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https://www.readbyqxmd.com/read/28214316/pre-and-perioperative-aspects-of-dermatosurgery
#1
Cornelia S L Müller, Wakiko Hubner, Sigrid Thieme-Ruffing, Claudia Pföhler, Thomas Vogt, Thomas Volk, Barbara C Gärtner, Patric Bialas
Dermatosurgery occupies an exceptional position among all surgical disciplines. Above all, this includes the fact that, with very few exceptions, the vast majority of surgical interventions can be performed under local or regional anesthesia, usually in smaller procedure rooms that are spatially separated from larger operating suites. Thus, peri- and postinterventional patient monitoring is the responsibility of the dermatosurgeon and his team. Though inherently smaller, this team still has to observe numerous perioperative requirements that - in larger surgical specialties - would be attended to by a host of various specialists working in concert...
February 2017: Journal der Deutschen Dermatologischen Gesellschaft, Journal of the German Society of Dermatology: JDDG
https://www.readbyqxmd.com/read/28213996/three-dimensional-computed-tomography-for-preoperative-assessment-of-the-pulmonary-artery-in-patients-undergoing-endoscopic-lobectomy-or-segmentectomy
#2
Amaia Ojanguren, José Luis Recuero, Marina Pardina, Lucía Milla, Maite Santamaría
BACKGROUND: The interest for endoscopic pulmonary anatomic resections has grown exponentially during the last decade. During thoracoscopic procedures surgeons cannot rely on digital handling and operative field is viewed on a two-dimensional video monitor, thus frequently encountering anatomical difficulties. The hypothesis is that foreknowledge of the anatomy of each patient would greatly contribute to the safety and accuracy of the operation. The aim of the study was to evaluate the effectiveness of 3dimensional multidetector computed tomography (3D-MDCT) software to identify the pulmonary artery branching pattern during the preoperative study of endoscopic lobectomies and segmentectomies...
February 14, 2017: Cirugía Española
https://www.readbyqxmd.com/read/28211134/effect-of-age-on-the-performance-of-bispectral-and-entropy-indices-during-sevoflurane-pediatric-anesthesia-a-pharmacometric-study
#3
Alberto Sciusco, Joseph F Standing, Yucheng Sheng, Pasquale Raimondo, Gilda Cinnella, Michele Dambrosio
BACKGROUND: Bispectral index (BIS) and entropy monitors have been proposed for use in children, but research has not supported their validity for infants. However, effective monitoring of young children may be even more important than for adults, to aid appropriate anesthetic dosing and reduce the chance of adverse consequences. This prospective study aimed to investigate the relationships between age and the predictive performance of BIS and entropy monitors in measuring the anesthetic drug effects within a pediatric surgery setting...
February 17, 2017: Paediatric Anaesthesia
https://www.readbyqxmd.com/read/28211006/surgical-margins-in-nephron-sparing-surgery-for-renal-cell-carcinoma
#4
REVIEW
Dean D Laganosky, Christopher P Filson, Viraj A Master
The oncologic impact of positive surgical margins after nephron-sparing surgery is controversial. Herein, we discuss current data surrounding surgical margins in the operative management of renal cell carcinoma. The prevalence, risk factors, outcomes, and subsequent management of positive surgical margins will be reviewed. Literature suggests that the prevalence of positive surgical margins following kidney surgery varies by practice setting, tumor characteristics, and operation type. For patients undergoing nephron-sparing surgery, it is not necessary to remove a margin of healthy tissue...
January 2017: Current Urology Reports
https://www.readbyqxmd.com/read/28203558/cerebral-monitoring-during-carotid-endarterectomy-by-transcranial-doppler-ultrasonography
#5
Woo-Sung Yun
PURPOSE: To evaluate the efficacy and safety of cerebral monitoring by transcranial Doppler ultrasonography (TCD) for the detection of cerebral ischemia during carotid endarterectomy (CEA). METHODS: From August 2004 to December 2013, 159 CEAs were performed in a tertiary hospital. All procedures were performed under general anesthesia. Intraoperative TCD was routinely used to detect cerebral ischemia. Of the 159 patients, 102 patients were included in this study, excluding 27 patients who had a poor transtemporal isonation window and 30 patients who used additional cerebral monitoring systems such as electroencephalography or somatosensory evoked potentials...
February 2017: Annals of Surgical Treatment and Research
https://www.readbyqxmd.com/read/28197025/current-perioperative-management-of-pheochromocytomas
#6
REVIEW
Rashmi Ramachandran, Vimi Rewari
Neuroendocrine tumors which have the potential to secrete catecholamines are either associated with sympathetic adrenal (pheochromocytoma) or nonadrenal (paraganglioma) tissue. Surgical removal of these tumors is always indicated to cure and prevent cardiovascular and other organ system complications associated with catecholamine excess. Some of these tumors have malignant potential as well. The diagnosis, localization and anatomical delineation of these tumors involve measurement of catecholamines and their metabolic end products in plasma and urine, (123)I-metaiodobenzylguanidine scintigraphy, computed tomography, and/or magnetic resonance imaging...
January 2017: Indian Journal of Urology: IJU: Journal of the Urological Society of India
https://www.readbyqxmd.com/read/28194664/phrenic-nerve-stimulation-during-neck-dissection-for-advanced-thyroid-cancer-involving-level-iv-is-it-worth-doing-it
#7
Carlos S Duque, Juan P Dueñas, Marcela Marulanda, Diana Pérez, Andres Londoňo, Soham Roy, Mai Al Khadem
During thyroidectomy and neck dissection surgery for advanced or recurrent metastatic thyroid cancer under intraoperative monitoring, we used the available technology to assess the feasibility of such an intervention to monitor those patients with phrenic nerves at risk. A retrospective review of patients operated on from January 2009 to December 2015 by a single surgeon (CSD) was conducted. Patients who had neck and mediastinal dissection, with or without total thyroidectomy, due to advanced or recurrent metastatic disease to the neck were selected...
February 13, 2017: Updates in Surgery
https://www.readbyqxmd.com/read/28192259/impact-of-intraoperative-monitoring-during-elective-complex-spinal-fusions-%C3%A2-4-levels-on-30-day-complication-and-readmission-rates-a-single-institutional-study-of-643-adult-spinal-deformity-patients
#8
Aladine A Elsamadicy, Owoicho Adogwa, Emily Lydon, Gireesh Reddy, Rayan Kaakati, Amanda Sergesketter, Oren N Gottfried, Isaac O Karikari
OBJECTIVE: The aim of this study is to determine if there are differences in 30-day postoperative complication and readmission rates between spinal deformity patients undergoing complex spinal fusion with and without intraoperative monitoring. METHODS: The medical records of 643 adult spine deformity patients undergoing elective complex spinal fusion (≥4 levels) at a major academic institution from 2005 to 2015 were reviewed. We identified 122 (19%) cases that involved intraoperative monitoring (IOM) including EMG, SSEP, and/or TcMEP and 521 (81%) that did not (IOM: n=122; No-IOM: n=521)...
February 9, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28186616/introduction-of-robot-assisted-radical-hysterectomy-for-early-stage-cervical-cancer-impact-on-complications-costs-and-oncologic-outcome
#9
Emelie Wallin, Angelique Flöter Rådestad, Henrik Falconer
INTRODUCTION: The objective was to assess the impact of robot-assisted radical hysterectomy (RRH) on surgical and oncologic outcome and costs compared to open radical hysterectomy (ORH) at a tertiary referral center in Sweden. MATERIAL AND METHODS: In this retrospective analysis all patients treated with radical hysterectomy and pelvic lymphadenectomy for early stage uterine cervical cancer during 2006 -2015 were included (n=304). The patients were divided into two groups, ORH (n=155) and RRH (n=149)...
February 10, 2017: Acta Obstetricia et Gynecologica Scandinavica
https://www.readbyqxmd.com/read/28185615/clinical-study-of-neuroregen-scaffold-combined-with-human-mesenchymal-stem-cells-for-the-repair-of-chronic-complete-spinal-cord-injury
#10
Yannan Zhao, Fengwu Tang, Guang Han, Nuo Wang, Na Yin, Bing Chen, Xianfeng Jiang, Chen Yun, Wanjun Han, Changyu Zhao, Shixiang Cheng, Zhifeng Xiao, Sai Zhang, Jianwu Dai
Regeneration of damaged neurons and recovery of sensation and motor function after complete spinal cord injury (SCI) are challenging. We previously developed a collagen scaffold, NeuroRegen scaffold, to promote axonal growth along collagen fibers and inhibit glial scar formation after SCI. When functionalized with multiple biomolecules, this scaffold promoted neurological regeneration and functional recovery in animals with SCI. In this study, eight patients with chronic complete SCI were enrolled to examine the safety and efficacy of implanting NeuroRegen scaffold with human umbilical cord mesenchymal stem cells (MSCs)...
February 9, 2017: Cell Transplantation
https://www.readbyqxmd.com/read/28185295/irreversible-electroporation-for-the-ablation-of-pancreatic-malignancies-a-patient-specific-methodology
#11
Eduardo L Latouche, Michael B Sano, Melvin F Lorenzo, Rafael V Davalos, Robert C G Martin
BACKGROUND AND OBJECTIVES: Irreversible Electroporation (IRE) is a focal ablation technique highly attractive to surgical oncologists due to its non-thermal nature that allows for eradication of unresectable tumors in a minimally invasive procedure. In this study, our group sought to address the challenge of predicting the ablation volume with IRE for pancreatic procedures. METHODS: In compliance with HIPAA and hospital IRB approval, we established a pre-treatment planning methodology for IRE procedures in pancreas, which optimized treatment protocols for individual cases of locally advanced pancreatic cancer (LAPC)...
February 10, 2017: Journal of Surgical Oncology
https://www.readbyqxmd.com/read/28184338/the-clinical-importance-of-perforator-preservation-in-intracranial-aneurysm-surgery-an-overview-with-a-review-of-the-literature
#12
REVIEW
Sung-Pil Joo, Tae-Sun Kim
Clipping for intracranial aneurysms is done to achieve complete occlusion of the aneurysm without a remnant sac. Despite modern advancements of neurosurgical techniques, morbidity related to the clipping of intracranial aneurysms still exists. Clip occlusion of a parent artery or small hidden perforators commonly leads to permanent neurological deficits, and is a serious and unwanted complication. Thus, preserving blood flow in the branches and perforators of a parent artery is very important for successful surgery without postoperative morbidity and mortality...
January 2017: Chonnam Medical Journal
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
#13
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/28183584/monitoring-of-the-intraoperative-analgesia-by-pupillometry-during-laparoscopic-splenectomy-for-splenic-hydatid-cyst
#14
Ana Abad-Torrent, Albert Sueiras-Gil, Miquel Martínez-Vilalta, Josep Vallet-Fernández, María Guisasola-Rabés
Echinococcosis causes a hydatid cyst, a worldwide disease. Human beings are intermediate hosts, but dogs complete the life cycle of the cestode. The most common presentation sites are the liver and lungs. We present an unusual case of a primary splenic hydatid cyst. Open splenectomy has traditionally been the treatment of choice for splenic hydatid cysts. In recent years, minimally invasive laparoscopic surgery has been used in appropriate cases. A healthy 48-year-old woman was scheduled for laparoscopic splenectomy...
February 2017: Journal of Clinical Anesthesia
https://www.readbyqxmd.com/read/28183558/frequency-of-inadequate-neuromuscular-blockade-during-general-anesthesia
#15
Timur Dubovoy, Amy M Shanks, Scott Devine, Sachin Kheterpal
STUDY OBJECTIVE: We used electronic health record data to define frequency of inadequate intraoperative neuromuscular blockade (NMB). DESIGN: Retrospective observational study using electronic health record data. SETTING: Operating room in a tertiary care academic hospital. PATIENTS: A total of 129,209 adult patients with American Society of Anesthesiologists physical status 1 to 5 undergoing general anesthesia in an outpatient or inpatient setting who received nondepolarizing NMB...
February 2017: Journal of Clinical Anesthesia
https://www.readbyqxmd.com/read/28182829/transoral-endoscopic-thyroidectomy-vestibular-approach-toetva-from-a-to-z
#16
Gianlorenzo Dionigi, Matteo Lavazza, Alessandro Bacuzzi, Davide Inversini, Vincenzo Pappalardo, Ralph P Tufano, Hoon Yub Kim, Angkoon Anuwong
We depict the transoral endoscopic thyroidectomy vestibular approach (TOETVA). Patient selection criteria are (1) ultrasonographically (US) estimated thyroid diameter no larger than 10cm, (2) US estimated gland volume ≥45mL, (3) nodule size ≥5mm, (4) a benign tumor, such as a thyroid cyst, single-nodular goiter, or multinodular goiter, (5) follicular neoplasm, and (6) papillary microcarcinoma without evidence of metastasis. TOETVA is carried out through a three-port technique placed at the oral vestibule, one 10mm port for 30° endoscope and two additional 5mm ports for dissecting and coagulating instruments...
February 7, 2017: Surgical Technology International
https://www.readbyqxmd.com/read/28181055/endotracheal-bioimpedance-cardiography-improves-immediate-postoperative-outcome-a-case-control-study-in-off-pump-coronary-surgery
#17
Thomas Leclercq, Marc Lilot, Thomas Schulz, Alexandre Meyer, Fadi Farhat, Jean-Luc Fellahi
The feasibility and clinical utility of the endotracheal cardiac output monitor (ECOM) to optimize intraoperative hemodynamics and improve short-term outcome in off-pump coronary artery bypass grafting (OPCAB) is unknown. We aimed to compare ECOM with a standard of care in that specific surgical setting. Twenty consecutive adult ECOM-monitored patients undergoing OPCAB were prospectively included (ECOM group) and retrospectively compared to 42 patients scheduled for similar surgery without ECOM monitoring (Control group)...
February 8, 2017: Journal of Clinical Monitoring and Computing
https://www.readbyqxmd.com/read/28180042/brainstem-auditory-evoked-potentials-diagnostic-accuracy-for-hearing-loss-systematic-review-and-meta-analysis
#18
Parthasarathy D Thirumala, Gregory Carnovale, Yoon Loke, Miguel E Habeych, Donald J Crammond, Jeffrey R Balzer, Raymond F Sekula
Background Microvascular decompression (MVD) utilizes brainstem auditory evoked potential (BAEP) intraoperative monitoring to reduce the risk of iatrogenic hearing loss. Studies report varying efficacy and hearing loss rates during MVD with intraoperative monitoring. Objectives This study aims to perform a comprehensive review and study of diagnostic accuracy of BAEPs during MVD to predict hearing loss in studies published from January 1984 to December 2013. Methods The PubMed/MEDLINE and World Science databases were searched...
February 2017: Journal of Neurological Surgery. Part B, Skull Base
https://www.readbyqxmd.com/read/28179597/sinus-pericranii-with-dominant-venous-outflow-in-the-superior-eyelid
#19
Eiji Ito, Syuntaro Takasu, Kenichi Hattori
Sinus pericranii (SP) located in the superior eyelid is an unusual clinical presentation. Here, we report a case of 72-year-old woman with an unruptured cerebral aneurysm presented with an SP located in the left superior eyelid. The SP was found to have a dominant venous outflow from the bilateral frontal region with an arterialized blood flow pattern on color Doppler ultrasonography (CDUS). During the aneurysmal surgery, intraoperative monitoring of the dominant venous outflow with CDUS was useful for the prevention of venous outflow obstruction...
February 9, 2017: Neurologia Medico-chirurgica
https://www.readbyqxmd.com/read/28179198/cesarean-scar-ectopic-pregnancy-laparoscopic-resection-and-total-scar-dehiscence-repair-a-case-report
#20
Sara Mahgoub, Victor Gabriele, Emilie Faller, Bruno Langer, Arnaud Wattiez, Lise Lecointre, Cherif Akladios
STUDY OBJECTIVE: Illustrate laparoscopic technique for resection of cesarean scar ectopic pregnancy, associated with isthmocele repair. DESIGN: Case report SETTING: Tertiary referral centre in Strasbourg, France. The study was approved by the local IRB. BACKGROUND: Cesarean scar pregnancy is a rare form of ectopic pregnancy. The major risk of this type of pregnancy is the early uterine rupture with massive bleeding and maternal life-threatening...
February 4, 2017: Journal of Minimally Invasive Gynecology
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