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Intraoperative awareness

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https://www.readbyqxmd.com/read/28093635/different-intraoperative-kinematics-stability-and-range-of-motion-between-cruciate-substituting-ultracongruent-and-posterior-stabilized-total-knee-arthroplasty
#1
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
#2
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
#3
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
#4
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
#5
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
#6
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
#7
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
#8
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
#9
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
#10
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
https://www.readbyqxmd.com/read/27900811/exuberant-squamous-metaplasia-with-calcification-following-intraoperative-radiotherapy-for-breast-carcinoma-report-of-an-unusual-case-and-retrospective-review-of-cases-from-a-single-institution
#11
Paula S Ginter, John Ng, Rebecca Zhuo, Alexander J Swistel, Timothy M D'Alfonso
Intraoperative radiotherapy (IORT) is a novel and increasingly utilized radiation technique in the treatment of breast carcinoma. There are few reports on the histologic changes seen in breast tissue from patients who have undergone IORT. We sought to evaluate the histologic changes observed in specimens received following IORT, as well as report an unusual case which prompted our study. A retrospective review of patients who received IORT and subsequently had breast tissue histologically evaluated at our institution was performed...
November 30, 2016: Breast Journal
https://www.readbyqxmd.com/read/27871582/glucagon-induced-hypertensive-emergency-a-case-report
#12
Aron Legler, Richard K Kim, Nikhil Chawla
Glucagon is well acknowledged as a sphincter of Oddi relaxant for both diagnostic and therapeutic uses in choledocholithiasis, and an empiric treatment for β-blocker overdose. Although it has been implicated in inducing cardiovascular crises in patients with asymptomatic pheochromocytoma, adverse effects in other patient populations have not been characterized. This case report describes a patient with hypertension controlled on β blockers who, after glucagon administration during an intraoperative cholangiography, experienced hypertensive emergency despite adequate pain control...
December 2016: Journal of Clinical Anesthesia
https://www.readbyqxmd.com/read/27871516/pediatric-patients-on-ketogenic-diet-undergoing-general-anesthesia-a-medical-record-review
#13
Elif Soysal, Heike Gries, Carter Wray
STUDY OBJECTIVE: To identify guidelines for anesthesia management and determine whether general anesthesia is safe for pediatric patients on ketogenic diet (KD). DESIGN: Retrospective medical record review. SETTING: Postoperative recovery area. PATIENTS: All pediatric patients who underwent general anesthesia while on KD between 2009 and 2014 were reviewed. We identified 24 patients who underwent a total of 33 procedures...
December 2016: Journal of Clinical Anesthesia
https://www.readbyqxmd.com/read/27871494/current-surgical-management-of-carotid-body-tumors
#14
Victor J Davila, James M Chang, William M Stone, Richard J Fowl, Thomas C Bower, Michael L Hinni, Samuel R Money
BACKGROUND: Carotid body tumors (CBTs) are rare. Management guidelines may include genetic testing for succinate dehydrogenase (SDH) mutations. We performed an institutional review of the surgical management of CBT. METHODS: A retrospective analysis (1994-2015) of CBT excisions at our institution was performed. Data obtained included demographics, genetic testing (if performed), intraoperative details, postoperative morbidity, and long-term outcomes. Data from the first CBT excision were included in patients with bilateral tumors...
December 2016: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/27858533/revisiting-the-differences-between-irreducible-and-reducible-atlantoaxial-dislocation-in-the-era-of-direct-posterior-approach-and-c1-2-joint-manipulation
#15
Arsikere N Deepak, Pravin Salunke, Sushanta K Sahoo, Prashant K Prasad, Niranjan K Khandelwal
OBJECTIVE The current management of atlantoaxial dislocation (AAD) focuses on the C1-2 joints, commonly approached through a posterior route. The distinction between reducible AAD (RAAD) and irreducible AAD (IrAAD) seems to be less important in modern times. The roles of preoperative traction and dynamic radiographs are questionable. This study evaluated whether differentiating between the 2 groups is important in today's era. METHODS Ninety-six consecutive patients with congenital AAD (33 RAAD and 63 IrAAD), who underwent surgery through a posterior approach alone, were studied...
November 18, 2016: Journal of Neurosurgery. Spine
https://www.readbyqxmd.com/read/27843670/kirschner-wire-breakage-during-removal-requiring-retrieval
#16
Kai Yuen Wong, Rosalind Mole, Patrick Gillespie
Kirschner wires (K-wires) are widely used for fixation of fractures and dislocations in the hand as they are readily available, reliable, and cost-effective. Complication rates of up to 18% have been reported. However, K-wire breakage during removal is rare. We present one such case illustrating a simple technique for retrieval. A 35-year-old male presented with a distal phalanx fracture of his right middle finger. This open fracture was treated with K-wire fixation. Postoperatively, he developed a pin site infection with associated finger swelling...
2016: Case Reports in Surgery
https://www.readbyqxmd.com/read/27821134/asphyxia-due-to-laryngeal-spasm-as-a-severe-complication-of-awake-deep-brain-stimulation-for-parkinson-s-disease-a-case-report
#17
Kajetan L von Eckardstein, Friederike Sixel-Döring, Stephan Kazmaier, Claudia Trenkwalder, Jason M Hoover, Veit Rohde
BACKGROUND: In accordance with German neurosurgical and neurological consensus recommendations, lead placements for deep brain stimulation (DBS) in patients with Parkinson's disease (PD) are usually performed with the patient awake and in "medication off" state. This allows for optimal lead position adjustment according to the clinical response to intraoperative test stimulation. However, exacerbation of Parkinsonian symptoms after withdrawal of dopaminergic medication may endanger the patient by inducing severe "off" state motor phenomena...
November 8, 2016: BMC Neurology
https://www.readbyqxmd.com/read/27811496/a-case-report-of-onyx-pulmonary-arterial-embolism-contributing-to-hypoxemia-during-awake-craniotomy-for-arteriovenous-malformation-resection
#18
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...
November 2, 2016: A & A Case Reports
https://www.readbyqxmd.com/read/27806841/diagnostic-pitfalls-of-infarcted-warthin-tumor-in-frozen-section-evaluation
#19
Yaohong Tan, Oleksandr N Kryvenko, Darcy A Kerr, Jennifer R Chapman, Christina Kovacs, David J Arnold, Andrew E Rosenberg, Carmen R Gomez-Fernandez
Warthin tumor (WT) is the second most common benign salivary gland neoplasm and has characteristic cytologic and histologic findings. Fine-needle aspiration is a common and useful preoperative diagnostic technique, which sometimes leads to ischemic injury resulting in the infarction of these lesions. Infarcted WT may demonstrate variable gross and histologic alterations that may render the diagnosis challenging, particularly during intraoperative frozen section evaluation. In this study, we collected 11 resection specimens from 9 patients with infarcted WT...
December 2016: Annals of Diagnostic Pathology
https://www.readbyqxmd.com/read/27797096/a-comparison-of-bis-recordings-during-propofol-based-total-intravenous-anaesthesia-and-sevoflurane-based-inhalational-anaesthesia-in-obese-patients
#20
Tomasz Gaszyński, Andrzej Wieczorek
BACKGROUND: Intraoperative awareness is a rarely occurring phenomenon. Obesity is considered as one of the factors increasing the probability of intraoperative awareness due to problems with the dosing of anaesthetics. In a randomized prospective study we compared bispectral index (BIS) recordings during propofol-based total intravenous anaesthesia (TIVA) and sevoflurane-based inhalation anaesthesia in morbidly obese patients as a sign of possible intraoperative awareness. METHODS: 120 morbidly obese patients were randomly allocated into two subgroups: TIVA or SEVO...
2016: Anaesthesiology Intensive Therapy
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