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Perioperative management

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https://www.readbyqxmd.com/read/29222218/fat-embolism-a-rare-cause-of-perioperative-renal-transplant-dysfunction
#1
Jemima Scott, Neil Collin, Richard Baker, Rommel Ravanan
Fat embolism is a recognised complication of bony injury and orthopaedic surgery, commonly involving the long bones and pelvis. We report on the case of a 68-year-old renal transplant recipient who developed acute kidney injury following surgical stabilisation of metastatic carcinoma of the acetabulum and replacement of the proximal femur. A CT renal angiogram demonstrated a large fat embolus in the inferior vena cava (IVC) and left iliac veins below the level of IVC filter, with impaired renal perfusion. The risks of open or endovascular lipothrombectomy were felt to outweigh the potential benefits...
December 7, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/29221284/comparison-of-perioperative-outcomes-following-hybrid-minimally-invasive-versus-open-ivor-lewis-esophagectomy-for-esophageal-cancer
#2
Ju Sik Yun, Kook Joo Na, Sang Yun Song, Seok Kim, In Seok Jeong, Sang Gi Oh
Background: The outcomes of various minimally invasive esophagectomy (MIE) procedures for esophageal cancer have been reported; however, those of the hybrid approach are lacking. This study aimed to assess the impacts of hybrid minimally invasive Ivor Lewis esophagectomy (HIL, laparoscopy and right thoracotomy) for esophageal cancer on perioperative outcomes compared with the open approach. Methods: This was a retrospective study of 153 patients who underwent Ivor Lewis esophagectomy for squamous cell carcinoma between January 2008 and December 2016...
September 2017: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/29220299/perioperative-management-of-extremity-soft-tissue-sarcomas
#3
Rick L Haas, Alessandro Gronchi, Michiel A J van de Sande, Elizabeth H Baldini, Hans Gelderblom, Christina Messiou, Eva Wardelmann, Axel Le Cesne
Surgery is potentially curative for primary nonmetastatic extremity soft tissue sarcomas. After surgery alone, patients may remain at risk for local recurrences and/or metastatic disease. To reduce the likelihood of a local relapse, the addition of radiotherapy (RT) to limb-sparing surgery may result in higher local control rates of at least 85%. Generally, it can be stated that local control after both preoperative and postoperative RT is comparable, but that preoperative RT comes with a more favorable toxicity profile after prolonged follow-up, albeit at the cost of a higher wound complication rate...
December 8, 2017: Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology
https://www.readbyqxmd.com/read/29218310/non-invasive-hemodynamic-monitoring-for-hemodynamic-management-in-perioperative-medicine
#4
Julia Y Nicklas, Bernd Saugel
No abstract text is available yet for this article.
2017: Frontiers in Medicine
https://www.readbyqxmd.com/read/29217632/perioperative-management-of-anticoagulant-and-antiplatelet-therapy
#5
Alfonso Tafur, James Douketis
No abstract text is available yet for this article.
December 7, 2017: Heart: Official Journal of the British Cardiac Society
https://www.readbyqxmd.com/read/29217288/avelumab-in-metastatic-urothelial-carcinoma-after-platinum-failure-javelin-solid-tumor-pooled-results-from-two-expansion-cohorts-of-an-open-label-phase-1-trial
#6
Manish R Patel, John Ellerton, Jeffrey R Infante, Manish Agrawal, Michael Gordon, Raid Aljumaily, Carolyn D Britten, Luc Dirix, Keun-Wook Lee, Mathew Taylor, Patrick Schöffski, Ding Wang, Alain Ravaud, Arnold B Gelb, Junyuan Xiong, Galit Rosen, James L Gulley, Andrea B Apolo
BACKGROUND: The approval of anti-programmed death ligand 1 (PD-L1) and anti-programmed death 1 agents has expanded treatment options for patients with locally advanced or metastatic urothelial carcinoma. Avelumab, a human monoclonal anti-PD-L1 antibody, has shown promising antitumour activity and safety in this disease. We aimed to assess the safety profile in patients (both post-platinum therapy and cisplatin-naive) treated with avelumab and to assess antitumour activity of this drug in post-platinum patients...
December 4, 2017: Lancet Oncology
https://www.readbyqxmd.com/read/29217253/update-on-cardiovascular-implantable-electronic-devices-for-anesthesiologists
#7
REVIEW
Brett Cronin, Michael K Essandoh
With the advent of "wireless" endocardial pacing, the subcutaneous implantable cardioverter defibrillator, and leadless pacemakers comes an added layer of complexity to the perioperative management of cardiovascular implantable electronic devices (CIED). Since no formal recommendations currently exist for these new CIED technologies, preoperative identification of these devices, understanding their functionality, and developing an individualized perioperative management plan are imperative for the anesthesiologist...
September 7, 2017: Journal of Cardiothoracic and Vascular Anesthesia
https://www.readbyqxmd.com/read/29217238/feasibility-and-impact-of-focused-intraoperative-transthoracic-echocardiography-on-management-in-thoracic-surgery-patients-an-observational-study
#8
Thomas Kratz, Sarah Holz, Thorsten Steinfeldt, Maik Exner, Marco Campo dell'Orto, Caroline Kratz, Hinnerk Wulf, Martin Zoremba
OBJECTIVES: Intraoperative focused transthoracic echocardiography (TTE) is feasible and has an effect on the management of hemodynamically unstable surgical patients. Furthermore, in noncardiac thoracic surgery, TTE might provide additional information for hemodynamic treatment. Transthoracic accessibility during thoracic surgical interventions is assumed to be difficult. For patients positioned on their right side, a modified subcostal transthoracic view might be helpful. DESIGN: A prospective observational study...
September 9, 2017: Journal of Cardiothoracic and Vascular Anesthesia
https://www.readbyqxmd.com/read/29216650/-have-multimodal-and-perioperative-therapeutic-strategies-changed-the-survival-after-oncological-oesophageal-surgery-in-the-last-two-decades-a-retrospective-cohort-analysis-over-23-years
#9
Philipp Lingohr, Julia Zender, Cornelius van Beekum, Jonas Dohmen, Hanno Matthaei, Nico Schaefer, Jörg C Kalff, Tim Oliver Vilz
Background Esophageal malignoma is among the most frequent causes for cancer-related deaths. The only definite curative therapy is esophagectomy embedded in various multimodal treatment regimens. The aim of this study was to evaluate long-term development after esophageal surgery in the last two decades in order to observe possible trends and their influence on short, medium and long term survival. Patients and Methods Cases of 301 patients who underwent esophagectomy between 1989 and 2012 were analysed retrospectively...
December 7, 2017: Zentralblatt Für Chirurgie
https://www.readbyqxmd.com/read/29216230/a-comprehensive-scoring-system-in-correlation-with-perioperative-airway-management-for-neonatal-pierre-robin-sequence
#10
Ning Yin, Lei Fang, Xiaohua Shi, Hongqiang Huang, Li Zhang
PURPOSE: To evaluate a comprehensive scoring system which combines clinical manifestations of Pierre Robin Sequence (PRS) including severity of breathing difficulties, body weight and preoperative Cormack-Lehane grade, for its correlation with perioperative PRS airway management decision. DESIGN: Forty PRS children were retrospectively recruited after surgery. Specialists examined all subjects and scored for clinical manifestations (1´ - 4´), weight gain (1´- 4´), dyspnea scores (1´- 4´), and Cormack-Lehane grade (1´- 4´)...
2017: PloS One
https://www.readbyqxmd.com/read/29215949/laparoscopic-retroperitoneal-lymph-node-dissection-as-a-safe-procedure-for-postchemotherapy-residual-mass-in-testicular-cancer
#11
Eliney Ferreira Faria, Hugo Silva Neves, Breno Dauster, Roberto Dias Machado, Wesley Justino Magnabosco, Roberto Lodeiro Muller, Alexandre César Santos, Marcos Tobias-Machado
BACKGROUND: To evaluate the feasibility, clinical and perioperative outcomes of laparoscopic retroperitoneal lymph node dissection (L-RPLND) in the management of patients with germ cell tumors (GCT) and residual post-chemotherapy mass. METHODS: We report our experience of 25 patients treated with L-RPLND between 2008 and 2015. All 25 patients were diagnosed with GCT by primary pathological evaluation of the specimens after orchiectomy. All patients received cisplatin-based chemotherapy...
December 7, 2017: Journal of Laparoendoscopic & Advanced Surgical Techniques. Part A
https://www.readbyqxmd.com/read/29214364/diverticular-colovesical-fistula-what-should-we-really-be-doing
#12
N L Bertelson, H Abcarian, K A Kalkbrenner, J Blumetti, J L Harrison, V Chaudhry, T M Young-Fadok
BACKGROUND: Colovesical fistula secondary to diverticular disease is increasing in incidence. Presentation and severity may differ, but a common management strategy may be applied. The aim of this study is to evaluate the characteristics and perioperative management of patients with colovesical fistulae and determine optimal management. METHODS: From 2003 to 2012, all charts of surgical patients with diverticular colovesical fistulae at two different institutions were reviewed...
December 6, 2017: Techniques in Coloproctology
https://www.readbyqxmd.com/read/29211841/perioperative-benefit-and-outcome-of-thoracic-epidural-in-esophageal-surgery-a-clinical-review
#13
P Feltracco, A Bortolato, S Barbieri, E Michieletto, E Serra, A Ruol, S Merigliano, C Ori
Surgery for esophageal cancer is a highly stressful and painful procedure, and a significant amount of analgesics may be required to eliminate perioperative pain and blunt the stress response to surgery. Proper management of postoperative pain has invariably been shown to reduce the incidence of postoperative complications and accelerate recovery. Neuraxial analgesic techniques after major thoracic and upper abdominal surgery have long been established to reduce respiratory, cardiovascular, metabolic, inflammatory, and neurohormonal complications...
December 2, 2017: Diseases of the Esophagus: Official Journal of the International Society for Diseases of the Esophagus
https://www.readbyqxmd.com/read/29210790/management-of-1-lung-ventilation-variation-and-trends-in-clinical-practice-a-report-from-the-multicenter-perioperative-outcomes-group
#14
Douglas A Colquhoun, Bhiken I Naik, Marcel E Durieux, Amy M Shanks, Sachin Kheterpal, S Patrick Bender, Randal S Blank
BACKGROUND: Lung-protective ventilation (LPV) has been demonstrated to improve clinical outcomes in surgical patients. There are very limited data on the current use of LPV for patients undergoing 1-lung ventilation (1LV) despite evidence that 1LV may be a particularly important setting for its use. In this multicenter study, we report trends in ventilation practice for patients undergoing 1LV. METHODS: The Multicenter Perioperative Outcomes Group database was used to identify patients undergoing 1LV...
November 22, 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/29210724/anesthetic-management-of-a-pacemaker-with-a-rate-drop-response-setting-a-case-report
#15
Alex K Saltzman, Peter J Fu, Brian Egan
Permanent pacemakers are used for a variety of conditions and are commonly encountered in the perioperative period. This report describes the anesthetic management of a patient with a permanent pacemaker with a rate drop response (RDR) who presented for a laparoscopic left adrenalectomy. The RDR setting is a novel pacemaker mode often used in patients with a history of vasovagal syncope. There are no previous reports describing the anesthetic management of such a pacemaker. This case report describes the features of the RDR setting with the goal of educating clinicians who may encounter patients with this type of pacemaker...
November 27, 2017: A & A Case Reports
https://www.readbyqxmd.com/read/29210159/safety-of-mtor-inhibitor-continuation-in-pediatric-heart-transplant-recipients-undergoing-surgical-procedures
#16
Ann Heble, Melanie D Everitt, Jane Gralla, Shelley D Miyamoto, Michael Lahart, Jennifer Eshelman
mTOR inhibitors have been associated with SWC when used in the perioperative period. Limited literature is available to guide providers in managing chronic mTOR inhibitor use in the perioperative period, especially in the pediatric setting. The primary aim of this study was to describe the prevalence of SWC with mTOR inhibitor continuation during the perioperative period for major surgeries. Heart transplant recipients ≤25 years old at the time of primary heart transplant receiving sirolimus maintenance therapy during a surgical procedure and within the study period were included...
December 6, 2017: Pediatric Transplantation
https://www.readbyqxmd.com/read/29208813/decision-making-and-management-of-uveitic-cataract
#17
REVIEW
Nicole Shu-Wen Chan, Seng-Ei Ti, Soon-Phaik Chee
The visual outcome of uveitic cataract surgery depends on the underlying uveitic diagnosis, the presence of vision-limiting pathology and perioperative optimization of disease control. A comprehensive preoperative ophthalmic assessment for the presence of concomitant ocular pathology, with particular emphasis on macula and optic nerve involvement, is essential to determine which patients will benefit from improved vision after cataract surgery. Meticulous examination in conjunction with adjunct investigations can help in preoperative surgical planning and in determining the need for combined or staged procedures...
December 2017: Indian Journal of Ophthalmology
https://www.readbyqxmd.com/read/29207250/a-survey-of-dog-and-cat-anaesthesia-in-a-sample-of-veterinary-practices-in-new-zealand
#18
H Sano, K Barker, T Odom, K Lewis, P Giordano, V Walsh, J P Chambers
AIMS: To survey current anaesthesia practices for dogs and cats in small and mixed animal practices in New Zealand in order to improve anaesthesia education. METHODS: A questionnaire was sent to 440 small and mixed animal practices, including questions regarding the type of practice, preanaesthetic examination, anaesthetic drugs and management, anaesthetic machines, monitoring and topics of interest for continuing professional development. RESULTS: Responses were obtained from 113/440 (26%) practices, with 78 (69%) respondents from small and 35 (31%) from mixed animal practices...
December 5, 2017: New Zealand Veterinary Journal
https://www.readbyqxmd.com/read/29206696/the-perioperative-significance-of-systemic-arterial-diastolic-hypertension-in-adults
#19
Daniel I Asher, Edwin G Avery
PURPOSE OF REVIEW: Hypertension affects approximately one third of the U.S. population and is the most common preventable medical reason that surgical cases are postponed or cancelled. However, subtypes of hypertension and their perioperative risks are poorly studied and understood. We will review the natural history and pathophysiology of essential hypertension and discuss the perioperative significance of diastolic blood pressure elevation. RECENT FINDINGS: There is evidence that elevated preoperative diastolic blood pressures are associated with an increased perioperative risk of cardiovascular and cerebrovascular events and increased postoperatively 30-day mortality...
December 4, 2017: Current Opinion in Anaesthesiology
https://www.readbyqxmd.com/read/29205678/perioperative-management-of-gastrostomy-tube-placement-in-duchenne-muscular-dystrophy-adolescent-and-young-adult-patients-a-role-for-a-perioperative-surgical-home
#20
Ariane Boivin, Richard Antonelli, Navil F Sethna
BACKGROUND: In past decades, Duchenne muscular dystrophy patients have been living longer and as the disease advances, patients experience multisystemic deterioration. Older patients often require gastrostomy tube placement for nutritional support. For optimizing the perioperative care, a practice of multidisciplinary team can better anticipate, prevent, and manage possible complications and reduce the overall perioperative morbidity and mortality. AIMS: The aim of this study was to review our experience with perioperative care of adolescent and young adults with Duchenne muscular dystrophy undergoing gastrostomy by various surgical approaches in order to identify challenges and improve future perioperative care coordination to reduce morbidity...
December 5, 2017: Paediatric Anaesthesia
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