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https://www.readbyqxmd.com/read/28437809/reactive-rather-than-proactive-diabetes-management-in-the-perioperative-period
#1
Inge Hommel, Petra J van Gurp, Alfons A den Broeder, Hub Wollersheim, Femke Atsma, Marlies E J L Hulscher, Cees J Tack
As perioperative hyperglycemia is associated with poor postoperative patient outcomes, clinical guidelines provide recommendations for optimal perioperative glucose control. It is unclear to what extent recommended glucose levels are met in daily practice, and little is known about factors that influence these levels. We describe blood glucose levels throughout the hospital care pathway in 375 non-critically ill patients with diabetes who underwent major surgery (abdominal, cardiac, or orthopedic) in 6 hospitals, examine determinants of these levels including adherence to 9 quality indicators for optimal perioperative diabetes care, and perform qualitative interviews to identify barriers for optimal care...
April 24, 2017: Hormone and Metabolic Research, Hormon- und Stoffwechselforschung, Hormones et Métabolisme
https://www.readbyqxmd.com/read/28437804/-prognostic-factors-of-open-abdomen-treatment-in-visceral-surgery
#2
Martin W von Websky, Agnes Jedig, Arnulf Willms, Azin Jafari, Hanno Matthaei, Jörg C Kalff, Steffen Manekeller
Introduction In general surgery, open abdomen treatment (OAT) is used to treat abdominal compartment syndrome (ACS) and sepsis, often after a primary surgical procedure associated with complications. The results achieved in this patient population may depend on factors that are yet unknown. This study evaluates independent patient-related prognostic factors after OAT. Methods 38 clinical parameters and survival data of 165 consecutive general surgery patients after OAT were entered into a prospective database according to a defined algorithm in order to analyse the underlying surgical pathology, predictors of survival and important aspects of OAT-related morbidity...
April 24, 2017: Zentralblatt Für Chirurgie
https://www.readbyqxmd.com/read/28437672/eosinophilic-funiculitis-initially-diagnosed-as-irreducible-inguinal-hernia-a-case-report
#3
Kohei Yamada, Akashi Ikubo, Shota Ikeda, Satoko Koga, Yasuhiro Tsuru, Hideo Kuroki, Naohiko Koya, Ryuichiro Samejima, Masashi Sakai, Masanobu Tabuchi, Seiji Yunotani, Shinichi Kido, Kazushige Nishimura, Hiroyuki Meiri
BACKGROUND: Most groin masses are first suspected to be groin hernias. More than 80% of bulging groin lesions are reportedly diagnosed as hernias by ultrasonography. Establishment of the correct diagnosis of hernia among all differential diagnoses is not easy. We herein describe a very rare case of groin eosinophilic funiculitis that presented as an irreducible groin hernia. CASE PRESENTATION: A 59-year-old man presented to our hospital with suspicion of a right groin hernia...
April 5, 2017: International Journal of Surgery Case Reports
https://www.readbyqxmd.com/read/28437498/superior-mesenteric-artery-syndrome-as-a-complication-of-scoliosis-surgery
#4
Philip K Louie, Bryce A Basques, Adam Bitterman, Shalin Shah, Kishan Patel, Isaac Abramchayev, Jonathan Lewin
Superior mesenteric artery (SMA) syndrome is a rare and potentially life-threatening complication of scoliosis surgery. The anatomical relationship of the duodenum and the superior mesenteric artery, the correction of angular deformity of the spine, and the normal adolescent growth spurt all contribute to the condition. We report the case of a 14-year-old boy who had a history of idiopathic scoliosis and presented with bilious vomiting that had persisted for 7 days after posterior T9-L4 fusion with instrumentation...
March 2017: American Journal of Orthopedics
https://www.readbyqxmd.com/read/28437313/enhanced-recovery-after-surgery-for-noncolorectal-surgery-a-systematic-review-and-meta-analysis-of-major-abdominal-surgery
#5
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/28437197/pressure-irrigation-of-surgical-incisions-and-traumatic-wounds
#6
Donald E Fry
BACKGROUND: Pressure irrigation of surgical incisions and traumatic wounds is commonly used to prevent infections. Commercial pressure irrigation devices have proliferated rapidly, but scientific validation of clinical benefit or appropriate use remains uncertain. METHODS: The published experimental and clinical investigations of pressure irrigation have been reviewed since the introduction of the Waterpik device in 1967 to identify the evidence for use to prevent soft tissue infections associated with injury wounds or surgical incisions...
March 1, 2017: Surgical Infections
https://www.readbyqxmd.com/read/28436213/bilateral-inguinal-hernia-after-axillary-femoral-artery-bypass-effectively-treated-with-laparoscopic-repair-a-case-report
#7
Seiya Susumu, Kantoku Nagakawa, Shunsuke Kawakami, Kazuya Okada, Hiroki Kishikawa
We report herein our experience with bilateral inguinal hernia surgery for a patient who had previously undergone a Y-shaped vascular graft for an abdominal aortic aneurysm and then right axillary-bilateral femoral artery bypass surgery. Preoperative physical examination and imaging revealed a subcutaneous vascular graft passing from the right axilla through the right flank region and branching at the lower abdomen to reach the femoral areas on both sides. As repair surgery by inguinal incision was considered difficult, we performed laparoscopic surgery...
April 24, 2017: Asian Journal of Endoscopic Surgery
https://www.readbyqxmd.com/read/28436060/pneumatosis-intestinalis-in-a-cohort-of-children-with-neurological-impairment-a-patient-group-with-a-management-dilemma
#8
Karim Awad, Melissa Short, Anindya Niyogi, Gareth Hosie, Alok Godse
AIM: Pneumatosis intestinalis (PI) is uncommon in school-age children. We studied a cohort of neurologically impaired school-age children with PI to formulate an optimum management plan. METHODS: We retrospectively studied all school-age children who were referred to paediatric surgeons with radiological evidence of PI identified between 2011 and 2015. We analysed data on patient demographics, medications, feeding, associated comorbidities, presentation, investigations and treatments...
April 24, 2017: Journal of Paediatrics and Child Health
https://www.readbyqxmd.com/read/28435651/a-pediatric-case-of-meckel-diverticulum-with-uncommon-presentation-showing-no-lower-gastrointestinal-bleeding
#9
Sanaz Mehrabani, Soheil Osia
Meckel's diverticulum (MD) is the most common congenital abnormality of the gastrointestinal tract. Painless intestinal hemorrhage is a frequently occurring complication that relates to MD in children. Bowel obstruction is a rare complication of MD in children. We report on the case of a four-year old male child who presented with abdominal pain and hematemesis. Finally, bowel obstruction due to MD was confirmed at surgery.
March 22, 2017: Pediatric Reports
https://www.readbyqxmd.com/read/28434964/reconstruction-of-cranial-vault-defect-with-polyetheretherketone-peek-implants
#10
Pierre Brandicourt, Franck Delanoé, Franck-Emmanuel Roux, Florian Jalbert, David Brauge, Frédéric Lauwers
OBJECT: Reconstruction of a cranial vault defect is a frequent challenge in neurosurgery. Polyetheretherketone (PEEK) is used in many types of prostheses and has been employed for 10 years in our institution (University Hospital of Toulouse - France). The objectives of this study are to describe the benefits and drawbacks of reconstructing the cranial vault defect with a PEEK prosthesis. METHODS: Clinical data of the 37 patients who received a reconstruction with a custom-made PEEK prosthesis from 2007 to 2015 were retrospectively analysed...
April 18, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28434377/a-primary-extraskeletal-osteosarcoma-of-the-mesentery-a-case-report
#11
Nathalie E J van den Broek, Paul Willemsen, Caroline Mattelaer
Extraskeletal osteosarcoma is a rare and invasive malignancy, typically located in the soft tissue without attachment to the skeleton. The present study reports a case of a primary mesenteric extraskeletal osteosarcoma of a 71-year-old woman. The patient complained of an incomplete defecation. Colonoscopy showed an ulcer with impression of external compression of the sigmoid. An additional abdominal computed tomography (CT) scan revealed a large, almost completely calcified, mass in the left lower abdomen causing hydronephrosis of the left kidney...
April 24, 2017: Acta Chirurgica Belgica
https://www.readbyqxmd.com/read/28434082/senior-general-surgery-residents-can-be-trained-to-perform-focused-assessment-with-sonography-for-trauma-patients-accurately
#12
Sheng-Der Hsu, Cheng-Jueng Chen, De-Chuan Chan, Jyh-Cherng Yu
PURPOSES: Researchers studying trauma have found that physicians are able to perform a focused assessment with sonography for trauma (FAST) with minimal training and achieve ideal accuracy. However, there are currently no consensus or standard guidelines regarding the performance of this assessment. The aim of our study was to clarify the value of FAST performed by well-qualified senior general surgery residents in cases of suspected blunt abdominal trauma, which presents an important diagnostic problem in emergency departments...
April 22, 2017: Surgery Today
https://www.readbyqxmd.com/read/28433843/use-of-pneumoperitoneal-puncture-for-peritoneal-catheter-placement-in-lumboperitoneal-shunt-surgery-technical-note
#13
Junhua He, Xin Jin, Jun Kong, Yihai Lin, Zhangyi Wu, Xinwen Zhang
BACKGROUND: In hydrocephalus shunt surgery, a peritoneal catheter is traditionally inserted with laparotomy incision. The abdominal incision length will not be shorter than 3 cm in most cases. A longer incision has to be made in obese patients. The lateral position in lumboperitoneal shunt (LPS) surgery also increases the difficulty of laparotomy. The present report introduces a simple technique of pneumoperitoneal puncture for peritoneal catheter placement in LPS. METHODS: Twenty-eight communicating hydrocephalus cases underwent pneumoperitoneal puncture in an LPS operation...
April 19, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28433486/gallstone-ileus-an-overview-of-the-literature
#14
C F Ploneda-Valencia, M Gallo-Morales, C Rinchon, E Navarro-Muñiz, C A Bautista-López, L F de la Cerda-Trujillo, L A Rea-Azpeitia, C R López-Lizarraga
INTRODUCTION: Gallstone ileus represents 4% of the causes of bowel obstruction in the general population, but increases to 25% in patients above the age of 65 years. Gallstone ileus does not present with unique symptoms, making diagnosis difficult. Its management is surgical, but there is no consensus as to which of the different surgical techniques is the procedure of choice. At present, there is no recent review of this pathology. AIM: To conduct an up-to-date review of this disease...
April 19, 2017: Revista de Gastroenterología de México
https://www.readbyqxmd.com/read/28433350/open-repair-of-chronic-thoracic-and-thoracoabdominal-aortic-dissection-using-deep-hypothermia-and-circulatory-arrest
#15
Joel Corvera, Hannah Copeland, David Blitzer, Adam Hicks, Joshua Manghelli, Philip Hess, John Fehrenbacher
BACKGROUND: Chronic dissection of the thoracic and thoracoabdominal aorta as sequela of a prior type A or B dissection is a challenging problem that requires close radiographic surveillance and prompt operative intervention in the presence of symptoms or aneurysm formation. Open repair of chronic thoracic and thoracoabdominal aortic dissection using deep hypothermia has been our preferred method to treat this complex pathology. The advantages of this technique include organ and spinal cord protection, the flexibility to extend the repair proximally into the arch, and the ability to limit ischemia to all vascular beds...
March 18, 2017: Journal of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/28433333/effects-of-hospital-safety-net-burden-and-hospital-volume-on-failure-to-rescue-after-open-abdominal-aortic-surgery
#16
Eric B Rosero, Girish P Joshi, Abu Minhajuddin, Carlos H Timaran, J Gregory Modrall
OBJECTIVE: Failure to rescue (FTR) is defined as the inability to rescue a patient from major perioperative complications, resulting in operative mortality. FTR is a known contributor to operative mortality after open abdominal aortic surgery. Understanding the causes of FTR is essential to designing interventions to improve perioperative outcomes. The objective of this study was to determine the relative contributions of hospital volume and safety-net burden (the proportion of uninsured and Medicaid-insured patients) to FTR...
April 19, 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/28431896/pressurized-intraperitoneal-aerosol-chemotherapy-%C3%A2-practical-aspects
#17
M Hübner, F Grass, H Teixeira-Farinha, B Pache, P Mathevet, N Demartines
INTRODUCTION: Pressurized Intraperitoneal Aerosol Chemotherapy (PIPAC) has been introduced as novel treatment for peritoneal carcinomatosis. Only proper patient selection, stringent safety protocol and careful surgery allow for a secure procedure. We hereby report the essentials for safe implementation. METHODS: All consecutive procedures within 20 months after PIPAC implementation were analyzed with regards to practical and surgical aspects. Special emphasis was laid on modifications of technique and safety measures during the implementation process with systematic use of a dedicated checklist...
April 8, 2017: European Journal of Surgical Oncology
https://www.readbyqxmd.com/read/28429947/a-practical-guide-to-development-of-a-successful-robotic-abdominal-surgery-program-the-path-to-implementation
#18
Z Jutric, S Warner, Y Fong
The authors describe current situation in robotic assisted operations. The most important aspects of establishing a successful robotic program are patience and flexibility. The improved patient satisfaction, return to function, and decreased perioperative pain for patients and surgeons will be seen, but the road is long and requires careful navigation.Key Words: robot abdominal surgery - program development.
2017: Rozhledy V Chirurgii: Měsíčník Československé Chirurgické Společnosti
https://www.readbyqxmd.com/read/28429925/robot-assisted-laparoendoscopic-single-site-versus-mini-laparoscopic-pyeloplasty-a-comparison-of-perioperative-functional-and-cosmetic-results
#19
Cristian Fiori, Riccardo Bertolo, Matteo Manfredi, Fabrizio Mele, Daniele Amparore, Giovanni Cattaneo, Ivano Morra, Roberto M Scarpa, Francesco Porpiglia
BACKGROUND: New approaches have been developed to further reduce the invasiveness of laparoscopic pyeloplasty (P) as treatment for uretero-pelvic junction obstruction (UPJO). Aim of the study was to compare perioperative, functional and cosmetic results of mini-laparoscopic (mL-P) versus robot-assisted laparoendoscopic single-site P (rLESS-P). METHODS: Since April 2009 to June 2010, 12 adult patients with primary UPJO, BMI<25 and no previous abdominal surgeries were enrolled undergoing mLP (3-mm instruments only)...
April 20, 2017: Minerva Urologica e Nefrologica, the Italian Journal of Urology and Nephrology
https://www.readbyqxmd.com/read/28429863/abdominal-vagus-nerve-stimulation-as-a-new-therapeutic-approach-to-prevent-postoperative-ileus
#20
N Stakenborg, A M Wolthuis, P J Gomez-Pinilla, G Farro, M Di Giovangiulio, G Bosmans, E Labeeuw, M Verhaegen, I Depoortere, A D'Hoore, G Matteoli, G E Boeckxstaens
BACKGROUND: Electrical stimulation of the cervical vagus nerve (VNS) prevents postoperative ileus (POI) in mice. As this approach requires an additional cervical procedure, we explored the possibility of peroperative abdominal VNS in mice and human. METHODS: The effect of cervical and abdominal VNS was studied in a murine model of POI and lipopolysaccharide (LPS)-induced sepsis. Postoperative ileus was quantified by assessment of intestinal transit of fluorescent dextran expressed as geometric center (GC)...
April 21, 2017: Neurogastroenterology and Motility: the Official Journal of the European Gastrointestinal Motility Society
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