February 12, 2018: Spine Journal: Official Journal of the North American Spine Society
https://www.readbyqxmd.com/read/29447407/the-feasibility-of-venovenous-ecmo-at-role-2-facilities-in-austere-military-environments
#4
Mohamed A T Mohamed, Tareq Maraqa, Matthew D Bacchetta, Michael McShane, Kenneth L Wilson
Introduction: Venovenous extracorporeal membrane oxygenation (VV-ECMO) has been gaining use to bridge the recovery from acute respiratory distress syndrome (ARDS) refractory to conventional treatment. However, these interventions are often limited to higher echelons of military care. We present a case of lung salvage from severe ARDS in an Afghani soldier with VV-ECMO at a Role-2 (R2) facility in an austere military environment in Afghanistan. Case: A 25-year-old Afghani soldier presented to an R2 facility with blast lung injury and multiple penetrating injuries following an explosion...
February 13, 2018: Military Medicine
https://www.readbyqxmd.com/read/29443839/how-common-and-how-serious-is-clostridium-difficile-colitis-after-geriatric-hip-fracture-findings-from-the-nsqip-dataset
#5
Patawut Bovonratwet, Daniel D Bohl, Glenn S Russo, Nathaniel T Ondeck, Denis Nam, Craig J Della Valle, Jonathan N Grauer
BACKGROUND: Patients with geriatric hip fractures may be at increased risk for postoperative Clostridium difficile colitis, which can cause severe morbidity and can influence hospital quality metrics. However, to our knowledge, no large database study has calculated the incidence of, factors associated with, and effect of C. difficile colitis on geriatric patients undergoing hip fracture surgery. QUESTIONS/PURPOSES: To use a large national database with in-hospital and postdischarge data (National Surgical Quality Improvement Program [NSQIP®]) to (1) determine the incidence and timing of C...
March 2018: Clinical Orthopaedics and related Research
https://www.readbyqxmd.com/read/29435996/type-ii-minimal-invasive-extracorporeal-circuit-for-aortic-valve-replacement-a-randomized-controlled-trial
#6
Erich Gygax, Hans-Ulrich Kaeser, Mario Stalder, Brigitta Gahl, Robert Rieben, Thierry Carrel, Gabor Erdoes
Extracorporeal circulation triggers systemic inflammatory response and coagulation disorders which may lead to unfavorable clinical outcome. A type II minimally-invasive extracorporeal circuit (MiECC) is a closed system with markedly reduced artificial surface as compared to conventional extracorporeal circuits (CECC). The aim of this study was to investigate and compare inflammatory responses, complement activation and selected clinical end-points in isolated surgical aortic valve replacement (SAVR) performed with a type II MiECC circuit or a CECC...
February 12, 2018: Artificial Organs
https://www.readbyqxmd.com/read/29433878/the-effect-of-resident-involvement-on-bariatric-surgical-outcomes-an-acs-nsqip-analysis
#7
Ivy N Haskins, Jihad Kudsi, Kathleen Hayes, Richard L Amdur, Paul P Lin, Khashayar Vaziri
BACKGROUND: Surgical residency training programs in the United States are modeled on the principle of graduated responsibility. Residents are given greater responsibility and autonomy in the operating room and during perioperative care as they gain surgical skills and progress through their training. The impact of this method of surgical training on patient outcomes remains unknown. The purpose of this study is to compare early patient morbidity and mortality after bariatric surgery in cases with and without resident participation using the American College of Surgeons National Surgical Quality Improvement Program database...
March 2018: Journal of Surgical Research
https://www.readbyqxmd.com/read/29428155/statin-medications-are-associated-with-decreased-risk-of-sepsis-and-anastomotic-leaks-after-rectal-resections
#8
David Disbrow, Corie L Seelbach, Jeremy Albright, Jane Ferraro, Juan Wu, Jon M Hain, Beth-Ann Shanker, Robert K Cleary
BACKGROUND: This study was designed to determine the effect of statins on colorectal postoperative complications related to sepsis. Previous studies have reported conflicting results. METHODS: This is a retrospective propensity score analysis of postoperative outcomes from a large regional database of patients who underwent elective colorectal resection from June 2012-July 2015. RESULTS: 7285 patients met inclusion criteria: 34.5% received statins...
January 31, 2018: American Journal of Surgery
https://www.readbyqxmd.com/read/29423742/the-effect-of-preoperative-pneumonia-on-postsurgical-mortality-and-morbidity-a-nsqip-analysis
#9
Sarah Jamali, Michael Dagher, Nadeem Bilani, Aurelie Mailhac, Mohamad Habbal, Salah Zeineldine, Hani Tamim
BACKGROUND: Currently, only indirect evidence suggests that preoperative pneumonia is a significant risk factor for poor postsurgical outcomes. Although this relationship is clinically intuitive, this is the first study that aims to quantify the extent to which pneumonia impacts morbidity and mortality. The objective of this study was to determine the impact of preoperative pneumonia on 30-day mortality and morbidity among both elective and emergency surgical patients. METHODS: We conducted a retrospective cohort study using 2008-2012 data from the American College of Surgeons National Surgical Quality Improvement Program database...
February 8, 2018: World Journal of Surgery
https://www.readbyqxmd.com/read/29421911/intrathoracic-leak-after-an-ivor-lewis-procedure-for-an-esophageal-neoplasm-treated-with-a-stent
#10
Natalia Afonso Luis, Maria Asunsión Acosta Mérida, Joaquín Marchena Gómez
A 75-year-old male who underwent an Ivor Lewis esophagectomy due to a distal adenocarcinoma had a leak at the gastroplasty on the 5th day after surgery, which required two surgeries and a primary suture. He was transferred to our hospital due to a poor outcome and endoscopy revealed a 2.5cm gap perianastomotically on the gastroplasty wall, for which a stent was placed. Due to hemodynamic impairment, a thoracotomy procedure was performed, which revealed stent protrusion into the cavity. The patient underwent an esophagogastric anastomosis resection, cervical esophagostomy and gastrostomy...
February 9, 2018: Revista Española de Enfermedades Digestivas
https://www.readbyqxmd.com/read/29416321/perioperative-outcome-of-elderly-versus-younger-patients-undergoing-major-hepatic-or-pancreatic-surgery
#11
Qiang Lu, Jian-Wen Lu, Zheng Wu, Xue-Min Liu, Jian-Hui Li, Jian Dong, Guo-Zhi Yin, Yi Lv, Xu-Feng Zhang
Objective: The aim of this study was to determine the safety of elderly cancer patients (≥70 years) undergoing hepatic resection (HR) or pancreaticoduodenectomy (PD) in comparison with younger adults (<70 years). Methods: A total of 1,012 consecutive patients undergoing HR or PD were included. The incidence and severity of morbidity were documented within 30 days postoperatively and compared between elderly and younger groups. Risk factors associated with postoperative morbidity were investigated by multivariate logistic regression analysis...
2018: Clinical Interventions in Aging
https://www.readbyqxmd.com/read/29408429/complications-of-recognized-and-unrecognized-iatrogenic-ureteral-injury-at-time-of-hysterectomy-a-population-based-analysis
#12
Robert H Blackwell, Eric J Kirshenbaum, Arpeet S Shah, Paul C Kuo, Gopal N Gupta, Thomas M T Turk
PURPOSE: Ureteral injury represents an uncommon but potentially morbid complication surgical complication. This study sought to characterize the complications of iatrogenic ureteral injury and assess the effect of recognized vs delayed recognition on patient outcomes. MATERIALS AND METHODS: Hysterectomy patients were identified in the Healthcare Cost and Utilization Project State Inpatient Database for California, years 2007-2011. Ureteral injuries were identified and categorized as recognized (diagnosed/repaired the day of hysterectomy) and unrecognized (diagnosed/repaired postoperatively)...
February 2, 2018: Journal of Urology
https://www.readbyqxmd.com/read/29406797/sequelae-of-index-complications-following-inpatient-head-and-neck-surgery-characterizing-secondary-complications
#13
Alexander N Goel, Karam W Badran, Alexander M Garrett, Maie A St John, Jennifer L Long
Objective To characterize patterns of secondary complications after inpatient head and neck surgery. Study Design Retrospective cohort study. Setting National Surgical Quality Improvement Program (2005-2015). Subjects and Methods We identified 18,584 patients who underwent inpatient otolaryngologic surgery. Four index complications were studied: pneumonia, bleeding or transfusion event (BTE), deep/organ space surgical site infection (SSI), and myocardial infarction (MI). Each patient with an index complication was matched to a control patient based on propensity for the index event and event-free days...
February 1, 2018: Otolaryngology—Head and Neck Surgery
https://www.readbyqxmd.com/read/29398629/post-op-a-strategy-to-improve-clinical-documentation-in-the-early-postoperative-period
#14
Paul M Cromwell, Michael Flood, Emer O Connell, Waqar Khan, Ronan Waldron, Iqbal Khan, Kevin Barry
OBJECTIVE: To construct and pilot an educational tool to improve the quality of postoperative documentation at Mayo University Hospital. DESIGN: Retrospective data were collected from 100 consecutive patients treated surgically during October to November 2016. The first written ward based note following surgery was analyzed against RCS quality standards outlined in "Good Surgical Practice." An educational tool was then constructed to improve postoperative documentation...
February 1, 2018: Journal of Surgical Education
https://www.readbyqxmd.com/read/29397102/predictors-of-failure-to-rescue-after-esophagectomy
#15
Douglas Z Liou, Derek Serna-Gallegos, James Mirocha, Vahak Bairamian, Rodrigo F Alban, Harmik J Soukiasian
BACKGROUND: Failure to rescue (FTR), defined as death after a major complication, is a metric increasingly being used to assess quality of care. Risk factors associated with FTR after esophagectomy have not been previously studied. METHODS: The American College of Surgeons National Surgical Quality Improvement Program database was queried for patients who underwent esophagectomy with gastric conduit between 2010 and 2014. Patients with at least one major postoperative complication were grouped according to inhospital mortality (FTR group) and survival to discharge (SUR group)...
January 31, 2018: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/29390466/iatrogenic-acute-aortic-dissection-induced-by-off-pump-coronary-artery-bypass-grifting-a-case-report-and-review-of-the-literature
#16
Jiachen Li, Xinliang Guan, Ming Gong, Xiaolong Wang, Hongjia Zhang
RATIONALE: Iatrogenic acute aortic dissection (IAAD) induced by cardiac surgery is a fatal complication, with 0.04% of therapeutic procedures and worse outcomes than spontaneous aortic dissection. PATIENTS CONCERNS: A 64-year-old male complaining of intermittent chest tightness for 4 years received an off-pump coronary artery bypass grifting (OPCABG) and IAAD was found during surgery. DIAGNOSIS: Unstable angina, coronary artery triple vessel lesion, IAAD...
December 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29388457/avoidable-30-day-mortality-analysis-and-failure-to-rescue-in-dysvascular-lower-extremity-amputees
#17
Christian Wied, Nicolai B Foss, Peter T Tengberg, Gitte Holm, Anders Troelsen, Morten T Kristensen
Background and purpose - An enhanced treatment program may decrease 30-day mortality below 20% after lower extremity amputations (LEA). The potential and limitations for further reduction are unknown. We analyzed postoperative causes of 30-day mortality, and assessed failure to rescue (FTR) rate in LEA patients who followed an enhanced treatment program. Patients and methods - Medical charts of 195 primary LEA procedures were reviewed independently by 3 of the authors, and deaths during hospitalization following amputation were classified according to consensus...
February 1, 2018: Acta Orthopaedica
https://www.readbyqxmd.com/read/29384922/a-case-report-and-literature-review-of-sigmoid-volvulus-in-children
#18
Po-Hsiung Chang, Chin-Ming Jeng, Der-Fang Chen, Lung-Huang Lin
RATIONALE: Sigmoid volvulus (SV) is an exceptionally rare but potentially life-threatening condition in children. CHIEF COMPLAINT: Abdominal distention for 1 week. DIAGNOSES: Sigmoid volvulus. PATIENT CONCERNS: We present a case of a 12-year-old boy with mechanical ileus who was finally confirmed to have SV with the combination of abdominal plain film, sonography, and computed tomography (CT) with the finding of mesenteric artery rotation...
December 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29382792/prolonged-mechanical-ventilation-as-a-predictor-of-mortality-after-cardiac-surgery
#19
Maria Dolores Fernandez-Zamora, Antonio Gordillo-Brenes, Esther Banderas-Bravo, José Andrés Arboleda-Sánchez, Rafael Hinojosa-Pérez, Eduardo Aguilar-Alonso, Ángel Herruzo-Aviles, Emilio Curiel-Balsera, Ángel Sánchez-Rodríguez, Ricardo Rivera-Fernández
BACKGROUND: Mortality among the small percentage of cardiac surgery patients receiving prolonged mechanical ventilation is high, but this issue appears to be inadequately addressed in guidelines. METHODS: This study is a retrospective analysis of prospective, multi-center, and observational study in Spain including all adults undergoing cardiac surgery in 3 Andalusian hospitals between June 2008 and December 2012. RESULTS: The study included 3,588 adults with mean ± SD age of 63...
January 30, 2018: Respiratory Care
https://www.readbyqxmd.com/read/29375747/neoadjuvant-hyperfractionated-accelerated-radiotherapy-plus-concomitant-5-fluorouracil-infusion-in-locally-advanced-rectal-cancer-a-phase-ii-study
#20
Zeynep Gural, Sezer Saglam, Serap Yucel, Esra Kaytan-Saglam, Oktar Asoglu, Cetin Ordu, Hediye Acun, Rasul Sharifov, Semen Onder, Ahmet Kizir, Ethem N Oral
AIM: To evaluate the efficacy and tolerability of neoadjuvant hyperfractionated accelerated radiotherapy (HART) and concurrent chemotherapy in patients with locally advanced infraperitoneal rectal cancer. METHODS: A total of 30 patients with histopathologically confirmed T2-3/N0+ infraperitoneal adenocarcinoma of rectum cancer patients received preoperative 42 Gy/1.5 Gy/18 days/bid radiotherapy and continuous infusion of 5-fluorouracil (325 mg/m2). All patients were operated 4-8 wk after neoadjuvant concomitant therapy...
January 15, 2018: World Journal of Gastrointestinal Oncology
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