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https://www.readbyqxmd.com/read/28817444/strategies-for-reducing-population-surgical-costs-in-medicare-local-referrals-to-low-cost-hospitals
#1
Hari Nathan, Jyothi R Thumma, Edward C Norton, Justin B Dimick
OBJECTIVE: We sought to assess hospital cost variation for elective inpatient surgical procedures within small geographic areas. SUMMARY BACKGROUND DATA: Previous studies have documented cost variation for inpatient surgical procedures on a national basis, suggesting opportunities for savings. Cost variation within small geographic areas is more relevant to policymakers, providers, and patients, but it has not been studied. METHODS: Using Medicare payment data, we identified elderly patients undergoing 1 of 7 elective inpatient surgical procedures during 2010-2012...
August 16, 2017: Annals of Surgery
https://www.readbyqxmd.com/read/28817157/extent-and-morbidity-of-lateralization-of-a-trochanteric-fixation-nail-blade
#2
Phillip A Sandifer, Robert M Hulick, Matthew L Graves, Clay A Spitler, George V Russell, Josie M Hydrick, LaRita C Jones, Patrick F Bergin
This study examined the incidence and risk factors associated with lateral helical blade migration and trochanteric pain with the trochanteric fixation nail. A retrospective review was performed of 141 cases of pertrochanteric femur fracture treated with a trochanteric fixation nail at a level I trauma center over a period of 42 months. Exclusion criteria included follow-up of less than 60 days, preexisting osteonecrosis of the femoral head, and prophylactic trochanteric fixation nail treatment. Patient demographics, operative findings, and radiographic findings were recorded...
August 17, 2017: Orthopedics
https://www.readbyqxmd.com/read/28816389/clinical-indications-for-hysteroscopic-removal-of-uterine-masses-time-age-at-diagnosis-and-mass-size
#3
Hyun-Woong Cho, Yu-Jin Koo, Jin-Hwa Hong, Jae-Kwan Lee
AIM: The aim of this study was to investigate clinical factors associated with abnormal pathologies of uterine masses resected via hysteroscopy. METHODS: Women who underwent hysteroscopic surgery for presumptive diagnoses of abnormal endometrial or endocervical masses, such as polyps or leiomyomas on ultrasonography, between January 2012 and April 2015, were enrolled. Clinical and pathologic data were retrospectively reviewed. RESULTS: Among 189 patients, pathologic diagnoses of the uterine mass were abnormal in 172 (91...
August 17, 2017: Journal of Obstetrics and Gynaecology Research
https://www.readbyqxmd.com/read/28816299/-application-of-intraoperative-cell-salvage-combined-with-leukocyte-depletion-filter-on-radical-nephrectomy-for-renal-carcinoma-with-inferior-vena-cava-tumor-thrombus-2-case-reports
#4
H Zeng, X Y Rong, X Q Zhang, X Y Guo
Intraoperative cell salvage (IOCS) has been widely used to reduce allogeneic blood transfusion and prevent blood transfusion related complications during surgery. However, due to the risk of transfusion related reaction, contamination, and immunological reaction, its use for tumor patients has been controversial and limited. To explore the feasibility of the application of IOCS in cancer patients, we reported 2 cases of renal cell carcinoma (RCC) with tumor embolism in IVC that underwent radical nephrectomy,and inferior caval venous thrombectomy receiving IOCS combined with leukocyte depletion filter (LDF) from August 2016 to November 2016 in our hospital...
August 18, 2017: Beijing da Xue Xue Bao. Yi Xue Ban, Journal of Peking University. Health Sciences
https://www.readbyqxmd.com/read/28816275/-clinical-application-of-retroperitoneal-laparoscopic-surgery-combined-with-mini-flank-incision-hybrid-surgery-for-partial-nephrectomy-of-complex-renal-tumors
#5
X J Ye, J Liu, A Ablimit, L L Xiong, S J Liu, T Xu, X B Huang
OBJECTIVE: To evaluate the clinical effect and safety of retroperitoneal laparoscopic surgery combined with mini-flank incision "hybrid surgery" for partial nephrectomy of complex renal tumors. METHODS: Between April 2015 and December 2016, the clinical data from 16 patients with complex renal tumors who underwent the "hybrid surgery", including 10 males and 6 females, were retrospectively reviewed. The average age was (50.2±10.7) years, 9 cases were located in the left side and 7 cases in the right side, the mean tumor size was (6...
August 18, 2017: Beijing da Xue Xue Bao. Yi Xue Ban, Journal of Peking University. Health Sciences
https://www.readbyqxmd.com/read/28815075/the-feeding-route-after-esophagectomy-a-review-of-literature
#6
REVIEW
Gijs H Berkelmans, Frans van Workum, Teus J Weijs, Grard A Nieuwenhuijzen, Jelle P Ruurda, Ewout A Kouwenhoven, Marc J van Det, Camiel Rosman, Richard van Hillegersberg, Misha D Luyer
Enhanced recovery programs effectively optimize perioperative care and reduce postoperative morbidity. In esophagectomy, several components of the ERAS program are successfully introduced. However, timing and type of postoperative feeding remain a matter of debate. Adequate nutritional support is essential in patients undergoing an esophagectomy. These patients often present with weight loss and their eating pattern is strongly altered by the procedure and reconstruction. Total parenteral nutrition (TPN) is associated with severe septic complications and enteral nutrition (EN) does not increase major complications...
July 2017: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/28814172/novel-endovascular-management-of-proximal-type-a-debakey-ii-aortic-dissection-with-a-patent-foramen-ovale-occluder
#7
Xun Yuan, Andreas Mitsis, David Mozalbat, Christoph A Nienaber
PURPOSE: To present a novel endovascular management option that avoids open surgery in selected patients with subacute type A aortic dissection (DeBakey II). CASE REPORT: A 75-year-old woman with previous infrarenal abdominal aortic aneurysm repaired in 2006 and multiple comorbidities (EURO score II 20.5%) was admitted with chest pain; computed tomography angiography (CTA) showed a new dissection in the ascending aorta just above the right coronary ostium. As the patient was considered unfit to undergo surgery, an endovascular solution was suggested after multidisciplinary team discussion...
August 1, 2017: Journal of Endovascular Therapy
https://www.readbyqxmd.com/read/28813774/pulmonary-embolism-caused-by-popliteal-vein-aneurysm-a-case-report
#8
Kevin Marquez, Kalyan Chakravarthy Potu, Chad Laurich, Randall Lamfers
In this case report, we describe an unusual episode of bilateral submassive pulmonary embolism (PE) caused by a popliteal vein aneurysm (PVA). The development of PE stems from many risk factors including obesity (BMI³ 30 kg/m2), hypertension, cigarette smoking (greater than 25 cigarettes per day), increasing age, surgery, immobility, malignancy, and inherited thrombophilia. A PVA is a rare but significant cause of PE. A 28-year-old male presented to the emergency department with progressive shortness of breath...
March 2017: South Dakota Medicine: the Journal of the South Dakota State Medical Association
https://www.readbyqxmd.com/read/28813702/tocolysis-for-in-utero-surgery-atosiban-performs-distinctly-better-than-magnesium-sulfate
#9
Nicole Ochsenbein-Kölble, Franziska Krähenmann, Margret Hüsler, Martin Meuli, Ueli Moehrlen, Lucca Mazzone, Peter Biro, Roland Zimmermann
INTRODUCTION: To compare tocolysis with magnesium sulfate versus atosiban regarding the occurrence of short-term preterm labor and maternal side effects during and after open fetal myelomeningocele (MMC) repair. MATERIAL AND METHODS: A prospective nonrandomized cohort study was performed including 30 fetal MMC cases. The first 15 cases (group 1) received magnesium sulfate according to the MOMS protocol. In the following 15 cases (group 2), magnesium sulfate was substituted by atosiban...
August 17, 2017: Fetal Diagnosis and Therapy
https://www.readbyqxmd.com/read/28812193/cost-analysis-of-robot-assisted-choledochotomy-and-common-bile-duct-exploration-as-an-option-for-complex-choledocholithiasis
#10
Ahmed Almamar, Nawar A Alkhamesi, Ward T Davies, Christopher M Schlachta
AIM: The aim of this study is to evaluate the clinical outcomes and cost-effectiveness of elective, robot-assisted choledochotomy and common bile duct exploration (RCD/CBDE) compared to open surgery for ERCP refractory choledocholithiasis. METHOD: A prospective database of all RCD/CBDE has been maintained since our first procedure in April 2007 though April 2016. With ethics approval, this database was compared with all contemporaneous elective open procedures (OCD/CBDE) performed since March 2005...
August 15, 2017: Surgical Endoscopy
https://www.readbyqxmd.com/read/28812144/-trends-in-ablation-surgery-what-has-changed-compared-to-2001
#11
C V Fischer, M Kulanga, H Hoerauf
INTRODUCTION: In 2001 a survey among retinal surgeons regarding the treatment of rhegmatogenous retinal detachment either with scleral buckling methods or primary vitrectomy was performed. Due to the technical progress of vitrectomy and observational systems, it seemed appropriate to renew and update this survey supplemented with current aspects. METHODS: In this study 78 vitreoretinal surgeons from German-speaking countries were surveyed via an anonymous online questionnaire on their treatment decisions for defined retinal detachment constellations...
August 15, 2017: Der Ophthalmologe: Zeitschrift der Deutschen Ophthalmologischen Gesellschaft
https://www.readbyqxmd.com/read/28811985/incidence-impact-and-risk-factors-for-30-day-wound-complications-following-elective-adult-spinal-deformity-surgery
#12
Nathan J Lee, John I Shin, Parth Kothari, Jun S Kim, Dante M Leven, Jeremy Steinberger, Javier Z Guzman, Branko Skovrlj, John M Caridi, Samuel K Cho
STUDY DESIGN: Case-control study. OBJECTIVE: To determine the incidence, impact, and risk factors for wound complications within 30 days following elective adult spinal deformity surgery. METHODS: Current Procedural Terminology and International Classification of Diseases, Ninth Edition, diagnosis codes were used to query the database for adults who underwent spinal deformity surgery from 2010 to 2014. Patients were separated into groups of those with and without wound complications...
August 2017: Global Spine Journal
https://www.readbyqxmd.com/read/28811982/a-matched-cohort-analysis-comparing-stand-alone-cages-and-anterior-cervical-plates-used-for-anterior-cervical-discectomy-and-fusion
#13
Samuel C Overley, Robert K Merrill, Dante M Leven, Joshua J Meaike, Abhishek Kumar, Sheeraz A Qureshi
STUDY DESIGN: Retrospective cohort study. OBJECTIVE: To compare perioperative characteristics of stand-alone cages and anterior cervical plates used for anterior cervical discectomy and fusion (ACDF). METHODS: We reviewed 40 adult patients who received a stand-alone cage for elective ACDF and matched them with 40 patients who received an anterior cervical plate. We statistically compared operative time, length of stay, proportion of ambulatory cases, overall complications necessitating a trip to the ED, readmission, or reoperation related to index procedure...
August 2017: Global Spine Journal
https://www.readbyqxmd.com/read/28811789/single-incision-laparoscopic-cholecystectomy-with-conventional-instruments-and-ports-initial-experience-at-tertiary-care-public-sector-hospital
#14
Abdul Razaque Shaikh, Syed Asad Ali, Ambreen Munir, Aijaz Ali Shaikh
OBJECTIVE: To find out safety and feasibility of single incision laparoscopic cholecystectomy (SLIC) using conventional instruments. METHODS: This study was conducted at surgical department of LUMHS Jamshoro Pakistan from Jan: 2014 to Dec: 2015. All cases of symptomatic cholelithiasis that consented for laparoscopic surgery were included. The exclusion criteria were acute cholecystitis, acute gall stone pancreatitis, common bile duct stones and patients with co-morbid...
May 2017: Pakistan Journal of Medical Sciences Quarterly
https://www.readbyqxmd.com/read/28811110/characterizing-the-diagnosis-and-treatment-of-allergic-contact-dermatitis-to-2-octyl-cyanoacrylate-used-for-skin-closure-in-elective-orthopedic-surgery
#15
Brian P Chalmers, Heath P Melugin, Peter K Sculco, Jennifer J Schoch, Rafael J Sierra, Mark W Pagnano, Michael J Stuart, Michael J Taunton
BACKGROUND: While studies have shown that postoperative wound complications can predispose to deep infection following orthopedic surgery, the best form of skin closure has not been elucidated. Furthermore, the unique risks and benefits of each type of wound closure have not been studied. The goal of this study is to present the diagnosis and treatment of patients with allergic contact dermatitis (ACD) from 2-octyl cyanoacrylate, a skin adhesive commonly used in wound closure. METHODS: Twenty-nine patients with ACD to 2-octyl cyanoacrylate (Prineo, Ethicon, NJ) following elective orthopedic surgeries from 2013 to 2016 were retrospectively reviewed; this occurred in 29 of 6088 units of Prineo used at our institution, for an estimated incidence of 0...
July 18, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28811042/understanding-readmissions-in-children-undergoing-surgery-a-pediatric-nsqip-analysis
#16
Afif N Kulaylat, Dorothy V Rocourt, Anthony Y Tsai, Kathryn L Martin, Brett W Engbrecht, Mary C Santos, Robert E Cilley, Christopher S Hollenbeak, Peter W Dillon
BACKGROUND: Readmission is increasingly being utilized as an important clinical outcome and measure of hospital quality. Our aim was to delineate rates, risk factors, and reasons for unplanned readmission in pediatric surgery. MATERIALS AND METHODS: Retrospective review of pediatric patients (n=130,274) undergoing surgery (2013-2014) at hospitals enrolled in the Pediatric National Surgical Quality Improvement Program (NSQIP-P) was performed. Logistic regression was used to model factors associated with unplanned 30-day readmission...
July 31, 2017: Journal of Pediatric Surgery
https://www.readbyqxmd.com/read/28810991/posterior-cruciate-ligament-injuries-associated-with-military-survival-swim-training
#17
Michael S Crowell, John S Mason, Matthew A Posner, Chad A Haley
OBJECTIVES: Posterior cruciate ligament (PCL) injuries are relatively common injuries associated with athletic activities and high-energy trauma. Posterolateral corner (PLC) injuries frequently accompany injury to the PCL. Diagnosis can be challenging and requires a comprehensive history and physical examination. Patients frequently report vague, nonspecific symptoms and the mechanism of injury is often useful in localizing injured structures. Two of the more common mechanisms for PCL injury include a direct blow to the proximal anterior tibia with the knee flexed, as well as a significant knee hyperextension injury...
July 2017: Military Medicine
https://www.readbyqxmd.com/read/28810647/limb-graft-occlusion-following-endovascular-aortic-repair-incidence-causes-treatment-and-prevention-in-a-study-cohort
#18
Guoquan Wang, Shuiting Zhai, Tianxiao Li, Xuan Li, Danghui Lu, Bo Wang, Dongbin Zhang, Shuaitao Shi, Zhidong Zhang, Kai Liang, Kewei Zhang, Xiaoyang Fu, Kun Li, Weixiao Li
The present study investigated the incidence, causes, treatment and prevention of limb graft occlusion following endovascular aortic repair (EVAR). A total of 66 cases of abdominal aortic aneurysm receiving EVAR at our department from January 2005 to December 2013 were enrolled. After EVAR, patients received routine antiplatelet therapy of 75 mg PLAVIX for 6 months and then 100 mg Aspirin for another 6 months by oral administration. According to previous clinical experiences, antiplatelet therapy is able to effectively reduce the incidence of iliac occlusion after EVAR...
August 2017: Experimental and Therapeutic Medicine
https://www.readbyqxmd.com/read/28809642/fibular-strut-graft-for-posterior-pelvic-ring-nonunion-a-case-report
#19
M Frank, J R McCallum, T Dědek
Posttraumatic pelvic nonunions in combination with malposition are uncommon in the present-day era of modern pelvic surgery. The case describes a new surgical technique for treatment of the nonunion localized to iliosacral joint. A 42-year-old polytraumatized male presented with a pelvic fracture (type 61-C2.3) associated with a complex acetabular fracture. The patient was treated and the pelvis stabilized according to damage control principles (external fixation and pelvic C-clamp) and subsequently definitively treated according to principles of current pelvic surgery...
2017: Acta Chirurgiae Orthopaedicae et Traumatologiae Cechoslovaca
https://www.readbyqxmd.com/read/28808605/fatal-cerebral-swelling-immediately-after-cranioplasty-a-case-report
#20
Yuta Kaneshiro, Keiji Murata, Shigeru Yamauchi, Yumiko Urano
BACKGROUND: Cranioplasty is a standard neurosurgical procedure which is performed after decompressive craniotomy. Fatal complications associated with this procedure are not well documented. Here, we report a case of fatal cerebral swelling after cranioplasty and discuss the possible mechanism of this complication. CASE DESCRIPTION: A 64-year-old man was admitted with the diagnosis of cerebral hemorrhage, and emergency surgery for hemorrhage removal and decompressive craniotomy were performed...
2017: Surgical Neurology International
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