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https://www.readbyqxmd.com/read/29160639/predictors-of-mortality-in-neonates-with-giant-omphaloceles
#1
Amulya K Saxena, Maja Raicevic
INTRODUCTION: This analysis was performed a review of giant-omphaloceles to determine the predictors of mortality. EVIDENCE ACQUISITION: Pubmed® and KoBson databases were searched for terms "giant" "omphalocele" and "mortality". Primary end points included mortality correlation with gestational age (GA), birth weight (BW), eviscerated organs, associated anomalies and management. To calculate mean and median values IBM SPSS version 23.0 was used. EVIDENCE SYNTHESIS: After de-duplication and review search revealed 42 articles of which 23 met our inclusion criteria with 396 giant-omphaloceles for this analysis...
November 21, 2017: Minerva Pediatrica
https://www.readbyqxmd.com/read/29159603/prophylactic-intraperitoneal-onlay-mesh-reinforcement-reduces-the-risk-of-incisional-hernia-two-year-results-of-a-randomized-clinical-trial
#2
Philippe Brosi, Philippe M Glauser, Benjamin Speich, Samuel A Käser, Christoph A Maurer
BACKGROUND: Incisional hernias still are a major concern after laparotomy and are causing substantial morbidity. This study examines the feasibility, safety and incisional hernia rate of the use of a prophylactic intraperitoneal onlay mesh stripe (IPOM) to prevent incisional hernia following midline laparotomy. METHODS: This prospective, randomized controlled trial randomly allocated patients undergoing median laparotomy either to mass closure of the abdominal wall with a PDS-loop running suture reinforced by an intraperitoneal composite mesh stripe (Group A) or to the same procedure without the additional mesh stripe (Group B)...
November 20, 2017: World Journal of Surgery
https://www.readbyqxmd.com/read/29157889/the-effect-of-damage-control-laparotomy-on-major-abdominal-complications-a-matched-analysis
#3
Mitchell J George, Sasha D Adams, Michelle K McNutt, Joseph D Love, Rondel Albarado, Laura J Moore, Charles E Wade, Bryan A Cotton, John B Holcomb, John A Harvin
INTRODUCTION: Damage control laparotomy (DCL) for trauma is thought to be associated with increased abdominal complications. The purpose of this study is to determine the effect of DCL on abdominal complications by comparing two groups of trauma patients: DCL patients who were prospectively adjudicated to potentially being closed at the primary laparotomy (potential DEF or pDEF) and those who underwent definitive laparotomy (DEF). METHODS: The pDEF group was matched to DEF patients according to mechanism of injury, abdominal injury severity, operating room transfusions, and performance of a colon resection...
November 11, 2017: American Journal of Surgery
https://www.readbyqxmd.com/read/29155940/stented-balloon-fenestration-before-entry-repair-using-the-frozen-elephant-trunk-technique-for-chronic-aortic-dissection
#4
Naomichi Uchida, Yoshitaka Yamane, Tomokuni Furukawa
Endovascular fenestration on the abdominal aorta is effective for preventing visceral malperfusion in aortic dissection. We report a case of stented balloon fenestration before residual entry repair using the frozen elephant trunk technique for chronic aneurysmal dissection after ascending aortic replacement for DeBakey I aortic dissection. We recognized poor communication between the true lumen and false lumen in the abdominal aorta, and visceral perfusion depended almost entirely on the proximal large entry...
October 9, 2017: Interactive Cardiovascular and Thoracic Surgery
https://www.readbyqxmd.com/read/29154517/a-proposal-for-a-tailored-approach-to-diverting-ostomy-for-colorectal-anastomosis
#5
Lisa Manzenreiter, Georg Spaun, Michael Weitzendorfer, Rosalia Luketina, Stavros A Antoniou, Helwig Wundsam, Oliver O Koch, Klaus Emmanuel
BACKGROUND: The use of a protective stoma represents an important issue in colorectal surgery. Although evidence suggests that loop ileostomy may be superior, the optimal method for temporary decompression of colorectal anastomosis still remains controversial. Aim of this study was to make an evidence-based proposal for a tailored approach to the use of diverting colostomy or ileostomy. METHODS: A retrospective analysis of all patients subjected to creation and closure of a diverting loop colostomy or loop ileostomy between May 2007 and November 2014 in our institution was performed...
November 20, 2017: Minerva Chirurgica
https://www.readbyqxmd.com/read/29151703/3d-printed-fistula-stent-designed-for-management-of-enterocutaneous-fistula-an-advanced-strategy
#6
Jin-Jian Huang, Jian-An Ren, Ge-Fei Wang, Zong-An Li, Xiu-Wen Wu, Hua-Jian Ren, Song Liu
Enterocutaneous fistulas (ECFs) are great challenges during the open abdomen. The loss of digestive juice, water-electrolyte imbalance and malnutrition are intractable issues during management of ECF. Techniques such as "fistula patch" and vacuum-assisted closure therapy have been applied to prevent contamination of open abdominal wounds by intestinal fistula drainage. However, failures are encountered due to high-output fistula and anatomical complexity. Here, we report 3D-printed patient-personalized fistula stent for ECF treatment based on 3D reconstruction of the fistula image...
November 7, 2017: World Journal of Gastroenterology: WJG
https://www.readbyqxmd.com/read/29150964/de-novo-donor-specific-hla-antibodies-after-combined-intestinal-and-vascularised-composite-allotransplantation
#7
Annemarie Weissenbacher, Georgios Vrakas, Mian Chen, Srikanth Reddy, Philip Allan, Henk Giele, Martin Cnm Barnardo, Anil Vaidya, Peter J Friend, Susan V Fuggle
Combining vascularised composite allotransplantation (VCA) with intestinal transplantation to achieve primary abdominal closure has become a feasible procedure. Besides facilitating closure, the abdominal wall can be used to monitor intestinal rejection. As the inclusion of a VCA raises the possibility of an enhanced alloimmune response, we investigated the incidence and clinical effect of de novo donor specific HLA antibodies (dnDSA) in a cohort of patients receiving an intestinal transplant with or without a VCA...
November 18, 2017: Transplant International: Official Journal of the European Society for Organ Transplantation
https://www.readbyqxmd.com/read/29150929/biomechanical-properties-of-feline-ventral-abdominal-wall-and-celiotomy-closure-techniques
#8
Fernando S Reina Rodriguez, Conor T Buckley, Joshua Milgram, Barbara M Kirby
OBJECTIVE: To compare biomechanical properties and mechanism of failure of 3 regions of ventral abdominal wall in cats by using 2 suture materials, 2 suture bite-to-stitch intervals (SBSI), and full-thickness versus fascia-only closure. STUDY DESIGN: Randomized, cadaveric, ex vivo mechanical testing. SAMPLE POPULATION: 16 adult cat cadavers, 3 samples per cat. METHODS: Three regions of ventral abdominal wall were mechanically tested (N = 48 samples)...
November 18, 2017: Veterinary Surgery: VS
https://www.readbyqxmd.com/read/29147897/vacuum-assisted-wound-closure-with-mesh-mediated-fascial-traction-achieves-better-outcomes-than-vacuum-assisted-wound-closure-alone-a-comparative-study
#9
Giuseppe Salamone, Leo Licari, Giovanni Guercio, Albert Comelli, Mirko Mangiapane, Nicolò Falco, Roberta Tutino, Noemi Bagarella, Sofia Campanella, Calogero Porrello, Roberto Gullo, Gianfranco Cocorullo, Gaspare Gulotta
BACKGROUND: Open abdomen (OA) permits the application of damage control surgery principles when abdominal trauma, sepsis, severe acute peritonitis and abdominal compartmental syndrome (ACS) occur. METHODS: Non-traumatic patients treated with OA between January 2010 and December 2015 were identified in a prospective database, and the data collected were retrospectively reviewed. Patients' records were collected from charts and the surgical and intensive care unit (ICU) registries...
November 16, 2017: World Journal of Surgery
https://www.readbyqxmd.com/read/29140948/hypertonic-saline-resuscitation-following-emergent-laparotomy-and-temporary-abdominal-closure
#10
Tyler J Loftus, Philip A Efron, Trina M Bala, Martin D Rosenthal, Chasen A Croft, R Stephen Smith, Frederick A Moore, Alicia M Mohr, Scott C Brakenridge
BACKGROUND: Our objective was to establish the safety of 3% hypertonic saline (HTS) resuscitation for trauma and acute care surgery patients undergoing emergent laparotomy and temporary abdominal closure (TAC) with the hypothesis that HTS administration would be associated with hyperosmolar hypercholoremic acidosis, lower resuscitation volumes, and higher fascial closure rates, without adversely affecting renal function. METHODS: We performed a retrospective cohort analysis of 189 trauma and acute care surgery patients who underwent emergent laparotomy and TAC, comparing patients with normal baseline renal function who received 3% HTS at 30 mL/h (n=36) to patients with standard resuscitation (n=153) by baseline characteristics, resuscitation parameters, and outcomes including primary fascial closure and KDIGO stages of acute kidney injury...
November 14, 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/29140545/neobladder-vaginal-fistula-the-university-of-southern-california-experience
#11
Shilo Rosenberg, Gus Miranda, David A Ginsberg
AIMS: The use of orthotropic neobladder (ONB) construction in women has increased in popularity. With increasing numbers so have complications distinct to this procedure. Neobladder vaginal fistula (NVF) is a rare but challenging complication. We present our experience correcting this problem. METHODS: An IRB approved database of female patients with an ONB was retrospectively reviewed. Patients with a history of NVF were identified and charts reviewed. Our standard technique of radical cystectomy and orthotopic diversion in female patients includes interposition of omentum between the neobladder and anterior vaginal wall and sacrocolpopexy...
November 15, 2017: Neurourology and Urodynamics
https://www.readbyqxmd.com/read/29134308/appendicitis-rural-patient-status-is-associated-with-increased-duration-of-prehospital-symptoms-and-worse-outcomes-in-high-and-low-middle-income-countries
#12
Matthew C Hernandez, Eric Finnesgaard, Johnathon M Aho, Victor Y Kong, John L Bruce, Stephanie F Polites, Grant L Laing, Damian L Clarke, Martin D Zielinski
INTRODUCTION: Appendicitis is a significant economic and healthcare burden in low-, middle-, and high-income countries. We aimed to determine whether urban and rural patient status would affect outcomes in appendicitis in a combined population regardless of country of economic status. We hypothesize that patients from rural areas and both high- and low-middle-income countries would have disproportionate outcomes and duration of symptoms compared to their urban counterparts. METHODS: Adults (≥18 years) with appendicitis during 2010-2016 in South Africa and USA were reviewed using multi-institutional data...
November 13, 2017: World Journal of Surgery
https://www.readbyqxmd.com/read/29118559/long-term-efficacy-of-vacuum-assisted-therapy-endo-sponge-%C3%A2-in-large-anastomotic-leakages-following-anterior-rectal-resection
#13
Alessandro Mussetto, Rosario Arena, Andrea Buzzi, Lorenzo Fuccio, Silvia Dari, Mario Luciano Brancaccio, Omero Triossi
Background: The aim of our study was to test the long-term efficacy of Endo-SPONGE(®) therapy in a group of patients treated in our center with vacuum-assisted therapy because of anastomotic leakages after colorectal surgery. Methods: Eleven patients [male: 6; mean age: 71 (range: 44-82) years] who had anastomotic leakage treated with Endo-SPONGE(®) placement were included in the study. Patient records were examined retrospectively. All patients with documented anastomotic leakage on abdominal computed tomography following an anterior resection of the rectum for rectal cancer underwent sigmoidoscopy to determine the extent of the anastomotic defect and the size of the presacral abscess...
2017: Annals of Gastroenterology: Quarterly Publication of the Hellenic Society of Gastroenterology
https://www.readbyqxmd.com/read/29117026/the-american-association-for-the-surgery-of-trauma-severity-grade-is-valid-and-generalizable-in-adhesive-small-bowel-obstruction
#14
Martin D Zielinski, Nadeem N Haddad, Asad Choudhry, Matthew C Hernandez, Daniel C Cullinane, David Turay, Ji-Ming Yune, Salina Wydo, Kenji Inaba, D Dante Yeh, Therese M Duane, Andrea Pakula, Ruby Skinner, Jill Watras, Carlos J Rodriguez, Kenneth A Widom, John Cull, Julie Dunn, Eric A Toschlog, Valerie G Sams, John C Graybill
INTRODUCTION: The American Association for the Surgery of Trauma (AAST) anatomic severity grading system for adhesive small bowel obstruction (ASBO) was validated at a single institution. We aimed to externally validate the AAST ASBO grading system using the Eastern Association for the Surgery of Trauma (EAST) multi-institutional SBO prospective observational study. METHODS: Adults (age≥18) with (ASBO) were included. Baseline demographics, physiologic parameters (heart rate, blood pressure, respiratory rate), labs (lactate, hemoglobin, creatinine, leukocytosis), imaging findings, operative details, length of stay, and Clavien-Dindo complications were collected...
November 7, 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/29103209/internal-hernia-after-proximal-gastrectomy-with-jejunal-interposition
#15
Yuichi Takayama, Yuji Kaneoka, Atsuyuki Maeda, Yasuyuki Fukami, Takamasa Takahashi, Shunsuke Onoe, Masahito Uji
Although internal hernia (IH) has been reported after laparoscopic distal or total gastrectomy with Roux-en-Y reconstruction, there are few reports of IH after proximal gastrectomy with jejunal interposition (PG-JI). The aim of this study was to analyze the incidence and clinical features of IH after PG-JI. This study retrospectively reviewed 71 patients who underwent PG-JI for gastric cancer at a single institution between July 2007 and December 2016. The median follow-up period after PG-JI was 50 months...
November 4, 2017: Updates in Surgery
https://www.readbyqxmd.com/read/29103165/the-urethral-closure-mechanism-is-deteriorated-after-anterior-colporrhaphy
#16
Yasmine Khayyami, Gunnar Lose, Niels Klarskov
INTRODUCTION AND HYPOTHESIS: Urethral pressure reflectometry (UPR) has proven highly reproducible in women with pelvic organ prolapse. We hypothesized that urethral parameters would decrease after anterior colporrhaphy. METHODS: A prospective, observational study where women with anterior vaginal wall prolapse ≥stage II were assessed before and after anterior colporrhaphy. Assessments consisted of prolapse staging according to the Pelvic Organ Prolapse Quantification system, UPR measurements at rest, during squeezing and straining (at a standardized abdominal pressure of 50 cmH2O, PO-Abd 50), standardized stress tests with 300 ml saline, and answering the International Consultation on Incontinence - Urinary incontinence short form...
November 4, 2017: International Urogynecology Journal
https://www.readbyqxmd.com/read/29099149/closure-methods-for-laparotomy-incisions-for-preventing-incisional-hernias-and-other-wound-complications
#17
REVIEW
Sunil V Patel, David D Paskar, Richard L Nelson, Satyanarayana S Vedula, Scott R Steele
BACKGROUND: Surgeons who perform laparotomy have a number of decisions to make regarding abdominal closure. Material and size of potential suture types varies widely. In addition, surgeons can choose to close the incision in anatomic layers or mass ('en masse'), as well as using either a continuous or interrupted suturing technique, of which there are different styles of each. There is ongoing debate as to which suturing techniques and suture materials are best for achieving definitive wound closure while minimising the risk of short- and long-term complications...
November 3, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/29094323/enormous-postoperative-perforation-after-endoscopic-submucosal-dissection-for-duodenal-cancer-successfully-treated-with-filling-and-shielding-by-polyglycolic-acid-sheets-with-fibrin-glue-and-computed-tomography-guided-abscess-puncture
#18
Yoshiko Ohara, Kengo Takimoto, Takashi Toyonaga, Tomohiro Yamaguchi, Hiroya Sakaguchi, Fumiaki Kawara, Shinwa Tanaka, Tsukasa Ishida, Yoshinori Morita, Eiji Umegaki
A female in her 70s underwent esophagogastroduodenoscopy (EGD) for screening, and a 0-IIa lesion measuring approximately 15 mm was detected in the descending portion of the duodenum. Due to the malignant potency of the lesion, endoscopic submucosal dissection (ESD) was performed. Microperforation occurred during ESD. The lesion was removed en bloc and the post-ESD ulcer bed was closed with clips. The next day, the patient had abdominal pain and computed tomography (CT) revealed a small amount of free air in the retroperitoneal space...
November 1, 2017: Clinical Journal of Gastroenterology
https://www.readbyqxmd.com/read/29089695/intra-abdominal-pressure-monitoring-in-open-abdomen-management-with-dynamic-abdominal-closure
#19
A Ebru Sarer, Fahri Yetisir, Muhittin Aygar, Hasan Zafer Acar, Yılmaz Polat, Gokhan Osmanoglu
The importance of elevated intra-abdominal pressure (IAP) and abdominal compartment syndrome (ACS) have been recognized in critical care for its potential damaging effects. But, quantification of IAP values may be useful as a clinical tool for determining efficacy of coughing and straining for functional recovery of OA patients. We would like to evaluate IAP generated in an OA patient and the effect of negative pressure therapy (NPT) and dynamic abdominal closure systems (ABRA) on the IAP values at rest and during coughing and straining and compare those with IAP measurements of closed abdomen after standard open elective colorectal surgery (non-OA)...
October 2017: Indian Journal of Surgery
https://www.readbyqxmd.com/read/29083473/intracavity-lavage-and-wound-irrigation-for-prevention-of-surgical-site-infection
#20
REVIEW
Gill Norman, Ross A Atkinson, Tanya A Smith, Ceri Rowlands, Amber D Rithalia, Emma J Crosbie, Jo C Dumville
BACKGROUND: Surgical site infections (SSIs) are wound infections that occur after an operative procedure. A preventable complication, they are costly and associated with poorer patient outcomes, increased mortality, morbidity and reoperation rates. Surgical wound irrigation is an intraoperative technique, which may reduce the rate of SSIs through removal of dead or damaged tissue, metabolic waste, and wound exudate. Irrigation can be undertaken prior to wound closure or postoperatively...
October 30, 2017: Cochrane Database of Systematic Reviews
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