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Perioperative managment

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https://www.readbyqxmd.com/read/29244167/tracheal-surgery-in-children-outcome-of-a-12-year-survey
#1
Luigi Arcieri, Vitali Pak, Vincenzo Poli, Roberto Baggi, Paola Serio, Nadia Assanta, Riccardo Moschetti, Bruno Noccioli, Salvatore De Masi, Lorenzo Mirabile, Bruno Murzi
OBJECTIVES: Despite the fact that team management has improved the results in recent years, perioperative deaths and complications remain high in paediatric tracheal surgery. We reviewed our institutional experience by comparing our results with those in the literature. METHODS: Between 2005 and 2017, 30 children underwent surgery for tracheal disease. Fifteen were boys and fifteen were girls (50% vs 50%). The median age at operation was 7 months (15 days-9...
December 12, 2017: Interactive Cardiovascular and Thoracic Surgery
https://www.readbyqxmd.com/read/29243158/bilateral-native-nephrectomy-to-reduce-oxalate-stores-in-children-at-the-time-of-combined-liver-kidney-transplantation-for-primary-hyperoxaluria-type-1
#2
Eliza Lee, Gabriel Ramos-Gonzalez, Nancy Rodig, Scott Elisofon, Khashayar Vakili, Heung Bae Kim
OBJECTIVE: Primary hyperoxaluria type-1 (PH-1) is a rare genetic disorder in which normal hepatic metabolism of glyoxylate is disrupted resulting in diffuse oxalate deposition and end-stage renal disease (ESRD). While most centers agree that combined liver-kidney transplant (CLKT) is the appropriate treatment for PH-1, perioperative strategies for minimizing recurrent oxalate-related injury to the transplanted kidney remain unclear. We present our management of children with PH-1 and ESRD on hemodialysis (HD) who underwent CLKT at our institution from 2005 to 2015...
December 14, 2017: Pediatric Nephrology: Journal of the International Pediatric Nephrology Association
https://www.readbyqxmd.com/read/29242067/severe-contralateral-carotid-stenosis-or-occlusion-does-not-have-an-impact-on-risk-of-ipsilateral-stroke-after-carotid-endarterectomy
#3
Priya B Patel, Glenn M LaMuraglia, Robert T Lancaster, William D Clouse, Christopher J Kwolek, Mark F Conrad, Richard P Cambria, Virendra I Patel
OBJECTIVE: This study evaluates the impact of severe (>70%) contralateral carotid stenosis or occlusion (SCSO) on outcomes after carotid endarterectomy (CEA). METHODS: Clinical data for all patients undergoing CEA at a single center were prospectively gathered and retrospectively reviewed, with the sample population stratified according to the presence of SCSO. Perioperative outcomes of CEA in the presence of SCSO were analyzed using univariate and multivariate methods...
December 11, 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/29242065/preliminary-results-of-endovascular-aneurysm-sealing-from-the-multicenter-italian-research-on-nellix-endoprosthesis-irene-study
#4
Bruno Gossetti, Ombretta Martinelli, Michelangelo Ferri, Roberto Silingardi, Fabio Verzini
OBJECTIVE: Because of advances in technology and experience of the operator, endovascular aneurysm repair (EVAR) has supplanted open repair to treat abdominal aortic aneurysm (AAA). The low 30-day mortality and morbidity of EVAR make the endovascular approach particularly suitable for patients at high surgical risk. However, endoleak or endograft migration requiring secondary intervention or open surgical conversion is a limitation of EVAR. The Nellix system (Endologix, Inc, Irvine, Calif) has been designed to seal the entire AAA to overcome these limitations with EVAR...
December 11, 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/29242033/the-evidence-and-rationale-for-the-perioperative-use-of-loop-diuretics-during-kidney-transplantation-a-comprehensive-review
#5
REVIEW
Shaifali Sandal, Pannya Bansal, Marcelo Cantarovich
PURPOSE: Loop diuretics (LD) attenuate ischemic injury in nephrons. They are thought to decrease delayed graft function (DGF) during kidney transplantation (KT). This review aimed to summarize the current evidence for the perioperative use of LD during KT. METHODS: We performed an analysis of all articles that were published since the inception of Medline and Embase: 26 studies were selected for inclusion. Scope was LD use during the perioperative phase of KT only...
November 23, 2017: Transplantation Reviews
https://www.readbyqxmd.com/read/29241961/management-of-neonates-with-right-sided-aortic-arch-and-esophageal-atresia-international-survey-on-ipeg-and-espes-members%C3%A2-experience
#6
REVIEW
Monserrat Aguilera-Pujabet, Jose Andres Molino Gahete, Gabriela Guillén, Sergio López-Fernández, Marta Patricia Martin-Giménez, Josep Lloret, Manuel López
AIM: The optimum surgical approach of neonates with right-sided aortic arch (RAA) and esophageal atresia (EA)/tracheoesophageal fistula (TEF) is still an unsolved question. In order to propose an operative algorithm in the era of endoscopic surgery, we performed an international survey to know the current practice between pediatric endoscopic surgeons. Two of the most important societies in endoscopic pediatric surgery were queried: the International Pediatric Endosurgery Group (IPEG) and the European Society of Paediatric Endoscopic Surgeons (ESPES)...
November 23, 2017: Journal of Pediatric Surgery
https://www.readbyqxmd.com/read/29241314/perioperative-antithrombotic-therapy-in-patients-undergoing-endoscopic-urologic-surgery-where-do-we-stand-with-current-literature
#7
Richard Naspro, Lori B Lerner, Roberta Rossini, Michele Manica, Henry H Woo, Ross J Calopedos, Cecilia M Cracco, Cesare M Scoffone, Thomas R Herrmann, Jean J de la Rosette, Jean-Nicolas Cornu, Luigi F DA Pozzo
INTRODUCTION: The number of patients on chronic anticoagulant or antiplatelet therapy requiring endoscopic urological surgery is increasing worldwide. Therefore, there is a strong demand to standardize the peri-operative treatment of this cohort of patients, both from a surgical and cardiological point of view, balancing the risks of bleeding versus thrombosis, and the important possible clinical and medical legal repercussions therein. EVIDENCE ACQUISITION: Although literature is scarce and the quality of evidence quite low, in line with other surgical specialties, guidelines and recommendations for the management of urological patients have begun to emerge...
December 14, 2017: Minerva Urologica e Nefrologica, the Italian Journal of Urology and Nephrology
https://www.readbyqxmd.com/read/29241177/surgical-management-of-recurrent-intracranial-gliomas
#8
Sherise D Ferguson, Eric N Momin, Jeffrey S Weinberg
In cases of recurrent gliomas, the treatment options are limited and not yet standardized. Choices usually include re-operation, systemic chemotherapy, salvage re-irradiation, and supportive care, which can be used either separately or in combination. From a surgical perspective, management of recurrent brain tumor poses a significant challenge, as the desire to attain aggressive lesion resection must be balanced against the need to preserve neurological functions and to maximize the quality of life. Additionally, specific practical difficulties in performing repeat craniotomies and significant risk of perioperative morbidity in such cases necessitate careful selection of the optimal candidates for surgery...
2018: Progress in Neurological Surgery
https://www.readbyqxmd.com/read/29240913/the-2017-eacts-guidelines-on-perioperative-medication-in-adult-cardiac-surgery-and-patient-blood-management
#9
Miguel Sousa-Uva, Milan Milojevic, Stuart J Head, Anders Jeppsson
No abstract text is available yet for this article.
January 1, 2018: European Journal of Cardio-thoracic Surgery
https://www.readbyqxmd.com/read/29237666/spigelian-hernia-and-pitfalls-of-postoperative-anticoagulation
#10
Xiaotong Cheryl Tan, Sunny Nalavenkata, Michael Yunaev
Spigelian hernias are a rare lateral ventral abdominal hernia that carry a high risk of strangulation due to their smaller sizes, and require surgical intervention. In more complex cases involving an anticoagulated patient, perioperative management of anticoagulation must be monitored and reviewed to avoid potential pitfalls. We present an 81-year-old woman who presented with right groin pain, and was requiring warfarin anticoagulation due to her cardiac history. The spigelian hernia was diagnosed and reduced laparoscopically, and the defect was repaired and reinforced by mesh...
December 13, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/29237658/emergency-salpingectomy-for-ruptured-ectopic-pregnancy-in-patient-with-melnick-needles-syndrome-a-rare-otopalatodigital-syndrome
#11
Mark Zachary Johnson, Cormac Francis Mullins, Declan Keane, Ingrid Browne
Melnick-Needles syndrome (M-NS) is a rare genetic disorder which primarily affects skeletal developments. M-NS may also affect the cardiorespiratory and renal systems. A 35 kg patient presented complaining of abdominal pain. Following a positive pregnancy test and ultrasound examination, she was diagnosed with a ruptured ectopic pregnancy. She had a significant background history of M-NS, obstructive sleep apnoea (with narrow gauge tracheostomy in situ), obstructive lung disease and scoliosis. She received fluid resuscitation, and the case was managed using an open salpingectomy and clot evacuation under combined spinal/epidural anaesthesia...
December 13, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/29237132/anastomotic-stricture-rates-following-roux-en-y-gastric-bypass-for-morbid-obesity-a-comparison-between-linear-and-circular-stapled-anastomosis
#12
Harbi Khalayleh, Guy Pines, Ashraf Imam, Shimon Sapojnikov, Victor Buyeviz, Eli Mavor
BACKGROUND: Laparoscopic Roux-en-Y gastric bypass (LRYGB) is an effective procedure in the management of morbid obesity with variations in outcome, which are technique dependent. Anastomotic stricture remains an important complication. The aim of this study was to assess the long-term outcome of patients undergoing either a linear-stapled anastomosis (LSA) or circular-stapled anastomosis (CSA) with an emphasis on postoperative stricture formation and excess body weight loss (EBWL). METHODS: Medical records of all patients who underwent bariatric surgery between 2008 and 2013 at a single bariatric surgical center were reviewed...
December 13, 2017: Journal of Laparoendoscopic & Advanced Surgical Techniques. Part A
https://www.readbyqxmd.com/read/29236967/postoperative-analgesia-after-pulmonary-resection-with-a-focus-on-video-assisted-thoracoscopic-surgery
#13
Marzia Umari, Valentina Carpanese, Valeria Moro, Gaia Baldo, Stefano Addesa, Enrico Lena, Stefano Lena, Umberto Lucangelo
Video-assisted thoracoscopic surgery is a widespread technique that has been linked to improved postoperative respiratory function, reduced hospital length of stay and a higher level of tolerability for the patients. Acute postoperative pain is of considerable significance, and the late development of neuropathic pain syndrome is also an issue. As anaesthesiologists, we have investigated the available evidence to optimize postoperative pain management. An opioid-sparing multimodal approach is highly recommended...
December 8, 2017: European Journal of Cardio-thoracic Surgery
https://www.readbyqxmd.com/read/29234998/reduction-of-cardiopulmonary-renal-complications-with-serum-bnp-guided-volume-status-management-in-posthepatectomy-patients
#14
Sameer H Patel, Bradford J Kim, Ching-Wei D Tzeng, Yun Shin Chun, Claudius Conrad, Jean-Nicolas Vauthey, Thomas A Aloia
BACKGROUND: After hepatectomy, over- and under-resuscitations induce cardiopulmonary complications and acute kidney injury, respectively, leading to significant perioperative morbidity and mortality. Unlike serum chemistries or urine output, serum brain natriuretic peptide (BNP) levels have been shown to accurately reflect current intravascular fluid balance without influence from alterations of hormonal axes. Based on these data, this study was designed to measure the impact of a serum BNP-guided hepatobiliary fluid protocol on the incidence of posthepatectomy cardiopulmonary/renal complications...
October 11, 2017: Journal of Gastrointestinal Surgery: Official Journal of the Society for Surgery of the Alimentary Tract
https://www.readbyqxmd.com/read/29234960/a-new-postoperative-pain-management-intravenous-acetaminophen-acelio%C3%A2-leads-to-enhanced-recovery-after-esophagectomy-a-propensity-score-matched-analysis
#15
Yu Ohkura, Junichi Shindoh, Masaki Ueno, Toshiro Iizuka, Shusuke Haruta, Harushi Udagawa
PURPOSES: To investigate the efficacy of postoperative scheduled intravenous acetaminophen to reduce the opioid use and enhance the recovery after esophagectomy. METHODS: A propensity score-matched population was created using the 93 and 69 consecutive patients who underwent esophagectomy for esophageal cancer before and after the introduction of postoperative scheduled intravenous acetaminophen, and the short-term clinical outcomes were compared. RESULTS: Significant defervescence was demonstrated in the Acetaminophen group (A-group) compared with control group (C-group) during the perioperative period (p < 0...
December 12, 2017: Surgery Today
https://www.readbyqxmd.com/read/29234940/st-gallen-consensus-on-safe-implementation-of-transanal-total-mesorectal-excision
#16
Michel Adamina, Nicolas C Buchs, Marta Penna, Roel Hompes
BACKGROUND: The management of rectal cancer has evolved over the years, including the recent rise of Transanal Total Mesorectal Excision (TaTME). TaTME addresses the limitations created by the bony confines of the pelvis, bulky tumours, and fatty mesorectum, particularly for low rectal cancers. However, guidance is required to ensure safe implementation and to avoid the pitfalls and potential major morbidity encountered by the early adopters of TaTME. We report a broad international consensus statement, which provides a basis for optimal clinical practice...
December 12, 2017: Surgical Endoscopy
https://www.readbyqxmd.com/read/29234540/bipolar-plasma-kinetic-enucleation-of-non-muscle-invasive-bladder-cancer-initial-experience-with-a-novel-technique
#17
Ahmed A Abotaleb, Wael S Kandeel, Basheer Elmohamady, Yasser A Noureldin, Waleed El-Shaer, Ahmed Sebaey
Objective: To assess the effectiveness and safety of bipolar plasma kinetic energy for en bloc enucleation of non-muscle-invasive bladder cancer (NMIBC). Patients and methods: In all, 46 patients diagnosed with suspected NMIBC were included. All patients were diagnosed using ultrasonography, computed tomography, and diagnostic cystoscopy, and then underwent bipolar plasma kinetic enucleation of bladder tumour (PKEBT). At the end of the procedure, all patients had a single-dose (40 mg in 40 mL saline) intravesical installation of mitomycin C (<6 h after bipolar PKEBT)...
December 2017: Arab Journal of Urology
https://www.readbyqxmd.com/read/29234539/transurethral-bipolar-plasmakinetic-vapo-enucleation-of-the-prostate-is-it-safe-for-patients-on-chronic-oral-anticoagulants-and-or-platelet-aggregation-inhibitors
#18
Waleed El-Shaer, Ahmed Abou-Taleb, Wael Kandeel
Objectives: To assess the safety and efficacy of bipolar plasmakinetic enucleation and resection of the prostate (PKERP) for the management of benign prostatic hyperplasia (BPH) in patients on oral anticoagulant (OAC) therapy and/or platelet aggregation inhibitors (PAIs). Patients and methods: In all, 91 patients were recruited and underwent PKERP whilst they were receiving PAIs (aspirin, 56 patients; clopidogrel, three; aspirin and clopidogrel, 11). In all, 15 patients were receiving an OAC drug perioperatively, whilst another six patients were on dual PAIs and OACs...
December 2017: Arab Journal of Urology
https://www.readbyqxmd.com/read/29234537/day-care-bipolar-transurethral-resection-vs-photoselective-vaporisation-under-sedoanalgesia-a-prospective-randomised-study-of-the-management-of-benign-prostatic-hyperplasia
#19
Rajeev Sood, T Manasa, Hemant Goel, Ritesh Kumar Singh, Rajpal Singh, Nikhil Khattar, Praveen Pandey
Objective: To conduct a prospective randomised study comparing the safety, effectiveness and treatment outcomes in patients undergoing bipolar transurethral resection of the prostate (bTURP) and photoselective vaporisation of the prostate (PVP) under sedoanalgesia, as sedoanalgesia is a safe and effective technique suitable for minimally invasive endourological procedures and although studies have confirmed that both TURP and PVP are feasible under sedoanalgesia there are none comparing the two...
December 2017: Arab Journal of Urology
https://www.readbyqxmd.com/read/29233756/paediatric-minimally-invasive-abdominal-and-urological-surgeries-current-trends-and-perioperative-management
#20
Myriam Bellon, Alia Skhiri, Florence Julien-Marsollier, Serge Malbezin, Diallo Thierno, Julie Hilly, Alaa ElGhoneimi, Arnaud Bonnard, Daphné Michelet, Souhayl Dahmani
Minimally invasive surgery during abdominal, thoracic and urological procedures has become the standard management of many surgical interventions in adults. Recent development of smaller devices has allowed the management of many paediatric surgeries using these minimally invasive techniques. However, the lack of knowledge of (a) adequate management of haemodynamic and respiratory alterations occurring during those procedures and (b) postoperative advantages of these techniques over open surgeries, still impairs their development...
December 9, 2017: Anaesthesia, Critical Care & Pain Medicine
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