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https://www.readbyqxmd.com/read/28742758/the-effect-of-an-adjustable-hinged-operating-table-on-lumbar-lordosis-during-lumbar-surgery
#1
Arjun Sebastian, Amin Ahmed, Brian Vernon, Emily C Nguyen, Ilyas Aleem, Michelle J Clarke, Bradford L Currier, Paul Anderson, Mohamad Bydon, Ahmad Nassr
STUDY DESIGN: Prospective observational study OBJECTIVES.: Quantify the amount of lumbar lordosis achieved on a hinged operative table in neutral, flexion, and extension. SUMMARY OF BACKGROUND DATA: Hinged operative tables may allow surgeons to adjust lumbar spine positioning intraoperatively. The amount of lumbar lordosis in neutral, flexion, and extension positions has not been quantified prospectively using a hinged table. METHODS: Thirty patients undergoing elective lumbar surgery were enrolled...
July 24, 2017: Spine
https://www.readbyqxmd.com/read/28742736/comparative-analysis-of-perioperative-outcomes-using-nationally-derived-hospital-discharge-data-relative-to-a-prospective-multicenter-surgical-database-of-adult-spinal-deformity-surgery
#2
Gregory W Poorman, Peter G Passias, Aaron J Buckland, Cyrus M Jalai, Michael Kelly, Daniel M Sciubba, Brian J Neuman, D Kojo Hamilton, Amit Jain, Bassel Diebo, Virginie Lafage, Shay Bess, Eric O Klineberg
STUDY DESIGN: Retrospective analysis of three prospectively collected databases. OBJECTIVE: To compare perioperative outcomes in Adult Spinal Deformity (ASD) surgeries in a surgeon-run (SR-ASD) and two national databases: the Nationwide Inpatient Sample (NIS) and the National Surgical Quality Improvement Program (NSQIP). SUMMARY OF BACKGROUND DATA: Much has been learned on the treatment of ASD in the last decade with prospective multicenter collaborative research focusing on this specific condition...
August 1, 2017: Spine
https://www.readbyqxmd.com/read/28742711/readiness-of-us-general-surgery-residents-for-independent-practice
#3
Brian C George, Jordan D Bohnen, Reed G Williams, Shari L Meyerson, Mary C Schuller, Michael J Clark, Andreas H Meier, Laura Torbeck, Samuel P Mandell, John T Mullen, Douglas S Smink, Rebecca E Scully, Jeffrey G Chipman, Edward D Auyang, Kyla P Terhune, Paul E Wise, Jennifer N Choi, Eugene F Foley, Justin B Dimick, Michael A Choti, Nathaniel J Soper, Keith D Lillemoe, Joseph B Zwischenberger, Gary L Dunnington, Debra A DaRosa, Jonathan P Fryer
OBJECTIVE: This study evaluates the current state of the General Surgery (GS) residency training model by investigating resident operative performance and autonomy. BACKGROUND: The American Board of Surgery has designated 132 procedures as being "Core" to the practice of GS. GS residents are expected to be able to safely and independently perform those procedures by the time they graduate. There is growing concern that not all residents achieve that standard. Lack of operative autonomy may play a role...
July 24, 2017: Annals of Surgery
https://www.readbyqxmd.com/read/28742702/trends-on-axillary-surgery-in-nondistant-metastatic-breast-cancer-patients-treated-between-2011-and-2015-a-dutch-population-based-study-in-the-acosog-z0011-and-amaros-era
#4
Ingrid G M Poodt, Pauline E R Spronk, Guusje Vugts, Thijs van Dalen, M T F D Vrancken Peeters, Marjolijn L Rots, Anne Kuijer, Grard A P Nieuwenhuijzen, Robert-Jan Schipper
OBJECTIVES: To evaluate patterns of care in axillary surgery for Dutch clinical T1-4N0M0 (cT1-4N0M0) breast cancer patients and to assess the effect of the American College for Surgeons Oncology Group (ACOSOG)-Z0011 and After Mapping of the Axilla: Radiotherapy Or Surgery (AMAROS) trial on axillary surgery patterns in Dutch cT1-2N0M0 sentinel node positive breast cancer patients. BACKGROUND: Since publication of the ACOSOG-Z0011 and AMAROS trial, omitting a completion axillary lymph node dissection (cALND) in sentinel node positive breast cancer patients is proposed in selected patients...
July 24, 2017: Annals of Surgery
https://www.readbyqxmd.com/read/28742701/postoperative-delirium-as-a-target-for-surgical-quality-improvement
#5
Julia R Berian, Lynn Zhou, Marcia M Russell, Melissa A Hornor, Mark E Cohen, Emily Finlayson, Clifford Y Ko, Ronnie A Rosenthal, Thomas N Robinson
OBJECTIVE: To explore hospital-level variation in postoperative delirium using a multi-institutional data source. BACKGROUND: Postoperative delirium is closely related to serious morbidity, disability, and death in older adults. Yet, surgeons and hospitals rarely measure delirium rates, which limits quality improvement efforts. METHODS: The American College of Surgeons National Surgical Quality Improvement Program (ACS NSQIP) Geriatric Surgery Pilot (2014 to 2015) collects geriatric-specific variables, including postoperative delirium using a standardized definition...
July 24, 2017: Annals of Surgery
https://www.readbyqxmd.com/read/28742695/does-surgeon-sex-matter-practice-patterns-and-outcomes-of-female-and-male-surgeons
#6
Catherine E Sharoky, Morgan M Sellers, Luke J Keele, Christopher J Wirtalla, Giorgos C Karakousis, Jon B Morris, Rachel R Kelz
OBJECTIVE: We sought to compare postoperative outcomes of female surgeons (FS) and male surgeons (MS) within general surgery. SUMMARY OF BACKGROUND DATA: FS in the workforce are increasing in number. Female physicians provide exceptional care in other specialties. Differences in surgical outcomes of FS and MS have not been examined. METHODS: We linked the AMA Physician Masterfile to discharge claims from New York, Florida, and Pennsylvania (2012 to 2013) to examine practice patterns and to compare surgical outcomes of FS and MS...
July 24, 2017: Annals of Surgery
https://www.readbyqxmd.com/read/28742681/targeting-value-driven-quality-improvement-for-laparoscopic-cholecystectomy-in-michigan
#7
Kyle H Sheetz, Brooke Kenney, James M Dupree, Darrell A Campbell, Michael J Englesbe
OBJECTIVE: The purpose of this study was to evaluate complete episode expenditures for laparoscopic cholecystectomy, a common and lower-risk operation, to characterize novel targets for value-based quality improvement. SUMMARY BACKGROUND DATA: Despite enthusiasm for improving the overall value of surgical care, most efforts have focused on high-risk inpatient surgery. METHODS: We identified 19,213 patients undergoing elective laparoscopic cholecystectomy from 2012 to 2015 using data from Medicare and a large private payer...
July 24, 2017: Annals of Surgery
https://www.readbyqxmd.com/read/28742116/sutureless-microvascular-anastomosis-assisted-by-an-expandable-shape-memory-alloy-stent
#8
Noriko Saegusa, Shunji Sarukawa, Kunihiro Ohta, Kensuke Takamatsu, Mitsuhiro Watanabe, Takashi Sugino, Masahiro Nakagawa, Yasuto Akiyama, Masatoshi Kusuhara, Kazuo Kishi, Keita Inoue
Vascular anastomosis is the highlight of cardiovascular, transplant, and reconstructive surgery, which has long been performed by hand using a needle and suture. However, anastomotic thrombosis occurs in approximately 0.5-10% of cases, which can cause serious complications. To improve the surgical outcomes, attempts to develop devices for vascular anastomosis have been made, but they have had limitations in handling, cost, patency rate, and strength at the anastomotic site. Recently, indwelling metal stents have been greatly improved with precise laser metalwork through programming technology...
2017: PloS One
https://www.readbyqxmd.com/read/28742011/toward-late-career-transitioning-a-proposal-for-academic-surgeons
#9
Robin Richards, Robin McLeod, David Latter, Shaf Keshavjee, Ori Rotstein, Michael G Fehlings, Najma Ahmed, Avery Nathens, James Rutka
In the absence of a defined retirement age, academic surgeons need to develop plans for transition as they approach the end of their academic surgical careers. The development of a plan for late career transition represents an opportunity for departments of surgery across Canada to initiate a constructive process in cooperation with the key stakeholders in the hospital or institution. The goal of the process is to develop an individual plan for each faculty member that is agreeable to the academic surgeon; informs the surgical leadership; and allows the late career surgeon, the hospital, the division and the department to make plans for the future...
August 1, 2017: Canadian Journal of Surgery. Journal Canadien de Chirurgie
https://www.readbyqxmd.com/read/28741439/rudolf-ulrich-kr%C3%A3-nlein-1847-1910-an-innovative-general-thoracic-neuro-and-ocular-surgeon
#10
Konstantinos Laios
The Swiss Professor Rudolf Ulrich Krönlein (1847-1910) was a pioneer in many fields of surgery, because he succeeded in introducing many innovations in different fields of surgery, for example, general surgery, thoracic surgery, neurosurgery, and ocular surgery. He was a reputable Professor of Surgery at Zurich University and was nominated for Nobel Prize in 1902.
July 1, 2017: Surgical Innovation
https://www.readbyqxmd.com/read/28741396/intraoperative-nerve-monitoring-reduces-recurrent-laryngeal-nerve-injury-in-geriatric-patients-undergoing-thyroid-surgery
#11
Huang Kai, Lin Xixia, Long Miaoyun, Chen Qinchang, Peng Xinzhi, Luo Dingyuan, Li Honghao
OBJECTIVE: This research was aimed to investigate whether the intraoperative nerve monitoring (IONM) can reduce the incidence of recurrent laryngeal nerve (RLN) injury in geriatric patients undergoing thyroid surgery. METHODS: This retrospective cohort study included 522 geriatric patients undergoing thyroid surgery between January 2013 and June 2016 in the Sun Yat-sen Memorial Hospital. Patients with IONM during the surgery (n = 340) were compared with patients without IONM (n = 212)...
July 25, 2017: Acta Oto-laryngologica
https://www.readbyqxmd.com/read/28741249/ambroise-par%C3%A3-1510-1590-on-the-diagnosis-and-treatment-of-shoulder-dislocations
#12
REVIEW
Konstantinos Markatos, Marianna Karamanou, Gerasimos Tsourouflis, Georgios Androutsos, Andreas F Mavogenis
AIM OF STUDY: This article aims to summarize the treatment methods for shoulder dislocations supported by Ambroise Paré, and his clinical and academic contribution to this subject. INTRODUCTION: Ambroise Paré (1510-1590) was one of the most prominent surgeons of his time, and one of the most significant innovators of the Renaissance in the fields of military operation, bandages, wound healing, bloodletting, close blood vessels techniques and cesarean section. For many, he is considered "the Father of Modern Surgery"...
July 24, 2017: International Orthopaedics
https://www.readbyqxmd.com/read/28741198/significance-of-body-mass-index-for-postoperative-outcomes-after-lung-cancer-surgery-in-elderly-patients
#13
Katsunari Matsuoka, Tetsu Yamada, Takahisa Matsuoka, Shinjiro Nagai, Mitsuhiro Ueda, Yoshihiro Miyamoto
BACKGROUND: Although the frequency of elderly patients undergoing surgery for lung cancer has been increasing, indications for surgery in elderly patients are still controversial. Low body mass index is a significant predictor of poor prognosis in elderly patients with various medical conditions. Then, we examined the long-term outcome of elderly patients who had undergone thoracic surgery for lung cancer, focusing especially on body mass index. PATIENTS AND METHODS: Between January 2004 and March 2011, 1673 patients with lung cancer underwent surgical resection at our institution...
July 24, 2017: World Journal of Surgery
https://www.readbyqxmd.com/read/28741197/axillobifemoral-bypasses-reappraisal-of-an-extra-anatomic-bypass-by-analysis-of-results-and-prognostic-factors
#14
D Dickas, F Verrel, J Kalff, A Koscielny
BACKGROUND: Axillobifemoral bypass (AFB) is method of second choice. It is reserved for patients at high operative risk or to bypass infected vessels or grafts. In this study, we analyzed prognostic factors for AFB patency and limb salvage rate to facilitate the choice of procedure. METHODS: Between Jan 2006 and Aug 2013, 45 patients underwent AFB surgery in our department, 24 for critical limb ischemia (CLI) and 23 for infection. Endpoints of study were graft occlusion, graft infection, amputation and patient's death...
July 24, 2017: World Journal of Surgery
https://www.readbyqxmd.com/read/28741193/burr-hole-craniostomy-for-chronic-subdural-hematomas-by-general-surgeons-in-rural-kenya
#15
John K Kanyi, Timothy V Ogada, Mark J Oloo, Robert K Parker
INTRODUCTION: Chronic subdural hematoma (cSDH) is a common condition that causes significant morbidity and mortality. In rural sub-Saharan Africa, there are very few neurosurgeons. Yet, cSDH is treatable by relatively simple surgical intervention with potential for rapid clinical improvement. METHODS: We conducted a retrospective chart review of all patients with cSDH who underwent burr-hole trephination at Tenwek Hospital, Kenya, between July 2014 and July 2016...
July 24, 2017: World Journal of Surgery
https://www.readbyqxmd.com/read/28740974/wound-closure-and-wound-healing-suture-techniques-in-contemporary-periodontal-and-implant-surgery-interactions-requirements-and-practical-considerations
#16
Otto Zuhr, Dodji Lukas Akakpo, Markus Hürzeler
In contemporary reconstructive periodontal and implant surgery, attaining uncomplicated wound healing in the early postoperative healing phase is the key to achieving a successful treatment outcome and is of central interest, from the clinical as well as the scientific perspective. The realization of primary wound healing is the central challenge in most cases. Two of the evidence-based factors that affect postoperative wound healing can be influenced by the surgeon: the blood supply to the surgical site and postoperative wound stability...
July 20, 2017: Quintessence International
https://www.readbyqxmd.com/read/28740949/good-surgeon-a-search-for-meaning
#17
REVIEW
Andrey L Akopov, Dmitri Y Artioukh
The art and philosophy of surgery are not as often discussed as scientific discoveries and technological advances in the modern era of surgery. Although these are difficult to teach and pass on to the next generations of surgeons they are no less important for training good surgeons and maintaining their high standards. The authors of this review and opinion article tried to define what being a good surgeon really means and to look into the subject by analysing the essential conditions for being a good surgeon and the qualities that such a specialist should possess...
2017: Turk J Surg
https://www.readbyqxmd.com/read/28740890/satisfaction-of-breast-cancer-patients-regarding-surgery-and-radiation-therapy-a-survey-in-japan
#18
Anneyuko I Saito, Masaru Suda, Keisuke Sasai, Reshma Jagsi
PURPOSE: To evaluate patient satisfaction in Japan and factors, including timing factors, cost, and specific medical practices derived from Western influence (shared decision-making and second opinion), which might affect satisfaction. METHODS AND MATERIALS: All patients who presented to 1 large Japanese department of radiation oncology for postoperative radiation therapy for breast cancer from September 2010 to November 2013 were included in this study. The questionnaire was distributed to patients after the radiation oncologist consultation, and patients were asked to complete it anonymously by the end of treatment...
October 2016: Advances in Radiation Oncology
https://www.readbyqxmd.com/read/28740847/fournier-s-gangrene-lessons-learned-from-multimodal-and-multidisciplinary-management-of-perineal-necrotizing-fasciitis
#19
Orestis Ioannidis, Loukiani Kitsikosta, Dimitris Tatsis, Ioannis Skandalos, Aggeliki Cheva, Aikaterini Gkioti, Ioannis Varnalidis, Savvas Symeonidis, Natalia Antigoni Savvala, Styliani Parpoudi, George K Paraskevas, Manousos George Pramateftakis, Efstathios Kotidis, Ioannis Mantzoros, Konstantinos George Tsalis
BACKGROUND: Fournier's gangrene (FG) is a rapidly evolving necrotizing fasciitis of the perineum and the genital area, the scrotum as it most commonly affects man in the vast majority of cases. It is polymicrobial in origin, due to the synergistic action of anaerobes and aerobes and has a very high mortality. There are many predisposing factors including diabetes mellitus, alcoholism, immunosuppression, renal, and hepatic disease. The prognosis of the disease depends on a lot of factors including but not limited to patient age, disease extent, and comorbidities...
2017: Frontiers in Surgery
https://www.readbyqxmd.com/read/28740765/lipoabdominoplasty-with-progressive-traction-sutures
#20
Javier Vera Cucchiaro, Horacio Lostia, Patricia Velazquez, Elizabeth Liska
BACKGROUND: Proactively preserving Scarpa's fascia and thus its intrinsic lymphatic drainage and tensile strength for suture placement can eliminate the need for drains after lipoabdominoplasty and therefore reduce the rate of seroma development. In this article, we describe the effectiveness of a modified progressive traction suture (PTS) technique, which enables us to lessen the most common complications and avoid hospital readmission; these sutures take 3-5 minutes of additional surgery time...
June 2017: Plastic and Reconstructive Surgery. Global Open
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