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Surgical nutrition

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https://www.readbyqxmd.com/read/27934650/parenteral-or-enteral-arginine-supplementation-safety-and-efficacy
#1
REVIEW
Martin D Rosenthal, Phillip W Carrott, Jayshil Patel, Laszlo Kiraly, Robert G Martindale
Arginine supplementation has the potential to improve the health of patients. Its use in hospitalized patients has been a controversial topic in the nutrition literature, especially concerning supplementation of septic patients. In this article, we review the relevant literature both for and against the use of arginine in critically ill, surgical, and hospitalized patients. The effect of critical illness on arginine metabolism is reviewed, as is its use in septic and critically ill patients. Although mounting evidence supports immunonutrition, there are only a few studies that suggest that this is safe in patients with severe sepsis...
December 2016: Journal of Nutrition
https://www.readbyqxmd.com/read/27931029/selective-necrosectomy-for-infected-pancreatic-necrosis
#2
Ola Ahmed, Claire L Donohoe, Daragh B Murphy, Brian J Marsh, John Conneely, Gerry P McEntee
BACKGROUND: Until recently, a diagnosis of infected pancreatic necrosis (IPN) warranted necrosectomy, which was associated with high morbidity and mortality rates greater than 20%. Preoperative percutaneous drainage delayed the need for necrosectomy with improved outcomes. METHODS: In 2008, this institution changed its approach to the management of such cases opting instead for percutaneous drainage with selective deferred necrosectomy. A total of 38 consecutive patients with IPN from January 2008 to December 2014 were included...
December 9, 2016: Digestive Surgery
https://www.readbyqxmd.com/read/27928446/gastrostomy-with-peritoneal-collar-versus-percutaneous-endoscopic-gastrostomy
#3
Tudor C, Branescu C, Savlovschi C, El-Khatib A, Pantu H, Nica A, Dascalu Am, Masoumeh B, Tudor As, Oprescu Sm, Serban D
Aim. The present study aimed to perform a medico-surgical comparative analysis of the 2 most widely used techniques: gastrostomy with peritoneal collar versus percutaneous endoscopic gastrostomy, based on the vast clinical experience in an Upper Digestive Surgery Clinic. Materials and method. A retrospective study was carried out between January 2010 and January 2015 on the patients admitted for a surgical solution for feeding. The indications, preoperative preparation, surgical techniques, and postoperative outcomes were analyzed...
October 2016: Journal of Medicine and Life
https://www.readbyqxmd.com/read/27927660/effect-of-prehabilitation-in-gastro-oesophageal-adenocarcinoma-study-protocol-of-a-multicentric-randomised-control-trial-the-prehab-study
#4
Bertrand Le Roy, Bruno Pereira, Corinne Bouteloup, Frédéric Costes, Ruddy Richard, Marie Selvy, Caroline Pétorin, Johan Gagnière, Emmanuel Futier, Karem Slim, Bernard Meunier, Jean-Yves Mabrut, Christophe Mariette, Denis Pezet
INTRODUCTION: Perioperative chemotherapy is the gold standard treatment of the resectable gastro-oesophageal adenocarcinoma. However, 70% of patients cannot receive the complete sequence because of a postoperative complication or a decrease in functional and nutritional reserves. Recently, a new concept appeared in digestive surgery: prehabilitation. This interventional process consists of patient preparation, between surgical consultation and surgery, and is based on 3 components: (1) physical management, (2) nutritional care and (3) psychological care...
December 7, 2016: BMJ Open
https://www.readbyqxmd.com/read/27926559/preoperative-immunonutrition-and-elective-colorectal-resection-outcomes
#5
Lucas W Thornblade, Thomas K Varghese, Xu Shi, Eric K Johnson, Amir Bastawrous, Richard P Billingham, Richard Thirlby, Alessandro Fichera, David R Flum
BACKGROUND: Randomized controlled trials demonstrate the efficacy of arginine-enriched nutritional supplements (immunonutrition) in reducing complications after surgery. The effectiveness of preoperative immunonutrition has not been evaluated in a community setting. OBJECTIVE: This study aims to determine whether immunonutrition before elective colorectal surgery improves outcomes in the community at large. DESIGN: This is a prospective cohort study with a propensity score-matched comparative effectiveness evaluation...
January 2017: Diseases of the Colon and Rectum
https://www.readbyqxmd.com/read/27921048/surgical-treatment-of-metabolic-syndrome
#6
REVIEW
Norbert Runkel, Rainer Brydniak
BACKGROUND: Bariatric surgery is gastrointestinal surgery for weight control, and metabolic surgery refers to the use of surgery to primarily and purposely treat type 2 diabetes mellitus (T2DM)/metabolic syndrome mellitus. METHODS: The most recent literature was reviewed for surgery and T2DM in a non-systematic fashion. RESULTS: Roux-Y gastric bypass, biliopancreatic diversion with duodenal switch, and sleeve gastrectomy (SG) are the dominant procedures today...
October 2016: Visceral Medicine
https://www.readbyqxmd.com/read/27919768/proximal-femoral-fractures-in-centenarians-a-retrospective-analysis-of-39-patients
#7
A Morice, N Reina, G Gracia, P Bonnevialle, J-M Laffosse, K Wytrykowski, E Cavaignac, N Bonnevialle
BACKGROUND: A corollary of the current population ageing in France is an increase in proximal femoral fractures (PFFs), particularly among centenarians. The outcomes of PFF in centenarians in France are unknown. We therefore conducted a retrospective study of centenarians with PFFs both to assess: 1) assess clinical outcomes according to geriatric and trauma scores, 2) and to determine whether routine surgery is warranted. HYPOTHESIS: Morbidity and mortality in a single-centre cohort of centenarians with surgically treated PFFs are consistent with previous reports...
December 2, 2016: Orthopaedics & Traumatology, Surgery & Research: OTSR
https://www.readbyqxmd.com/read/27919767/internal-fixation-of-intra-capsular-proximal-femoral-fractures-in-patients-older-than-80-years-still-relevant-multivariate-analysis-of-a-prospective-multicentre-cohort
#8
Nicolas Reina, Paul Bonnevialle, Brice Rubens Duval, Philippe Adam, François Loubignac, Thierry Favier, Philippe Massin
BACKGROUND: Arthroplasty is now widely used to treat intra-capsular proximal femoral fractures (PFFs) in older patients, even when there is little or no displacement. However, whether arthroplasty is associated with lower mortality and complication rates in non-displaced or mildly displaced PFFs is unknown. The objectives of this prospective study were: 1) to evaluate early mortality rates with the two treatment methods, 2) to identify risk factors for complications, 3) and to identify predictors of functional decline...
December 2, 2016: Orthopaedics & Traumatology, Surgery & Research: OTSR
https://www.readbyqxmd.com/read/27915421/the-frequency-and-treatment-of-pneumothorax-associated-with-pulmonary-nontuberculous-mycobacterial-infection
#9
Masaki Ikeda, Koji Takahashi, Teruya Komatsu, Toru Tanaka, Tatsuo Kato, Takuji Fujinaga
OBJECTIVES: Characteristics of pneumothorax associated with nontuberculous mycobacterium (NTM) infection are rarely reported, especially in terms of surgical treatments. Our objectives were to show the tendency and clinical courses of pneumothorax due to NTM and discuss the way of therapy in our hospital. METHODS: We retrospectively analyzed 557 patients with NTM infection over a period of 5 years at the Nagara Medical Center. RESULTS: A total of 12 out of the 557 patients (2...
December 3, 2016: General Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/27913000/surgical-prehabilitation-in-patients-with-cancer-state-of-the-science-and-recommendations-for-future-research-from-a-panel-of-subject-matter-experts
#10
REVIEW
Francesco Carli, Julie K Silver, Liane S Feldman, Andrea McKee, Sean Gilman, Chelsia Gillis, Celena Scheede-Bergdahl, Ann Gamsa, Nicole Stout, Bradford Hirsch
This review by a 10-member panel of experts in surgical prehabilitation addresses processes that may improve oncologic care. Surgical prehabilitation is the process on the continuum of care that occurs between the time of cancer diagnosis and the beginning of surgical treatment. The panel focused on the current state-of-the-science and recommended future research that would help to identify the elements that enhance preoperative physical, nutritional, and psychological health in anticipation of surgery, mitigate the burden of disease, facilitate the return of patient health status to baseline values, decrease postoperative morbidity, and reduce health care costs...
February 2017: Physical Medicine and Rehabilitation Clinics of North America
https://www.readbyqxmd.com/read/27908316/-frail-patients-and-surgery
#11
Nadia A Henriksen, Frederik Helgstrand, Ismail Gögenur
It is estimated that 15% of patients above 65 years of age are frail. Frail patients have significantly higher risk of post-operative complications when undergoing both elective and emergency surgery than patients who are not frail. Therefore, it is recommended that all patients above 65 years are frailty scored prior to a surgical procedure. It seems advisable to include the following items in a multimodal frailty score: evaluation of the patient's cognitive ability, functional status, nutritional status and pulmonary and cardiac function...
November 21, 2016: Ugeskrift for Laeger
https://www.readbyqxmd.com/read/27901247/anabolic-steroids-for-rehabilitation-after-hip-fracture-in-older-people
#12
Vaqas Farooqi, Maayken E L van den Berg, Ian D Cameron, Maria Crotty
BACKGROUND: Hip fracture occurs predominantly in older people, many of whom are frail and undernourished. After hip fracture surgery and rehabilitation, most patients experience a decline in mobility and function. Anabolic steroids, the synthetic derivatives of the male hormone testosterone, have been used in combination with exercise to improve muscle mass and strength in athletes. They may have similar effects in older people who are recovering from hip fracture. OBJECTIVES: To examine the effects (primarily in terms of functional outcome and adverse events) of anabolic steroids after surgical treatment of hip fracture in older people...
September 2016: São Paulo Medical Journal, Revista Paulista de Medicina
https://www.readbyqxmd.com/read/27898350/cronkhite-canada-syndrome-complicated-by-pulmonary-embolism-a-case-report
#13
Neha L Nemade, Urvi B Shukla, Gajanan D Wagholikar
INTRODUCTION: Cronkhite Canada Syndrome (CCS) is a rare syndrome, described in 1955 by Americans, Leonard Wolsey Cronkhite and Wilma Jeanne Canada in the New England Journal of Medicine [1]. About 450 cases have been reported. Complications, like malignant transformation, unprovoked thromboembolism is known. Since there is wide variability in medical presentation, no definitive diagnostic and treatment protocol s have been set. The mortality remains at 55%. CASE PRESENTATION: We report a case of a 50 year old male patient presenting with diarrhea, weight loss, abdominal pain, ectodermal features...
November 17, 2016: International Journal of Surgery Case Reports
https://www.readbyqxmd.com/read/27896179/clinical-factors-associated-with-the-non-operative-airway-management-of-patients-with-robin-sequence
#14
Frank P Albino, Benjamin C Wood, Kevin D Han, Sojung Yi, Mitchel Seruya, Gary F Rogers, Albert K Oh
BACKGROUND: The indications for surgical airway management in patients with Robin sequence (RS) and severe airway obstruction have not been well defined. While certain patients with RS clearly require surgical airway intervention and other patients just as clearly can be managed with conservative measures alone, a significant proportion of patients with RS present with a more confusing and ambiguous clinical course. The purpose of this study was to describe the clinical features and objective findings of patients with RS whose airways were successfully managed without surgical intervention...
November 2016: Archives of Plastic Surgery
https://www.readbyqxmd.com/read/27896159/intestinal-atresia-experience-at-a-busy-center-of-north-west-india
#15
Shilpi Gupta, Rahul Gupta, Soumyodhriti Ghosh, Arun Kumar Gupta, Arvind Shukla, Vinita Chaturvedi, Praveen Mathur
Objective: To evaluate the presentation, management, complications and outcome of intestinal atresia (IA) managed at our center over a period of 1 year. Materials and methods: Records of patients of IA admitted in our center from January 2015 to December 2015 were retrospectively analyzed. Demographic data, antenatal history, presenting complaints, location (duodenal, jejunoileal, colonic) of atresia, surgery performed and peri-operative complications were noted. Results: Total 78 cases of IA were included in the analyses...
October 2016: Journal of Neonatal Surgery
https://www.readbyqxmd.com/read/27893697/morbidity-and-mortality-predictivity-of-nutritional-assessment-tools-in-the-postoperative-care-unit
#16
Şule Özbilgin, Volkan Hanc, Dilek Ömür, Mücahit Özbilgin, Mine Tosun, Serhan Yurtlu, Semih Küçükgüçlü, Atalay Arkan
The aim was to evaluate the nutritional situation of patients admitted to the Postoperative Acute Care Unit using classic methods of objective anthropometry, systemic evaluation methods, and Nutrition Risk in Critically Ill (NUTRIC) score, and to compare them as a predictor of morbidity and mortality.At admission to the postoperative care unit, patients undergoing various surgeries were assessed for the following items: Subjective Global Assessment (SGA), Nutritional Risk Index (NRI), Nutritional Risk Screening (NRS)-2002, Mini Nutritional Assessment (MNA), Charlson comorbidity index (CCI), and NUTRIC score, anthropometric measurements, serum total protein, serum albumin, and lymphocyte count...
October 2016: Medicine (Baltimore)
https://www.readbyqxmd.com/read/27889271/assessment-of-perioperative-nutrition-practices-and-attitudes-a-national-survey-of-colorectal-and-gi-surgical-oncology-programs
#17
J D Williams, Paul E Wischmeyer
BACKGROUND: Implementation of evidence-based peri-operative nutrition in the U.S. is poorly described and hypothesized to be suboptimal. This study broadly describes practices and attitudes regarding nutrition screening/intervention in U.S. gastrointestinal and oncologic surgeons. METHODS: Nationwide nutritional practice survey of GI/Oncologic surgical faculty. RESULTS: Program response rates were 57% and 81% for colorectal and oncology fellowships, respectively...
November 17, 2016: American Journal of Surgery
https://www.readbyqxmd.com/read/27887932/assessing-national-provision-of-care-variability-in-bariatric-clinical-care-pathways
#18
Dana A Telem, Saniea F Majid, Kinga Powers, Eric DeMaria, John Morton, Daniel B Jones
BACKGROUND: The American Society for Metabolic and Bariatric Surgery (ASMBS) Quality Improvement and Patient Safety (QIPS) Committee hypothesized that collecting and sharing clinical pathways could provide a valuable resource to new and existing bariatric programs. OBJECTIVE: To shed light on the variability in practice patterns across the country by analyzing pathways. SETTING: United States Centers of Excellence METHODS: From June 2014 to April 2015, clinical pathways pertaining to preoperative, intraoperative, and postoperative management of bariatric patients were solicited from the ASMBS executive council (EC), QIPS committee members, and state chapter presidents...
August 3, 2016: Surgery for Obesity and related Diseases: Official Journal of the American Society for Bariatric Surgery
https://www.readbyqxmd.com/read/27886406/disrupted-pancreatic-duct-treated-with-a-combination-of-endoscopic-cystoduodenostomy-and-pancreatic-duct-fistualization-through-a-pseudocyst-wall-via-lumen-apposing-metal-stent
#19
Robert M Wilechansky, Ali S Khan, Amrita Sethi
The management of disconnected pancreatic duct syndrome is complex and is increasingly approached using emerging endoscopic techniques. Here, we present a case of recurrent pancreatitis in an elderly woman complicated by pseudocyst formation and complete pancreatic duct disruption. Her condition was treated with a novel combination of transpapillary stenting and cystduodenostomy in which a pancreatic duct stent was placed into an opening in the pseudocyst wall via lumen-apposing metal stent. This allowed for effective drainage into the gastrointestinal tract and resolution of duct disruption...
November 25, 2016: Digestive Endoscopy: Official Journal of the Japan Gastroenterological Endoscopy Society
https://www.readbyqxmd.com/read/27878457/poorly-understood-and-often-miscategorized-congenital-umbilical-cord-hernia-an-alternative-repair-method
#20
E İnce, A Temiz, S S Ezer, H Ö Gezer, A Hiçsönmez
PURPOSE: Umbilical cord hernia is poorly understood and often miscategorized as "omphalocele minor". Careless clamping of the cord leads to iatrogenic gut injury in the situation of umbilical cord hernia. This study aimed to determine the characteristics and outcomes of umbilical cord hernias. We also highlight an alternative repair method for umbilical cord hernias. METHODS: We recorded 15 cases of umbilical cord hernias over 10 years. The patients' data were retrospectively reviewed, and preoperative preparation of the newborn, gestational age, birth weight, other associated malformations, surgical technique used, enteral nutrition, and length of hospitalization were recorded...
November 22, 2016: Hernia: the Journal of Hernias and Abdominal Wall Surgery
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