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https://www.readbyqxmd.com/read/29141380/-the-analysis-of-anesthetic-management-for-renal-cell-carcinoma-with-associated-inferior-vena-cava-tumor-thrombus
#1
H Zeng, X Y Rong, Y Wang, X Y Guo
Objective: To explore the key points of anesthetic management for renal cell carcinoma combined with inferior vena cava (IVC) tumor thrombus. Methods: Twenty-seven cases of renal cell carcinoma with inferior vena cava (IVC) tumor thrombus underwent radical nephrectomy and inferior caval venous thrombectomy were reviewed retrospectively during January 2014 to January 2017 in our hospital.Analyzed data includs demographics, classification of tumor, perioperative anesthetic management and monitoring approaches, IVC clamping time , vital signs during cardiopulmonary bypass(CPB), estimated blood loss (EBL), usage of blood products, hospitalization time and ICU time , as well as postoperative outcomes...
November 14, 2017: Zhonghua Yi Xue za Zhi [Chinese medical journal]
https://www.readbyqxmd.com/read/29140848/mortality-trends-after-a-voluntary-checklist-based-surgical-safety-collaborative
#2
Alex B Haynes, Lizabeth Edmondson, Stuart R Lipsitz, George Molina, Bridget A Neville, Sara J Singer, Aunyika T Moonan, Ashley Kay Childers, Richard Foster, Lorri R Gibbons, Atul A Gawande, William R Berry
OBJECTIVE: To determine whether completion of a voluntary, checklist-based surgical quality improvement program is associated with reduced 30-day postoperative mortality. BACKGROUND: Despite evidence of efficacy of team-based surgical safety checklists in improving perioperative outcomes in research trials, effective methods of population-based implementation have been lacking. The Safe Surgery 2015 South Carolina program was designed to foster state-wide engagement of hospitals in a voluntary, collaborative implementation of a checklist program...
December 2017: Annals of Surgery
https://www.readbyqxmd.com/read/29140834/prognostic-factors-in-patients-with-metastatic-spinal-cord-compression-secondary-to-melanoma-a-systematic-review
#3
Nicholas J Hadden, Jerome R D McIntosh, Samuel Jay, Paula J Whittaker
Melanoma is one of the most common primary tumours associated with metastatic spinal cord compression (MSCC). The aim of this review is to identify prognostic factors specifically for MSCC secondary to melanoma. A systematic search of literature was performed in MEDLINE, Embase and the Cochrane Library to identify studies reporting prognostic factors for patients with MSCC secondary to melanoma. Two studies, involving a total of 39 patients, fulfilled the inclusion criteria. The variables associated with increased survival were receiving postoperative radiotherapy, receiving chemotherapy, perioperative lactate dehydrogenase level less than or equal to 8...
November 14, 2017: Melanoma Research
https://www.readbyqxmd.com/read/29140601/pilot-study-of-living-donor-liver-transplantation-for-patients-with-hcc-exceeding-milan-criteria-bclc-extended-criteria
#4
Josep M Llovet, Mihai Pavel, Jordi Rimola, Maria Alba Diaz, Jordi Colmenero, David Saavedra, Constantino Fondevila, Carmen Ayuso, Josep Fuster, Pere Ginès, Jordi Bruix, Juan Carlos Garcia Valdecasas
BACKGROUND & AIMS: A subset of patients with hepatocellular carcinoma (HCC) beyond Milan criteria might obtain acceptable survival outcomes after liver transplantation. Living donor liver transplantation (LDLT) has emerged as a feasible alternative to overcome the paucity of donors. METHODS: In 2001 we started a protocol for LDLT in Child A-B patients with HCC fulfilling a set of criteria - the BCLC expanded criteria- that expanded the conventional indications of transplantation: 1 tumor ≤ 7cm, 5 tumors ≤ 3cm, 3 tumors ≤ 5cm without macrovascular invasion or down-staging to Milan after loco-regional therapies...
November 15, 2017: Liver Transplantation
https://www.readbyqxmd.com/read/29140542/perioperative-von-willebrand-factor-dynamics-are-associated-with-liver-regeneration-and-predict-outcome-after-liver-resection
#5
Patrick Starlinger, David Pereyra, Stefanie Haegele, Paul Braeuer, Lukas Oehlberger, Florian Primavesi, Andreas Kohler, Florian Offensperger, Thomas Reiberger, Arnulf Ferlitsch, Barbara Messner, Guido Beldi, Stefan Staettner, Christine Brostjan, Thomas Gruenberger
Von Willebrand Factor (vWF) was found to mediate platelet influx during the early phase of liver regeneration in mice. Further, increased vWF-antigen (vWF-Ag) levels were shown to be predictive for outcome of patients with chronic liver disease. Accordingly, we aimed to assess the relevance of perioperative vWF-Ag dynamics in terms of liver regeneration and clinical outcome in patients undergoing liver resection (LR). Accordingly, we observed that vWF-Ag and its activity - estimated via ristocetin cofactor measurement - increased immediately after induction of liver regeneration and was associated with platelet accumulation within the liver...
November 15, 2017: Hepatology: Official Journal of the American Association for the Study of Liver Diseases
https://www.readbyqxmd.com/read/29139096/the-modified-frailty-index-and-30-day-adverse-events-in-oncologic-neurosurgery
#6
Brett E Youngerman, Alfred I Neugut, Jingyan Yang, Dawn L Hershman, Jason D Wright, Jeffrey N Bruce
The modified frailty index (mFI) is emerging as a leading measure for preoperative risk assessment using routinely available medical record data. Our objective was to determine if mFI predicts morbidity and mortality in the diverse national cohort of patients undergoing neurosurgery for intracranial neoplasms. We identified patients in the National Surgical Quality Improvement Program who underwent oncologic neurosurgery procedures between 2008 and 2012. The mFI, ranging from 0 to 1, was calculated as the proportion of 11 possible risk factors present...
November 14, 2017: Journal of Neuro-oncology
https://www.readbyqxmd.com/read/29139083/comparison-of-hepatectomy-for-patients-with-metabolic-syndrome-related-hcc-and-hbv-related-hcc
#7
Yunhong Tian, Huan Lyu, Yunhong He, Yong Xia, Jun Li, Feng Shen
BACKGROUND: Metabolic syndrome (MetS) is a group of clinicopathological manifestations. The outcome of liver surgery in metabolic syndrome-related hepatocellular carcinoma (MetS-HCC) still needs to be evaluated. We aim to clarify the outcomes following liver resection in patients with MetS-HCC compared those with hepatitis B virus-related HCC (HBV-HCC). METHODS: All the consecutive patients undergoing hepatectomy for HCC between January 2009 and December 2012 were retrospectively considered...
November 14, 2017: Journal of Gastrointestinal Surgery: Official Journal of the Society for Surgery of the Alimentary Tract
https://www.readbyqxmd.com/read/29138974/medical-complications-and-mortality-in-octogenarians-undergoing-elective-spinal-fusion-surgeries
#8
Sharad Rajpal, E Lee Nelson, Alan T Villavicencio, Jayratna Telang, Roshan Kantha, Kara Beasley, Sigita Burneikiene
BACKGROUND: The consequences of suffering postoperative complications in elderly undergoing spinal surgeries may be different compared to younger patients. The primary objective of this study was to identify the types and frequency of medical complications and mortality rates in patients 80 years of age or older undergoing elective spinal fusion surgeries for degenerative spinal disease. METHODS: A prospective observational study with a retrospective chart review was performed, which included all consecutive patients ≥80 years old undergoing elective spinal fusion surgeries from May 2012 to August 2015...
November 14, 2017: Acta Neurochirurgica
https://www.readbyqxmd.com/read/29138242/role-of-ecmo-in-congenital-diaphragmatic-hernia
#9
REVIEW
Merrill McHoney, Philip Hammond
Congenital diaphragmatic hernia (CDH) is typified morphologically by failure of diaphragmatic development with accompanying lung hypoplasia and persistent pulmonary hypertension of the newborn (PPHN). Patients who have labile physiology and low preductal saturations despite optimal ventilatory and inotropic support may be considered for extracorporeal membrane oxygenation (ECMO). Systematic reviews into the benefits of ECMO in CDH concluded that any benefit is unclear. Few randomised trials exist to demonstrate clear benefit and guide management...
November 14, 2017: Archives of Disease in Childhood. Fetal and Neonatal Edition
https://www.readbyqxmd.com/read/29138143/minimally-invasive-stand-alone-cox-maze-procedure-for-persistent-and-long-standing-persistent-atrial-fibrillation-perioperative-safety-and-5-year-outcomes
#10
Niv Ad, Sari D Holmes, Ted Friehling
BACKGROUND: Rhythm control is challenging in patients with extended atrial fibrillation (AF) duration and persistent/long-standing persistent AF. Among surgical approaches to treat AF, the Cox maze procedure performed using alternative energy sources remains superior to other beating heart techniques. We examined permanence of safety and success for the on-pump, minimally invasive, stand-alone Cox maze procedure 5 years after surgery. METHODS AND RESULTS: Stand-alone, right 5 cm minithoracotomy, Cox maze III/IV procedure for nonparoxysmal AF was conducted in 133 patients (mean follow-up=65±34 months)...
November 2017: Circulation. Arrhythmia and Electrophysiology
https://www.readbyqxmd.com/read/29138076/the-effect-of-obesity-on-clinical-outcomes-following-minimally-invasive-spine-surgery-a-systematic-review-and-meta-analysis
#11
Tao Wang, Chao Han, Hongqiang Jiang, Peng Tian
BACKGROUND: Obesity is associated with increasing morbidity and mortality in many prevalent diseases, especially for lumbar degenerative disease. The relationship between minimally invasive spine (MIS) surgery and perioperative adverse events in obese patients with lumbar degenerative disease has not been well evaluated. METHODS: We conducted a systematic review and meta-analysis to identify relevant studies involving obese patients with MIS surgery in electronic databases, including Web of Science, Embase, PubMed, the Cochrane Controlled Trials Register, and the Cochrane Library up to June 2017...
November 11, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/29137884/uptake-and-effectiveness-of-folfirinox-for-advanced-pancreatic-cancer-a-population-based-study
#12
S Karim, J Zhang-Salomans, J J Biagi, T Asmis, C M Booth
AIMS: Although FOLFIRINOX is a standard treatment option for advanced pancreas cancer, there are few data describing utilisation and effectiveness in routine clinical practice. Here we report practice patterns and outcomes in the general population of Ontario, Canada. MATERIALS AND METHODS: Using the Ontario Cancer Registry and New Drug Funding Program, we identified all patients with pancreas cancer treated with palliative intent gemcitabine or FOLFIRINOX in Ontario during 2006-2014...
November 11, 2017: Clinical Oncology: a Journal of the Royal College of Radiologists
https://www.readbyqxmd.com/read/29137600/perioperative-blood-transfusion-does-not-affect-recurrence-free-and-overall-survivals-after-curative-resection-for-intrahepatic-cholangiocarcinoma-a-propensity-score-matching-analysis
#13
Pei-Yun Zhou, Zheng Tang, Wei-Ren Liu, Meng-Xin Tian, Lei Jin, Xi-Fei Jiang, Han Wang, Chen-Yang Tao, Zhen-Bin Ding, Yuan-Fei Peng, Shuang-Jian Qiu, Zhi Dai, Jian Zhou, Jia Fan, Ying-Hong Shi
BACKGROUND: Whether perioperative blood transfusions (PBTs) adversely influence oncological outcomes for intrahepatic cholangiocarcinoma (ICC) patients after curative resection remains undetermined. METHODS: Of the 605 patients who underwent curative liver resection for ICC between 2000 and 2012, 93 received PBT. We conducted Cox regression and variable selection logistic regression analyses to identify confounding factors of PBT. Propensity score matching (PSM) and Cox regression analyses were used to compare the overall survival (OS) and disease-free survival (DFS) between the patients with or without PBT...
November 14, 2017: BMC Cancer
https://www.readbyqxmd.com/read/29137576/perioperative-assessment-of-older-surgical-patients-using-a-frailty-index-feasibility-and-association-with-adverse-post-operative-outcomes
#14
H Lin, N M Peel, I A Scott, D L Vardesh, P Sivalingam, R L McBride, J J Morong, M J Nelson, R E Hubbard
This study aimed to examine the feasibility of using a frailty index (FI) based on comprehensive geriatric assessment (CGA), to assess the level of frailty in older surgical patients preoperatively and to evaluate the association of FI-CGA with poorer postoperative outcomes. Two hundred and forty-six patients aged ≥70 years undergoing intermediate- to high-risk surgery in a tertiary hospital were recruited. Frailty was assessed using a 57-item FI-CGA form, with fit, intermediate frail, and frail patients defined as FI ≤0...
November 2017: Anaesthesia and Intensive Care
https://www.readbyqxmd.com/read/29137011/a-prospective-observational-study-evaluating-the-efficacy-of-prophylactic-internal-iliac-artery-balloon-catheterization-in-the-management-of-placenta-previa-accreta-a-strobe-compliant-article
#15
Yao Fan, Xun Gong, Nan Wang, Ketao Mu, Ling Feng, Fuyuan Qiao, Suhua Chen, Wanjiang Zeng, Haiyi Liu, Yuanyuan Wu, Qiong Zhou, Yuan Tian, Qiang Li, Meitao Yang, Fanfan Li, Mengzhou He, Rajluxmee Beejadhursing, Dongrui Deng
We studied the efficacy of prophylactic internal iliac artery balloon catheterization for managing severe hemorrhage caused by pernicious placenta previa.This prospective observational study was conducted in Tongji Hospital, Wuhan, China. One hundred sixty-three women past 32-week's gestation with placenta previa-accreta were recruited and managed. Women in the balloon group accepted prophylactic internal iliac artery balloon catheterization before scheduled caesarean delivery and controls had a conventional caesarean delivery...
November 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29136712/-long-term-outcome-and-prognostic-factors-in-pregnant-women-with-pulmonary-arterial-hypertension-associated-with-congenital-heart-disease
#16
Q T Ou, J K Lu, J Zhang, Y Chen, Q Li, J L Zhang
Objective: To investigate the perinatal outcome, risk factors and long-term outcome of pregnancy complicated with pulmonary arterial hypertension(PAH) and congenital heart diseases (CHD). Methods: Clinical data of 110 pregnant women who were diagnosed as PAH-CHD were retrospectively analyzed in the Department of Obstetrics and Gynecology and Surgical Intensive Care Unit at Beijing Anzhen Hospital from 2004 to 2013. The survival and treatment status were followed up. Results: 110 subjects consisted of 11 mild PAH, 33 moderate and 66 severe ones...
November 1, 2017: Zhonghua Nei Ke za Zhi [Chinese Journal of Internal Medicine]
https://www.readbyqxmd.com/read/29136038/midterm-outcomes-of-single-port-thoracoscopic-surgery-for-major-pulmonary-resection
#17
Kook Nam Han, Hyun Koo Kim, Young Ho Choi
INTRODUCTION: Single-port thoracoscopic surgery has widened the current minimally invasive surgical techniques toward more less invasive procedures in terms of reducing the number of incisions. However, the current status of oncologic outcome with this technique is not well known for lung cancer surgery. The purpose of this study is to evaluate the oncologic outcomes in early stage lung cancer for impact of the survival outcomes with our experience of conversion to a single-port approach from the conventional three-port approach...
2017: PloS One
https://www.readbyqxmd.com/read/29135700/safety-outcomes-following-spine-and-cranial-neurosurgery-evidence-from-the-national-surgical-quality-improvement-program
#18
Andrew K Rock, Charles F Opalak, Kathryn G Workman, William C Broaddus
BACKGROUND: The American College of Surgeons National Surgical Quality Improvement Program (ACS-NSQIP) was used to establish predictors for 30-day postoperative complications following spine and cranial neurosurgery. MATERIALS AND METHODS: The ACS-NSQIP participant use files were queried for neurosurgical cases between 2005 and 2015. Prevalence of postoperative complications following neurosurgery was determined. Nested multivariable logistic regression analysis was used to identify demographic, comorbidity, and perioperative characteristics associated with any complication and mortality for spine and cranial surgery...
November 10, 2017: Journal of Neurosurgical Anesthesiology
https://www.readbyqxmd.com/read/29135598/cardiac-arrest-in-the-operating-room-resuscitation-and-management-for-the-anesthesiologist-part-1
#19
Vivek K Moitra, Sharon Einav, Karl-Christian Thies, Mark E Nunnally, Andrea Gabrielli, Gerald A Maccioli, Guy Weinberg, Arna Banerjee, Kurt Ruetzler, Gregory Dobson, Matthew McEvoy, Michael F O'Connor
Cardiac arrest in the operating room and procedural areas has a different spectrum of causes (ie, hypovolemia, gas embolism, and hyperkalemia), and rapid and appropriate evaluation and management of these causes require modification of traditional cardiac arrest algorithms. There is a small but growing body of literature describing the incidence, causes, treatments, and outcomes of circulatory crisis and perioperative cardiac arrest. These events are almost always witnessed, frequently known, and involve rescuer providers with knowledge of the patient and their procedure...
November 10, 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/29135493/relationship-between-postoperative-pain-and-overall-30-day-complications-in-a-broad-surgical-population-an-observational-study
#20
Regina L M van Boekel, Michiel C Warlé, Renske G C Nielen, Kris C P Vissers, Rob van der Sande, Ewald M Bronkhorst, Jos G C Lerou, Monique A H Steegers
OBJECTIVE: The aim of this study was to establish the relationship between postoperative pain and 30-day postoperative complications. BACKGROUND: Only scarce data are available on the association between postoperative pain and a broad range of postoperative complications in a large heterogeneous surgical population. METHODS: Having postoperative pain was assessed in 2 ways: the movement-evoked pain score on the Numerical Rating Scale (NRS-MEP) and the patients' opinion whether the pain was acceptable or not...
November 13, 2017: Annals of Surgery
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