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Preoperative risk evaluation

Gijsbert D Musters, Charlotte E L Klaver, Robbert J I Bosker, Jacobus W A Burger, Peter van Duijvendijk, Boudewijn van Etten, Anna A W van Geloven, Eelco J R de Graaf, Christiaan Hoff, Jeroen W A Leijtens, Harm J T Rutten, Baljit Singh, Ronald J C L M Vuylsteke, Johannes H W de Wilt, Marcel G W Dijkgraaf, Willem A Bemelman, Pieter J Tanis
OBJECTIVE: To determine the effect of biological mesh closure on perineal wound healing after extralevator abdominoperineal resection (eAPR). BACKGROUND: Perineal wound complications frequently occur after eAPR with preoperative radiotherapy for rectal cancer. Cohort studies have suggested that biological mesh closure of the pelvic floor improves perineal wound healing. METHODS: Patients were randomly assigned to primary closure (standard arm) or biological mesh closure (intervention arm)...
September 20, 2016: Annals of Surgery
David Altschul, Andrew Kobets, Jonathan Nakhla, Ajit Jada, Rani Nasser, Merritt D Kinon, Reza Yassari, John Houten
OBJECTIVE Postoperative urinary retention (POUR) is a common problem leading to morbidity and an increased hospital stay. There are limited data regarding its baseline incidence in patients undergoing spinal surgery and the risk factors with which it may be associated. The purpose of this study was to evaluate the incidence of POUR in elective spine surgery patients and determine the factors associated with its occurrence. METHODS The authors retrospectively reviewed the records of patients who had undergone elective spine surgery and had been prospectively monitored for POUR during an 18-month period...
October 21, 2016: Journal of Neurosurgery. Spine
Xin Jiang, Dong Chen, Yahao Lou, Zhongshi Li
BACKGROUND: Postoperative delirium is a common complication following various operative procedures with an incidence rate of 10-77 %. AIM: To analyze various risk factors for postoperative delirium after spine surgery in the middle- and old-aged patients. METHODS: This study retrospectively reviewed 451 patients (226 males and 225 females, an average age of 65.1 ± 18.3 years) who underwent spinal surgery in our hospital between January 2010 and August 2015...
October 20, 2016: Aging Clinical and Experimental Research
Ingrid Eitzen, Hege Grindem, Agnethe Nilstad, Håvard Moksnes, May Arna Risberg
BACKGROUND: Reduced quadriceps strength influences knee function and increases the risk of knee osteoarthritis. Thus, it is of significant clinical relevance to precisely quantify strength deficits in patients with knee injuries. PURPOSE: To evaluate isokinetic concentric quadriceps muscle strength torque values, assessed both from peak torque and at specific knee flexion joint angles, in patients with anterior cruciate ligament (ACL) injury, focal cartilage lesions, and degenerative meniscus tears...
October 2016: Orthopaedic Journal of Sports Medicine
Ronald J Caras, Michael B Lustik, Sean Q Kern, Leah P McMann, Joseph R Sterbis
INTRODUCTION: Multiple studies have linked preoperative nutrition status to postoperative outcomes. This relationship has been little studied in urology. We used a standardized, national, risk-adjusted surgical database to evaluate 30-day outcomes of patients undergoing common urologic oncologic procedures as they related to preoperative albumin. METHODS: The American College of Surgeons National Surgical Quality Improvement Program is a risk-adjusted dataset analyzing preoperative risk factors, demographics, and 30-day outcomes...
September 23, 2016: Clinical Genitourinary Cancer
Michele M Merten, M Regina Castro, Jun Zhang, Jolanta M Durski, Mabel Ryder
BACKGROUND: Cytologically defined indeterminate thyroid nodules are a diagnostic challenge. Surgical lobectomy remains gold standard for definitive diagnosis, however, 70-85% of nodules are ultimately benign. The primary objective of this study was to evaluate the negative predictive value (NPV) of F18-Fluorodeoxyglucose (FDG) positron emission computed tomography (PET/CT) in excluding cancer among cytologically indeterminate thyroid nodules within our institution using surgical pathology as a gold standard reference and to perform a systematic review of published prospective studies on the NPV of PET/CT in evaluating indeterminate thyroid nodules...
October 20, 2016: Thyroid: Official Journal of the American Thyroid Association
H Weiss, R Zorron, K-H Vestweber, B Vestweber, L Boni, W Brunner, C Sietses, S Morales Conde, O Bulut, K Gash, A R Dixon, C Mittermair, A Klaus, O Stanger, M Weiss, A Muratore, T Hell
BACKGROUND: The international multicentre registry ECSPECT (European Consensus of Single Port Expertise in Colorectal Treatment) was established to evaluate the general feasibility and safety of single-port colorectal surgery with regard to preoperative risk assessment. METHODS: Consecutive patients undergoing single-port colorectal surgery were enrolled from 11 European centres between March 2010 and March 2014. Data were analysed to assess patient-, technique- and procedure-dependent parameters...
October 20, 2016: British Journal of Surgery
Marina Pieri, Alessandro Belletti, Fabrizio Monaco, Antonio Pisano, Mario Musu, Veronica Dalessandro, Giacomo Monti, Gabriele Finco, Alberto Zangrillo, Giovanni Landoni
BACKGROUND: In patients undergoing cardiac surgery, a reduced preoperative left ventricular ejection fraction (LVEF) is common and is associated with a worse outcome. Available outcome data for these patients address specific surgical procedures, mainly coronary artery bypass graft (CABG). Aim of our study was to investigate perioperative outcome of surgery on patients with low pre-operative LVEF undergoing a broad range of cardiac surgical procedures. METHODS: Data from patients with pre-operative LVEF ≤40 % undergoing cardiac surgery at a university hospital were reviewed and analyzed...
October 18, 2016: BMC Anesthesiology
Massimo Del Fabbro, Stefano Corbella, Patrick Sequeira-Byron, Igor Tsesis, Eyal Rosen, Alessandra Lolato, Silvio Taschieri
BACKGROUND: When primary root canal therapy fails, periapical lesions can be retreated with or without surgery. Root canal retreatment is a non-surgical procedure that involves removal of root canal filling materials from the tooth, followed by cleaning, shaping and obturating of the canals. Root-end resection is a surgical procedure that involves exposure of the periapical lesion through an osteotomy, surgical removal of the lesion, removal of part of the root-end tip, disinfection and, commonly, retrograde sealing or filling of the apical portion of the remaining root canal...
October 19, 2016: Cochrane Database of Systematic Reviews
Sergio Eduardo Alonso Araujo, Lucas de Araujo Horcel, Victor Edmond Seid, Alexandre Bruno Bertoncini, Sidney Klajner
Background: Stapled hemorrhoidopexy is associated with less postoperative pain and faster recovery. However, it may be associated with a greater risk of symptomatic recurrence. We hypothesized that undertaking a limited surgical excision of hemorrhoid disease after stapling may be a valid approach for selected patients. Aim: To compare long-term results after stapled hemorrhoidopexy with and without complementation with closed excisional technique. Method: In a retrospective uni-institutional cohort study, sixty-five (29 men) patients underwent stapled hemorrhoidopexy and 21 (13 men) underwent stapled hemorrhoidopexy with excision...
July 2016: Arquivos Brasileiros de Cirurgia Digestiva: ABCD, Brazilian Archives of Digestive Surgery
Kwan Mo Yang, In Ja Park, Chan Wook Kim, Seon Ae Roh, Dong-Hyung Cho, Jin Cheon Kim
PURPOSE: The purpose of this study was to evaluate the prognostic significance of serum CEA (s-CEA) changes in colorectal cancer (CRC) patients with sustained elevated postoperative s-CEA levels. METHODS: Between January 1999 and December 2008, 9,380 CRC patients underwent surgery. Curative resection was performed in 1,242 CRC patients with high preoperative s-CEA levels (>6 ng/mL). High s-CEA levels were normalized in 924 patients (74.4%) within 2 weeks from surgery, whereas high s-CEA levels were persistent in 318 patients (25...
October 2016: Annals of Surgical Treatment and Research
Chairat Burusapat, Tirapat Nanasilp, Paiboon Kunaphensaeng, Anuchit Ruamthanthong
: The anterolateral thigh (ALT) flap has been widely used for reconstructions. Nevertheless, the atherosclerotic risk factors that affect the lateral circumflex femoral artery (LCFA) are still inconclusive. The aim was to study the effect of atherosclerosis on the LCFA and descending branch (dLCFA) visualized by computer tomographic angiography (CTA) between nonatherosclerosis and atherosclerosis. METHODS: Retrospective studies of CTA of lower extremity were reviewed...
September 2016: Plastic and Reconstructive Surgery. Global Open
Shinsuke Koshita, Yutaka Noda, Kei Ito, Yoshihide Kanno, Takahisa Ogawa, Kaori Masu, Yoshiharu Masaki, Jun Horaguchi, Masaya Oikawa, Takashi Tsuchiya, Takashi Sawai, Miwa Uzuki, Fumiyoshi Fujishima
BACKGROUND AND AIMS: To elucidate the efficacy of pancreatic juice cytology with the cell block method (CB-PJC) for the determination of surgery in patients with branch duct intraductal papillary mucinous neoplasm (BD-IPMN). METHODS: In 138 patients with BD-IPMN from whom pancreatic juice was collected under ERCP for CB-PJC, we retrospectively evaluated the following: (1) the rate of the CB-PJC successfully evaluated, (2) the ability of CB-PJC for the diagnosis of malignant BD-IPMNs and for the identification of pathological subtypes in resected BD-IPMNs, (3) the rate of development into invasive cancer and progression of BD-IPMNs in patients with BD-IPMN diagnosed as benignancy by CB-PJC, and (4) post-ERCP adverse events...
October 15, 2016: Gastrointestinal Endoscopy
Do Hee Kim, Hee Jin Kwon, Sang A Ji, Hye Ryoun Jang, Sin-Ho Jung, Jung-Han Kim, Jae Hyeon Kim, Jung Eun Lee, Wooseong Huh, Yoon-Goo Kim, Dae Joong Kim, Ha Young Oh
Primary aldosteronism (PA) may induce significant decline of renal function and structural damage of kidney. However, it is difficult to evaluate accurate renal function in patients with PA, because glomerular hyperfiltration and aldosterone escape can conceal renal impairment. In this retrospective cohort study, we compared changes in renal function after unilateral adrenalectomy between patients with PA and patients with other adrenal diseases. Risk factors associated with postoperative renal impairment in patients with PA were analyzed...
July 2016: Medicine (Baltimore)
Susan Peters, Venerina Johnston, Sonia Hines, Mark Ross, Michel Coppieters
BACKGROUND: Carpal tunnel syndrome (CTS) is a common problem, that can be effectively managed by surgery. Screening for prognostic factors is important to identify workers who are at a greater risk of a poor work outcome in order to implement tailored interventions to facilitate their return-to-work. OBJECTIVE: To synthesize the best available evidence on the association of preoperative prognostic factors with work-related outcomes in people who have undergone carpal tunnel surgery...
September 2016: JBI Database of Systematic Reviews and Implementation Reports
John C Kubasiak, Mackenzie Landin, Scott Schimpke, Jennifer Poirier, Jonathan A Myers, Keith W Millikan, Minh B Luu
INTRODUCTION: Tobacco smoking is a known risk factor for complications after major surgical procedures. The full effect of tobacco use on these complications has not been studied over large populations for ventral hernia repairs. This effect is more important as the preoperative conditioning, and optimization of patients is adopted. We sought to use the prospectively collected ACS-NSQIP dataset to evaluate respiratory and infectious complications for patients undergoing both laparoscopic and open ventral hernia repairs...
October 17, 2016: Surgical Endoscopy
M Ohashi, T Hirano, K Watanabe, K Katsumi, H Shoji, A Sano, H Tashi, I Takahashi, M Wakasugi, Y Shibuya, N Endo
STUDY DESIGN: Retrospective multicenter study. OBJECTIVES: To analyze the predictive factors for postoperative ambulatory recovery in paretic non-ambulatory patients with metastatic spinal cord compression (MSCC). SETTING: Japan. METHODS: Eighty-two consecutive patients (74.4% men; mean age, 66.2 years) who could not walk before surgery due to cervical or thoracic MSCC and underwent posterior decompressive surgery between 2003 and 2014 were included...
October 18, 2016: Spinal Cord
Rodolfo Pini, Gianluca Faggioli, Matteo Longhi, Liborio Ferrante, Andrea Vacirca, Enrico Gallitto, Mauro Gargiulo, Andrea Stella
BACKGROUND: The influence of acute cerebral ischemic lesions (CILs) on the revascularization outcome of symptomatic carotid stenosis has been scarcely investigated in the literature. This study evaluated the effect of CILs and their volume on the results of carotid revascularization in symptomatic patients. METHODS: All patients with symptomatic carotid artery stenosis who underwent carotid endarterectomy (CEA) or carotid artery stenting (CAS) between 2005 and 2014 were considered...
October 14, 2016: Journal of Vascular Surgery
Qinliang Li, Cai Yun, Shichun Li
BACKGROUND: Complications in posterior pedicle screw fixation using a conventional posterior approach for thoracolumbar fractures include vertebral height loss, kyphosis relapse and breakage, or loosening of instrumentation. The purpose of this study was to evaluate the clinical effects of transpedicular bone grafting and pedicle screw fixation in injured vertebrae using a paraspinal approach for thoracolumbar fractures. METHODS: We retrospectively analyzed 50 patients with thoracolumbar fractures treated with transpedicular bone grafting and pedicle screw fixation in injured vertebrae using a paraspinal approach...
October 17, 2016: Journal of Orthopaedic Surgery and Research
Brian H Lang, Tony Shek, Angel On-Kei Chan, C Y Lo, Koon Yat Wan
Background To balance the risk of disease progression, morbidity and efficacy of reoperative central neck dissection (RCND) in papillary thyroid carcinoma, the latest clinical guidelines recommend early surgery over surveillance when the largest diseased node is >8 mm in its smallest dimension. However, the evidence remains scarce. To determine an appropriate size for first-time RCND, we examined the relationship between size of largest diseased central node, morbidity and response-to-therapy following RCND...
October 17, 2016: Thyroid: Official Journal of the American Thyroid Association
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