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https://www.readbyqxmd.com/read/28645644/-antiplatelet-agents-and-transfusion
#1
P Gaussem, A-C Martin, T Belleville-Rolland, D Helley, C Bachelot-Loza, A Godier
Antiplatelet agents are at risk for bleeding complications, the management of which differs depending on the clinical situation and on the antiplatelet agent itself. Neutralization of antiplatelets is sometimes necessary, most often leading to platelet transfusion, although the benefit of this strategy is poorly documented. In addition, if platelet transfusion corrects the platelet inhibition induced by aspirin and probably by clopidogrel and prasugrel, it does not neutralize ticagrelor, as a consequence of its pharmacological properties...
June 20, 2017: Transfusion Clinique et Biologique: Journal de la Société Française de Transfusion Sanguine
https://www.readbyqxmd.com/read/28644187/perioperative-blood-management-in-pediatric-spine-surgery
#2
Matthew E Oetgen, Jody Litrenta
Blood management strategies are integral to successful outcomes in many types of orthopaedic surgery. These strategies minimize blood loss and transfusion requirements, ultimately decreasing complications, improving outcomes, and potentially eliminating risks associated with allogeneic transfusion. Practices to achieve these goals include preoperative evaluation and optimization of hemoglobin, the use of pharmacologic agents or anesthetic methods, intraoperative techniques to improve hemostasis and cell salvage, and the use of predonated autologous blood...
July 2017: Journal of the American Academy of Orthopaedic Surgeons
https://www.readbyqxmd.com/read/28641294/the-impact-of-gender-on-tumour-stage-in-in-house-complications-and-choice-of-urinary-diversion-results-of-the-austrian-cystectomy-registry
#3
Tanja Gschliesser, Klaus Eredics, Ingrid Berger, Michael Szelinger, Hans Christoph Klingler, Thomas Colombo, Anton Ponholzer, Eugen Plas, Karl Grubmüller, Michael Dunzinger, Klaus Jeschke, Erich Würnschimmel, Frens Steffen Krause, Sharokh Shariat, Karl Leeb, Alexandre Pelzer, Claus Riedl, Michael Rauchenwald, Wilhelm Hübner, Clemens Brössner, Stephan Madersbacher
INTRODUCTION AND OBJECTIVES: Bladder cancer is characterized by gender-dependent disparities. To further address this issue, we analysed a prospective, multicentre cystectomy registry. METHODS: An online database was developed that included patient demographics, intra/perioperative data, surgical data and in-house complications. RESULTS: Four hundred fifty-eight patients (112 [24.5%] women and 346 [75.5%] men) were analysed. Men and women were comparable regarding age (mean 68 years), body mass index (mean 26...
June 23, 2017: Urologia Internationalis
https://www.readbyqxmd.com/read/28637364/comparison-of-perioperative-outcomes-between-holmium-laser-enucleation-of-the-prostate-and-robotic-assisted-simple-prostatectomy
#4
Mimi Zhang, Marawan El Tayeb, Michael Borofsky, Casey Dauw, Kristofer R Wagner, Patrick S Lowry, Erin T BIrd, Tillman C Hudson, James E Lingeman
OBJECTIVES: To compare perioperative outcomes for patients undergoing holmium laser enucleation of the prostate (HoLEP) and robotic assisted simple prostatectomy (RSP) for benign prostatic hypertrophy (BPH). METHODS: Patient demographics and perioperative outcomes were compared between 600 patients undergoing HoLEP and 32 patients undergoing RSP at two separate academic institutions between 2008 and 2015. RESULTS: Patients undergoing HoLEP and RSP had comparable ages (71 vs...
June 22, 2017: Journal of Endourology
https://www.readbyqxmd.com/read/28633147/tranexamic-acid-safely-reduced-blood-loss-in-hemi-and-total-hip-arthroplasty-for-acute-femoral-neck-fracture-a-randomized-clinical-trial
#5
Chad D Watts, Matthew T Houdek, S Andrew Sems, William W Cross, Mark W Pagnano
OBJECTIVES: We aimed to determine whether (1) tranexamic acid (TXA) reduces the incidence of transfusion (2) TXA reduces the calculated blood loss, and (3) there are any observable differences in 30- and 90-day complications with TXA administration during arthroplasty for femoral neck fracture (FNF). DESIGN: Prospective, double-blinded, randomized controlled trial. SETTING: Level 1 Academic Trauma Center. PATIENTS/PARTICIPANTS: One hundred thirty-eight patients who presented with a low-energy, isolated, FNF (AO 31B) treated with either hemi- or total hip arthroplasty within 72 hours of injury were randomized to either the TXA group (69 patients) or placebo group (69 patients)...
July 2017: Journal of Orthopaedic Trauma
https://www.readbyqxmd.com/read/28629904/perioperative-morbidity-of-same-day-and-staged-bilateral-total-hip-arthroplasty
#6
Lazaros A Poultsides, Georgios K Triantafyllopoulos, Stavros G Memtsoudis, Huong T Do, Michael M Alexiades, Thomas P Sculco
BACKGROUND: Management strategies for bilateral hip degenerative disease include same-day or staged bilateral total hip arthroplasty (THA), but information on outcomes remains sparse. We sought to describe in-hospital complications and blood transfusion rates after same-day and staged bilateral THAs at different time intervals and to assess risk factors for these events. METHODS: We retrospectively reviewed administrative data for 3785 patients treated with same-day bilateral (n = 1946; group A) and staged bilateral THA within (1) 0-3 months apart (n = 328; group B); (2) 3-6 months apart (n = 703; group C); and (3) 6-12 months apart (n = 808; group D), between 1999 and 2014...
May 23, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28628713/robotic-versus-laparoscopic-distal-pancreatectomy-a-propensity-score-matched-study
#7
Rong Liu, Qu Liu, Zhi-Ming Zhao, Xiang-Long Tan, Yuan-Xing Gao, Guo-Dong Zhao
BACKGROUND: Robotic distal pancreatectomy (RDP) is considered a safe and feasible alternative to laparoscopic distal pancreatectomy (LDP). However, previous studies have some limitations including small sample size and selection bias. This study aimed to evaluate whether the robotic approach has advantages over laparoscopic surgery in distal pancreatectomy. METHODS: Demographics and perioperative outcomes among patients undergoing RDP (n = 102) and LDP (n = 102) between January 2011 and December 2015 were reviewed...
June 19, 2017: Journal of Surgical Oncology
https://www.readbyqxmd.com/read/28625825/red-blood-cell-transfusion-in-surgical-cancer-patients-targets-risks-mechanistic-understanding-and-further-therapeutic-opportunities
#8
REVIEW
Vassilis L Tzounakas, Jerard Seghatchian, Elissavet Grouzi, Styliani Kokoris, Marianna H Antonelou
Anemia is present in more than half of cancer patients and appears to be an independent prognostic factor of short- and long-term adverse outcomes. It increases in the advanced period of cancer and perioperatively, in patients with solid tumors who undergo surgery. As a result, allogeneic red blood cell (RBC) transfusion is an indispensable treatment in cancer. However, its safety remains controversial, based on several laboratory and clinical data reporting a linkage with increased risk for cancer recurrence, infection and cancer-related mortality...
May 26, 2017: Transfusion and Apheresis Science
https://www.readbyqxmd.com/read/28625450/vasoplegic-syndrome-an-update-on-perioperative-considerations
#9
REVIEW
Henry Liu, Ling Yu, Longqiu Yang, Michael S Green
Vasoplegic syndrome (VS) is increasingly recognized as an important clinical entity in perioperative medicine. VS is characterized by significant arterial hypotension, normal or high cardiac output, low systemic vascular resistance, and increased requirements for intravenous volume and vasopressors. Tremendous variations exist regarding incidence reported in the literature and management at different institutions; and the incidence of VS is likely significantly higher than many anesthesiologists believe. Thus the aims of this article are to review the pertinent aspects related to VS and alert clinical anesthesiologists to this under-recognized yet very challenging clinical condition...
August 2017: Journal of Clinical Anesthesia
https://www.readbyqxmd.com/read/28622333/acute-40-exchange-transfusion-with-hemoglobin-vesicles-in-a-mouse-pneumonectomy-model
#10
Mitsutomo Kohno, Tatsuhiko Ikeda, Ryo Hashimoto, Yotaro Izumi, Masazumi Watanabe, Hirohisa Horinouchi, Hiromi Sakai, Koichi Kobayashi, Masayuki Iwazaki
OBJECTIVES: Hemoglobin vesicles (HbVs) function as a red blood cell (RBC) substitute and are composed of purified hemoglobin encapsulated in a phospholipid bilayer membrane. The performance of HbVs as a substitute for RBC transfusions was examined in a mouse model of pneumonectomy following acute 40% exchange-transfusion with HbVs. METHODS: Before performing left pneumonectomies, 40% of the blood volume of mice was replaced with a) lactated Ringer's solution (control), b) 5% recombinant human serum albumin (rHSA), c) mouse RBCs shed in rHSA (mRBCs/rHSA), or d) HbV suspended in rHSA (HbV/rHSA)...
2017: PloS One
https://www.readbyqxmd.com/read/28614270/computer-tomography-urography-assisted-real-time-ultrasound-guided-percutaneous-nephrolithotomy-on-renal-calculus
#11
You-Qiang Fang, Jie-Ying Wu, Teng-Cheng Li, Hao-Feng Zheng, Guan-Can Liang, Yan-Xiong Chen, Xiao-Bin Hong, Wei-Zhong Cai, Zhi-Jun Zang, Jin-Ming Di
This study aimed to assess the role of pre-designed route on computer tomography urography (CTU) in the ultrasound-guided percutaneous nephrolithotomy (PCNL) for renal calculus.From August 2013 to May 2016, a total of 100 patients diagnosed with complex renal calculus in our hospital were randomly divided into CTU group and control group (without CTU assistance). CTU was used to design a rational route for puncturing in CTU group. Ultrasound was used in both groups to establish a working trace in the operation areas...
June 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28614262/minimally-invasive-mitral-valve-replacement-is-a-safe-and-effective-surgery-for-patients-with-rheumatic-valve-disease-a-retrospective-study
#12
Junyu Zhai, Lai Wei, Ben Huang, Chunsheng Wang, Hongqiang Zhang, Kanhua Yin
The aim of the study was to evaluate the treatment of minimally invasive mitral valve replacement (MIMVR) through a right minithoracotomy for patients with rheumatic mitral valve disease.From February 2009 to December 2016, 360 patients with rheumatic mitral valve disease underwent mitral valve replacement by the same surgeon. Among them, 150 patients accepted MIMVR through a right minithoracotomy, whereas the other 210 accepted a traditional median sternotomy. After matching by patients by age, sex, EuroSCORE, New York Heart Association (NYHA) classification, renal and liver function, and degree of mitral valve disease, we selected 224 patients for analysis in our retrospective study...
June 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28614226/tranexamic-acid-plus-diluted-epinephrine-versus-tranexamic-acid-alone-for-blood-loss-in-total-joint-arthroplasty-a-meta-analysis
#13
Zhanxia Yu, Lulan Yao, Qin Yang
BACKGROUND: We conducted the present meta-analysis to assess the efficacy and safety of tranexamic acid (TXA) plus diluted-epinephrine (DEP) for patients with total joint arthroplasty (TJA, including total knee arthroplasty (TKA) and total hip arthroplasty (THA)). METHODS: Electronic databases (PubMed, EMBASE, the Cochrane Central Register of Controlled Trials (CENTRAL), Chinese Wanfang databases, and Google databases) were systematically searched up to December 2016...
June 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28613206/-evolution-from-percutaneous-nephrolithotomy-to-mini-pcnl-in-supine-position-on-the-treatment-of-complex-renal-calculi-feasibility-study
#14
Fernando Ramón de Fata-Chillón, Helena Gimbernat-Díaz, Cristina Redondo-Redondo, Elisa Meilán-Hernández, Erika Mateo-Martínez
OBJECTIVES: Mini-PCNL is a potentially less invasive technique than standard percutaneous nephrolithotomy (PCNL). We present our experience and results comparing both approaches in large burden complex renal calculi. METHODS: Prospective non randomized study comparing PCNL (24/26F nephroscope; Group A) and Mini-PCNL (15/18F; Group B) perioperative and postoperative results, in 40 (20 each group) consecutive patients between 2013 and 2014. We analyze demographic data, hemoglobin drop, urine culture, stone characteristics, operative time, puncture, number and size of the tract, disintegration energy sources, nephrostomy placement, hospital stay, stone free rate and Clavien-Dindo complications...
June 2017: Archivos Españoles de Urología
https://www.readbyqxmd.com/read/28606725/do-packed-red-blood-cell-transfusions-really-worsen-oncologic-outcomes-in-colon-cancer
#15
Ramzi Amri, Anne M Dinaux, Lieve G J Leijssen, Hiroko Kunitake, Liliana G Bordeianou, David L Berger
BACKGROUND: Data from small retrospective studies have argued that perioperative packed red blood cell transfusions may increase the risk of developing metastatic recurrence in cancer patients. This study tests this assumption in a large cohort spanning a decade of operatively treated colon cancer patients. METHODS: All patients undergoing primary resection of a colon cancer at a tertiary care center between 2004-2014 (n = 1,423) were included in a retrospective review of a prospectively maintained data repository...
June 9, 2017: Surgery
https://www.readbyqxmd.com/read/28606640/medical-comorbidities-and-perioperative-allogeneic-red-blood-cell-transfusion-are-risk-factors-for-surgical-site-infection-after-shoulder-arthroplasty
#16
Joshua S Everhart, Julie Y Bishop, Jonathan D Barlow
BACKGROUND: Multiple perioperative factors have been implicated in infection risk after shoulder arthroplasty. The purpose of this study was to determine surgical site infection (SSI) risk due to medical comorbidities or blood transfusion after primary or revision shoulder arthroplasty. METHODS: Comprehensive data on medical comorbidities, surgical indication, perioperative transfusion, and SSI were obtained for 707 patients who underwent primary or revision hemiarthroplasty or total shoulder arthroplasty in a single hospital system...
June 9, 2017: Journal of Shoulder and Elbow Surgery
https://www.readbyqxmd.com/read/28601954/perioperative-outcomes-of-robot-assisted-laparoscopic-partial-cystectomy
#17
George C Bailey, Igor Frank, Matthew K Tollefson, Matthew T Gettman, John J Knoedler
Reports of surgical outcomes after robotic partial cystectomy are limited. The objective of this study is to review surgical outcomes after robotic partial cystectomy at a large tertiary referral center and compare outcomes with patients undergoing open partial cystectomy. Patients undergoing robotic partial cystectomy between 2003 and 2014 were identified. Patients were matched 2:1 based on gender, age, and Charlson Comorbidity Score with patients undergoing open partial cystectomy during the same time period...
June 10, 2017: Journal of Robotic Surgery
https://www.readbyqxmd.com/read/28601642/comparison-of-citrated-and-fresh-whole-blood-for-viscoelastic-coagulation-testing-during-elective-neurosurgery
#18
E Silverberg, F Tornqvist, T Kander, J Bengzon, C Solomon, J Bonnevier, U Schött
BACKGROUND: Previous viscoelastic haemostatic tests studies have often indicated a hypercoagulative test signal with citrated blood, which could influence clinical decision makings. PURPOSE: The aim of this study was to compare fresh and citrated whole blood using two non-automated viscoelastic ROTEM and Sonoclot tests. Our hypothesis was that citrated blood would demonstrate a hypercoagulative response in this setting, not tested before. METHODS: Perioperative viscoelastic coagulation changes were evaluated with a ROTEM and Sonoclot in 38 patients undergoing elective brain tumor surgery...
June 3, 2017: Thrombosis Research
https://www.readbyqxmd.com/read/28601313/a-propensity-score-analysis-of-two-methods-of%C3%A2-hepatic-vascular-occlusion-in-hepatectomy
#19
Xin Luo, Lin Chen, Wenhua Liu, Shuilin Dong, Hongping Luo, Bixiang Zhang, Xiaoping Chen
BACKGROUND: The key points in hepatectomy are reducing blood loss and preservation of hepatic function. The aim of this study was to compare the perioperative outcomes of partial hepatectomy using two techniques of hepatic vascular inflow occlusion. MATERIALS AND METHODS: A total of 1817 patients were selected from our multi-institutional hepatectomy database in China and classified into two groups: the hemihepatic inflow occlusion (HIO) group (n = 1693) and the ipsilateral portal vein branch occlusion (IPVBO) group (n = 124)...
June 1, 2017: Journal of Surgical Research
https://www.readbyqxmd.com/read/28600378/association-between-preoperative-anaemia-with-length-of-hospital-stay-among-patients-undergoing-primary-total-knee-arthroplasty-in-singapore-a-single-centre-retrospective-study
#20
Hairil Rizal Abdullah, Yilin Eileen Sim, Ying Hao, Geng Yu Lin, Geoffrey Haw Chieh Liew, Ecosse L Lamoureux, Mann Hong Tan
OBJECTIVES: Studies in western healthcare settings suggest that preoperative anaemia is associated with poor outcomes after elective orthopaedic surgery. We investigated the prevalence of preoperative anaemia among patients with primary unilateral total knee arthroplasty (TKA) in Singapore and its association with length of hospital stay (LOS), perioperative blood transfusion and hospital readmission rates. METHODS: Retrospective cohort study performed in a tertiary academic medical centre in Singapore, involving patients who underwent primary unilateral TKA between January 2013 and June 2014...
June 8, 2017: BMJ Open
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