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Perioperative outcomes

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https://www.readbyqxmd.com/read/28431425/the-association-of-frailty-with-outcomes-and-resource-use-after-emergency-general-surgery-a-population-based-cohort-study
#1
Daniel I McIsaac, Husein Moloo, Gregory L Bryson, Carl van Walraven
BACKGROUND: Older patients undergoing emergency general surgery (EGS) experience high rates of postoperative morbidity and mortality. Studies focused primarily on elective surgery indicate that frailty is an important predictor of adverse outcomes in older surgical patients. The population-level effect of frailty on EGS is poorly described. Therefore, our objective was to measure the association of preoperative frailty with outcomes in a population of older patients undergoing EGS. METHODS: We created a population-based cohort study using linked administrative data in Ontario, Canada, that included community-dwelling individuals aged >65 years having EGS...
May 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28430692/lack-of-association-between-the-use-of-nerve-blockade-and-the-risk-of-postoperative-chronic-opioid-use-among-patients-undergoing-total-knee-arthroplasty-evidence-from-the-marketscan-database
#2
Eric C Sun, Brian T Bateman, Stavros G Memtsoudis, Mark D Neuman, Edward R Mariano, Laurence C Baker
BACKGROUND: Total knee arthroplasty (TKA) is associated with high rates of prolonged opioid use after surgery (10%-34%). By decreasing opioid use in the immediate postoperative period, perioperative nerve blockade has been hypothesized to decrease the risk of persistent opioid use. METHODS: Using health care utilization data, we constructed a sample of 120,080 patients undergoing TKA between 2002 and 2012 and used billing data to identify the utilization of peripheral or neuraxial blockade...
April 19, 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28430689/perioperative-outcomes-of-robotic-assisted-hysterectomy-compared-with-open-hysterectomy
#3
Bhargavi Gali, Jamie N Bakkum-Gamez, David J Plevak, Darrell Schroeder, Timothy O Wilson, Christopher J Jankowski
BACKGROUND: Increasing numbers of robotic hysterectomies (RH) are being performed. To provide ventilation (with pneumoperitoneum and steep Trendelenburg position) for these procedures, utilization of lung protective strategies with limiting airway pressures and tidal volumes is difficult. Little is known about the effects of intraoperative mechanical ventilation and high peak airway pressures on perioperative complications. We performed a retrospective review to determine whether patients undergoing RH had increased pulmonary complications compared to total abdominal hysterectomy (TAH)...
April 19, 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28430639/should-surgery-be-conducted-for-small-nonfunctioning-pancreatic-neuroendocrine-tumors-a-systemic-review
#4
REVIEW
Jingfei Guo, Jianjun Zhao, Xinyu Bi, Zhiyu Li, Zhen Huang, Yefan Zhang, Jianqiang Cai, Hong Zhao
BACKGROUND: The incidence of nonfunctioning pancreatic neuroendocrine tumors smaller than 2cm has increased remarkably in the last two decades. Controversies exist regarding whether surgery should be conducted for this group of tumors. METHODS: MEDLINE, EMBASE and CENTRAL were search until 2017/01/17. Studies with comparative results between operation and observation group were included. Primary outcomes were overall survival and disease specific survival. Secondary outcomes were disease progression and surgical death and complications...
February 25, 2017: Oncotarget
https://www.readbyqxmd.com/read/28430328/outcome-of-various-hydrophobic-acrylic-intraocular-lens-implantations-in-children-with-congenital-cataract
#5
Jaspreet Sukhija, Savleen Kaur, Jagat Ram, Sonam Yangzes, Siddharth Madan, Jitender Jinagal
PURPOSE: To evaluate performance of different intraocular lenses (IOLs) after cataract surgery in children aged less than 2 years with regards to rates of visual axis opacification (VAO). METHODS: This was a retrospective chart review of children <2 years of age undergoing cataract surgery with primary posterior capsulotomy, anterior vitrectomy, and IOL over a period of 5 years with minimum follow-up of 1 year at a tertiary care institute. Children with microphthalmos, persistent fetal vasculature, traumatic cataract, aphakia, secondary IOLs, or any other coexisting ocular disease were excluded...
April 13, 2017: European Journal of Ophthalmology
https://www.readbyqxmd.com/read/28430049/minimally-invasive-instrumentation-without-fusion-during-posterior-thoracic-corpectomies-a-comparison-of-percutaneously-instrumented-nonfused-segments-with-open-instrumented-fused-segments
#6
Darryl Lau, Dean Chou
OBJECTIVE During the mini-open posterior corpectomy, percutaneous instrumentation without fusion is performed above and below the corpectomy level. In this study, the authors' goal was to compare the perioperative and long-term implant failure rates of patients who underwent nonfused percutaneous instrumentation with those of patients who underwent traditional open instrumented fusion. METHODS Adult patients who underwent posterior thoracic corpectomies with cage reconstruction between 2009 and 2014 were identified...
April 21, 2017: Journal of Neurosurgery. Spine
https://www.readbyqxmd.com/read/28429903/causes-of-interruptions-in-postoperative-enteral-nutrition-in-children-with-congenital-heart-disease
#7
Jirong Qi, Zhuo Li, Yueshuang Cun, Xiaonan Li
BACKGROUND AND OBJECTIVES: Perioperative nutritional support has become a hot topic in the clinical management of congenital heart disease (CHD). Postoperative enteral nutrition (EN) offers many benefits, such as protection of the intestinal mucosa, reduced risk of infection, and low clinical costs. Interruptions in EN frequently influence nutritional support and clinical outcomes. We, therefore, aimed to determine the causes of interruptions in postoperative EN in CHD patients and discuss clinical counter measures...
May 2017: Asia Pacific Journal of Clinical Nutrition
https://www.readbyqxmd.com/read/28429278/-trans-hepatico-cystic-coledochostomy-for-the-opening-hydatid-cyst-in-the-biliary-tract-indications-and-outcome-evaluation-of-25-cases
#8
S Daldoul, G H El Kebir, I Messoudi, A Mabrouk, M Tahar Bouzidi, M Ben Moussa
The treatment of hydatid cysts of the liver opened in the bile ducts is sometimes difficult and complex. The trans-hepaticocystic coledochostomy (CTHK) is one of these processes. We conducted a review of the indications for this surgical procedure and its perioperative outcomes through a series of 25 patients and then we analyzed predictor factors of complications. During the period's study, 909 patients with liver hydatid cyst went under the surgery. Ninety two (92, i.e. 10.1%) of them had an opening in the bile ducts through a large fistula...
April 20, 2017: Bulletin de la Société de Pathologie Exotique
https://www.readbyqxmd.com/read/28428722/therapeutic-experience-of-289-elderly-patients-with-biliary-diseases
#9
Zong-Ming Zhang, Zhuo Liu, Li-Min Liu, Chong Zhang, Hong-Wei Yu, Bai-Jiang Wan, Hai Deng, Ming-Wen Zhu, Zi-Xu Liu, Wen-Ping Wei, Meng-Meng Song, Yue Zhao
AIM: To present clinical characteristics, diagnosis and treatment strategies in elderly patients with biliary diseases. METHODS: A total of 289 elderly patients with biliary diseases were enrolled in this study. The clinical data relating to these patients were collected in our hospital from June 2013 to May 2016. Patient age, disease type, coexisting diseases, laboratory examinations, surgical methods, postoperative complications and therapeutic outcomes were analyzed...
April 7, 2017: World Journal of Gastroenterology: WJG
https://www.readbyqxmd.com/read/28427082/perioperative-outcomes-and-safety-of-atrial-fibrillation-catheter-ablation-in-octogenarians-a-retrospective-study-and-review-of-the-benefits-of-rhythm-control
#10
Stephanie Hakimian, Juan C Camacho, Edwin Grajeda Silvestri, Farid AbdelMalak, Elie Donath, Robert Chait
OBJECTIVES: Catheter ablation for rhythm control has emerged as a successful therapeutic option for the treatment of atrial fibrillation (AF), though it has not been well studied in octogenarians. This study evaluates its safety in octogenarians in a community hospital and reviews the benefits of rhythm control. METHODS: Among 1,592 patients undergoing AF ablation, 84 octogenarian were identified. The primary outcome was normal sinus rhythm (NSR) on electrocardiogram at discharge...
April 21, 2017: Cardiology
https://www.readbyqxmd.com/read/28426944/a-comparison-between-reduced-port-robotic-surgery-and-multiport-robot-assisted-laparoscopy-for-myomectomy
#11
Su Hyun Nam, Jiheum Paek, Chahien Choi, Se Hyun Nam, Woo Young Kim
OBJECTIVE: To compare the surgical outcomes between reduced-port robotic surgery (RPRS) using the Octo-Port channel and multiport robot-assisted laparoscopy for myomectomy. STUDY DESIGN: This prospective study compared and analyzed data from 15 consecutive women who underwent RPRS for myomectomy and 15 consecutive women who underwent multiport robot-assisted laparoscopy to treat symptomatic uterine myoma from January 2016 to June 2016. The patients were treated by two surgeons at two institutions...
April 10, 2017: European Journal of Obstetrics, Gynecology, and Reproductive Biology
https://www.readbyqxmd.com/read/28426577/can-the-perioperative-anesthesia-care-of-patients-with-cancer-affect-their-long-term-oncological-outcomes
#12
Juan P Cata
No abstract text is available yet for this article.
May 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28426464/comparative-effectiveness-in-urology-a-state-of-the-art-review-utilizing-a-systematic-approach
#13
Jathin Bandari, Charles B Wessel, Bruce L Jacobs
PURPOSE OF REVIEW: Comparative effectiveness research plays a vital role in healthcare delivery by guiding evidence-based practices. We performed a state-of-the-art review of comparative effectiveness research in the urology literature for 2016, utilizing a systematic approach. Seven high-impact papers are reviewed in detail. RECENT FINDINGS: Across the breadth of urology, there were several important studies in comparative effectiveness research, of which we will highlight two randomized controlled trials and five observational trials: radiotherapy, prostatectomy, and active monitoring have equivalent mortality outcomes in patients with localized prostate cancer; the ideal modality of patient education is yet to be determined, and written education has minimal effect on patient perception of prostate specific antigen screening; robotic prostatectomy is associated with higher perioperative complication rates on a population basis; racial disparities exist in incontinence rates after treatment for localized prostate cancer, but not in irritative, bowel, or sexual function; androgen deprivation therapy is associated with higher fracture, peripheral artery disease, and cardiac-related complications than bilateral orchiectomy; robotic and open cystectomy offer comparable cancer-specific mortality and perioperative outcomes; and bonuses for low-cost hospitals can inadvertently reward low-quality hospitals...
April 19, 2017: Current Opinion in Urology
https://www.readbyqxmd.com/read/28426125/cerclage-use-a-review-of-3-national-guidelines
#14
Jeffrey D Sperling, Joshua D Dahlke, Juan M Gonzalez
Importance: Preterm birth is a major contributor to perinatal morbidity and mortality. The most common intervention performed to improve perinatal outcomes for a woman experiencing cervical dilation in the second trimester without signs or symptoms of preterm labor is the cerclage. Objective: We sought to review and compare available national guidelines on cerclage use. Evidence Acquisition: We performed a descriptive review of 3 national guidelines on cerclage: The American Congress of Obstetricians and Gynecologists Practice Bulletin on "Cerclage for the Management of Cervical Insufficiency," Green-top Guideline from the Royal College of Obstetricians and Gynaecologists entitled "Cervical Cerclage," and the Society of Obstetricians and Gynaecologists of Canada Clinical Practice Bulletin entitled "Cervical Insufficiency and Cervical Cerclage...
April 2017: Obstetrical & Gynecological Survey
https://www.readbyqxmd.com/read/28425054/can-a-three-component-prosthesis-be-used-for-conversion-of-painful-ankle-arthrodesis-to-total-ankle-replacement
#15
Markus Preis, Travis Bailey, Lucas S Marchand, Alexej Barg
BACKGROUND: In patients with painful ankle arthrodesis, the surgical treatment is challenging, and may include takedown of ankle arthrodesis and conversion to a total ankle replacement (TAR). This procedure is technically demanding given the altered anatomy after arthrodesis. Few studies have evaluated TAR in the setting of prior arthrodesis. QUESTIONS/PURPOSES: (1) What intraoperative and perioperative complications were observed in patients who underwent conversion of an ankle arthrodesis to a TAR? (2) Was durable fixation achieved at short term, and what was the alignment of the components? (3) What subsequent surgical procedures were performed, including revisions? (4) What improvements were observed in pain, tibiotalar range of motion (ROM), and quality of life? METHODS: Between January 2007 and December 2014, 18 patients with a painful ankle arthrodesis underwent conversion to TAR at our tertiary referral center...
April 19, 2017: Clinical Orthopaedics and related Research
https://www.readbyqxmd.com/read/28424936/preoperative-chemoradiotherapy-versus-perioperative-chemotherapy-for-patients-with-resectable-esophageal-or-gastroesophageal-junction-adenocarcinoma
#16
M C J Anderegg, P C van der Sluis, J P Ruurda, S S Gisbertz, M C C M Hulshof, M van Vulpen, N Haj Mohammed, H W M van Laarhoven, M J Wiezer, M Los, M I van Berge Henegouwen, R van Hillegersberg
BACKGROUND: This study compares neoadjuvant chemoradiotherapy (nCRT) with perioperative chemotherapy (pCT) for patients with resectable esophageal or gastroesophageal junction (GEJ) adenocarcinoma in terms of toxicity, postoperative complications, pathologic response, and survival. METHODS: This study retrospectively analyzed and compared 313 patients with resectable esophageal or GEJ adenocarcinoma treated with either nCRT (carboplatin/paclitaxel 41.4 Gy, n = 176) or pCT (epirubicin, cisplatin and capecitabine, n = 137)...
April 19, 2017: Annals of Surgical Oncology
https://www.readbyqxmd.com/read/28424911/long-term-outcomes-of-endoscopic-resection-of-gastric-gists
#17
Changji Yu, Guobin Liao, Chaoqiang Fan, Jing Yu, Xubiao Nie, Shiming Yang, Jianying Bai
OBJECTIVE: Although the endoscopic treatment of gastric stromal tumors is a recently accepted therapy, the long-term outcomes of this approach remain unknown. The aims of this study were to assess the long-term effectiveness and safety of endoscopic resection for gastric GISTs. METHODS: A total of 60 consecutive patients undergoing endoscopic resection of gastric GISTs were enrolled in a retrospective single-center study. Clinical data, perioperative complications, histopathologic characteristics of the tumors, and long-term outcomes were recorded...
April 19, 2017: Surgical Endoscopy
https://www.readbyqxmd.com/read/28424776/socially-responsible-surgery-building-recognition-and-coalition
#18
Tyler D Robinson, Thiago M Oliveira, Theresa R Timmes, Jacqueline M Mills, Nichole Starr, Matthew Fleming, Megan Janeway, Diane Haddad, Feroze Sidhwa, Ryan D Macht, Douglas F Kauffman, Tracey A Dechert
IMPORTANCE: Socially responsible surgery (SRS) integrates surgery and public health, providing a framework for research, advocacy, education, and clinical practice to address the social barriers of health that decrease surgical access and worsen surgical outcomes in underserved patient populations. These patients face disparities in both health and in health care, which can be effectively addressed by surgeons in collaboration with allied health professionals. OBJECTIVE: We reviewed the current state of surgical access and outcomes of underserved populations in American rural communities, American urban communities, and in low- and middle-income countries...
2017: Frontiers in Surgery
https://www.readbyqxmd.com/read/28421351/characteristics-and-prognosis-of-rectal-gastrointestinal-stromal-tumors-an-analysis-of-registry-data
#19
Masayoshi Yasui, Toshimasa Tsujinaka, Masaki Mori, Tsuyoshi Takahashi, Yasuo Nakashima, Toshirou Nishida
PURPOSE: Rectal gastrointestinal stromal tumors (GISTs) are rare. Accordingly, their clinical features are not well-documented and optimal treatment has not been established. The objective of this study is to clarify the rates and patterns of recurrence after surgical resection of rectal GISTs, with a focus on outcomes and therapeutic modalities. METHODS: The registry was designed to collect data on rectal GISTs recorded between January, 2003 and December, 2007 at 40 participating institutions of the Kinki GIST Study Group...
April 18, 2017: Surgery Today
https://www.readbyqxmd.com/read/28421314/the-impact-of-body-mass-index-on-the-risk-of-high-spinal-block-in-parturients-undergoing-cesarean-delivery-a-retrospective-cohort-study
#20
Agnes M Lamon, Lisa M Einhorn, Mary Cooter, Ashraf S Habib
PURPOSE: To investigate the hypothesis that the risk of high spinal block is not increased in obese parturients undergoing cesarean delivery compared to non-obese parturients. METHODS: This is a retrospective study at an academic center. We searched the perioperative database for women who underwent cesarean delivery under spinal or combined spinal epidural anesthesia with hyperbaric bupivacaine ≥10.5 mg. A body mass index (BMI) ≥30 kg/m(2) was defined as obese...
April 18, 2017: Journal of Anesthesia
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