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Costs of surgery

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https://www.readbyqxmd.com/read/29786818/management-of-traumatic-arteriovenous-fistulas-a-tertiary-academic-center-experience
#1
Mazlum Şahin, Cihan Yücel, Eyüp Murat Kanber, Fatma Tuba İlal Mert, Burcu Bıçakhan
BACKGROUND: To present the surgical experience at a tertiary academic center of treating patients with traumatic arteriovenous fistulas (AVFs) who in whom endovascular treatment was contraindicated or in whom unsuccessful endovascular treatment had been performed. METHODS: A total of 27 patients with traumatic AVFs who underwent surgery between September 2014 and May 2016 were included. The site of injury, timing of surgery, and the surgical methods utilized were analyzed retrospectively...
May 2018: Ulusal Travma Ve Acil Cerrahi Dergisi, Turkish Journal of Trauma & Emergency Surgery: TJTES
https://www.readbyqxmd.com/read/29786534/-the-gynecological-pessary-is-it-really-a-device-of-another-age-a-fig-leaf
#2
E Nohuz, E Jouve, G Clement, B Jacquetin
OBJECTIVES: The use of pessary to put back up prolapsed organs to their normal position dates back prior to several millennia. This work aims to discuss its place in our clinical practice through an updated bibliographic review and emphasizes a hands-on approach to pessary fitting and management in terms of indication, pessary type selection, device' size, insertion, removal, follow-up visits and care. METHODS: A review of the literature, in the light of the latest publications and recommendations of French and international learned societies, as well as our own experience, were analyzed...
May 18, 2018: Gynecologie, Obstetrique, Fertilite & Senologie
https://www.readbyqxmd.com/read/29785926/intramedullary-nail-fixation-versus-locking-plate-fixation-for-adults-with-a-fracture-of-the-distal-tibia-the-uk-fixdt-rct
#3
Matthew L Costa, Juul Achten, Susie Hennings, Nafisa Boota, James Griffin, Stavros Petrou, Mandy Maredza, Melina Dritsaki, Thomas Wood, James Masters, Ian Pallister, Sarah E Lamb, Nick R Parsons
BACKGROUND: The best treatment for fractures of the distal tibia remains controversial. Most of these fractures require surgical fixation, but the outcomes are unpredictable and complications are common. OBJECTIVES: To assess disability, quality of life, complications and resource use in patients treated with intramedullary (IM) nail fixation versus locking plate fixation in the 12 months following a fracture of the distal tibia. DESIGN: This was a multicentre randomised trial...
May 2018: Health Technology Assessment: HTA
https://www.readbyqxmd.com/read/29785665/why-weight-an-analytic-review-of-obesity-management-diabetes-prevention-and-cardiovascular-risk-reduction
#4
REVIEW
L I Igel, K H Saunders, J J Fins
PURPOSE OF REVIEW: In this review, we examine one of the ironies of American health care-that we pay more for disease management than disease prevention. Instead of preventing type 2 diabetes (T2DM) by treating its precursor, obesity, we fail to provide sufficient insurance coverage for weight management only to fund the more costly burden of overt T2DM. RECENT FINDINGS: There is a vital need for expanded insurance coverage to help foster a weight-centric approach to T2DM management...
May 21, 2018: Current Atherosclerosis Reports
https://www.readbyqxmd.com/read/29785655/early-results-after-operatively-versus-non-operatively-treated-flail-chest-a-retrospective-study-focusing-on-outcome-and-complications
#5
Mathieu M E Wijffels, Tjebbe Hagenaars, Diba Latifi, Esther M M Van Lieshout, Michael H J Verhofstad
PURPOSE: Flail chest was traditionally treated non-operatively using mechanical ventilation and pain control. In order to reduce the occurrence of ventilation-associated complications and long-term disability, operative rib fixation is becoming a proven standard therapy for these patients. However, the consequences of the surgical complications may influence success rates negatively. The aim of this study was to compare the outcome of flail chest treatment by surgical rib fixation with non-operative treatment, with special focus on the impact of surgical complications...
May 21, 2018: European Journal of Trauma and Emergency Surgery: Official Publication of the European Trauma Society
https://www.readbyqxmd.com/read/29785458/high-resolution-standardization-reduces-delay-due-to-workflow-disruptions-in-laparoscopic-cholecystectomy
#6
Marco von Strauss Und Torney, Sohelia Aghlmandi, Jasmin Zeindler, Debora Nowakowski, Christian A Nebiker, Christoph Kettelhack, Rachel Rosenthal, Raoul A Droeser, Savas D Soysal, Henry Hoffmann, Robert Mechera
BACKGROUND: Optimal resource utilization in high-cost environments like operating theatres is fundamental in today's cost constrained health care systems. Interruptions of the surgical workflow, i.e. microcomplications (MC), lead to prolonged procedure times and higher costs and can be indicative of surgical mistakes. Reducing MC can improve operating room efficiency and prevent intraoperative complications. We, therefore, aimed to evaluate the impact of a high-resolution standardized laparoscopic cholecystectomy protocol (HRSL) on operative time and intraoperative interruptions in a teaching hospital...
May 21, 2018: Surgical Endoscopy
https://www.readbyqxmd.com/read/29784634/evaluation-of-app-based-serious-gaming-as-a-training-method-in-teaching-chest-tube-insertion-to-medical-students-randomized-controlled-trial
#7
Patrick Haubruck, Felix Nickel, Julian Ober, Tilman Walker, Christian Bergdolt, Mirco Friedrich, Beat Peter Müller-Stich, Franziska Forchheim, Christian Fischer, Gerhard Schmidmaier, Michael C Tanner
BACKGROUND: The insertion of a chest tube should be as quick and accurate as possible to maximize the benefit and minimize possible complications for the patient. Therefore, comprehensive training and assessment before an emergency situation are essential for proficiency in chest tube insertion. Serious games have become more prevalent in surgical training because they enable students to study and train a procedure independently, and errors made have no effect on patients. However, up-to-date evidence regarding the effect of serious games on performance in procedures in emergency medicine remains scarce...
May 21, 2018: Journal of Medical Internet Research
https://www.readbyqxmd.com/read/29784549/cost-implications-of-varying-the-surgical-technique-surgical-setting-and-anesthesia-type-for-carpal-tunnel-release-surgery
#8
Nikolas H Kazmers, Angela P Presson, Yizhe Xu, Abby Howenstein, Andrew R Tyser
PURPOSE: Carpal tunnel release (CTR) is a common surgical procedure, representing a financial burden to the health care system. The purpose of this study was to test whether the choice of CTR technique (open carpal tunnel release [OCTR] vs endoscopic carpal tunnel release [ECTR]), surgical setting (operating room vs procedure room [PR]), and anesthetic type (local, monitored anesthesia care [MAC], Bier block, general) affected costs or payments. METHODS: Consecutive adult patients undergoing isolated unilateral CTR between July 2014, and October 2017, at a single academic medical center were identified...
May 18, 2018: Journal of Hand Surgery
https://www.readbyqxmd.com/read/29784426/financial-validation-of-the-european-society-of-thoracic-surgeons-risk-score-predicting-prolonged-air-leak-after-video-assisted-thoracic-surgery-lobectomy
#9
Alessandro Brunelli, Cecilia Pompili, Padma Dinesh, Vinod Bassi, Andrea Imperatori
OBJECTIVES: The objective of this study was to verify whether the European Society of Thoracic Surgeons prolonged air leak risk score for video-assisted thoracoscopic lobectomy was associated with incremental postoperative costs. METHODS: We retrospectively analyzed 353 patients subjected to video-assisted thoracoscopic lobectomy or segmentectomy (April 2014 to March 2016). Postoperative costs were obtained from the hospital Finance Department. Patients were grouped in different classes of risk according to their prolonged air leak risk score...
April 27, 2018: Journal of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/29784157/recording-and-viewing-stereoscopic-ophthalmic-surgical-videos-with-smartphones
#10
Samuel M Philbrick, Darrell E Baskin
OBJECTIVE: To determine whether stereoscopic footage of cataract surgery could be captured with smartphones and to develop a procedure for editing and viewing the footage. The authors sought to measure whether subjectively convincing stereo footage could be captured with smartphones, whether it would be possible to sync this footage for stereoscopic viewing, and whether these tasks could easily be performed at lower cost than commercially available options. DESIGN: Brief research report...
June 2018: Canadian Journal of Ophthalmology. Journal Canadien D'ophtalmologie
https://www.readbyqxmd.com/read/29784004/positive-impact-of-retrograde-autologous-priming-in-adult-patients-undergoing-cardiac-surgery-a-randomized-clinical-trial
#11
Britt Hofmann, Claudia Kaufmann, Markus Stiller, Thomas Neitzel, Andreas Wienke, Rolf-Edgar Silber, Hendrik Treede
BACKGROUND: Adult cardiac surgery with extracorporeal circulation is known to be associated with increased risk of blood transfusion leading to adverse outcomes. Procedures like retrograde autologous priming (RAP) may reduce these negative side effects. This randomized prospective study was initiated to assess whether RAP using specifically designed RAP bag (Terumo) has immediate effects on patient outcome. METHODS: One hundred eighteen adults undergoing elective CABG or elective aortic valve replacement were randomly assigned by a computer program into two groups: the RAP group (n = 54) in which the retrograde autologous priming was applied and the non-RAP (n = 64) group in which the same setting was used without the possibility to save priming volume...
May 21, 2018: Journal of Cardiothoracic Surgery
https://www.readbyqxmd.com/read/29782913/statewide-collaborative-to-reduce-surgical-site-infection-results-of-the-hawaii-surgical-unit-based-safety-program
#12
Della M Lin, Kathryn A Carson, Lisa H Lubomski, Elizabeth C Wick, Julius Cuong Pham
BACKGROUND: Surgical Site Infections (SSI) after colorectal surgery are common, lead to patient harm, and are costly to the healthcare system. This study's purpose was to evaluate the effectiveness of the Agency for Healthcare Research and Quality (AHRQ) Safety Program for Surgery in Hawaii. STUDY DESIGN: This pre-post cohort study involved 100% of 15 hospitals in Hawaii from January 2013-June 2015. The intervention was a statewide implementation of the Comprehensive-Unit-based-Safety-Program (CUSP) and individualized bundles of interventions to reduce SSI...
May 3, 2018: Journal of the American College of Surgeons
https://www.readbyqxmd.com/read/29782358/neoadjuvant-interdigitated-chemoradiotherapy-using-mesna-doxorubicin-and-ifosfamide-for-large-high-grade-soft-tissue-sarcomas-of-the-extremity-improved-efficacy-and-reduced-toxicity
#13
Mudit Chowdhary, Neilayan Sen, Elizabeth B Jeans, Luke Miller, Marta Batus, Steven Gitelis, Dian Wang, Ross A Abrams
OBJECTIVES: Patients with large, high-grade extremity soft tissue sarcoma (STS) are at high risk for both local and distant recurrence. RTOG 95-14, using a regimen of neoadjuvant interdigitated chemoradiotherapy with mesna, doxorubicin, ifosfamide, and dacarbazine followed by surgery and 3 cycles of adjuvant mesna, doxorubicin, ifosfamide, and dacarbazine, demonstrated high rates of disease control at the cost of significant toxicity (83% grade 4, 5% grade 5). As such, this regimen has not been widely adopted...
May 18, 2018: American Journal of Clinical Oncology
https://www.readbyqxmd.com/read/29782345/precision-surgery-for-obesity
#14
Zhiyong Dong, Sheikh Mohammed Shariful Islam, Enan Simms-Walker, Cunchuan Wang
Precision medicine is targeted towards improving the effectiveness of treatment, reducing the side effects of drugs and reducing medical costs. The application of precision surgery for obesity is a new concept that involves 2 stages: the first stage is to attain a precise obesity surgery, and the second stage is to achieve individualized obese gene therapy. In this article, we discuss the value of precision surgery for obesity, its stages and its future application to improve obesity surgery. Due to recent advancements in medical technologies, genetics, surgical and clinical research; precision surgery for obesity will lead the future of obesity surgery...
May 16, 2018: American Journal of Therapeutics
https://www.readbyqxmd.com/read/29782050/sequels-to-tattoo-removal-by-caustic-products
#15
K Hutton Carlsen, J Serup
BACKGROUND: Caustic products are used as affordable alternatives to laser removal of tattoos. OBJECTIVE: Describe a series of patients with sequels after tattoo removal by caustic products. METHODS: 11 patients with complications referred from 2013 to 2017 were studied. Objective findings, sequels, corrective treatments, cost and psychological aspects were obtained. Numeric Rating Scale (NRS, score 10 extremely dissatisfied) was used to describe patient satisfaction with tattoos before and after removal...
May 21, 2018: Skin Research and Technology
https://www.readbyqxmd.com/read/29781854/salvage-of-threatened-cardiovascular-implantable-electronic-devices-case-series-and-review-of-literature
#16
Andrew M Simpson, W Tyler Rockwell, Roger A Freedman, W Bradford Rockwell
BACKGROUND: The treatment of infected or exposed cardiac pacing and defibrillator devices is controversial. The conservative and widely accepted management calls for removal of the device and leads with immediate or delayed replacement of new components in a new site. Lead extraction carries a 2% major complication risk. In this article, we describe our experience with device salvage techniques and review the current literature. METHODS: This is a retrospective case series of consecutive patients with infected, exposed, or at-risk implanted cardiac devices that were treated with aggressive surgical debridement, local pocket irrigation, and revision...
May 17, 2018: Annals of Plastic Surgery
https://www.readbyqxmd.com/read/29781362/the-era-of-the-large-databases-outcomes-after-gastroesophageal-surgery-according-to-nsqip-nis-and-ncdb-databases-systematic-literature-review
#17
Gabriela Batista Rodríguez, Andrea Balla, Sonia Fernández-Ananín, Carmen Balagué, Eduard M Targarona
BACKGROUND: The term big data refers to databases that include large amounts of information used in various areas of knowledge. Currently, there are large databases that allow the evaluation of postoperative evolution, such as the American College of Surgeons National Surgical Quality Improvement Program (ACS-NSQIP), the Healthcare Cost and Utilization Project (HCUP) National Inpatient Sample (NIS), and the National Cancer Database (NCDB). The aim of this review was to evaluate the clinical impact of information obtained from these registries regarding gastroesophageal surgery...
May 1, 2018: Surgical Innovation
https://www.readbyqxmd.com/read/29781319/assessing-the-role-of-ranibizumab-in-improving-the-outcome-of-glaucoma-filtering-surgery-and-neovascular-glaucoma
#18
Andreas Katsanos, Kostantina Gorgoli, Dimitrios G Mikropoulos, Esther Arranz-Marquez, Georgios P Athanasopoulos, Miguel A Teus, Anastasios G P Konstas
Ranibizumab was the first anti-vascular endothelial growth factor (VEGF) agent approved for the treatment of neovascular age-related macular degeneration. The use of ranibizumab and other anti-VEGF medications in recent years has revolutionized the treatment of several sight-threatening retinal disorders. Emerging evidence has demonstrated that anti-VEGF treatment can offer advantages in the management of other ocular conditions where VEGFs play a key role: ocular scarring following glaucoma filtering surgery and neovascular glaucoma (NVG)...
May 19, 2018: Expert Opinion on Biological Therapy
https://www.readbyqxmd.com/read/29780831/impact-exerted-by-nutritional-risk-screening-on-clinical-outcome-of-patients-with-esophageal-cancer
#19
Rui Wang, Hongfei Cai, Yang Li, Caiwen Chen, Youbin Cui
Objective: Preoperative nutritional status of patients is closely associated with their recovery after the surgery. This study aims to ascertain the impact exerted by the nutritional risk screening on clinical outcome of patients with esophageal cancer. Methods: 160 patients with esophageal cancer aged over 60, having got therapy at the First Hospital of Jilin University from Jun 2016 to Feb 2017 were evaluated by adopting the NRS2002. 80 cases of patients got active therapy of nutritional support, and the other patients not supported nutritionally were selected as the control group...
2018: BioMed Research International
https://www.readbyqxmd.com/read/29780731/the-resident-s-point-of-view-in-the-learning-curve-of-thymic-mis-why-should-i-learn-it
#20
REVIEW
Anna E Frick, Hans Van Veer, Herbert Decaluwé, Willy Coosemans, Dirk Van Raemdonck
Minimally invasive surgery (MIS) in thoracic surgery became quite popular during the last years. The aim of introducing and performing more MIS is to reduce surgical trauma, pain and complications in patients. Training in MIS increases operative time and thus cost in theatre but thus improves with experience. For a resident, the cases should be well selected with experienced supervision in a suitable setting with supporting staff and optimal instruments. Understanding the anatomy of the lung, using simulators, and attending workshops makes the learning curve shorter...
2018: Journal of Visualized Surgery
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