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https://www.readbyqxmd.com/read/28731404/jackson-pratt-drainage-in-pediatric-craniofacial-reconstructive-surgery-is-it-helping-or-hurting
#1
Kumar Vasudevan, Ahyuda Oh, R Shane Tubbs, David Garcia, Andrew Reisner, Joshua J Chern
OBJECTIVE Jackson-Pratt drains (JPDs) are commonly employed in pediatric craniofacial reconstructive surgery (CRFS) to reduce postoperative wound complications, but their risk profile remains unknown. Perioperative blood loss and volume shifts are major risks of CFRS. The goal of this study was to evaluate the risks of JPD usage in CFRS, particularly with regard to perioperative blood loss, hyponatremia, intensive care unit (ICU) length of stay, and postoperative wound complications. METHODS The authors performed a retrospective review of data obtained in pediatric patients who underwent CFRS at a single institution, as performed by multiple surgeons between January 2010 and December 2014...
July 21, 2017: Journal of Neurosurgery. Pediatrics
https://www.readbyqxmd.com/read/28728715/robotic-lobectomy-and-segmentectomy-technical-details-and-results
#2
REVIEW
Benjamin Wei, Robert J Cerfolio
Robotic-assisted pulmonary lobectomy can be considered for patients fit for conventional lobectomy. Contraindications include prohibitive lung function or medical comorbidities, multistation N2, gross N2 disease, or evidence of N3 disease. Team training, familiarity with equipment, troubleshooting, and preparation are critical for successful robotic lobectomy. Similar to video-assisted thoracoscopic surgery (VATS) lobectomy, robotic lobectomy is associated with decreased blood loss, blood transfusion, air leak, chest tube duration, duration of stay, and mortality compared with thoracotomy...
August 2017: Surgical Clinics of North America
https://www.readbyqxmd.com/read/28726140/outcomes-following-laparoscopic-versus-open-major-hepatectomy-for-hepatocellular-carcinoma-in-patients-with-cirrhosis-a-propensity-score-matched-analysis
#3
Hong-Wei Xu, Fei Liu, Hong-Yu Li, Yong-Gang Wei, Bo Li
BACKGROUND: Laparoscopic major hepatectomy (LMH) for hepatocellular carcinoma (HCC) in patients with cirrhosis remains controversial due to limited reports in the literature. This study analyzed the perioperative and oncological outcomes of LMH for HCC with cirrhosis compared with open major hepatectomy (OMH). METHODS: A retrospective analysis of patients with cirrhosis who underwent major hepatectomy for HCC between January 2015 and January 2017 was performed. Patients were divided into the LMH group and the OMH group...
July 19, 2017: Surgical Endoscopy
https://www.readbyqxmd.com/read/28723873/total-disc-arthroplasty-and-anterior-interbody-fusion-in-the-lumbar-spine-have-relatively-few-differences-in-readmission-and-short-term-adverse-events
#4
Blake N Shultz, Alexander T Wilson, Nathaniel T Ondeck, Patawut Bovonratwet, Ryan P McLynn, Jonathan J Cui, Jonathan N Grauer
STUDY DESIGN: Retrospective matched cohort study of prospectively collected data. OBJECTIVE: To compare rates of adverse events and readmission between lumbar total disc arthroplasty (TDA) and anterior lumbar interbody fusion (ALIF) using the American College of Surgeons National Surgical Quality Improvement Program (NSQIP) database. SUMMARY OF BACKGROUND DATA: TDA and ALIF may be considered for similar degenerative indications. However, there have been few large-cohort comparison studies of short-term clinical outcomes for these procedures...
July 18, 2017: Spine
https://www.readbyqxmd.com/read/28715503/effects-of-preoperative-aspirin-on-perioperative-platelet-activation-and-dysfunction-in-patients-undergoing-off-pump-coronary-artery-bypass-graft-surgery-a-prospective-randomized-study
#5
Jiwon Lee, Chul-Woo Jung, Yunseok Jeon, Tae Kyong Kim, Youn Joung Cho, Chang-Hoon Koo, Yoon Hyeong Choi, Ki-Bong Kim, Ho Young Hwang, Hang-Rae Kim, Ji-Young Park
The benefit of aspirin use after coronary artery bypass graft surgery has been well proven. However, the effect of preoperative aspirin use in patients undergoing off-pump coronary artery bypass graft surgery (OPCAB) has not been evaluated sufficiently. To evaluate platelet function changes during OPCAB due to preoperative aspirin use, we conducted a randomized controlled trial using flow cytometry and the Multiplate® analyzer. Forty-eight patients scheduled for elective OPCAB were randomized to the aspirin continuation (100 mg/day until operative day) and discontinuation (4 days before the operative day) groups...
2017: PloS One
https://www.readbyqxmd.com/read/28714229/implementing-a-protocol-to-optimize-blood-use-in-a-cardiac-surgery-service-results-of-a-pre-post-analysis-and-the-impact-of-high-volume-blood-users
#6
Juan B Grau, Jacqueline H Fortier, Cyrus Kuschner, Giovanni Ferrari, Mariano E Brizzio, Alex Zapolanski, Richard E Shaw
BACKGROUND: Blood transfusions are a common and costly intervention for cardiac surgery patients. Evidence suggests that a more restrictive transfusion strategy may reduce costs and transfusion-related complications without increasing perioperative morbidity and mortality. STUDY DESIGN AND METHODS: A transfusion-limiting protocol was developed and implemented in a cardiovascular surgery unit. Over a 5-year period, data were collected on patient characteristics, procedures, utilization of blood products, morbidity, and mortality, and these were compared before and after the protocol was implemented...
July 16, 2017: Transfusion
https://www.readbyqxmd.com/read/28702679/predictive-factors-of-bleeding-among-pediatric-patients-undergoing-percutaneous-nephrolithotomy
#7
Cagri Senocak, Ridvan Ozbek, Omer Faruk Bozkurt, Ali Unsal
The purpose of this study is to determine the perioperative risk factors for increased blood loss in children undergoing percutaneous nephrolithotomy (PCNL).We retrospectively reviewed the data on pediatric patients who had undergone PCNL for stone disease in our department. Blood loss estimation was quantified by measuring the changes in hematocrit plus the volume of red blood cells transfused. Univariate and multivariate linear regression analyses were performed to evaluate risk factors associated with increased blood loss after pediatric PCNL...
July 12, 2017: Urolithiasis
https://www.readbyqxmd.com/read/28701190/a-novel-algorithm-for-the-treatment-strategy-for-advanced-epithelial-ovarian-cancer-consecutive-imaging-frailty-assessment-and-diagnostic-laparoscopy
#8
Kyung Jin Eoh, Jung Won Yoon, Jung-Yun Lee, Eun Ji Nam, Sunghoon Kim, Sang Wun Kim, Young Tae Kim
BACKGROUND: This study aimed to evaluate the perioperative outcomes and prognostic impact of the consecutive steps of imaging, frailty assessment, and diagnostic laparoscopy (DLS) in patients with advanced epithelial ovarian cancer (EOC). METHODS: Patients diagnosed with EOC during 2012-2015 were analyzed retrospectively. Surgical and survival outcomes were compared between three treatment groups: patients without high tumor dissemination (HTD) who underwent primary debulking surgery (PDS group); patients with HTD who underwent DLS (DLS group); and patients with HTD diagnosed by cytological confirmation of malignancy followed by neoadjuvant chemotherapy (NACT group)...
July 12, 2017: BMC Cancer
https://www.readbyqxmd.com/read/28700983/intratumoral-coagulation-by-radiofrequency-ablation-facilitated-the-laparoscopic-resection-of-giant-hepatic-hemangioma-a-surgical-technique-report-of-two-cases
#9
Shaohong Wang, Jun Gao, Mengmeng Yang, Shan Ke, Xuemei Ding, Jian Kong, Li Xu, Wenbing Sun
BACKGROUND: Traditionally, open hepatic resection is the first choice of treatment for symptomatic enlarging hepatic hemangiomas, which requires a large abdominal incision and is associated with substantial recovery time and morbidity. Minimally invasive laparoscopic resection has been used recently in liver surgery for treating selected hepatic hemangiomas. However, laparoscopic liver surgery poses the significant technical challenges and high rate of conversion. Radiofrequency (RF) ablation has been proved feasible in the treatment of hepatic hemangiomas with a size range of 5...
July 5, 2017: Oncotarget
https://www.readbyqxmd.com/read/28700610/perioperative-hemodynamics-and-risk-for-delirium-and-new-onset-dementia-in-hip-fracture-patients-a-prospective-follow-up-study
#10
Bjørn Erik Neerland, Maria Krogseth, Vibeke Juliebø, Anette Hylen Ranhoff, Knut Engedal, Frede Frihagen, Johan Ræder, Torgeir Bruun Wyller, Leiv Otto Watne
BACKGROUND: Delirium is common in hip fracture patients and many risk factors have been identified. Controversy exists regarding the possible impact of intraoperative control of blood pressure upon acute (delirium) and long term (dementia) cognitive decline. We explored possible associations between perioperative hemodynamic changes, use of vasopressor drugs, risk of delirium and risk of new-onset dementia. METHODS: Prospective follow-up study of 696 hip fracture patients, assessed for delirium pre- and postoperatively, using the Confusion Assessment Method...
2017: PloS One
https://www.readbyqxmd.com/read/28700450/comparison-of-thirty-day-complications-between-navigated-and-conventional-single-level-instrumented-posterior-lumbar-fusion-a-propensity-score-matched-analysis
#11
Patawut Bovonratwet, Stephen J Nelson, Nathaniel T Ondeck, Benjamin J Geddes, Jonathan N Grauer
STUDY DESIGN: cohort comparison study. OBJECTIVE: To compare perioperative outcomes between navigated and conventional single-level instrumented posterior lumbar fusions in the American College of Surgeons National Surgical Quality Improvement Program (NSQIP) database. SUMMARY OF BACKGROUND DATA: Although multiple studies have investigated the accuracy of pedicle screw placement and radiation exposure with navigation, no study has compared perioperative complications between navigated and conventional posterior lumbar fusion...
July 11, 2017: Spine
https://www.readbyqxmd.com/read/28698413/-aortic-stenosis-combined-with-cold-agglutinin-disease
#12
Zaiqiang Yu, Masahito Minakawa, Takashi Aoki, Norihiro Kondo, Kazuyuki Daitoku, Yasuyuki Suzuki, Ikuo Fukuda
Cardiac surgery on a patient with cold agglutinin disease is high risk for thromboembolism due to hypothermia perioperative. A 75-year-old woman with cold agglutinin disease underwent aortic valve replacement for severe aortic stenosis. Cold antibody was detected by preoperative screening test for blood transfusion. In order to prevent thromboembolic event during the operation, we maintained rectal temperature at around 36 degrees centigrade during the cardiopulmonary bypass by warming blood in the bypass circuit...
July 2017: Kyobu Geka. the Japanese Journal of Thoracic Surgery
https://www.readbyqxmd.com/read/28697860/multimodal-nutritional-management-in-primary-total-knee-arthroplasty-a-randomized-controlled-trial
#13
Guorui Cao, Qiang Huang, Bin Xu, Zeyu Huang, Jinwei Xie, Fuxing Pei
BACKGROUND: This study aims at evaluating the effectiveness of a new multimodal nutritional management (MNM) on albumin (ALB) transfusion, the incidence of electrolyte disorders, blood loss, perioperative levels of ALB and electrolyte, length of hospital stay (LOH), and complications in patients following total knee arthroplasty without tourniquet. METHODS: A total of 162 patients were randomized to receive either the MNM protocol (n = 81, experimental group) or traditional protocol (n = 81, control group)...
June 17, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28695560/minimally-invasive-extracorporeal-circulation-excellent-outcome-and-life-expectancy-after-coronary-artery-bypass-grafting-surgery
#14
Bernhard Winkler, Paul Philipp Heinisch, Grzegorz Zuk, Katarzyna Zuk, Brigitta Gahl, Hans-Jörg Jenni, Alexander Kadner, Christoph Huber, Thierry Carrel
OBJECTIVE: Coronary artery bypass grafting (CABG) remains the gold standard for complex revascularisation in multivessel disease. The concept of the minimally invasive extracorporeal circulation circuit (MiECC) was introduced to minimise pathophysiological side effects of conventional extracorporeal circulation. This study presents early and long-term outcomes after CABG with use of MiECC in a single-centre consecutive patient cohort. METHODS: From 1 January 2005 to 31 December 2010, 2130 patients underwent isolated CABG with MiECC at our centre...
July 11, 2017: Swiss Medical Weekly
https://www.readbyqxmd.com/read/28694078/robotic-versus-open-level-i-ii-inferior-vena-cava-thrombectomy-a-matched-group-comparative-analysis
#15
Liangyou Gu, Xin Ma, Yu Gao, Hongzhao Li, Xintao Li, Luyao Chen, Baojun Wang, Yongpeng Xie, Yang Fan, Xu Zhang
PURPOSE: To compare treatment outcomes of robotic inferior vena cava (IVC) thrombectomy (R-IVCTE) vs open IVC thrombectomy (O-IVCTE) for renal tumors with level I-II IVC tumor thrombus. MATERIALS AND METHODS: We retrospectively reviewed the medical records of patients who underwent either R-IVCTE or O-IVCTE between 2006 and 2015. To reduce the inherent biases of a nonrandomized study, robotic and open groups were matched 1:1 based on key variables. Perioperative data and oncologic outcomes were reviewed...
July 7, 2017: Journal of Urology
https://www.readbyqxmd.com/read/28692467/intravenous-tranexamic-acid-bolus-plus-infusion-is-not-more-effective-than-a-single-bolus-in-primary-hip-arthroplasty-a-randomized-controlled-trial
#16
Paul J Zufferey, Julien Lanoiselée, Céline Chapelle, Dmitry B Borisov, Jean-Yves Bien, Pierre Lambert, Rémi Philippot, Serge Molliex, Xavier Delavenne, Béatrice Deygas, Mathilde Donnat, Juanita Techer, Laurent Tordella, Jean-Noël Fort, Nicolas Barbe, Julie Gavory, Sylvie Passot, Laetitia Burnol, Stéphanie Seve
BACKGROUND: Preoperative administration of the antifibrinolytic agent tranexamic acid reduces bleeding in patients undergoing hip arthroplasty. Increased fibrinolytic activity is maintained throughout the first day postoperation. The objective of the study was to determine whether additional perioperative administration of tranexamic acid would further reduce blood loss. METHODS: This prospective, double-blind, parallel-arm, randomized, superiority study was conducted in 168 patients undergoing unilateral primary hip arthroplasty...
July 10, 2017: Anesthesiology
https://www.readbyqxmd.com/read/28692337/a-multidisciplinary-perioperative-strategy-for-attaining-more-physiologic-cardiac-surgery
#17
Kyriakos Anastasiadis, Polychronis Antonitsis, Apostolos Deliopoulos, Helena Argiriadou
BACKGROUND: Cardiac surgery is, by definition, a "non-physiologic" intervention associated with systemic adverse effects. Despite advances in surgical technique, cardiopulmonary bypass (CPB) technology as well as anaesthesia management and patient care, there is still significant morbidity and subsequent mortality. AIM: We consider that the contemporary demand for further improving patient outcome mandates the upgrade from optimal perfusion during the procedure as the gold standard to the concept of a "more physiologic" cardiac surgery...
March 1, 2017: Perfusion
https://www.readbyqxmd.com/read/28691229/desmopressin-use-for-minimising-perioperative-blood-transfusion
#18
REVIEW
Michael J Desborough, Kathryn Oakland, Charlotte Brierley, Sean Bennett, Carolyn Doree, Marialena Trivella, Sally Hopewell, Simon J Stanworth, Lise J Estcourt
BACKGROUND: Blood transfusion is administered during many types of surgery, but its efficacy and safety are increasingly questioned. Evaluation of the efficacy of agents, such as desmopressin (DDAVP; 1-deamino-8-D-arginine-vasopressin), that may reduce perioperative blood loss is needed. OBJECTIVES: To examine the evidence for the efficacy of DDAVP in reducing perioperative blood loss and the need for red cell transfusion in people who do not have inherited bleeding disorders...
July 10, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28690465/thrombotic-and-infectious-morbidity-are-associated-with-transfusion-in-posterior-spine-fusion
#19
Daniel J Johnson, Christine C Johnson, David B Cohen, Joshua A Wetzler, Khaled M Kebaish, Steven M Frank
BACKGROUND: Although previous investigators have established an association between blood transfusion and adverse outcomes, the relative frequency of different morbid events and the association with transfusion dose are not well understood. QUESTIONS/PURPOSES: The purpose of the study is to characterize the relationship between blood transfusion and different types of morbidity after posterior spine fusion. METHODS: We retrospectively analyzed electronic medical records for 963 patients who underwent posterior spinal fusion surgery at a single institution, of which 603 (62...
July 2017: HSS Journal: the Musculoskeletal Journal of Hospital for Special Surgery
https://www.readbyqxmd.com/read/28689939/variation-in-transfusion-practices-and-the-association-with-perioperative-adverse-events-in-patients-undergoing-open-abdominal-aortic-aneurysm-repair-and-lower-extremity-arterial-bypass-in-the-vascular-quality-initiative
#20
Zachary Osborne, Kristine Hanson, Benjamin S Brooke, Marc Schermerhorn, Peter Henke, Rumi Faizer, Andres Schanzer, Philip Goodney, Thomas Bower, Randall R DeMartino
INTRODUCTION: Blood transfusions are associated with adverse events. We examined perioperative transfusion practices and associated complications following open vascular procedures nationwide in the Vascular Quality Initiative (VQI). METHODS: Adults undergoing open abdominal aortic aneurysm repair (OAR) and lower extremity arterial bypass (Bypass) within VQI (2003-2016) were identified. All emergent cases, patients with pre-operative hemoglobin<7 g/dL, pre-operative hospitalization >1 day, or a return to OR during the index hospitalization were excluded...
July 6, 2017: Annals of Vascular Surgery
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