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https://www.readbyqxmd.com/read/28447103/comparison-of-clinical-outcomes-following-head-and-neck-surgery-among-patients-who-contract-to-abstain-from-alcohol-vs-patients-who-abuse-alcohol
#1
Azeem S Kaka, Songzhu Zhao, Enver Ozer, Amit Agrawal, Stephen Kang, James Rocco, Ricardo Carrau, Theodoros Teknos, John D Clapp, Harrison Weed, Matthew O Old
Importance: Alcohol abuse is highly prevalent in the population of patients with head and neck cancer, and active abuse at the time of surgery results in poor postoperative outcomes. Objective: To determine the association of alcohol abstinence with postoperative outcome in alcohol misusers undergoing major surgical procedures of the head and neck. Design, Setting, and Participants: As a case-control study, from July 2013 to August 2015, outcomes were collected in patients at an academic tertiary referral center requiring free flap reconstruction who had undergone an abstinence contract (n = 15) and compared with those who were abusers of alcohol prior to the inception of the protocol (n = 30)...
April 26, 2017: JAMA Otolaryngology—Head & Neck Surgery
https://www.readbyqxmd.com/read/28445024/an-economic-evaluation-of-the-enhanced-recovery-after-surgery-eras-multisite-implementation-program-for-colorectal-surgery-in-alberta
#2
Nguyen X. Thanh, Anderson W. Chuck, Tracy Wasylak, Jeannette Lawrence, Peter Faris, Olle Ljungqvist, Gregg Nelson, Leah M. Gramlich
BACKGROUND: In February 2013, Alberta Health Services established an Enhanced Recovery After Surgery (ERAS) implementation program for adopting the ERAS Society colorectal guidelines into 6 sites (initial phase) that perform more than 75% of all colorectal surgeries in the province. We conducted an economic evaluation of this initiative to not only determine its cost-effectiveness, but also to inform strategy for the spread and scale of ERAS to other surgical protocols and sites. METHODS: We assessed the impact of ERAS on patients’ health services utilization (HSU; length of stay [LOS], readmissions, emergency department visits, general practitioner and specialist visits) within 30 days of discharge by comparing pre- and post-ERAS groups using multilevel negative binomial regressions...
December 1, 2016: Canadian Journal of Surgery. Journal Canadien de Chirurgie
https://www.readbyqxmd.com/read/28444464/effectiveness-of-antibiotic-prophylaxis-in-non-emergency-cholecystectomy-using-data-from-a-population-based-cohort-study
#3
Ravinder S Vohra, James Hodson, Sandro Pasquali, Ewen A Griffiths
BACKGROUND: There is a variation in the administration of antibiotics prophylaxis to reduce the perceived risk of SSI in patients undergoing non-emergency cholecystectomy. The aim of this study was to determine the effectiveness of antibiotic prophylaxis following non-emergency cholecystectomy to prevent 30-day superficial surgical site infections (SSIs) using non-selected, nationally collected, prospective data. METHODS: Data were extracted from the CholeS study, which examined and independently validated the outcomes on consecutive patients following non-emergency cholecystectomy across 166 hospitals in the UK and Ireland...
April 25, 2017: World Journal of Surgery
https://www.readbyqxmd.com/read/28443721/evaluation-of-surgical-outcomes-with-photoselective-greenlight-xps-laser-vaporization-of-the-prostate-in-high-medical-risk-men-with-benign-prostatic-enlargement-a-multicenter-study
#4
Emad Sabri Rajih, Côme Tholomier, Pierre-Alain Hueber, Abdullah M Alenizi, Roger Valdivieso, Mounsif Azizi, Ricardo R Gonzalez, Greg Eure, Lewis Kriteman, Mahmood A Hai, Kevin Christopher Zorn
Objective To evaluate the safety and short-term outcomes of photoselective vaporization of the prostate using GreenLight XPSTM in treatment of high medical risk men. Methods A multicenter retrospective analysis of 941 men who underwent photoselective vaporization of the prostate between August 2010 and August 2014 was performed. Patients were considered high medical risk if they had an American Society of Anesthesiologists physical status score ≥ 3. Postoperative adverse events, unexpected postoperative medical provider visits after intervention, and functional urinary outcomes were examined...
April 26, 2017: Journal of Endourology
https://www.readbyqxmd.com/read/28442185/modified-frailty-index-is-an-effective-risk-assessment-tool-in-primary-total-knee-arthroplasty
#5
Robert P Runner, Jaime L Bellamy, CatPhuong Cathy L Vu, Greg A Erens, Mara L Schenker, George N Guild
BACKGROUND: "Frailty" is a marker of physiological decline of multiple organ systems, and the frailty index identifies patients who are more susceptible to postoperative complications. The purpose of this study is to validate the modified frailty index (MFI) as a predictor of postoperative complications, reoperations, and readmissions in patients who underwent primary total knee arthroplasty (TKA). METHODS: The American College of Surgeons National Surgical Quality Improvement Program database from 2005 to 2014 was queried by the Current Procedural Terminology code for primary TKA (27447)...
March 29, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28441311/feasibility-and-outcome-of-an-accelerated-recovery-protocol-in-asian-adolescent-idiopathic-scoliosis-patients
#6
Chris Yin Wei Chan, Shweh Fern Loo, Jun Yin Ong, Kulathunga Arachchige Lisitha, M Shahnaz Hasan, Chee Kean Lee, Chee Kidd Chiu, Mun Keong Kwan
STUDY DESIGN: Prospective cohort study OBJECTIVE.: To determine the feasibility of an accelerated recovery protocol for Asian Adolescent Idiopathic Scoliosis (AIS) patients undergoing posterior spinal fusion (PSF). SUMMARY OF BACKGROUND DATA: There has been successful implementation of an accelerated recovery protocol for AIS patients undergoing PSF in the western population. No similar studies have been reported in the Asian population. METHODS: 74 AIS (65F, 9 M) patients scheduled for PSF surgery were recruited...
April 24, 2017: Spine
https://www.readbyqxmd.com/read/28438629/the-impact-of-multiple-prostate-biopsies-on-risk-for-major-complications-following-radical-prostatectomy-a-population-based-cohort-study
#7
Daniel Olvera-Posada, Blayne Welk, J Andrew McClure, Jennifer Winick-Ng, Jonathan I Izawa, Stephen E Pautler
OBJECTIVE: To evaluate the impact of multiple transrectal ultrasound-guided prostate biopsies (TRUS-Bx) before radical prostatectomy (RP) on surgical outcomes. METHODS: Administrative databases were used to identify all patients who had a RP performed in the province of Ontario from April 1, 2002 to March 31, 2013. TRUS-Bx prior to RP were identified and patients were categorized as having one or more than one prior TRUS-Bx. The primary end point was a composite index of serious surgical complications...
April 21, 2017: Urology
https://www.readbyqxmd.com/read/28438453/effect-of-bundled-payments-and-health-care-reform-as-alternative-payment-models-in-total-joint-arthroplasty-a-clinical-review
#8
REVIEW
Ahmed Siddiqi, Peter B White, Jaydev B Mistry, Chukwuweike U Gwam, James Nace, Michael A Mont, Ronald E Delanois
BACKGROUND: In an effort to control rising healthcare costs, healthcare reforms have developed initiatives to evaluate the efficacy of alternative payment models (APMs) for Medicare reimbursements. The Center for Medicare and Medicaid Services Innovation Center (CMMSIC) introduced the voluntary Bundled Payments for Care Improvement (BPCI) model experiment as a means to curtail Medicare cost by allotting a fixed payment for an episode of care. The purpose of this review is to (1) summarize the preliminary clinical results of the BPCI and (2) discuss how it has led to other healthcare reforms and alternative payment models...
March 20, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28437313/enhanced-recovery-after-surgery-for-noncolorectal-surgery-a-systematic-review-and-meta-analysis-of-major-abdominal-surgery
#9
Anthony Visioni, Rupen Shah, Emmanuel Gabriel, Kristopher Attwood, Moshim Kukar, Steven Nurkin
OBJECTIVE: To evaluate the impact of enhanced recovery after surgery (ERAS) protocols across noncolorectal abdominal surgical procedures. BACKGROUND: ERAS programs have been studied extensively in colorectal surgery and adopted at many centers. Several studies testing such protocols have shown promising results in improving postoperative outcomes across various surgical procedures. However, surgeons performing major abdominal procedures have been slower to adopt these ERAS protocols...
April 21, 2017: Annals of Surgery
https://www.readbyqxmd.com/read/28436569/association-of-waist-circumference-with-outcomes-in-an-acute-general-surgical-unit
#10
Thomas Ryan, Preet Gosal, Alexa Seal, Joe McGirr, Nicholas Williams
BACKGROUND: Obesity prevalence is increasing in Australia, particularly in non-metropolitan areas. The effect of obesity on acute surgical outcomes is not known. We aimed to record waist circumference (WC) (surrogate for obesity) amongst acute surgical unit (ASU) patients in a New South Wales regional hospital, and compare outcome measures (length of stay (LOS), unplanned return to theatre, readmission rates, intensive care unit (ICU) admission and mortality). METHODS: Retrospective cohort study of 4 months of consecutive ASU admissions, excluding age <16, pregnancy, out-of-area transfer and incomplete data...
April 24, 2017: ANZ Journal of Surgery
https://www.readbyqxmd.com/read/28435915/impact-of-surgical-approach-on-complication-rates-after-elective-spinal-fusion-%C3%A2-3-levels-for-adult-spine-deformity
#11
Aladine A Elsamadicy, Owoicho Adogwa, Shay Behrens, Amanda Sergesketter, Angel Chen, Ankit I Mehta, Raul A Vasquez, Joseph Cheng, Carlos A Bagley, Isaac O Karikari
BACKGROUND: While there are variations in techniques and surgical approaches to spinal fusion, there is not a defined consensus on a recommended surgical approach. The aim of this study is to determine if there was a difference in intra- and post-operative complication rates between different surgical approaches after elective spinal fusion (≥3 levels) for adult spine deformity. METHODS: The medical records of 443 adult spine deformity patients undergoing elective spinal fusion (≥3) at a major academic institution from 2005 to 2015 were reviewed...
March 2017: Journal of Spine Surgery (Hong Kong)
https://www.readbyqxmd.com/read/28435128/randomized-trial-on-fast-track-care-in-colorectal-surgery-for-deep-infiltrating-endometriosis
#12
Marco Scioscia, Marcello Ceccaroni, Irene Gentile, Roberto Rossini, Roberto Clarizia, Davide Brunelli, Giacomo Ruffo
STUDY OBJECT: To study the application of a fast-track care protocol in colorectal surgery for deep infiltrating endometriosis. Bowel endometriosis is an infrequent but not rare condition that often needs intestinal surgery and imposes a high economic burden on society. DESIGN: Prospective randomized trial (Canadian Task Force I). SETTING: Tertiary referral center. PATIENTS: We randomly assigned 227 patients with preoperative evidence of bowel endometriosis to a fast-track (no preoperative bowel preparation, early restoration of diet, no postoperative antibiotics, and early post-operative mobilization) or conventional care for laparoscopic intestinal surgery...
April 18, 2017: Journal of Minimally Invasive Gynecology
https://www.readbyqxmd.com/read/28434635/readmissions-unplanned-emergency-room-visits-and-surgical-retreatment-rates-after-anti-reflux-procedures
#13
Hsin-Hsiao S Wang, Rohit Tejwani, Steven Wolf, John S Wiener, Jonathan C Routh
INTRODUCTION/BACKGROUND: The choice between endoscopic injection (EI) and ureteroneocystotomy (UNC) for surgical correction of vesicoureteral reflux (VUR) is controversial. OBJECTIVE: To compare postoperative outcomes of EI vs UNC. STUDY DESIGN: This study reviewed linked inpatient (SID), ambulatory surgery (SASD), and emergency department (SEDD) data from five states in the United States (2007-10) to identify pediatric patients with primary VUR undergoing EI or UNC as an initial surgical intervention...
April 7, 2017: Journal of Pediatric Urology
https://www.readbyqxmd.com/read/28433362/effect-of-preadmission-bowel-preparation-on-outcomes-of-elective-colorectal-procedures-in-young-children
#14
Guillermo J Ares, Irene Helenowski, Catherine J Hunter, Marybeth Madonna, Marleta Reynolds, Timothy Lautz
BACKGROUND: The utility of mechanical bowel preparation (MBP) to minimize infectious complications in elective colorectal surgery is contentious. Though data is scarce in children, adult studies suggest a benefit to MBP when administered with oral antibiotics (OAB). METHODS: After IRB approval, the Pediatric Health Information System (PHIS) was queried for young children undergoing elective colon surgery from 2011 to 2014. Patients were divided into: no bowel preparation (Group 1), MBP (Group 2), and MBP plus OAB (Group 3)...
March 30, 2017: Journal of Pediatric Surgery
https://www.readbyqxmd.com/read/28433337/increased-resource-utilization-and-overall-morbidity-are-associated-with-general-versus-regional-anesthesia-for-carotid-endarterectomy-in-data-collected-by-the-michigan-surgical-quality-collaborative
#15
Ahmad S Hussain, Andrew Mullard, William F Oppat, Kevin D Nolan
OBJECTIVE: Advocates for performing carotid endarterectomy (CEA) under regional anesthesia (RA) cite reduction in hemodynamic instability and the ability for neurologic monitoring, but many still prefer general anesthesia (GA) as benefits of RA have not been clearly demonstrated, reliable RA may not be available in all centers, and a certain amount of movement by the patient during the procedure may not be uniformly tolerated. We evaluated the association of anesthesia type and perioperative morbidity and mortality as well as resource utilization in patients undergoing CEA using the Michigan Surgical Quality Collaborative (MSQC) database...
April 19, 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/28433224/the-importance-of-age-on-short-term-outcomes-associated-with-repair-of-giant-paraesophageal-hernias
#16
Mustapha A El Lakis, Stephen J Kaplan, Michal Hubka, Kamran Mohiuddin, Donald E Low
BACKGROUND: Older patients have an increased incidence of paraesophageal hernia (PEH) and can be denied surgical assessment due to the perception of increased complications and mortality. This study examines the influence of age and comorbidities on early complications and other short-term outcomes of PEH repair. METHODS: From 2000 to 2016, data of surgically treated patients with PEH were prospectively recorded in an Institutional Review Board-approved database...
April 19, 2017: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/28432506/elective-colectomy-for-diverticulitis-in-transplant-patients-is-it-worth-the-risk
#17
Janet T Lee, Steve Skube, Genevieve B Melton, Mary R Kwaan, Christine C Jensen, Robert D Madoff, Wolfgang B Gaertner
BACKGROUND: The aim of this study was to determine morbidity and mortality for transplant patients undergoing elective colectomy for diverticulitis and determine the impact of recurrent diverticulitis on postoperative complications. METHODS: We identified transplant recipients that underwent elective colectomy for diverticulitis between 2000 and 2015 at a tertiary care institution. Patient and procedure variables, postoperative complications, length of stay, 30-day readmission, and mortality were identified through retrospective chart review...
April 21, 2017: Journal of Gastrointestinal Surgery: Official Journal of the Society for Surgery of the Alimentary Tract
https://www.readbyqxmd.com/read/28424140/impact-of-multimodality-pain-regimens-on-elective-colorectal-surgery-outcomes
#18
Jennifer A Kaplan, Emily Finlayson, Andrew D Auerbach
Trials of enhanced recovery programs suggest that multimodality pain regimens improve outcomes after colorectal surgery. We sought to determine whether patients receiving postoperative multimodality pain regimens would have shorter lengths of stay without an associated increase in readmission rate as compared to those receiving opioid-based pain regimens. Retrospective cohort study of adults who underwent elective colorectal surgery between January 1, 2006, and December 31, 2012, in a national hospital network participating in the Premier Perspective database...
April 1, 2017: American Surgeon
https://www.readbyqxmd.com/read/28424131/postoperative-complications-predict-30-day-readmission-in-geriatric-general-surgery-patients
#19
James D Dieterich, Celia M Divino
The Affordable Care Act has placed unplanned patient readmissions under more scrutiny than ever. Geriatric patients, in particular, suffer a disproportionate amount of complications from any kind of hospitalization, including readmissions. This study seeks to identify risk factors in this population that predispose them to an unplanned readmission within 30 days after index surgery. The National Surgical Quality Improvement Program database was used to select patients 65 years and older, who underwent general surgery procedures in 2012...
April 1, 2017: American Surgeon
https://www.readbyqxmd.com/read/28420587/should-recent-smoking-be-a-contraindication-for-sleeve-gastrectomy
#20
Ivy N Haskins, Amy S Nowacki, Zhamak Khorgami, Karen Schulz, Leslie J Heinberg, Phillip R Schauer, Stacy A Brethauer, Ali Aminian
BACKGROUND: One of the ultimate goals of bariatric and metabolic surgery is to decrease cardiovascular morbidity and mortality. Obese individuals who smoke tobacco are at an increased risk of cardiovascular events and may benefit the most by positive effects of bariatric surgery on cardiometabolic risk factors. The safety profile of sleeve gastrectomy in patients who smoke has not yet been characterized. OBJECTIVES: To investigate the independent effect of smoking on early postoperative morbidity and mortality of laparoscopic sleeve gastrectomy...
March 9, 2017: Surgery for Obesity and related Diseases: Official Journal of the American Society for Bariatric Surgery
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