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https://www.readbyqxmd.com/read/29453729/perioperative-outcomes-of-robotic-hysterectomy-with-mini-laparotomy-versus-open-hysterectomy-for-uterus-weighing-more-than-250-g
#1
Natasha Gupta, Shanti Mohling, Rebecca Mckendrick, Rayan Elkattah, Jenny Holcombe, Robert S Furr, Todd Boren, Stephen DePasquale
To compare perioperative outcomes in patients undergoing robotic hysterectomy and extraction of specimen via mini-laparotomy (RHML) versus open hysterectomy (OH) when uterus weighs more than 250 g. To study the factors determining the length of hospital stay in 2 groups. A retrospective analysis of all hysterectomies performed for uterus weighing more than 250 g from the year 2012 to 2015 was conducted. A total of 140 patients were divided into 2 groups based on the type of surgery; RHML (n = 82) and OH (n = 58)...
February 16, 2018: Journal of Robotic Surgery
https://www.readbyqxmd.com/read/29453331/a-prospective-cohort-evaluation-of-the-cortisol-response-to-cardiac-surgery-with-occurrence-of-early-postoperative-cognitive-decline
#2
Sandro Glumac, Goran Kardum, Nenad Karanović
BACKGROUND A recent study reported that patients with higher cortisol levels on the 1st postoperative morning after cardiac surgery exhibited an increased risk of early postoperative cognitive decline (POCD). Therefore, we conducted the current study to gain further insight into the stress response to a surgical procedure as a potential risk factor for early POCD after cardiac surgery. MATERIAL AND METHODS This prospective cohort study enrolled 125 patients undergoing elective cardiac surgery with or without cardiopulmonary bypass (CPB)...
February 17, 2018: Medical Science Monitor: International Medical Journal of Experimental and Clinical Research
https://www.readbyqxmd.com/read/29452810/interleukin-6-is-both-necessary-and-sufficient-to-produce-perioperative-neurocognitive-disorder-in-mice
#3
J Hu, X Feng, M Valdearcos, D Lutrin, Y Uchida, S K Koliwad, M Maze
BACKGROUND: Perioperative neurocognitive disorders (PND) result in long-term morbidity and mortality with no effective interventions available. Because interleukin-6 (IL-6), a pro-inflammatory cytokine, is consistently up-regulated by trauma, including after surgery, we determined whether IL-6 is a putative therapeutic target for PND in a mouse model. METHODS: Following institutional approval, adult (12-14 weeks) male C57/Bl6 mice were pretreated with the IL-6 receptor (IL6R) blocking antibody tocilizumab prior to open tibia fracture with internal fixation under isoflurane anaesthesia...
March 2018: British Journal of Anaesthesia
https://www.readbyqxmd.com/read/29452805/perioperative-cardiopulmonary-exercise-testing-cpet-consensus-clinical-guidelines-on-indications-organization-conduct-and-physiological-interpretation
#4
D Z H Levett, S Jack, M Swart, J Carlisle, J Wilson, C Snowden, M Riley, G Danjoux, S A Ward, P Older, M P W Grocott
The use of perioperative cardiopulmonary exercise testing (CPET) to evaluate the risk of adverse perioperative events and inform the perioperative management of patients undergoing surgery has increased over the last decade. CPET provides an objective assessment of exercise capacity preoperatively and identifies the causes of exercise limitation. This information may be used to assist clinicians and patients in decisions about the most appropriate surgical and non-surgical management during the perioperative period...
March 2018: British Journal of Anaesthesia
https://www.readbyqxmd.com/read/29451147/perioperative-single-donor-platelet-apheresis-and-red-blood-cell-transfusion-impact-on-90-day-and-overall-survival-in-living-donor-liver-transplantation
#5
Wei Zheng, Kang-Mei Zhao, Li-Hui Luo, Yang Yu, Sheng-Mei Zhu
Background: Although many previous studies have confirmed that perioperative blood transfusion is associated with poor outcomes after liver transplantation (LT), few studies described the influence of single-donor platelet apheresis transfusion in living donor LT (LDLT). This study aimed to assess the effect of blood products on outcomes for LDLT recipients, focusing on apheresis platelets. Methods: This retrospective study included 126 recipients who underwent their first adult-to-adult LDLT...
February 20, 2018: Chinese Medical Journal
https://www.readbyqxmd.com/read/29450640/incidence-of-perioperative-complications-in-total-hip-and-knee-arthroplasty-in-patients-with-parkinson-disease
#6
Tankamani Sharma, Wolfgang Hönle, René Handschu, Werner Adler, Tarun Goyal, Alexander Schuh
INTRODUCTION: The aim of this study is to evaluate the difference in perioperative complication rate in total hip, bipolar hemiarthroplasties and total knee arthroplasty in patients with Parkinson disease in trauma and elective surgery in our Musculoskeletal Center during a period of 10 years. MATERIAL AND METHOD: Between 2006 and 2016, 45 bipolar hemiarthroplasties in trauma surgery, 15 total knee and 19 total hip arthroplasties in patients with Parkinson's disease were performed...
February 15, 2018: Archives of Orthopaedic and Trauma Surgery
https://www.readbyqxmd.com/read/29447890/outcomes-of-adenoidectomy-alone-in-patients-less-than-3-years-old
#7
Kishan M Thadikonda, Amber D Shaffer, Amanda L Stapleton
OBJECTIVES: 1. Determine the percentage of patients under the age of 3 undergoing adenoidectomy-alone who require subsequent management of residual sleep disordered breathing (SDB).2. Characterize complications following adenoidectomy and determine if any perioperative factors are associated with intra-operative or post-operative complications and outcomes. METHODS: Case series with chart review was conducted including children seen at a tertiary care children's hospital between 2008 and 2012...
March 2018: International Journal of Pediatric Otorhinolaryngology
https://www.readbyqxmd.com/read/29447402/intraoperative-endotracheal-cuff-pressure-study-how-education-and-availability-of-manometers-help-guide-safer-pressures
#8
Gregory J Stevens, Joel W Warfel, James K Aden, Scott D Blackwell
Introduction: Endotracheal intubation is a medical procedure that is often indicated in both the perioperative and critical care environments. Cuffed endotracheal tubes (ETT) allow for safer and more efficient delivery of positive pressure ventilation, as well as create a barrier to reduce the risk of micro-aspiration and anesthetic pollution in the operating room environment. Over-inflation of the endotracheal cuff can lead to serious and harmful sequelae. This study aimed to assess if departmental education paired with ready access to a manometer to assess cuff pressure would result in an improvement in the proportion of ETT cuff pressures in the goal range...
February 13, 2018: Military Medicine
https://www.readbyqxmd.com/read/29447344/the-balance-between-short-term-and-long-term-outcomes-of-bilateral-internal-thoracic-artery-skeletonization-in-coronary-artery-bypass-surgery-a-propensity-matched-cohort-study
#9
Janet M C Ngu, Ming Hao Guo, David Glineur, Diem Tran, Fraser D Rubens
OBJECTIVES: There is growing interest in the use of bilateral internal thoracic arteries (BITAs) for myocardial revascularization. This study sought to compare the balance between early benefits and long-term outcomes of skeletonized or non-skeletonized conduits and to determine whether differences in outcomes are affected by other patient risk factors. METHODS: BITAs were used in 1504 cases with either SK or NSK conduits. Propensity matching was completed using 22 covariates identifying 441 pairs of patients...
February 13, 2018: European Journal of Cardio-thoracic Surgery
https://www.readbyqxmd.com/read/29444973/eight-hours-adaptive-deep-brain-stimulation-in-patients-with-parkinson-disease
#10
Mattia Arlotti, Sara Marceglia, Guglielmo Foffani, Jens Volkmann, Andres M Lozano, Elena Moro, Filippo Cogiamanian, Marco Prenassi, Tommaso Bocci, Francesca Cortese, Paolo Rampini, Sergio Barbieri, Alberto Priori
OBJECTIVES: To assess the feasibility and clinical efficacy of local field potentials (LFPs)-based adaptive deep brain stimulation (aDBS) in patients with advanced Parkinson disease (PD) during daily activities in an open-label, nonblinded study. METHODS: We monitored neurophysiologic and clinical fluctuations during 2 perioperative experimental sessions lasting for up to 8 hours. On the first day, the patient took his/her daily medication, while on the second, he/she additionally underwent subthalamic nucleus aDBS driven by LFPs beta band power...
February 14, 2018: Neurology
https://www.readbyqxmd.com/read/29443839/how-common-and-how-serious-is-clostridium-difficile-colitis-after-geriatric-hip-fracture-findings-from-the-nsqip-dataset
#11
Patawut Bovonratwet, Daniel D Bohl, Glenn S Russo, Nathaniel T Ondeck, Denis Nam, Craig J Della Valle, Jonathan N Grauer
BACKGROUND: Patients with geriatric hip fractures may be at increased risk for postoperative Clostridium difficile colitis, which can cause severe morbidity and can influence hospital quality metrics. However, to our knowledge, no large database study has calculated the incidence of, factors associated with, and effect of C. difficile colitis on geriatric patients undergoing hip fracture surgery. QUESTIONS/PURPOSES: To use a large national database with in-hospital and postdischarge data (National Surgical Quality Improvement Program [NSQIP®]) to (1) determine the incidence and timing of C...
March 2018: Clinical Orthopaedics and related Research
https://www.readbyqxmd.com/read/29443404/new-immunomodulatory-oral-nutrition-formula-for-use-prior-to-surgery-in-patients-with-head-and-neck-cancer-an-exploratory-study
#12
Samara Palma-Milla, Bricia López-Plaza, Beatriz Santamaría, Álvaro de Arriba-Sánchez, Laura M Bermejo, Carmen Gómez-Candela
BACKGROUND: The perioperative use of immunomodulatory nutrition formulas in patients with head and neck cancer reduces the number of postoperative infections and the length of hospital stay. OBJECTIVE: An exploratory, randomized, controlled, blind, clinical trial was designed to examine the effect of the preoperative consumption of a new, immunomodulatory, oral nutrition formula in patients with head and neck cancer. METHODS: Thirty-eight patients were randomized to receive either 400 mL/d of either the new immunomodulatory formula (IF) or that commonly used in clinical practice (CF) over 10 days prior to surgery...
February 2018: JPEN. Journal of Parenteral and Enteral Nutrition
https://www.readbyqxmd.com/read/29439725/natural-progress-of-d-dimer-following-total-joint-arthroplasty-a-baseline-for-the-diagnosis-of-the-early-postoperative-infection
#13
Yong Seuk Lee, Young-Kyun Lee, Seung Bum Han, Chang Hyun Nam, Javad Parvizi, Kyung-Hoi Koo
BACKGROUND: Early detection followed by prompt intervention is essential for the treatment of periprosthetic joint infection (PJI). D-dimer, a fibrin degradation product, characteristically changes rapidly during early postoperative period and has a short half-life. The aim of this prospective study was to measure postoperative change of D-dimer level after joint arthroplasty in conjunction with ESR and CRP. METHODS: ESR, CRP, and D-dimer levels were measured on the day before surgery, postoperative days 1, 2, 3, and 5 and weeks 2 and 6 in 65 patients who underwent elective primary total hip arthroplasty (38 hips in 38 patients) or total knee arthroplasty (27 knees in 27 patients)...
February 13, 2018: Journal of Orthopaedic Surgery and Research
https://www.readbyqxmd.com/read/29435832/myocardial-injury-in-elderly-patients-after-abdominal-surgery
#14
Shun Huang, WenPing Peng, Ning Yang, Tao Yu, Hong Yuan Cui, Jing Yong Xu, Qi An, Hua Yang, Yan Nan Liu, Zhe Li, Ming Zhang Zuo
BACKGROUND: The development of sensitive myocardial-specific cardiac biomarkers allows for detection of very small amounts of myocardial injury or necrosis. Myocardial injury (MI) as a prelude of the serious perioperative complication myocardial infarction, should be paid more attention, especially in elderly susceptible patients. Myocardial injury after abdominal surgery in elderly patients has not been described yet. The objectives of this study were to identify the incidence, predictors, characteristics and the impact of MI on outcome in elderly patients underwent abdominal surgery...
February 12, 2018: Aging Clinical and Experimental Research
https://www.readbyqxmd.com/read/29435797/phacoemulsification-cataract-surgery-in-patients-receiving-novel-oral-anticoagulant-medications
#15
Janice J C Cheung, Shasha Liu, Kenneth K W Li
INTRODUCTION: An increasing number of patients are taking novel oral anticoagulant (NOAC) medication, making perioperative management in phacoemulsification surgery an important issue. This study reports the haemorrhagic complications of NOAC in phacoemulsification surgery. DESIGN: Retrospective case study over a 4-year period. METHODS: Consecutive cases receiving NOAC during the time of phacoemulsification were reviewed. Patients were either advised to continue medications (continued group) or withhold medications before surgery (withheld group)...
February 13, 2018: International Ophthalmology
https://www.readbyqxmd.com/read/29435747/clinical-versus-patient-reported-measures-of-depression-in-bariatric-surgery
#16
Sudarshan Srivatsan, Vinay Guduguntla, Kelly Z Young, Aliasghar Arastu, Cameron R Strong, Ruth Cassidy, Amir A Ghaferi
BACKGROUND: Bariatric surgery patients with mental illness may experience worse surgical outcomes compared to those without. Depression is the most prevalent mental health diagnosis amongst Americans with obesity. Accurate diagnosis and treatment is of paramount importance to mitigate perioperative risk. Unfortunately, there is no standard method to screen patients for depression prior to surgery. Our goal was to understand the relationship between traditional clinical screening tools and a novel patient-reported depression screening survey, Patient Health Questionnaire 8 (PHQ-8), in the setting of the bariatric surgery preoperative assessment...
February 12, 2018: Surgical Endoscopy
https://www.readbyqxmd.com/read/29430491/total-knee-arthroplasty-in-patients-with-retention-of-prior-hardware-material-what-is-the-outcome
#17
Jorge Manrique, Mohammad R Rasouli, Camilo Restrepo, Mitchell G Maltenfort, Jonathan Beri, Jeffrey Oliver, Raj Patel, Javad Parvizi
Background: There is an information gap in literature regarding postoperative outcome of total knee arthroplasty (TKA) in patients with hardware in-situ from the previous knee surgery. The present study aims to evaluate impact of retained hardware on short-term outcome of TKA patients. Methods: Perioperative radiographs of patients who had undergone TKA between 2007 and 2012 were reviewed and patients in whom partial or complete retention of hardware was evident after TKA were included...
January 2018: Archives of Bone and Joint Surgery
https://www.readbyqxmd.com/read/29428620/postoperative-chylothorax-after-thoracoabdominal-aortic-aneurysm-repair
#18
Darrell Wu, Arina E Chesnokova, Shahab Akvan, Matt D Price, David J Sugarbaker, Joseph S Coselli, Scott A LeMaire
OBJECTIVE: Chylothorax is a potentially deadly complication that can occur after thoracoabdominal aortic aneurysm (TAAA) repair. We describe our contemporary experience (2005-2014) with this complication, our efforts to identify perioperative variables associated with it, and our attempts to assess treatment outcomes. METHODS: We reviewed the records of 1092 consecutive patients who underwent TAAA repair between 2005 and 2014. Standard bivariate analysis was used to test for between-group differences...
February 8, 2018: Seminars in Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/29425598/emergency-manuals-how-quality-improvement-and-implementation-science-can-enable-better-perioperative-management-during-crises
#19
REVIEW
Sara N Goldhaber-Fiebert, Carl Macrae
How can teams manage critical events more effectively? There are commonly gaps in performance during perioperative crises, and emergency manuals are recently available tools that can improve team performance under stress, via multiple mechanisms. This article examines how the principles of implementation science and quality improvement were applied by multiple teams in the development, testing, and systematic implementations of emergency manuals in perioperative care. The core principles of implementation have relevance for future patient safety innovations perioperatively and beyond, and the concepts of emergency manuals and interprofessional teamwork are applicable for diverse fields throughout health care...
March 2018: Anesthesiology Clinics
https://www.readbyqxmd.com/read/29424648/association-of-plasma-d-dimer-level-with-thromboembolic-events-after-endovascular-coil-treatment-of-ruptured-cerebral-aneurysms
#20
Hitoshi Fukuda, Akira Handa, Masaomi Koyanagi, Benjamin Lo, Sen Yamagata
OBJECTIVE Although endovascular therapy is favored for acutely ruptured intracranial aneurysms, hematological factors associated with acute subarachnoid hemorrhage (SAH) may predispose to procedure-related ischemic complications. The aim of this study was to evaluate whether an elevated level of plasma D-dimer, a parameter of hypercoagulation in patients with acute SAH, is correlated with increased incidence of thromboembolic events during endovascular coiling of ruptured aneurysms. METHODS The authors analyzed data from 103 cases of acutely ruptured aneurysms (in 103 patients) treated with endovascular coil embolization at a single institution...
February 9, 2018: Journal of Neurosurgery
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