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https://www.readbyqxmd.com/read/28811789/single-incision-laparoscopic-cholecystectomy-with-conventional-instruments-and-ports-initial-experience-at-tertiary-care-public-sector-hospital
#1
Abdul Razaque Shaikh, Syed Asad Ali, Ambreen Munir, Aijaz Ali Shaikh
OBJECTIVE: To find out safety and feasibility of single incision laparoscopic cholecystectomy (SLIC) using conventional instruments. METHODS: This study was conducted at surgical department of LUMHS Jamshoro Pakistan from Jan: 2014 to Dec: 2015. All cases of symptomatic cholelithiasis that consented for laparoscopic surgery were included. The exclusion criteria were acute cholecystitis, acute gall stone pancreatitis, common bile duct stones and patients with co-morbid...
May 2017: Pakistan Journal of Medical Sciences Quarterly
https://www.readbyqxmd.com/read/28810280/-dual-antiplatelet-therapy-in-the-perioperative-period-to%C3%A2-continue-or-discontinue-treatment
#2
Jürgen Koscielny, Christian von Heymann, Uwe Zeymer, Jochen Cremer, Michael Spannagl, Joachim Labenz, Evangelos Giannitsis, Franz Goss
Background For secondary prevention of acute coronary syndrome, guidelines recommend dual antiplatelet therapy (DAPT) with acetylsalicylic acid and a P2Y12 receptor antagonist such as clopidogrel, prasugrel or ticagrelor for a period of 12 months. Often, uncertainty exists with respect to surgical or diagnostic procedures in these high-risk patients: can the DAPT be continued without interruption? If not, what is the recommended withdrawal strategy? What should be considered for the perioperative management? Methods An interdisciplinary group of experienced experts in the fields of cardiology, cardiac surgery, gastroenterology, anaesthesiology, intensive care and haemostaseology developed recommendations relevant to daily clinical practice based on the current scientific evidence...
August 2017: Deutsche Medizinische Wochenschrift
https://www.readbyqxmd.com/read/28807202/do-acute-care-surgeons-follow-best-practices-for-breast-abscess-management-a-single-institution-analysis-of-325-consecutive-cases
#3
Alison Unzeitig Barron, Stephen Luk, Herb A Phelan, Brian H Williams
BACKGROUND: The breast surgery community has adopted needle aspiration as the standard of care for breast abscesses, which have a size less than 5 cm on ultrasound, no skin changes, and fewer than 5 days of symptoms. Our acute-care surgery (ACS) service manages all breast abscess consults at our urban safety-net hospital. We undertook this descriptive study to identify the rate of operative incisions and drainage performed by ACS surgeons which were not compatible with best practices for breast abscess management...
August 2017: Journal of Surgical Research
https://www.readbyqxmd.com/read/28806283/expanding-the-scope-of-quality-measurement-in-surgery-to-include-non-operative-care-results-from-the-acs-nsqip-emergency-general-surgery-pilot
#4
Michael W Wandling, Clifford Y Ko, Paul E Bankey, Chris Cribari, H Gill Cryer, Jose J Diaz, Therese M Duane, S Morad Hameed, Matthew M Hutter, Michael H Metzler, Justin L Regner, Patrick M Reilly, H David Reines, Jason L Sperry, Kristan L Staudenmayer, Garth H Utter, Marie L Crandall, Karl Y Bilimoria, Avery B Nathens
BACKGROUND: Patients managed non-operatively have been excluded from risk-adjusted benchmarking programs, including the American College of Surgeons (ACS) National Surgical Quality Improvement Program (NSQIP). Consequently, optimal performance evaluation is not possible for specialties like emergency general surgery (EGS) where non-operative management is common. We developed a multi-institutional EGS clinical data registry within ACS NSQIP that includes patients managed non-operatively to evaluate variability in non-operative care across hospitals and identify gaps in performance assessment that occur when only operative cases are considered...
August 12, 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28806175/point-of-care-ultrasound-facilitated-detection-of-femoral-occlusive-septic-emboli-during-mitral-valve-surgery-a-case-report
#5
Melissa L Bellomy, Susan Eagle, Mias Pretorius, Ben R Barton, Yafen Liang
Acute lower extremity ischemia from septic emboli is a surgical emergency. Timely diagnosis and management are critical to improve patient outcome. However, traditional diagnostic modalities such as intraoperative angiogram are time-consuming, require special equipment and personnel, and introduce contrast exposure for critically ill patients. There are limited reports of utilization of point-of-care ultrasound to detect peripheral septic emboli. We present a case where femoral occlusive septic emboli were identified by point-of-care ultrasound after mitral valve replacement...
August 10, 2017: A & A Case Reports
https://www.readbyqxmd.com/read/28803772/perioperative-statins-do-not-prevent-acute-kidney-injury-after-cardiac-surgery-a-meta-analysis-of-randomized-controlled-trials
#6
Bing-Cheng Zhao, Pu Shen, Ke-Xuan Liu
OBJECTIVES: To evaluate whether perioperative statins reduce the risk of acute kidney injury (AKI) after cardiac surgery. DESIGN: Systematic review and meta-analysis of randomized trials. SETTING: Perioperative management in hospitals that perform cardiac surgery. PARTICIPANTS: Adult patients undergoing cardiac surgery. INTERVENTIONS: PubMed, EMBASE, and the Cochrane Library databases were searched for randomized trials...
April 21, 2017: Journal of Cardiothoracic and Vascular Anesthesia
https://www.readbyqxmd.com/read/28802614/uncommon-combinations-of-icd10-pcs-or-icd-9-cm-operative-procedure-codes-account-for-most-inpatient-surgery-at-half-of-texas-hospitals
#7
Liam O'Neill, Franklin Dexter, Sae-Hwan Park, Richard H Epstein
STUDY OBJECTIVE: Recently, there has been interest in activity-based cost accounting for inpatient surgical procedures to facilitate "value based" analyses. Research 10-20years ago, performed using data from 3 large teaching hospitals, found that activity-based cost accounting was practical and useful for modeling surgeons and subspecialties, but inaccurate for individual procedures. We hypothesized that these older results would apply to hundreds of hospitals, currently evaluable using administrative databases...
September 2017: Journal of Clinical Anesthesia
https://www.readbyqxmd.com/read/28799580/risk-prediction-of-acute-kidney-injury-by-timp-2-%C3%A2-igfbp7
#8
M Kimmel, M Schanz, M D Alscher
Acute kidney injury (AKI) is a common syndrome with increased mortality, a heavy burden of illness and high cost. The Kidney Disease Improving Global Outcomes (KDIGO) criteria for staging of AKI have been validated in large patient cohorts and classify AKI into three stages. In order to achieve prevention or early therapy, the focus of scientific interest is early detection and risk prediction of AKI. The combination of the two cell cycle arrest markers [TIMP-2]·[IGFBP7] in the urine shows good results in the risk prediction of AKI in different clinical settings (intensive care medicine, sepsis, cardiac surgery, emergency department)...
June 2017: Drugs of Today
https://www.readbyqxmd.com/read/28796275/immature-platelets-as-a-novel-biomarker-for-adverse-cardiovascular-events-in-patients-after-non-cardiac-surgery
#9
Aida Anetsberger, Manfred Blobner, Bernhard Haller, Sebastian Schmid, Katrin Umgelter, Theresa Hager, Clemens Langgartner, Eberhard F Kochs, Karl-Ludwig Laugwitz, Bettina Jungwirth, Isabell Bernlochner
This study evaluates whether immature platelets (IPF) determined in the post anesthesia care unit (PACU) can predict major adverse cardiovascular events (MACE) or other thromboembolic events after intermediate and high-risk surgery. IPF are increased in patients with acute coronary syndrome and recently gained interest as novel biomarker for risk stratification. In this prospective observational trial 732 patients undergoing intermediate or high-risk non-cardiac surgery were enrolled (NCT02097602). IPF was measured preoperatively and postoperatively in the PACU...
August 10, 2017: Thrombosis and Haemostasis
https://www.readbyqxmd.com/read/28794144/nasal-high-flow-therapy-a-novel-treatment-rather-than-a-more-expensive-oxygen-device
#10
REVIEW
Eleni Ischaki, Ioannis Pantazopoulos, Spyros Zakynthinos
Nasal high flow is a promising novel oxygen delivery device, whose mechanisms of action offer some beneficial effects over conventional oxygen systems. The administration of a high flow of heated and humidified gas mixture promotes higher and more stable inspiratory oxygen fraction values, decreases anatomical dead space and generates a positive airway pressure that can reduce the work of breathing and enhance patient comfort and tolerance. Nasal high flow has been used as a prophylactic tool or as a treatment device mostly in patients with acute hypoxaemic respiratory failure, with the majority of studies showing positive results...
September 30, 2017: European Respiratory Review: An Official Journal of the European Respiratory Society
https://www.readbyqxmd.com/read/28793902/30-year-experience-of-fontan-surgery-single-centre-s-data
#11
Laurynas Bezuska, Virgilijus Lebetkevicius, Rita Sudikiene, Daina Liekiene, Virgilijus Tarutis
BACKGROUND: The Fontan procedure has been modified several times since it was introduced into practice in 1968. As many patients now survive to adulthood, attention is directed towards their clinical status and late morbidity. We report our surgical experience of 30 years in Fontan procedures. METHODS: From January 1985 to January 2015, 80 patients underwent Fontan surgery. Twenty-one patients received an atrio-pulmonary Fontan (Group I), four patients underwent total cavopulmonary connection (TCPC) with an intra-atrial lateral tunnel (Group II), six patients received extra-cardiac TCPC with an aortic homograft (group III) and 49 patients received extra-cardiac TCPC with an expanded polytetrafluoroethylene conduit...
August 9, 2017: Journal of Cardiothoracic Surgery
https://www.readbyqxmd.com/read/28793825/controlling-acute-pain-to-improve-the-quality-of-postoperative-pain-management-an-update-from-the-european-society-of-regional-anesthesia-meeting-held-in-maastricht-september-2016
#12
Jose De Andrés, Esther Pogatzki-Zahn, Frank Huygen, Edmund Neugebauer, William Fawcett
Improvement in postoperative pain management remains a global concern with a significant unmet need for patients. This was the focus of a 'Change Pain' session at the 35th European Society of Regional Anesthesia meeting (Maastricht, September 2016). Awareness of the size and nature of the problem is important to improve postoperative pain management strategies. Optimal treatment of acute pain should aim to avoid long-term sequelae such as the development of chronic pain disorders (e.g., phantom limb pain)...
August 10, 2017: Pain Management
https://www.readbyqxmd.com/read/28791424/-to-stent-or-not-to-stent-immediate-emergency-surgery-with-laparoscopic-radical-colectomy-with-cme-and-primary-anastomosis-is-feasible-for-obstructing-left-colon-carcinoma
#13
Salomone Di Saverio, Arianna Birindelli, Edoardo Segalini, Matteo Novello, Anna Larocca, Francesco Ferrara, Gian Andrea Binda, Marco Bassi
Great debate exists in the initial acute management of large bowel obstruction from obstructing left colon carcinoma. While endoscopic stenting is well established as the first approach in the setting of palliative care of patients with advanced metastatic disease as well as a bridge to elective surgery in elderly patients who have an increased risk of postoperative mortality (age >70 years and/or ASA status ≥3), controversies exist regarding oncological safety and long-term outcomes of endoscopic colonic stenting in younger patients and ESGE Guidelines do not recommend SEMS placement in patients <70 and fit for curative surgery...
August 8, 2017: Surgical Endoscopy
https://www.readbyqxmd.com/read/28782123/the-effects-of-storage-of-red-blood-cells-on-the-development-of-postoperative-infections-after-noncardiac-surgery
#14
Savino Spadaro, Fabio Silvio Taccone, Alberto Fogagnolo, Vito Fontana, Riccardo Ragazzi, Marco Verri, Giorgia Valpiani, Pantaleo Greco, Margherita Bianconi, Maurizio Govoni, Roberto Reverberi, Carlo Alberto Volta
BACKGROUND: Prolonged storage of red blood cells (RBCs) is a potential risk factor for postoperative infections. The objective of this study was to examine the effect of age of RBCs transfused on development of postoperative infection. STUDY DESIGN AND METHODS: In this prospective, double-blind randomized trial, 199 patients undergoing elective noncardiac surgery and requiring RBC transfusion were assigned to receive nonleukoreduced RBCs stored for not more than 14 days ("fresh blood" group, n = 101) or for more than 14 days ("old blood" group, n = 98)...
August 7, 2017: Transfusion
https://www.readbyqxmd.com/read/28781918/primary-decompressive-craniectomy-is-associated-with-worse-neurological-outcome-in-patients-with-traumatic-brain-injury-requiring-acute-surgery
#15
Julius Tapper, Markus B Skrifvars, Riku Kivisaari, Jari Siironen, Rahul Raj
BACKGROUND: The role of decompressive craniectomy in treating raised intracranial pressure (ICP) after traumatic brain injuries (TBI) is controversial. The aim of this study was to assess the differences in prognosis of patients initially treated by decompressive craniectomy, craniotomy, or conservatively. METHODS: We conducted a single-center retrospective study on adult blunt TBI patients admitted to a neurosurgical intensive care unit during 2009-2012. Patients were divided into three groups based on their initial treatment - decompressive craniectomy, craniotomy, and conservative...
2017: Surgical Neurology International
https://www.readbyqxmd.com/read/28780877/-identification-of-risk-factors-of-multiresistant-infections-on-two-intensive-care-units
#16
Marcell Szabó, Noémi Kanász, Katalin Darvas, János Gál
INTRODUCTION: Intensive care units are favourable environment for infections, many of them are caused by antibiotic resistant bacteria. AIM: Identifying risk factors of ICU-acquired multiresistant infections. METHOD: We performed observational study on two academic intensive care units (a multidisciplinary and a surgical ICU) between 01/09/2014 and 30/11/2015. Patients with a first infection caused by predefined organisms (P. aeruginosa, E...
August 2017: Orvosi Hetilap
https://www.readbyqxmd.com/read/28780610/pancreatic-leaks-and-fistulae-an-endoscopy-oriented-classification
#17
REVIEW
Massimiliano Mutignani, Stefanos Dokas, Alberto Tringali, Edoardo Forti, Francesco Pugliese, Marcello Cintolo, Raffaele Manta, Lorenzo Dioscoridi
BACKGROUND: Pancreatic leaks occur as a complication of upper gastrointestinal surgery, acute pancreatitis, or abdominal trauma. Pancreatic fistulas and leaks are primarily managed conservatively. Overall, conservative measures are successful in more than half of cases. Whenever conservative treatment is not efficient, surgery is usually considered the treatment of choice. Nowadays however, endoscopic treatment is being increasingly considered and employed in many cases, as a surgery sparing intervention...
August 5, 2017: Digestive Diseases and Sciences
https://www.readbyqxmd.com/read/28780362/predictors-of-prolonged-mechanical-ventilation-in-adults-after-acute-type-a-aortic-dissection-repair
#18
Mu Jin, Wei-Guo Ma, Shiyao Liu, Junming Zhu, Lizhong Sun, Jiakai Lu, Weiping Cheng
OBJECTIVES: Prolonged mechanical ventilation (PMV) after surgical repair of acute type-A aortic dissection (ATAAD) is associated with an increased risk for mortality and morbidity. The goal of this study was to evaluate the influence of PMV on early and late outcomes and to identify the risk factors for PMV after ATAAD repair. DESIGN, SETTING, AND PARTICIPANTS: This study was a retrospective analysis of prospectively collected data, which resulted from a prior clinical trial...
March 28, 2017: Journal of Cardiothoracic and Vascular Anesthesia
https://www.readbyqxmd.com/read/28765795/inpatient-versus-outpatient-anterior-cervical-discectomy-and-fusion-a-perioperative-complication-analysis-of-259-414-patients-from-the-healthcare-cost-and-utilization-project-databases
#19
Shearwood McClelland Iii, Peter G Passias, Thomas J Errico, R Shay Bess, Themistocles S Protopsaltis
BACKGROUND: Anterior cervical discectomy and fusion (ACDF) is one of the most common operations utilized to address pathology of the cervical spine. Few reports have attempted to compare complications associated with inpatient versus outpatient ACDF. METHODS: The Nationwide Inpatient Sample (NIS) from 2001-2012 and the State Ambulatory Services Database (SASD) for New Jersey (NJ) from 2003-2012 were used for analysis. Patients receiving ACDF (defined as anterior cervical fusion (ICD-0 code=81...
2017: International Journal of Spine Surgery
https://www.readbyqxmd.com/read/28761965/-mtl30-as-surrogate-parameter-for-quality-of-surgically-treated-diseases-establishment-based-on-the-studoq-register-of-the-german-society-for-general-and-visceral-surgery
#20
A Wiegering, U Wellner, F Seyfried, J Hardt, C Klinger, H Buhr, S Post
From a sociopolitical aspect there is increasing interest in the quality of healthcare. In this context valid, reproducible, comparable and risk-adjustable markers that are easily identified have become crucial for consistent documentation of quality. We recommend MTL30 (mortality, transfer, length of stay) as one of these markers to consistently measure the quality of large visceral surgical interventions. The MTL30 subsumes a number of known markers that may help to predict postoperative complications. The MTL30 is considered to be fulfilled when a patient on the 30th day following surgery, a) has died b) is still in the hospital or c) has been transferred to another acute care hospital...
July 31, 2017: Der Chirurg; Zeitschrift Für Alle Gebiete der Operativen Medizen
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