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Standards for General Surgery

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https://www.readbyqxmd.com/read/27931221/the-patterns-and-timing-of-recurrence-after-curative-resection-for-gastric-cancer-in-china
#1
Dan Liu, Ming Lu, Jian Li, Zuyao Yang, Qi Feng, Menglong Zhou, Zhen Zhang, Lin Shen
BACKGROUND: The recurrence of gastric cancer after curative resection had adverse effects on patients' survival. The treatment presence varied from different countries. The aims of this study were to understand the recurrence incidence, patterns, and timing and to explore the risk factors in China. METHODS: One thousand three hundred four patients who undergoing curative resection from more than 100 hospitals between January 1st 1986 and September 1st 2013, were surveyed in detail...
December 8, 2016: World Journal of Surgical Oncology
https://www.readbyqxmd.com/read/27930509/current-challenges-in-providing-bariatric-surgery-in-france-a-nationwide-study
#2
Sébastien Czernichow, Michel Paita, David Nocca, Simon Msika, Arnaud Basdevant, Bertrand Millat, Anne Fagot-Campagna
Bariatric surgery is a well-accepted procedure for severe and massive obesity management. We aimed to determine trends, geographical variations, and factors influencing bariatric surgery and the choice of procedure in France in a large observational study.The Health Insurance Fund for Salaried Workers (Caisse National Assurance Maladie Travailleurs Salariés) covers about 86% of the French population. The Système National d'Information Inter-régimes de l'Assurance Maladie database contains individualized and anonymized patient data on all reimbursements for healthcare expenditure...
December 2016: Medicine (Baltimore)
https://www.readbyqxmd.com/read/27926758/association-between-surgeon-scorecard-use-and-operating-room-costs
#3
Corinna C Zygourakis, Victoria Valencia, Christopher Moriates, Christy K Boscardin, Sereina Catschegn, Alvin Rajkomar, Kevin J Bozic, Kent Soo Hoo, Andrew N Goldberg, Lawrence Pitts, Michael T Lawton, R Adams Dudley, Ralph Gonzales
Importance: Despite the significant contribution of surgical spending to health care costs, most surgeons are unaware of their operating room costs. Objective: To examine the association between providing surgeons with individualized cost feedback and surgical supply costs in the operating room. Design, Setting, and Participants: The OR Surgical Cost Reduction (OR SCORE) project was a single-health system, multihospital, multidepartmental prospective controlled study in an urban academic setting...
December 7, 2016: JAMA Surgery
https://www.readbyqxmd.com/read/27918202/treatment-of-soft-tissue-sarcoma-a-focus-on-earlier-stages
#4
Alessandro Gronchi, Robert G Maki, Robin L Jones
Surgery, with or without radiation therapy, is the standard of care for primary soft tissue sarcoma, with adjuvant/neodjuvant chemotherapy playing a role only in high-risk patients. Chemotherapy is generally the principal treatment modality for locally advanced or metastatic disease. Within this context, newer techniques and promising new treatments are challenging traditional treatment paradigms. For example, identification of histology-specific treatments is leading the field toward individualized care, with better outcomes...
January 2017: Future Oncology
https://www.readbyqxmd.com/read/27917665/the-potential-effect-of-biological-sealants-on-colorectal-anastomosis-healing-in-experimental-research-involving-severe-diabetes
#5
K Stergios, K Kontzoglou, V Pergialiotis, L M Korou, M Frountzas, O Lalude, N Nikiteas, D N Perrea
Colorectal anastomoses continuous to pose a significant challenge in current surgical practice. Anastomotic leakage remains one of the most frequent and dramatic complications of colorectal surgery, even in centres of high specialisation. Diabetes is a well-established independent factor which results in higher anastomotic leakage rates. Fibrin sealants have been applied in experimental and clinical studies for the prevention of anastomotic dehiscence. However, little is known regarding their impact on diabetic patients...
December 5, 2016: Annals of the Royal College of Surgeons of England
https://www.readbyqxmd.com/read/27916737/suprascapular-block-associated-with-interscalene-block-an-alternative-to-isolated-interscalene-block-for-analgesia-in-shoulder-instability-surgery
#6
Walid Trabelsi, Abdelkader Ben Gabsia, Anis Lebbi, Walid Sammoud, Iheb Labbène, Mustapha Ferjani
BACKGROUND: Interscalene brachial plexus block (ISB) is the gold standard for postoperative pain management in shoulder surgery. However, this technique has side effects and potentially serious complications. The aim of this study was to compare the combinations of ultrasound-guided suprascapular (SSB) associated with supraclavicular nerve block (SCB) and ultrasound-guided ISB for postoperative analgesia after shoulder instability surgery. METHODS: Sixty ASA physical status I-II patients scheduled to undergo shoulder instability surgery were included...
December 1, 2016: Orthopaedics & Traumatology, Surgery & Research: OTSR
https://www.readbyqxmd.com/read/27916473/aseptic-revision-knee-arthroplasty-with-total-stabilizer-prostheses-achieves-similar-functional-outcomes-to-primary-total-knee-arthroplasty-at-2-years-a-longitudinal-cohort-study
#7
David F Hamilton, Philip M Simpson, James T Patton, Colin R Howie, Richard Burnett
BACKGROUND: Patient function is poorly characterized following revision total knee arthroplasty (TKA), although is generally accepted to be inferior to that following primary procedures. METHODS: Fifty-three consecutive aseptic revisions to total stabilizer devices were prospectively evaluated, preoperatively and at 6, 26, 52, and 104 weeks postoperatively, using the Oxford Knee Score (OKS), range of motion, pain rating scale, and timed functional performance battery...
October 31, 2016: Journal of Arthroplasty
https://www.readbyqxmd.com/read/27916378/incidence-and-significance-of-postoperative-complications-occurring-between-discharge-and-30%C3%A2-days-a-prospective-cohort-study
#8
John C Woodfield, Wiqqas Jamil, Peter M Sagar
BACKGROUND: Accurate documentation of complications is fundamental to clinical audit and research. While it is established that accurate diagnosis of surgical site infection (SSI) requires follow-up for 30 days; for other complications, there are minimal data quantifying their importance between discharge and 30 days. METHODS: In this prospective cohort study, inpatients undergoing general or vascular surgery were reviewed daily for complications by the medical team and a research fellow...
November 2016: Journal of Surgical Research
https://www.readbyqxmd.com/read/27913320/the-concept-of-effective-inflow-application-to-interictal-localization-of-the-epileptogenic-focus-from-ieeg
#9
Ioannis Vlachos, Balu Krishnan, David Treiman, Konstantinos Tsakalis, Dimitris Kugiumtzis, Leon Iassemidis
GOAL: Accurate determination of the epileptogenic focus is of paramount diagnostic and therapeutic importance in epilepsy. The current gold standard for focus localization is from ictal (seizure) onset and thus requires the occurrence and recording of multiple typical seizures of a patient. Localization of the focus from seizure-free (interictal) periods remains a challenging problem, especially in the absence of interictal epileptiform activity. METHODS: By exploring the concept of effective inflow, we developed a focus localization algorithm (FLA) based on directed connectivity between brain sites...
November 29, 2016: IEEE Transactions on Bio-medical Engineering
https://www.readbyqxmd.com/read/27909197/severity-assessment-in-rabbits-after-partial-hepatectomy-part-ii
#10
N Drude, K Pawlowsky, H Tanaka, K Fukushima, B Kögel, R H Tolba
Although the recognition of pain, distress and discomfort has already been described in 1985 by Morton and Griffiths there is still very little known about the establishment of score sheets especially, regarding post-surgical pain and severity assessment for laboratory animals such as rabbits. In this paper we describe the estimation of severity and recovery status of 36 female New Zealand White rabbits (NZW) in a standardized liver resection model using two different adhesive treatments and one control group...
December 2016: Laboratory Animals
https://www.readbyqxmd.com/read/27908681/preoperative-anemia-is-associated-with-disease-recurrence-and-progression-in-patients-with-non-muscle-invasive-bladder-cancer
#11
Francesco Soria, Marco Moschini, Mohammad Abufaraj, Gregory J Wirth, Beat Foerster, Kilian M Gust, Mehmet Özsoy, Alberto Briganti, Paolo Gontero, Romain Mathieu, Morgan Rouprêt, Pierre I Karakiewicz, Shahrokh F Shariat
PURPOSE: To evaluate the effect of preoperative anemia (PA) on oncological outcomes in a multicenter cohort of patients with non-muscle-invasive bladder cancer (NMIBC) treated with transurethral resection of the bladder (TURB) and adjuvant intravesical therapies. We hypothesize that PA represents a marker of disease aggressiveness and could be used to improve the discrimination of prognostic tools for the prediction of disease recurrence and progression. METHODS: This multicenter retrospective study included 1,117 patients from 4 different centers...
November 28, 2016: Urologic Oncology
https://www.readbyqxmd.com/read/27904649/fasciocutaneous-flap-reinforcement-of-ventral-onlay-buccal-mucosa-grafts-enables-neophallus-revision-urethroplasty
#12
Stelios C Wilson, John T Stranix, Kiranpreet Khurana, Shane D Morrison, Jamie P Levine, Lee C Zhao
BACKGROUND: Urethral strictures or fistulas are common complications after phalloplasty. Neourethral defects pose a difficult reconstructive challenge using standard techniques as there is generally insufficient ventral tissue to support a graft urethroplasty. We report our experience with local fasciocutaneous flaps for support of ventrally-placed buccal mucosal grafts (BMGs) in phalloplasty. METHODS: A retrospective review of patients who underwent phalloplasty and subsequently required revision urethroplasty using BMGs between 2011 and 2015 was completed...
December 2016: Therapeutic Advances in Urology
https://www.readbyqxmd.com/read/27901329/comparing-incidence-of-emergence-delirium-between-sevoflurane-and-desflurane-in-children-following-routine-otolaryngology-procedures
#13
Jeremy N Driscoll, Brian M Bender, Carlos A Archilla, Carol M Klim, J Hossain, George Mychaskiw, Julie L Wei
BACKGROUND: Emergence delirium (ED) is a state of aggressive agitation that can occur temporarily in the process of emerging from anesthesia in children exposed to volatile or intravenous anesthetics. Emergence delirium is typically assessed using the published and validated pediatric emergence delirium (PAED) scale. Due to some variation in properties between sevoflurane and desflurane for maintenance of anesthesia after standard sevoflurane induction, we designed a prospective study to examine potential differences in emergence behavior and incidence of ED in children undergoing elective ear-nose-throat (ENT) surgery...
November 30, 2016: Minerva Anestesiologica
https://www.readbyqxmd.com/read/27895521/impact-of-a-medical-university-on-laparoscopic-surgery-in-a-service-oriented-public-hospital-in-the-caribbean
#14
Shamir O Cawich, Suresh Pooran, Barbara Amow, Ernest Ali, Fawwaz Mohammed, Marlon Mencia, Samuel Ramsewak, Seetharaman Hariharan, Vijay Naraynsingh
INTRODUCTION: The Caribbean lags behind global trends for volume and complexity of laparoscopic operations. In an attempt to promote laparoscopy at a single facility, a partnership was formed between the University of the West Indies (UWI) and the Port of Spain General Hospital in Trinidad and Tobago. This study seeks to document the effect of this partnership on laparoscopic practice. MATERIALS AND METHODS: In this partnership, the UWI took the bold step of volunteering to staff a surgical team if the Ministry of Health provided the necessary legislative changes...
2016: Risk Management and Healthcare Policy
https://www.readbyqxmd.com/read/27894347/estimation-of-utility-weights-for-human-papilloma-virus-related-health-states-according-to-disease-severity
#15
Minsu Ock, Jeong-Yeol Park, Woo-Seung Son, Hyeon-Jeong Lee, Seon-Ha Kim, Min-Woo Jo
BACKGROUND: A cost-utility study of a human papilloma virus (HPV) vaccine requires that the utility weights for HPV-related health states (i.e., cervical intraepithelial neoplasia (CIN), cervical cancer, and condyloma) be evaluated. The aim of the present study was to determine the utility weights for HPV-related health states. METHODS: Hypothetical standardised health states related to HPV were developed based on patient education material and previous publications...
November 28, 2016: Health and Quality of Life Outcomes
https://www.readbyqxmd.com/read/27893579/the-psychological-impact-of-first-burn-camp-in-nicaragua
#16
Lisa L Tropez-Arceneaux, Arlen Tatiana Castillo Alaniz, Ivette Lucia Icaza, Eevelyn Alejandra Murillo
Asociacion Pro-Ninos Quemados de Nicaragua (APROQUEN) is a comprehensive burn center that provides a holistic and integrated approach to treating burns. APROQUEN has set the standards internationally with acute treatment for burns, intensive care, reconstructive surgeries, nutritional care, rehabilitation, occupational therapy, and psychological treatment. APROQUEN is excelling within Central and South America with life-saving techniques and quality of care. It is imperative that burn centers in Central America recognize that the treatment of a child with a burn injury surpasses physical care to include psychological treatment for the complete well-being of the child...
November 11, 2016: Journal of Burn Care & Research: Official Publication of the American Burn Association
https://www.readbyqxmd.com/read/27893575/variations-in-burn-excision-and-grafting-a-survey-of-the-american-burn-association
#17
Jacqueline S Israel, David G Greenhalgh, Angela L Gibson
It is unknown whether variations in burn care affect outcomes or affect the success of emerging therapeutics. The purpose of this study was to assess burn surgeons' preferences in excision and grafting to determine if surgical technique affects outcomes. A 71-item survey evaluating skin grafting techniques was emailed to members of the American Burn Association in July and August 2015. The survey was anonymous and voluntary. Relationships between variables were evaluated using Fisher's exact test. A P-value of ≤...
November 15, 2016: Journal of Burn Care & Research: Official Publication of the American Burn Association
https://www.readbyqxmd.com/read/27893492/safety-of-local-intracutaneous-lidocaine-anesthesia-used-by-dermatologic-surgeons-for-skin-cancer-excision-and-postcancer-reconstruction-quantification-of-standard-injection-volumes-and-adverse-event-rates
#18
Murad Alam, Matthew R Schaeffer, Amelia Geisler, Emily Poon, Scott W Fosko, Divya Srivastava
BACKGROUND: Intracutaneous lidocaine is used for anesthesia in dermatologic surgery for skin cancer excision and repair with exceedingly low incidence of reported adverse events. OBJECTIVE: To measure (1) the quantity of lidocaine typically used for facial skin cancer excision and reconstruction; and (2) the frequency and character of associated adverse events. METHODS: Survey study of dermatologic surgeons with longitudinal reporting. Reported practice during 10 business days: (1) mean volume of 1% lidocaine per skin cancer excision; (2) maximum per excision; (3) mean per reconstruction; and (4) maximum per reconstruction...
December 2016: Dermatologic Surgery: Official Publication for American Society for Dermatologic Surgery [et Al.]
https://www.readbyqxmd.com/read/27888350/totally-implantable-vascular-access-device-tivad-placement-a-modified-technique-that-takes-post-procedure-aesthetic-aspects-into-account
#19
Gabriel Liberale
Major progress has been made in breast cancer reconstruction surgery. The standard technique for totally implanted vascular access device (TIVAD) implantation generally requires an incision for port insertion on the anterior part of the thorax that leaves a scar in the middle of the neckline in patients who have undergone mastectomy with complex breast reconstruction. The aim of this technical note is to report our revised surgical technique for TIVAD placement. In patients with breast cancer, we take a lateralized approach, performing an oblique incision on the lowest part of the deltopectoral groove...
November 25, 2016: Supportive Care in Cancer: Official Journal of the Multinational Association of Supportive Care in Cancer
https://www.readbyqxmd.com/read/27886974/evaluating-coding-accuracy-in-general-surgery-residents-accreditation-council-for-graduate-medical-education-procedural-case-logs
#20
REVIEW
Fadi Balla, Tabitha Garwe, Prasenjeet Motghare, Tessa Stamile, Jennifer Kim, Heidi Mahnken, Jason Lees
INTRODUCTION: The Accreditation Council for Graduate Medical Education (ACGME) case log captures resident operative experience based on Current Procedural Terminology (CPT) codes and is used to track operative experience during residency. With increasing emphasis on resident operative experiences, coding is more important than ever. It has been shown in other surgical specialties at similar institutions that the residents' ACGME case log may not accurately reflect their operative experience...
November 2016: Journal of Surgical Education
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