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https://www.readbyqxmd.com/read/28922231/use-of-regional-anesthesia-for-outpatient-surgery-within-the-united-states-a-prevalence-study-using-a-nationwide-database
#1
Rodney A Gabriel, Brian M Ilfeld
BACKGROUND: Regional anesthesia is of benefit for outpatient surgery given its demonstrated improvement in analgesia and decrease in complications, resulting in shorter average recovery room times and lower hospital readmission rates. Unfortunately, there are few epidemiological studies outlining the overall utilization of peripheral nerve blocks (PNBs) in this setting. Therefore, the primary objective of this study was to report the overall utilization of several types of PNBs among all candidate cases in the outpatient setting within the United States...
September 14, 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28917012/operative-and-short-term-oncologic-outcomes-of-laparoscopic-versus-open-liver-resection-for-colorectal-liver-metastases-located-in-the-posterosuperior-liver-a-propensity-score-matching-analysis
#2
Masayuki Okuno, Claire Goumard, Takashi Mizuno, Kiyohiko Omichi, Ching-Wei D Tzeng, Yun Shin Chun, Thomas A Aloia, Jason B Fleming, Jeffrey E Lee, Jean-Nicolas Vauthey, Claudius Conrad
BACKGROUND: Laparoscopic resection (LLR) of colorectal liver metastases (CRLM) located in the posterosuperior liver (segments 4a, 7, and 8) is challenging but has become more practical recently due to progress in operative techniques. We aimed to compare tumor-specific, perioperative, and short-term oncological outcomes after LLR and open liver resection (OLR) for CRLM. METHODS: Patients who underwent curative resection of CRLM with at least 1 tumor in the posterosuperior liver during 2012-2015 were analyzed...
September 15, 2017: Surgical Endoscopy
https://www.readbyqxmd.com/read/28916971/emergency-room-visits-and-readmissions-following-implementation-of-an-enhanced-recovery-after-surgery-ieras-program
#3
Trevor Wood, Mary-Anne Aarts, Allan Okrainec, Emily Pearsall, J Charles Victor, Marg McKenzie, Ori Rotstein, Robin S McLeod
BACKGROUND: Enhanced Recovery After Surgery (ERAS) guidelines have been widely promoted and supported largely due to several studies showing decreased post-operative complications and length of stay. The objective of this study was to review the emergency room (ER) visits and readmission rates and reasons for both in patients who were part of the Implementation of an Enhanced Recovery After Surgery (iERAS) program for colorectal surgery. METHODS: All patients having elective colorectal surgery at 15 academic hospitals were enrolled in the iERAS program...
September 15, 2017: Journal of Gastrointestinal Surgery: Official Journal of the Society for Surgery of the Alimentary Tract
https://www.readbyqxmd.com/read/28916892/precision-in-robotic-rectal-surgery-using-the-da-vinci-xi-system-and-integrated-table-motion-a-technical-note
#4
Sofoklis Panteleimonitis, Mick Harper, Stuart Hall, Nuno Figueiredo, Tahseen Qureshi, Amjad Parvaiz
Robotic rectal surgery is becoming increasingly more popular among colorectal surgeons. However, time spent on robotic platform docking, arm clashing and undocking of the platform during the procedure are factors that surgeons often find cumbersome and time consuming. The newest surgical platform, the da Vinci Xi, coupled with integrated table motion can help to overcome these problems. This technical note aims to describe a standardised operative technique of single docking robotic rectal surgery using the da Vinci Xi system and integrated table motion...
September 15, 2017: Journal of Robotic Surgery
https://www.readbyqxmd.com/read/28902101/early-ambulation-decreases-length-of-hospital-stay-perioperative-complications-and-improves-functional-outcomes-in-elderly-patients-undergoing-surgery-for-correction-of-adult-degenerative-scoliosis
#5
Owoicho Adogwa, Aladine A Elsamadicy, Jared Fialkoff, Joseph Cheng, Isaac O Karikari, Carlos Bagley
STUDY DESIGN: Ambispective cohort review. OBJECTIVE: To examine the effects of early mobilization on patient outcomes, complications profile, and 30-day readmission rates. SUMMARY OF BACKGROUND DATA: Prolonged immobilization after surgery can result in functional decline and an increased risk of hospital-associated complications. METHODS: We conducted an ambispective study of 125 elderly patients (>65 years) undergoing elective spinal surgery for correction of adult degenerative scoliosis...
September 15, 2017: Spine
https://www.readbyqxmd.com/read/28902086/operative-stabilization-of-flail-chest-injuries-reduces-mortality-to-that-of-stable-chest-wall-injuries
#6
Niloofar Dehghan, Jeffrey M Mah, Emil H Schemitsch, Aaron Nauth, Milena Vicente, Michael D McKee
OBJECTIVE: To determine the prevalence, management and outcomes of patients with flail chest injuries, compared to patients without flail chest injuries (single rib fractures and multiple rib fractures without a flail segment). DESIGN: Retrospective cohort study SETTING:: Ontario, Canada PARTICIPANTS:: Ontario residents over the age of 16 who had been admitted to hospital with a chest wall injury from 2004 to 2015 were identified using administrative health care databases...
August 29, 2017: Journal of Orthopaedic Trauma
https://www.readbyqxmd.com/read/28899592/the-american-college-of-surgeons-national-surgical-quality-improvement-program-surgical-risk-calculator-has-a-role-in-predicting-discharge-to-post-acute-care-in-total-joint-arthroplasty
#7
Daniel E Goltz, Billy T Baumgartner, Cary S Politzer, Marcus DiLallo, Michael P Bolognesi, Thorsten M Seyler
BACKGROUND: Patient demand and increasing cost awareness have led to the creation of surgical risk calculators that attempt to predict the likelihood of adverse events and to facilitate risk mitigation. The American College of Surgeons National Surgical Quality Improvement Program Surgical Risk Calculator is an online tool available for a wide variety of surgical procedures, and has not yet been fully evaluated in total joint arthroplasty. METHODS: A single-center, retrospective review was performed on 909 patients receiving a unilateral primary total knee (496) or hip (413) arthroplasty between January 2012 and December 2014...
August 18, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28895462/is-hospitalization-necessary-after-ear-surgery-a-national-survey-and-retrospective-review-of-postoperative-events
#8
Tanja Jelicic, Julian Richard Savage, Margaret Aron
Objective First, to survey our national otolaryngology colleagues on their postoperative care habits (hospitalization vs day surgery) after elective middle ear surgery. Second, to evaluate the necessity of hospitalization and safety of day surgery after these procedures. Methods A national survey regarding postoperative habits after elective middle ear surgery was launched. Then, the cases of all patients having undergone these surgical procedures at our center between 2010 and 2016 were reviewed. They were divided into 2 groups: hospitalization and day surgery...
September 1, 2017: Otolaryngology—Head and Neck Surgery
https://www.readbyqxmd.com/read/28894682/frailty-is-predictive-of-adverse-postoperative-events-in-patients-undergoing-lumbar-fusion
#9
Dante M Leven, Nathan J Lee, Jun S Kim, Parth Kothari, Jeremy Steinberger, Javier Guzman, Branko Skovrlj, John I Shin, Kevin Phan, John M Caridi, Samuel K Cho
STUDY DESIGN: Retrospective study of prospectively collected data. OBJECTIVE: To analyze the modified frailty index (mFI) as a predictor of adverse postoperative events following posterior lumbar fusion. METHODS: The American College of Surgeons National Surgical Quality Improvement Program (ACS NSQIP) database including all adult patients undergoing posterior lumbar interbody fusion or transforaminal lumbar interbody fusion between 2005 and 2012...
September 2017: Global Spine Journal
https://www.readbyqxmd.com/read/28891039/a-systematic-review-of-transabdominal-levator-division-during-abdominoperineal-excision-of-the-rectum-aper
#10
D L H Baird, C Simillis, C Kontovounisios, Q Sheng, S Nikolaou, W L Law, S Rasheed, P P Tekkis
BACKGROUND: The aim of the present study was to evaluate the surgical technique, short-term oncological and perioperative outcomes for the transabdominal division of the levator ani muscles during abdominoperineal excision of the rectum (APER). METHODS: A systematic review was performed to identify studies reporting on transabdominal division of the levator ani during APER. A comprehensive literature search was performed using a combination of free-text terms and controlled vocabulary when applicable on the following databases: MEDLINE, EMBASE, Science Citation Index Expanded and Cochrane Central Register of Controlled Trials in the Cochrane Library...
September 11, 2017: Techniques in Coloproctology
https://www.readbyqxmd.com/read/28890310/evaluating-the-american-college-of-surgeons-national-surgical-quality-improvement-project-risk-calculator-results-from-the-u-s-extrahepatic-biliary-malignancy-consortium
#11
Eliza W Beal, Ezra Lyon, Joe Kearney, Lai Wei, Cecilia G Ethun, Sylvester M Black, Mary Dillhoff, Ahmed Salem, Sharon M Weber, Thuy B Tran, George Poultsides, Rivfka Shenoy, Ioannis Hatzaras, Bradley Krasnick, Ryan C Fields, Stefan Buttner, Charles R Scoggins, Robert C G Martin, Chelsea A Isom, Kamron Idrees, Harveshp D Mogal, Perry Shen, Shishir K Maithel, Timothy M Pawlik, Carl R Schmidt
BACKGROUND: The objective of this study is to evaluate use of the American College of Surgeons (ACS) National Surgical Quality Improvement Program (NSQIP) online risk calculator for estimating common outcomes after operations for gallbladder cancer and extrahepatic cholangiocarcinoma. METHODS: Subjects from the United States Extrahepatic Biliary Malignancy Consortium (USE-BMC) who underwent operation between January 1, 2000 and December 31, 2014 at 10 academic medical centers were included in this study...
September 7, 2017: HPB: the Official Journal of the International Hepato Pancreato Biliary Association
https://www.readbyqxmd.com/read/28888796/laparoscopic-treatment-of-gastroparesis-a-single-center-experience
#12
Kotaro Wakamatsu, Federico Perez Quirante, Lisandro Montorfano, Emanuele Lo Menzo, Yasuyuki Seto, Raul J Rosenthal
BACKGROUND: Gastroparesis (GP) is a chronic disorder of gastric motility with delayed gastric emptying. Gastric electrical stimulator (GES) implantation and Roux-en-Y gastric bypass (RYGB) are surgical options for medically refractory GP. OBJECTIVE: Evaluate operational outcomes and symptom improvement of patients with diabetic (DM) and idiopathic (IP) GP. SETTING: University Hospital, United States. METHODS: A retrospective chart review was performed of all patients who underwent surgical treatment of GP from February 2003 to December 2014...
July 29, 2017: Surgery for Obesity and related Diseases: Official Journal of the American Society for Bariatric Surgery
https://www.readbyqxmd.com/read/28887272/establishing-benchmarks-for-the-volume-outcome-relationship-for-common-lumbar-spine-surgical-procedures
#13
Andrew J Schoenfeld, Daniel J Sturgeon, Camden B Burns, Tyler J Hunt, Christopher M Bono
BACKGROUND CONTEXT: The importance of surgeon volume as a quality measure has been defined for a number of surgical specialties. Meaningful procedural volume benchmarks have not been established, however, particularly with respect to lumbar spine surgery. PURPOSE: To establish surgeon volume benchmarks for the performance of four common lumbar spine surgical procedures (discectomy, decompression, lumbar interbody fusion, lumbar posterolateral fusion). STUDY DESIGN: Retrospective review of data in the Florida Statewide Inpatient Dataset (2011-2014)...
September 5, 2017: Spine Journal: Official Journal of the North American Spine Society
https://www.readbyqxmd.com/read/28887259/morphometric-assessment-as-a-predictor-of-outcome-in-older-vascular-surgery-patients
#14
Mohammed M Chowdhury, Graeme K Ambler, Naail Al Zuhir, Alex Walker, Ellie R Atkins, Andrew Winterbottom, Patrick A Coughlin
INTRODUCTION: Frailty is a recognised predictor of poor outcome in patients undergoing surgical intervention. Frailty is intricately linked with body morphology, which can be evaluated using morphometric assessment via computerised tomographic (CT) imaging. We aimed to assess the predictive power of such objective assessments in a broad cohort of vascular surgical patients. PATIENTS AND METHODS: A consecutive series of patients aged over 65 years admitted to a vascular unit, who had undergone CT imaging of the abdomen, were analysed...
September 5, 2017: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/28887066/neoadjuvant-chemoradiation-is-associated-with-improved-overall-survival-in-older-patients-with-esophageal-cancer
#15
David M Guttmann, Nandita Mitra, James M Metz, John Plastaras, Weiwei Feng, Samuel Swisher-McClure
OBJECTIVES: The aim of this study was to characterize outcomes associated with neoadjuvant chemoradiation prior to esophagectomy, compared to esophagectomy alone, in older patients with esophageal cancer. MATERIALS AND METHODS: We conducted an observational cohort study in patients ≥70years with locally-advanced esophageal cancer undergoing esophagectomy ± neoadjuvant chemoradiation between 2006 and 2012 using the National Cancer Database. A Cox proportional hazards model with inverse probability of treatment weighting (IPTW) using the propensity score was developed to assess the association between trimodality therapy and overall survival...
September 5, 2017: Journal of Geriatric Oncology
https://www.readbyqxmd.com/read/28886677/unplanned-return-to-operating-room-after-endovascular-repair-of-abdominal-aortic-aneurysm-evar-is-associated-with-increased-risk-of-hospital-readmission
#16
Faisal Aziz, Katelynn Ferranti, Erik B Lehman
Objectives Hospital readmissions after surgical operations are considered serious events. Centers for Medicare and Medicaid (CMS) consider surgical readmissions as preventable and hold hospitals responsible for them. Endovascular abdominal aortic aneurysm (EVAR) has become the first line modality of treatment for suitable patients with abdominal aortic aneurysm (AAA). The purpose of this study is to retrospectively review the factors associated with hospital readmission after EVAR. Methods The 2013 EVAR targeted American College of Surgeons (ACS-NSQIP) database and generalized 2013 general and vascular surgery ACS-NSQIP participant use files were used for this study...
January 1, 2017: Vascular
https://www.readbyqxmd.com/read/28885412/outcomes-associated-with-a-five-point-surgical-site-infection-prevention-bundle-in-women-undergoing-surgery-for-ovarian-cancer
#17
Melissa H Lippitt, Melissa Gerardi Fairbairn, Rayna Matsuno, Rebecca L Stone, Edward J Tanner, Elizabeth C Wick, Ana C Angarita, Kara Long Roche, Kimberly L Levinson, Jennifer E Bergstrom, Abdulrahman K Sinno, Melanie S Curless, Stephanie Wethington, Sarah M Temkin, Jonathan Efron, Deborah Hobson, Amanda N Fader
OBJECTIVE: To identify risk factors for surgical site infection and to define rates associated with cytoreductive surgery before and after implementation of an infection prevention bundle. METHODS: We conducted a prospective quality improvement study. Patients who underwent ovarian, fallopian tube, or peritoneal cancer cytoreductive surgery at an academic tertiary care center from April 2014 to April 2016 were prospectively enrolled. Patient demographics, surgical variables, and surgical site infection rates were compared with a historical cohort after introduction of a 5-point infection prevention bundle, including: 1) preoperative and intraoperative skin preparation with 4% chlorhexidine and intraoperative vaginal preparation with 4% chlorhexidine; 2) preoperative use of oral antibiotics and mechanical bowel preparation; 3) appropriate timing of intraoperative antibiotics; 4) adoption of enhanced sterile surgical techniques for colon procedures and incisional closure; and 5) perioperative incision management...
September 5, 2017: Obstetrics and Gynecology
https://www.readbyqxmd.com/read/28885237/exploring-the-perceived-value-of-a-personalized-informatics-tool-to-anticipate-and-mitigate-patient-risk
#18
Michael D Kneeland, Catherine H Ivory, Phebe Bloomingburg, Neesha N Choma
Health care systems are implementing a myriad of strategies to improve patient outcomes and reduce both adverse events and unplanned readmissions. These approaches include interventions related to people, processes, and technology. This article describes the development of a technology-based model in the form of an actionable risk profile, which was used by one inpatient surgical unit (people) during a daily care team briefing (process). The risk profile was evaluated for its perceived value to the care team as a method of organizing care and anticipating patients' needs...
September 1, 2017: Journal for Healthcare Quality: Official Publication of the National Association for Healthcare Quality
https://www.readbyqxmd.com/read/28882683/structured-operative-autonomy-an-institutional-approach-to-enhancing-surgical-resident-education-without-impacting-patient-outcomes
#19
Brandon M Wojcik, Zhi Ven Fong, Madhukar S Patel, David C Chang, Dustin R Long, Haytham Ma Kaafarani, Emil Petrusa, John T Mullen, Keith D Lillemoe, Roy Phitayakorn
BACKGROUND: Though barriers to granting surgical residents autonomy in the operating room are well described, few have proposed practical strategies to overcome them. Our department adopted a multidisciplinary approach to develop a rotation that aimed to grant chief residents structured operative autonomy. In this study, we assess the feasibility of implementation, impact on patient safety and educational benefit to residents following the program's pilot year. STUDY DESIGN: During a one-month rotation, chief residents began cases alone using their own operative block time...
September 4, 2017: Journal of the American College of Surgeons
https://www.readbyqxmd.com/read/28882357/evaluation-of-negative-pressure-wound-therapy-to-closed-laparotomy-incisions-in-acute-care-surgery
#20
Elleson Schurtz, Jerome Differding, Eric Jacobson, Christopher Maki, Mentor Ahmeti
BACKGROUND: Surgical site complications in the form of wound infections are a major burden to the healthcare system. Negative pressure wound therapy (NPWT) as delivered by a surgical incision management system (SIMS) is a novel approach to improve wound healing when applied to closed incisions. However, data is limited in its application to laparotomy incisions in the acute care surgery setting. METHODS: A retrospective case-control study was performed to evaluate the outcomes of SIMS with regard to surgical site infections in a series of 48 consecutive patients in which SIMS was applied to closed laparotomy incisions in the acute care surgery setting...
August 23, 2017: American Journal of Surgery
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