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Chronic postOP pain

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https://www.readbyqxmd.com/read/29342445/case-report-of-an-uncommon-case-of-drain-site-hernia-after-colorectal-surgery
#1
M Manigrasso, P Anoldo, F Milone, G D De Palma, M Milone
BACKGROUND: trocar site herniation is a rare but potentially serious complication of laparoscopic surgery. Data about drain site hernia after laparoscopic surgery is scarce and anecdotal. CASE PRESENTATION: we report an uncommon case of drain site hernia in a man undergone laparoscopic left colectomy for a colonic adenocarcinoma who developed small bowel herniation in a 10 mm port site, in which a 24 FR drain was inserted leaving a real free space of 2 mm. DISCUSSION: laparoscopic approach has gained widespread acceptance in each surgical fields because of the perceived better postoperative outcomes in terms of less pain, faster recovery, and lower risk of incisional hernia...
January 9, 2018: International Journal of Surgery Case Reports
https://www.readbyqxmd.com/read/29342018/mini-or-less-open-sublay-operation-milos-a-new-minimally-invasive-technique-for-the-extraperitoneal-mesh-repair-of-incisional-hernias
#2
Wolfgang Reinpold, Michael Schröder, Cigdem Berger, Jennifer Nehls, Alexander Schröder, Martin Hukauf, Ferdinand Köckerling, Reinhard Bittner
OBJECTIVE: Improvement of ventral hernia repair. BACKGROUND: Despite the use of mesh and other recent improvements, the currently popular techniques of ventral hernia repair have specific disadvantages and risks. METHODS: We developed the endoscopically assisted mini- or less-open sublay (MILOS) concept. The operation is performed transhernially via a small incision with light-holding laparoscopic instruments either under direct, or endoscopic visualization...
January 16, 2018: Annals of Surgery
https://www.readbyqxmd.com/read/29341457/different-effects-of-dexmedetomidine-and-midazolam-on-the-expression-of-nr2b-and-gabaa-%C3%AE-1-following-peripheral-nerve-injury-in-rats
#3
Jiayu Chen, Hanjun Li, Grewo Lim, Michael F McCabe, Wei Zhao, Yunli Yang, Weiqing Ma, Na Li
Neuropathic pain is a complex, chronic pain condition and the treatment is a major clinical challenge. Recent studies have shown that two FDA approved drugs dexmedetomidine (DEX) and midazolam (MZL), may be useful in treating neuropathic pain, but the mechanism is not fully dementated. Here, we investigated the effects and mechanisms of DEX and MZL treatment in the peripheral nerve injury model. Intramuscular injection with DEX and MZL attenuated the development of mechanical allodynia and thermal hyperalgesia in rats with chronic constriction injury (CCI)...
January 17, 2018: IUBMB Life
https://www.readbyqxmd.com/read/29339085/wnt5a-mediates-chronic-post-thoracotomy-pain-by-regulating-non-canonical-pathways-nerve-regeneration-and-inflammation-in-rats
#4
Afang Zhu, Le Shen, Li Xu, Weiyun Chen, Yuguang Huang
As well-characterized ligands involved in neurogenesis, Wnts are emerging as promising targets in pain pathogenesis. Our previous pilot study showed that intrathecal inhibition of Wnt5a, but not Wnts, relieves chronic post-thoracotomy pain (CPTP) in rats. In the present study, we aimed to further explore the regulatory mechanism of Wnt5a in CPTP development. Increased protein levels of Wnt5a, transmembrane receptor Ror2, and activated non-canonical Wnt pathway members were found in the thoracic dorsal root ganglions from postoperative day (POD) 7 to POD 21...
January 12, 2018: Cellular Signalling
https://www.readbyqxmd.com/read/29336771/surgical-and-endovascular-management-of-patients-with-chronic-mesenteric-ischemia-a-single-center-experience
#5
Panagiotis Paliogiannis, Giorgio C Ginesu, Alessandro Fancellu, Aldo Pischedda, Mario Maiore, Eleonora Maiore, Antonio Pinna, Michele Barmina, Alberto Porcu
Chronic mesenteric ischemia is a rare intestinal disorder, with a potential evolution toward intestinal infraction. The choice of the appropriate treatment is currently the most crucial issue in the management of patients with chronic mesenteric ischemia. We describe our experience with 16 cases, and we discuss the current diagnostic and therapeutic approaches. A retrospective review of the clinical records was performed, and demographic, clinical, therapeutic, and prognostic data were collected. Six patients were females (37%), and the mean age was 62 years...
December 1, 2017: American Surgeon
https://www.readbyqxmd.com/read/29330835/international-guidelines-for-groin-hernia-management
#6
(no author information available yet)
INTRODUCTION: Worldwide, more than 20 million patients undergo groin hernia repair annually. The many different approaches, treatment indications and a significant array of techniques for groin hernia repair warrant guidelines to standardize care, minimize complications, and improve results. The main goal of these guidelines is to improve patient outcomes, specifically to decrease recurrence rates and reduce chronic pain, the most frequent problems following groin hernia repair. They have been endorsed by all five continental hernia societies, the International Endo Hernia Society and the European Association for Endoscopic Surgery...
January 12, 2018: Hernia: the Journal of Hernias and Abdominal Wall Surgery
https://www.readbyqxmd.com/read/29326812/endovascular-laser-treatment-of-incompetent-saphenous-veins-using-the-1470%C3%A2-nm-diode-laser-and-radial-fiber
#7
Georgios Vourliotakis, Georgios Sahsamanis, Paschalis Evagelidis, Christina Aivatidi
Objectives: To assess the technical success, complications, and patients' quality of life (QoL) after treatment of chronic venous disease (CVD) using the 1470 nm radial fiber laser. Methods: A total of 170 patients with chronic venous disease, classified as C2 to C4 according to CEAP classification, were treated for incompetent greater (GSV) and small (SSV) saphenous veins, using the 1470 nm radial fiber laser and application of tumescent anesthesia. Additional phlebectomies were performed through stab microincisions, while 11 patients further underwent sclerotherapy intraoperatively...
January 2018: Annals of Medicine and Surgery
https://www.readbyqxmd.com/read/29325836/interleukin-6-and-leptin-levels-are-associated-with-preoperative-pain-severity-in-patients-with-osteoarthritis-but-not-with-acute-pain-after-total-knee-arthroplasty
#8
Syed Azim, James Nicholson, Mario J Rebecchi, William Galbavy, Tian Feng, Sabeen Rizwan, Ruth A Reinsel, Martin Kaczocha, Helene Benveniste
BACKGROUND: Identifying drivers of pain that can serve as novel drug targets is important for improving perioperative analgesia. Total knee arthroplasty (TKA) is associated with significant postoperative pain. Cytokines contribute to the pathophysiology of osteoarthritis (OA) and associated pain. However, the influence of perioperative cytokine levels after TKA surgery upon postoperative pain remains unexplored. METHODS: We designed a prospective observational study to profile three proinflammatory cytokines, interleukin-6 (IL-6), tumor necrosis factor α (TNFα), and leptin in serum, synovial, and cerebrospinal fluid of TKA patients perioperatively to determine associations between cytokine levels and pain...
January 8, 2018: Knee
https://www.readbyqxmd.com/read/29325513/use-of-methylene-blue-in-the-prevention-of-recurrent-intra-abdominal-postoperative-adhesions
#9
Octavian C Neagoe, Mihaela Ionica, Octavian Mazilu
Objective To evaluate the efficacy of methylene blue in preventing recurrent symptomatic postoperative adhesions. Methods Patients with a history of >2 surgeries for intra-abdominal adhesion-related complications were selected for this study. Adhesiolysis surgery was subsequently performed using administration of 1% methylene blue. The follow-up period was 28.5 ± 11.1 months. Results Data were available from 20 patients (seven men and 13 women) whose mean ± SD age was 51.2 ± 11.4 years. Adhesions took longer to become symptomatic after the first abdominal surgery when the initial pathology was malignant compared with benign...
January 2018: Journal of International Medical Research
https://www.readbyqxmd.com/read/29321104/neurectomy-for-anterior-cutaneous-nerve-entrapment-syndrome-in-children
#10
Lindsey B Armstrong, Pradeep Dinakar, David P Mooney
INTRODUCTION: Anterior cutaneous nerve entrapment syndrome (ACNES) is an underrecognized etiology of chronic abdominal pain that causes great morbidity to those affected. We sought to determine the outcome of neurectomy for ACNES in children. METHODS: Demographic and clinical data on children who underwent neurectomy for ACNES by a single surgeon from 10/2011 to 01/2017 were reviewed. RESULTS: Twenty-six patients underwent neurectomy for ACNES...
December 8, 2017: Journal of Pediatric Surgery
https://www.readbyqxmd.com/read/29318178/outcomes-after-dermal-allograft-reconstruction-of-chronic-or-subacute-pectoralis-major-tendon-ruptures
#11
Julie A Neumann, Christopher M Klein, Carola F van Eck, Hithem Rahmi, John M Itamura
Background: Avoiding delay in the surgical management of pectoralis major (PM) ruptures optimizes outcomes. However, this is not always possible, and when a tear becomes chronic or when a subacute tear has poor tissue quality, a graft can facilitate reconstruction. Purpose: The primary aim was to evaluate the clinical outcomes of PM reconstruction with dermal allograft augmentation for chronic tears or for subacute tears with poor tissue quality. A second aim was to determine patient and surgical factors affecting outcome...
January 2018: Orthopaedic Journal of Sports Medicine
https://www.readbyqxmd.com/read/29316592/the-addition-of-diclofenac-to-a-multimodal-pain-control-regimen-decreases-postoperative-pain-and-opioid-consumption
#12
Nicole E George, Cheryle Gurk-Turner, Jennifer I Etcheson, Chukwuweike U Gwam, Randal De Souza, Spencer S Smith, James Nace, Ronald E Delanois
INTRODUCTION: Total knee arthroplasty (TKA) is a commonly-performed orthopaedic procedure in the United States. However, inadequate postoperative pain management following TKA has been associated with a number of negative consequences, including chronic postoperative pain requiring long-term opioid use. Multimodal pain control is a recently-popularized means of maximizing analgesia and postoperative outcomes. We aimed to evaluate the outcomes of a multimodal pain regimen incorporating diclofenac, including: 1) length of stay (LOS); 2) pain intensity; and 3) opioid consumption in primary TKA patients...
December 22, 2017: Surgical Technology International
https://www.readbyqxmd.com/read/29313852/response-to-vats-vs-thoracotomy-regarding-postoperative-chronic-pain
#13
COMMENT
Emine Ozgur Bayman, Kalpaj R Parekh, John Keech, Timothy J Brennan
No abstract text is available yet for this article.
December 2017: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/29290135/preoperative-depression-lumbar-fusion-and-opioid-use-an-assessment-of-postoperative-prescription-quality-and-economic-outcomes
#14
Chloe O'Connell, Tej Deepak Azad, Vaishali Mittal, Daniel Vail, Eli Johnson, Atman Desai, Eric Sun, John K Ratliff, Anand Veeravagu
OBJECTIVE Preoperative depression has been linked to a variety of adverse outcomes following lumbar fusion, including increased pain, disability, and 30-day readmission rates. The goal of the present study was to determine whether preoperative depression is associated with increased narcotic use following lumbar fusion. Moreover, the authors examined the association between preoperative depression and a variety of secondary quality indicator and economic outcomes, including complications, 30-day readmissions, revision surgeries, likelihood of discharge home, and 1- and 2-year costs...
January 2018: Neurosurgical Focus
https://www.readbyqxmd.com/read/29289751/patient-selection-for-total-pancreatectomy-with-islet-autotransplantation-in-the-surgical-management-of-chronic-pancreatitis
#15
Katherine A Morgan, William P Lancaster, Stefanie M Owczarski, Hongjun Wang, Jeffrey Borckardt, David B Adams
BACKGROUND: Best practice to select patients with chronic pancreatitis for surgical management with total pancreatectomy with islet autotransplantation (TPIAT) is in evolution as new discoveries are made in the pathogenesis of chronic pancreatitis. METHODS: A prospectively maintained database of patients undergoing TPIAT is reviewed. Islet function is inferred from daily insulin requirement. Pain relief is evaluated by healthcare utilization and narcotic use. Quality of life (QOL) is measured with SF-12...
December 28, 2017: Journal of the American College of Surgeons
https://www.readbyqxmd.com/read/29288309/the-effect-of-intraoperative-nefopam-administration-on-acute-postoperative-pain-and-chronic-discomfort-after-robotic-or-endoscopic-assisted-thyroidectomy-a-randomized-clinical-trial
#16
B G Kim, J Y Moon, J Y Choi, I S Park, A Y Oh, Y T Jeon, J W Hwang, J H Ryu
BACKGROUND: Acute postoperative pain and chronic discomfort are reported after robotic or endoscopic thyroidectomy. The purpose of this prospective, randomized, and double-blinded clinical trial was to investigate whether intraoperative infusion of nefopam decreases acute postoperative pain and chronic discomfort following either a robotic or endoscopic thyroidectomy via the bilateral axillo-breast approach (BABA). METHODS: Patients were randomized into two groups: The control group (n = 29) or the nefopam group (n = 29)...
December 29, 2017: World Journal of Surgery
https://www.readbyqxmd.com/read/29284534/perineural-local-anaesthetic-catheter-after-major-lower-limb-amputation-trial-placement-study-protocol-for-a-randomised-controlled-pilot-study
#17
David C Bosanquet, Graeme K Ambler, Cherry-Ann Waldron, Emma Thomas-Jones, Lucy Brookes-Howell, Mark Kelson, Tim Pickles, Debbie Harris, Deborah Fitzsimmons, Neeraj Saxena, Christopher P Twine
BACKGROUND: Pain after major lower limb amputation for peripheral arterial disease (PAD) is a significant problem. A perineural catheter (PNC) can be placed adjacent to the major nerve at the time of amputation with a continuous local anaesthetic infusion given postoperatively to try and reduce pain. Although low-quality observational data suggest that PNC usage reduces postoperative opioid requirements, there are limited data regarding its effect on pain. The aim of PLACEMENT is to explore the feasibility of running an effectiveness trial to assess the impact of a PNC with continuous local anaesthetic infusion, inserted at the time of amputation, on short and medium-term postoperative outcomes...
December 28, 2017: Trials
https://www.readbyqxmd.com/read/29280878/ability-to-cope-with-pain-puts-migraine-surgery-patients-in-perspective
#18
Lisa Gfrerer, Jonathan Lans, Heather R Faulkner, Sjoerd Nota, Arjan G J Bot, William Gerald Austen
BACKGROUND: Candidates for migraine surgery are chronic pain patients with significant disability. Currently, migraine-specific questionnaires are used to evaluate these patients. Analysis tools widely used in evaluation of better understood pain conditions are not typically applied. This is the first study to include a commonly used pain questionnaire, the Pain Self-Efficacy Questionnaire (PSEQ) that is used to determine patients' pain coping abilities and function. It is an important predictor of pain intensity/disability in patients with musculoskeletal pain, as low scores have been associated with poor outcome...
January 2018: Plastic and Reconstructive Surgery
https://www.readbyqxmd.com/read/29279662/ct-scan-reliability-in-detecting-internal-hernia-after-gastric-bypass
#19
Mohammad A Farukhi, Michael S Mattingly, Benjamin Clapp, Alan H Tyroch
Background and Objectives: Internal hernia (IH) after gastric bypass can be a life-threatening complication. Obstruction presents acutely or as chronic relapses, with symptoms of abdominal pain, nausea, and vomiting. Early detection and exploration of IH as the cause of small bowel obstruction (SBO) is critical in this surgical emergency and can reduce morbidity and mortality. We conducted a retrospective review of laparoscopic Roux-en-Y bypass (LRYGB) records to determine the specificity and sensitivity of computed tomography (CT) in identifying postoperative IH...
October 2017: JSLS: Journal of the Society of Laparoendoscopic Surgeons
https://www.readbyqxmd.com/read/29258479/surgical-treatment-strategies-for-giant-inguinoscrotal-hernia-a-case-report-with-review-of-the-literature
#20
Julia Isabelle Staubitz, Peter Gassmann, Daniel Wilhelm Kauff, Hauke Lang
BACKGROUND: An inguinoscrotal hernia is defined as "giant" if descending below the midpoint of the inner thigh of a patient in upright position. In developed countries this is a rare entity. In the literature different surgical techniques have been reported so far to achieve a successful treatment. CASE PRESENTATION: We present the case of a 63 year-old man suffering from a giant inguinoscrotal hernia, whom we treated using a combined open transabdominal and inguinal approach following an unsuccessful laparoscopic attempt...
December 19, 2017: BMC Surgery
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