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Intraoperative awareness

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https://www.readbyqxmd.com/read/28222645/total-intravenous-anesthesia-produces-outcomes-superior-to-those-with-combined-intravenous-inhalation-anesthesia-for-laparoscopic-gynecological-surgery-at-high-altitude
#1
Rui Xu, Shuqin Zhou, Jin Yang, Haiyan Li, Qingguo Zhang, Guohong Zhang, Shiyuan Xu, Qing Peng
Objective We compared efficacy and adverse outcomes following totally intravenous anesthesia (TIVA) versus combined intravenous-inhalation anesthesia (CIVIA) on hemodynamics and postoperative recovery following laparoscopic gynecological (LG) surgery at high altitudes. Methods We enrolled 80 ASA I or II patients scheduled for LG surgery and randomly assigned them to TIVA with propofol (group P, n = 40) or CIVIA with isoflurane (group I, n = 40). Mean arterial pressure, heart rate, pulse oxygen saturation, and partial pressure of end-tidal carbon dioxide were measured at various time points...
February 2017: Journal of International Medical Research
https://www.readbyqxmd.com/read/28210083/incidental-adenocarcinoma-in-patients-undergoing-surgery-for-stricturing-crohn-s-disease
#2
Ivan Kristo, Stefan Riss, Stanislaus Argeny, Svenja Maschke, Praminthra Chitsabesan, Anton Stift
AIM: To evaluate frequency and clinical course of incidental adenocarcinoma in patients with stricturing Crohn's disease (CD). METHODS: In this study, consecutive patients, who were operated on for stricturing CD between 1997-2012, were included at an academic tertiary referral center. Demographic data and clinical course were obtained by an institutional database and individual chart review. Besides baseline characteristics, intraoperative findings and CD related history were also recorded...
January 21, 2017: World Journal of Gastroenterology: WJG
https://www.readbyqxmd.com/read/28199784/allosensitization-following-bone-graft
#3
Eoin D O'Sullivan, Richard K Battle, Sharon Zahra, John F Keating, Lorna P Marson, David M Turner
It is recognised that patients may become sensitized to donor-specific HLA antigens as a result of previous antigenic exposures, classically through previous transplantation, pregnancy or blood transfusion. We present an unusual case of a patient who unexpectedly developed a range of anti-HLA antibodies following orthopaedic surgery where a bone graft was deployed intraoperatively. We describe the case of a 52-year-old male awaiting a renal transplantation, undergoing elective orthopaedic surgery requiring a small volume bone graft...
February 15, 2017: American Journal of Transplantation
https://www.readbyqxmd.com/read/28195862/a-case-report-of-onyx-pulmonary-arterial-embolism-contributing-to-hypoxemia-during-awake-craniotomy-for-arteriovenous-malformation-resection
#4
Brian T Tolly, Jenna L Kosky, Antoun Koht, Laura B Hemmer
A healthy 26-year-old man with cerebral arteriovenous malformation underwent staged endovascular embolization with Onyx followed by awake craniotomy for resection. The perioperative course was complicated by tachycardia and severe intraoperative hypoxemia requiring significant oxygen supplementation. Postoperative chest computed tomography (CT) revealed hyperattenuating Onyx embolization material within the pulmonary vasculature, and an electrocardiogram indicated possible right heart strain, supporting clinically significant embolism...
February 15, 2017: A & A Case Reports
https://www.readbyqxmd.com/read/28194399/the-role-of-permissive-and-induced-hypotension-in-current-neuroanesthesia-practice
#5
Suren Soghomonyan, Nicoleta Stoicea, Gurneet S Sandhu, Jeffrey J Pasternak, Sergio D Bergese
BACKGROUND: Induced hypotension (IH) had been used for decades in neurosurgery to reduce the risk for intraoperative blood loss and decrease blood replacement. More recently, this method fell out of favor because of concerns for cerebral and other end-organ ischemia and worse treatment outcomes. Other contributing factors to the decline in its popularity include improvements in microsurgical technique, widespread use of endovascular procedures, and advances in blood conservation and transfusion protocols...
2017: Frontiers in Surgery
https://www.readbyqxmd.com/read/28184249/atlantoaxial-rotatory-fixation-as-a-rare-complication-from-head-positioning-in-otologic-surgery-report-of-two-cases-in-young-children
#6
Hiroshi Sakaida, Koji Akeda, Akihiro Sudo, Kazuhiko Takeuchi
BACKGROUND: Atlantoaxial rotatory fixation is a condition in which the first and second vertebrae of the cervical spine become interlocked in a rotated position. This condition can result in serious consequences and thus have a significant impact on patients, especially when diagnosis and treatment are delayed. Some cases of atlantoaxial rotatory fixation have been described in association with otologic surgery or plastic surgery involving the ear. We present the cases of two pediatric patients who developed atlantoaxial rotatory fixation following otologic surgery and we review the relevant literature...
2017: Patient Safety in Surgery
https://www.readbyqxmd.com/read/28152795/integrated-post-surgical-colon-cancer-care-planning-at-the-rutgers-cancer-institute-of-new-jersey-and-robert-wood-johnson-university-hospital
#7
Kristen Donohue, Sondra Patella, Viktor Y Dombrovskiy, Rebecca Anne Moss, Nell Maloney Patel
: 75 Background: Colorectal cancer is the second leading cause of cancer death in the United States each year. The use of adjuvant chemotherapy after surgical resection of colon cancer has been associated with a survival benefit. Timely initiation of adjuvant chemotherapy has been shown to have an effect on overall and disease-free survival. There is no integrated post-surgical colon cancer care planning for patients who have surgery at our institution. Poor understanding on the part of patients and ancillary providers regarding appropriate follow up may cause delay in time to adjuvant chemotherapy initiation...
March 2016: Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology
https://www.readbyqxmd.com/read/28149926/tissue-classification-for-laparoscopic-image-understanding-based-on-multispectral-texture-analysis
#8
Yan Zhang, Sebastian J Wirkert, Justin Iszatt, Hannes Kenngott, Martin Wagner, Benjamin Mayer, Christian Stock, Neil T Clancy, Daniel S Elson, Lena Maier-Hein
Intraoperative tissue classification is one of the prerequisites for providing context-aware visualization in computer-assisted minimally invasive surgeries. As many anatomical structures are difficult to differentiate in conventional RGB medical images, we propose a classification method based on multispectral image patches. In a comprehensive ex vivo study through statistical analysis, we show that (1) multispectral imaging data are superior to RGB data for organ tissue classification when used in conjunction with widely applied feature descriptors and (2) combining the tissue texture with the reflectance spectrum improves the classification performance...
January 2017: Journal of Medical Imaging
https://www.readbyqxmd.com/read/28129610/aberrant-subvesical-bile-ducts-identified-during-laparoscopic-cholecystectomy-a-rare-case-report-and-review-of-the-literature
#9
Theodoros Mariolis-Sapsakos, Maria Zarokosta, Menelaos Zoulamoglou, Theodoros Piperos, Ioannis Papapanagiotou, Markos Sgantzos, Konstantinos Birbas, Ioannis Kaklamanos
INTRODUCTION: Aberrant subvesical bile ducts are a scarce anatomical variation, consisted by a network of bile ducts located in the peri-hepatic capsule of the gallbladder fossa. These rare ducts are usually discovered intraoperatively and their presence poses the risk of bile injury and clinically significant bile leak. PRESENTATION OF CASE: Aberrant subvesical bile ducts were unexpectedly identified in a young woman during laparoscopic cholecystectomy. These three ducts were clipped carefully for avoidance of bile duct injury and subsequent bile leak...
January 16, 2017: International Journal of Surgery Case Reports
https://www.readbyqxmd.com/read/28110742/comparison-of-fft-and-marginal-spectra-of-eeg-using-empirical-mode-decomposition-to-monitor-anesthesia
#10
Shih-Jui Chen, Chia-Ju Peng, Yi-Chun Chen, Yean-Ren Hwang, Ying-Sian Lai, Shou-Zen Fan, Kuo-Kuang Jen
BACKGROUND AND OBJECTIVE: Intraoperative awareness refers that patients can recall aspects of their surgery after being put under general anesthesia. This distressing complication causes affected patients to be conscious and probably feel pain, leading to emotional trauma or other sequelae. Monitoring and administrating the depth of anesthesia is necessary to prevent patients from awareness during a medical operation. In this paper, we analyzed the electroencephalograms (EEGs) of patients to characterize their anesthesia...
December 2016: Computer Methods and Programs in Biomedicine
https://www.readbyqxmd.com/read/28093635/different-intraoperative-kinematics-stability-and-range-of-motion-between-cruciate-substituting-ultracongruent-and-posterior-stabilized-total-knee-arthroplasty
#11
Hagen Fritzsche, Franziska Beyer, Anne Postler, Jörg Lützner
PURPOSE: The aim of this study was the comparison of intraoperative kinematics, stability, and range of motion (ROM) between the native osteoarthritic knee and cruciate-substituting fixed-bearing total knee arthroplasty (TKA) using both an ultracongruent (UC) and a posterior-stabilized (PS) insert design in the same patient. We hypothesized less knee flexion and less antero-posterior stability in the UC TKA. METHODS: Intraoperative measurements of kinematics, stability, and ROM were performed in 40 patients before soft-tissue release and bone cuts, and after implantation of the final femoral and tibial implants with both a UC insert and a PS insert...
January 16, 2017: Knee Surgery, Sports Traumatology, Arthroscopy: Official Journal of the ESSKA
https://www.readbyqxmd.com/read/28061766/chemotherapy-induced-sinusoidal-injury-csi-score-a-novel-histologic-assessment-of-chemotherapy-related-hepatic-sinusoidal-injury-in-patients-with-colorectal-liver-metastasis
#12
Heather L Stevenson, Mariana M Prats, Eizaburo Sasatomi
BACKGROUND: Preoperative neoadjuvant therapy for colorectal liver metastases (CRLM) is increasing in use and can lead to chemotherapy-induced damage to sinusoidal integrity, namely sinusoidal obstruction syndrome (SOS). SOS has been associated with an increased need for intraoperative blood transfusions, increased length of hospitalization post-surgery, decreased tumor response, and a shorter overall survival after resection due to liver insufficiency. It is critical for clinicians and pathologists to be aware of this type of liver injury, and for pathologists to include the status of the background, non-neoplastic liver parenchyma in their pathology reports...
January 7, 2017: BMC Cancer
https://www.readbyqxmd.com/read/28061037/single-port-laparoscopic-surgery-can-be-performed-safely-and-appropriately-for-colon-cancer-short-term-results-of-a-pilot-randomized-controlled-trial
#13
Byung Mo Kang, Sun Jin Park, Kil Yeon Lee, Suk-Hwan Lee
INTRODUCTION: Single-port laparoscopic surgery (SPLS) has gained popularity due to its cosmetic benefit, and therefore, has been applied to several kinds of benign operations, such as appendectomy and cholecystectomy. The safety and suitability of SPLS for colon cancer has not been widely proved. We aimed at validating the safety, efficacy, and short-term quality of life (QOL) of SPLS compared with conventional laparoscopic surgery (CLS) in patients with colon cancer. MATERIALS AND METHODS: Between June 2010 and April 2011, a total of 62 patients with pathology-proven colon cancer were randomly allocated to two groups: SPLS and CLS...
January 6, 2017: Journal of Laparoendoscopic & Advanced Surgical Techniques. Part A
https://www.readbyqxmd.com/read/28048665/su-f-t-243-major-risks-in-radiotherapy-a-review-based-on-risk-analysis-literature
#14
J López-Tarjuelo, A Bouché-Babiloni, V Morillo-Macías, M Guasp-Tortajada, N Iglesias-Montenegro, P Monasor-Denia, C Ferrer-Albiach
PURPOSE: We present a literature review of risk analyses in radiotherapy to highlight the most reported risks and facilitate the spread of this valuable information so that professionals can be aware of these major threats before performing their own studies. METHODS: We considered studies with at least an estimation of the probability of occurrence of an adverse event (O) and its associated severity (S). They cover external beam radiotherapy, brachytherapy, intraoperative radiotherapy, and stereotactic techniques...
June 2016: Medical Physics
https://www.readbyqxmd.com/read/28031042/transitional-cell-carcinoma-with-extension-of-the-renal-vein-and-ivc-tumor-thrombus-report-of-three-cases-and-literature-review
#15
Mingyang Li, An Shi, Wen Kong, Jin Zhang, Yonghui Chen, Jiwei Huang, Yiran Huang
BACKGROUND: Transitional cell carcinoma (TCC) originating from the renal pelvis with a venous tumor thrombus is a rare entity. However, clinicians should be aware of it because of its high malignancy and poor prognosis. CASE PRESENTATION: Here, we report three cases of pathologically confirmed TCC originating from the renal pelvis with extension into the renal vein or inferior vena cava (IVC). Of these patients, two are males and one is female (58~73 years old)...
December 28, 2016: World Journal of Surgical Oncology
https://www.readbyqxmd.com/read/27941317/clinical-analysis-of-stercoral-perforation-without-mortality
#16
Chun-Geun Ryu, Pyeongsu Kim, Min Jeng Cho, Milljae Shin, Eun-Joo Jung
AIMS: This study was designed to review the clinical features of stercoral colonic perforation and to evaluate the appropriate intraoperative procedures and postoperative management to achieve the best surgical outcomes. METHODS: Between January 2009 and December 2015, 12 patients with stercoral perforation confirmed surgically and pathologically were included in this study, and their medical records were reviewed retrospectively. RESULTS: The enrolled patients included 2 men and 10 women; their mean age was 73...
December 10, 2016: Digestive Surgery
https://www.readbyqxmd.com/read/27928670/tensile-strength-and-failure-load-of-sutures-for-robotic-surgery
#17
Ahmad Abiri, Omeed Paydar, Anna Tao, Megan LaRocca, Kang Liu, Bradley Genovese, Robert Candler, Warren S Grundfest, Erik P Dutson
BACKGROUND: Robotic surgical platforms have seen increased use among minimally invasive gastrointestinal surgeons (von Fraunhofer et al. in J Biomed Mater Res 19(5):595-600, 1985. doi: 10.1002/jbm.820190511 ). However, these systems still suffer from lack of haptic feedback, which results in exertion of excessive force, often leading to suture failures (Barbash et al. in Ann Surg 259(1):1-6, 2014. doi: 10.1097/SLA.0b013e3182a5c8b8 ). This work catalogs tensile strength and failure load among commonly used sutures in an effort to prevent robotic surgical consoles from exceeding identified thresholds...
December 7, 2016: Surgical Endoscopy
https://www.readbyqxmd.com/read/27926358/recent-advances-in-pancreatic-cancer-surgery-of-relevance-to-the-practicing-pathologist
#18
REVIEW
Lennart B van Rijssen, Steffi J E Rombouts, Marieke S Walma, Jantien A Vogel, Johanna A Tol, Isaac Q Molenaar, Casper H J van Eijck, Joanne Verheij, Marc J van de Vijver, Olivier R C Busch, Marc G H Besselink
Recent advances in pancreatic surgery have the potential to improve outcomes for patients with pancreatic cancer. We address 3 new, trending topics in pancreatic surgery that are of relevance to the pathologist. First, increasing awareness of the prognostic impact of intraoperatively detected extraregional and regional lymph node metastases and the international consensus definition on lymph node sampling and reporting. Second, neoadjuvant chemotherapy, which is capable of changing 10% to 20% of initially unresectable, to resectable disease...
December 2016: Surgical Pathology Clinics
https://www.readbyqxmd.com/read/27920491/interactive-navigation-guided-ophthalmic-plastic-surgery-navigation-enabling-of-telescopes-and-their-use-in-endoscopic-lacrimal-surgeries
#19
Mohammad Javed Ali, Swati Singh, Milind N Naik, Swathi Kaliki, Tarjani Vivek Dave
PURPOSE: The aims of this study were to report the preliminary experience of using telescopes, which were enabled for navigation guidance, and their utility in complex endoscopic lacrimal surgeries. METHODS: Navigation enabling of the telescope was achieved by using the AxiEM™ malleable neuronavigation shunt stylet. Image-guided dacryolocalization was performed in five patients using the intraoperative image-guided StealthStation™ system in the electromagnetic mode...
2016: Clinical Ophthalmology
https://www.readbyqxmd.com/read/27917264/systemic-to-pulmonary-artery-pressure-ratio-as-a-predictor-of-patient-outcome-following-liver-transplantation
#20
Annette Rebel, Dung Nguyen, Brooke Bauer, Paul A Sloan, Amy DiLorenzo, Zaki-Udin Hassan
AIM: To assess the value of the mean systemic-to-pulmonary artery pressure (MAP/mPAP) ratio for predicting outcomes following orthotopic liver transplant (OLT). METHODS: A retrospective data analysis was performed and data (mean arterial blood pressure, mean pulmonary artery pressure and Cardiac Index) were collected at several points during OLT. Outcomes evaluated were duration of postoperative endotracheal intubation [ET; minutes after intensive care unit (ICU) arrival], length of ICU stay, total hospitalization and frequency of immediate postoperative complications...
November 18, 2016: World Journal of Hepatology
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