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Perioperative management

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https://www.readbyqxmd.com/read/28723765/perioperative-management-of-intracardiac-leiomyomatosis-an-observational-cohort-study
#1
Jiaying Xu, Min Wei, Qi Miao, Bin Zhu, Chunhua Yu, Yuguang Huang
Intracardiac leiomyomatosis (ICLM) is a rare condition in which the benign tumor extends into the right heart chambers through inferior vena cava. The best surgical approach still remains unclear.We present a retrospective cohort of 36 patients diagnosed with ICLM in Peking Union Medical College Hospital between 2002 and 2016.The mean patient age was 44.5 (range 25-55) years. The clinical manifestations were various, including shortness of breath, chest tightness, edema of the lower extremities, palpitations, syncope, etc...
July 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28723491/robotic-surgery-for-renal-cell-carcinoma-with-vena-caval-tumor-thrombus
#2
REVIEW
Ronney Abaza, Daniel D Eun, Michele Gallucci, Inderbir S Gill, Mani Menon, Alexandre Mottrie, Ahmad Shabsigh
CONTEXT: Robotic surgery has significantly advanced the minimally-invasive management of kidney tumors with extension into the inferior vena cava requiring caval cross-clamping and tumor thrombectomy. Additional techniques have recently been developed to continue the evolution of this complex procedure and extend its indications. OBJECTIVE: To review the current state of the art as regards robotic nephrectomy with inferior vena cava thrombectomy (RNIT). EVIDENCE ACQUISITION: A systematic review of the Medline database was performed...
December 15, 2016: European Urology Focus
https://www.readbyqxmd.com/read/28721349/hepatocellular-carcinoma-early-stage-management-challenges
#3
REVIEW
Derek J Erstad, Kenneth K Tanabe
Hepatocellular carcinoma (HCC) is a major cause of cancer death and is increasing in incidence. This review focuses on HCC surveillance and treatment of early-stage disease, which are essential to improving outcomes. Multiple societies have published HCC surveillance guidelines, but screening efforts have been limited by noncompliance and overall lack of testing for patients with undiagnosed chronic liver disease. Treatment of early-stage HCC has become increasingly complex due to expanding therapeutic options and better outcomes with established treatments...
2017: Journal of Hepatocellular Carcinoma
https://www.readbyqxmd.com/read/28721286/open-stone-surgery-a-still-in-use-approach-for-complex-stone-burden
#4
Özer Ural Çakici, Kemal Ener, Murat Keske, Serkan Altinova, Abdullah Erdem Canda, Mustafa Aldemir, Arslan Ardicoglu
INTRODUCTION: Urinary stone disease is a major urological condition. Endourologic techniques have influenced the clinical approach and outcomes. Open surgery holds a historic importance in the management of most conditions. However, complex kidney stone burden may be amenable to successful results with open stone surgery. In this article, we report our eighteen cases of complex urinary stone disease who underwent open stone removal. MATERIAL AND METHODS: A total of 1701 patients have undergone surgical treatment for urinary stone disease in our clinic between July 2012 and July 2016, comprising eighteen patients who underwent open stone surgery...
June 30, 2017: Central European Journal of Urology
https://www.readbyqxmd.com/read/28719887/anesthetic-management-of-cytoreductive-surgery-and-hyperthermic-intraperitoneal-chemotherapy-crs-hipec-the-importance-of-hydro-electrolytic-and-acid-basic-control
#5
Fabrício Tavares Mendonça, Marília Moreira Guimarães, Sérgio Honorato de Matos, Rúbia Garcia Dusi
JUSTIFICATION AND OBJECTIVES: Patients affected by gynecological or gastrointestinal tract neoplasms that evolve to peritoneal carcinomatosis experience a significant drop in their quality of life, high morbidity and short survival times with currently available chemotherapeutic schemes. The surgical treatment based on cytoreduction and the employment of hyperthermic intraperitoneal chemotherapy in the intra-operative period is a true challenge to anesthesiologist. CASE REPORT: A 67 years old patient diagnosed with mucinous adenocarcinoma of the Appendix associated with mucinous carcinomatosis, was submitted to cytoreductive surgery (CRS) and hyperthermic intraperitoneal chemotherapy (HIPEC), under general anesthesia and epidural block...
July 10, 2017: International Journal of Surgery Case Reports
https://www.readbyqxmd.com/read/28719560/perioperative-and-delayed-major-complications-following-surgical-treatment-of-adolescent-idiopathic-scoliosis
#6
Carrie E Bartley, Burt Yaszay, Tracey P Bastrom, Suken A Shah, Baron S Lonner, Jahangir Asghar, Firoz Miyanji, Amer Samdani, Peter O Newton
BACKGROUND: Reporting accurate surgical complication rates to patients and their families is important in the management of adolescent idiopathic scoliosis (AIS). In this study, we report the rate of major complications following the surgical treatment of AIS both in the perioperative period and among patients with a minimum of 2 years of follow-up. METHODS: We reviewed the prospectively collected data of a multicenter registry of patients who underwent surgical treatment of AIS during the period of 1995 to 2014 in order to identify all complications...
July 19, 2017: Journal of Bone and Joint Surgery. American Volume
https://www.readbyqxmd.com/read/28719515/anaesthetic-management-of-patients-with-myopathies
#7
Mark Schieren, Jerome Defosse, Andreas Böhmer, Frank Wappler, Mark U Gerbershagen
: The anaesthetic management of patients with myopathies is challenging. Considering the low incidence and heterogeneity of these disorders, most anaesthetists are unfamiliar with key symptoms, associated co-morbidities and implications for anaesthesia. The pre-anaesthetic assessment aims at the detection of potentially undiagnosed myopathic patients and, in case of known or suspected muscular disease, on the quantification of disease progression. Ancillary testing (e.g. echocardiography, ECG, lung function testing etc...
July 15, 2017: European Journal of Anaesthesiology
https://www.readbyqxmd.com/read/28719459/coagulation-management-in-patients-undergoing-neurosurgical-procedures
#8
Chiara Robba, Rita Bertuetti, Frank Rasulo, Alessando Bertuccio, Basil Matta
PURPOSE OF REVIEW: Management of coagulation in neurosurgical procedures is challenging. In this contest, it is imperative to avoid further intracranial bleeding. Perioperative bleeding can be associated with a number of factors, including anticoagulant drugs and coagulation status but is also linked to the characteristic and the site of the intracranial disorder. The aim of this review will be to focus primarily on the new evidence regarding the management of coagulation in patients undergoing craniotomy for neurosurgical procedures...
July 14, 2017: Current Opinion in Anaesthesiology
https://www.readbyqxmd.com/read/28719432/perioperative-fluid-management
#9
Brenton Alexander, Alexandre Joosten
No abstract text is available yet for this article.
July 14, 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28718308/ulnar-shortening-versus-distal-radius-corrective-osteotomy-in-the-management-of-ulnar-impaction-after-distal-radius-malunion
#10
William R Aibinder, Ali Izadpanah, Bassem T Elhassan
BACKGROUND: Distal radius malunions lead to functional deficits. This study compares isolated ulnar shortening osteotomy (USO) to distal radius osteotomy (DRO) for the treatment of ulnar impaction syndrome following distal radius malunion. METHODS: We retrospectively reviewed 11 patients with extra-articular distal radius malunions treated for ulnar impaction with isolated USO. This group was compared to a 1:1 age- and sex-matched cohort treated with isolated DRO for the same indication...
January 1, 2017: Hand: Official Journal of the American Association for Hand Surgery
https://www.readbyqxmd.com/read/28717870/laparoscopic-liver-resections-for-hepatocellular-carcinoma-can-we-extend-the-surgical-indication-in-cirrhotic-patients
#11
Federica Cipriani, Corrado Fantini, Francesca Ratti, Roberto Lauro, Hadrien Tranchart, Mark Halls, Vincenzo Scuderi, Leonid Barkhatov, Bjorn Edwin, Roberto I Troisi, Ibrahim Dagher, Paolo Reggiani, Giulio Belli, Luca Aldrighetti, Mohammad Abu Hilal
BACKGROUND: Evidence on the value of laparoscopic liver resections (LLR) for hepatocellular carcinoma (HCC) and severe cirrhosis is still lacking. The aim of this study is to assess surgical and oncological outcomes of LLR in cirrhotic HCC patients. METHODS: The analysis included 403 LLR for HCC from seven European centres. 333 cirrhotic and 70 non-cirrhotic patients were compared. A matched comparison was performed between 100 Child-Pugh A and 25 Child-Pugh B patients...
July 17, 2017: Surgical Endoscopy
https://www.readbyqxmd.com/read/28717740/curative-intent-surgery-for-pancreatic-tumors-a-review-of-procedures-from-the-brazilian-national-health-system
#12
Lucas V Dos Santos, Marco Antonio O Lessa, João Paulo S N Lima, Benjamin Haaland, Gilberto L Lopes
PURPOSE: In Brazil, a country with major health access disparities, resource limitations make management of pancreatic cancer (PC) challenging. This study evaluated curative-intent surgery for PC in the Brazilian public health care system. METHODS: We collected data for PC surgical procedures with curative intent in Brazil's public health care system (DATASUS) and from the demographic database. Costs, lengths of stay, number of perioperative deaths, and PC deaths were analyzed for each state and then associated with population, gross domestic product (GDP) per capita, and number of procedures...
February 2017: Journal of Global Oncology
https://www.readbyqxmd.com/read/28717057/glucose-variability-based-on-continuous-glucose-monitoring-assessment-is-associated-with-postoperative-complications-after-cardiovascular-surgery
#13
Hiroki Sato, Michihiro Hosojima, Tomomi Ishikawa, Kenji Aoki, Takeshi Okamoto, Akihiko Saito, Masanori Tsuchida
PURPOSE: This purpose of this prospective study was to use a continuous glucose monitoring (CGM) system to evaluate the suitability of our institution's glucose management protocol after cardiovascular surgery and to clarify the impact of glycemic variability on postoperative complications. METHODS: In all, 76 patients who underwent elective cardiovascular surgery and were monitored perioperatively using a CGM system were evaluated. Postoperative glucose management consisted of continuous intravenous insulin infusion (CIII) in the intensive care unit, and subcutaneous insulin injections (SQII) after oral food intake started...
July 18, 2017: Annals of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/28715066/comparison-of-phenoxybenzamine-and-doxazosin-in-perioperative-management-of-patients-with-pheochromocytoma
#14
Klaudia Malec, Piotr Miśkiewicz, Agnieszka Witkowska, Ewa Krajewska, Sadegh Toutounchi, Zbigniew Gałązka, Mariusz Piotrowski, Agata Kącka, Tomasz Bednarczuk, Urszula Ambroziak
BACKGROUND: adrenalectomy with preoperative pharmacological preparation is strongly recommended in patients diagnosed with pheochromocytoma in order to prevent perioperative complications. AIM: to compare phenoxybenzamine and doxazosin in terms of perioperative hemodynamic status in patients with pheochromocytoma prepared to adrenalectomy. METHODS: retrospective analysis of 44 patients with pheochromocytoma (aged 16-80 yr, female-29) who underwent adrenalectomy...
July 17, 2017: Kardiologia Polska
https://www.readbyqxmd.com/read/28712704/impact-of-perioperative-voice-therapy-on-outcomes-in-the-surgical-management-of-vocal-fold-cysts
#15
Kathleen M Tibbetts, Laura M Dominguez, C Blake Simpson
INTRODUCTION: Vocal fold cysts are benign mid-membranous lesions of the true vocal fold, classified as mucus retention or epidermal inclusion cysts. Treatment is surgical excision with or without postoperative voice therapy. METHODS: A retrospective review was performed of the demographics, treatment approach, and outcomes of patients treated for vocal fold cysts between 2009 and 2014. Voice Handicap Index (VHI)-10 scores before and after treatment were compared using the Wilcoxon Rank-Sum test and the two-tailed Student's t test...
July 13, 2017: Journal of Voice: Official Journal of the Voice Foundation
https://www.readbyqxmd.com/read/28711167/perioperative-management-of-hypertensive-neuroblastoma-a-study-from-the-italian-group-of-pediatric-surgical-oncologists-gicop
#16
Luca Pio, Stefano Avanzini, Girolamo Mattioli, Giuseppe Martucciello, Angela Rita Sementa, Massimo Conte, Annarita Gigliotti, Claudio Granata, Ernesto Leva, Anna Maria Fagnani, Umberto Caccioppoli, Nino Tedesco, Jurgen Schleef, Elisa Tirtei, Fortunato Siracusa, Paolo D'Angelo, Pierluigi Lelli Chiesa, Lucia Miglionico, Bruno Noccioli, Elisa Severi, Claudio Carlini, Francesco Vaccarella, Francesco Camoglio, Simone Cesaro, Alessandra Narciso, Giovanna Riccipetitoni, Giovanni Cecchetto, Alessandro Inserra
BACKGROUND: Hypertension (HT) is rarely reported in patients affected by Neuroblastoma (NB), and management guidelines are lacking. Clinical features and perioperative medical treatment in such patients were reviewed to 1) ascertain whether a shared treatment strategy exists among centers and 2) if possible, propose some recommendations for the perioperative management of HT in NB patients. METHODS: A retrospective multicenter survey was conducted on patients affected by NB who presented HT symptoms...
July 3, 2017: Journal of Pediatric Surgery
https://www.readbyqxmd.com/read/28710563/an-observational-study-examining-the-effects-of-a-surgically-induced-inflammatory-response-on-the-distribution-of-morphine-and-its-metabolites-into-cerebrospinal-fluid
#17
Yan Wang, Kerry B Goralski, Derek J Roberts, Kathryn Landry, Mark E Issa, Lekha Sleno, Lisa C Julien, Jeremy Wood, Richard I Hall
PURPOSE: Morphine is administered intravenously for pain management in the perioperative period. The effect of the inflammatory response to surgery on morphine distribution across the blood-brain barrier (BBB) in humans was investigated. We hypothesized that a graded surgically induced, systemic inflammatory response alters cerebrospinal fluid (CSF) levels of morphine, morphine-3-glucuronide (M3G), and morphine-6-glucuronide (M6G) through a temporary reduction in BBB drug efflux transporter function...
July 14, 2017: Canadian Journal of Anaesthesia, Journal Canadien D'anesthésie
https://www.readbyqxmd.com/read/28709169/the-challenge-of-liver-resection-in-benign-solid-liver-tumors-in-modern-times-in-which-cases-should-surgery%C3%A2-be-done
#18
Hans-Michael Hau, Anne Kloss, Georg Wiltberger, Nora Jahn, Felix Krenzien, Christian Benzing, Moritz Schmelzle, Daniel Seehofer, Georgi Atanasov, Michael Bartels
Background Due to improved diagnostical and therapeutical approaches, benign liver tumors represent a challenge in clinical management. We here report our experience with patients undergoing liver resection for benign liver tumors. Methods 188 One hundred eighty-eight consecutive patients, who underwent surgery for solid benign liver tumors from 1992 - 2014, were analyzed retrospectively. The focus was on diagnostic pathways, indications for surgery, and perioperative and postoperative quality of life (QoL)...
July 2017: Zeitschrift Für Gastroenterologie
https://www.readbyqxmd.com/read/28708482/metabolic-surgery-for-treating-type-2-diabetes-mellitus-now-supported-by-the-world-s-leading-diabetes-organizations
#19
REVIEW
Philip R Schauer, Zubaidah Nor Hanipah, Francesco Rubino
The term metabolic surgery describes bariatric surgical procedures used primarily to treat type 2 diabetes and related metabolic conditions. Originally, bariatric surgery was used as an alternative weight-loss therapy for patients with severe obesity, but clinical data revealed its metabolic benefits in patients with type 2 diabetes. Metabolic surgery is more effective than lifestyle or medical management in achieving glycemic control, sustained weight loss, and reducing diabetes comorbidities. Perioperative adverse events are similar to other gastrointestinal surgeries...
July 2017: Cleveland Clinic Journal of Medicine
https://www.readbyqxmd.com/read/28708024/quality-improvement-initiative-preventative-surgical-site-infection-protocol-in-vascular-surgery
#20
David Parizh, Enrico Ascher, Syed Ali Raza Rizvi, Anil Hingorani, Michael Amaturo, Eric Johnson
Objective A quality improvement initiative was employed to decrease single institution surgical site infection rate in open lower extremity revascularization procedures. SUMMARY BACKGROUND DATA: In an attempt to lower patient morbidity, we developed and implemented the Preventative Surgical Site Infection Protocol in Vascular Surgery. Surgical site infections lead to prolonged hospital stays, adjunctive procedure, and additive costs. We employed targeted interventions to address the common risk factors that predispose patients to post-operative complications...
January 1, 2017: Vascular
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