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https://www.readbyqxmd.com/read/28334429/liver-parenchyma-transection-first-approach-in-hemihepatectomy-with-en-bloc-caudate-lobectomy-for-hilar-cholangiocarcinoma-a-safe-technique-to-secure-favorable-surgical-outcomes
#1
Yasunari Kawabata, Hikota Hayashi, Seiji Yano, Yoshitsugu Tajima
BACKGROUND: Although hemihepatectomy with total caudate lobectomy (hemiHx-tc) is essential for the surgical treatment of hilar cholangiocarcinoma, the advantage of an anterior approach for hemiHx-tc has not been fully discussed technically; the significance of an anterior approach without liver mobilization for preventing infectious complications also remains unknown. METHODS: The liver parenchyma transection-first approach (Hp-first) technique is an early transection of the hepatic parenchyma without mobilization of the liver that utilizes a modified liver-hanging maneuver to avoid damaging the future remnant liver...
March 23, 2017: Journal of Surgical Oncology
https://www.readbyqxmd.com/read/28331851/predicting-factors-for-allogeneic-blood-transfusion-and-excessive-postoperative-blood-loss-after-single-low-dosage-intra-articular-tranexamic-acid-application-in-total-knee-replacement
#2
Paphon Sa-Ngasoongsong, Siwadol Wongsak, Noratep Kulachote, Pongsthorn Chanplakorn, Patarawan Woratanarat, Viroj Kawinwonggowit
Background. Recently, intra-articular tranexamic acid (IA-TXA) application has become a popular method for perioperative blood loss (PBL) reduction in total knee replacement (TKR). Nevertheless, through our knowledge, no previous studies had shown the correlation perioperative factors and the risk of excessive PBL or need of blood transfusion (BT) after IA-TXA. Materials and Methods. A retrospective study was conducted in patients underwent 299 primary TKRs, using IA-TXA, during 2-year period (2013-2014). Patient's characteristic and perioperative data were reviewed and collected...
2017: BioMed Research International
https://www.readbyqxmd.com/read/28331607/-simplified-international-recommendations-for-the-implementation-of-patient-blood-management-sir4pbm
#3
Patrick Meybohm, Bernd Froessler, Lawrence T Goodnough, Andrew A Klein, Manuel Muñoz, Michael F Murphy, Toby Richards, Aryeh Shander, Donat R Spahn, Kai Zacharowski
BACKGROUND: More than 30% of the world's population are anemic with serious medical and economic consequences. Red blood cell transfusion is the mainstay to correct anemia, but it is also one of the top five overused procedures and carries its own risk and cost burden. Patient blood management (PBM) is a patient-centered and multidisciplinary approach to manage anemia, minimize iatrogenic blood loss, and harness tolerance to anemia in an effort to improve patient outcome. Despite resolution 63...
2017: Perioperative Medicine
https://www.readbyqxmd.com/read/28330800/tourniquet-and-closed-suction-drains-in-total-knee-arthroplasty-no-beneficial-effects-on-bleeding-management-and-knee-function-at-a-higher-cost
#4
David Yin, JoséeDelisle, AndreeaBanica, Andrea Senay, Pierre Ranger, G Yves Laflamme, Jiang Jun, Julio Fernandes
BACKGROUND: Blood loss is a major concern in total knee arthroplasty (TKA) along with postoperative knee function. The present study explores the impact of tourniquet (T) and closed-suction drains (D) on these parameters in TKA. MATERIALS AND METHODS: A prospective study was conducted on 111 patients admitted for TKA. Subjects were divided into three groups: 36 in group T+D+, 42 in T-D+ and 33 in T-D- (where T+: prolonged tourniquet use, T-: cementation-only tourniquet, D+: closed-suction drain use, and D-: no drain)...
March 19, 2017: Orthopaedics & Traumatology, Surgery & Research: OTSR
https://www.readbyqxmd.com/read/28328863/surgical-outcomes-of-laparoscopic-versus-open-liver-resection-for-hepatocellular-carcinoma-for-various-resection-extent
#5
Junhua Chen, Hongyu Li, Fei Liu, Bo Li, Yonggang Wei
Although the number of laparoscopic liver resections (LRRs) has increased, studies of surgical outcomes in comparison with the conventional open approach are limited. The purpose of this study was to analyze the surgical outcomes (safety and efficacy) of LLR versus open liver resection (OLR) for hepatocellular carcinoma (HCC).We collected data on all patients who received liver resection for HCC between April 2015 and September 2016 in our institution, and retrospectively investigated the demographic and perioperative data, and also surgical outcomes...
March 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28328851/survival-outcomes-of-hepatocellular-carcinoma-resection-with-postoperative-complications-a-propensity-score-matched-analysis
#6
Kenneth S H Chok, Millies M Y Chan, Wing Chiu Dai, Albert C Y Chan, Tan To Cheung, Tiffany C L Wong, Wong Hoi She, Chung Mau Lo
Curative resection remains the only hope of cure for hepatocellular carcinoma (HCC), but postoperative complications can have a significant impact on long-term survival. However, only scarce data on such impact can be found in the literature.This retrospective study reviewed the prospectively collected data of patients who underwent primary liver resection for HCC at our hospital during the period from December 1989 to December 2014. Patients with and without postoperative complications were compared. A 1:1 propensity score matching was adopted by matching age, comorbidity, Model of End-stage Liver Disease score, tumor stage, and extent of resection...
March 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28328243/factors-associated-with-bleeding-and-thrombosis-in-children-receiving-extracorporeal-membrane-oxygenation-ecmo
#7
Heidi J Dalton, Ron Reeder, Pamela Garcia-Filion, Richard Holubkov, Robert A Berg, Athena Zuppa, Frank W Moler, Thomas Shanley, Murray M Pollack, Christopher Newth, John Berger, David Wessel, Joseph Carcillo, Michael Bell, Sabrina Heidemann, Kathleen L Meert, Richard Harrison, Allan Doctor, Robert F Tamburro, J Michael Dean, Tammara Jenkins, Carol Nicholson
RATIONALE: Extracorporeal membrane oxygenation (ECMO) is employed for respiratory and cardiac failure in children but is complicated by bleeding and thrombosis. OBJECTIVES: (1) Measure the incidence of bleeding (blood loss requiring transfusion or intracranial hemorrhage) and thrombosis during ECMO support; (2) identify factors associated with these complications; and (3) determine the impact of these complications on patient outcome. METHODS: Prospective, observational cohort study in pediatric, cardiac, and neonatal intensive care units in eight hospitals from December 2012 to September 2014...
March 22, 2017: American Journal of Respiratory and Critical Care Medicine
https://www.readbyqxmd.com/read/28327167/optimal-release-timing-of-temporary-drain-clamping-after-total-knee-arthroplasty
#8
Yoon Sang Jeon, Jun Sung Park, Myung Ku Kim
BACKGROUND: Bleeding control is critical after total knee arthroplasty (TKA). The purpose of this study was to evaluate the optimal time to release the clamped drain after TKA. METHODS: We performed unilateral TKA in 120 patients using three methods of drainage. Group A (N = 40) had a 3-hour clamp applied, and group B (N = 40) had a 4-hour clamp applied. Group C (N = 40) underwent conventional negative drainage. We evaluated the drainage volume, as well as the hemodynamic markers, transfusion volume, visual analog scale (VAS) scores, and range of motion (ROM)...
March 21, 2017: Journal of Orthopaedic Surgery and Research
https://www.readbyqxmd.com/read/28324671/dose-de-escalation-of-intrapleural-tissue-plasminogen-activator-therapy-for-pleural-infection-the-adapt-project
#9
Natalia Popowicz, Oliver Bintcliffe, Duneesha De Fonseka, Kevin G Blyth, Nicola A Smith, Francesco Piccolo, Geoffrey Martin, Donny Wong, Anthony Edey, Nick Maskell, Y C Gary Lee
RATIONALE: Intrapleural therapy with a combination of tissue plasminogen activator (tPA) 10mg and deoxyribonuclease (DNase) 5mg administered twice daily has been shown in randomized and open-label studies to enable adequate drainage of over 90% of infected pleural effusions without surgery. Potential bleeding risks associated with intrapleural tPA and the drug costs remain important concerns. The ongoing ADAPT (Alteplase Dose Assessment for Pleural infection Therapy) project aims to investigate the efficacy and safety of dose de-escalation for intrapleural tPA...
March 21, 2017: Annals of the American Thoracic Society
https://www.readbyqxmd.com/read/28323241/the-safety-efficacy-and-cost-effectiveness-of-intraoperative-cell-salvage-in-metastatic-spine-tumour-surgery
#10
Mahmoud Elmalky, Naveed Yasin, Ricardo Rodrigues-Pinto, John Stephenson, Craig Carroll, Glyn Smurthwaite, Rajat Verma, Saeed Mohammad, Irfan Siddique
BACKGROUND CONTEXT: Metastatic spine tumour surgery (MSTS) is associated with substantial blood loss therefore leading to high morbidity and mortality. While intraoperative cell salvage with leucocyte depletion filter (IOCS-LDF) has been studied as an effective mean of reducing blood loss in other surgical settings, including the spine, no study has yet analysed the efficacy of re-infusion of salvaged blood in reducing the need for allogenic blood transfusion in patients who have had surgery for MSTS...
March 17, 2017: Spine Journal: Official Journal of the North American Spine Society
https://www.readbyqxmd.com/read/28321971/risk-factors-for-perioperative-mortality-and-transfusion-in-sacrococcygeal-teratoma-resections
#11
Rebecca S Isserman, Olivia Nelson, Kha M Tran, Lingyu Cai, Marcia Polansky, Julia M Rosenbloom, Theodora K Goebel, Elaina E Lin
BACKGROUND: Sacrococcygeal teratomas are a common congenital tumor. Surgical resection can occur in utero, in the neonatal period, or in the postneonatal period. AIMS: We describe patient and tumor factors associated with mortality and transfusion in this population. METHODS: We did a retrospective chart review of patients who underwent sacrococcygeal teratoma resection between January 1998 and March 2016. Demographic data, transfusion data, and tumor characteristics were collected...
March 21, 2017: Paediatric Anaesthesia
https://www.readbyqxmd.com/read/28319822/comparison-of-intravenous-versus-topical-tranexamic-acid-in-primary-total-hip-and-knee-arthroplasty-an-updated-meta-analysis
#12
REVIEW
Jinwei Xie, Qinsheng Hu, Qiang Huang, Jun Ma, Yiting Lei, Fuxing Pei
BACKGROUND: The appropriate route for administering tranexamic acid in primary total hip (THA) and knee arthroplasty (TKA) remains controversial. The purpose of this meta-analysis was to compare the efficacy and safety of topical or intravenous tranexamic acid. METHODS: PubMed, EMBASE, and the Cochrane Library databases were systematically searched for randomized controlled trials (RCTs) comparing topical and intravenous tranexamic acid following primary THA or TKA...
March 10, 2017: Thrombosis Research
https://www.readbyqxmd.com/read/28315968/the-efficacy-of-bipolar-sealer-on-blood-loss-in-spine-surgery-a-meta-analysis
#13
REVIEW
Tao Lan, Shi-Yu Hu, Xin-Jian Yang, Yang Chen, Yi-Yan Qiu, Wei-Zhuang Guo, Jian-Ze Lin, Kai Ren
OBJECTIVE: The purpose of this meta-analysis of randomized controlled trials (RCTs) and non-RCTs was to gather data to evaluate the efficacy and safety of bipolar sealer versus standard electrocautery in the management of spinal disease. METHODS: The electronic databases including Embase, PubMed and Cochrane library were searched to identify relevant studies published from the time of the establishment of these databases up to January 2017. The primary outcomes were total blood loss, requirement of transfusion (rate and amount), and operation time...
March 18, 2017: European Spine Journal
https://www.readbyqxmd.com/read/28314307/post-hepatectomy-refractory-ascites-in-cirrhotic-patients-with-hepatocellular-carcinoma-risk-factor-analysis-to-overcome-this-problematic-complication
#14
Shinji Itoh, Hideaki Uchiyama, Yasuharu Ikeda, Kazutoyo Morita, Noboru Harada, Keishi Sugimachi, Hirofumi Kawanaka, Daisuke Korenaga, Tomoharu Yoshizumi, Kenji Takenaka, Yoshihiko Maehara
BACKGROUND: Refractory ascites is a serious post-hepatectomy complication in cirrhotic patients with hepatocellular carcinoma (HCC). In order to avoid this complication, surgeons should preserve as much liver parenchyma as possible in performing hepatectomy in such patients. However, we still occasionally encounter refractory ascites even after limited or small hepatectomy. The aim of this study was to identify risk factors for post-hepatectomy refractory ascites in cirrhotic patients, focusing on limited or small hepatectomy...
March 2017: Anticancer Research
https://www.readbyqxmd.com/read/28304318/placenta-accreta-elective-versus-emergent-delivery-as-a-major-predictor-of-blood-loss
#15
M A Seoud, R Nasr, G A Berjawi, G S Zaatari, Talal M Seoud, Afifa S Shatila, Fadi G Mirza
OBJECTIVE: To compare blood loss and the use for blood transfusion between elective (planned) and emergent cesarean hysterectomy performed for placenta accreta by a single, multidisciplinary team and to present the team's pre-operative evaluation and the surgical technique. STUDY DESIGN: Prospective cohort study at a single tertiary care center. Maternal and neonatal outcomes were compared between elective and emergent delivery of pregnancies complicated by placenta accreta...
March 16, 2017: Journal of Neonatal-perinatal Medicine
https://www.readbyqxmd.com/read/28304254/clinical-trypanosoma-cruzi-disease-after-cardiac-transplantation-in-a-cynomolgus-macaque-macaca-fascicularis
#16
Elana R Rybak, Steve Shipley, Ivan Tatarov, Tianshu Zhang, Wenji Sun, Gheorghe Braileanu, Lars Burdorf, Evelyn Sievert, Agnes M Azimzadeh, Louis J DeTolla, Richard N Pierson Iii
A cynomolgus macaque received a heterotopic cardiac allograft as part of a transplant study, with monoclonal antibodies targeted to specific immune costimulation molecules (CD154, CD28) but no traditional immunosuppressive therapy after surgery. Clinical anemia was detected on postoperative day (POD) 35 and had worsened (Hgb, 2.3 g/dL; Hct = 7.3%) by POD 47, despite type-matched whole-blood transfusions. After a total of 4 blood transfusions, hematologic parameters were improved (Hgb, 5.9 g/dL; Hct, 18.7%)...
December 1, 2016: Comparative Medicine
https://www.readbyqxmd.com/read/28304214/retroperitoneal-laparoscopic-partial-nephrectomy-for-tumors-larger-than-7%C3%A2-cm-in-renal-cell-carcinoma-initial-experience-of-single-institution
#17
Erlin Song, Xin Ma, Ruihua An, Peng Zhang, Xu Zhang, Baojun Wang, Taoping Shi, Shengkun Sun
BACKGROUND: To report our initial experience dealing with retroperitoneal laparoscopic partial nephrectomy (LPN) for tumors larger than 7 cm in renal cell carcinoma (RCC). MATERIALS AND METHODS: A total of 15 patients with malignant tumors larger than 7 cm underwent retroperitoneal LPN at our institution. Patient baseline demographics, perioperative outcomes, pathological characteristics, and estimated glomerular filtration rate (eGFR) were analyzed retrospectively in our collected database...
March 17, 2017: Journal of Laparoendoscopic & Advanced Surgical Techniques. Part A
https://www.readbyqxmd.com/read/28300465/laparoscopic-radical-hysterectomy-in-early-stage-cervical-cancer-a-systematic-review-and-meta-analysis
#18
Yue Zhao, Bo Hang, Guang-Wu Xiong, Xiao-Wei Zhang
PURPOSE: To investigate the value of laparoscopic radical hysterectomy (LRH) in the treatment of early stage cervical cancer by comparing intraoperative and postoperative outcomes with abdominal radical hysterectomy (ARH). MATERIALS AND METHODS: We searched the Medline, Web of Knowledge, Cochrane Library, and Chinese National Knowledge Infrastructure, through February 2, 2016 with keywords of "laparoscopic OR laparoscopy" AND "radical hysterectomy OR early cervical cancer OR stage IB, stage IB1, stage IB2, stage IIA, stage IIA1, stage IIA2, stage IIA cervical cancer" to identify all relevant studies that compared LRH with ARH in treating early cervical cancer...
March 16, 2017: Journal of Laparoendoscopic & Advanced Surgical Techniques. Part A
https://www.readbyqxmd.com/read/28298641/risk-factors-of-postoperative-pancreatic-fistula-in-patients-after-distal-pancreatectomy-a-systematic-review-and-meta-analysis
#19
Yun-Peng Peng, Xiao-Le Zhu, Ling-Di Yin, Yi Zhu, Ji-Shu Wei, Jun-Li Wu, Yi Miao
Postoperative pancreatic fistula (POPF) is a common complication following distal pancreatectomy (DP). However, the risk factors of this complication in patients after DP still remain controversial. The aim of our study is to estimate the association between potential risk factors and POPF. Relevant articles published up to June 21, 2016 were identified via PubMed, EMBASE, Web of Science, and The Cochrane Library. Studies that examined the risk factors of POPF following DP were enrolled. 20 articles (2070 patients) were finally included in this study...
March 15, 2017: Scientific Reports
https://www.readbyqxmd.com/read/28297730/point-of-care-coagulation-monitoring-in-trauma-patients
#20
Philipp Stein, Alexander Kaserer, Gabriela H Spahn, Donat R Spahn
Trauma remains one of the major causes of death and disability all over the world. Uncontrolled blood loss and trauma-induced coagulopathy represent preventable causes of trauma-related morbidity and mortality. Treatment may consist of allogeneic blood product transfusion at a fixed ratio or in an individualized goal-directed way based on point-of-care (POC) and routine laboratory measurements. Viscoelastic POC measurement of the developing clot in whole blood and POC platelet function testing allow rapid and tailored coagulation and transfusion treatment based on goal-directed, factor concentrate-based algorithms...
March 15, 2017: Seminars in Thrombosis and Hemostasis
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