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https://www.readbyqxmd.com/read/29342445/case-report-of-an-uncommon-case-of-drain-site-hernia-after-colorectal-surgery
#1
M Manigrasso, P Anoldo, F Milone, G D De Palma, M Milone
BACKGROUND: trocar site herniation is a rare but potentially serious complication of laparoscopic surgery. Data about drain site hernia after laparoscopic surgery is scarce and anecdotal. CASE PRESENTATION: we report an uncommon case of drain site hernia in a man undergone laparoscopic left colectomy for a colonic adenocarcinoma who developed small bowel herniation in a 10 mm port site, in which a 24 FR drain was inserted leaving a real free space of 2 mm. DISCUSSION: laparoscopic approach has gained widespread acceptance in each surgical fields because of the perceived better postoperative outcomes in terms of less pain, faster recovery, and lower risk of incisional hernia...
January 9, 2018: International Journal of Surgery Case Reports
https://www.readbyqxmd.com/read/29342431/comparison-of-access-type-on-perioperative-outcomes-after-endovascular-aortic-aneurysm-repair
#2
Jeffrey J Siracuse, Alik Farber, Jeffrey A Kalish, Douglas W Jones, Denis Rybin, Gheorghe Doros, Salvatore T Scali, Marc L Schermerhorn
OBJECTIVE: Endovascular aneurysm repair (EVAR) can be performed through percutaneous or surgical access. Our goal was to assess the difference in perioperative outcomes based on access type in a real-world setting. METHODS: The Vascular Quality Initiative (VQI) database was queried for EVAR. Univariable analysis and multivariable analysis were used to determine the independent effect of access type. RESULTS: There were 8340 (64%) and 4747 (36%) EVAR procedures performed through percutaneous and surgical access (3395 [72%] transverse and 1352 [28%] vertical incisions)...
January 13, 2018: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/29342427/reconstructive-aortic-valve-surgery-in-the-elderly-techniques-and-outcomes
#3
Paul P Urbanski, Atanas Jankulovski, Kiril Doldurov, Xiaochun Zhan, Ayman Sodah, Michael Zacher, Anno Diegeler
OBJECTIVES: The aim of the study was to evaluate operative techniques and long-term results after aortic valve or root repair in patients aged 75 years or more. METHODS: Between November 2002 and January 2016, a total of 815 patients underwent aortic valve or root repair. Among them were 100 patients aged 75 years or more (mean, 78 ± 3; range, 75-88 years), including 17 patients operated on an emergency basis because of acute aortic dissection. None/trivial, mild, moderate, and severe insufficiency grades were presented in 9, 23, 27, and 41 patients, respectively...
December 19, 2017: Journal of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/29342360/sustained-delivery-of-doxorubicin-via-acetalated-dextran-scaffold-prevents-glioblastoma-recurrence-after-surgical-resection
#4
Elizabeth G Graham-Gurysh, Kathryn M Moore, Andrew B Satterlee, Kevin T Sheets, Feng-Chang Lin, Eric M Bachelder, C Ryan Miller, Shawn Hingtgen, Kristy M Ainslie
The primary cause of mortality for glioblastoma (GBM) is local tumor recurrence following standard-of-care therapies, including surgical resection. With most tumors recurring near the site of surgical resection, local delivery of chemotherapy at the time of surgery is a promising strategy. Herein drug loaded polymer scaffolds with two distinct degradation profiles were fabricated to investigate the effect of local drug delivery rate on GBM recurrence following surgical resection. The novel biopolymer, acetalated dextran (Ace-DEX), was compared to commercially available polyester, poly(L-lactide) (PLA)...
January 17, 2018: Molecular Pharmaceutics
https://www.readbyqxmd.com/read/29342066/resident-participation-in-fixation-of-intertrochanteric-hip-fractures-analysis-of-the-nsqip-database
#5
Alexander L Neuwirth, Russell N Stitzlein, Madalyn G Neuwirth, Rachel K Kelz, Samir Mehta
BACKGROUND: Future generations of orthopaedic surgeons must continue to be trained in the surgical management of hip fractures. This study assesses the effect of resident participation on outcomes for the treatment of intertrochanteric hip fractures. METHODS: The National Surgical Quality Improvement Program (NSQIP) database (2010 to 2013) was queried for intertrochanteric hip fractures (International Classification of Diseases, 9th Revision, Clinical Modification [ICD-9-CM] code 820...
January 17, 2018: Journal of Bone and Joint Surgery. American Volume
https://www.readbyqxmd.com/read/29342064/minimally-manipulated-bone-marrow-concentrate-compared-with-microfracture-treatment-of-full-thickness-chondral-defects-a-one-year-study-in-an-equine-model
#6
Constance R Chu, Lisa A Fortier, Ashley Williams, Karin A Payne, Taralyn M McCarrel, Megan E Bowers, Diego Jaramillo
BACKGROUND: Microfracture is commonly performed for cartilage repair but usually results in fibrocartilage. Microfracture augmented by autologous bone marrow concentrate (BMC) was previously shown to yield structurally superior cartilage repairs in an equine model compared with microfracture alone. The current study was performed to test the hypothesis that autologous BMC without concomitant microfracture improves cartilage repair compared with microfracture alone. METHODS: Autologous sternal bone marrow aspirate (BMA) was concentrated using a commercial system...
January 17, 2018: Journal of Bone and Joint Surgery. American Volume
https://www.readbyqxmd.com/read/29342059/patients-living-alone-can-be-safely-discharged-directly-home-after-total-joint-arthroplasty-a-prospective-cohort-study
#7
Andrew N Fleischman, Matthew S Austin, James J Purtill, Javad Parvizi, William J Hozack
BACKGROUND: Despite the expense and potential hazards of inpatient rehabilitation, there is a prevailing belief that patients living alone cannot be safely discharged directly home after total joint arthroplasty. The purpose of this study was to assess the safety and efficacy of direct home discharge for patients living alone during convalescence after primary total joint arthroplasty. METHODS: We prospectively studied 910 consecutive patients undergoing primary, unilateral total hip arthroplasty or total knee arthroplasty over an 8-month period...
January 17, 2018: Journal of Bone and Joint Surgery. American Volume
https://www.readbyqxmd.com/read/29342051/does-hospital-volume-affect-outcomes-in-patients-undergoing-vestibular-schwannoma-surgery
#8
Jonathan L Hatch, Michael J Bauschard, Shaun A Nguyen, Paul R Lambert, Ted A Meyer, Theodore R McRackan
OBJECTIVE: To determine the effect of hospital surgical case volume on the outcomes of vestibular schwannoma surgery. STUDY DESIGN: Retrospective case review. SETTING: University HealthSystem Consortium member hospitals (includes nearly every US academic medical center). PATIENTS: Three thousand six hundred ninety-seven patients who underwent vestibular schwannoma resection over a 3-year timespan (2012-2015) grouped by race, age, comorbidities, payer, and sex...
January 16, 2018: Otology & Neurotology
https://www.readbyqxmd.com/read/29341337/endoscopic-endonasal-approach-for-sinonasal-and-anterior-skull-base-malignancies-in-the-elderly
#9
Davide Lepera, Federico Leone, Luca Volpi, Maurizio Bignami, Apostolos Karligkiotis, Alessia Lambertoni, Andrea Pistochini, Remo Accorona, Piero Nicolai, Paolo Castelnuovo
BACKGROUND: The purpose of this study was to report the outcomes of endoscopic transnasal resection for sinonasal and anterior skull-base cancers in elderly patients. METHODS: A retrospective review was performed. The patients were divided into 2 groups, <70 years old and ≥70 years old and compared by univariate analysis. Prognostic factors were evaluated with a multivariate analysis. Survival rates were also calculated. RESULTS: Two hundred three elderly patients and 397 younger patients were enrolled in this study...
January 17, 2018: Head & Neck
https://www.readbyqxmd.com/read/29341336/identification-of-perioperative-pulmonary-aspiration-in-children-using-quality-assurance-and-hospital-administrative-billing-data
#10
Lisa Eisler, Grace Huang, Ka-Eun M Lee, Jennifer A Busse, Ming Sun, Albert Y Lin, Lena S Sun, Caleb Ing
BACKGROUND: Perioperative aspiration is a rare but potentially devastating complication, occurring in 1-10 per 10 000 anesthetics based on studies of quality assurance databases. Quality assurance reporting is known to underestimate the incidence of adverse outcomes, but few large studies use supplementary data sources. This study aims to identify the incidence of and risk factors for perioperative aspiration in children using quality assurance data supplemented by administrative billing records, and to examine the utility of billing data as a supplementary data source...
January 17, 2018: Paediatric Anaesthesia
https://www.readbyqxmd.com/read/29341162/impact-of-genomics-on-the-surgical-management-of-melanoma
#11
REVIEW
P M Ferguson, G V Long, R A Scolyer, J F Thompson
BACKGROUND: Although surgery for early-stage melanoma offers the best chance of cure, recent advances in molecular medicine have revolutionized the management of late-stage melanoma, leading to significant improvements in clinical outcomes. Research into the genomic drivers of disease and cancer immunology has not only ushered in a new era of targeted and immune-based therapies for patients with metastatic melanoma, but has also provided new tools for monitoring disease recurrence and selecting therapeutic strategies...
January 2018: British Journal of Surgery
https://www.readbyqxmd.com/read/29341155/long-term-outcome-of-prophylactic-thyroidectomy-in-children-carrying-ret-germline-mutations
#12
A Machens, M Elwerr, K Lorenz, F Weber, H Dralle
BACKGROUND: A comprehensive assessment has not been undertaken of long-term outcomes in children carrying germline RET mutations and undergoing prophylactic thyroidectomy with the aim of preventing medullary thyroid cancer (MTC). METHODS: A retrospective outcome study (1994-2017) of prophylactic thyroidectomy in children, with and without central node dissection, was performed at a tertiary surgical centre. RESULTS: Some 167 children underwent prophylactic thyroidectomy, 109 without and 58 with concomitant central node dissection...
January 2018: British Journal of Surgery
https://www.readbyqxmd.com/read/29341148/outcomes-after-prophylactic-gastrectomy-for-hereditary-diffuse-gastric-cancer
#13
R T van der Kaaij, J P van Kessel, J M van Dieren, P Snaebjornsson, O Balagué, F van Coevorden, L E van der Kolk, K Sikorska, A Cats, J W van Sandick
BACKGROUND: Patients with hereditary diffuse gastric cancer and a CDH1 mutation have a 60-80 per cent lifetime risk of developing diffuse gastric cancer. Total prophylactic gastrectomy eliminates this risk, but is associated with considerable morbidity. The effectiveness (removal of all gastric mucosa) and outcomes of this procedure were evaluated retrospectively. METHODS: All consecutive individuals undergoing a prophylactic gastrectomy for a CDH1 mutation or gastric signet ring cell foci at the authors' institute between 2005 and 2017 were included...
January 2018: British Journal of Surgery
https://www.readbyqxmd.com/read/29341106/the-effect-of-surgery-on-subsequent-pregnancy-outcomes-among-patients-with-cesarean-scar-diverticulum
#14
Xian-Ying Cheng, Li Cheng, Wen-Juan Li, Ling-Hua Qian, Yong-Qin Zhang
OBJECTIVE: To determine whether surgical treatment of cesarean scar diverticulum (CSD) reduced adverse outcomes during the subsequent pregnancy. METHODS: A retrospective observational study was conducted using the medical records of pregnant women with CSD who attended a single hospital in Hangzhou, China, between January 1, 2014, and December 31, 2016. Baseline characteristics and pregnancy outcomes were compared between the surgery group and the no surgery group...
January 17, 2018: International Journal of Gynaecology and Obstetrics
https://www.readbyqxmd.com/read/29340992/prospective-comparative-study-of-laparoscopic-narrow-band-imaging-nbi-versus-standard-imaging-in-gynecologic-oncology
#15
Alessia Aloisi, Yukio Sonoda, Ginger J Gardner, Kay J Park, Sarah L Elliott, Qin C Zhou, Alexia Iasonos, Nadeem R Abu-Rustum
BACKGROUND: Narrow band imaging (NBI) is an optic filtration enhancement for endoscopy that uses two wavelengths of light (415 and 540 nm) to highlight superficial microvascular patterns. It has been successfully utilized to improve identification of lesions with abnormal vasculature, which is associated with endometriosis and endometrial cancer. Case studies suggest it may also facilitate surgical staging of gynecologic cancer, which is critical in determining appropriate adjuvant therapies...
January 16, 2018: Annals of Surgical Oncology
https://www.readbyqxmd.com/read/29340924/impact-of-preoperative-opioid-use-after-emergency-general-surgery
#16
Young Kim, Alexander R Cortez, Koffi Wima, Vikrom K Dhar, Krishna P Athota, Jason J Schrager, Timothy A Pritts, Michael J Edwards, Shimul A Shah
BACKGROUND: Preoperative exposure to narcotics has recently been associated with poor outcomes after elective major surgery, but little is known as to how preoperative opioid use impacts outcomes after common, emergency general surgical procedures (EGS). METHODS: A high-volume, single-center analysis was performed on patients who underwent EGS from 2012 to 2013. EGS was defined as the seven emergent operations that account for 80% of the national burden. Preoperative opioid use was defined as having an active opioid prescription within 7 days prior to surgery...
January 16, 2018: Journal of Gastrointestinal Surgery: Official Journal of the Society for Surgery of the Alimentary Tract
https://www.readbyqxmd.com/read/29340922/prevention-of-internal-hernia-during-robotic-total-gastrectomy-for-gastric-cancer
#17
Toshiyasu Ojima, Masaki Nakamura, Mikihito Nakamori, Keiji Hayata, Masahiro Katsuda, Toshiaki Tsuji, Shimpei Maruoka, Hiroki Yamaue
BACKGROUND: Postoperative internal hernia (IH) is a potentially life-threatening acute protrusion of viscus through an iatrogenic mesenteric defect. In our retrospective study of 1943 consecutive gastric cancer (GC) patients who had undergone surgery, the incidence of IH after laparoscopic total gastrectomy (LTG) was 4.9%.1 This high incidence seems to be caused by decreased adhesion formation after LTG. There is no consensus regarding orifice management during robotic total gastrectomy (RTG)...
January 16, 2018: Journal of Gastrointestinal Surgery: Official Journal of the Society for Surgery of the Alimentary Tract
https://www.readbyqxmd.com/read/29340829/trends-and-surgical-outcomes-of-laparoscopic-versus-open-pyloromyotomy
#18
William C Kethman, Alex H S Harris, Mary T Hawn, James K Wall
BACKGROUND: Hypertrophic pyloric stenosis (HPS) is one of the most common pediatric illnesses necessitating surgical intervention. Controversy remains over the optimal surgical approach between laparoscopic pyloromyotomy (LP) and open pyloromyotomy (OP). LP has gained acceptance for management of HPS in an era of expanding minimal access surgical approaches to pediatric conditions. Several studies suggest advantages of LP over OP; however, selection bias and small sample sizes remain a concern...
January 16, 2018: Surgical Endoscopy
https://www.readbyqxmd.com/read/29340825/laparoscopic-surgery-in-colon-cancer-patients-treated-with-chronic-anti-thrombotic-therapy
#19
Hiroaki Nozawa, Takahide Shinagawa, Kazushige Kawai, Keisuke Hata, Toshiaki Tanaka, Takeshi Nishikawa, Kensuke Otani, Kazuhito Sasaki, Manabu Kaneko, Shigenobu Emoto, Koji Murono
BACKGROUND: Anti-thrombotic medications are commonly used for the treatment and prevention of cardiovascular diseases. Laparoscopic resection of colon cancer has generally been accepted with favorable outcomes being reported in randomized control trials. However, the safety and efficacy of laparoscopic surgery for colon cancer patients receiving chronic anti-thrombotic therapy (AT) remain unclear. METHODS: We identified 951 patients who underwent elective resection for colon cancer between 2009 and 2016 from our database...
January 16, 2018: Surgical Endoscopy
https://www.readbyqxmd.com/read/29340823/endoscopic-perforations-what-are-the-indications-for-surgery
#20
Diane Mege, Laura Beyer-Berjot, Walid Ezzedine, Anderson Loundou, Jean-Charles Grimaud, Marc Barthet, Stéphane Berdah
BACKGROUND: Despite their low occurrence, endoscopic perforations (EPs) are concerning. Some predictive factors have been identified, and EP management is debated, whether non-surgical (medical and/or endoscopic) or surgical. The objective was to elaborate a predictive score for surgical management of EP. METHODS: All the patients addressed for upper and lower EP, except oesophageal EP, were retrospectively included (2004-2015). Demographic data, endoscopic features (indication, location, type), clinical, biological and radiological presentations of EP were reviewed...
January 16, 2018: Surgical Endoscopy
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