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Perioperative blood management

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https://www.readbyqxmd.com/read/28921529/metastatic-spine-tumor-surgery-does-perioperative-blood-transfusion-influence-postoperative-complications
#1
Aye Sandar Zaw, Shashidhar B Kantharajanna, Karthikeyan Maharajan, Barry Tan, Amarasinghe A Saparamadu, Naresh Kumar
BACKGROUND: The question of independent association between allogeneic blood transfusion (ABT) and postoperative complications in cancer surgeries has been controversial and remains so. In metastatic spine tumor surgery (MSTS), previous studies investigated the influence of ABT on survival, but not on postoperative complications. We aimed to evaluate the influence of perioperative ABT on postoperative complications and infections in patients undergoing MSTS. STUDY DESIGN AND METHODS: This retrospective study included 247 patients who underwent MSTS at a single tertiary institution between 2005 and 2014...
September 16, 2017: Transfusion
https://www.readbyqxmd.com/read/28916408/robot-assisted-kidney-transplantation-the-european-experience
#2
Alberto Breda, Angelo Territo, Luis Gausa, Volkan Tuğcu, Antonio Alcaraz, Mireia Musquera, Karel Decaestecker, Liesbeth Desender, Michael Stockle, Martin Janssen, Paolo Fornara, Nasreldin Mohammed, Giampaolo Siena, Sergio Serni, Luis Guirado, Carma Facundo, Nicolas Doumerc
BACKGROUND: Robot-assisted kidney transplantation (RAKT) has recently been introduced to reduce the morbidity of open kidney transplantation (KT). OBJECTIVE: To evaluate perioperative and early postoperative RAKT outcomes. DESIGN, SETTING AND PARTICIPANTS: This was a multicenter prospective observational study of 120 patients who underwent RAKT, predominantly with a living donor kidney, in eight European institutions between July 2015 and May 2017, with minimum follow-up of 1 mo...
September 12, 2017: European Urology
https://www.readbyqxmd.com/read/28913958/preoperative-nutritional-management-of-bariatric-patients-in-australia-the-current-practice-of-dietitians
#3
Ruth Bourne, Judith Tweedie, Fiona Pelly
AIM: The aim of this observational study was to investigate the reported practices of Australian dietitians managing bariatric surgery patients in the preoperative stage. METHODS: An online survey of dietitians providing nutritional care to bariatric patients was developed for the purpose of this investigation. The survey questions were guided by the Clinical Practice Guidelines for the Perioperative Nutritional, Metabolic and Nonsurgical Support of the Bariatric Surgery Patient guidelines and current literature...
September 15, 2017: Nutrition & Dietetics: the Journal of the Dietitians Association of Australia
https://www.readbyqxmd.com/read/28913494/the-public-perception-of-the-anaesthesiologist-in-romania-a-survey
#4
Adela Hilda Onutu, Cristina Rus, Iurie Acalovschi
BACKGROUND: Previous studies have shown that the public perception of anaesthesiologists' duties regarding perioperative management lacks a good understanding. The aim of this study was to assess the public perception of the anaesthesiologist's role before, during and after surgery, in Romania. METHOD: The prospective cross-sectional study was undertaken between January 2015 and August 2016. A questionnaire that comprised 23 questions was uploaded on Google at https://docs...
April 2017: Rom J Anaesth Intensive Care
https://www.readbyqxmd.com/read/28894686/risk-factors-for-delirium-after-spine-surgery-in-extremely-elderly-patients-aged-80-years-or-older-and-review-of-the-literature-japan-association-of-spine-surgeons-with-ambition-multicenter-study
#5
Kazuyoshi Kobayashi, Shiro Imagama, Kei Ando, Naoki Ishiguro, Masaomi Yamashita, Yawara Eguchi, Morio Matsumoto, Ken Ishii, Tomohiro Hikata, Shoji Seki, Hidetomi Terai, Akinobu Suzuki, Koji Tamai, Masaaki Aramomi, Tetsuhiro Ishikawa, Atsushi Kimura, Hirokazu Inoue, Gen Inoue, Masayuki Miyagi, Wataru Saito, Kei Yamada, Michio Hongo, Yuji Matsuoka, Hidekazu Suzuki, Atsushi Nakano, Kazuyuki Watanabe, Hirotaka Chikuda, Junichi Ohya, Yasuchika Aoki, Masayuki Shimizu, Toshimasa Futatsugi, Keijiro Mukaiyama, Masaichi Hasegawa, Katsuhito Kiyasu, Haku Iizuka, Yoichi Iizuka, Ryoichi Kobayashi, Kotaro Nishida, Kenichiro Kakutani, Hideaki Nakajima, Hideki Murakami, Satoru Demura, Satoshi Kato, Katsuhito Yoshioka, Takashi Namikawa, Kei Watanabe, Kazuyoshi Nakanishi, Yukihiro Nakagawa, Mitsunori Yoshimoto, Hiroyasu Fujiwara, Norihiro Nishida, Yasuaki Imajo, Masashi Yamazaki, Masataka Sakane, Tetsuya Abe, Kengo Fujii, Takashi Kaito, Takeo Furuya, Sumihisa Orita, Seiji Ohtori
STUDY DESIGN: Retrospective database analysis. OBJECTIVE: Spine surgeries in elderly patients have increased in recent years due to aging of society and recent advances in surgical techniques, and postoperative complications have become more of a concern. Postoperative delirium is a common complication in elderly patients that impairs recovery and increases morbidity and mortality. The objective of the study was to analyze postoperative delirium associated with spine surgery in patients aged 80 years or older with cervical, thoracic, and lumbar lesions...
September 2017: Global Spine Journal
https://www.readbyqxmd.com/read/28885412/outcomes-associated-with-a-five-point-surgical-site-infection-prevention-bundle-in-women-undergoing-surgery-for-ovarian-cancer
#6
Melissa H Lippitt, Melissa Gerardi Fairbairn, Rayna Matsuno, Rebecca L Stone, Edward J Tanner, Elizabeth C Wick, Ana C Angarita, Kara Long Roche, Kimberly L Levinson, Jennifer E Bergstrom, Abdulrahman K Sinno, Melanie S Curless, Stephanie Wethington, Sarah M Temkin, Jonathan Efron, Deborah Hobson, Amanda N Fader
OBJECTIVE: To identify risk factors for surgical site infection and to define rates associated with cytoreductive surgery before and after implementation of an infection prevention bundle. METHODS: We conducted a prospective quality improvement study. Patients who underwent ovarian, fallopian tube, or peritoneal cancer cytoreductive surgery at an academic tertiary care center from April 2014 to April 2016 were prospectively enrolled. Patient demographics, surgical variables, and surgical site infection rates were compared with a historical cohort after introduction of a 5-point infection prevention bundle, including: 1) preoperative and intraoperative skin preparation with 4% chlorhexidine and intraoperative vaginal preparation with 4% chlorhexidine; 2) preoperative use of oral antibiotics and mechanical bowel preparation; 3) appropriate timing of intraoperative antibiotics; 4) adoption of enhanced sterile surgical techniques for colon procedures and incisional closure; and 5) perioperative incision management...
September 5, 2017: Obstetrics and Gynecology
https://www.readbyqxmd.com/read/28876572/haemoperitoneum-secondary-to-snake-bite
#7
S Rahim
BACKGROUND: Literature supports that very rarely the venom of "Hemotoxic Snake" (Russell's Vipers) affect haemostasis by secreting thrombin-like enzyme which promotes formation of unstable clots. Such clots could lead to fibrin deposition in micro circulation that in turn consume platelets and coagulation factors (consumption coagulopathy). Clinical presentation is mainly spontaneous bleeding and coagulopathy. In this case the significant effects of altered coagulation were observed in retropetitoneum and the patient presented in casuality as acute abdomen...
September 2017: South African Journal of Surgery. Suid-Afrikaanse Tydskrif Vir Chirurgie
https://www.readbyqxmd.com/read/28875952/role-of-r-e-n-a-l-nephrometry-score-in-laparoscopic-partial-nephrectomy
#8
Hai-Jiang Zhou, Yong Yan, Jian-Zhong Zhang, Li-Rong Liang, Shu-Bin Guo
Background: Preoperative anatomical scoring system is conducive to comparison between treatment options and evaluation of postoperative outcomes in patients with small renal tumors. This study aimed to evaluate the clinical application efficacy of the R.E.N.A.L. nephrometry score (RNS) in predicting perioperative outcomes in patients with renal tumor who underwent laparoscopic partial nephrectomy (LPN). Methods: The clinical data of 139 patients with renal tumors who underwent LPN between 2009 and 2015 were collected and analyzed...
September 20, 2017: Chinese Medical Journal
https://www.readbyqxmd.com/read/28874960/impact-of-laparoscopic-liver-resection-on-bleeding-complications-in-patients-receiving-antithrombotics
#9
Takahisa Fujikawa, Hiroshi Kawamoto, Yuichiro Kawamura, Norio Emoto, Yusuke Sakamoto, Akira Tanaka
AIM: To assess the impact of laparoscopic liver resection (LLR) on surgical blood loss (SBL), especially in patients with antithrombotics for thromboembolic risks. METHODS: Consecutive 258 patients receiving liver resection at our institution between 2010 and 2016 were retrospectively reviewed. Preoperative antithrombotic therapy (ATT; antiplatelets and/or anticoagulation) was regularly used in 100 patients (ATT group, 38.8%) whereas not used in 158 (non-ATT group, 61...
August 16, 2017: World Journal of Gastrointestinal Endoscopy
https://www.readbyqxmd.com/read/28870300/enhancing-recovery-after-total-knee-arthroplasty
#10
REVIEW
Richard W Rutherford, Jason M Jennings, Douglas A Dennis
There have been multiple successful efforts to improve and shorten the recovery period after elective total joint arthroplasty. The development of rapid recovery protocols through a multidisciplinary approach has occurred in recent years to improve patient satisfaction as well as outcomes. Bundled care payment programs and the practice of outpatient total joint arthroplasty have provided additional pressure and incentives for surgeons to provide high-quality care with low cost and complications. In this review, the evidence for modern practices are reviewed regarding patient selection and education, anesthetic techniques, perioperative pain management, intraoperative factors, blood management, and postoperative rehabilitation...
October 2017: Orthopedic Clinics of North America
https://www.readbyqxmd.com/read/28870052/-clinical-efficacy-of-enhanced-recovery-after-surgery-in-atrial-caval-shunting-for-type-%C3%A2-budd-chiari-syndrome
#11
G J Tian, D Y Li, H B Yu, Y D Dong, Y N Peng, P Liu, Y K Wei, H Z Xue
Objective: To investigate the clinical efficacy of enhanced recovery after surgery(ERAS) in atrial caval shunting (ACS) for type Ⅱ Budd-Chiari syndrome(BCS). Methods: The clinical data of patients underwent ACS for type Ⅱ BCS in the Henan Province People's Hospital from January 2014 to June 2016 were prospectively analyzed.Randomized and single-blind, controlled study was performed among the patients, and all of them underwent ACS and were divided into control group (patients underwent traditional perioperative management) and ERAS group (patients underwent ERAS perioperative management) based on a random number table...
September 1, 2017: Zhonghua Wai Ke za Zhi [Chinese Journal of Surgery]
https://www.readbyqxmd.com/read/28870047/-expert-consensus-for-the-diagnosis-and-treatment-of-patients-with-gitelman-syndrome
#12
(no author information available yet)
Gitelman syndrome (GS) is an autosomal recessive, salt-losing tubulopathy caused by inactivating mutations in the SLC12A3 gene that encodes the thiazide-sensitive sodium-chloride cotransporter (NCC). GS is characterized by hypokalemic metabolic alkalosis, hypomagnesemia and hypocalciuria. GS is one of the most common inherited renal tubulopathy with a prevalence estimated at about one to ten per 40 000 people. The prevalence of GS is even higher in Asia than other countries. The majority of GS patients present mild and nonspecific symptoms during adolescence or adulthood...
September 1, 2017: Zhonghua Nei Ke za Zhi [Chinese Journal of Internal Medicine]
https://www.readbyqxmd.com/read/28861304/laparoscopic-ureteral-reimplantation-with-boari-flap-for-the-management-of-long-segment-ureteral-defect-a-case-series-with-review-of-the-literature
#13
Ankur Bansal, Rahul Janak Sinha, Ankur Jhanwar, Gaurav Prakash, Bimalesh Purkait, Vishwajeet Singh
OBJECTIVE: The incidence of ureteral stricture is showing a rising trend due to increased use of laparoscopic and upper urinary tract endoscopic procedures. Boari flap is the preferred method of repairing long- segment ureteral defects of 8-12 cm. The procedure has undergone change from classical open (transperitoneal and retroperitoneal) method to laparoscopic surgery and recently robotic surgery. Laparoscopic approach is cosmetically appealing, less morbid and with shorter hospital stay...
September 2017: Turkish Journal of Urology
https://www.readbyqxmd.com/read/28857329/anesthetic-considerations-for-a-novel-anterior-surgical-approach-to-pediatric-scoliosis-correction
#14
Jonathan S Gal, Christopher J Curatolo, Jeron Zerillo, Bryan Hill, Baron Lonner, Laury A Cuddihy, M D Antonacci, Randal R Betz, Samuel DeMaria, Yury Khelemsky
BACKGROUND: Idiopathic scoliosis is a condition that may require surgical correction. Limitations of previous surgical modalities, however, created the need for novel methods of repair. One such technique, a newer form of anterolateral scoliosis correction, has shown considerable promise, which our center has had substantial experience performing. AIM: In this article, we present the case details of our first 105 patients for the purposes of describing the evolution and details of the anesthetic management and considerations for this procedure...
August 31, 2017: Paediatric Anaesthesia
https://www.readbyqxmd.com/read/28854815/robotic-assisted-versus-open-simple-prostatectomy-for-benign-prostatic-hyperplasia-in-large-glands-a-propensity-score-matched-comparison-of-peri-operative-and-short-term-outcomes
#15
Igor Sorokin, Varun Sundaram, Nirmish Singla, Jordon Walker, Vitaly Margulis, Claus Roehrborn, Jeffrey C Gahan
OBJECTIVE: To report the largest comparative analysis of robotic versus open simple prostatectomy for large volume prostate glands. MATERIALS AND METHODS: We retrospectively reviewed 103 patients that underwent open and 64 patients that underwent robotic simple prostatectomy from 2012-2016 at a single institution. A propensity score matched analysis was performed with 5 covariates including age, body mass index, race, Charlson-comorbidity index, and prostate volume...
August 30, 2017: Journal of Endourology
https://www.readbyqxmd.com/read/28853010/coagulation-after-cytoreductive-surgery-and-hyperthermic-intraperitoneal-chemotherapy-a-retrospective-cohort-analysis
#16
Heather Hurdle, Graeme Bishop, Andrew Walker, Afra Moazeni, Elizabeth Oddone Paloucci, Walley Temple, Lloyd Mack, Molly Shing
PURPOSE: Cytoreductive surgery (CRS) and hyperthermic intraperitoneal chemotherapy (HIPEC) benefit patients with peritoneal carcinomatosis. Nevertheless, this therapy is associated with considerable postoperative pain due to the extensive abdominal incision. While epidural analgesia offers efficacious pain control, CRS and HIPEC therapy is associated with perioperative coagulopathy that may impact its use. The purpose of this retrospective study is to characterize the postoperative coagulopathy in this patient subset and to develop a model that will help predict those at risk...
August 29, 2017: Canadian Journal of Anaesthesia, Journal Canadien D'anesthésie
https://www.readbyqxmd.com/read/28844370/technology-is-there-sufficient-evidence-to-change-practice-in-point-of-care-management-of-coagulopathy
#17
REVIEW
Michael Fabbro, Anne M Winkler, Jerrold H Levy
Currently, hemostasis is one of the most widely researched topics in perioperative medicine. As investigators learn more about the complexity of coagulation, developing tests with the ability to rapidly monitor coagulation and guide targeted therapy is the key to optimizing hemostasis management. There is mounting evidence that algorithmic transfusion using point-of-care (POC) testing can reduce red cell and platelet transfusions and major bleeding after cardiac surgery. Integrating these tests during cardiac surgery and trauma management is especially important because these groups use the most blood products within a health system and the risks of transfusion are well documented...
May 19, 2017: Journal of Cardiothoracic and Vascular Anesthesia
https://www.readbyqxmd.com/read/28843035/risk-prediction-of-post-hepatectomy-liver-failure-in-patients-with-perihilar-cholangiocarcinoma
#18
Eung Chang Lee, Sang-Jae Park, Sung-Sik Han, Jae Ryong Shim, Hyeong Min Park, Seung Duk Lee, Seong Hoon Kim
BACKGROUND AND AIM: In most patients with perihilar cholangiocarcinoma (PHCC), major hepatectomy and extrahepatic bile duct resection are needed for surgical radicality, and a high risk of hepatic insufficiency exists. This study aims to develop a prediction model for post-hepatectomy liver failure (PHLF) in patients with PHCC. METHODS: A total of 143 patients who underwent major liver resection and extrahepatic bile duct resection for PHCC between October 2001 and December 2013 were included...
August 26, 2017: Journal of Gastroenterology and Hepatology
https://www.readbyqxmd.com/read/28838449/successful-blood-transfusion-management-of-a-living-donor-liver-transplant-recipient-in-the-presence-of-anti-jr-a-a-case-report
#19
N Kurata, Y Onishi, H Kamei, T Hori, M Komagome, C Kato, T Matsushita, Y Ogura
A 48-year-old Japanese woman was diagnosed with Budd-Chiari syndrome and transferred for possible living donor liver transplantation (LDLT). Examinations before LDLT revealed that the recipient had anti-Jr(a) and preformed donor-specific anti-human leukocyte antigen (HLA) antibodies (DSA). Rituximab was administrated at 16 days prior to the patient's scheduled LDLT for the prophylaxis of antibody-mediated rejection by DSA. The clinical significance of anti-Jr(a) has not been clearly established because of the rarity of this antibody, so we discussed blood transfusion strategy with the Department of Blood Transfusion Service and prepared for Jr(a)-negative packed red blood cells (RBCs)...
September 2017: Transplantation Proceedings
https://www.readbyqxmd.com/read/28832866/association-of-fluid-administration-with-morbidity-in-cytoreductive-surgery-with-hyperthermic-intraperitoneal-chemotherapy
#20
Oliver S Eng, Sinziana Dumitra, Michael O'Leary, Mustafa Raoof, Mark Wakabayashi, Thanh H Dellinger, Ernest S Han, Stephen J Lee, I Benjamin Paz, Byrne Lee
Importance: Cytoreductive surgery (CRS) with hyperthermic intraperitoneal chemotherapy (HIPEC) for peritoneal cancers can be associated with significant complications. Randomized trials have demonstrated increased morbidity with liberal fluid regimens in abdominal surgery. Objective: To investigate the association of intraoperative fluid administration and morbidity in patients undergoing CRS/HIPEC. Design, Setting, and Participants: A retrospective analysis of information from a prospectively collected institutional database was conducted at a National Cancer Institute-designated comprehensive cancer center...
August 23, 2017: JAMA Surgery
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