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https://www.readbyqxmd.com/read/28097332/effect-of-incentive-spirometry-on-postoperative-hypoxemia-and-pulmonary-complications-after-bariatric-surgery-a-randomized-clinical-trial
#1
Haddon Pantel, John Hwang, David Brams, Thomas Schnelldorfer, Dmitry Nepomnayshy
Importance: The combination of obesity and foregut surgery puts patients undergoing bariatric surgery at high risk for postoperative pulmonary complications. Postoperative incentive spirometry (IS) is a ubiquitous practice; however, little evidence exists on its effectiveness. Objective: To determine the effect of postoperative IS on hypoxemia, arterial oxygen saturation (Sao2) level, and pulmonary complications after bariatric surgery. Design, Setting, and Participants: A randomized noninferiority clinical trial enrolled patients undergoing bariatric surgery from May 1, 2015, to June 30, 2016...
January 11, 2017: JAMA Surgery
https://www.readbyqxmd.com/read/28097311/association-of-lymphovascular-space-invasion-with-locoregional-failure-and-survival-in-patients-with-node-negative-oral-tongue-cancers
#2
Richard J Cassidy, Jeffrey M Switchenko, Naresh Jegadeesh, Mutlay Sayan, Matthew J Ferris, Bree R Eaton, Kristin A Higgins, Jeffrey T Wadsworth, Kelly R Magliocca, Nabil F Saba, Jonathan J Beitler
Importance: The indications for adjuvant therapy in resected oral tongue cancers are based on both clinical and pathological factors, with clear evidence for adjuvant radiation in patients with pathologically positive neck lymph nodes, positive margins, and extracapsular extension, but the data for patients with no nodal disease are sparse. Objective: To investigate determinants of failure and survival in patients with node-negative oral tongue cancer. Design, Setting, and Participants: Medical records for patients with oral tongue cancer treated with definitive surgery from 2003 to 2013 were reviewed...
January 12, 2017: JAMA Otolaryngology—Head & Neck Surgery
https://www.readbyqxmd.com/read/28097305/enhanced-recovery-after-surgery-a-review
#3
Olle Ljungqvist, Michael Scott, Kenneth C Fearon
Importance: Enhanced Recovery After Surgery (ERAS) is a paradigm shift in perioperative care, resulting in substantial improvements in clinical outcomes and cost savings. Observations: Enhanced Recovery After Surgery is a multimodal, multidisciplinary approach to the care of the surgical patient. Enhanced Recovery After Surgery process implementation involves a team consisting of surgeons, anesthetists, an ERAS coordinator (often a nurse or a physician assistant), and staff from units that care for the surgical patient...
January 11, 2017: JAMA Surgery
https://www.readbyqxmd.com/read/28095994/outcome-of-early-stage-cervical-cancer-patients-treated-according-to-a-radiosurgical-approach-clinical-results-and-prognostic-factors
#4
Escande Alexandre, Gouy Sebastien, Mazeron Renaud, Bentivegna Enrica, Bacorro Warren, Maroun Pierre, Schernberg Antoine, Oberlander Anne-Sophie, Dumas Isabelle, Genestie Catherine, Deutsch Eric, Morice Philippe, Haie-Meder Christine, Chargari Cyrus
OBJECTIVE: To report clinical results of a multimodal strategy based on preoperative brachytherapy followed with surgery in early stage cervical cancer. MATERIALS/METHODS: The outcome of consecutive patients receiving brachytherapy in our Institution for an early stage IB1-IIA1 invasive cervical cancer with risk factors (lymphovascular embols and/or tumor >2cm) between 2000 and 2013 was analyzed. The treatment consisted of preoperative low dose or pulse dose-rate utero-vaginal brachytherapy followed, 6-8weeks later, by a radical hysterectomy/bilateral salpingo-oophorectomy plus pelvic±para-aortic lymph node dissection...
January 14, 2017: Gynecologic Oncology
https://www.readbyqxmd.com/read/28094198/late-side-effects-and-cosmetic-results-of-accelerated-partial-breast-irradiation-with-interstitial-brachytherapy-versus-whole-breast-irradiation-after-breast-conserving-surgery-for-low-risk-invasive-and-in-situ-carcinoma-of-the-female-breast-5-year-results
#5
Csaba Polgár, Oliver J Ott, Guido Hildebrandt, Daniela Kauer-Dorner, Hellen Knauerhase, Tibor Major, Jaroslaw Lyczek, José Luis Guinot, Jürgen Dunst, Cristina Gutierrez Miguelez, Pavel Slampa, Michael Allgäuer, Kristina Lössl, Bülent Polat, György Kovács, Arnt-René Fischedick, Rainer Fietkau, Alexandra Resch, Anna Kulik, Leo Arribas, Peter Niehoff, Ferran Guedea, Annika Schlamann, Richard Pötter, Christine Gall, Wolfgang Uter, Vratislav Strnad
BACKGROUND: We previously confirmed the non-inferiority of accelerated partial breast irradiation (APBI) with interstitial brachytherapy in terms of local control and overall survival compared with whole-breast irradiation for patients with early-stage breast cancer who underwent breast-conserving surgery in a phase 3 randomised trial. Here, we present the 5-year late side-effects and cosmetic results of the trial. METHODS: We did this randomised, controlled, phase 3 trial at 16 centres in seven European countries...
January 13, 2017: Lancet Oncology
https://www.readbyqxmd.com/read/28093615/the-open-abdomen-route-by-eurahs-introduction-of-the-data-set-and-initial-results-of-procedures-and-procedure-related-complications
#6
A Willms, F Muysoms, C Güsgen, R Schwab, J Lock, S Schaaf, C Germer, I Richardsen, U Dietz
INTRODUCTION: Open abdomen management has become a well-established strategy in the treatment of serious intra-abdominal pathologies. Key objectives are fistula prevention and high fascial closure rates. The current level of evidence on laparostoma is insufficient. This is due to the rareness of laparostomas, the heterogeneity of study cohorts, and broad diversity of techniques. Collecting data in a standardised, multicentre registry is necessary to draw up evidence-based guidelines. MATERIALS AND METHODS: In order to improve the level of evidence on laparostomy, CAMIN (surgical working group for military and emergency surgery) of DGAV (German Society for General and Visceral Surgery), initiated the implementation of a laparostomy registry...
January 16, 2017: Hernia: the Journal of Hernias and Abdominal Wall Surgery
https://www.readbyqxmd.com/read/28092994/current-status-and-future-prospects-of-hyperthermic-intraoperative-intraperitoneal-chemotherapy-hipec-clinical-trials-in-ovarian-cancer
#7
Renee A Cowan, Roisin E O'Cearbhaill, Oliver Zivanovic, Dennis S Chi
The natural history of advanced-stage epithelial ovarian cancer is one of clinical remission after surgery and platinum/taxane-based intravenous and/or intraperitoneal chemotherapy followed by early or late recurrence in the majority of patients. Prevention of progression and recurrence remains a major hurdle in the management of ovarian cancer. Recently, many investigators have evaluated the use of normothermic and hyperthermic intraoperative intraperitoneal drug delivery as a management strategy. This is a narrative review of the current status of clinical trials of hyperthermic intraoperative intraperitoneal chemotherapy (HIPEC) in ovarian cancer and the future directions for this treatment strategy...
January 16, 2017: International Journal of Hyperthermia
https://www.readbyqxmd.com/read/28092285/perioperative-%C3%AE-blockers-in-patients-undergoing-noncardiac-surgery-scientific-misconduct-and-clinical-guidelines
#8
Dhauna Karam, Rohit Arora
BACKGROUND: β-blocker use in perioperative period of noncardiac surgeries has been a topic of debate since many years. Earlier studies conducted in the 90s showed decreased cardiac adverse events and improved postoperative outcomes with β-blocker use. Based on this, the ACCF and ESC published guidelines strongly supporting β-blocker use. But contemporaneous studies conducted revealed conflicting evidence and have also proven some of the earlier studies to be fraudulent. Although ACCF guidelines have been updated to partially reflect the changes, ESC guidelines continue to support β-blocker use...
January 10, 2017: American Journal of Therapeutics
https://www.readbyqxmd.com/read/28091825/preoperative-sport-improves-the-outcome-of-lumbar-disc-surgery-a-prospective-monocentric-cohort-study
#9
Anja Tschugg, Sara Lener, Sebastian Hartmann, Matthias Wildauer, Wolfgang N Löscher, Sabrina Neururer, Claudius Thomé
A lumbar disc herniation resulting in surgery may be an incisive event in a patient's everyday life. The patient's recovery after sequestrectomy may be influenced by several factors. There is evidence that regular physical activity can lower pain perception and improve the outcome after surgery. For this purpose, we hypothesized that patients performing regular sports prior to lumbar disc surgery might have less pain perception and disability thereafter. Fifty-two participants with a single lumbar disc herniation confirmed on MRI treated by a lumbar sequestrectomy were included in the trial...
January 13, 2017: Neurosurgical Review
https://www.readbyqxmd.com/read/28091816/pediatric-cerebral-sinovenous-thrombosis-following-cranial-surgery
#10
Dmitriy Petrov, Michael Y Uohara, Rebecca Ichord, Zarina Ali, Laura Jastrzab, Shih-Shan Lang, Lori Billinghurst
PURPOSE: Pediatric cerebral sinovenous thrombosis (CSVT) is an important, though less common subtype of pediatric stroke. It has been linked to several risk factors, including cranial procedures, with few studies highlighting this relationship. The aim of this study was to characterize the diagnosis and treatment of CSVT after cranial surgery. METHODS: An institutional pediatric stroke research database was used to identify all CSVT cases diagnosed within 30 days of cranial surgery from November 2004 to December 2014...
January 14, 2017: Child's Nervous System: ChNS: Official Journal of the International Society for Pediatric Neurosurgery
https://www.readbyqxmd.com/read/28091710/role-of-concurrent-vaginal-hysterectomy-in-the-outcomes-of-mesh-based-vaginal-pelvic-organ-prolapse-surgery
#11
James C Forde, Bilal Chughtai, Jennifer T Anger, Jialin Mao, Art Sedrakyan
INTRODUCTION AND HYPOTHESIS: Hysterectomy is often performed at the time of pelvic organ prolapse (POP) surgery; yet, there is insufficient evidence regarding the specific effect of hysterectomy on outcomes. We sought to determine the outcomes and associated short-term complications of mesh-based POP surgery with and without concurrent hysterectomy. METHODS: We utilized the New York Statewide Planning and Research Cooperation System (SPARCS) database to identify patients under 55 years of age undergoing surgeries for POP with mesh between 2009 and 2014...
January 13, 2017: International Urogynecology Journal
https://www.readbyqxmd.com/read/28089836/delayed-csf-rhinorrhea-after-gamma-knife-radiosurgery-with-or-without-preceding-transsphenoidal-resection-for-pituitary-pathology
#12
Avital Perry, Christopher S Graffeo, William R Copeland, Kathryn M Van Abel, Matthew L Carlson, Bruce E Pollock, Michael J Link
BACKGROUND: Skull base cerebrospinal fluid (CSF) leak after gamma knife radiosurgery (GKRS) is a very rare complication. In patients who were treated with both GKRS and transsphenoidal resection (TSR) for pituitary lesions, early CSF leak occurs at a comparable rate to the general TSR population (4%). Delayed CSF leak occurring more than a year after TSR, GKRS, or dual therapy, is exceedingly rare. METHODS: Retrospective chart review and review of the literature RESULTS: We present two cases of delayed CSF leak following GKRS to treat pituitary adenoma...
January 9, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28089196/descriptive-analysis-of-unplanned-readmission-and-reoperation-rates-after-intradural-spinal-tumor-resection
#13
Christian Fisahn, Felipe H Sanders, Marc Moisi, Jeni Page, Peter C Oakes, Mary Wingerson, Joe Dettori, R Shane Tubbs, Parthasarathi Chamiraju, Peter Nora, David Newell, Johnny Delashaw, Rod J Oskouian, Jens R Chapman
INTRODUCTION: Spinal cord tumors (SCT) are relatively uncommon and usually require surgical treatment. Readmission within 30days after discharge is an important indicator of health care quality. The aim of this study was to investigate the rates and causes of unplanned readmissions and reoperations after SCT surgery. METHODS: A retrospective analysis of patients' charts at a single center from May 2007 to September 2015 was completed. INCLUSION CRITERIA: history of laminectomy with excision of neoplasm in the spinal cord...
January 11, 2017: Journal of Clinical Neuroscience: Official Journal of the Neurosurgical Society of Australasia
https://www.readbyqxmd.com/read/28088378/antimicrobial-coated-implants-in-trauma-and-orthopaedics-a-clinical-review-and-risk-benefit-analysis
#14
REVIEW
Volker Alt
Implant-associated infections remain a major issue in orthopaedics and antimicrobial functionalization of the implant surface by antibiotics or other anti-infective agents have gained interest. The goal of this article is to identify antimicrobial coatings, for which clinical data are available and to review their clinical need, safety profile, and their efficacy to reduce infection rates. PubMed database of the National Library of Medicine was searched for clinical studies on antimicrobial coated implants for internal fracture fixation devices and endoprostheses for bone surgery, for which study design, level of evidence, biocompatibility, development of resistance, and effectiveness to reduce infection rates were analyzed...
December 21, 2016: Injury
https://www.readbyqxmd.com/read/28088218/spinal-versus-general-anaesthesia-in-surgery-for-inguinodynia-spinasia-trial-study-protocol-for-a-randomised-controlled-trial
#15
Willem A R Zwaans, Léon H P M le Mair, Marc R M Scheltinga, Rudi M H Roumen
BACKGROUND: Chronic inguinodynia (groin pain) is a common complication following open inguinal hernia repair or a Pfannenstiel incision but may also be experienced after other types of (groin) surgery. If conservative treatments are to no avail, tailored remedial surgery, including a neurectomy and/or a (partial) meshectomy, may be considered. Retrospective studies in patients with chronic inguinodynia suggested that spinal anaesthesia is superior compared to general anaesthesia in terms of pain relief following remedial operations...
January 14, 2017: Trials
https://www.readbyqxmd.com/read/28086937/a-meta-analysis-of-randomized-control-trials-of-surgical-methods-with-osteosarcoma-outcomes
#16
REVIEW
Xiaojun He, Zhenzhen Gao, Hongwei Xu, Zhongwei Zhang, Peng Fu
BACKGROUND: Osteosarcoma is a high malignant neoplasm, and conflicting findings have been reported on the survival and function recovery of osteosarcoma patients experiencing limb salvage or amputation. In the present study, we compared limb salvage surgery (LSS) with amputation in clinical outcomes of osteosarcoma patients by a meta-analysis. METHODS: The survival rate of osteosarcoma patients was collected from research reports from CNKI, MEDLINE, EMBASE, the Cochrane Database, and Google Scholar till April 30, 2016...
January 13, 2017: Journal of Orthopaedic Surgery and Research
https://www.readbyqxmd.com/read/28078482/irreversible-electroporation-as-treatment-of-locally-advanced-and-as-margin-accentuation-in-borderline-resectable-pancreatic-adenocarcinoma
#17
P Marsanic, A Mellano, A Sottile, M De Simone
In recent years, many local ablation technologies based on thermal damage have been used in the treatment of locally advanced pancreatic carcinoma (LAPC) and borderline resectable pancreatic carcinoma (BLRPC). However, they are associated with major complications because of possible vascular and ductal damage. Irreversible electroporation (IRE) is a nonthermal ablation technology that seems safe near vital vascular and ductal structures. IRE could be used as exclusive treatment of LAPC (en situ to IRE) after induction chemotherapy In BLRPC, surgery is not really radical in 6% of patients (microscopic residual) and local recurrences occur in 11-42% of apparent radical resections...
January 11, 2017: Medical & Biological Engineering & Computing
https://www.readbyqxmd.com/read/28076610/intraoperative-near-infrared-fluorescent-imaging-during-robotic-operations
#18
Antonio Luiz de Vasconcellos Macedo, Vladimir Schraibman
The intraoperative identification of certain anatomical structures because they are small or visually occult may be challenging. The development of minimally invasive surgery brought additional difficulties to identify these structures due to the lack of complete tactile sensitivity. A number of different forms of intraoperative mapping have been tried. Recently, the near-infrared fluorescence imaging technology with indocyanine green has been added to robotic platforms. In addition, this technology has been tested in several types of operations, and has advantages such as safety, low cost and good results...
October 2016: Einstein
https://www.readbyqxmd.com/read/28076485/glp-2-a-poorly-understood-mediator-enrolled-in-various-bariatric-metabolic-surgery-related-pathophysiologic-mechanisms
#19
Everton Cazzo, Martinho Antonio Gestic, Murillo Pimentel Utrini, Felipe David Mendonça Chaim, Bruno Geloneze, José Carlos Pareja, Elinton Adami Chaim, Daniéla Oliveira Magro
Introduction: Glucagon-like peptide-2 (GLP-2) is a gastrointestinal hormone whose effects are predominantly trophic on the intestinal mucosa. Aim: Critically evaluate the current literature on the influence of bariatric/metabolic surgery on the levels of GLP-2 and its potential clinical implications. Method: s: Narrative review through online research on the databases Medline and Lilacs. There were six prospective human studies, two cross-sectional human studies, and three experimental animal studies selected...
November 2016: Arquivos Brasileiros de Cirurgia Digestiva: ABCD, Brazilian Archives of Digestive Surgery
https://www.readbyqxmd.com/read/28075157/visual-occlusion-during-minimally-invasive-surgery-a-contemporary-review-of-methods-to-reduce-laparoscopic-and-robotic-lens-fogging-and-other-sources-of-optical-loss
#20
Todd Galvin Manning, Marlon Perera, Daniel Christidis, Ned Kinnear, Shannon McGrath, Richard O'Beirne, Paul Zotov, Damien M Bolton, Nathan Lawrentschuk
Background Maintenance of optimal vision during minimally invasive surgery is crucial to maintaining operative awareness, efficiency and safety. Hampered vision is commonly caused by laparoscopic lens fogging (LLF) which has prompted the development of various anti-fogging fluids and warming devices. However, limited comparative evidence exists in contemporary literature. Despite technological advancements there remains no consensus as to superior methods to prevent LLF or restore visual acuity once LLF has occurred...
January 11, 2017: Journal of Endourology
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