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Perioperative assessment

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https://www.readbyqxmd.com/read/29785542/perioperative-hemorrhagic-complications-in-pelvic-floor-reconstructive-surgery
#1
Wenjin Cheng, Chunyan Bu, Fanling Hong, Xiaozhu Zhong, Chengyue Jin, Xin Yang, Xiuli Sun, Jianliu Wang
INTRODUCTION AND HYPOTHESIS: We sought to assess the incidence, symptoms, and risk factors of perioperative hemorrhagic complications in patients undergoing pelvic floor reconstructive surgery. METHODS: This is a retrospective study on 694 consecutive patients who underwent pelvic floor reconstructive surgery with or without using mesh in our hospital over a 3-year period. RESULTS: We identified 694 pelvic floor reconstructive procedures from 2014 to 2016, including complete/incomplete colpocleisis (176, 25...
May 21, 2018: International Urogynecology Journal
https://www.readbyqxmd.com/read/29784256/perioperative-delirium-protocol-for-the-older-patient
#2
Thomas J Pallaria, Casey Panebianco, Mary C Kamienski
PURPOSE: Delirium is an acute change in cognition and attention. It may affect any age group. It is most common in older patients and is associated with a significant increase in mortality. The purpose of this project was to implement an assessment protocol to identify patients at risk for postoperative delirium. DESIGN: A case study approach was used. METHODS: The Confusion Assessment Method (CAM) tool for screening and diagnostic purposes was used to train surgeons, anesthesia providers, and nurses...
June 2018: Journal of Perianesthesia Nursing: Official Journal of the American Society of PeriAnesthesia Nurses
https://www.readbyqxmd.com/read/29784191/outcomes-of-robot-assisted-partial-nephrectomy-for-clinical-t2-renal-tumors-a-multicenter-analysis-rosula-collaborative-group
#3
Riccardo Bertolo, Riccardo Autorino, Giuseppe Simone, Ithaar Derweesh, Juan D Garisto, Andrea Minervini, Daniel Eun, Sisto Perdona, James Porter, Koon Ho Rha, Alexander Mottrie, Wesley M White, Luigi Schips, Bo Yang, Kenneth Jacobsohn, Robert G Uzzo, Ben Challacombe, Matteo Ferro, Jay Sulek, Umberto Capitanio, Uzoma A Anele, Gabriele Tuderti, Manuela Costantini, Stephen Ryan, Ahmet Bindayi, Andrea Mari, Marco Carini, Aryeh Keehn, Giuseppe Quarto, Michael Liao, Kidon Chang, Alessandro Larcher, Geert De Naeyer, Ottavio De Cobelli, Francesco Berardinelli, Chao Zhang, Peter Langenstroer, Alexander Kutikov, David Chen, Nicolo De Luyk, Chandru P Sundaram, Francesco Montorsi, Robert J Stein, Georges Pascal Haber, Lance J Hampton, Prokar Dasgupta, Michele Gallucci, Jihad Kaouk, Francesco Porpiglia
BACKGROUND: While partial nephrectomy (PN) represents the standard surgical management for cT1 renal masses, its role for cT2 tumors is controversial. Robot-assisted PN (RAPN) is being increasingly implemented worldwide. OBJECTIVE: To analyze perioperative, functional, and oncological outcomes of RAPN for cT2 tumors. DESIGN, SETTING, AND PARTICIPANTS: Retrospective analysis of a large multicenter, multinational dataset of patients with nonmetastatic cT2 masses treated with robotic surgery (ROSULA: RObotic SUrgery for LArge renal mass)...
May 18, 2018: European Urology
https://www.readbyqxmd.com/read/29782405/the-impact-of-anesthesia-influenced-process-measure-compliance-on-length-of-stay-results-from-an-enhanced-recovery-after-surgery-for-colorectal-surgery-cohort
#4
Michael C Grant, Claro M Pio Roda, Joseph K Canner, Philip Sommer, Daniel Galante, Deborah Hobson, Susan Gearhart, Christopher L Wu, Elizabeth Wick
BACKGROUND: Process measure compliance has been associated with improved outcomes in enhanced recovery after surgery (ERAS) programs. Herein, we sought to assess the impact of compliance with measures directly influenced by anesthesiology in an ERAS for colorectal surgery cohort. METHODS: From January 2013 to April 2015, data from 1140 consecutive patients were collected for all patients before (pre-ERAS) and after (ERAS) implementation of an ERAS program. Compliance with 9 specific process measures directly influenced by the anesthesiologist or acute pain service was analyzed to determine the impact on hospital length of stay (LOS)...
May 17, 2018: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/29781564/non-steroidal-anti-inflammatory-drugs-reduce-the-time-to-recovery-of-gut-function-after-elective-colorectal-surgery-a-systematic-review-and-meta-analysis
#5
REVIEW
Tony Ge Milne, Rebekah Jaung, Gregory O'Grady, Ian P Bissett
BACKGROUND: Postoperative ileus causes significant patient morbidity after abdominal surgery. Some evidence suggests non-steroidal anti-inflammatory drugs (NSAIDs) may reduce time to gut recovery, but there has not been a meta-analysis to assess their efficacy. AIM: To determine the benefit of NSAIDs in patients undergoing elective colorectal surgery on recovery of post-operative gut function by systematic review and meta-analysis. METHODS: MEDLINE, EMBASE, CENTRAL and reference lists were searched with no date or language restrictions...
May 21, 2018: Colorectal Disease: the Official Journal of the Association of Coloproctology of Great Britain and Ireland
https://www.readbyqxmd.com/read/29781530/a-comparison-between-methadone-and-buprenorphine-for-perioperative-analgesia-in-dogs-undergoing-ovariohysterectomy
#6
M D Shah, D Yates, J Hunt, J C Murrell
OBJECTIVE: To investigate whether preoperative methadone provides superior perioperative analgesia compared to buprenorphine in dogs undergoing ovariohysterectomy. METHODS: Eighty female dogs were recruited to an assessor-blinded, randomised, clinical trial. Dogs received a premedication dose of 0·05 mg/kg acepromazine or 10 μg/kg medetomidine combined with either 0·3 mg/kg methadone or 20 μg/kg buprenorphine intramuscularly. Anaesthesia was induced with propofol and maintained with isoflurane...
May 21, 2018: Journal of Small Animal Practice
https://www.readbyqxmd.com/read/29780599/perioperative-blood-transfusion-is-associated-with-post-operative-infectious-complications-in-patients-with-crohn-s-disease
#7
Nan Lan, Luca Stocchi, Yi Li, Bo Shen
Background: We have previously demonstrated that blood transfusion (BT) was associated with post-operative complications in patients undergoing surgery for Crohn's disease (CD), based on our institutional data registry. The aim of this study was to verify the association between perioperative BT and infectious complications in CD patients enrolled in the American College of Surgeons National Surgical Quality Improvement Program (ACS NSQIP) database. Methods: All CD patients undergoing surgery between 2005 and 2013 were identified from NSQIP...
May 2018: Gastroenterology Report
https://www.readbyqxmd.com/read/29779995/factors-predicting-postoperative-febrile-urinary-tract-infection-following-percutaneous-nephrolithotomy-in-prepubertal-children
#8
Onur Kaygısız, Nihat Satar, Ali Güneş, Hasan Serkan Doğan, Ahmet Erözenci, Ender Özden, Mehmet Mesut Pişkin, Deniz Demirci, Serdar Toksöz, Tufan Çiçek, Serhat Gürocak, Hakan Kılıçarslan, Oktay Nazlı, Aykut Kefi, Volkan İzol, Ali Beytur, Şaban Sarıkaya, Serdar Tekgül, Bülent Önal
BACKGROUND: Predictive tables and scoring systems can predict stone clearance. However, there is a paucity of evidence regarding the prediction of complications during percutaneous nephrolithotomy (PCNL), particularly in children, which remains under-researched. To our knowledge, no studies have evaluated the risk factors for febrile urinary tract infection (FUTI) after pediatric PCNL. OBJECTIVES: To assess the predictive factors of FUTI in prepubertal children after PCNL and determine whether any prophylactic cephalosporins are superior for decreasing the FUTI rate...
May 5, 2018: Journal of Pediatric Urology
https://www.readbyqxmd.com/read/29779809/identification-of-core-items-in-the-enhanced-recovery-pathway
#9
Marco Braga, Marco Scatizzi, Felice Borghi, Giancarlo Missana, Danilo Radrizzani, Marco Gemma
BACKGROUND & AIMS: The Enhanced Recovery After Surgery (ERAS) pathway represents an optimal approach in patients undergoing colorectal surgery but complexity in implementing its items could limit its application. The aim of this study is to identify possible core items within an ERAS pathway following elective colorectal resection. METHODS: This is a retrospective review of data prospectively collected between January 2014 and September 2015 by 14 Italian Hospitals in an electronic registry dedicated to an ERAS protocol...
June 2018: Clinical Nutrition ESPEN
https://www.readbyqxmd.com/read/29779305/-expert-consensus-on-standardized-processes-of-ambulatory-biliary-surgery-2018-edition
#10
(no author information available yet)
The definition of ambulatory surgery is that the patient is admitted, operated and discharged within a day (24 hours) , but does not include outpatient surgery. It can shorten the average hospital stay, reduce medical expenses, accelerate the recovery of patients, and has been approved to have great social and economic benefits.The main contents of this consensus include: (1)the establishment of ambulatory biliary surgery system, which involves the facilities building, team building, the construction of management systems, operation management, operation state analysis and benefit evaluation; (2)Patient selection criteria, pre-hospital assessment, surgical scheduling, preoperative education, anesthesia and management of adverse reactions after anesthesia, intraoperative application of general surgical principles and postoperative emergency plans, perioperative nursing; (3)Discharge criteria and pre-discharge assessment, post-discharge follow-up and rehabilitation guidance; (4) quality and safety control index system of ambulatory biliary surgery...
May 1, 2018: Zhonghua Wai Ke za Zhi [Chinese Journal of Surgery]
https://www.readbyqxmd.com/read/29779231/specialist-perioperative-allergy-clinic-services-in-the-uk-2018-results-from-the-royal-college-of-anaesthetists-sixth-national-audit-project-nap6-investigation-of-perioperative-anaphylaxis
#11
W Egner, T M Cook, T Garcez, S Marinho, H Kemp, D N Lucas, K Floss, S Farooque, H Torevell, M Thomas, K Ferguson, S Nasser, S Karanam, K-L Kong, N McGuire, M Bellamy, A Warner, J Hitchman, L Farmer, N J N Harper
BACKGROUND: The Royal College of Anaesthetists 6th National Audit Project examined Grade 3-5 perioperative anaphylaxis for one year in the UK. OBJECTIVE: To describe the causes and investigation of anaphylaxis in the NAP6 cohort, in relation to published guidance and previous baseline survey results. METHODS: We used a secure registry to gather details of Grade 3-5 perioperative anaphylaxis. Anonymous reports were aggregated for analysis and reviewed in detail...
May 19, 2018: Clinical and Experimental Allergy: Journal of the British Society for Allergy and Clinical Immunology
https://www.readbyqxmd.com/read/29778821/evaluating-mastectomy-skin-flap-necrosis-in-the-extended-breast-reconstruction-risk-assessment-score-for-one-year-prediction-of-prosthetic-reconstruction-outcomes
#12
Nora Hansen, Sasa Espino, Jordan T Blough, Michael M Vu, Neil A Fine, John Ys Kim
BACKGROUND: Rates of mastectomy for breast cancer treatment and immediate reconstruction continue to rise. With increasing scrutiny on outcomes and patient satisfaction, there is an impetus for providers to be more deliberate in deciding appropriate patient selection for breast reconstruction. The Breast Reconstruction Risk Assessment (BRA) Score was developed for prediction of complications after primary prosthetic breast reconstruction, focusing on calculating risk estimations for a variety of complications based on individual patient demographics and perioperative characteristics...
May 17, 2018: Journal of the American College of Surgeons
https://www.readbyqxmd.com/read/29778636/surgeon-performed-ultrasound-for-the-assessment-of-parotid-masses
#13
Melissa Zheng, Karolina A Plonowska, Madeleine P Strohl, William R Ryan
BACKGROUND: Studies on parotid gland ultrasound assessments performed specifically by surgeons are seldom reported. METHODS: Retrospective series of a single academic surgeon experience, analyzing 70 new parotid masses with evaluable preoperative SP-US characteristics, location measurements, and perioperative events. RESULTS: 31/70 masses were malignant. SP-US characteristics significantly associated with both malignancy and positive margins included extraparenchymal extension, irregular borders, hypervascularity, infiltration, and the lack of deep enhancement...
April 16, 2018: American Journal of Otolaryngology
https://www.readbyqxmd.com/read/29778609/emergency-department-utilization-after-lower-extremity-bypass-for-critical-limb-ischemia
#14
Vangelina Osteguin, Thomas W Cheng, Alik Farber, Mohammad H Eslami, Jeffrey A Kalish, Douglas W Jones, Denis Rybin, Stephen J Raulli, Jeffrey J Siracuse
OBJECTIVES: Patients with critical limb ischemia (CLI) utilize hospital resources at high rates. One major driver for resource utilization are Emergency Department (ED) visits. Our goal was to assess perioperative ED visits after lower extremity bypass (LEB) for CLI. METHODS: All patients undergoing LEB for CLI from 2008 to 2017 at our institution were analyzed. Emergency department visits and details of the visit within 30 and 90 days of discharge from index admission were recorded...
May 17, 2018: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/29778600/microendoscopy-assisted-minimally-invasive-versus-open-transforaminal-lumbar-interbody-fusion-for-lumbar-degenerative-diseases-five-year-outcomes
#15
Yang Yang, Zhong-Yu Liu, Liang-Ming Zhang, Mao Pang, Kishor Chhantyal, Wen-Bin Wu, Zi-Hao Chen, Chun-Xiao Luo, Li-Min Rong, Bin Liu, Yang Yang, Zhong-Yu Liu
OBJECTIVE: To evaluate five-year outcomes between microendoscopy-assisted minimally invasive (MIS) and open transforaminal lumbar interbody fusion (TLIF). METHODS: Sixty single-level MIS and open surgeries were performed (30 patients in either group). Perioperative parameters, including operative duration, intraoperative estimated blood loss (EBL) and fluoroscopy time, postoperative analgesic usage and ambulatory time, as well as complications, were recorded. Visual analogue scale (VAS, back and leg), Japanese Orthopaedics Association score (JOA) and Oswestry disability index (ODI) were obtained...
May 17, 2018: World Neurosurgery
https://www.readbyqxmd.com/read/29777846/an-academic-tertiary-referral-center-s-experience-with-a-vascular-surgery-based-uterine-artery-embolization-program
#16
Naiem Nassiri, Adrian Balica, Nolan C Cirillo-Penn, Dustin Tyler Crystal, Gloria A Bachmann
OBJECTIVE: Despite growing endovascular experience within the vascular surgery community, some catheter-based interventions - such as uterine artery embolization (UAE) - remain outside the clinical scope of most vascular surgeons, owing in part to established referral patterns and limited awareness among referring colleagues. We present our experience with a vascular surgery-based, multidisciplinary UAE program at an academic tertiary referral center. METHODS: In a collaborative effort between vascular surgery and gynecology, a Pelvic Vascular Disease Program has been established to provide palliative, prophylactic, and therapeutic embolizations including, but not limited to, UAE...
May 16, 2018: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/29777351/development-of-a-patient-reported-outcome-measure-of-recovery-after-abdominal-surgery-a-hypothesized-conceptual-framework
#17
Roshni Alam, Sabrina M Figueiredo, Saba Balvardi, Bénédicte Nauche, Tara Landry, Lawrence Lee, Nancy E Mayo, Liane S Feldman, Julio F Fiore
BACKGROUND: We initiated a research program to develop a novel patient-reported outcome measure (PROM) to assess postoperative recovery from the perspective of abdominal surgery patients. In light of FDA recommendations, the first stage of our program aimed to, based on previous literature and expert input, develop a hypothesized conceptual framework portraying the health domains that are potentially relevant to the process of recovery after abdominal surgery. METHODS: This study was conducted in three phases: (1) systematic review to identify PROMs with measurement properties appraised in the context of recovery after abdominal surgery, (2) content analysis to categorize the health domains covered by the PROMs according to the ICF, and (3) two-round Delphi study to gain expert input regarding which of these health domains are relevant to the process of recovery...
May 17, 2018: Surgical Endoscopy
https://www.readbyqxmd.com/read/29776428/evidence-of-the-impact-of-systemic-inflammation-on-neuroinflammation-from-a-non-bacterial-endotoxin-animal-model
#18
Chunxia Huang, Michael Garnet Irwin, Gordon Tin Chun Wong, Raymond Chuen Chung Chang
BACKGROUND: Systemic inflammation induces neuroinflammation and cellular changes such as tau phosphorylation to impair cognitive function, including learning and memory. This study uses a single model, laparotomy without any pathogen, to characterize these changes and their responses to anti-inflammatory treatment in the intermediate term. METHODS: In a two-part experiment, wild-type C57BL/6N mice (male, 3 month old, 25 ± 2 g) were subjected to sevoflurane anesthesia alone or to a laparotomy...
May 17, 2018: Journal of Neuroinflammation
https://www.readbyqxmd.com/read/29776386/impact-of-vkorc1-cyp4f2-and-nqo1-gene-variants-on-warfarin-dose-requirement-in-han-chinese-patients-with-catheter-ablation-for-atrial-fibrillation
#19
Jiao Li, Wenlong Yang, Zhonghui Xie, Kun Yu, Yuhua Chen, Kaijun Cui
BACKGROUND: The anticoagulation of atrial fibrillation catheter ablation during the perioperative stage does matter and should be treated with discretion. We aimed to assess impact of three important genes participating in vitamin K cycle (i.e. VKORC1 rs9923231, CYP4F2 rs2108622 and NQO1 rs1800566) on the daily stable warfarin dose requirement in Sichuan Han Chinese patients with catheter ablation of atrial fibrillation. METHODS: A total of 222 atrial fibrillation patients taking stable warfarin therapy after catheter ablation operation were enrolled in this study...
May 18, 2018: BMC Cardiovascular Disorders
https://www.readbyqxmd.com/read/29775153/feasibility-safety-and-changes-in-systolic-blood-pressure-associated-with-endovascular-revascularization-of-symptomatic-and-chronically-occluded-cervical-internal-carotid-artery-using-a-newly-suggested-radiographic-classification-of-chronically-occluded-cervical
#20
David Hasan, Mario Zanaty, Robert M Starke, Elias Atallah, Nohra Chalouhi, Pascal Jabbour, Amit Singla, Waldo R Guerrero, Daichi Nakagawa, Edgar A Samaniego, Nnenna Mbabuike, Rabih G Tawk, Adnan H Siddiqui, Elad I Levy, Roberta L Novakovic, Jonathan White, Clemens M Schirmer, Thomas G Brott, Hussain Shallwani, L Nelson Hopkins
OBJECTIVE The overall risk of ischemic stroke from a chronically occluded internal carotid artery (COICA) is around 5%-7% per year despite receiving the best available medical therapy. Here, authors propose a radiographic classification of COICA that can be used as a guide to determine the technical success and safety of endovascular recanalization for symptomatic COICA and to assess the changes in systemic blood pressure following successful revascularization. METHODS The radiographic images of 100 consecutive subjects with COICA were analyzed...
May 18, 2018: Journal of Neurosurgery
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