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Effect of specialization on surgery safety

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https://www.readbyqxmd.com/read/28360973/endoluminal-solutions-to-bariatric-surgery-complications-a-review-with-a-focus-on-technical-aspects-and-results
#1
REVIEW
Raquel Souto-Rodríguez, María-Victoria Alvarez-Sánchez
Obesity is a growing problem in developed countries, and surgery is the most effective treatment in terms of weight loss and improving medical comorbidity in a high proportion of obese patients. Despite the advances in surgical techniques, some patients still develop acute and late postoperative complications, and an endoscopic evaluation is often required for diagnosis. Moreover, the high morbidity related to surgical reintervention, the important enhancement of endoscopic procedures and technological innovations introduced in endoscopic equipment have made the endoscopic approach a minimally-invasive alternative to surgery, and, in many cases, a suitable first-line treatment of bariatric surgery complications...
March 16, 2017: World Journal of Gastrointestinal Endoscopy
https://www.readbyqxmd.com/read/28272086/effectiveness-and-safety-of-surgical-excision-in-the-treatment-of-digital-mucoid-cysts
#2
Galina Balakirski, Christoph Loeser, Jens M Baron, Edgar Dippel, Laurenz Schmitt
BACKGROUND: Digital mucoid cysts have a tendency for recurrence after operative intervention. Several procedures are in use. OBJECTIVE: Retrospective evaluation for effectiveness, safety and patient satisfaction by using a questionnaire after treatment for digital mucoid cysts with targeted surgical excision and closure by flap-design. MATERIALS AND METHODS: All patients treated with surgical excision for digital mucoid cysts at the Dermatology Department of the Ludwigshafen City Hospital between 2007 and 2011 were evaluated using a specially designed questionnaire...
March 7, 2017: Dermatologic Surgery: Official Publication for American Society for Dermatologic Surgery [et Al.]
https://www.readbyqxmd.com/read/28072800/modified-percutaneous-lumbar-foraminoplasty-and-percutaneous-endoscopic-lumbar-discectomy-instrument-design-technique-notes-and-5-years-follow-up
#3
Zhen-Zhou Li, Shu-Xun Hou, Wei-Lin Shang, Ke-Ran Song, Hong-Liang Zhao
BACKGROUND: Conventional percutaneous endoscopic lumbar discectomy (PELD) with an "inside-outside" technique has 4.3% - 10.3% surgical failure rate, especially in central herniated discs (HDs), migrated HDs, and axillary type HDs. PELD with foraminoplasty has been used for complex HDs. Percutaneous lumbar foraminoplasty (PLF), which is performed with a trephine or bone reamer introduced over a guidewire without a protective working cannula in the original Tessys technique, can quickly cut the hypertrophied bony structure under fluoroscopic guidance, and risk injury to the exiting and traversing nerve roots...
January 2017: Pain Physician
https://www.readbyqxmd.com/read/27924508/ultrasonography-guided-percutaneous-nephrolithotomy-with-chinese-one-shot-tract-dilation-technique-based-on-stimulated-diuresis-a-report-of-67-cases
#4
Ying Shi, Hua-Geng Liang, Xiong Yang, Bo Hai, Liang Wang, Yi-Fei Xing, Wen Ju, Fu-Qing Zeng, Xiao-Ping Zhang, Wen-Cheng Li
The safety and effectiveness of a novel Chinese one-shot dilation technique based on stimulated diuresis for percutaneous nephrolithotomy (PCNL) were investigated. After the feasibility of the Chinese one-shot dilation based on stimulated diuresis was verified by an animal study, this technique was applied in the clinical practice. A total of 67 patients in our department underwent the modified PCNL from July 2014 to June 2015. After the renal infundibulum was distended by stimulated diuresis, the kidney was punctured under the ultrasonographic guidance via the fornix of the target calyx...
December 2016: Journal of Huazhong University of Science and Technology. Medical Sciences
https://www.readbyqxmd.com/read/27921198/-metabolic-surgery-or-conservative-measures-as-therapy-of-obese-type%C3%A2-2%C3%A2-diabetics
#5
REVIEW
Udo Jahn, Thomas Schubert, Sibylle Schlepp, Heinz Jürgen Deuber
After bariatric surgery there are some favourable effects on comorbidities of obesity as glucose and lipid metabolism besides weight loss. Therefore surgical measures targeting at improvement of such metabolic disorders especially diabetes type 2 has been called "metabolic surgery". The complexity of its underlying metabolic mechanisms is not yet clear, but restriction of energy and weight loss (maintenance) seem to be the cornerstones.Risks of these procedures which are drawn of the established methods of bariatric surgery are reported to be relatively low in qualified centers...
December 5, 2016: Wiener Medizinische Wochenschrift
https://www.readbyqxmd.com/read/27731885/transfusion-thresholds-and-other-strategies-for-guiding-allogeneic-red-blood-cell-transfusion
#6
REVIEW
Jeffrey L Carson, Simon J Stanworth, Nareg Roubinian, Dean A Fergusson, Darrell Triulzi, Carolyn Doree, Paul C Hebert
BACKGROUND: There is considerable uncertainty regarding the optimal haemoglobin threshold for the use of red blood cell (RBC) transfusions in anaemic patients. Blood is a scarce resource, and in some countries, transfusions are less safe than others because of a lack of testing for viral pathogens. Therefore, reducing the number and volume of transfusions would benefit patients. OBJECTIVES: The aim of this review was to compare 30-day mortality and other clinical outcomes in participants randomized to restrictive versus liberal red blood cell (RBC) transfusion thresholds (triggers) for all conditions...
October 12, 2016: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/27695249/the-use-of-intraoperative-computed-tomography-navigation-in-pituitary-surgery-promises-a-better-intraoperative-orientation-in-special-cases
#7
Stefan Linsler, Sebastian Antes, Sebastian Senger, Joachim Oertel
OBJECTIVE: The safety of endoscopic skull base surgery can be enhanced by accurate navigation in preoperative computed tomography (CT) and magnetic resonance imaging (MRI). Here, we report our initial experience of real-time intraoperative CT-guided navigation surgery for pituitary tumors in childhood. MATERIALS AND METHODS: We report the case of a 15-year-old girl with a huge growth hormone-secreting pituitary adenoma with supra- and perisellar extension. Furthermore, the skull base was infiltrated...
October 2016: Journal of Neurosciences in Rural Practice
https://www.readbyqxmd.com/read/27677879/preoperative-planning-with-three-dimensional-reconstruction-of-patient-s-anatomy-rapid-prototyping-and-simulation-for-endoscopic-mitral-valve-repair
#8
Peyman Sardari Nia, Samuel Heuts, Jean Daemen, Peter Luyten, Jindrich Vainer, Jan Hoorntje, Emile Cheriex, Jos Maessen
OBJECTIVES: Mitral valve repair performed by an experienced surgeon is superior to mitral valve replacement for degenerative mitral valve disease; however, many surgeons are still deterred from adapting this procedure because of a steep learning curve. Simulation-based training and planning could improve the surgical performance and reduce the learning curve. The aim of this study was to develop a patient-specific simulation for mitral valve repair and provide a proof of concept of personalized medicine in a patient prospectively planned for mitral valve surgery...
September 27, 2016: Interactive Cardiovascular and Thoracic Surgery
https://www.readbyqxmd.com/read/27555214/effect-of-prolonged-released-oxycodone-naloxone-in-postoperative-pain-management-after-total-knee-replacement-a-nonrandomized-prospective-trial
#9
Johannes Oppermann, Jan Bredow, Christian K Spies, Julia Lemken, Frank Unglaub, Christoph K Boese, Jens Dargel, Peer Eysel, Jan Zöllner
PURPOSE: The purpose of this study was to examine the effect of postoperative prolonged release oxycodone/naloxone (OXN) in comparison to other opioids (control group) on the early postoperative rehabilitation outcome after total knee replacement. METHODS: In a prospective, noninterventional, nonrandomized clinical trial, 80 patients were assigned to either the OXN group or a control group. Postoperative outcome and pain level at days 3, 6, 21, 35, and 6months were evaluated using the Bowel Function Index, Brief Pain Inventory Short Form questionnaire, the Hospital for Special Surgery score, modified Larson score, and the ability to attend physiotherapy...
September 2016: Journal of Clinical Anesthesia
https://www.readbyqxmd.com/read/27388136/hemilaminectomy-for-spinal-meningioma-a-case-series-of-20-patients-with-a-focus-on-ventral-and-ventrolateral-lesions
#10
S Tola, M De Angelis, S Bistazzoni, C Chiaramonte, V Esposito, S Paolini
OBJECTIVE: To demonstrate the effectiveness and safety of hemilaminectomy in spinal-meningioma surgery, with special attention to ventral lesions. We also describe technical tips to enhance surgical-corridor width. PATIENTS AND METHODS: A total of 20 patients (14 female and 6 male) underwent hemilaminectomy for resection of a spinal meningioma between January 2005 and December 2015. Preoperative magnetic resonance imaging defined the tumor location (16 thoracic, 3 cervical, 1 lumbar) and the dural-attachment site (4 ventral, 11 ventrolateral, 3 lateral, 2 posterior)...
September 2016: Clinical Neurology and Neurosurgery
https://www.readbyqxmd.com/read/27275050/the-efficacy-and-safety-of-epidural-dexmedetomidine-and-clonidine-with-bupivacaine-in-patients-undergoing-lower-limb-orthopedic-surgeries
#11
Safiya I Shaikh, Sarala B Mahesh
BACKGROUND AND AIMS: Alpha (α-2) adrenergic agonists have both analgesic and sedative properties when used as an adjuvant in regional anesthesia. A prospective randomized double-blind study was carried out to evaluate the efficacy of epidural route and to compare the efficacy and clinical profile of dexmedetomidine and clonidine as an adjuvant to bupivacaine with special emphasis on their quality of analgesia, sedation and the ability to provide the smooth intra-operative and postoperative course...
April 2016: Journal of Anaesthesiology, Clinical Pharmacology
https://www.readbyqxmd.com/read/27258495/impact-of-type-of-surgery-on-survival-outcome-in-patients-with-early-gallbladder-cancer-in-the-era-of-minimally-invasive-surgery-oncologic-safety-of-laparoscopic-surgery
#12
MULTICENTER STUDY
Jin-Young Jang, Jin Seok Heo, Youngmin Han, Jihoon Chang, Jae Ri Kim, Hongbeom Kim, Wooil Kwon, Sun-Whe Kim, Seong Ho Choi, Dong Wook Choi, Kyoungbun Lee, Kee-Taek Jang, Sung-Sik Han, Sang-Jae Park
Laparoscopic surgery has been widely accepted as a feasible and safe treatment modality in many cancers of the gastrointestinal tract. However, most guidelines on gallbladder cancer (GBC) regard laparoscopic surgery as a contraindication, even for early GBC. This study aims to evaluate and compare recent surgical outcomes of laparoscopic and open surgery for T1(a,b) GBC and to determine the optimal surgical strategy for T1 GBC.The study enrolled 197 patients with histopathologically proven T1 GBC and no history of other cancers who underwent surgery from 2000 to 2014 at 3 major tertiary referral hospitals with specialized biliary-pancreas pathologists and optimal pathologic handling protocols...
May 2016: Medicine (Baltimore)
https://www.readbyqxmd.com/read/27167018/when-a-checklist-is-not-enough-how-to-improve-them-and-what-else-is-needed
#13
Jaishankar Raman, Nancy Leveson, Aubrey Lynn Samost, Nikola Dobrilovic, Maggie Oldham, Sidney Dekker, Stan Finkelstein
OBJECTIVES: Checklists are being introduced to enhance patient safety, but the results have been mixed. The goal of this research is to understand why time-outs and checklists are sometimes not effective in preventing surgical adverse events and to identify additional measures needed to reduce these events. METHODS: A total of 380 consecutive patients underwent complex cardiac surgery over a 24-month period between November 2011 and November 2013 at an academic medical center, out of a total of 529 cardiac cases...
August 2016: Journal of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/27130717/chest-pain-control-with-kinesiology-taping-after-lobectomy-for-lung-cancer-initial-results-of-a-randomized-placebo-controlled-study
#14
Andrea Imperatori, Annamaria Grande, Massimo Castiglioni, Laura Gasperini, Agnese Faini, Sebastiano Spampatti, Elisa Nardecchia, Lorena Terzaghi, Lorenzo Dominioni, Nicola Rotolo
OBJECTIVES: Kinesiology taping (KT) is a rehabilitative technique performed by the cutaneous application of a special elastic tape. We tested the safety and efficacy of KT in reducing postoperative chest pain after lung lobectomy. METHODS: One-hundred and seventeen consecutive patients, both genders, age 18-85, undergoing lobectomy for lung cancer between January 2013 and July 2015 were initially considered. Lobectomies were performed by the same surgical team, with thoracotomy or video-assisted thoracoscopic surgery (VATS) access...
August 2016: Interactive Cardiovascular and Thoracic Surgery
https://www.readbyqxmd.com/read/27116669/stem-cell-therapy-in-nonneovascular-age-related-macular-degeneration
#15
Amir H Kashani
Age-related macular degeneration (ARMD) is the leading cause of blindness in subjects older than 50 years of age in the developed world. There are two types of ARMD, neovascular (NV) and nonneovascular (NN). While anti-VEGF-based therapies have significantly decreased the visual morbidity associated with NV-ARMD, there are no effective treatments for NN-ARMD. A detailed discussion of NV-ARMD and related therapies is the topic of another section of this special supplement. This review will focus mainly on NN-ARMD...
April 1, 2016: Investigative Ophthalmology & Visual Science
https://www.readbyqxmd.com/read/27005688/the-efficacy-and-safety-of-knotless-barbed-sutures-in-the-surgical-field-a-systematic-review-and-meta-analysis-of-randomized-controlled-trials
#16
REVIEW
Yifei Lin, Sike Lai, Jin Huang, Liang Du
The knotless barbed suture is an innovative type of suture that can accelerate the placement of sutures and eliminate knot tying. However, the outcomes of previous studies are still confounding. This study reviewed the application of different types of barbed sutures in different surgeries. We searched PubMed, EMBASE, CENTRAL and ClinicalTrials.gov to identify randomized controlled trials (RCTs) addressing the application of barbed sutures up to Feb. 2015. Two reviewers independently screened the literature and assessed the risk of bias of included studies...
March 23, 2016: Scientific Reports
https://www.readbyqxmd.com/read/26965026/safety-of-community-based-minor-surgery-performed-by-gps-an-audit-in-different-settings
#17
Jonathan Botting, Ana Correa, James Duffy, Simon Jones, Simon de Lusignan
BACKGROUND: Minor surgery is a well-established part of family practice, but its safety and cost-effectiveness have been called into question. AIM: To audit the performance of GP minor surgeons in three different settings. DESIGN AND SETTING: A community-based surgery audit of GP minor surgery cases and outcomes from three settings: GPs who carried out minor surgery in their practice funded as enhanced (primary care) services (ESGPs); GPs with a special interest (GPwSIs) who worked independently within a healthcare organisation; and GPs working under acute trust governance (Model 2 GPs)...
May 2016: British Journal of General Practice: the Journal of the Royal College of General Practitioners
https://www.readbyqxmd.com/read/26949700/commonly-used-dietary-supplements-on-coagulation-function-during-surgery
#18
Chong-Zhi Wang, Jonathan Moss, Chun-Su Yuan
BACKGROUND: Patients who undergo surgery appear to use dietary supplements significantly more frequently than the general population. Because they contain pharmacologically active compounds, dietary supplements may affect coagulation and platelet function during the perioperative period through direct effects, pharmacodynamic interactions, and pharmacokinetic interactions. However, in this regard, limited studies have been conducted that address the pharmacological interactions of dietary supplements...
September 2015: Medicines (Basel, Switzerland)
https://www.readbyqxmd.com/read/26907998/percutaneous-lumbar-foraminoplasty-and-percutaneous-endoscopic-lumbar-decompression-for-lateral-recess-stenosis-through-transforaminal-approach-technique-notes-and-2-years-follow-up
#19
Zhen-zhou Li, Shu-xun Hou, Wei-lin Shang, Zheng Cao, Hong-liang Zhao
OBJECTIVE: To evaluate the outcome and safety of percutaneous lumbar foraminoplasty (PLF) and percutaneous endoscopic lumbar decompression (PELD) with specially designed instrument for lumbar lateral recess stenosis with/without herniated discs (HDs). METHOD: From August of 2011 to August of 2013, 96 patients met the inclusion criteria were treated with PLF-PELD and 85 cases were followed up to 2 years postoperatively. MRI or CT checkup performed in the next morning after operation...
April 2016: Clinical Neurology and Neurosurgery
https://www.readbyqxmd.com/read/26811621/single-incision-laparoscopic-surgery-for-biliary-tract-disease
#20
REVIEW
Shu-Hung Chuang, Chih-Sheng Lin
Single-incision laparoscopic surgery (SILS), or laparoendoscopic single-site surgery, has been employed in various fields to minimize traumatic effects over the last two decades. Single-incision laparoscopic cholecystectomy (SILC) has been the most frequently studied SILS to date. Hundreds of studies on SILC have failed to present conclusive results. Most randomized controlled trials (RCTs) have been small in scale and have been conducted under ideal operative conditions. The role of SILC in complicated scenarios remains uncertain...
January 14, 2016: World Journal of Gastroenterology: WJG
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