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Postoperative care

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https://www.readbyqxmd.com/read/29353444/mortality-is-rare-following-elective-and-non-elective-surgery-for-ulcerative-colitis-but-mild-postoperative-complications-are-common
#1
Joseph D Feuerstein, Thomas Curran, Michael Alosilla, Thomas Cataldo, Kenneth R Falchuk, Vitaliy Poylin
BACKGROUND DATA: Currently, data regarding the rates of morbidity and mortality following non-elective colectomy for ulcerative colitis (UC) are variable. We sought to determine the rates and predictors of 90-day mortality and complications following colectomy for UC. METHODS: Patients undergoing an initial surgery for UC at a tertiary care center between January 2002 and January 2014 were included. Patients were identified using ICD-9 code 556.x. Each record was manually reviewed for demographic information, medical histories, UC history, medications, and data regarding the admission and discharge...
January 20, 2018: Digestive Diseases and Sciences
https://www.readbyqxmd.com/read/29351034/postoperative-complications-following-lefort-1-maxillary-advancement-surgery-in-cleft-palate-patients-a-5-year-retrospective-study
#2
Isabelle Moran, Satnam Virdee, Ian Sharp, Jagdeep Sulh
OBJECTIVE: To investigate the postoperative complication rates of LeFort 1 maxillary advancement surgery in cleft patients when performed by a single surgeon over a 5-year period. DESIGN: A retrospective case note review of 79 cleft palate patients. SETTING: All surgery was performed by a single oral and maxillofacial surgeon in a tertiary care center. PARTICIPANTS: All cleft palate patients over 17 years of age who opted for surgical correction of maxillary hypoplasia with a LeFort 1 between 2010 and 2015...
February 2018: Cleft Palate-craniofacial Journal
https://www.readbyqxmd.com/read/29350594/determinants-of-perioperative-transfusion-risk-in-patients-with-adult-spinal-deformity
#3
Varun Puvanesarajah, Sandesh S Rao, Hamid Hassanzadeh, Khaled M Kebaish
OBJECTIVE To determine predictors of perioperative allogeneic packed red blood cell (pRBC) transfusion requirement (total units transfused) in patients with adult spinal deformity (ASD). METHODS The authors retrospectively analyzed records of patients aged 18 years or older who underwent surgical correction of ASD that involved 4 or more spinal levels by the same spine surgeon between 2010 and 2016. Data regarding patient characteristics, comorbidities, surgical factors, and perioperative transfusions (up to 10 days after surgery) were analyzed using a linear regression model...
January 19, 2018: Journal of Neurosurgery. Spine
https://www.readbyqxmd.com/read/29350570/benefits-of-laparoscopic-approach-for-resection-of-liver-tumors-in-cirrhotic-patients
#4
Fabien Le Roux, Lionel Rebibo, Cyril Cosse, Denis Chatelain, Eric Nguyen-Khac, Rachid Badaoui, Jean-Marc Regimbeau
INTRODUCTION: Liver resection in cirrhotic patients is associated with increased morbidity and mortality. The objective of this study was to compare short-term results of laparoscopic resection (LR) and open surgery (OS) for minor liver resection in patients with hepatocellular carcinoma (HCC) hepatocellularcarcinoma on nontumor cirrhotic liver (HCC/F4) and patients with colorectal cancer liver metastases (CRLMs) colorectal liver metastases on healthy liver (CRLM/F0). MATERIALS AND METHODS: Between January 2005 and December 2014, all patients undergoing liver resection (n = 754) were included in this study...
January 19, 2018: Journal of Laparoendoscopic & Advanced Surgical Techniques. Part A
https://www.readbyqxmd.com/read/29350363/is-nighttime-laparoscopic-general-surgery-under-general-anesthesia-safe
#5
Ahmet Kemalettin Koltka, Mehmet İlhan, Achmet Ali, Ali Fuat Kaan Gök, Nükhet Sivrikoz, Teoman Hakan Yanar, Mustafa Kayıhan Günay, Cemalettin Ertekin
BACKGROUND: Fatigue and sleep deprivation can affect rational decision-making and motor skills, which can decrease medical performance and quality of patient care. The aim of the present study was to investigate the association between times of the day when laparoscopic general surgery under general anesthesia was performed and their adverse outcomes. METHODS: All laparoscopic cholecystectomies and appendectomies performed at the emergency surgery department of a tertiary university hospital from 01...
January 2018: Ulusal Travma Ve Acil Cerrahi Dergisi, Turkish Journal of Trauma & Emergency Surgery: TJTES
https://www.readbyqxmd.com/read/29349529/esophageal-cancer-surgery-spontaneous-centralization-in-the-us-contributed-to-reduce-mortality-without-causing-health-disparities
#6
Francisco Schlottmann, Paula D Strassle, Anthony G Charles, Marco G Patti
BACKGROUND: Improvement in mortality has been shown for esophagectomies performed at high-volume centers. OBJECTIVE: This study aimed to determine if centralization of esophageal cancer surgery occurred in the US, and to establish its impact on postoperative mortality. In addition, we aimed to analyze the relationship between regionalization of cancer care and health disparities. METHODS: A retrospective population-based analysis was performed using the National Inpatient Sample for the period 2000-2014...
January 18, 2018: Annals of Surgical Oncology
https://www.readbyqxmd.com/read/29349484/overall-survival-of-papillary-thyroid-carcinoma-patients-a-single-institution-long-term-follow-up-of-5897-patients
#7
Yasuhiro Ito, Akira Miyauchi, Minoru Kihara, Mitsuhiro Fukushima, Takuya Higashiyama, Akihiro Miya
INTRODUCTION: Papillary thyroid carcinoma (PTC) generally shows an excellent prognosis except in cases with aggressive backgrounds or clinicopathological features. Although the cause-specific survival (CSS) of PTC patients has been extensively investigated, the overall survival (OS) of these patients is unclear. We herein investigated both the OS and CSS of a large PTC patient series. MATERIALS AND METHODS: We enrolled 5897 PTC patients who underwent initial surgery between 1987 and 2005 (658 males and 5339 females; median age 51 years)...
January 18, 2018: World Journal of Surgery
https://www.readbyqxmd.com/read/29349373/lower-extremity-compartment-syndrome-after-elective-percutaneous-fenestrated-endovascular-repair-of-an-abdominal-aortic-aneurysm
#8
John F Charitable, Thomas S Maldonado
Ischemic complications after fenestrated endovascular aortic aneurysm repair (FEVAR) can result in significant morbidity and mortality. We present a case of a 65-year-old man who underwent a FEVAR complicated by bilateral lower extremity compartment syndrome requiring four-compartment fasciotomies. This ischemic complication was likely caused by sheath occlusion because the patient had no evidence of arterial injury or distal plaque embolization. This case highlights the importance of careful postoperative monitoring after FEVAR, because the larger sheaths required can be occlusive and result in lower extremity ischemia, even for relatively short cases...
March 2017: Journal of Vascular Surgery Cases and Innovative Techniques
https://www.readbyqxmd.com/read/29349029/puncture-capsulotomy-during-hip-arthroscopy-for-femoroacetabular-impingement-preserving-anatomy-and-biomechanics
#9
William K Conaway, Scott D Martin
We describe an arthroscopic technique for the treatment of labral pathology and femoroacetabular impingement that provides excellent access to the central and peripheral compartments while preserving the biomechanically crucial components of hip joint stability. The hip capsule and the ligaments within it have been shown to be integral to hip biomechanical stability. Other popular techniques such as interportal and T-capsulotomy inherently damage the capsuloligamentous complex of the hip and can be associated with postoperative gross instability, micro-instability, heterotopic ossification, and seroma...
December 2017: Arthroscopy Techniques
https://www.readbyqxmd.com/read/29346558/thoraco-abdominal-aortic-aneurysm-rupture-in-a-patient-with-shprintzen-goldberg-syndrome
#10
Naritaka Kimura, Yu Inaba, Kaori Kameyama, Hideyuki Shimizu
Shprintzen-Goldberg syndrome is a rare systemic connective tissue disorder characterized by craniosynostosis, skeletal abnormalities, infantile hypotonia, mild-to-moderate intellectual disability and cardiovascular anomalies. To our knowledge, this is the first report of a Shprintzen-Goldberg syndrome patient who developed a thoraco-abdominal aortic aneurysm. The aneurysm grew rapidly necessitating emergent thoraco-abdominal aortic replacement. The postoperative course was uneventful, and a careful lifetime follow-up was planned...
January 16, 2018: Interactive Cardiovascular and Thoracic Surgery
https://www.readbyqxmd.com/read/29346187/quality-in-postoperative-patient-handover-different-perceptions-of-quality-between-transferring-and-receiving-nurses
#11
Elizabeth Reine, Johan Ræder, Tanja Manser, Milada C Småstuen, Tone Rustøen
This cross-sectional study assessed how nurses transferring and receiving patients in the postoperative care unit evaluate quality in patient handovers. Analysis of 192 questionnaires showed that transferring nurses had more positive evaluations of handover quality compared with the receiving nurses. Handovers evaluated as having lower quality had a higher frequency of time pressure, uncertainty, and clinical problems. The findings in the study point at a need to assess handover quality in a wider perspective...
January 16, 2018: Journal of Nursing Care Quality
https://www.readbyqxmd.com/read/29344689/early-versus-late-tracheostomy-in-trauma-patients-a-propensity-matched-cohort-study-of-5-years-data-at-a-single-institution-in-korea
#12
Byung Hee Kang, Jayun Cho, John Cook-Jong Lee, Kyoungwon Jung
BACKGROUND: Although there have been many studies dealing with tracheostomy timing in trauma patients, the optimal timing is still being debated. This study aimed to compare outcomes between early tracheostomy (ET) and late tracheostomy (LT) in trauma populations to estimate the optimal timing of tracheostomy after intubation. METHODS: We retrospectively reviewed the 5 years' data of trauma patients who underwent tracheostomy during their acute intensive care unit (ICU) stay...
January 17, 2018: World Journal of Surgery
https://www.readbyqxmd.com/read/29344022/role-of-body-mass-index-in-acute-kidney-injury-patients-after-cardiac-surgery
#13
Zhouping Zou, Yamin Zhuang, Lan Liu, Bo Shen, Jiarui Xu, Zhe Luo, Jie Teng, Chunsheng Wang, Xiaoqiang Ding
Background/Aims: To explore the association of body mass index (BMI) with the risk of developing acute kidney injury after cardiac surgery (CS-AKI) and for AKI requiring renal replacement therapy (AKI-RRT) after cardiac surgery. Methods: Clinical data of 8,455 patients undergoing cardiac surgery, including demographic preoperative, intraoperative, and postoperative data were collected. Patients were divided into underweight (BMI <18.5), normal weight (18.5≤ BMI <24), overweight (24≤ BMI <28), and obese (BMI ≥28) groups...
December 2017: Cardiorenal Medicine
https://www.readbyqxmd.com/read/29343246/influence-of-preoperative-life-satisfaction-on-recovery-and-outcomes-after-colorectal-cancer-surgery-a-prospective-pilot-study
#14
B Romain, O Rohmer, S Schimchowitsch, M Hübner, J B Delhorme, C Brigand, S Rohr, D Guenot
BACKGROUND: Colorectal surgery has an important impact on a patient's quality of life, and postoperative rehabilitation shows large variations. To enhance the understanding of recovery after colorectal cancer, health-related quality of life has become a standard outcome measurement for clinical care and research. Therefore, we aimed to correlate the influence of preoperative global life satisfaction on subjective feelings of well-being with clinical outcomes after colorectal surgery. METHODS: In this pilot study of consecutive colorectal surgery patients, various dimensions of feelings of preoperative life satisfaction were assessed using a self-rated scale, which was validated in French...
January 17, 2018: Health and Quality of Life Outcomes
https://www.readbyqxmd.com/read/29343048/physiology-intervention-and-outcome-three-critical-questions-about-cerebral-tissue-oxygen-saturation-monitoring
#15
Lingzhong Meng, Shaun E Gruenbaum, Feng Dai, Tianlong Wang
The balance between cerebral tissue oxygen consumption and supply can be continuously assessed by cerebral tissue oxygen saturation (SctO2) monitor. A construct consisting of three sequential questions, targeting the physiology monitored, the intervention implemented, and the outcomes affected, is proposed to critically appraise this monitor. The impact of the SctO2- guided care on patient outcome was examined through a systematic literature search and meta- analysis. We concluded that the physiology monitored by SctO2 is robust and dynamic, fragile (prone to derangement), and adversely consequential when deranged...
January 17, 2018: Minerva Anestesiologica
https://www.readbyqxmd.com/read/29341986/pulmonary-dead-space-fraction-and-extubation-success-in-children-after-cardiac-surgery
#16
Renee L Devor, Paul Kang, Chasity Wellnitz, John J Nigro, Daniel A Velez, Brigham C Willis
OBJECTIVES: 1) Determine the correlation between pulmonary dead space fraction and extubation success in postoperative pediatric cardiac patients; and 2) document the natural history of pulmonary dead space fractions, dynamic compliance, and airway resistance during the first 72 hours postoperatively in postoperative pediatric cardiac patients. DESIGN: A retrospective chart review. SETTING: Cardiac ICU in a quaternary care free-standing children's hospital...
January 16, 2018: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/29341940/mucocele-of-the-sphenoid-sinus
#17
Karen B Djambazov, Borislav D Kitov, Christo B Zhelyazkov, Atanas N Davarski, Alexandrina R Topalova
Mucocele of the paranasal sinuses is a rare disease with slow evolution. It is a benign, encapsulated and destructive formation filled with mucous fluid and tapistrated with respiratory epithelium. Of all the paranasal sinuses, the sphenoid sinus is affected in only 1-7% of the cases. We present two cases of mucocele of the sphenoid sinus involving the posterior ethmoidal cells. We consider here their clinical presentation, use of neuroimaging in the diagnosis, surgical care and postoperative results. Both patients presented with a history of persistent headache and in addition, one of them had a paresis of the right oculomotor and abducens nerves...
December 20, 2017: Folia Medica
https://www.readbyqxmd.com/read/29341066/cerebral-near-infrared-spectroscopy-nirs-for-perioperative-monitoring-of-brain-oxygenation-in-children-and-adults
#18
REVIEW
Yun Yu, Kaiying Zhang, Ling Zhang, Huantao Zong, Lingzhong Meng, Ruquan Han
BACKGROUND: Various techniques have been employed for the early detection of perioperative cerebral ischaemia and hypoxia. Cerebral near-infrared spectroscopy (NIRS) is increasingly used in this clinical scenario to monitor brain oxygenation. However, it is unknown whether perioperative cerebral NIRS monitoring and the subsequent treatment strategies are of benefit to patients. OBJECTIVES: To assess the effects of perioperative cerebral NIRS monitoring and corresponding treatment strategies in adults and children, compared with blinded or no cerebral oxygenation monitoring, or cerebral oxygenation monitoring based on non-NIRS technologies, on the detection of cerebral oxygen desaturation events (CDEs), neurological outcomes, non-neurological outcomes and socioeconomic impact (including cost of hospitalization and length of hospital stay)...
January 17, 2018: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/29340924/impact-of-preoperative-opioid-use-after-emergency-general-surgery
#19
Young Kim, Alexander R Cortez, Koffi Wima, Vikrom K Dhar, Krishna P Athota, Jason J Schrager, Timothy A Pritts, Michael J Edwards, Shimul A Shah
BACKGROUND: Preoperative exposure to narcotics has recently been associated with poor outcomes after elective major surgery, but little is known as to how preoperative opioid use impacts outcomes after common, emergency general surgical procedures (EGS). METHODS: A high-volume, single-center analysis was performed on patients who underwent EGS from 2012 to 2013. EGS was defined as the seven emergent operations that account for 80% of the national burden. Preoperative opioid use was defined as having an active opioid prescription within 7 days prior to surgery...
January 16, 2018: Journal of Gastrointestinal Surgery: Official Journal of the Society for Surgery of the Alimentary Tract
https://www.readbyqxmd.com/read/29340920/pure-laparoscopic-transhepatic-enucleation-of-a-mucinous-cystic-neoplasm-abutting-the-major-hepatic-veins-at-the-hepatocaval-confluence-with-video
#20
Ji Hoon Kim
BACKGROUND: A mucinous cystic neoplasm (MCN) of the liver is a rare disease entity, occurring predominantly in the left hemiliver as reported by Simo et al.1 Thomas et al.2 and Vogt et al.3 Surgical resection of tumors at the hepatocaval confluence is a technically demanding procedure. Enucleation procedures have been performed for the management of benign or premalignant lesions such as cystic tumors as previously described by Thomas et al.2 and Vogt et al.3. We present a patient who underwent pure laparoscopic transhepatic enucleation to treat a MCN abutting the major hepatic veins at the hepatocaval confluence...
January 16, 2018: Journal of Gastrointestinal Surgery: Official Journal of the Society for Surgery of the Alimentary Tract
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