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Anesthesia for liver surgery

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https://www.readbyqxmd.com/read/29690758/hyperthermia-associated-with-biliary-obstruction-during-living-donor-liver-transplantation
#1
Hyeryung Kang, Joohyun Park, Jeong Jin Lee, Gaab-Soo Kim
Intraoperative hypothermia occurs frequently, but hyperthermia is relatively rare during general anesthesia. We experienced a case of hyperthermia during living donor liver transplantation that appeared to be significantly associated with biliary obstruction. A 65-year-old male patient was diagnosed with intrahepatic cholangiocarcinoma, and living donor liver transplantation was planned after confirmation of no metastasis via intraoperative frozen biopsy. Following resection of a segment of common bile duct for frozen biopsy, the surgeon clamped the common bile duct, and the patient's body temperature increased gradually to 39...
April 25, 2018: Korean Journal of Anesthesiology
https://www.readbyqxmd.com/read/29630119/intramuscular-islet-allotransplantation-in-type-1-diabetes-mellitus
#2
F Bertuzzi, G Colussi, A Lauterio, L De Carlis
OBJECTIVE: Alternative sites to the liver for islet transplantation have been studied for a long time. Intramuscular islet transplantation appears to be an alternative site to the liver because of the ease of access. First islet autotransplantations were reported in patients after total pancreatectomies. The transplanted islets showed a proper revascularization and their function was observed for up to 2 years after the implant. However, only a few cases of autotransplantation and no allotransplantation have been performed...
March 2018: European Review for Medical and Pharmacological Sciences
https://www.readbyqxmd.com/read/29540661/assessment-of-renal-and-hepatic-tissue-protective-effects-of-n-acetylcysteine-via-ammonia-metabolism-a-prospective-randomized-study
#3
Didem Onk, Fatih Özçelik, Oruç Alper Onk, Murat Günay, Tülin Akarsu Ayazoğlu, Ethem Ünver
BACKGROUND The present study sought to assess the renal and liver protective effect of N-acetylcysteine through NH3 and urea metabolism in patients with chronic obstructive pulmonary disease who were scheduled for coronary artery bypass grafting surgery. MATERIAL AND METHODS Patients with chronic obstructive pulmonary disease (COPD) who were scheduled for coronary artery bypass grafting were divided into 2 groups so as to receive (Group 1, n=35) or not receive (Group 2, n=35) 900 mg/day of n-acetylcysteine for 7 days before the operation starting from their admission to the service by a pulmonologist with the purpose of treating COPD until the day of surgery...
March 15, 2018: Medical Science Monitor: International Medical Journal of Experimental and Clinical Research
https://www.readbyqxmd.com/read/29488444/rapid-recovery-of-liver-transplantation-recipients-by-implementation-of-fast-track-care-steps-what-is-holding-us-back
#4
Gianni Biancofiore, Dana Rodica Tomescu, M Susan Mandell
A body of scientific studies has shown that early extubation is safe and cost-effective in a large number of liver transplant (LT) recipients including pediatric patients. However, fast-track practices are not universally accepted, and debate still lingers about whether these interventions are safe and serve the patients' best interest. In this article, we focus on reasons why physicians still have a persistent, although diminishing, reluctance to adopt fast-track protocols. We stress the importance of collection/analysis of perioperative data, adoption of a consensus-based standardized protocol for perioperative care, and formation of LT anesthesia focused teams and leadership...
February 1, 2018: Seminars in Cardiothoracic and Vascular Anesthesia
https://www.readbyqxmd.com/read/29465210/-correction-energy-deficient-states-as-possible-perioperative-adaptation-of-cancer-hepatopancreatoduodenal-zone-patients
#5
O I Kit, S V Tumanyan, O V Oros, L G Ivanova, N V Netyvchenko, E Y Sugak
The aim of this study was to determine the role remaxol in complex intensive therapy of various jorms gipoergosis dur- ing the perioperative period in patients with hepatopancreatoduodenal zone malignancies. The treatment of 48 patients was analyzed. Immediately prior to surgery, at random, patients were divided into primary (n = 26) and control group (n = 22). In the study group for compensation the energy deficient states and organ hypoxia in the pancreas and the liver during the intra- and postoperative periods remaxol was included in the infusion therapy, the introduction ofwhich had been began before the start of anesthesia...
September 2017: Anesteziologiia i Reanimatologiia
https://www.readbyqxmd.com/read/29424263/intraoperative-transesophageal-echocardiogram-during-orthotopic-liver-transplantation-tee-to-the-rescue
#6
Lorenzo De Marchi, Janice Lee, Nina Rawtani, Vinh Nguyen
Supported by a growing number of studies and case reports in the literature, perioperative use of TEE in non-cardiac cases has significantly increased the past two decades. The utility of TEE in monitoring hemodynamic, and diagnosing causes of hypotension refractory to conventional therapy, have made it an almost indispensible tool during major surgeries, such liver transplantation. Despite this fact, compared to the adult population, there is a lack of an equivalent amount of literature on the perioperative use of TEE in pediatric cases...
February 1, 2018: Seminars in Cardiothoracic and Vascular Anesthesia
https://www.readbyqxmd.com/read/29423554/performance-of-a-second-generation-pulmonary-capnotracking-system-for-continuous-monitoring-of-cardiac-output
#7
Philip J Peyton, Monique Kozub
Technologies for minimally-invasive cardiac output measurement in patients during surgery remain little used in routine practice. We tested a redeveloped system based on CO 2 elimination (VCO 2 ) by the lungs for use in ventilated patients, which can be seamlessly integrated into a modern anesthesia/monitoring platform, and provides automated, continuous breath-by-breath cardiac output monitoring. A prototype measurement system was constructed to measure VCO 2 and end-tidal CO 2 concentration with each breath...
February 8, 2018: Journal of Clinical Monitoring and Computing
https://www.readbyqxmd.com/read/29335811/surgical-stress-response-and-promotion-of-metastasis-in-colorectal-cancer-a-complex-and-heterogeneous-process
#8
Corina Behrenbruch, Carolyn Shembrey, Sophie Paquet-Fifield, Christina Mølck, Hyun-Jung Cho, Michael Michael, Benjamin N J Thomson, Alexander G Heriot, Frédéric Hollande
Surgery remains the curative treatment modality for colorectal cancer in all stages, including stage IV with resectable liver metastasis. There is emerging evidence that the stress response caused by surgery as well as other perioperative therapies such as anesthesia and analgesia may promote growth of pre-existing micro-metastasis or potentially initiate tumor dissemination. Therapeutically targeting the perioperative period may therefore reduce the effect that surgical treatments have in promoting metastases, for example by combining β-adrenergic receptor antagonists and cyclooxygenase-2 (COX-2) inhibitors in the perioperative setting...
January 15, 2018: Clinical & Experimental Metastasis
https://www.readbyqxmd.com/read/29306581/pringle-maneuver-increases-the-risk-of-anastomotic-leakage-after-colonic-resection-in-rats
#9
Boris Jansen-Winkeln, Evangelos Tagkalos, Axel Heimann, Timo Gaiser, Daniela Hirsch, Ines Gockel, Jens Mittler, Hauke Lang, Stefan Heinrich
BACKGROUND: Many centers use the Pringle's maneuver during liver resections. Since this maneuver might impair healing of bowel anastomoses, we evaluated its influence on the healing of colonic anastomosis in rats. METHODS: Male Wistar rats underwent median laparotomy and sigmoid resection with end-to-end anastomosis under inhalation anesthesia. Thereafter, rats received a 25 minutes Pringle's maneuver (PM, group 1) or were kept under anesthesia for the same period of time (group 2)...
January 3, 2018: HPB: the Official Journal of the International Hepato Pancreato Biliary Association
https://www.readbyqxmd.com/read/29284893/anesthetic-management-of-a-parturient-with-hemolysis-elevated-liver-enzyme-levels-and-low-platelet-syndrome-complicated-by-renal-insufficiency-and-coagulopathy
#10
Jinguo Wang, Na Wang, Wei Han, Zhanyang Han
The objective of this study is to describe the anesthetic management of a parturient with hemolysis, elevated liver enzyme levels, and low platelet (HELLP) syndrome and renal insufficiency. A 28-year-old female patient, gestational age of 35 weeks, with hypertensive crisis (blood pressure 190/110 mmHg), was admitted for an emergency cesarean section after diagnosis of HELLP syndrome and renal insufficiency. We performed total intravenous general anesthesia with rapid sequence induction. During the surgical procedure, reduced urine output and coagulopathy were detected...
October 2017: Anesthesia, Essays and Researches
https://www.readbyqxmd.com/read/29274831/preoperative-cesarean-delivery-intravenous-acetaminophen-treatment-for-postoperative-pain-control-a-randomized-double-blinded-placebo-control-trial
#11
Craig V Towers, Sarah Shelton, Jaclyn van Nes, Emily Gregory, Emily Liske, Arion Smalley, Edward Mobley, Barbara Faircloth, Kim B Fortner
BACKGROUND: The United States currently has an opioid use disorder epidemic and research evaluating ways to minimize the use of opioids postsurgery are needed. One of these options is intravenous acetaminophen. If the use of preoperative intravenous acetaminophen was found to be effective for cesarean delivery, this would be beneficial for both the mother and breast-feeding neonate. OBJECTIVE: The primary study objective was to see if maternal opioid use was significantly less in the postoperative period for the study group that received 1 g of intravenous acetaminophen preoperatively compared with a control group that received placebo...
March 2018: American Journal of Obstetrics and Gynecology
https://www.readbyqxmd.com/read/29260920/potent-hemostatic-efficacy-of-a-novel-recombinant-fibrin-sealant-patch-ktf-374-in-rabbit-bleeding-models
#12
Sumika Miyabashira Tanaka, Takayuki Imamura, Miho Fujimoto, Akitoshi Ohno, Tsunefumi Kobayashi, Noriko Shinya
PURPOSE: Fibrin sealants are used for hemostasis during surgery. Commercially available fibrin sealants are made of materials of human or animal origin. We developed a novel recombinant fibrin sealant patch (KTF-374) that has thin and flexible properties. This study evaluated the hemostatic efficacy of KTF-374 for various patterns of bleeding in rabbits, as compared with that of the existing fibrin-coated collagen fleece (FCCF). MATERIALS AND METHODS: Test hemostats used were KTF-374 and FCCF...
December 20, 2017: Journal of Investigative Surgery: the Official Journal of the Academy of Surgical Research
https://www.readbyqxmd.com/read/29229261/preliminary-experience-in-combined-somatic-and-cerebral-oximetry-monitoring-in-liver-transplantation
#13
Tina Hu, Yves Collin, Réal Lapointe, François Martin Carrier, Luc Massicotte, Annik Fortier, Jean Lambert, Franck Vandenbroucke-Menu, André Y Denault
OBJECTIVE: The use of cerebral near-infrared spectroscopy (NIRS) has become widespread in cardiac surgery after research demonstrated an association between perioperative cerebral desaturations and postoperative complications. Somatic NIRS desaturation also is associated with an increased risk of postoperative complications and mortality. The objective of this study was to explore the trends of both somatic and cerebral NIRS during liver transplantation. DESIGN: A prospective, single-site, observational case series...
February 2018: Journal of Cardiothoracic and Vascular Anesthesia
https://www.readbyqxmd.com/read/29138380/-three-patients-with-gastric-cancer-who-underwent-surgery-during-ramucirumab-treatment
#14
Hayato Omori, Sadayuki Kawai, Rie Makuuchi, Tomoyuki Irino, Masanori Tokunaga, Yutaka Tanizawa, Etsuro Bando, Taiichi Kawamura, Hirofumi Yasui, Masanori Terashima
According to the REGARD and RAINBOW trials, ramucirumab(RAM)was introduced as second-line therapy for advanced or metastatic gastric cancer. RAM may impair wound healing due to the inhibition of angiogenesis; details on the postoperative course of patients who underwent surgery during RAM treatment remain unclear. Between 2011 and 2016, 93 patients with incurable gastric cancer were treated with RAM in our institute. Among them, 3 patients underwent surgery after RAM treatment. Case 1: A 74-year-old man with liver metastasis from gastric cancer was treated with a paclitaxel(PTX)plus RAM regimen...
November 2017: Gan to Kagaku Ryoho. Cancer & Chemotherapy
https://www.readbyqxmd.com/read/29108324/age-adjusted-charlson-comorbidity-index-score-as-predictor-of-survival-of-patients-with-digestive-system-cancer-who-have-undergone-surgical-resection
#15
Yaohua Tian, Zhong Jian, Beibei Xu, Hui Liu
Comorbidities have considerable effects on survival outcomes. The primary objective of this retrospective study was to examine the association between age-adjusted Charlson comorbidity index (ACCI) score and postoperative in-hospital mortality in patients with digestive system cancer who have undergone surgical resection of their cancers. Using electronic hospitalization summary reports, we identified 315,464 patients who had undergone surgery for digestive system cancer in top-rank (Grade 3A) hospitals in China between 2013 and 2015...
October 3, 2017: Oncotarget
https://www.readbyqxmd.com/read/29045240/prediction-of-thromboembolic-complications-after-liver-resection-for-cholangiocarcinoma-is-there-a-place-for-thromboelastometry
#16
Annabel Blasi, Victor Molina, Santiago Sanchez-Cabús, Jaume Balust, J Carlos Garcia-Valdecasas, Pilar Taura
: Postoperative venous thromboembolism has a poor prognosis in patients with cancer. We aimed to investigate the utility of thromboelastometry in detecting the risk of postoperative venous thromboembolism in patients with cholangiocarcinoma. We prospectively included patients submitted to liver resection for cholangiocarcinoma at our hospital between May 2011 and July 2014. Patients undergoing major hepatectomy for adult living donor transplantation in the same time period served as a control group. Thromboelastometry was performed before anesthesia...
January 2018: Blood Coagulation & Fibrinolysis: An International Journal in Haemostasis and Thrombosis
https://www.readbyqxmd.com/read/28992877/perioperative-fluid-management-in-major-hepatic-resection-an-integrative-review
#17
REVIEW
Osamu Yoshino, Marcos Vinicius Perini, Christopher Christophi, Laurence Weinberg
BACKGROUND: Fluid intervention and vasoactive pharmacological support during hepatic resection depend on the preference of the attending clinician, institutional resources, and practice culture. Evidence-based recommendations to guide perioperative fluid management are currently limited. Therefore, we provide a contemporary clinical integrative overview of the fundamental principles underpinning fluid intervention and hemodynamic optimization for adult patients undergoing major hepatic resection...
October 15, 2017: Hepatobiliary & Pancreatic Diseases International: HBPD INT
https://www.readbyqxmd.com/read/28922227/incidence-and-risk-factors-of-coagulation-profile-derangement-after-liver-surgery-implications-for-the-use-of-epidural-analgesia-a-retrospective-cohort-study
#18
Pierre Jacquenod, Grégoire Wallon, Mathieu Gazon, Benjamin Darnis, Pierre Pradat, Victor Virlogeux, Olivier Farges, Frédéric Aubrun
BACKGROUND: Hepatic surgery is a major abdominal surgery. Epidural analgesia may decrease the incidence of postoperative morbidities. Hemostatic disorders frequently occur after hepatic resection. Insertion or withdrawal (whether accidental or not) of an epidural catheter during coagulopathic state may cause an epidural hematoma. The aim of the study is to determine the incidence of coagulopathy after hepatectomy, interfering with epidural catheter removal, and to identify the risk factors related to coagulopathy...
September 14, 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28858130/effect-of-bispectral-index-guided-anesthesia-on-consumption-of-anesthetics-and-early-postoperative-cognitive-dysfunction-after-liver-transplantation-an-observational-study
#19
Ying-Hao Cao, Ping Chi, Yan-Xing Zhao, Xi-Chen Dong
The objective of this study was to summarize the incidence of postoperative cognitive dysfunction (POCD) after 7days following liver transplantation (LT), and to evaluate the effectiveness of bispectral index (BIS) guided anesthetic intervention in reducing POCD. Additional serum concentrations of S100β and neuron-specific enolase (NSE) were detected during surgery to determine whether they were reliable predictors of POCD.Patients who underwent LT at Beijing YouAn Hospital Affiliated to Capital University of Medical Science from January 2014 to December 2015 were enrolled...
September 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28833618/intra-operative-predictors-of-postoperative-takotsubo-syndrome-in-liver-transplant-recipients-an-exploratory-case-control-study
#20
Stephen Aniskevich, Ryan M Chadha, Prith Peiris, Cemal Burcin Taner, Klaus L Torp, Colleen S Thomas, Maria L Yataco, Sher-Lu Pai
INTRODUCTION: Takotsubo syndrome (TTS), also known as Takotsubo cardiomyopathy or stress-induced cardiomyopathy, has been described following a variety of surgeries and disease states. The relationship between intra-operative anesthesia management and the development of this syndrome has never been fully elucidated. OBJECTIVES: The primary objective of this study was to determine the relationship of multiple intra-operative factors on the pathogenesis of TTS. METHODS: A single-center retrospective review of all liver transplants performed at Mayo Clinic Florida from January 2005 to December 2014...
August 22, 2017: Clinical Transplantation
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