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Incident reporting in Surgery

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https://www.readbyqxmd.com/read/29155938/cerebral-autoregulation-in-cardiopulmonary-bypass-surgery-a-systematic-review
#1
Juliana R Caldas, Victoria J Haunton, Ronney B Panerai, Ludhmila A Hajjar, Thompson G Robinson
Cardiopulmonary bypass surgery is associated with a high incidence of neurological complications, including stroke, delirium and cognitive impairment. The development of strategies to reduce the incidence of such neurological events has been hampered by the lack of a clear understanding of their pathophysiology. Cerebral autoregulation (CA), which describes the ability of the brain to maintain a stable cerebral blood flow over a wide range of cerebral perfusion pressures despite changes in blood pressure, is known to be impaired in various neurological disorders...
November 16, 2017: Interactive Cardiovascular and Thoracic Surgery
https://www.readbyqxmd.com/read/29155522/impact-of-conversion-during-laparoscopic-gastrectomy-on-outcomes-of-patients-with-gastric-cancer
#2
Feng Yue, Xiushuang Geng
PURPOSE: This study reports the impact of conversion from laparoscopic gastrectomy to open gastrectomy on the short- and long-term outcomes of patients with gastric cancer. METHODS: Retrospective analysis of clinical and follow-up data of 236 patients with gastric cancer who underwent laparoscopic gastrectomy between January 2010 and October 2016 was performed. Patients were divided into the conversion and complete laparoscopy groups based on whether conversion to open gastrectomy occurred during surgery or not...
July 2017: Journal of B.U.ON.: Official Journal of the Balkan Union of Oncology
https://www.readbyqxmd.com/read/29155001/postoperative-pain-following-posterior-iliac-crest-bone-graft-harvesting-in-spine-surgery-a-prospective-randomized-trial
#3
Evan D Sheha, Dennis S Meredith, Grant D Shifflett, Benjamin T Bjerke, Sravisht Iyer, Jennifer Shue, Joseph Nguyen, Russel C Huang
BACKGROUND CONTEXT: Post-operative pain at the site of bone graft harvest for posterior spine fusion is reported to occur in 6% to 39% of cases. However, the area around the posterior, superior iliac spine is a frequent site of referred pain for many structures. Therefore, many postoperative spine patients may have pain in the vicinity of the posterior iliac crest that may not in fact be caused by bone graft harvesting. The literature may then overestimate the true incidence of postoperative iliac crest pain...
November 14, 2017: Spine Journal: Official Journal of the North American Spine Society
https://www.readbyqxmd.com/read/29153469/postoperative-urinary-retention-or-difficulties-to-empty-the-bladder-in-young-patients-undergoing-posterior-spinal-fusion-for-adolescent-idiopathic-scoliosis
#4
Heli Keskinen, Linda Helenius, Olli Pajulo, Ilkka J Helenius
BACKGROUND: Postoperative urinary retention has been reported to affect up to 27% of adults undergoing degenerative lumbar spine surgery and approximately one-third of children undergoing lower-extremity orthopedic surgery. No data exist on the incidence and risk factors of postoperative urinary tract retention/difficulties to empty the bladder in young patients undergoing instrumented posterior spinal fusion. We aimed to characterize incidence, risk factors and treatment of postoperative urinary retention (POUR) and difficulties to empty the bladder in young patients undergoing posterior spinal fusion (PSF) for idiopathic scoliosis...
October 13, 2017: Journal of Pediatric Surgery
https://www.readbyqxmd.com/read/29153450/is-external-fixation-needed-for-the-treatment-of-tibial-fractures-with-acute-compartment-syndrome
#5
Tae Hun Kim, Jun Young Chung, Keun Su Kim, Hyung Keun Song
Acute compartment syndrome (ACS) after tibial fracture carries a risk of various complications, including infection, delayed union, nonunion, nerve damage, and poor prognosis. For the treatment of fractures with ACS, fasciotomy is conducted, and the method to stabilise the fracture has to be considered. Thirty-five patients who underwent surgery for ACS with tibial shaft fractures were evaluated, and the results of initial internal fixation (Group I, 20 patients) and initial external fixation (Group II, 15 patients) were analysed...
November 16, 2017: Injury
https://www.readbyqxmd.com/read/29151681/incidence-and-risk-factors-of-early-onset-glaucoma-following-pediatric-cataract-surgery-in-egyptian-children-one-year-study
#6
Ghada I Gawdat, Maha M Youssef, Nermeen M Bahgat, Dina M Elfayoumi, Mohamed As Eddin
Aim: To study the incidence and risk factors of glaucoma occurring within 1 year following pediatric cataract surgery in Egyptian children. Materials and methods: This is a prospective nonrandomized study conducted at Aburich Children's Hospital, over a period of 1 year on a cohort of Egyptian patients with congenital and infantile cataract. One hundred and fifty eyes of 88 patients were enrolled in this study. All the patients underwent anterior approach removal of lens matter, whereas primary intraocular lens (IOL) implantation was carried at the age of 1 and 2 years for unilateral and bilateral cases respectively...
September 2017: Journal of Current Glaucoma Practice
https://www.readbyqxmd.com/read/29150999/focus-on-focus-lack-of-coherence-between-systemic-and-microvascular-indices-of-edema-formation
#7
Birkitt Ten Tusscher, Corien Gudden, Suus van Vliet, Bob Smit, Can Ince, E Christiaan Boerma, Harm-Jan S de Grooth, Paul W G Elbers
BACKGROUND: Fluid therapy remains a cornerstone of therapy in shock states. However, fluid overloading ultimately results in edema formation which is related to excess morbidity and mortality. Handheld microscopes are now frequently used to study the sublingual microcirculation. As a corollary, these devices measure focal distance, or surface to capillary distance. Physiologically, this could represent a microvascular index of edema formation and could have the potential to guide fluid therapy...
November 18, 2017: Anaesthesiology Intensive Therapy
https://www.readbyqxmd.com/read/29150782/nitrous-oxide-added-at-the-end-of-isoflurane-anesthesia-hastens-early-recovery-without-increasing-the-risk-for-postoperative-nausea-and-vomiting-a-randomized-clinical-trial
#8
Boris Mraovic, Tatjana Simurina, Tong J Gan
BACKGROUND: Nitrous oxide (N2O) has been reported to increase the risk of postoperative nausea and vomiting (PONV) in a dose-dependent manner. We investigated the effect of adding N2O at the end of isoflurane inhalational anesthesia on the recovery and incidence of PONV. Our hypothesis was that N2O would reduce the time to early recovery without increasing the incidence of PONV. METHODS: After obtaining ethics committee approval and written informed consent, 100 women at American Society of Anesthesiologists physical status I-III and scheduled for laparoscopic-assisted vaginal hysterectomy were randomized into two groups (G) according to the carrier gas: GO2 (air in 30% oxygen) and GN2O (the same mixture until the last 30 min of surgery, when 70% N2O in 30% oxygen was used)...
November 17, 2017: Canadian Journal of Anaesthesia, Journal Canadien D'anesthésie
https://www.readbyqxmd.com/read/29150228/surgeons-perceptions-of-the-causes-of-preventable-harm-in-arterial-surgery-a-mixed-methods-study
#9
Rachael Lear, Anthony D Godfrey, Celia Riga, Christine Norton, Charles Vincent, Colin D Bicknell
BACKGROUND: System factors contributing to preventable harm in vascular patients have not been previously reported in detail. The aim of this exploratory mixed-methods study was to describe vascular surgeons' perceptions of factors contributing to adverse events (AEs) in arterial surgery. A secondary aim was to report recommendations to improve patient safety. METHODS: Vascular consultants/registrars working in the British National Health Service were questioned about the causes of preventable AEs through survey and semi-structured interview (response rates 77% and 83%, respectively)...
November 15, 2017: European Journal of Vascular and Endovascular Surgery
https://www.readbyqxmd.com/read/29148580/ultrasound-guided-reduction-of-an-incarcerated-obturator-hernia-in-an-elderly-patient
#10
Bente M de Kok, Julien B C M Puylaert, Frank M Zijta
Obturator hernia is a rare but clinically relevant cause of intestinal obstruction, usually found in elderly, thin, multiparous women. It is difficult to diagnose, leading to diagnostic delay with a high incidence of strangulation and a high mortality rate. Surgery is the only reported treatment. We report the case of an 86-year-old woman, in whom an early diagnosis of incarcerated obturator hernia was made with subsequent reduction by compression with an ultrasound transducer. When the risk of strangulation is presumed to be low, ultrasound-guided reduction of an obturator hernia is achievable and worth considering...
November 17, 2017: Journal of Clinical Ultrasound: JCU
https://www.readbyqxmd.com/read/29145314/incidence-of-lower-limb-lymphedema-after-vulvar-cancer-a-systematic-review-and-meta-analysis
#11
Jiuzuo Huang, Nanze Yu, Xiaojun Wang, Xiao Long
BACKGROUND: Lower limb lymphedema (LLL) is an important concern for patients with vulvar cancer. Studies of the incidence of vulvar cancer-related lymphedema and its risk factors have substantially increased in the new millennium. OBJECTIVES: This article is a meta-analysis that aimed to systematically evaluate the incidence of LLL and its risk factors related to vulvar cancer. DATA SOURCES: Data were collected from eligible studies from PubMed, ScienceDirect, and Web of Science...
November 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29141384/-problems-deserving-attention-in-preventing-infection-in-cataract-surgery
#12
J Ye
Endophthalmitis is one of the most serious complications of cataract surgery. The surgeons try to reduce the incidence of endophthalmitis. In order to prevent postoperative infection, irrigation of the conjunctival sac with povidone iodine and injection of antibiotics into the anterior chamber before the end of the surgery are used. Although there are a lot of reports about the concentration, mode and duration of povidone iodine application, there is no consensus. There are many options for antibiotics, including cefuroxime, vancomycin and moxifloxacin...
November 11, 2017: [Zhonghua Yan Ke za Zhi] Chinese Journal of Ophthalmology
https://www.readbyqxmd.com/read/29139105/preoperative-medical-therapy-before-surgery-for-uterine-fibroids
#13
REVIEW
Anne Lethaby, Lucian Puscasiu, Beverley Vollenhoven
BACKGROUND: Uterine fibroids occur in up to 40% of women aged over 35 years. Some are asymptomatic, but up to 50% cause symptoms that warrant therapy. Symptoms include anaemia caused by heavy menstrual bleeding, pelvic pain, dysmenorrhoea, infertility and low quality of life. Surgery is the first choice of treatment. In recent years, medical therapies have been used before surgery to improve intraoperative and postoperative outcomes. However, such therapies tend to be expensive.Fibroid growth is stimulated by oestrogen...
November 15, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/29136676/papillary-thyroid-cancer-and-coexisting-autoimmune-thyroiditis
#14
Franziska Veit, Dieter Graf, Saskia Momberger, Brigitte Helmich-Kapp, Ilka Ruschenburg, Anja Peters, Jochen Kussmann, Wolfgang Saeger, Kurt Werner Schmidt, Martin Toetsch, Kai Nestler, Klaus Mann
Histological findings often display an association between papillary thyroid carcinomas (PTC) and autoimmune thyroiditis (AIT) and so differ significantly from follicular thyroid carcinomas (FTC). The aim of this interdisciplinary, retrospective study was to evaluate the association of AIT in patients with PTC and FTC and a control group of benign nodular goiters. One hundred thyroidectomies with histologically confirmed differentiated thyroid carcinomas, 67 with PTC and 33 with FTC, were submitted for examination...
November 2017: Hormone and Metabolic Research, Hormon- und Stoffwechselforschung, Hormones et Métabolisme
https://www.readbyqxmd.com/read/29135883/an-analysis-of-the-incidence-and-outcomes-of-major-vs-minor-neurological-decline-after-complex-adult-spinal-deformity-surgery-a-sub-analysis-of-scoli-risk-1-study
#15
So Kato, Michael G Fehlings, Stephen J Lewis, Lawrence G Lenke, Christopher I Shaffrey, Kenneth M C Cheung, Leah Carreon, Mark B Dekutoski, Frank J Schwab, Oheneba Boachie-Adjei, Khaled M Kebaish, Christopher P Ames, Yong Qiu, Yukihiro Matsuyama, Benny T Dahl, Hossein Mehdian, Ferran Pellisé, Sigurd H Berven
STUDY DESIGN: A sub-analysis from a prospective, multicenter, international cohort study in 15 sites (Scoli-RISK-1). OBJECTIVE: To report detailed information regarding the severity of neurological decline related to complex adult spine deformity (ASD) surgery and to examine outcomes based on severity. SUMMARY OF BACKGROUND DATA: The basis of post-operative neurological decline after ASD surgeries can occur due to nerve root(s) or spinal cord dysfunction...
November 10, 2017: Spine
https://www.readbyqxmd.com/read/29134456/european-hernia-society-guidelines-on-prevention-and-treatment-of-parastomal-hernias
#16
REVIEW
S A Antoniou, F Agresta, J M Garcia Alamino, D Berger, F Berrevoet, H-T Brandsma, K Bury, J Conze, D Cuccurullo, U A Dietz, R H Fortelny, C Frei-Lanter, B Hansson, F Helgstrand, A Hotouras, A Jänes, L F Kroese, J R Lambrecht, I Kyle-Leinhase, M López-Cano, L Maggiori, V Mandalà, M Miserez, A Montgomery, S Morales-Conde, M Prudhomme, T Rautio, N Smart, M Śmietański, M Szczepkowski, C Stabilini, F E Muysoms
BACKGROUND: International guidelines on the prevention and treatment of parastomal hernias are lacking. The European Hernia Society therefore implemented a Clinical Practice Guideline development project. METHODS: The guidelines development group consisted of general, hernia and colorectal surgeons, a biostatistician and a biologist, from 14 European countries. These guidelines conformed to the AGREE II standards and the GRADE methodology. The databases of MEDLINE, CINAHL, CENTRAL and the gray literature through OpenGrey were searched...
November 13, 2017: Hernia: the Journal of Hernias and Abdominal Wall Surgery
https://www.readbyqxmd.com/read/29134372/systematic-review-of-cytoreductive-surgery-and-bevacizumab-containing-chemotherapy-in-advanced-ovarian-cancer-focus-on-safety
#17
REVIEW
Marco Petrillo, Camilla Nero, Vittoria Carbone, Matteo Bruno, Giovanni Scambia, Anna Fagotti
BACKGROUND: Initial experiences reported increased surgical morbidities in patients receiving cytoreductive surgery for colorectal cancer after bevacizumab-containing chemotherapy; however, more recent literature suggests a favorable toxicity profile in patients with advanced ovarian cancer (AOC). With the aim of providing a more objective point of view on this controversial issue, we present here a systematic literature review. METHODS: Systematic revision of the available literature was conducted using the PubMed, MEDLINE, and EMBASE electronic databases...
November 13, 2017: Annals of Surgical Oncology
https://www.readbyqxmd.com/read/29133855/effect-of-short-term-exposure-to-ambient-air-particulate-matter-on-incidence-of-delirium-in-a-surgical-population
#18
Lu Che, Yan Li, Cheng Gan
Delirium remains an independent risk factor for morbidity and mortality among older surgical adults. Recent research has shed light on the relationship between pollution and dementia, yet little is known about the health impacts of particulate matter (PM) on delirium. Therefore, we aim to further explore association of PM and delirium among surgical population. We conducted a time-stratified case-crossover study. Electronic hospitalization summary reports derived from 26 major cities in China between 1 January 2014 and 31 December 2015 were used...
November 13, 2017: Scientific Reports
https://www.readbyqxmd.com/read/29133325/minimally-invasive-surgery-versus-open-surgery-in-the-treatment-of-lumbar-spondylolisthesis-study-protocol-of-a-multicentre-randomised-controlled-trial-misos-trial
#19
Mark P Arts, Jasper Fc Wolfs, Jos Ma Kuijlen, Godard Cw de Ruiter
INTRODUCTION: Patients with symptomatic spondylolisthesis are frequently treated with nerve root decompression, in addition to pedicle screw fixation and interbody fusion. Minimally invasive approaches are gaining attention in recent years, although there is no clear evidence supporting the proclamation of minimally invasive spine surgery (MISS) being better than open surgery. We present the design of the MISOS (Minimal Invasive Surgery versus Open Surgery) trial on the effectiveness of MISS versus open surgery in patients with degenerative or spondylolytic spondylolisthesis...
November 12, 2017: BMJ Open
https://www.readbyqxmd.com/read/29133170/hydronephrosis-and-crossing-vessels-in-children-optimization-of-diagnostic-therapeutic-pathway-and-analysis-of-color-doppler-ultrasound-and-magnetic-resonance-urography-diagnostic-accuracy
#20
M C Y Wong, G Piaggio, M B Damasio, C Molinelli, S M Ferretti, A Pistorio, G Ghiggeri, M L Degl'Innocenti, A Canepa, V Incarbone, G Mattioli
INTRODUCTION: Ureteropelvic junction obstruction (UPJO) is one of the most frequent urological diseases affecting the pediatric population. It can be due to both intrinsic stenosis of the junction and extrinsic causes such as the presence of crossing vessels (CVs), which can be detected by color Doppler ultrasound (CD-US). Magnetic resonance urography (MRU) is a good alternative, but sedation and infusion of a contrast agent are required. OBJECTIVE: The aim of this study was to analyze the diagnostic accuracy of CD-US and MRU in visualizing CVs in pediatric hydronephrosis, in order to decide the correct diagnostic pathway in the pre-operative phase...
October 27, 2017: Journal of Pediatric Urology
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