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principles of surgery

X Q Wang, C S Wu, S Sun, J Wang, W Li, W Zhang
Objective: To investigate the situation of hip dislocation with the application of "femur first" principle and "combined anteversion technique" during total hip arthroplasty. Methods: A retrospective analysis has been done on the clinical data about 104 patients(133 hips)who were diagnosed as hip disease and were treated with total hip arthroplasty by the doctors from the Department of Joint Orthorpaedics of Shandong Provincial Hospital Affiliated to Shandong University from June 2014 to June 2016, and all the prostheses applied in the operation were cementless ones...
April 1, 2018: Zhonghua Wai Ke za Zhi [Chinese Journal of Surgery]
A A Polyantsev, A V Bykov, A A Polyantsev, V V Kotrunov, A G Zimin, Yu A Dyachkova
AIM: To analyze the errors and complications of surgical care in patients with the first episode of spontaneous pneumothorax at different hospitals. MATERIAL AND METHODS: From 2005 to 2015 three hundreds and seventeen patients with the first episode of spontaneous pneumothorax have been treated at the thoracic department of Volgograd State Medical University. Patients were divided into 2 groups: 79 of them underwent thoracotomy while in 238 cases minimally invasive technologies were applied...
2018: Khirurgiia
Bram D Vermeulen, Peter D Siersema
OPINION STATEMENT: PURPOSE OF REVIEW: Esophageal stents are used in clinical practice for endoscopic treatment of a wide variety of esophageal diseases and conditions. This review provides key principles and a literature update on the utility and limitations of esophageal stenting in clinical practice. RECENT FINDINGS: Indications for esophageal stenting can be subdivided into two groups. The first group consists of patients with malignant or benign dysphagia, in which an esophageal stent restores luminal patency...
March 19, 2018: Current Treatment Options in Gastroenterology
Chenzhou Wu, John Gleysteen, Nutte Tarn Teraphongphom, Yi Li, Eben Rosenthal
Head and neck cancers become a severe threat to human's health nowadays and represent the sixth most common cancer worldwide. Surgery remains the first-line choice for head and neck cancer patients. Limited resectable tissue mass and complicated anatomy structures in the head and neck region put the surgeons in a dilemma between the extensive resection and a better quality of life for the patients. Early diagnosis and treatment of the pre-malignancies, as well as real-time in vivo detection of surgical margins during en bloc resection, could be leveraged to minimize the resection of normal tissues...
March 18, 2018: International Journal of Oral Science
Sarina R Isenberg, Norah L Crossnohere, Manali I Patel, Alison Conca-Cheng, John F P Bridges, Sandy M Swoboda, Thomas J Smith, Timothy M Pawlik, Matthew Weiss, Angelo E Volandes, Anne Schuster, Judith A Miller, Carolyn Pastorini, Debra L Roter, Rebecca A Aslakson
OBJECTIVE: Video-based advanc care planning (ACP) tools have been studied in varied medical contexts; however, none have been developed for patients undergoing major surgery. Using a patient- and family-centredness approach, our objective was to implement human-centred design (HCD) to develop an ACP decision support video for patients and their family members when preparing for major surgery. DESIGN AND METHODS: The study investigators partnered with surgical patients and their family members, surgeons and other health professionals to design an ACP decision support video using key HCD principles...
March 18, 2018: BMJ Supportive & Palliative Care
Geoffrey A Anderson, Peter Kayima, Lenka Ilcisin, Noralis Portal Benitez, Katherine H Albutt, Susan M Briggs, Deepika Nehra
OBJECTIVE: The goal of this project was to create a multitiered trauma training curriculum that was designed specifically for the low-resource setting. DESIGN: We developed 2 courses designed to teach principles and skills necessary for trauma care. The first course, "Emergency Ward Management of Trauma (EWMT)," is designed to teach interns the initial assessment and stabilization of trauma patients in the emergency ward. The second course for mid-level surgical residents, "Surgical Techniques and Repairs in Trauma for the Low-resource Environment" (STaRTLE), is a cadaver-based operative trauma course designed to teach surgical exposures and techniques...
March 16, 2018: Journal of Surgical Education
Amna Diwan, Kyle R Eberlin, Raymond Malcolm Smith
The principles of open fracture management are to manage the overall injury and specifically prevent primary contamination becoming frank infection. The surgical management of these complex injuries includes debridement & lavage of the open wound with combined bony and soft tissue reconstruction. Good results depend on early high quality definitive surgery usually with early stable internal fixation and associated soft tissue repair. While all elements of the surgical principles are very important and depend on each other for overall success the most critical element appears to be achieving very early healthy soft tissue cover...
February 21, 2018: Chinese Journal of Traumatology, Zhonghua Chuang Shang za Zhi
Jacqueline J Blank, Abby E Rothstein, Cheong Jun Lee, Michael J Malinowski, Brian D Lewis, Timothy J Ridolfi, Mary F Otterson
Aortic graft infections are a rare but devastating complication of aortic revascularization. Often infections occur due to contamination at the time of surgery. Iatrogenic misplacement of the limbs of an aortobifemoral graft is exceedingly rare, and principles of evaluation and treatment are not well defined. We report 2 cases of aortobifemoral bypass graft malposition through the colon. CASE REPORT: Case 1 is a 54-year-old male who underwent aortobifemoral bypass grafting for acute limb ischemia...
January 1, 2018: Vascular and Endovascular Surgery
Jesse J Liu, Jeffrey S Raskin, Fran Hardaway, Katherine Holste, Sarah Brown, Ahmed M Raslan
BACKGROUND: Delivery of higher value healthcare is an ultimate government and public goal. Improving efficiency by standardization of surgical steps can improve patient outcomes, reduce costs, and lead to higher value healthcare. Lean principles and methodology have improved timeliness in perioperative medicine; however, process mapping of surgery itself has not been performed. OBJECTIVE: To apply Plan/Do/Study/Act (PDSA) cycles methodology to lumbar posterior instrumented fusion (PIF) using lean principles to create a standard work flow, identify waste, remove intraoperative variability, and examine feasibility among pilot cases...
March 14, 2018: Operative Neurosurgery (Hagerstown, Md.)
Saravanan Sampoornam Pape Reddy
The field of periodontal plastic surgery is always a subject of fascination for periodontists, and the importance of pink esthetics is gaining its pace. Preservation of what is existing is more important than its replacement. The same principle also applies to soft-tissue esthetic procedures thereby the concept of minimal surgical invasion came into existence. This article presents a series of five cases with 18 recession sites which were treated with a minimally invasive Pinhole Surgical Technique which resulted in overall root coverage of 96...
November 2017: Journal of Indian Society of Periodontology
Maria Loreto Alvarez-Nebreda, Nathalie Bentov, Richard D Urman, Sabeena Setia, Joe Chin-Sun Huang, Kurt Pfeifer, Katherine Bennett, Thuan D Ong, Deborah Richman, Divya Gollapudi, G Alec Rooke, Houman Javedan
Frailty is an age-related, multi-dimensional state of decreased physiologic reserve that results in diminished resiliency and increased vulnerability to stressors. It has proven to be an excellent predictor of unfavorable health outcomes in the older surgical population. There is agreement in recommending that a frailty evaluation should be part of the preoperative assessment in the elderly. However, the consensus is still building with regards to how it should affect perioperative care. The Society for Perioperative Assessment and Quality Improvement (SPAQI) convened experts in the fields of gerontology, anesthesiology and preoperative assessment to outline practical steps for clinicians to assess and address frailty in elderly patients who require elective intermediate or high risk surgery...
March 15, 2018: Journal of Clinical Anesthesia
Nils Gessert, Matthias Schlüter, Alexander Schlaefer
Tracking the pose of instruments is a central problem in image-guided surgery. For microscopic scenarios, optical coherence tomography (OCT) is increasingly used as an imaging modality. OCT is suitable for accurate pose estimation due to its micrometer range resolution and volumetric field of view. However, OCT image processing is challenging due to speckle noise and reflection artifacts in addition to the images' 3D nature. We address pose estimation from OCT volume data with a new deep learning-based tracking framework...
March 10, 2018: Medical Image Analysis
Kurt F Heiss, Mehul V Raval
For over 20 years enhanced recovery protocols (ERPs) have been used to decrease the physiologic stress and inflammation of surgery using evidence-based principles. ERPs include optimizing patient preparation, creating less trauma using minimally invasive anesthetic and surgical techniques, and regular audit of outcomes. A critical aspect of ERPs is patient engagement in all phases of care, which facilitates effective team function and focused oversight of patient flow through the system. Counseling extends beyond traditional review of surgical risks and benefits, by creating clear daily patient goals, establishing pain management plans, optimizing nutrition, and defining criteria for discharge...
April 2018: Seminars in Pediatric Surgery
Shengtao Zhang, Conglin Ye, Qi Lai, Xiaolong Yu, Xuqiang Liu, Tao Nie, Haibo Zhan, Min Dai, Bin Zhang
BACKGROUND: Lumbar spondylolysis and isthmic spondylolisthesis are common conditions. However, double-level lumbar spondylolysis and spondylolisthesis are rare. We report 24 cases of it along with a review of literature and a briefly description of the clinical and radiological features and integrated management of patients with this condition. METHODS: Of 1700 inpatients diagnosed with lumbar spondylolisthesis at our hospital between January 2008 and September 2015, we selected those with a diagnosis of double-level spondylolisthesis who underwent surgery...
March 16, 2018: Journal of Orthopaedic Surgery and Research
Nancy Wang, Matthias Osswald
The majority of meningiomas, the most common primary brain tumor, are considered to be benign, and characteristic magnetic resonance imaging features allow a preliminary diagnosis. Meningiomas can be classified in the World Health Organization system as grade I, II, or III, depending on various histological features. In many cases, observation is the preferred management option, although this means the absence of a histological diagnosis. If necessary, standard therapy consists of surgery with or without adjuvant radiation, depending on the tumor grade and the degree of resection...
February 2018: Seminars in Neurology
Shawn Dason, Alvin C Goh
PURPOSE OF REVIEW: More than a century of development has led to contemporary urinary diversion. It is paramount that robotic intracorporeal diversions uphold the principles defined by open surgery. RECENT FINDINGS: In this review, we discuss the fundamental open surgical principles that have led to contemporary techniques of urinary diversion. We then outline the technical aspects of several recently described robotic intracorporeal urinary diversions in the context of these surgical principles...
March 15, 2018: Current Urology Reports
Thomas C Sauter, Balthasar Eberle, Walter A Wuillemin, Thomas Thiele, Anne Angelillo-Scherrer, Aristomenis K Exadaktylos, Gabor Erdös, Adam Cuker, Michael Nagler
Antithrombotic treatment puts patients at risk of major bleeding. Fast and adequate response to anticoagulant-associated bleeding may not only stop the bleeding but prevent severe complications. However, practical treatment algorithms to guide physicians in emergency situations are lacking. Important principles that arise from management of bleeding in general are (a) implementation of an in-house algorithm, (b) rapid identification and treatment of the bleeding source, (c) adequate fluid resuscitation, (d) consideration of the application of tranexamic acid and (e) appropriate coagulation testing...
March 14, 2018: Swiss Medical Weekly
Markus Alexander Küper, Alexander Trulson, Inga Maria Trulson, Christian Minarski, Leonard Grünwald, Christoph Gonser, Christian Bahrs, Bernhard Hirt, Ulrich Stöckle, Fabian Maria Stuby
BACKGROUND: Minimally invasive surgical approaches to reduce approach-associated morbidity are an interdisciplinary goal in surgery. In principle, the endoscopic approach for the extraperitoneal repair of groin hernias is the minimally invasive variant of the modified Stoppa-approach, which is used for the treatment of pelvic ring injuries in traumatology. METHOD: Anatomical feasibility study regarding the plate osteosynthesis of the anterior pelvic ring via a minimally invasive variant of the modified Stoppa-approach...
March 13, 2018: European Journal of Trauma and Emergency Surgery: Official Publication of the European Trauma Society
Shandiz Tehrani, R Katherine Delf, William O Cepurna, Lauren Davis, Elaine C Johnson, John C Morrison
Small molecule delivery to the optic nerve would allow for exploration of molecular and cellular pathways involved in normal physiology and optic neuropathies such as glaucoma, and provide a tool for screening therapeutics in animal models. We report a novel surgical method for small molecule drug delivery to the optic nerve head (ONH) in a rodent model. In proof-of-principle experiments, we delivered cytochalasin D (Cyt D; a filamentous actin inhibitor) to the junction of the superior optic nerve and globe in rats to target the actin-rich astrocytic cytoskeleton of the ONH...
March 13, 2018: Scientific Reports
Kathrin Oehl, Jelena Kresoja-Rakic, Isabelle Opitz, Bart Vrugt, Walter Weder, Rolf Stahel, Peter Wild, Emanuela Felley-Bosco
Experimental models closely representing in vivo conditions allow investigating mechanisms of resistance. Our aims were to establish a live-cell biobank of malignant pleural mesothelioma (MPM) samples and to obtain proof of principle that primary culture chemoresistant models, mimicking tumor progression observed in patients, can be obtained in vitro , providing a useful tool to investigate underlying mechanisms. Primary mesothelioma cultures were established from 235 samples between 2007 and 2014. Of two MPM patients, primary cultures obtained at different time points: at initial diagnosis, after neoadjuvant treatment at surgery and/or after tumor recurrence, were deeply investigated...
2018: Frontiers in Oncology
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