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Perioperative renal protection

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https://www.readbyqxmd.com/read/29772311/mid-term-outcomes-of-endovascular-aortic-aneurysm-repair-with-carbon-dioxide-guided-angiography
#1
Yuriko Takeuchi, Noriyasu Morikage, Yutaro Matsuno, Tamami Nakamura, Makoto Samura, Koshiro Ueda, Takasuke Harada, Yoshitaka Ikeda, Kotaro Suehiro, Hiroshi Ito, Kensuke Sakata, Kimikazu Hamano
BACKGROUND: Although iodinated contrast (IC) agents are commonly used in endovascular aneurysm repair (EVAR), perioperative use in patients with renal dysfunction or IC allergies is avoided. Carbon dioxide (CO2 )-guided angiography is a promising alternative. We aimed to evaluate short-term and mid-term outcomes of EVAR using CO2 -guided angiography. METHODS: Three hundred and eighty-one patients who underwent EVAR from January 2012 to September 2016 were retrospectively reviewed and divided into an IC-EVAR group (n=351) and CO2 -EVAR group (n=30)...
May 14, 2018: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/29750392/laparoscopic-versus-robot-assisted-partial-nephrectomy-for-renal-tumors-larger-than-4-cm-a-propensity-score-based-analysis
#2
Liangyou Gu, Hongzhao Li, Baojun Wang, Yongpeng Xie, Xintao Li, Yu Gao, Xiangjun Lyu, Qingbo Huang, Yang Fan, Yuanxin Yao, Yunpeng Wang, Xin Ma, Xu Zhang
OBJECTIVES: To compare perioperative, functional, and oncological outcomes between laparoscopic partial nephrectomy (LPN) and robot-assisted partial nephrectomy (RAPN) for renal tumors >4 cm. MATERIAL AND METHODS: We retrospectively reviewed patients who underwent either LPN or RAPN between 2008 and 2015. To adjust for potential baseline confounders, propensity-score matching (1:1) was performed. Perioperative data, and functional and oncological outcomes were reviewed...
May 11, 2018: BJU International
https://www.readbyqxmd.com/read/29685515/cerebral-embolization-during-endovascular-infrarenal-juxtarenal-and-suprarenal-aortic-aneurysm-repair-high-risk-maneuvers-and-associated-neurologic-outcomes
#3
Ruth A Benson, David Matthews, Vanessa Loftus, Grainne Nicholson, David Tropman, Ian M Loftus
BACKGROUND: Risk factors for postoperative cognitive decline after noncardiac surgery are multifactorial and poorly understood. Evidence suggests that perioperative microembolic damage to the brain on movement of wires and catheters during endovascular aortic procedures may play an important role. Endovascular aortic aneurysm repair requires invasive manipulation of wires and cannulas within the aorta, but research into cerebral emboli during aortic aneurysm repair and cognitive or neurologic injury is scarce and limited to thoracic aneurysms...
April 20, 2018: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/29682104/predictors-of-perioperative-stroke-death-after-carotid-artery-stenting-a-review-article
#4
REVIEW
Ali F AbuRahma
Carotid artery stenting (CAS) has been recommended as an alternative treatment to carotid endarterectomy for patients with significant carotid stenosis. Only a few studies have analyzed clinical/anatomical and technical variables that affect perioperative outcomes of CAS. Following a comprehensive Medline search, it was reported that clinical factors, including age of >80 years, chronic renal failure, diabetes mellitus, symptomatic indications, and procedures performed within 2 weeks of transient ischemic attack symptoms, are associated with high perioperative stroke and death rates...
March 25, 2018: Annals of Vascular Diseases
https://www.readbyqxmd.com/read/29603885/synchronous-nephron-sparing-approaches-for-bilateral-renal-masses-perioperative-and-renal-functional-outcomes
#5
Ross J Mason, Thomas Atwell, Christine Lohse, Bimal Bhindi, Grant Schmit, John Schmitz, Bradley C Leibovich, Stephen A Boorjian, R Houston Thompson
OBJECTIVES: To evaluate the perioperative and renal functional outcomes of patients undergoing synchronous bilateral partial nephrectomy (PN) or percutaneous cryoablation (PCA). PATIENTS AND METHODS: We retrospectively reviewed our institutional nephrectomy and renal mass ablation registries to identify all patients with synchronous bilateral renal masses who underwent simultaneous bilateral PN (n = 76) or PCA (n = 13) between 1974 and 2013. Changes in estimated glomerular filtration rates as well as perioperative complications are descriptively reported for each procedure...
March 31, 2018: BJU International
https://www.readbyqxmd.com/read/29521269/the-effect-of-darbepoetin-alfa-on-renal-fibrosis-in-rats-with-acute-unilateral-ureteral-obstruction
#6
Ozgur Haki Yuksel, Caglar Yildirim, Ahmet Urkmez, Nurver Ozbay, Fatih Uruc, Aytac Sahin, Serkan Akan, Ayhan Verit
OBJECTIVES: The most important treatment strategy for obstructive nephropathy is to protect renal tissue from the deleterious effects of fibrosis. Therefore, we sought to investigate the renoprotective effects of darbepoetin alfa on unilateral ureteral obstructions. METHODS: We used 12 female and 12 male 3-monthold Wistar rats weighing between 250 and 350 g. The rats were divided equally into sham, darbepoetin and control groups. With the exception of the sham group, left unilateral obstructions were applied to all of the rats...
March 2018: Archivos Españoles de Urología
https://www.readbyqxmd.com/read/29468090/the-role-of-bmi-in-hip-fracture-surgery
#7
Sheriff D Akinleye, Garret Garofolo, Maya Deza Culbertson, Peter Homel, Orry Erez
Introduction: Obesity is an oft-cited cause of surgical morbidity and many institutions require extensive supplementary screening for obese patients prior to surgical intervention. However, in the elderly patients, obesity has been described as a protective factor. This article set out to examine the effect of body mass index (BMI) on outcomes and morbidity after hip fracture surgery. Methods: The National Surgical Quality Improvement Program database was queried for all patients undergoing 1 of 4 surgical procedures to manage hip fracture between 2008 and 2012...
2018: Geriatric Orthopaedic Surgery & Rehabilitation
https://www.readbyqxmd.com/read/29467353/can-tolvaptan-protect-renal-function-in-the-early-postoperative-period-of-cardiac-surgery-results-of-a-single-center-randomized-controlled-study
#8
Yuichiro Kishimoto, Yoshinobu Nakamura, Shingo Harada, Takeshi Onohara, Satoru Kishimoto, Tomohiro Kurashiki, Yoshikazu Fujiwara, Motonobu Nishimura
BACKGROUND: Oral administration of tolvaptan, a vasopressin V2 receptor antagonist, significantly reduces deterioration of renal function, which has recently been highlighted as an exacerbating factor for adverse events in patients with acute heart failure. In the present study we tested the hypothesis that concomitant administration of tolvaptan with a conventional diuretic is beneficial for perioperative body fluid management in patients who have undergone cardiac surgery.Methods and Results:In all, 280 patients who underwent cardiac surgery were prospectively randomized to concomitant treatment with tolvaptan and a conventional diuretic (tolvaptan group; 147 patients) or treatment with a conventional diuretic alone (control group; 133 patients)...
March 23, 2018: Circulation Journal: Official Journal of the Japanese Circulation Society
https://www.readbyqxmd.com/read/29453902/peri-operative-outcomes-and-complications-after-laparoscopic-vs-robot-assisted-dismembered-pyeloplasty-a-systematic-review-and-meta-analysis
#9
REVIEW
Alexander Light, Sandeep Karthikeyan, Sachan Maruthan, Oussama Elhage, Hansjörg Danuser, Prokar Dasgupta
OBJECTIVE: To analyse the current difference between dismembered robot-assisted pyeloplasty (RAP) and laparoscopic pyeloplasty (LP) in the treatment of pelvi-ureteric junction (PUJ) obstruction as of 26 June 2017, focusing on operating time, length of hospital stay, complication rate, and success rate. PATIENTS AND METHODS: We searched PubMed, Medline and Embase databases, consulted experts, reviewed reference lists, used the 'related articles' PubMed feature, and reviewed scientific meeting abstracts for eligible articles published between 1993 and 26 June 2017...
February 17, 2018: BJU International
https://www.readbyqxmd.com/read/29395954/perioperative-and-long-term-outcomes-after-radical-cystectomy-in-hemodialysis-patients
#10
Scott C Johnson, Zachary L Smith, Shay Golan, Joseph F Rodriguez, Shane M Pearce, Norm D Smith, Gary D Steinberg
PURPOSE: Patients on hemodialysis have an increased risk of developing advanced stage bladder cancer. They also have a significant risk of noncancer-related mortality. Radical cystectomy (RC) is the standard of care for nonmetastatic muscle-invasive bladder cancer, however little is known regarding outcomes in this population. MATERIALS AND METHODS: The United States Renal Disease System database was used to identify all patients on hemodialysis who underwent RC for bladder cancer in the United States between 1984 and 2013...
January 21, 2018: Urologic Oncology
https://www.readbyqxmd.com/read/29377282/impact-of-intraoperative-cytokine-adsorption-on-outcome-of-patients-undergoing-orthotopic-heart-transplantation-an-observational-study
#11
Endre Nemeth, Eniko Kovacs, Kristof Racz, Adam Soltesz, Szabolcs Szigeti, Nikolett Kiss, Gergely Csikos, Kinga B Koritsanszky, Viktor Berzsenyi, Gabor Trembickij, Szabolcs Fabry, Zoltan Prohaszka, Bela Merkely, Janos Gal
AIM: The aim of this study was to assess the influence of intraoperative cytokine adsorption on the perioperative vasoplegia, inflammatory response and outcome during orthotopic heart transplantation (OHT). METHODS: Eighty-four OHT patients were separated into the cytokine adsorption (CA)-treated group or controls. Vasopressor demand, inflammatory response described by procalcitonin and C-reactive protein, and postoperative outcome were assessed performing propensity score matching...
January 29, 2018: Clinical Transplantation
https://www.readbyqxmd.com/read/29357404/robot-assisted-partial-nephrectomy-for-large-renal-masses-a-multi-institutional-series
#12
Joan C Delto, David Paulucci, Michael W Helbig, Ketan K Badani, Daniel Eun, James Porter, Ronney Abaza, Ashok K Hemal, Akshay Bhandari
OBJECTIVES: To compare peri-operative outcomes after robot-assisted partial nephrectomy (RAPN) for cT2a (7 to <10 cm) to cT1 tumours. MATERIALS AND METHODS: Patients with a cT1a (n = 1 358, 76.4%), cT1b (n = 379, 21.3%) or cT2a (n = 41, 2.3%) renal mass were identified from a multi-institutional RAPN database. Intra- and postoperative outcomes were compared for cT2a masses vs cT1a and cT1b masses using multivariable regression models (linear, logistic, Poisson etc...
January 22, 2018: BJU International
https://www.readbyqxmd.com/read/29336383/perioperative-renal-protection-during-cardiac-surgery-a-choice-between-dopamine-and-dexmedetomidine
#13
EDITORIAL
Rajinder Singh Rawat, Said Musallam Al Maashani
No abstract text is available yet for this article.
January 2018: Annals of Cardiac Anaesthesia
https://www.readbyqxmd.com/read/29286569/patterns-of-kidney-injury-in-pediatric-nonkidney-solid-organ-transplant-recipients
#14
C Williams, K Borges, T Banh, J Vasilevska-Ristovska, R Chanchlani, V L Ng, A I Dipchand, M Solomon, D Hebert, S J Kim, B C Astor, R S Parekh
The incidence of acute kidney injury (AKI) and its impact on chronic kidney disease (CKD) following pediatric nonkidney solid organ transplantation is unknown. We aimed to determine the incidence of AKI and CKD and examine their relationship among children who received a heart, lung, liver, or multiorgan transplant at the Hospital for Sick Children between 2002 and 2011. AKI was assessed in the first year posttransplant. Among 303 children, perioperative AKI (within the first week) occurred in 67% of children, and AKI after the first week occurred in 36%, with the highest incidence among lung and multiorgan recipients...
December 29, 2017: American Journal of Transplantation
https://www.readbyqxmd.com/read/29232025/hospital-volume-and-outcomes-of-robot-assisted-partial-nephrectomy
#15
Leilei Xia, Jose E Pulido, Raju R Chelluri, Marshall C Strother, Benjamin L Taylor, Jay D Raman, Thomas J Guzzo
OBJECTIVE: To evaluate the impact of hospital volume on outcomes of robot-assisted partial nephrectomy (RAPN). MATERIALS AND METHODS: Patients with renal cell carcinoma who underwent RAPN between 2010 and 2013 were identified in the National Cancer Database. Hospital yearly RAPN volume was categorized into groups by sorting patients as closely as possible into five groups of equal size (quintiles): very low; low; medium; high; and very high volume. Outcomes included 30-day mortality, 90-day mortality, open conversion, prolonged length of hospital stay (PLOS; defined as >3 days), 30-day readmission rate, and positive surgical margin (PSM) rate...
December 12, 2017: BJU International
https://www.readbyqxmd.com/read/29145723/statin-initiation-and-renal-outcomes-following-isolated-coronary-artery-bypass-grafting-a-meta-analysis
#16
Yushu Wang, Sui Zhu, Rongsheng Du, Juteng Zhou, Yucheng Chen, Qing Zhang
BACKGROUND: The effects of preoperative statin therapy (PST) on renal outcomes in patients with isolated coronary artery bypass grafting (CABG) are in controversial. This study aimed to assess the effects of preoperative statin use on postoperative renal outcomes in patients undergoing isolated CABG. METHODS: PubMed, EMBASE, and Cochrane Library were searched for studies published up to February 2017. Pooled odds ratio (OR) and its corresponding 95% confidence interval (95% CI) were calculated...
November 16, 2017: Journal of Cardiovascular Surgery
https://www.readbyqxmd.com/read/29132469/-clinical-characteristics-and-prognostic-analysis-of-children-with-congenital-heart-disease-complicated-by-postoperative-acute-kidney-injury
#17
Lian Duan, Guo-Huang Hu, Meng Jiang, Cheng-Liang Zhang
OBJECTIVE: To analyze the perioperative clinical data of children with congenital heart disease complicated by acute kidney injury (AKI) after cardiopulmonary bypass (CPB) surgery, and to explore potential factors influencing the prognosis. METHODS: A retrospective analysis was performed among 118 children with congenital heart disease who developed AKI within 48 hours after CPB surgery. RESULTS: In the 118 patients, 18 died after 48 hours of surgery...
November 2017: Zhongguo Dang Dai Er Ke za Zhi, Chinese Journal of Contemporary Pediatrics
https://www.readbyqxmd.com/read/29131005/a-review-of-anesthetic-effects-on-renal-function-potential-organ-protection
#18
Negar Motayagheni, Sheshanna Phan, Crystal Eshraghi, Ala Nozari, Anthony Atala
BACKGROUND: Renal protection is a critical concept for anesthesiologists, nephrologists, and urologists, since anesthesia and renal function are highly interconnected and can potentially interfere with one another. Therefore, a comprehensive understanding of anesthetic drugs and their effects on renal function remains fundamental to the success of renal surgeries, especially transplant procedures. Some experimental studies have shown that some anesthetics provide protection against renal ischemia/reperfusion (IR) injury, but there is limited clinical evidence...
2017: American Journal of Nephrology
https://www.readbyqxmd.com/read/29062582/effect-of-remote-ischemic-preconditioning-on-perioperative-cardiac-events-in-patients-undergoing-elective-percutaneous-coronary-intervention-a-meta-analysis-of-16-randomized-trials
#19
REVIEW
Xiangming Wang, Na Kong, Chuanwei Zhou, Deeraj Mungun, Zakaria Iyan, Yan Guo, Zhijian Yang
BACKGROUND: The main objective of this meta-analysis was to investigate whether remote ischemic preconditioning (RIPC) reduces cardiac and renal events in patients undergoing elective cardiovascular interventions. METHODS AND RESULTS: We systematically searched articles published from 2006 to 2016 in PubMed, EMBASE, Web of Science, Cochrane Library, and Google Scholar. Odds ratios (ORs) with 95% confidence intervals (CIs) were used as the effect index for dichotomous variables...
2017: Cardiology Research and Practice
https://www.readbyqxmd.com/read/28976070/palliative-and-end-of-life-care-in-solid-organ-transplantation
#20
REVIEW
K Wentlandt, A Weiss, E O'Connor, E Kaya
Palliative care is an interprofessional approach that focuses on quality of life of patients who are facing life-threatening illness. Palliative care is consistently associated with improvements in advance care planning, patient and caregiver satisfaction, quality of life, symptom burden, and lower healthcare utilization. Most transplant patients have advanced chronic disease, significant symptom burden, and mortality awaiting transplant. Transplantation introduces new risks including perioperative death, organ rejection, infection, renal insufficiency, and malignancy...
December 2017: American Journal of Transplantation
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