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https://www.readbyqxmd.com/read/29243452/laparoscopic-appendectomy
#1
Ville Sallinen, Panu Mentula
Laparoscopic appendectomy has practically replaced open surgery. Appendectomy, i.e. surgical excision of the appendix, is one of the most common procedures of a specializing surgeon, and serves to help learn the basics of laparoscopy - first by following and later independently performing the operation. Properative preparation, precise diagnosis, correct surgical technique and follow-up treatment are the cornerstones of successful care. The anatomy of the patient must be considered in the placement of trocars...
2017: Duodecim; Lääketieteellinen Aikakauskirja
https://www.readbyqxmd.com/read/29241988/disparities-in-operative-outcomes-in-patients-with-comorbid-mental-illness
#2
Elizabeth A Bailey, Christopher Wirtalla, Catherine E Sharoky, Rachel R Kelz
BACKGROUND: Patients with mental health disorders have worse medical outcomes and experience excess mortality compared with those without a mental health comorbidity. This study aimed to evaluate the relationship between mental health comorbidities and surgical outcomes. METHODS: This retrospective cohort study used the National Inpatient Sample (2009-2011) to select patients who underwent one of the 4 most common general surgery procedures (cholecystectomy and common duct exploration, colorectal resection, excision and lysis of peritoneal adhesions, and appendectomy)...
December 11, 2017: Surgery
https://www.readbyqxmd.com/read/29241960/trends-in-common-surgical-procedures-at-children-s-and-nonchildren-s-hospitals-between-2000-and-2009
#3
Heather L Short, Samir Sarda, Curtis Travers, Jason M Hockenberry, Ian McCarthy, Mehul V Raval
PURPOSE: Though growth in children's surgical expenditures has been documented, procedure-specific differences in volume and costs at children's hospitals (CH) and non-hildren's hospitals (NCH) have not been explored. Our purpose was to compare trends in volume and costs of common pediatric surgical procedures between CH and NCH. METHODS: We performed a review of the 2000-2009 Kids' Inpatient Database identifying all cases of appendectomy for uncomplicated appendicitis (AP), tonsillectomy and adenoidectomy (TA), fundoplication (FP), humeral fracture repair (HFR), pyloromyotomy (PYL), and cholecystectomy (CHOLE)...
November 23, 2017: Journal of Pediatric Surgery
https://www.readbyqxmd.com/read/29241958/time-to-appendectomy-for-acute-appendicitis-a-systematic-review
#4
REVIEW
Danielle B Cameron, Regan Williams, Yimin Geng, Ankush Gosain, Meghan A Arnold, Yigit S Guner, Martin L Blakely, Cynthia D Downard, Adam B Goldin, Julia Grabowski, Dave R Lal, Roshni Dasgupta, Robert Baird, Robert L Gates, Julia Shelton, Tim Jancelewicz, Shawn J Rangel, Mary T Austin
OBJECTIVE: The goal of this systematic review by the American Pediatric Surgical Association Outcomes and Evidence-Based Practice Committee was to develop recommendations regarding time to appendectomy for acute appendicitis in children within the context of preventing adverse events, reducing cost, and optimizing patient/parent satisfaction. METHODS: The committee selected three questions that were addressed by searching MEDLINE, Embase, and the Cochrane Library databases for English language articles published between January 1, 1970 and November 3, 2016...
November 20, 2017: Journal of Pediatric Surgery
https://www.readbyqxmd.com/read/29234938/impact-of-incisional-hernia-development-following-abdominal-operations-on-total-healthcare-cost
#5
Vamsi V Alli, Jianying Zhang, Dana A Telem
BACKGROUND: Introduction of the category III CPT code (0437T) for prophylactic mesh augmentation (PMA) highlights efforts to reduce incisional hernia (IH). PMA's value in the context of value-based care requires understanding both the cost of IH development and the savings from prevention. We hypothesized large healthcare costs with IH development. Appreciating which subsets of patients are at highest risk for IH, and the subsets who have the costliest care is essential in targeting interventions for hernia prevention...
December 12, 2017: Surgical Endoscopy
https://www.readbyqxmd.com/read/29223920/streptococcus-agalactiae-bacteremia-in-non-pregnant-adult-patients-at-two-teaching-hospitals
#6
Emanuel J Saad, Diego F Baenas, Cecilia S Boisseau, Mercedes J García, Silvana A Núñez, Pablo E Sanchez, Domingo C Balderramo, Daniela Hernández, Juan P Caeiro
Streptococcus agalactiae or group B streptococcus (GBS) is a frequent pathogen in immunocompromised adults. The aim of this study was to determine the relative frequency, clinical presentation, antimicrobial susceptibility profile, and risk factors associated with GBS bacteremia in non-pregnant adult patients. We conducted a retrospective analysis of blood cultures performed in two hospitals between the years 2009-2013. From 1110 bacteremia episodes, 13 were caused by GBS, all of which were susceptible to ampicillin...
December 6, 2017: Revista Argentina de Microbiología
https://www.readbyqxmd.com/read/29223668/transumbilical-extracorporeal-laparoscopic-assisted-appendectomy
#7
Lindsey Perea, William H Peranteau, Pablo Laje
AIM OF THE STUDY: The perfect balance between safety, cosmesis, and cost effectiveness in a world with ever growing healthcare costs has yet to be found for nonperforated appendicitis. The aim is to present our data regarding safety and cost effectiveness of the transumbilical extracorporeal laparoscopic-assisted appendectomy technique. METHODS: A retrospective review was performed for all laparoscopic appendectomies for acute appendicitis from October 2014 to October 2016...
November 13, 2017: Journal of Pediatric Surgery
https://www.readbyqxmd.com/read/29223666/laparoscopic-versus-open-appendectomy-in-children-a-randomized-controlled-trial-from-a-developing-country
#8
Roshan Ali, Muhammad Anwar, Jamshed Akhtar
BACKGROUND: Acute appendicitis is a common surgical emergency. This study was conducted to compare the outcome in terms of duration of surgery, length of hospital stay, and wound infection rate following laparoscopic versus open appendectomy in children with acute appendicitis. METHODS: A prospective randomized controlled trial was conducted. Patients with the diagnosis of acute appendicitis were randomly assigned to Group A: Laparoscopic appendectomy (LA) and Group B: Open appendectomy (OA)...
November 14, 2017: Journal of Pediatric Surgery
https://www.readbyqxmd.com/read/29218659/single-site-robotic-assisted-laparoscopic-cholecystectomy-in-children-and-adolescents-a-report-of-20-cases
#9
Peter Mattei
BACKGROUND: Single-site laparoscopy is increasingly popular for straightforward operations like appendectomy. Due to limited triangulation and maneuverability, single-site cholecystectomy is riskier and more difficult. Robotics offer to make it easier and safer. METHODS: Twenty children and adolescents underwent robotic-assisted single-site cholecystectomy at a large academic children's hospital. Patients were not randomized; patients were offered the option of robotic-assisted single-site (SSR) or standard four-incision laparoscopic (LAP) cholecystectomy...
December 7, 2017: Surgical Endoscopy
https://www.readbyqxmd.com/read/29216527/laparoscopic-management-of-a-drain-site-evisceration-of-the-vermiform-appendix-a-case-report
#10
Anisse Tidjane, Benali Tabeti, Nabil Boudjenan Serradj, Salim Bensafir, Nacim Ikhlef, Noureddine Benmaarouf
INTRODUCTION: Peritoneal cavity drainage is not riskless and several publications reported drain induced complications. However, till this day, abdominal drainage is still a subject of divergence between necessity and usual operative practice. We describe in this publication an exceptional complication of drainage, which is the drain site evisceration of the appendix. CASE PRESENTATION: We report the case of a 47-years-old patient, initially operated for perforated ulcer peritonitis, in whom an evisceration occured 48h after the removal of an intraperitoneal drain placed in the Douglas pouch, the physical examination predicated the presence of a herniated omentum fringe, as a precaution a laparoscopic exploration was performed and revealed that the eviscerated organ was the vermiform appendix, then a two trocars appendectomy was performed and the orifice of the evisceration was safely closed...
November 28, 2017: International Journal of Surgery Case Reports
https://www.readbyqxmd.com/read/29205995/volume-and-health-outcomes-evidence-from-systematic-reviews-and-from-evaluation-of-italian-hospital-data
#11
Laura Amato, Danilo Fusco, Anna Acampora, Katia Bontempi, Alessandro Cesare Rosa, Paola Colais, Fabio Cruciani, Mariangela D'Ovidio, Francesca Mataloni, Silvia Minozzi, Zuzana Mitrova, Luigi Pinnarelli, Rosella Saulle, Salvatore Soldati, Chiara Sorge, Simona Vecchi, Martina Ventura, Marina Davoli
BACKGROUND Improving quality and effectiveness of healthcare is one of the priorities of health policies. Hospital or physician volume represents a measurable variable with an impact on effectiveness of healthcare. An Italian law calls for the definition of «qualitative, structural, technological, and quantitative standards of hospital care». There is a need for an evaluation of the available scientific evidence in order to identify qualitative, structural, technological, and quantitative standards of hospital care, including the volume of care above or below which the public and private hospitals may be accredited (or not) to provide specific healthcare interventions...
September 2017: Epidemiologia e Prevenzione
https://www.readbyqxmd.com/read/29205688/integration-of-radiological-findings-and-a-clinical-score-in-pediatric-appendicitis
#12
Derya Aydin, Caner Turan, Ali Yurtseven, Petek Bayindir, Bade Toker, Zafer Dokumcu, Murat Sezak, Eylem Ulas Saz
BACKGROUND: The efficacy of ultrasonography (US) and abdominal X-ray in combination with PAS is complicated in the diagnosis of acute appendicitis. Abdominal X-ray is as useful as US with clinical assessment when evaluated by experienced pediatric radiologist in acute appendicitis. We aimed to determine the value of US and abdominal X-ray for appendicitis in children when combined with clinical assessment based on the Pediatric Appendicitis Score (PAS). We also aimed to establish a practical pathway for acute appendicitis in childhood...
December 5, 2017: Pediatrics International: Official Journal of the Japan Pediatric Society
https://www.readbyqxmd.com/read/29200067/randomized-clinical-trial-of-preoperative-high-dose-methylprednisolone-on-postoperative-pain-at-rest-after-laparoscopic-appendectomy
#13
Jakob Kleif, Camilla I Hauge, Jesper Vilandt, Ismail Gögenur
BACKGROUND: Methylprednisolone administered intravenously preoperatively has been shown to reduce pain, nausea, and fatigue after elective surgery. We aimed to show that 125 mg of methylprednisolone given intravenously 30 minutes before laparoscopic surgery for suspected appendicitis would reduce pain at rest during the first 3 postoperative days. METHODS: A multicenter, parallel-group, double-blind, placebo-controlled study was conducted including patients 18 years of age and older with an American Society of Anesthesiologist class of I-III undergoing laparoscopic surgery for suspected appendicitis...
November 30, 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/29197848/challenging-and-uncommon-diagnosis-of-long-evolution-ascites
#14
Marta Gravito-Soares, Elisa Gravito-Soares, João Almeida, João Fraga, Luis Tomé
This is a case report of a 45-year-old Caucasian man with chronic alcoholism. No history of liver disease or asbestos exposure. He complained of ascites during the last 3 years with worsening in the last year with severe ascites development. Diagnostic paracentesis showed SAAG 1.1 and high cellularity with neutrophil count >250 cells/µL. Ascitic fluid cytology revealed reactive mesothelial hyperplasia. Thoracoabdominopelvic ultrasonography/CT/MRI and fludeoxyglucose positron emission tomography/CT showed 'omental cake' pattern suggesting peritoneal carcinomatosis...
December 2, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/29190038/closure-methods-of-the-appendix-stump-for-complications-during-laparoscopic-appendectomy
#15
REVIEW
Gurdeep S Mannu, Maria K Sudul, Joao H Bettencourt-Silva, Elspeth Cumber, Fangfang Li, Allan B Clark, Yoon K Loke
BACKGROUND: Laparoscopic appendectomy is amongst the most common general surgical procedures performed in the developed world. Arguably, the most critical part of this procedure is effective closure of the appendix stump to prevent catastrophic intra-abdominal complications from a faecal leak into the abdominal cavity. A variety of methods to close the appendix stump are used worldwide; these can be broadly divided into traditional ligatures (such as intracorporeal or extracorporeal ligatures or Roeder loops) and mechanical devices (such as stapling devices, clips, or electrothermal devices)...
November 13, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/29183522/peripheral-nerve-injury-during-abdominal-pelvic-surgery-analysis-of-the-national-surgical-quality-improvement-program-database
#16
Christopher J D Wallis, Sarah Peltz, James Byrne, Jamie Kroft, Paul Karanicolas, Natalie Coburn, Avery B Nathens, Robert K Nam, Julie Hallet, Raj Satkunasivam
Peripheral nerve injury (PNI) is a rare but preventable complication of surgery. We sought to assess whether the use of minimally invasive surgery (MIS) affects the occurrence of PNI. Using the American College of Surgeons National Surgical Quality Improvement Program database, we examined rates of PNI among patients undergoing appendectomy, hysterectomy, colectomy, or radical prostatectomy between 2005 and 2012. We assessed the effect of MIS, as compared with open surgery, on PNI occurrence using logistic regression...
November 1, 2017: American Surgeon
https://www.readbyqxmd.com/read/29180194/perioperative-complications-of-emergent-and-elective-procedures-in-psychiatric-patients
#17
Ayal Hassidim, Sharon Bratman Morag, Moshe Giladi, Yael Dagan, Roie Tzadok, Petachia Reissman, Amir Dagan
BACKGROUND: Patients with psychiatric disorders have an increased risk for morbidity and mortality from other medical conditions. METHODS: Medical records of all the patients undergoing appendectomy (n = 2594) and laparoscopic cholecystectomy (n = 2874) from 2009 to 2014 in one hospital were reviewed. For each patient with a documented psychiatric disorder undergoing surgery, four controls were matched. RESULTS: The final sample of patients undergoing appendectomy included 96 patients, whereas those undergoing laparoscopic cholecystectomy included 260 patients...
December 2017: Journal of Surgical Research
https://www.readbyqxmd.com/read/29180172/early-appendectomy-reduces-costs-in-children-with-perforated-appendicitis
#18
Joseph T Church, Edwin J Klein, Benjamin D Carr, Steven W Bruch
BACKGROUND: Perforated appendicitis can be managed with early appendectomy, or nonoperative management followed by interval appendectomy. We aimed to identify the strategy with the lowest health care utilization and cost. METHODS: We retrospectively reviewed the medical records of all children ≤18 years old with perforated appendicitis admitted to a single institution between January 2009 and March 2016. After excluding immunosuppressed patients and transfers from outside hospitals, we grouped the remaining patients by early or interval appendectomy...
December 2017: Journal of Surgical Research
https://www.readbyqxmd.com/read/29168372/tuba-ovarian-auto-amputation-caused-by-ovarian-teratoma-in-an-adolescent-girl
#19
Ahmet Atıcı, Engin Yılmaz, Ayşe Karaman, Sema Apaydın, Çağatay Evrim Afşarlar
Atıcı A, Yılmaz E, Karaman A, Apaydın S, Afşarlar ÇE. Tuba-ovarian auto-amputation caused by ovarian teratoma in an adolescent girl. Turk J Pediatr 2017; 59: 90-92. Ovarian auto-amputation is an extremely rare condition commonly encountered in the perinatal period. Spontaneous or secondary torsion of the ovary caused by an ovarian lesion may result in infarction and subsequent auto-amputation of the ovary. This paper demonstrates a case that underwent laparoscopic appendectomy with an incidental calcified auto-amputated right ovary...
2017: Turkish Journal of Pediatrics
https://www.readbyqxmd.com/read/29159839/increased-renal-echogenicity-in-children-with-appendicitis
#20
Hila Tal, Daniel Ben-Mordechay, Aviva Ben-Shlush, Lisa Raviv-Zilka, Michalle Soudack
OBJECTIVES: Ultrasound (US) is an important modality for the detection of acute appendicitis in children but has limited sensitivity and specificity. Therefore, additional US findings may contribute to the diagnosis. In our experience, children with acute appendicitis often have increased renal cortical echogenicity on US imaging. The purpose of this study was to examine the association of increased renal cortical echogenicity with appendicitis. METHODS: This study included 240 consecutive pediatric patients with no renal or liver disease who underwent US examinations for suspected appendicitis between February 2014 and January 2016...
November 21, 2017: Journal of Ultrasound in Medicine: Official Journal of the American Institute of Ultrasound in Medicine
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