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Surgical nutrition

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https://www.readbyqxmd.com/read/28107301/implementation-of-a-pediatric-orthopaedic-bundle-to-reduce-surgical-site-infections
#1
Jan Schriefer, James Sanders, Julie Michels, Kori Wolcott, Connor Ruddy, Jenna Hanson
Surgical site infections (SSIs) cost an estimated $27,288 per case. An analysis of the National Surgical Quality Improvement Program data at the University of Rochester Medical Center suggested that rates of SSIs could be lowered in comparison with both peers and baseline. The aim of this study was to reduce the number of SSIs to zero through the implementation of a "bundle" or a combination of practices. Meetings were held with the multidisciplinary care team that includes surgeons and staff from pediatric pharmacy, pediatric infectious diseases, anesthesia, and nursing to create a care bundle for all pediatric orthopaedic surgery patients...
January 2017: Orthopaedic Nursing
https://www.readbyqxmd.com/read/28107284/postsurgical-perforation-of-the-esophagus-can-be-treated-using-a-fully-covered-stent-in-children
#2
Chantal Chauvet, Arnaud Bonnard, Alexis Mosca, Marc Bellaïche, Pascale Philippe-Chomette, Jérôme Viala
OBJECTIVES: Surgery and conservative treatment of esophageal or gastric perforations are both often associated with poor results and carry a high morbidity and mortality rate. The aim of the present study was to evaluate the effectiveness and safety of using fully covered self-expending metallic stents (SEMS) in children with upper digestive leaks. METHODS: This retrospective study reviewed all children with esophageal or gastric perforation who were treated with placement of an SEMS from January 2011 to January 2015...
February 2017: Journal of Pediatric Gastroenterology and Nutrition
https://www.readbyqxmd.com/read/28107096/implementation-of-an-aggressive-enteral-nutrition-protocol-and-the-effect-on-clinical-outcomes
#3
Daniel Dante Yeh, Catrina Cropano, Sadeq A Quraishi, Eva Fuentes, Haytham M A Kaafarani, Jarone Lee, Yuchiao Chang, George Velmahos
BACKGROUND: Macronutrient deficiency in critical illness is associated with worse outcomes. We hypothesized that an aggressive enteral nutrition (EN) protocol would result in higher macronutrient delivery and fewer late infections. METHODS: We enrolled adult surgical intensive care unit (ICU) patients receiving >72 hours of EN from July 2012 to June 2014. Our intervention consisted of increasing protein prescription (2.0-2.5 vs 1.5-2.0 g/kg/d) and compensatory feeds for EN interruption...
January 1, 2017: Nutrition in Clinical Practice
https://www.readbyqxmd.com/read/28103699/vitamin-d-alteration-associated-with-obesity-and-bariatric-surgery
#4
Eric Lespessailles, Hechmi Toumi
Obesity and severe obesity constitute growing serious health problems reaching epidemic proportion in most countries. Interactions and relationships between obesity and bone tissue and its metabolism are complex but are more and more studied and recognized. Obesity is associated with an altered hormonal profile including particularly bone-regulating hormones like vitamin D. Bariatric surgery procedures, thanks to their effectiveness to achieve therapeutic endpoints for comorbidities associated with obesity, have had an increasing success...
January 1, 2017: Experimental Biology and Medicine
https://www.readbyqxmd.com/read/28096129/current-knowledge-of-necrotizing-enterocolitis-in-preterm-infants-and-the-impact-of-different-types-of-enteral-nutrition-products
#5
REVIEW
Jocelyn Shulhan, Bryan Dicken, Lisa Hartling, Bodil Mk Larsen
Preterm infants are extremely vulnerable to a range of morbidities and mortality. Underdeveloped cardiac, respiratory, gastrointestinal, and immune systems in the preterm period increase the risk of necrotizing enterocolitis (NEC), a serious disease of the gut. NEC affects 5-12% of very-low birth-weight infants, leads to surgery in 20-40% of cases, and is fatal in 25-50% of cases. There are multiple factors that may contribute to NEC, but the exact cause is not yet fully understood. Severe cases can result in intestinal resection or death, and the health care costs average >$300,000/infant when surgical management is required...
January 2017: Advances in Nutrition
https://www.readbyqxmd.com/read/28094538/the-obesity-paradox-in-colorectal-cancer-surgery-an-analysis-of-korean-healthcare-big-data-2012-2013
#6
Sanghun Lee
Although it is well known that obesity increases the risk of colorectal cancer, several studies have recently suggested that those who are overweight or class-one obese have better outcomes after surgery. However, the impact of obesity on the success of colorectal cancer surgery remains controversial. The medical records of patients diagnosed with colorectal cancer who were treated surgically from 2012 through 2013 were retrospectively analyzed. Data from a total of 36,740 patients were provided by the Healthcare Big Data Hub of the Korean Health Insurance Review & Assessment Service...
January 17, 2017: Nutrition and Cancer
https://www.readbyqxmd.com/read/28093897/presence-of-early-stage-cancer-does-not-impair-the-early-protein-metabolic-response-to-major-surgery
#7
Mariëlle P K J Engelen, V Suzanne Klimberg, Arianna Allasia, Nicolaas Ep Deutz
BACKGROUND: Combined bilateral mastectomy and reconstruction is a common major surgical procedure in women with breast cancer and in those with a family history of breast cancer. As this large surgical procedure induces muscle protein loss, a preserved anabolic response to nutrition is warranted for optimal recovery. It is unclear whether the presence of early stage cancer negatively affects the protein metabolic response to major surgery as this would mandate perioperative nutritional support...
January 16, 2017: Journal of Cachexia, Sarcopenia and Muscle
https://www.readbyqxmd.com/read/28091846/risk-factors-of-surgical-site-infections-in-patients-with-crohn-s-disease-complicated-with-gastrointestinal-fistula
#8
Kun Guo, Jianan Ren, Guanwei Li, Qiongyuan Hu, Xiuwen Wu, Zhiwei Wang, Gefei Wang, Guosheng Gu, Huajian Ren, Zhiwu Hong, Jieshou Li
PURPOSE: Surgical site infection (SSI) is the most common complication following surgical procedures. This study aimed to determine risk factors associated with SSI in patients with Crohn's disease (CD) complicated with gastrointestinal fistula. METHODS: This was a retrospective review of patients who underwent surgical resection in gastrointestinal fistula patients with CD between January 2013 and January 2015, identified from a prospectively maintained gastrointestinal fistula database...
January 16, 2017: International Journal of Colorectal Disease
https://www.readbyqxmd.com/read/28090472/prevalence-and-risk-factors-for-the-weight-loss-during-hospitalization-in-children-a-single-korean-children-s-hospital-experience
#9
Eun Ha Hwang, Jae Hong Park, Peter Chun, Yeoun Joo Lee
PURPOSE: Undernutrition during hospitalization increases the risk of nosocomial infection and lengthens the disease courses. The aim of this study was to evaluate the risk factors of weight loss during hospitalization in children. METHODS: All the patients who were admitted in general wards between April and May 2014 were enrolled. Patients aged >18 years and discharged within 2 days were excluded. Weight loss during hospitalization was defined as a decrease in body weight of >2% in 8 hospital days or on the day of discharge...
December 2016: Pediatric Gastroenterology, Hepatology & Nutrition
https://www.readbyqxmd.com/read/28072447/randomized-clinical-trial-comparing-standard-diet-with-perioperative-oral-immunonutrition-in-total-gastrectomy-for-gastric-cancer
#10
S Ida, N Hiki, H Cho, K Sakamaki, S Ito, K Fujitani, N Takiguchi, Y Kawashima, K Nishikawa, M Sasako, T Aoyama, M Honda, T Sato, S Nunobe, T Yoshikawa
BACKGROUND: Total gastrectomy for gastric cancer is associated with excessive weight loss and decreased calorie intake. Nutritional support using eicosapentaenoic acid modulates immune function and limits catabolism in patients with advanced cancer, but its impact in the perioperative period is unclear. METHODS: This was a randomized phase III clinical trial of addition of eicosapentaenoic acid-rich nutrition to a standard diet in patients having total gastrectomy for gastric cancer...
January 10, 2017: British Journal of Surgery
https://www.readbyqxmd.com/read/28068906/cherish-collaboration-for-hospitalised-elders-reducing-the-impact-of-stays-in-hospital-protocol-for-a-multi-site-improvement-program-to-reduce-geriatric-syndromes-in-older-inpatients
#11
Alison M Mudge, Merrilyn D Banks, Adrian G Barnett, Irene Blackberry, Nicholas Graves, Theresa Green, Gillian Harvey, Ruth E Hubbard, Sharon K Inouye, Sue Kurrle, Kwang Lim, Prue McRae, Nancye M Peel, Jessica Suna, Adrienne M Young
BACKGROUND: Older inpatients are at risk of hospital-associated geriatric syndromes including delirium, functional decline, incontinence, falls and pressure injuries. These contribute to longer hospital stays, loss of independence, and death. Effective interventions to reduce geriatric syndromes remain poorly implemented due to their complexity, and require an organised approach to change care practices and systems. Eat Walk Engage is a complex multi-component intervention with structured implementation, which has shown reduced geriatric syndromes and length of stay in pilot studies at one hospital...
January 9, 2017: BMC Geriatrics
https://www.readbyqxmd.com/read/28067101/promoting-a-culture-of-prehabilitation-for-the-surgical-cancer-patient
#12
Francesco Carli, Chelsia Gillis, Celena Scheede-Bergdahl
BACKGROUND: Traditional rehabilitative approaches to perioperative cancer care have focused on the postoperative period to facilitate the return to presurgical baseline conditions. However, there is some realization that the preoperative period can be a very effective time for intervention as the patients are more amenable to target their physiological condition to prepare to overcome the metabolic cost of the surgical stress. METHODS: We undertook a narrative review of the current literature on surgical prehabilitation and discussed the current evidence of preoperative interventions before cancer surgery in order to increase physiological reserve before surgery and accelerate postoperative recovery...
January 9, 2017: Acta Oncologica
https://www.readbyqxmd.com/read/28065734/laparoscopic-roux-en-y-gastric-bypass-in-adolescents-with-severe-obesity-amos-a-prospective-5-year-swedish-nationwide-study
#13
Torsten Olbers, Andrew J Beamish, Eva Gronowitz, Carl-Erik Flodmark, Jovanna Dahlgren, Gustaf Bruze, Kerstin Ekbom, Peter Friberg, Gunnar Göthberg, Kajsa Järvholm, Jan Karlsson, Staffan Mårild, Martin Neovius, Markku Peltonen, Claude Marcus
BACKGROUND: Severe obesity in adolescence is associated with reduced life expectancy and impaired quality of life. Long-term benefits of conservative treatments in adolescents are known to be modest, whereas short-term outcomes of adolescent bariatric surgery are promising. We aimed to compare 5-year outcomes of adolescent surgical patients after Roux-en-Y gastric bypass with those of conservatively treated adolescents and of adults undergoing Roux-en-Y gastric bypass, in the Adolescent Morbid Obesity Surgery (AMOS) study...
January 5, 2017: Lancet Diabetes & Endocrinology
https://www.readbyqxmd.com/read/28062328/optimal-nutrition-and-hydration-through-the-surgical-treatment-trajectory
#14
REVIEW
Carol DeNysschen, Mary E Platek, Drew Hemler, Nell Aronoff, Michelle L Zafron
OBJECTIVES: To review oncology nurses role of informational continuity in regards to nutrition and hydration to ensure continuity of care from one care center to another. DATA SOURCES: Peer-reviewed literature, PubMed, CINAHL, EMBASE, and web-based resources. CONCLUSION: Optimal nutrition and hydration during cancer treatment and survivorship requires assessment and preplanning of needs. Oncology nurses play a vital role in preparing patients and caregivers for optimal nutrition during the surgical treatment trajectory...
January 4, 2017: Seminars in Oncology Nursing
https://www.readbyqxmd.com/read/28061521/quality-of-life-after-surgical-treatment-for-esophageal-atresia-long-term-outcome-of-154-patients
#15
Alice Catherine Hölscher, Michael Laschat, Vera Choinitzki, Nadine Zwink, Ekkehart Jenetzky, Oliver Münsterer, Ralf Kurz, Marcus Pauly, Ulrike Brokmeier, Andreas Leutner, Benno Ure, Martin Lacher, Johannes Schumacher, Heiko Reutter, Thomas Michael Boemers
Background The short- and long-term surgical results in patients with esophageal atresia (EA) with or without tracheoesophageal fistula (TEF) have been described in depth from a physician's perspective. Contrarily, the perception and coping strategies of affected patients and their parents have rarely been reported. The aim of this study was to generate data on this matter. Patients and Methods A total of 154 patients who had operative reconstruction for EA between 1971 and 2012 were evaluated for demographic data, surgical technique, affection of daily life, and coping strategies...
January 6, 2017: European Journal of Pediatric Surgery
https://www.readbyqxmd.com/read/28057249/transposition-of-the-great-arteries-in-the-developing-world-surgery-and-outcomes
#16
David N Schidlow, Kathy J Jenkins, Kimberlee Gauvreau, Ulisses A Croti, Do Thi Cam Giang, Rama K Konda, William M Novick, Nestor F Sandoval, Aldo Castañeda
BACKGROUND: Little has been published regarding surgery for transposition of the great arteries (TGA) in the developing world. OBJECTIVES: This study sought to identify patient characteristics, surgical interventions, institutional characteristics, risk factors for mortality, and outcomes among patients undergoing surgery for TGA in this setting. METHODS: Developing world congenital heart surgical programs submitted de-identified data to a novel international collaborative database as part of a quality improvement project...
January 3, 2017: Journal of the American College of Cardiology
https://www.readbyqxmd.com/read/28054107/-evidence-based-supportive-measures-to-secure-pancreatic-anastomoses
#17
O Belyaev, W Uhl
BACKGROUND: Pancreatic anastomosis is the Achilles heel of pancreatic surgery. Despite substantial progress in surgical techniques the rate of postoperative pancreatic fistulas remains very high. For this reason various supportive measures to secure pancreatic anastomoses are of continuing interest. OBJECTIVE: This review presents the newest evidence-based data on supportive measures designed to secure a pancreatic anastomosis. MATERIAL AND METHODS: The most recent meta-analyses, randomized controlled trials and the largest retrospective studies on the role of pancreatic duct stenting, double loop reconstruction, autologous patches and drainage in pancreaticoduodenectomy were taken into account...
January 2017: Der Chirurg; Zeitschrift Für Alle Gebiete der Operativen Medizen
https://www.readbyqxmd.com/read/28052886/intestinal-rehabilitation-for-children-with-intestinal-failure-is-cost-effective-a-simulation-study
#18
Henk Groen, Esther G Neelis, Marten J Poley, Joanne F Olieman, René Scheenstra, Paul Fm Krabbe, Gerard Dijkstra, Edmond Hhm Rings
BACKGROUND: Children with intestinal failure (IF) depend on parenteral nutrition (PN). The goal in the treatment of IF is to wean children off PN through intestinal rehabilitation (IR). Although the healthcare burden of IF is enormous, to our knowledge there has been no previous cost-effectiveness analysis in pediatric IF including IR. OBJECTIVE: We sought to determine the cost-effectiveness of IR in terms of costs and life-years. DESIGN: We simulated the treatment of IF in children in a discrete-event model...
January 4, 2017: American Journal of Clinical Nutrition
https://www.readbyqxmd.com/read/28052576/pre-operative-oral-nutritional-supplementation-with-dietary-advice-versus-dietary-advice-alone-in-weight-losing-patients-with-colorectal-cancer-single-blind-randomized-controlled-trial
#19
Sorrel T Burden, Debra J Gibson, Simon Lal, James Hill, Mark Pilling, Mattias Soop, Aswatha Ramesh, Chris Todd
BACKGROUND: Pre-operative weight loss has been consistently associated with increased post-operative morbidity. The study aims to determine if pre-operative oral nutritional supplements (ONSs) with dietary advice reduce post-operative complications. METHODS: Single-blinded randomized controlled trial. People with colorectal cancer scheduled for surgery with pre-operative weight loss >1 kg/3-6 months were randomized by using stratified blocks (1:1 ratio) in six hospitals (1 November 2013-28 February 2015)...
January 3, 2017: Journal of Cachexia, Sarcopenia and Muscle
https://www.readbyqxmd.com/read/28052307/ultrashort-bowel-syndrome-outcome-in-children-treated-in-a-multidisciplinary-intestinal-rehabilitation-unit
#20
Mariela Dore, Paloma Triana Junco, Ane Andres Moreno, Vanesa Nuñez Cerezo, Martha Romo Muñoz, Alba Sánchez Galán, Alejandra Vilanova Sánchez, Gerardo Prieto, Esther Ramos, Francisco Hernandez, Leopoldo Martínez Martínez, Manuel Lopez Santamaria
Aim Short bowel syndrome (SBS) is the leading cause of intestinal failure (IF) in the pediatric population. Our aim was to review long-term outcome of ultrashort bowel syndrome (USBS) in an Intestinal Rehabilitation Unit (IRU). Patients and Methods Retrospective study of patients with USBS (defined as < 10 cm of remnant small bowel) treated between 2000 and 2015. Demographic data, clinical, and treatment variables including parenteral nutrition (PN), surgical techniques, and intestinal transplantation (IT) were analyzed...
January 4, 2017: European Journal of Pediatric Surgery
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