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https://www.readbyqxmd.com/read/29218670/systematic-review-of-robotic-low-anterior-resection-for-rectal-cancer
#1
Christoph Holmer, Martin E Kreis
BACKGROUND: Potential advantages of robotic surgery, such as 3-dimensional high-definition vision, wrist-like movements of instruments, stable camera holding, motion filter for tremor-free surgery, and improved ergonomics, may provide better clinical, oncological, and functional outcomes in rectal cancer surgery, as suggested in many comparative studies. However, there has not been a systematic review specific to LAR/TME for rectal cancer that includes both robotic versus laparoscopic and robotic versus open comparative studies...
December 7, 2017: Surgical Endoscopy
https://www.readbyqxmd.com/read/29112662/perioperative-complications-of-cesarean-delivery-myomectomy-a-meta-analysis
#2
Vasilios Pergialiotis, Ilias Sinanidis, Ioannis-Evangelos Louloudis, Theodoros Vichos, Despina N Perrea, Stergios K Doumouchtsis
OBJECTIVE: To assess the association of myomectomy during cesarean delivery with intraoperative and perioperative maternal morbidity. DATA SOURCES: We searched MEDLINE (1966-2017), Scopus (2004-2017), ClinicalTrials.gov (2008-2017), EMBASE (1980-2017), and Cochrane Central Register of Controlled Trials CENTRAL (1999-2017) databases. METHODS OF STUDY SELECTION: We selected all observational studies that reported outcomes on patients undergoing myomectomy at the time of cesarean delivery...
November 3, 2017: Obstetrics and Gynecology
https://www.readbyqxmd.com/read/29108378/preoperative-risk-factors-for-massive-blood-loss-in-adrenalectomy-for-pheochromocytoma
#3
Hongju Liu, Bin Li, Xuerong Yu, Yuguang Huang
Background: This retrospective analysis of patients who underwent adrenalectomy for pheochromocytoma aimed to determine preoperative risk factors for intraoperative massive blood loss. Preoperative identification of patients at high-risk of massive blood loss may be helpful in anesthesia management and preoperative preparation. Materials and Methods: The study involved data of 268 patients who had undergone pheochromocytoma surgery at the Peking Union Medical College Hospital between January 1, 2013 and October 31, 2016...
October 3, 2017: Oncotarget
https://www.readbyqxmd.com/read/29107032/the-effect-of-continued-low-dose-aspirin-therapy-in-patients-undergoing-percutaneous-nephrolithotomy
#4
Brandon J Otto, Russell S Terry, Forat G Lutfi, Jamil Syed, Harold C Hamann, Mohit Gupta, Vincent G Bird
PURPOSE: Aspirin is often stopped prior to percutaneous nephrolithotomy over concern for surgical bleeding risk. There is evidence that discontinuing ASA perioperatively increases thromboembolic events and that continuing it may be safe. We sought to assess the effect of low-dose ASA continuation through PCNL and its effect on surgical and safety outcomes. MATERIALS AND METHODS: We retrospectively reviewed 285 consecutive PCNLs between 2012-2015 at our institution...
October 26, 2017: Journal of Urology
https://www.readbyqxmd.com/read/29090267/perioperative-patient-blood-management-programme-multidisciplinary-recommendations-from-the-patient-blood-management-initiative-group
#5
Daniela Filipescu, Răzvan Bănăţeanu, Mircea Beuran, Traean Burcoş, Dan Corneci, Dan Cristian, Mircea Diculescu, Alina Dobrotă, Gabriela Droc, Dănuţ Isacoff, Doina Goşa, Ioana Grinţescu, Anca Lupu, Liliana Mirea, Corina Posea, Oana Stanca, Mihai Ştefan, Dana Tomescu, Cristina Tudor, Daniela Ungureanu, Gabriel Mircescu
Patients with untreated anaemia or iron deficiency who undergo surgical procedures have an increased risk for mortality and morbidity. Patient Blood Management programmes address this issue worldwide and try to improve patient outcomes through a complex set of measures targeting anaemia correction, minimisation of bleeding and improvement of anaemia tolerance, in all phases of perioperative care. The Patient Blood Management Initiative Group is a multidisciplinary team of physicians from specialties including anaesthesiology, nephrology, surgery, orthopaedics, haematology, gastroenterology and transfusion medicine...
October 2017: Romanian Journal of Anaesthesia and Intensive Care
https://www.readbyqxmd.com/read/29088950/neurosurgical-applications-of-viscoelastic-hemostatic-assays
#6
Svetlana Kvint, James Schuster, Monisha A Kumar
Patients taking antithrombotic agents are very common in neurosurgical practice. The perioperative management of these patients can be extremely challenging especially as newer agents, with poorly defined laboratory monitoring and reversal strategies, become more prevalent. This is especially true with emergent cases in which rapid reversal of anticoagulation is required and the patient's exact medical history is not available. With an aging patient population and the associated increase in diseases such as atrial fibrillation, it is expected that the use of these agents will continue to rise in coming years...
November 2017: Neurosurgical Focus
https://www.readbyqxmd.com/read/29076664/routine-preoperative-blood-group-and-save-testing-is-unnecessary-for-elective-laparoscopic-cholecystectomy
#7
Ashutosh Tandon, Kashif Shahzad, Quentin Nunes, Milind Shrotri, Raimundas Lunevicius
Background: Although the practice of preoperative testing of ABO group and Rh (D) type for elective cholecystectomy has deep historical roots, it is not evidence-based. We aimed to assess the preoperative blood group and save testing practice for a cohort of patients subjected to elective laparoscopic cholecystectomy for symptomatic cholecystolithiasis between January 2010 and October 2014. Methods: National Health Service (NHS) hospital based, surgical procedure-specific, retrospective study was conducted...
July 2017: Journal of Ayub Medical College, Abbottabad: JAMC
https://www.readbyqxmd.com/read/29016553/bleeding-and-neurologic-complications-in-58-000-interventional-pain-procedures
#8
Nafisseh S Warner, W Michael Hooten, Matthew A Warner, Tim J Lamer, Jason S Eldrige, Halena M Gazelka, Daryl J Kor, Bryan C Hoelzer, William D Mauck, Susan M Moeschler
BACKGROUND AND OBJECTIVES: Interventional pain procedures are commonly performed on patients receiving antiplatelet therapy. However, there is limited evidence to support or refute the safety of this practice. The goal of this investigation was to assess the rate of bleeding complications in a large cohort of patients undergoing intermediate- and low-risk pain procedures, with a specific focus on antiplatelet and anticoagulant medication use and baseline coagulation abnormalities. METHODS: This is a retrospective cohort study of adult patients undergoing low- and intermediate-risk pain procedures from 2005 through 2014 by the division of pain medicine at a single academic tertiary care center...
November 2017: Regional Anesthesia and Pain Medicine
https://www.readbyqxmd.com/read/28991109/patient-blood-management-in-pediatric-cardiac-surgery-a-review
#9
Jill M Cholette, David Faraoni, Susan M Goobie, Victor Ferraris, Nabil Hassan
Efforts to reduce blood product transfusions and adopt blood conservation strategies for infants and children undergoing cardiac surgical procedures are ongoing. Children typically receive red blood cell and coagulant blood products perioperatively for many reasons, including developmental alterations of their hemostatic system, and hemodilution and hypothermia with cardiopulmonary bypass that incites inflammation and coagulopathy and requires systemic anticoagulation. The complexity of their surgical procedures, complex cardiopulmonary interactions, and risk for inadequate oxygen delivery and postoperative bleeding further contribute to blood product utilization in this vulnerable population...
October 5, 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28952153/what-is-the-evidence-for-platelet-transfusion-in-perioperative-settings
#10
REVIEW
J H Levy, R Rossaint, K Zacharowski, D R Spahn
BACKGROUND AND OBJECTIVES: Platelet transfusions are widely administered to restore perioperative haemostasis in haemorrhagic patients; however, the role of platelet transfusion is not well understood and administration is often based on empiric data. This review aims to explore consensus regarding platelet transfusion trigger, dose and how the haemostatic efficacy of platelet transfusion was assessed for the treatment of perioperative bleeding. MATERIALS AND METHODS: A literature search was carried out using MEDLINE (PubMed) on 28 February 2017, to identify publications reporting the effect of platelet transfusion in relation to triggers, dose and assessment of haemostatic efficacy in bleeding patients in a perioperative setting...
November 2017: Vox Sanguinis
https://www.readbyqxmd.com/read/28940923/blood-conservation-in-cardiac-surgery
#11
REVIEW
G Blaudszun, A Butchart, A A Klein
This article aims at reviewing the currently available evidence about blood conservation strategies in cardiac surgery. Pre-operative anaemia and perioperative allogeneic blood transfusions are associated with worse outcomes after surgery. In addition, transfusions are a scarce and costly resource. As cardiac surgery accounts for a significant proportion of all blood products transfused, efforts should be made to decrease the risk of perioperative transfusion. Pre-operative strategies focus on the detection and treatment of anaemia...
September 21, 2017: Transfusion Medicine
https://www.readbyqxmd.com/read/28940786/cornerstones-of-patient-blood-management-in-surgery
#12
REVIEW
A Butcher, T Richards
Pre-operative anaemia and perioperative red blood cell transfusion carry significant consequence when it comes to surgical outcomes. The establishment of patient-centred clinical pathways has been designed to harness and endorse good transfusion practice, termed the three pillars of patient blood management (PBM). These focus on the timely and appropriate management of anaemia, prevention of blood loss and restrictive transfusion where appropriate. This article reviews the current evidence and ongoing research in the field of PBM in surgery...
September 22, 2017: Transfusion Medicine
https://www.readbyqxmd.com/read/28938282/efficacy-and-safety-of-tranexamic-acid-in-orthopaedic-fracture-surgery-a-meta-analysis-and-systematic-literature-review
#13
Kamil M Amer, Saqib Rehman, Kamal Amer, Christopher Haydel
BACKGROUND: Tranexamic acid (TXA) is an antifibrinolytic drug that has been shown to be effective in reducing blood loss and the need for transfusions after several orthopaedic surgeries. However, the effectiveness of TXA use in orthopaedic fracture surgeries still remains unclear. The purpose of this meta-analysis was to review existing literature with interest in the effectiveness and safety of TXA treatment in reducing total blood loss and transfusion rates for patients who underwent surgery for fracture repairs...
October 2017: Journal of Orthopaedic Trauma
https://www.readbyqxmd.com/read/28938281/tranexamic-acid-in-orthopaedic-trauma-surgery-a-meta-analysis
#14
Elizabeth B Gausden, Rameez Qudsi, Myles D Boone, Brian OʼGara, Joseph J Ruzbarsky, Dean G Lorich
AIM: To systematically review and quantify the efficacy of tranexamic acid (TXA) use in reducing the risk of receiving a blood transfusion in patients undergoing orthopaedic trauma surgery, in reducing blood loss, and risk of thromboembolic events. METHODS: A systematic literature search was performed using MEDLINE, Embase, ClinicalTrials.gov, and conference proceeding abstracts from 2014 to 2016. A minimum of 2 reviewers screened each study and graded quality. The primary outcome measure was the risk of receiving a blood transfusion in the TXA group versus control...
October 2017: Journal of Orthopaedic Trauma
https://www.readbyqxmd.com/read/28921529/metastatic-spine-tumor-surgery-does-perioperative-blood-transfusion-influence-postoperative-complications
#15
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/28902659/tranexamic-acid-in-shoulder-arthroplasty-a-systematic-review-and-meta-analysis
#16
Jacob M Kirsch, Asheesh Bedi, Nolan Horner, J Michael Wiater, Leo Pauzenberger, Denise M Koueiter, Bruce S Miller, Mohit Bhandari, Moin Khan
BACKGROUND: The role of tranexamic acid (TXA) in reducing blood loss following primary shoulder arthroplasty has been demonstrated in small retrospective and controlled clinical trials. This study comprehensively evaluates current literature on the efficacy of TXA to reduce perioperative blood loss and transfusion requirements following shoulder arthroplasty. METHODS: PubMed, MEDLINE, CENTRAL, and Embase were searched from the database inception date through October 27, 2016, for all articles evaluating TXA in shoulder arthroplasty...
September 2017: JBJS Reviews
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...
October 2017: Journal of Cardiothoracic and Vascular Anesthesia
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
#18
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/28826760/evidence-based-red-blood-cell-transfusion-practices-in-cardiac-surgery
#19
REVIEW
Nishith N Patel, Gavin J Murphy
Cardiac surgical patients are among the highest consumers of allogeneic red blood cells (RBCs) due to the prevalence of anemia and bleeding. Up until recently, there was a paucity of high-quality evidence informing transfusion decisions in this patient group which led to wide variability in transfusion decision making. The article reviews and critically analyzes the available evidence for RBC transfusion in cardiac surgery, focusing on trials of transfusion triggers and age of blood, and provides suggestions for future research...
October 2017: Transfusion Medicine Reviews
https://www.readbyqxmd.com/read/28749248/update-in-perioperative-medicine-practice-changing-evidence-published-in-2016
#20
REVIEW
Dennis W Regan, Deanne Kashiwagi, Brian Dougan, Karna Sundsted, Karen Mauck
This summary reviews 18 key articles published in 2016 which have significant practice implications for the perioperative medical care of surgical patients. Due to the multi-disciplinary nature of the practice of perioperative medicine, important new evidence is published in journals representing a variety of medical and surgical specialties. Keeping current with the evidence that drives best practice in perioperative medicine is therefore challenging. We set out to identify, critically review, and summarize key evidence which has the most potential for practice change...
October 2017: Hospital Practice (Minneapolis)
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