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https://www.readbyqxmd.com/read/28647788/the-efficacy-and-safety-of-two-low-dose-peri-operative-dexamethasone-on-pain-and-recovery-following-total-hip-arthroplasty-a-randomized-controlled-trial
#1
Yi-Ting Lei, Bin Xu, Xiao-Wei Xie, Jin-Wei Xie, Qiang Huang, Fu-Xing Pei
PURPOSE: To evalute the efficacy and safety of two low-dose peri-operative dexamethasone on pain and recovery following total hip arthroplasty (THA). METHODS: One hundred ten patients received two-dose of 10 mg IV-dexamethasone (group dexa) or IV-isotonic saline (group placebo). The level of C-reactive protein (CRP) and interleukin-6 (IL-6), pain at rest and during mobilization, incidence of post-operative nausea and vomiting (PONV), intensity of nausea, post-operative fatigue, consumption of analgesic and antiemetic rescue, range of motion (ROM), post-operative length of stay (post-operative LOS), wound problems and complications were recorded and compared...
June 25, 2017: International Orthopaedics
https://www.readbyqxmd.com/read/28647562/post-operative-complications-of-spina-bifida-patients-undergoing-urological-laparotomy-a-multi-institutional-analysis
#2
Christopher J Loftus, David C Moore, Joshua A Cohn, Douglas F Milam, Roger R Dmochowski, Dan Wood, Melissa R Kaufman, Hadley M Wood
OBJECTIVE: To characterize peri-operative morbidity and mortality of adult spina bifida patients undergoing laparotomy. METHODS: We retrospectively studied the post-operative complications of 59 operations of spina bifida patients undergoing abdominal laparotomies for urological indications at three institutions. We evaluated post-operative complications using the Clavien-Dindo classification scale. RESULTS: The overall complication rate was 91...
June 21, 2017: Urology
https://www.readbyqxmd.com/read/28643075/a-standardized-comparison-of-peri-operative-complications-after-minimally-invasive-esophagectomy-ivor-lewis-versus-mckeown
#3
Andrew M Brown, Michael J Pucci, Adam C Berger, Talar Tatarian, Nathaniel R Evans, Ernest L Rosato, Francesco Palazzo
BACKGROUND: While our institutional approach to esophageal resection for cancer has traditionally favored a minimally invasive (MI) 3-hole, McKeown esophagectomy (MIE 3-hole) during the last five years several factors has determined a shift in our practice with an increasing number of minimally invasive Ivor Lewis (MIE IL) resections being performed. We compared peri-operative outcomes of the two procedures, hypothesizing that MIE IL would be less morbid in the peri-operative setting compared to MIE 3-hole...
June 22, 2017: Surgical Endoscopy
https://www.readbyqxmd.com/read/28642109/neoaortic-xenoprosthetic-grafts-for-treatment-of-mycotic-aneurysms-and-infected-aortic-grafts
#4
C Anibueze, V Sankaran, U Sadat, K Tan, Y G Wilson, R E Brightwell, M S Delbridge, P W Stather
OBJECTIVE: There is no international consensus regarding the optimum management of infected aortae (mycotic aneurysms, infected aortic grafts). Neoaortoiliac reconstruction has advantages over extra anatomical bypass grafting; however use of autologous vein is associated with venous hypertension and compartment syndrome, alternatively cadaveric homografts are associated with high rates of perianastomotic haemorrhage, limb occlusion and pseudoaneurysm. Arterial repair using xenoprosthetic patches is associated with lower infection rates compared to the use of prosthetic material...
June 19, 2017: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/28639296/pathways-to-professionalism-quality-improvement-care-pathways-and-the-interplay-of-standardisation-and-clinical-autonomy
#5
Graham P Martin, David Kocman, Timothy Stephens, Carol J Peden, Rupert M Pearse
Care pathways are a prominent feature of efforts to improve healthcare quality, outcomes and accountability, but sociological studies of pathways often find professional resistance to standardisation. This qualitative study examined the adoption and adaptation of a novel pathway as part of a randomised controlled trial in an unusually complex, non-linear field - emergency general surgery - by teams of surgeons and physicians in six theoretically sampled sites in the UK. We find near-universal receptivity to the concept of a pathway as a means of improving peri-operative processes and outcomes, but concern about the impact on appropriate professional judgement...
June 21, 2017: Sociology of Health & Illness
https://www.readbyqxmd.com/read/28636771/is-transvaginal-contained-tissue-extraction-for-everyone
#6
Charles Miller
Professor Ghezzi, et al. should be congratulated for their excellent manuscript "Transvaginal Contained Tissue Extraction After Laparoscopic Myomectomy: A Cohort Study". This is a well-conceived, well-written retrospective cohort study describing operative and peri-operative outcomes for patients who have undergone transvaginal morcellation via a posterior colpotomy. Given the continued controversy regarding electronic power morcellation leading to restriction of use in certain areas, this study is not only impactful, in that it describes an alternative technique with data accumulated over a decade of experience, but it describes a technique of contained morcellation that is neither based on the controversial power morcellation, nor the mini-laparotomy (https://www...
June 21, 2017: BJOG: An International Journal of Obstetrics and Gynaecology
https://www.readbyqxmd.com/read/28634014/chemotherapy-for-resected-colorectal-cancer-pulmonary-metastases-utilization-and-outcomes-in-routine-clinical-practice
#7
S Karim, S Nanji, K Brennan, C S Pramesh, C M Booth
BACKGROUND: The role of chemotherapy in the setting of resected colorectal cancer pulmonary metastases (CRCPM) is not well defined. Here we describe utilization of peri-operative chemotherapy and outcomes among patients with resected CRCPM in the general population. METHODS: All cases of CRCPM who underwent resection from 2002 to 2009 were identified using the Ontario Cancer Registry (OCR). Electronic treatment records identified peri-operative chemotherapy delivered within 16 weeks before or after pulmonary metastasectomy (PM)...
June 1, 2017: European Journal of Surgical Oncology
https://www.readbyqxmd.com/read/28631121/-prudent-use-of-antimicrobial-prophylaxis-prevention-of-increasing-antibiotic-resistance
#8
REVIEW
C Hein, A Pilatz, F M E Wagenlehner
BACKGROUND: The use of peri-operative antimicrobial prophylaxis during urological procedures to prevent postoperative complications is very common. OBJECTIVES: What kind of recommendations for reasonable use of peri-operative antimicrobial prophylaxis during urological procedures to prevent increasing antibiotic resistance and postoperative complications exist? METHODS: Review of evidence-based recommendations from literature and current Guidelines of the EAU...
June 19, 2017: Der Urologe. Ausg. A
https://www.readbyqxmd.com/read/28630756/fast-track-in-hip-arthroplasty
#9
Torben Bæk Hansen
'Fast-track' surgery was introduced more than 20 years ago and may be defined as a co-ordinated peri-operative approach aimed at reducing surgical stress and facilitating post-operative recovery.The fast-track programmes have now been introduced into total hip arthroplasty (THA) surgery with reduction in post-operative length of stay, shorter convalescence and rapid functional recovery without increased morbidity and mortality. This has been achieved by focusing on a multidisciplinary collaboration and establishing 'fast-track' units, with a well-defined organisational set-up tailored to deliver an accelerated peri-operative course of fast-track surgical THA procedures...
May 2017: EFORT open reviews
https://www.readbyqxmd.com/read/28630739/danish-hip-arthroscopy-registry-dhar-the-outcome-of-patients-with-femoroacetabular-impingement-fai
#10
Bent Lund, Bjarne Mygind-Klavsen, Torsten Grønbech Nielsen, Niels Maagaard, Otto Kraemer, Per Hölmich, Søren Winge, Martin Lind
The Danish Hip Arthroscopy Registry (DHAR) was initiated in January 2012 as a web-based prospective registry. The purpose of this study was to evaluate and report the first registry based outcome data of a national population with radiological and clinical femoroacetabular impingement (FAI) undergoing hip arthroscopic treatment. Our primary hypothesis was that patients undergoing hip arthroscopy would improve significantly in pain, quality of life and sports related outcome measurements in Patient Related Outcome Measures (PROM)...
July 2017: Journal of Hip Preservation Surgery
https://www.readbyqxmd.com/read/28624106/alcohol-use-and-smoking-after-liver-transplantation-complications-and-prevention
#11
REVIEW
José Ursic-Bedoya, Hélène Donnadieu-Rigole, Stéphanie Faure, Georges-Philippe Pageaux
The last thirty years have been very prosperous in the field of liver transplantation (LT), with great advances in organ conservation, surgical techniques, peri-operative management and long-term immunosuppression, resulting in improved patient and graft survival rates as well as quality of life. However, substance addiction after LT, namely alcohol and tobacco, results in short term morbidity together with medium and long-term mortality. The main consequences can be vascular (increased risk of hepatic artery thrombosis in smokers), hepatic (recurrent alcoholic cirrhosis in alcohol relapsers) and oncological (increased risk of malignancy in patients consuming tobacco and/or alcohol after LT)...
April 2017: Best Practice & Research. Clinical Gastroenterology
https://www.readbyqxmd.com/read/28621510/laparoscopic-cholecystectomy-for-acute-cholecystitis-an-analysis-of-early-versus-delayed-cholecystectomy-and-predictive-factors-for-conversion
#12
Joel C Goh, Jarrod K Tan, Janice W Lim, Iyer G Shridhar, Krishnakumar Madhavan, Alfred W Kow
BACKGROUND: There is an increasing preference for early laparoscopic cholecystectomy (ELC) as compared to delayed LC (DLC) in the management of acute cholecystitis (AC). Conversion to open cholecystectomy (LOC) remains an important outcome. We aim to compare ELC and DLC outcomes and identify LOC predictors. METHODS: Retrospective analysis of 466 patients who underwent LC for AC from June 2010 - June 2015 was performed. Patients were divided into ELC and DLC groups, defined as LC performed within 7 days and between 4 to 24 weeks of symptom onset respectively...
June 16, 2017: Minerva Chirurgica
https://www.readbyqxmd.com/read/28618177/assessing-the-quality-of-primary-care-referrals-to-surgery-of-patients-with-diabetes-in-the-east-of-england-a-multi-centre-cross-sectional-cohort-study
#13
Dimitri J Pournaras, Evangelos S Photi, Nicholas Barnett, Christopher P Challand, Nikolaos A Chatzizacharias, Nokwanda P Dlamini, Triantafyllos Doulias, Aoibhinn Foley, James Hernon, Bhaskar Kumar, Jack Martin, Ian Nunney, Ioanna Panagiotopoulou, Neel Sengupta, Oshini Shivakumar, Piriyah Sinclair, Phil Stather, Miriam M Than, Antonia C Wells, Athanasios Xanthis, Ketan Dhatariya
AIM: Peri-operative hyperglycaemia is associated with an increased incidence of adverse outcomes. Communication between primary and secondary care is paramount to minimise these harms. National guidance in the UK recommends that the glycated haemoglobin (HbA1c) should be measured within 3 months prior to surgery and that the concentration should be less that 69 mmol/mol (8.5%). In addition, national guidance outlines the minimum dataset that should be included in any letter at the time of referral to the surgeons...
June 15, 2017: International Journal of Clinical Practice
https://www.readbyqxmd.com/read/28613004/a-survey-of-uk-peri-operative-medicine-pre-operative-care
#14
A-M Bougeard, A Brent, M Swart, C Snowden
The majority of UK hospitals now have a Local Lead for Peri-operative Medicine (n = 115). They were asked to take part in an online survey to identify provision and practice of pre-operative assessment and optimisation in the UK. We received 86 completed questionnaires (response rate 75%). Our results demonstrate strengths in provision of shared decision-making clinics. Fifty-seven (65%, 95%CI 55.8-75.4%) had clinics for high-risk surgical patients. However, 80 (93%, 70.2-87.2%) expressed a desire for support and training in shared decision-making...
June 14, 2017: Anaesthesia
https://www.readbyqxmd.com/read/28607592/the-role-of-adjuvant-chemotherapy-for-colorectal-liver-metastasectomy-after-pre-operative-chemotherapy-is-the-treatment-worthwhile
#15
Yun Wang, Zhi-Qiang Wang, Feng-Hua Wang, Yun-Fei Yuan, Bin-Kui Li, Pei-Rong Ding, Gong Chen, Xiao-Jun Wu, Zhen-Hai Lu, Zhi-Zhong Pan, De-Sen Wan, Peng Sun, Shu-Mei Yan, Rui-Hua Xu, Yu-Hong Li
Peri-operative chemotherapy has been proposed to improve the survival of patients with colorectal cancer hepatic metastases (CRCHM). However, the role of the adjuvant chemotherapy post-metastasectomy for CRCHM patients who have undergone pre-operative chemotherapy is still undetermined. We retrospectively analyzed the role of adjuvant chemotherapy post-metastasectomy on relapse-free survival (RFS) and overall survival (OS) in 163 CRCHM patients who received pre-operative chemotherapy using a Kaplan-Meier curve and univariate/multiple Cox model...
2017: Journal of Cancer
https://www.readbyqxmd.com/read/28607286/morbidity-analysis-in-minimally-invasive-esophagectomy-for-oesophageal-cancer-versus-conventional-over-the-last-10-years-a-single-institution-experience
#16
Misbah Khan, Muhammad Ijaz Ashraf, Aamir Ali Syed, Shahid Khattak, Namra Urooj, Anam Muzaffar
BACKGROUND: There has been an increasing inclination towards minimally invasive esophagectomies (MIEs) at our institute recently for resectable oesophageal cancer. OBJECTIVES: The purpose of the present study is to report peri-operative and long-term procedure specific outcomes of the two groups and analyse their changing pattern at our institute. METHODS: All adult patients with a diagnosis of oesophageal cancer managed at our institute from 2005 to 2015 were included in this retrospective study...
July 2017: Journal of Minimal Access Surgery
https://www.readbyqxmd.com/read/28606776/extraperitoneal-laparoscopic-radical-nephroureterectomy-and-lymph-node-dissection-in-modified-supine-position
#17
Pengchao Li, Jun Tao, Xiaheng Deng, Chao Qin, Yidong Cheng, Peng Li, Jiexiu Zhang, Yongke Cao, Xiao Yang, Chengdi Yang, Qiang Lu
Objective To explore the feasibilty of extraperitoneal laparoscopic radical nephroureterectomy (RNU) and lymph node dissection in modified supine position for managing urothelial carcinomas in renal pelvis or upper 2/3 ureter. Subjects / Patients and Methods Consecutively from January 2014 to October 2015, 15 patients with high-risk urothelial carcinoma in renal pelvis or upper 2/3 ureter underwent extraperitoneal laparoscopic radical nephroureterectomy (EL-RNU) and extraperitoneal laparoscopic lymph node dissection (EL-LND)...
June 9, 2017: Urology
https://www.readbyqxmd.com/read/28599884/comparing-single-site-and-multiport-robotic-hysterectomy-with-sentinel-lymph-node-mapping-for-endometrial-cancer-surgical-outcomes-and-cost-analysis
#18
Lea A Moukarzel, Abdulrahman K Sinno, Amanda N Fader, Edward J Tanner
STUDY OBJECTIVE: To compare operative times, surgical outcomes, and costs of robotic laparo-endoscopic single-site (R-LESS) versus multiport robotic (MPR) total laparoscopic hysterectomy (TLH) with sentinel lymph node (SLN) mapping for low risk endometrial cancer. DESIGN: Retrospective cohort study (Canadian Task Force Classification Level II-2) SETTING: Academic university hospital PATIENTS: Patients with biopsy proven diagnosis of complex atypical hyperplasia (CAH) or low grade (1 or 2) endometrial cancer with body mass index less than 30 kg/m(2) and a undergoing robotic TLH and SLN mapping between 2012 and 2016 were included...
June 6, 2017: Journal of Minimally Invasive Gynecology
https://www.readbyqxmd.com/read/28595426/patients-perceptions-of-palliative-surgical-procedures-a-qualitative-analysis
#19
Trevor D Hamilton, Debbie Selby, Melanie E Tsang, Audrey Kim, Frances C Wright
BACKGROUND: Patients with incurable malignancies can require surgical intervention. We prospectively evaluated patients treated with palliative surgery to qualitatively assess peri-operative outcomes. METHODS: Eligible patients were assessed at a tertiary care cancer center. Demographic information and peri-operative morbidity and mortality were collected. Semi-structured qualitative interviews were obtained pre-operatively and post-operatively (1 month). Qualitative evaluation was performed using content analysis and an inductive approach...
February 14, 2017: Annals of Palliative Medicine
https://www.readbyqxmd.com/read/28593780/-complications-tension-free-vaginal-tape-surgery
#20
P Piškytlová
OBJECTIVE: A comprehensive overview of the potential complications associated with vaginal tape operations, which are commonly used in the treatment of stress urinary incontinence in women. DESIGN: Review article. SETTING: Department of Obstetrics and Gynecology, Oblastní nemocnice Kolín, a.s. METHODS: Using medical databases were searched articles dealing with complications tension-free vaginal tape procedures. In individual cases, complications were observed their causes and solutions...
2017: Ceská Gynekologie
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