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Evidence based surgery

Sven Reuter, Andreas B Imhoff, Frank Martetschläger
BACKGROUND: The aim of this study was to systematically review the literature for the impact of rotator cuff tear (RCT) surgery on postoperative sporting activity in professional and recreational athletes. METHODS: To identify any published clinical study on return to sports data for athletes following rotator cuff surgery a systematic search in literature was conducted. Inclusion criteria were partial- and full-thickness rotator cuff tears and any open or arthroscopic RCT surgery in sports participating people...
October 20, 2016: Journal of Sports Medicine and Physical Fitness
Qiuyu Wang, Chuan Cao, Rui Guo, Xiaoge Li, Lele Lu, Wenping Wang, Shirong Li
OBJECTIVE: To assess the prevalence of body dysmorphic disorder (BDD) in an aesthetic surgery setting in the region of Southwest China, and to ascertain the differences in terms of body images between patients in the aesthetic setting and general Chinese population. This study tracked patient satisfaction with their body image changes while undergoing aesthetic medical procedures to identify whether the condition of patients who were presenting with BDD symptoms or their psychological symptoms could be improved by enhancing their appearance...
October 19, 2016: Aesthetic Plastic Surgery
Jie Chen, Xuezhi Hao, Fang Cheng, Tongtong Zhang, Puyuan Xing, Junling Li
BACKGROUND: As the prevalence of tobacco and the aging of the population, the incidence of lung cancer in the elderly rises. However, few elderly patients (older than 70 years old) with lung squamous cell carcinoma were involved into the clinical trials, which offered insufficient clinical evidence for these patients. Lung squamous cell carcinoma patients older than 80 years old were included in our study to analyze the clinical characteristics, treatment and prognostic factors, and to explore the optimal treatment choices for these patients...
October 20, 2016: Zhongguo Fei Ai za Zhi, Chinese Journal of Lung Cancer
Massimo Del Fabbro, Stefano Corbella, Patrick Sequeira-Byron, Igor Tsesis, Eyal Rosen, Alessandra Lolato, Silvio Taschieri
BACKGROUND: When primary root canal therapy fails, periapical lesions can be retreated with or without surgery. Root canal retreatment is a non-surgical procedure that involves removal of root canal filling materials from the tooth, followed by cleaning, shaping and obturating of the canals. Root-end resection is a surgical procedure that involves exposure of the periapical lesion through an osteotomy, surgical removal of the lesion, removal of part of the root-end tip, disinfection and, commonly, retrograde sealing or filling of the apical portion of the remaining root canal...
October 19, 2016: Cochrane Database of Systematic Reviews
Joseph E Cruz, Zachariah Thomas, David Lee, David M Moskowitz, Jeff Nemeth
BACKGROUND: Generic price inflation has resulted in rising acquisition costs for sodium nitroprusside (SNP), an agent historically described as the drug of choice for the treatment of perioperative hypertension in cardiac surgery. PURPOSE: To describe the implementation and cost avoidance achieved by utilizing clevidipine as an alternative to SNP in cardiac surgery patients at a 520-bed community teaching hospital that performs more than 300 cardiac surgeries each year...
October 2016: P & T: a Peer-reviewed Journal for Formulary Management
Takahiro Wakasaki, Hirofumi Omori, Shintaro Sueyoshi, Fumihide Rikimaru, Satoshi Toh, Kenichi Taguchi, Yuichiro Higaki, Masaru Morita, Muneyuki Masuda
BACKGROUND: Advanced head and neck squamous cell carcinomas frequently develop distant metastases to limited organs, including the lungs, bone, mediastinal lymph nodes, brain, and liver. Peritoneal carcinomatosis as an initial distant metastasis from hypopharyngeal squamous cell carcinoma is quite rare. CASE PRESENTATION: A 75-year-old man diagnosed with hypopharyngeal squamous cell carcinoma and his clinical stage was determined as T2N2cM0. Notably, the right retropharyngeal lymph node surrounded more than half of the right internal carotid artery...
October 18, 2016: World Journal of Surgical Oncology
Robert P Lamberts, Marlette Burger, Jacques du Toit, Nelleke G Langerak
BACKGROUND: Three-dimensional gait analysis (3DGA) is commonly used to assess the effect of orthopedic single-event multilevel surgery (SEMLS) in children with spastic cerebral palsy (CP). PURPOSE: The purpose of this systematic review is to provide an overview of different orthopedic SEMLS interventions and their effects on 3DGA parameters in children with spastic CP. METHODS: A comprehensive literature search within six databases revealed 648 records, from which 89 articles were selected for the full-text review and 24 articles (50 studies) included for systematic review...
2016: PloS One
Leila Rooshenas, Daisy Elliott, Julia Wade, Marcus Jepson, Sangeetha Paramasivan, Sean Strong, Caroline Wilson, David Beard, Jane M Blazeby, Alison Birtle, Alison Halliday, Chris A Rogers, Rob Stein, Jenny L Donovan
BACKGROUND: Randomised controlled trials (RCTs) are essential for evidence-based medicine and increasingly rely on front-line clinicians to recruit eligible patients. Clinicians' difficulties with negotiating equipoise is assumed to undermine recruitment, although these issues have not yet been empirically investigated in the context of observable events. We aimed to investigate how clinicians conveyed equipoise during RCT recruitment appointments across six RCTs, with a view to (i) identifying practices that supported or hindered equipoise communication and (ii) exploring how clinicians' reported intentions compared with their actual practices...
October 2016: PLoS Medicine
Fang Zhang, WenMing Hong, Yan Guo, QianYing Guo, XiaoPeng Hu
BACKGROUND: Microsurgery is a common treatment of brainstem tumors. However, misdirection, vascular damage, nerves injuries, paralysis, even death are all well-known complications, and the risk of adverse events is more likely in less experienced operators. This study was aimed to validate the accuracy of multimodal neuronavigation during microsurgery resection of brainstem tumors. METHODS: Ten patients with brainstem tumors underwent preoperative MRI, diffusion tensor imaging, computed tomography, three-dimensional print, and images loaded into the neuronavigation platform were used for its segmentation and preoperative planning...
October 14, 2016: Journal of Craniofacial Surgery
Yuki Sakamoto, Shuichi Fujita, Masaki Adachi, Hiroshi Sakamoto, Tomofumi Naruse, Souichi Yanamoto, Toru Ikeda, Masahiro Umeda
Carcinoma ex pleomorphic adenoma (CEPA) is a carcinoma that shows histologic evidence of arising in or from a benign pleomorphic adenoma. Carcinoma ex pleomorphic adenoma often occurs in parotid glands, but is extremely rarely in the tongue. A 53-year-old Japanese woman was referred to the Department of Oral and Maxillofacial Surgery, Nagasaki University Hospital, because of tumor of the right dorsum tongue. She had a history of surgery of breast cancer (invasive ductal carcinoma) and it was disseminated to the lung and bone...
October 14, 2016: Journal of Craniofacial Surgery
Kyle Lybrand, Anthony Bell, Deirdre Rodericks, David Templeman, Paul Tornetta
OBJECTIVE: To evaluate the influence of the symphyseal position at union, implant failure, and the type of posterior ring injury on validated outcome measures. DESIGN: Retrospective review with prospectively collected validated outcome data SETTING:: Two academic Level 1 trauma centersPatients/Participants: We evaluated 54 patients with operatively treated anterior-posterior compression (APC) type 2 and 3 injuries. INTERVENTION: Thirty-five APC type 2 and 19 APC type 3 injuries were reviewed at a minimum of 2 years after surgery...
October 7, 2016: Journal of Orthopaedic Trauma
Sophocles H Voineskos, Christopher J Coroneos, Achilleas Thoma, Mohit Bhandari
No abstract text is available yet for this article.
October 10, 2016: Plastic and Reconstructive Surgery
Yair Rubinstein, Chen Weiner, Adi Einan-Lifshitz, Noa Chetrit, Nadav Shoshany, David Zadok, Isaac Avni, Eran Pras
PURPOSE: This study reports the presentation of 2 families with macular corneal dystrophy (MCD). The aim of this study was to show whether ultrasound biomicroscopy (UBM) can, based on posterior changes of the cornea in MCD, assist in the choice of surgery, either anterior lamellar keratoplasty (DALK) or penetrating keratoplasty (PK), compared with optical coherence tomography (OCT) and Scheimpflug. METHODS: Six patients with MCD were examined for their best-corrected visual acuity, slit-lamp, OCT, UBM, and Scheimpflug findings...
October 14, 2016: Cornea
David Legouis, Pierre Galichon, Aurélien Bataille, Sylvie Chevret, Sophie Provenchère, Anne Boutten, Dimitrios Buklas, Jean-Luc Fellahi, Jean-Luc Hanouz, Alexandre Hertig
BACKGROUND: There is recent evidence to show that patients suffering from acute kidney injury are at increased risk of developing chronic kidney disease despite the fact that surviving tubular epithelial cells have the capacity to fully regenerate renal tubules and restore renal function within days or weeks. The aim of the study was to investigate the impact of acute kidney injury on de novo chronic kidney disease. METHODS: The authors conducted a retrospective population-based cohort study of patients initially free from chronic kidney disease who were scheduled for elective cardiac surgery with cardiopulmonary bypass and who developed an episode of acute kidney injury from which they recovered...
October 17, 2016: Anesthesiology
Soumyarwit Manna, James J Augsburger, Zelia M Correa, Marwan F Al-Rjoub, Marepalli B Rao, Rupak K Banerjee
PURPOSE: The purpose of this study is to noninvasively evaluate the safety and toxicity of a chitosan (CS) and polylactic acid (PLA)-based sustained-release methotrexate (MTX) intravitreal microimplant in normal rabbit eyes using electroretinography (ERG). METHODS: PLA-coated CS-based microimplants containing 400 μg of MTX and placebo microimplants (without drug) were surgically implanted in the vitreous of the right and the left eyes, respectively, in each of the 8 New Zealand rabbits using minimally invasive technique...
October 18, 2016: Journal of Ocular Pharmacology and Therapeutics
Anita Mohandas, Chris Summa, W Bradley Worthington, Jason Lerner, Kevin T Foley, Robert J Bohinski, Gregory B Lanford, Carol Holden, Richard N W Wohns
STUDY DESIGN: Delphi Panel expert panel consensus and narrative literature review OBJECTIVE.: To obtain expert consensus on best practices for patient selection and perioperative decision making for outpatient anterior cervical surgery (anterior cervical disc fusion (ACDF) and cervical total disc replacement (CTDR)). SUMMARY OF BACKGROUND DATA: Spine surgery in ambulatory settings is becoming a preferred option for both patients and providers. The transition from traditional inpatient environments has been enabled by innovation in anesthesia protocols and surgical technique, as well as favorable economics...
October 6, 2016: Spine
Nicolas Dea, Raphaële Charest-Morin, Daniel M Sciubba, Justin E Bird, Alexander C Disch, Addisu Mesfin, Áron Lazáry, Charles G Fisher, Christopher Ames
STUDY DESIGN: Systematic literature review. OBJECTIVE: To investigate if evidence-based principles of oncologic resection for primary spinal tumors are correlated with an acceptable morbidity and mortality profile and satisfactory health-related quality of life (HRQOL) measures. SUMMARY OF BACKGROUND DATA: Respecting oncologic principles for primary spinal tumor surgery is correlated with lower recurrence rates. These interventions are, however, often highly morbid...
October 15, 2016: Spine
Tamir Ailon, Radmehr Torabi, Charles G Fisher, Laurence D Rhines, Michelle J Clarke, Chetan Bettegowda, Stefano Boriani, Yoshiya J Yamada, Norio Kawahara, Peter P Varga, John H Shin, Arjun Saghal, Ziya L Gokaslan
STUDY DESIGN: Systematic review. OBJECTIVE: To determine evidence-based guidelines for the management of locally recurrent spinal chordoma. SUMMARY OF BACKGROUND DATA: Chordoma of the spine is a low-grade malignant tumor with a strong propensity for local recurrence. Salvage therapy is challenging due to its relentless nature and refractoriness to adjuvant therapies. There are currently no guidelines regarding the best management of recurrent chordoma...
October 15, 2016: Spine
James K Hamill, Jamie-Lee Rahiri, Gamage Gunaratna, Andrew G Hill
BACKGROUND: No enhanced recovery after surgery protocol has been published for laparoscopic appendectomy. This was a review of evidence-based interventions that could optimize recovery after appendectomy. METHODS: Interventions for the review Clinical pathway, fast-track or enhanced recovery protocols; needlescopic approach; single incision laparoscopic (SIL) approach; natural orifice transluminal endoscopic surgery (NOTES); regional nerve blocks; intraperitoneal local anaesthetic (IPLA); drains...
October 17, 2016: Surgical Endoscopy
Satoshi Nagayama, Suguru Hasegawa, Koya Hida, Kenji Kawada, Etsuro Hatano, Kojiro Nakamura, Satoru Seo, Kojiro Taura, Kentaro Yasuchika, Takashi Matsuo, Masazumi Zaima, Akiyoshi Kanazawa, Hiroaki Terajima, Masaharu Tada, Yukihito Adachi, Ryuta Nishitai, Dai Manaka, Tsunehiro Yoshimura, Koji Doi, Takahiro Horimatsu, Akira Mitsuyoshi, Kenichi Yoshimura, Miyuki Niimi, Shigemi Matsumoto, Yoshiharu Sakai, Shinji Uemoto
BACKGROUND: Although liver resection combined with preoperative chemotherapy is expected to improve outcomes of patients with resectable colorectal liver metastasis (CRLM), there is as yet insufficient clinical evidence supporting the efficacy of preoperative systemic chemotherapy. The aim of this phase II study was to assess the feasibility and efficacy of preoperative FOLFOX systemic chemotherapy for patients with initially resectable CRLM. METHODS: A prospective multi-institutional phase II study was conducted to evaluate the feasibility and efficacy of preoperative chemotherapy for resectable CRLM (ClinicalTrials...
October 17, 2016: International Journal of Clinical Oncology
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