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Delaying surgery

Claire M Lawlor, Charles A Riley, John M Carter, Kimsey H Rodriguez
Importance: The 1996 Tonsillectomy and Adenoidectomy Inpatient Guidelines of the American Academy of Otolaryngology-Head and Neck Surgery (AAO-HNS) Pediatric Otolaryngology Committee recommended that children younger than 3 years be admitted following tonsillectomy. Recommendations for hospital observation were not included as a key action statement in the 2011 AAO-HNS Clinical Practice Guidelines for Tonsillectomy in Children. Objective: To examine the association between posttonsillectomy complication rate and the age and weight of the child at the time of surgery...
March 15, 2018: JAMA Otolaryngology—Head & Neck Surgery
Young Hak Roh, Young Do Koh, Jong Oh Kim, Kyu Ho Lee, Hyun Sik Gong, Goo Hyun Baek
BACKGROUND: Postoperative pillar pain (deep-seated wrist pain worsened by leaning on the heel of the hand) sometimes occurs after carpal tunnel release (CTR), leading to weakness in the hand and delayed return to work. Increased pain sensitivity has been found to be associated with worse symptoms and poorer treatment response in a number of chronic musculoskeletal conditions, but few studies have investigated the association of pain sensitization with pillar pain after CTR. QUESTIONS/PURPOSES: (1) Is preoperative pain sensitization in patients with carpal tunnel syndrome (CTS) associated with increased severity of pillar pain after open CTR? (2) What other demographic, electrophysiological, or preoperative clinical characteristics are associated with pillar pain after CTR? METHODS: Over a 35-month period, one surgeon performed 162 open carpal tunnel releases...
April 2018: Clinical Orthopaedics and related Research
Yu V Pilipenko, An N Konovalov, Sh Sh Eliava, O B Belousova, D N Okishev, I A Sazonov, T F Tabasaranskiy
In recent years, the so-called primary or preventive decompressive craniectomy (DC) has been increasingly used in patients with aneurysmal subarachnoid hemorrhage (SAH). The main goal of the technique is prevention of refractory intracranial hypertension (ICH) and its consequences. PURPOSE: The study purpose was to define the CT criteria for reasonability and efficacy of DC as well as clarification of the indications for preventive DC in patients with SAH after microsurgical aneurysm exclusion...
2018: Zhurnal Voprosy Neĭrokhirurgii Imeni N. N. Burdenko
Marc A Furrer, Antoni Vilaseca, Renato B Corradi, Silvan Boxler, George N Thalmann, Daniel P Nguyen
BACKGROUND: A growing number of men undergo repeat biopsies prior to radical prostatectomy for prostate cancer. However, the long-term impact of repeat biopsies on functional outcomes in this patient population remains unelucidated. Thus, we compared functional outcomes between patients who underwent single biopsy versus repeat biopsies before radical prostatectomy. METHODS: From 1996 to 2015, 1015 consecutive patients underwent radical prostatectomy, and subsequently had urinary continence and erectile function assessed for >2 years follow-up...
March 14, 2018: Prostate
Carrie K Hui Mingalone, Zhiyi Liu, Judith M Hollander, Kirsten D Garvey, Averi L Gibson, Rose E Banks, Ming Zhang, Timothy E McAlindon, Heber C Nielsen, Irene Georgakoudi, Li Zeng
Osteoarthritis (OA) is a leading cause of chronic disability whose mechanism of pathogenesis is largely elusive. Local inflammation is thought to play a key role in OA progression, especially in injury-associated OA. While multiple inflammatory cytokines are detected, the timing and extent of overall inflammatory activities in early OA and the manner by which joint inflammation correlates with cartilage structural damage are still unclear. We induced OA via destabilization of the medial meniscus (DMM) in NFκB luciferase reporter mice, whose bioluminescent signal reflects the activity of NFκB, a central mediator of inflammation...
March 14, 2018: Laboratory Investigation; a Journal of Technical Methods and Pathology
Teishiki Shibata, Motoki Tanikawa, Tomohiro Sakata, Mitsuhito Mase
Craniopharyngiomas are benign tumors and account for approximately 5.6-13% of all intracranial tumors in children. Diagnosis of pediatric craniopharyngioma is often delayed until the tumor becomes relatively large and manifests severe visual and/or endocrine disturbance. Endoscopic endonasal approaches have recently been introduced to surgery for craniopharyngioma. These techniques, however, have rarely been utilized in patients affected with craniopharyngioma as young as 1 year old. This report documents a 12-month-old male infant with sellar craniopharyngioma who presented with acute total vision loss...
March 14, 2018: Pediatric Neurosurgery
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
Brian C Goh, Amit Jain, Paul D Sponseller
CASE: A 12-year-old girl with osteogenesis imperfecta (OI) underwent posterior spinal arthrodesis (from T2 to the sacrum) for double major-curve scoliosis. She developed complete paralysis of all of the extremities 24 hours after surgery, without evidence of ischemia or infarction. The rods were removed, and the neurologic status improved; there was full restoration of strength within 1 week. She then underwent in situ fixation. At the 2-year follow-up, there had been no lapse in neurologic function...
March 14, 2018: JBJS Case Connector
Mehdi Shajari, Emanuel Wanner, Vladimir Rusev, Shervin Mir Mohi Sefat, Wolfgang J Mayer, Thomas Kohnen, Siegfried Priglinger, Daniel Kook
PURPOSE: To compare corneal densitometry values after Femtosecond Laser-Assisted In Situ Keratomileusis (Fs-LASIK) and Small Incision Lenticule Extraction (SMILE) using Scheimpflug Imaging. METHODS: Our retrospective clinical trial included a total of 146 eyes where 57 eyes underwent Fs-LASIK and 89 eyes underwent SMILE. Examinations with a Pentacam Scheimpflug device (Oculus, Wetzlar, Germany) were performed before surgery, 1 week, 1 month, 3 months, 6 months, and 1 year after surgery...
March 14, 2018: Current Eye Research
Claudia Schlundt, Christian H Bucher, Serafeim Tsitsilonis, Hanna Schell, Georg N Duda, Katharina Schmidt-Bleek
PURPOSE OF REVIEW: Impaired healing outcomes or even non-unions after bone injury are still a highly relevant problem in the daily clinical life. Especially within an aging population, the occurrence of bone fractures increases and thus novel treatment approaches to overcome compromised bone regeneration are needed. RECENT FINDINGS: The gold standard to treat delayed or non-healing bone injuries is still the use of autologous bone grafts to foster regeneration. Besides its successful treatment outcome, it also has disadvantages: a second surgery is needed in order to harvest the bone material and the material is highly limited...
March 13, 2018: Current Osteoporosis Reports
Richard Rammo, Karam Asmaro, Lonni Schultz, Lisa Scarpace, Salim Siddiqui, Tobias Walbert, Steven Kalkanis, Ian Lee
Cerebral radiation necrosis (CRN) is a known complication of radiation therapy. Treatment options are limited and include steroids, bevacizumab, and surgery. This study seeks to determine the safety of laser interstitial thermal therapy (LITT) for CRN and identify the pattern of post-ablation volume change over time. Patients undergoing LITT for tumor treatment at Henry Ford Hospital between November 2013 and January 2016 with biopsy-confirmed CRN were prospectively collected and retrospectively reviewed with attention to ablation volume, survival, demographic data, steroid dose, and complications...
March 13, 2018: Journal of Neuro-oncology
Seif Sawalha, Inigo Guisasola
An important consideration when counselling patients with midshaft clavicle fractures is whether operative treatment of non-union, if it develops after non-operative treatment, is associated with higher complication rate than acute fracture fixation. The aim of this study is to compare complications and re-operations after open reduction and plate fixation for acute midshaft clavicle fractures versus non-unions. The study was retrospective. There were 90 patients in the acute fixation group and 20 patients in the non-union group...
March 13, 2018: European Journal of Orthopaedic Surgery & Traumatology: Orthopédie Traumatologie
Patrick Sven Plum, Arnulf Heinrich Hölscher, Kristin Pacheco Godoy, Henner Schmidt, Felix Berlth, Seung-Hun Chon, Hakan Alakus, Elfriede Bollschweiler
BACKGROUND: The aim of this retrospective study was to compare the prognosis of patients with esophageal cancer after non-curative endoscopic resection (ER) followed by esophagectomy (ER + S) with that of patients after primary surgery (PS). METHODS: Between 2000 and 2015, 287 patients had esophagectomy for T1 esophageal cancer. 81 of these patients underwent at least one ER in curative intention before surgery (7 squamous cell carcinomas, 74 adenocarcinomas)...
March 13, 2018: Surgical Endoscopy
Jae Min Lee, Beom Seok Kwak, Young Jin Park
Purpose: With varied reports on the impact of time to appendectomy on clinical outcomes, the purpose of this study was to determine the effect of preoperative in-hospital delay on the outcome for patients with acute appendicitis. Methods: A retrospective review of 1,076 patients who had undergone an appendectomy between January 2010 and December 2013 was conducted. Results: The outcomes of surgery and the pathologic findings were analyzed according to elapsed time...
February 2018: Annals of Coloproctology
Konstantin V Borisov
BACKGROUND: In patients with hypertrophic obstructive cardiomyopathy myocardial fibrosis is an independent predictor of adverse outcome. A new technique of HOCM surgical correction in patients with severe hypertrophy and septal myocardial fibrosis has been proposed. METHODS: The excision of the asymmetrical hypertrophied area of the interventricular septum causing obstruction was performed from the conal part of the right ventricle corresponding to the zone of obstruction of the left ventricle (LV)...
March 10, 2018: Annals of Thoracic Surgery
Kristy L Rialon, Eileen Crowley, Natashia M Seemann, Aleixo Muise, Jacob C Langer
PURPOSE: The timing of J-pouch surgery following colectomy for children with very early-onset colitis is controversial, with some advocating early reconstruction and others delaying reconstruction because of fear that the colitis may be owing to Crohn's disease (CD). We sought to determine the long-term incidence of CD in this population and whether there may be clinical features that predict the risk of CD. METHODS: Children with noninfectious colitis diagnosed prior to age 10, who underwent subtotal colectomy and ileostomy from 2000 to 2015, were reviewed...
February 8, 2018: Journal of Pediatric Surgery
Divya Singh, Anita Ganger, Noopur Gupta, Murugesan Vanathi, Rajesh Khadgawat, Radhika Tandon
Here, we present, to the best of our knowledge, the first case of Werner syndrome with corneal blindness due to bilateral primary bullous keratopathy. Werner syndrome is a rare autosomal recessive disorder characterized by features of premature aging, insulin-dependent diabetes mellitus, osteoporosis, atherosclerosis, hypergonadotrophic hypogonadism, hypertriglyceridemia, scleroderma-like skin changes, and sarcomas. Among ocular manifestations, cataracts, cystoid macular edema, and retinal detachment have been reported...
March 9, 2018: Experimental and Clinical Transplantation
M H Zou, L Ma, Y S Xia, S C Yang, W D Chen, F Cao, X X Chen
Objective: To review the early and mid-term results of end-to-side anastomosis technique for interrupted aortic arch in neonates and infants. Methods: Clinic data of 46 patients were diagnosed as interrupted aortic arch in Department of Cardiac Surgery, Guangzhou Women and Children's Medical Center between January 2010 and December 2016 were analyzed retrospectively. Twenty-six cases were neonates. The median age underwent surgery was 23 days (range: 2 days to 8 years). Anatomical subtypes included 36 cases of type A and 10 cases of type B...
March 1, 2018: Zhonghua Wai Ke za Zhi [Chinese Journal of Surgery]
X W Xu, R C Zhang, Y P Mou, Z Y Qian, C J Huang, Q C Zhu, W W Jin, Y C Zhou
Objective: To evaluate the safety and feasibility of laparoscopic radical antegrade modular pancreatosplenectomy(Lap-RAMPS) for left-sided pancreatic adenocarcinoma. Methods: Clinical data of total 12 patients underwent Lap-RAMPS for left-sided pancreatic adenocarcinoma at Department of Gastrointestinal and Pancreatic Surgery, Zhejiang Provincial People's Hospital from March 2016 to August 2017 were reviewed retrospectively.There were 7 male patients and 5 female patients, with median age of 60.5 years old(47-68 years old)...
March 1, 2018: Zhonghua Wai Ke za Zhi [Chinese Journal of Surgery]
W D Liang, Z L Ren, J Sheng, J Wang, Abulizi Yakefu, W B Sheng
Objective: To discuss the surgical treatment and its effectiveness of odontoid fracture complicated with atlantoaxial dislocation in children with spinal cord injury. Methods: From January 2010 to December 2014, 10 cases of children under 14 years old, with intractable odontoid fracture with atlantoaxial dislocation were enrolled. The mean duration between injury and admission was 8.5 d (range 1-30 d). The surgery was performed using posterior reduction and internal fixation or anterior release combined with posterior fixation...
February 27, 2018: Zhonghua Yi Xue za Zhi [Chinese medical journal]
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