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Site marking in Surgery

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https://www.readbyqxmd.com/read/28711623/prioritized-cervical-or-lumbar-surgery-for-coexisting-cervical-and-lumbar-stenosis-prognostic-analysis-of-222-case
#1
Haoxi Li, Zhaoxiong Chen, Xinhua Li, Tao Liu, Bin Shen, Yufeng Huang, Desheng Wu
BACKGROUND CONTEXT: Single-stage surgery is usually applied to improving the symptoms of coexisting cervical and lumbar stenosis. In most cases, patients' willingness, surgery affordability, surgical trauma, surgical complications and patients' tolerance to surgery all limit the application of single-stage surgery. For patients who cannot receive single-stage surgery, we hope that we can find out by weighing up merits and flaws of the two surgical sites in order to make decision of prioritize one of the two surgery, so as to bring more benefits to the patients...
July 12, 2017: International Journal of Surgery
https://www.readbyqxmd.com/read/28702703/transfixing-kirshner-wires-for-fixation-of-intertrochanteric-valgus-osteotomies-in-management-of-pediatric-coxa-vara
#2
Ahmed Shawkat Rizk
BACKGROUND: Coxa vara is a radiological term describing a decrease in the neck-shaft angle to 120° or less. Coxa vara is associated with pathomechanical changes that can manifest clinically. If left untreated, coxa vara can affect the normal development of the pediatric hip. Valgus osteotomy is the standard surgical treatment for coxa vara, but there is no consensus regarding the optimal osteotomy technique and fixation method. The work reported here aimed to highlight transfixing wires as a fixation method for valgus osteotomy applied as treatment for various types of pediatric coxa vara...
July 12, 2017: Journal of Orthopaedics and Traumatology: Official Journal of the Italian Society of Orthopaedics and Traumatology
https://www.readbyqxmd.com/read/28700780/distinction-of-risk-factors-for-superficial-vs-organ-space-surgical-site-infections-after-pancreatic-surgery
#3
Irmina A Elliott, Carmen Chan, Tara A Russell, Amanda M Dann, Jennifer L Williams, Lauren Damato, Hallie Chung, Mark D Girgis, O Joe Hines, Howard A Reber, Timothy R Donahue
Importance: Surgical site infection (SSI) rates are increasingly used as a quality metric. However, risk factors for SSI in pancreatic surgery remain undefined. Objective: To stratify superficial and organ-space SSIs after pancreatectomy and investigate their modifiable risk factors. Design, Setting, and Participants: This retrospective analysis included 201 patients undergoing pancreatic surgery at a university-based tertiary referral center from July 1, 2013, through June 30, 2015, and 10 371 patients from National Surgical Quality Improvement Program-Hepatopancreaticobiliary (NSQIP-HPB) Collaborative sites from January 1, 2014, through December 31, 2015...
July 12, 2017: JAMA Surgery
https://www.readbyqxmd.com/read/28697103/chlorhexidine-alcohol-compared-with-povidone-iodine-for-preoperative-topical-antisepsis-for-abdominal-hysterectomy
#4
Shitanshu Uppal, Ali Bazzi, R Kevin Reynolds, John Harris, Mark D Pearlman, Darrell A Campbell, Daniel M Morgan
OBJECTIVE: To compare preoperative chlorhexidine-alcohol topical antiseptic agent with povidone-iodine in patients undergoing abdominal hysterectomy for benign indications. METHODS: A retrospective cohort study of patients undergoing abdominal hysterectomy from July 2012 to February 2015 in the Michigan Surgical Quality Collaborative was performed. The primary exposure was the use of chlorhexidine-alcohol or povidone-iodine. The primary outcome was surgical site infection within 30 days...
July 7, 2017: Obstetrics and Gynecology
https://www.readbyqxmd.com/read/28685405/impact-of-removed-tumor-volume-and-location-on-patient-outcome-in-glioblastoma
#5
Al-Wala Awad, Michael Karsy, Nader Sanai, Robert Spetzler, Yue Zhang, Yizhe Xu, Mark A Mahan
Glioblastoma is an aggressive primary brain tumor with devastatingly poor prognosis. Multiple studies have shown the benefit of wider extent of resection (EOR) on patient overall survival (OS) and worsened survival with larger preoperative tumor volumes. However, the concomitant impact of postoperative tumor volume and eloquent location on OS has yet to be fully evaluated. We performed a retrospective chart review of adult patients treated for glioblastoma from January 2006 through December 2011. Adherence to standardized postoperative chemoradiation protocols was used as an inclusion criterion...
July 6, 2017: Journal of Neuro-oncology
https://www.readbyqxmd.com/read/28664442/safe-and-successful-resection-of-difficult-gi-lesions-using-a-novel-single-step-full-thickness-resection-device-ftrd-%C3%A2
#6
P V Valli, J Mertens, P Bauerfeind
BACKGROUND AND STUDY AIMS: Classic endoscopic resection techniques (EMR and ESD) are limited to mucosal lesions. In the case of deeper growth into the gut wall and anatomic sites prone to perforation, the novel full-thickness resection device (FTRD(®)) opens a new dimension of possibilities for endoscopic resection. PATIENTS AND METHODS: Sixty patients underwent endoscopic full-thickness resection (eFTR) at our institution. Safety, learning curve, R0 resection rate, and clinical outcome were studied...
June 29, 2017: Surgical Endoscopy
https://www.readbyqxmd.com/read/28661999/preoperative-site-marking-are-we-adhering-to-good-surgical-practice
#7
Sonia Bathla, Michael Chadwick, Edward J Nevins, Joanna Seward
OBJECTIVES: Wrong-site surgery is a never event and a serious, preventable patient safety incident. Within the United Kingdom, national guidance has been issued to minimize the risk of such events. The mandate includes preoperative marking of all surgical patients. This study aimed to quantify regional variation in practice within general surgery and opinions of the surgeons, to help guide the formulation and implementation of a regional general surgery preoperative marking protocol. METHODS: A SurveyMonkey questionnaire was designed and distributed to 120 surgeons within the Mersey region, United Kingdom...
June 29, 2017: Journal of Patient Safety
https://www.readbyqxmd.com/read/28658843/anatrophic-nephrolithotomy-in-the-management-of-large-staghorn-calculi-a-single-centre-experience
#8
Ramaiah Keshavamurthy, Vilvapathy Senguttuvan Karthikeyan, Ashwin Mallya, Jayaram Sreenivas, Girish Gurubasappa Nelivigi, Ananth Janarthan Kamath
INTRODUCTION: With advances in endourology, open stone surgery for staghorn calculi has markedly diminished. Anatrophic Nephrolithotomy (AN) is performed for complex staghorn stones which cannot be cleared by a reasonable number of Percutaneous Nephrolithotomy (PNL) attempts. AIM: To assess the indications and outcomes of AN in the modern era. MATERIALS AND METHODS: Between April 2008 and July 2015, AN was done in 14 renal units in 13 patients...
May 2017: Journal of Clinical and Diagnostic Research: JCDR
https://www.readbyqxmd.com/read/28652121/high-intensity-focused-ultrasound-for-radio-recurrent-prostate-cancer-a-north-american-clinical-trial
#9
Tonye A Jones, Joseph Chin, David Mcleod, Jack Barkin, Allan Pantuck, Leonard S Marks
PURPOSE: To determine the safety and efficacy of whole-gland HIFU in men with radio-recurrent prostate cancer (CaP). MATERIALS AND METHODS: 100 men with clinically localized recurrence of CaP at least 2 years after EBRT received whole-gland HIFU in an open-label trial (2009 to 2012). Treatments were performed at 16 sites in the U.S. (14) and Canada (2). Primary endpoint was a combination of both PSA nadir ≤0.5 ng/ml and negative biopsy at 12 months. Validated questionnaires were used to monitor changes in urinary and sexual function...
June 23, 2017: Journal of Urology
https://www.readbyqxmd.com/read/28643518/mini-c-arm-fluoroscopy-does-its-configuration-matter-for-radiation-exposure-to-the-surgeon
#10
Talia Chapman, Dennis P Martin, Christopher Williamson, Brian Tinsley, Mark L Wang, Asif M Ilyas
BACKGROUND: The risk of occupational radiation exposure to the surgeon associated with the use of a mini C-arm has yet to reach a wide consensus. Using a distal radius fracture surgery model, we tested the hypothesis that radiation exposure to the surgeon's critical body parts is independent of mini C-arm configuration. METHODS: An anthropomorphic mannequin (representing the upper body of a 60" male surgeon) was seated at a hand table as if operating on a volar-plated wrist Sawbone model...
June 1, 2017: Hand: Official Journal of the American Association for Hand Surgery
https://www.readbyqxmd.com/read/28637590/evaluation-of-readmissions-due-to-surgical-site-infections-a-potential-target-for-quality-improvement
#11
Romil Shah, Emily Pavey, Mila Ju, Ryan Merkow, Ravi Rajaram, Michael W Wandling, Mark E Cohen, Allison Dahlke, Anthony Yang, Karl Bilimoria
INTRODUCTION: Readmissions have become a focus of pay-for-performance programs. Surgical site infections (SSI) are the reason for most readmissions. Readmissions for SSI could be a unique target for quality improvement. METHODS: Readmission risk for SSI were evaluated for patients undergoing colectomies from 2013 to 2014. Hazard models were developed to examine factors associated with and hospital-level variation in risk-adjusted rates of readmission for SSI. RESULTS: Among 59,088 patients at 525 hospitals, the rate of readmissions for SSI ranged from 1...
June 8, 2017: American Journal of Surgery
https://www.readbyqxmd.com/read/28636718/trends-and-outcomes-of-off-label-use-of-transcatheter-aortic-valve-replacement-insights-from-the-ncdr-sts-acc-tvt-registry
#12
Ravi S Hira, Sreekanth Vemulapalli, Zhuokai Li, James M McCabe, John S Rumsfeld, Samir R Kapadia, Mahboob Alam, Hani Jneid, Creighton Don, Mark Reisman, Salim S Virani, Neal S Kleiman
Importance: Transcatheter aortic valve replacement (TAVR) was approved by the US Food and Drug Administration for severe aortic stenosis in patients who cannot undergo surgery and for patients at high operative risk. Use of TAVR for off-label indications has not been previously reported. Objective: To evaluate patterns and adverse outcomes of off-label use of TAVR in US clinical practice. Design, Setting and Participants: Patients receiving commercially funded TAVR in the United States are included in the Transcatheter Valve Therapy Registry...
June 21, 2017: JAMA Cardiology
https://www.readbyqxmd.com/read/28634690/long-term-retromuscular-and-intraperitoneal-mesh-size-changes-within-a-randomized-controlled-trial-on-incisional-hernia-repair-including-a-review-of-the-literature
#13
P Rogmark, O Ekberg, A Montgomery
Purpose Ingrowth of fibroblasts in a polypropylene mesh may cause contraction and a later recurrence. We assessed mesh contraction in intraabdominal and retromuscular implantation after incisional hernia repair. METHODS: A cohort of patients within an RCT on laparoscopic (LHR) versus open hernia repair (OHR) had their mesh borders marked with metal clips. X-ray was performed on postoperative day 1 and after 1 year. Total length, width, and dislocation were measured. A tacker fixated large-pore polypropylene mesh was used in LHR, and a retromuscular small-pore heavy-weight mesh was sutured to the midline in OHR...
June 20, 2017: Hernia: the Journal of Hernias and Abdominal Wall Surgery
https://www.readbyqxmd.com/read/28628357/continuous-periosteal-strapping-sutures-cpss-for-fixation-of-osseous-grafts-with-resorbable-membranes-for-buccal-ridge-augmentation
#14
Tamir Shalev, Gregori M Kurtzman, Alon H Shalev, Deborah K Johnson, Mark Elias Kersten
GBR is a technique sensitive procedure that routinely involves placement of particulate bone with or without fixation screws and either a resorbable or a non-resorbable membrane. Grafting of the buccal-crestal aspect of the implant site can be particularly challenging as external pressure from the flap or occlusal forces may displace the graft laterally and apically resulting in deficient bone in the desired region. A novel technique for stabilizing a resorbable membrane and underlying particulate graft allowing for predictable bone grafting across multiple edentulous sites...
June 19, 2017: Journal of Oral Implantology
https://www.readbyqxmd.com/read/28626415/a-case-of-childhood-onset-giant-cell-tumor-that-caused-optic-nerve-atrophy-in-both-eyes
#15
Masahiro Tonari, Junko Matsuo, Hidehiro Oku, Jun Sugasawa, Tsunehiko Ikeda, Kazunori Tatsuzawa, Tomoaki Fujita
PURPOSE: The purpose of this study was to report the case of a female patient who had a giant cell tumor in the paranasal sinus during childhood, and while undergoing multiple resection surgeries experienced optic atrophy in both eyes. CASE PRESENTATION: This study involved a 35-year-old woman who was previously diagnosed with a giant cell tumor of the paranasal sinus bone at age 13. A CT scan revealed a large tumor extending from the sphenoid sinus to the ethmoid sinus...
May 2017: Case Reports in Ophthalmology
https://www.readbyqxmd.com/read/28598913/xenon-as-an-adjuvant-to-propofol-anesthesia-in-patients-undergoing-off-pump-coronary-artery-bypass-graft-surgery-a-pragmatic-randomized-controlled-clinical-trial
#16
Layth Al Tmimi, Sarah Devroe, Geertrui Dewinter, Marc Van de Velde, Gert Poortmans, Bart Meyns, Bart Meuris, Mark Coburn, Steffen Rex
BACKGROUND: Xenon was shown to cause less hemodynamic instability and reduce vasopressor needs during off-pump coronary artery bypass (OPCAB) surgery when compared with conventionally used anesthetics. As xenon exerts its organ protective properties even in subanesthetic concentrations, we hypothesized that in patients undergoing OPCAB surgery, 30% xenon added to general anesthesia with propofol results in superior hemodynamic stability when compared to anesthesia with propofol alone...
June 8, 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28594761/wound-complication-rates-after-staples-or-suture-for-midline-vertical-skin-closure-in-obese-women-a-randomized-controlled-trial
#17
Lindsay M Kuroki, Mary M Mullen, L Stewart Massad, Ningying Wu, Jingxia Liu, David G Mutch, Matthew A Powell, Andrea R Hagemann, Premal H Thaker, Carolyn K McCourt, Akiva P Novetsky
OBJECTIVE: To compare wound complication rates after skin closure with staples and subcuticular suture in obese gynecology patients undergoing laparotomy through a midline vertical incision. METHODS: In this randomized controlled trial, women with body mass indexes (BMIs) of 30 or greater undergoing surgery by a gynecologic oncologist through a midline vertical incision were randomized to skin closure with staples or subcuticular 4-0 monofilament suture. The primary outcome was the rate of wound complication, defined as the presence of a wound breakdown, or infection, within 8 weeks postoperatively...
July 2017: Obstetrics and Gynecology
https://www.readbyqxmd.com/read/28585190/spinal-ampa-receptor-glua1-ser831-phosphorylation-controls-chronic-alcohol-consumption-produced-prolongation-of-postsurgical-pain
#18
Sufang Liu, Zhiying Zhao, Yan Guo, Hui Shu, Changsheng Li, Yuanyuan Tang, Ying Xing, Feng Tao
Previous studies have shown that excessive alcohol drinking is associated with chronic pain development; however, the molecular mechanism underlying this association is poorly understood. In this study, we investigated the effect of chronic alcohol consumption on plantar incision-induced postsurgical pain. We observed that 4-week ethanol drinking significantly prolonged plantar incision-induced mechanical pain, but not thermal pain. The chronic alcohol consumption enhanced plantar incision-produced α-amino-3-hydroxy-5-methyl-4-isoxazolepropionic acid (AMPA) receptor GluA1 phosphorylation at the Ser831 site in the spinal cord...
June 5, 2017: Molecular Neurobiology
https://www.readbyqxmd.com/read/28538571/angiosome-based-allografts-vascularized-composite-allotransplantation-for-tailored-subunit-reconstruction-with-volkmann-ischemic-contracture-as-a-case-in-point
#19
G Ian Taylor, David S Sparks, Adam C Gascoigne, Russell J Corlett, Mark W Ashton
BACKGROUND: As we enter an age with new approaches to tissue reconstruction, the emphasis on the adage "like for like" has become even more relevant. This study illustrates the potential for several tailored vascularized composite allotransplantation reconstructive techniques and, in particular, for the management of Volkmann contracture. METHODS: Twenty fresh cadaver dissections and 30 archival lead oxide radiographic studies were examined to (1) identify potential upper limb vascularized composite allotransplantation donor sites (i...
June 2017: Plastic and Reconstructive Surgery
https://www.readbyqxmd.com/read/28532856/implementation-of-a-referral-to-discharge-glycemic-control-initiative-for-reduction-of-surgical-site-infections-in-gynecologic-oncology-patients
#20
Laura Hopkins, Jennifer Brown-Broderick, James Hearn, Janine Malcolm, James Chan, Wendy Hicks-Boucher, Filomena De Sousa, Mark C Walker, Sylvain Gagné
OBJECTIVE(S): To evaluate the frequency of surgical site infections before and after implementation of a comprehensive, multidisciplinary perioperative glycemic control initiative. STUDY METHODS: As part of a CUSP (Comprehensive Unit-based Safety Program) initiative, between January 5 and December 18, 2015, we implemented comprehensive, multidisciplinary glycemic control initiative to reduce SSI rates in patients undergoing major pelvic surgery for a gynecologic malignancy ('Group II')...
May 20, 2017: Gynecologic Oncology
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