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Perioperative outcomes

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https://www.readbyqxmd.com/read/27914360/white-blood-cell-count-and-new-onset-atrial-fibrillation-after-cardiac-surgery
#1
Kirolos A Jacob, Marc P Buijsrogge, Jos F Frencken, Maarten J Ten Berg, Willem J L Suyker, Diederik van Dijk, Jan M Dieleman
BACKGROUND: Postoperative new-onset atrial fibrillation (PNAF) is the most common complication following cardiac surgery. The inflammatory response, as a potential underlying mechanism, has been extensively studied. In small studies, the white blood cell count (WBC) has been shown to be the only consistent inflammatory marker associated with PNAF. This study aimed to determine the association between perioperative WBC response and PNAF in a larger study cohort. METHODS: Patients ≥18years, undergoing elective cardiac surgery with a preoperative sinus rhythm were included...
November 17, 2016: International Journal of Cardiology
https://www.readbyqxmd.com/read/27913784/the-effectiveness-of-the-bone-bridge-transtibial-amputation-technique-a-systematic-review-of-high-quality-evidence
#2
Jason T Kahle, M Jason Highsmith, John Kenney, Tim Ruth, Paul A Lunseth, Janos Ertl
BACKGROUND: This literature review was undertaken to determine if commonly held views about the benefits of a bone bridge technique are supported by the literature. METHODS: Four databases were searched for articles pertaining to surgical strategies specific to a bone bridge technique of the transtibial amputee. A total of 35 articles were identified as potential articles. Authors included methodology that was applied to separate topics. Following identification, articles were excluded if they were determined to be low quality evidence or not pertinent...
December 1, 2016: Prosthetics and Orthotics International
https://www.readbyqxmd.com/read/27912973/micro-ureteroscopy-for-the-treatment-of-distal-ureteral-calculi-in-children
#3
Mehmet Mazhar Utanğaç, Ahmet Ali Sancaktutar, Abdulkadir Tepeler
OBJECTIVE: The objective of this study was to demonstrate the efficacy and safety of micro-ureteroscopy (micro-URS) in the management of distal ureteral stones in the pediatric population. MATERIALS AND METHODS: A total of 11 children, who had undergone micro-URS between September 2015 and April 2016 with the indication of distal ureteral calculi in two referral centers, were retrospectively evaluated. The procedures were performed with the patient in the lithotomy position under general anesthesia using the standard URS technique with a micro-ureteroscope that has a caliber of 4...
November 17, 2016: Journal of Pediatric Surgery
https://www.readbyqxmd.com/read/27911468/radical-cystectomy-and-cutaneous-ureterostomy-in-4-dogs-with-trigonal-transitional-cell-carcinoma-description-of-technique-and-case-series
#4
Rafael Ricardo Huppes, Leandro Z Crivellenti, Andrigo Barboza De Nardi, Bruno Roque Lima, Cristiane Alves Cintra, Jorge Luiz Costa Castro, Christopher A Adin
OBJECTIVE: To describe radical cystectomy followed by cutaneous ureterostomy as a treatment of invasive bladder neoplasia in dogs. STUDY DESIGN: Retrospective study. ANIMALS: Client-owned dogs with transitional cell carcinoma of the bladder trigone (n=4). METHODS: Perioperative complications and long-term outcomes of dogs that underwent cutaneous ureterostomy following radical cystectomy and lymphadenectomy for transitional cell carcinoma of the urinary bladder trigone were reviewed...
December 1, 2016: Veterinary Surgery: VS
https://www.readbyqxmd.com/read/27909035/randomised-controlled-pilot-study-to-investigate-the-effectiveness-of-thoracic-epidural-and-paravertebral-blockade-in-reducing-chronic-post-thoracotomy-pain-topic-feasibility-study-protocol
#5
Joyce Yeung, Teresa Melody, Amy Kerr, Babu Naidu, Lee Middleton, Kostas Tryposkiadis, Jane Daniels, Fang Gao
INTRODUCTION: Open chest surgery (thoracotomy) is considered the most painful of surgical procedures. Forceful wound retraction, costochondral dislocation, posterior costovertebral ligament disruption, intercostal nerve trauma and wound movement during respiration combine to produce an acute, severe postoperative pain insult and persistent chronic pain many months after surgery is common. Three recent systematic reviews conclude that unilateral continuous paravertebral blockade (PVB) provides analgesia at least equivalent to thoracic epidural blockade (TEB) in the postoperative period, has a lower failure rate, and symptom relief that lasted months...
December 1, 2016: BMJ Open
https://www.readbyqxmd.com/read/27908636/impact-of-neoadjuvant-chemotherapy-on-complications-of-minimally-invasive-radical-cystectomy
#6
D Lizée, R S Salas, E Barret, M Galiano, E Di Trapani, F Montorsi, X Cathelineau
BACKGROUND: Neoadjuvant chemotherapy (NC) before minimally invasive radical cystectomy (MIRC) is considered a standard of care in muscle-invasive bladder cancer or recurrent high-risk non-muscle-invasive bladder cancer. OBJECTIVE: To evaluate the impact of NC on morbidity and mortality after MIRC. DESIGN, SETTING, AND PARTICIPANTS: We prospectively evaluated 135 patients who underwent MIRC (laparoscopic: n=100; robotic: n=35) between 2007 and 2013 with ≥90 days of follow-up (median age: 66 year)...
November 28, 2016: Actas Urologicas Españolas
https://www.readbyqxmd.com/read/27908634/systematic-review-of-perioperative-outcomes-and-complications-after-open-laparoscopic-and-robot-assisted-radical-cystectomy
#7
A Palazzetti, R Sanchez-Salas, P Capogrosso, E Barret, N Cathala, A Mombet, D Prapotnich, M Galiano, F Rozet, X Cathelineau
Radical cystectomy and regional lymph node dissection is the standard treatment for localized muscle-invasive and for high-risk non-muscle-invasive bladder cancer, and represents one of the main surgical urologic procedures. The open surgical approach is still widely adopted, even if in the last two decades efforts have been made in order to evaluate if minimally invasive procedures, either laparoscopic or robot-assisted, might show a benefit compared to the standard technique. Open radical cystectomy is associated with a high complication rate, but data from the laparoscopic and robotic surgical series failed to demonstrate a clear reduction in post-operative complication rates compared to the open surgical series...
November 28, 2016: Actas Urologicas Españolas
https://www.readbyqxmd.com/read/27908309/an-unrecognised-presentation-of-takayasu-arteritis-superficial-femoral-artery-involvement
#8
Hui Dong, Wuqiang Che, Xiongjing Jiang, Meng Peng, Yubao Zou, Huimin Zhang, Bo Xu, Yuejin Yang, Runlin Gao
OBJECTIVES: Superficial femoral artery (SFA) involvement in Takayasu arteritis (TA) has rarely been reported. The purpose of this study was to investigate the clinical characteristic and clinical outcomes of endovascular therapy in such patients. METHODS: We analysed the data collected from 105 consecutive patients with TA, who were diagnosed from January 2011 to December 2013. All patients underwent ankle brachial index (ABI) measurements and angiography. Nine patients with an ABI <0...
November 18, 2016: Clinical and Experimental Rheumatology
https://www.readbyqxmd.com/read/27907923/association-between-the-surgical-apgar-score-and-perioperative-complications-after-radical-prostatectomy
#9
Matthias Orberger, Jüri Palisaar, Florian Roghmann, Ludger Mittelstädt, Petra Bischoff, Joachim Noldus, Björn Löppenberg
OBJECTIVE: To evaluate whether the Surgical Apgar Score (SAS) can identify patients who are at risk for perioperative adverse events (PAE) following radical prostatectomy for prostate cancer. PATIENTS AND METHODS: At a single academic institution, 994 patients undergoing radical prostatectomy between 2010 and 2013 were analyzed retrospectively. The SAS was calculated from anesthesia records, evaluated to predict PAE within a 30-day time period postoperatively; these events were classified according to standardized classification systems...
December 2, 2016: Urologia Internationalis
https://www.readbyqxmd.com/read/27907921/feasibility-of-preoperative-chemotherapy-with-docetaxel-cisplatin-and-5-fluorouracil-versus-adriamycin-cisplatin-and-5-fluorouracil-for-resectable-advanced-esophageal-cancer
#10
Osamu Shiraishi, Makoto Yamasaki, Tomoki Makino, Masaaki Motoori, Hiroshi Miyata, Masayuki Shinkai, Yutaka Kimura, Motohiro Hirao, Kazumasa Fujitani, Shigeyuki Tamura, Kenji Kobayashi, Masahiko Yano, Yuichiro Doki, Takushi Yasuda
BACKGROUND: Neoadjuvant chemotherapy for resectable advanced esophageal squamous cell carcinoma (ESCC) requires reassessment. We have conducted a trial aiming at the comparison between DCF and ACF concerning perioperative adverse events. METHODS: Patients were randomly assigned to receive either DCF [docetaxel 70 mg/m2, cisplatin 70 mg/m2 on day 1, and 5-fluorouracil (5-FU) 700 mg/m2 for 5 days] every 3 weeks or ACF (adriamycin 35 mg/m2, cisplatin 70 mg/m2 on day 1, and 5-FU 700 mg/m2 for 7 days) every 4 weeks...
December 2, 2016: Oncology
https://www.readbyqxmd.com/read/27907053/the-effect-of-diabetes-on-the-perioperative-outcomes-of-colorectal-cancer-surgery-patients
#11
Raymond Yap, Simon Wilkins, Margaret Staples, Karen Oliva, Paul J McMurrick
There are approximately 1.3 million patients in Australia with diabetes. Conflicting reports exist in the literature as to the effect of diabetes on the outcomes of colorectal cancer patients. We hypothesized that patients with diabetes would have poorer perioperative outcomes, and that diabetes was an independent risk factor for both 30-day mortality and perioperative morbidity. The aim of this study was to assess the impact of diabetes on perioperative colorectal cancer surgery outcomes, as compared to a diabetes-free reference population, and to examine factors affecting perioperative risk...
2016: PloS One
https://www.readbyqxmd.com/read/27906757/effect-of-an-immersive-preoperative-virtual-reality-experience-on-patient-reported-outcomes-a-randomized-controlled-trial
#12
Kimon Bekelis, Daniel Calnan, Nathan Simmons, Todd A MacKenzie, George Kakoulides
OBJECTIVE: To investigate the effect of exposure to a virtual reality (VR) environment preoperatively on patient-reported outcomes for surgical operations. BACKGROUND: There is a scarcity of well-developed quality improvement initiatives targeting patient satisfaction. METHODS: We performed a randomized controlled trial of patients undergoing cranial and spinal operations in a tertiary referral center. Patients underwent a 1:1 randomization to an immersive preoperative VR experience or standard preoperative experience stratified on type of operation...
November 30, 2016: Annals of Surgery
https://www.readbyqxmd.com/read/27906739/posterior-vertebral-column-resection-with-intraoperative-manual-retraction-for-the-treatment-of-posttubercular-kyphosis-in-upper-thoracic-spine-or-cervicothoracic-junction
#13
Yuqiao Chen, Guohua Lü, Bing Wang, Lei Li, Lei Kuang
STUDY DESIGN: This is a case-series. OBJECTIVE: To evaluate the clinical and radiologic outcomes of posterior vertebral column resection (PVCR) for treatment of posttubercular kyphosis in upper thoracic spine and cervicothoracic junction (CTJ). SUMMARY OF BACKGROUND DATA: Surgical management of severe posttubercular kyphosis in upper thoracic spine or CTJ is challenging. A new technique that combines PVCR and intraoperative manual traction in a single procedure, was developed to maximize the correction rate and minimize the risk of dural buckling and spinal cord injury...
November 30, 2016: Clinical Spine Surgery
https://www.readbyqxmd.com/read/27905691/is-volume-important-in-aneurysm-treatment-outcome
#14
Athanasios Katsargyris, Chris Klonaris, Eric L Verhoeven
Several studies have suggested that surgical procedures performed at high-volume centers may result in superior outcome. Technically more demanding procedures such as aortic aneurysm repair appear to demonstrate a stronger relationship with volume. The present chapter reviewed the literature using the MEDLINE database to identify studies investigating the effect of volume in aortic aneurysm repair outcomes. The great majority of studies identified shows an advantage for high-volume hospitals with regard to perioperative mortality of abdominal (AAA), thoracic (TAA) and thoracoabdominal (TAAA) aortic aneurysm repair...
December 1, 2016: Journal of Cardiovascular Surgery
https://www.readbyqxmd.com/read/27905231/monitoring-during-anaesthesia-and-recovery
#15
Andreia Trigo
Essential facts Respiratory compromise is a critical perioperative complication associated with increased costs and poor outcomes. It is common, costly, deadly and, most importantly, preventable.
December 1, 2016: Nursing Management (Harrow)
https://www.readbyqxmd.com/read/27905060/perioperative-risk-adjustment-for-total-shoulder-arthroplasty-are-simple-clinically-driven-models-sufficient
#16
David N Bernstein, Aakash Keswani, David Ring
BACKGROUND: There is growing interest in value-based health care in the United States. Statistical analysis of large databases can inform us of the factors associated with and the probability of adverse events and unplanned readmissions that diminish quality and add expense. For example, increased operating time and high blood urea nitrogen (BUN) are associated with adverse events, whereas patients on antihypertensive medications were more likely to have an unplanned readmission. Many surgeons rely on their knowledge and intuition when assessing the risk of a procedure...
November 30, 2016: Clinical Orthopaedics and related Research
https://www.readbyqxmd.com/read/27904903/prediction-of-severe-bleeding-after-coronary-surgery-the-will-bleed-risk-score
#17
Fausto Biancari, Debora Brascia, Francesco Onorati, Daniel Reichart, Andrea Perrotti, Vito G Ruggieri, Giuseppe Santarpino, Daniele Maselli, Giovanni Mariscalco, Riccardo Gherli, Antonino S Rubino, Marisa De Feo, Giuseppe Gatti, Francesco Santini, Magnus Dalén, Matteo Saccocci, Eeva-Maija Kinnunen, Juhani K E Airaksinen, Paola D'Errigo, Stefano Rosato, Francesco Nicolini
Severe perioperative bleeding after coronary artery bypass grafting (CABG) is associated with poor outcome. An additive score for prediction of severe bleeding was derived (n=2494) and validated (n=1250) in patients from the E-CABG registry. Severe bleeding was defined as E-CABG bleeding grades 2-3 (transfusion of >4 units of red blood cells or reoperation for bleeding). The overall incidence of severe bleeding was 6.4 %. Preoperative anaemia (3 points), female gender (2 points), eGFR <45 ml/min/1.73 m(2) (3 points), potent antiplatelet drugs discontinued less than five days (2 points), critical preoperative state (5 points), acute coronary syndrome (2 points), use of low-molecular-weight heparin/fondaparinux/unfractionated heparin (1 point) were independent predictors of severe bleeding...
December 1, 2016: Thrombosis and Haemostasis
https://www.readbyqxmd.com/read/27903931/comparison-of-perioperative-outcomes-in-endovascular-versus-open-repair-for-juxtarenal-and-pararenal-aortic-aneurysms-a-propensity-matched-analysis
#18
Nathan T Orr, Daniel L Davenport, David J Minion, Eleftherios S Xenos
OBJECTIVE: Endoluminal aortic aneurysm repair is suitable within certain anatomic specifications. This study aims to compare 30-day outcomes of endovascular versus open repairs for juxtarenal and pararenal aortic aneurysms (JAA/PAAs). METHODS: The ACS-NSQIP database was queried from 2012 to 2015 for JAA/PAA repairs. Procedures characterized as emergent were included in the study; however, failed prior repairs and ruptured aneurysms were excluded. The preoperative and perioperative patient characteristics, operative techniques, and outcome variables were compared between the open aortic repair and the endovascular aortic repair groups...
November 30, 2016: Vascular
https://www.readbyqxmd.com/read/27903475/technical-aspects-of-open-repair-for-degenerative-aneurysmal-evolution-despite-early-thoracic-endovascular-repair-of-type-b-aortic-dissection
#19
Sonia Aguir, Salma El Batti, Paul Achouh, Pierre Julia, Alain Bel, Jean-Noël Fabiani, Jean-Marc Alsac
: Closure of the proximal tear by Thoracic Endovascular Aortic Repair (TEVAR) at the acute phase appears to be an safe effective treatment to prevent aneurysmal degeneration type B dissection. However, it appears to be inefficient in up to a third of the patient. We report the technical aspects of our experience with patients undergoing secondary open repair after TEVAR for dissecting thoraco-abdominal aneurysm despite early closure proximal tear by TEVAR. METHODS: During a period of 5 years, 96 patients presenting acute Type B Aortic Dissections (TBAD) were treated by TEVAR and followed-up in our institution...
November 26, 2016: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/27903337/-risk-factors-for-perioperative-stroke-in-aged-patients-undergoing-nonneurologic-and-noncardiovascular-surgery
#20
B L Jiang, L Yao, Y Feng, J H Liu
Objective: To assess the incidence, risk factors, and outcomes of perioperative stroke in aged patients undergoing nonneurologic and noncardiovascular surgery. Methods: A total of 21 419 in-patients who were older than 65 years undergoing nonneurologic and noncardiovascular surgery in Peking University People's Hospital from January 2010 to May 2016 were retrospectively recruited in this study.The patients were divided into two groups: patients with perioperative stroke were allocated in stroke group, and the other patients were in the non-stroke group...
November 22, 2016: Zhonghua Yi Xue za Zhi [Chinese medical journal]
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