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Surgical outcomes

Min Gyu Kyung, Seung Hoo Lee, Min Bom Kim
Patellar fractures are characterized by injuries to the extensor and typically require surgical fixation. Among the methods used for fixation, the most common is the modified AO tension-band wiring technique. However, using this technique, implant migration occurs due to the lack of connections between the K-wires and the tension-band wire, which causes irritation and reduces fracture stability. Recently, new methods for tension-band wiring have been developed in which tension bands lock the K-wires through an attached "ring" to prevent migration...
October 24, 2016: Journal of Knee Surgery
Justin Ernat, Christine Ho, Robert L Wimberly, ChanHee Jo, Anthony I Riccio
BACKGROUND: Few studies have prospectively assessed functional outcomes after the surgical management of supracondylar humerus fractures (SCHFXs) and the relationship between fracture pattern and ultimate patient outcome has never been prospectively evaluated. The purpose of this study was to prospectively evaluate fracture classification and functional outcome in children with extension SCHFXs using validated outcome measures. METHODS: An Institutional Review Board-approved prospective enrollment of consecutive patients with operative SCHFX was performed over a 3-year period...
October 21, 2016: Journal of Pediatric Orthopedics
Zhao-Qing Du, Li-Na Zhang, Qiang Lu, Yi-Fan Ren, Yi Lv, Xue-Min Liu, Xu-Feng Zhang
The standard therapeutic protocols of pyogenic liver abscess (PLA) have not been well established yet. We investigated the clinical characteristics, disease progression, choices of treatments and outcomes of PLA with different size. 410 cases of patients with PLA were enrolled retrospectively from 2000 to 2014, and were grouped as small abscess (≤5 cm, n = 125), large abscess (5 cm to 10 cm, n = 218) and giant abscess (>10 cm, n = 36). The most common bacteria were Klebsiella pneumonia (22%) and Escherichia coli (11%) by pus culture, and Escherichia coli (36...
October 24, 2016: Scientific Reports
M M F Aubuchon, L J J Bolt, M L G Janssen-Heijnen, S T H P Verleisdonk-Bolhaar, A van Marion, C L H van Berlo
BACKGROUND: Malignant melanoma (MM) is the most aggressive type of skin cancer, accounting for 90% of all the skin cancer mortality. The objective of this study was providing an overview of current patient- and tumour characteristics, treatment strategies, complications and survival in patients with MM over the past ten years. Hereby, an up-to-date view of every day clinical practice is obtained. METHODS: Files of patients treated for primary cutaneous melanoma (n = 686) in the VieCuri Medical Centre in the Netherlands between January 2002 and December 2013 were retrospectively reviewed...
October 23, 2016: Acta Chirurgica Belgica
Seo Ki Kim, Jung-Woo Woo, Inhye Park, Jun Ho Lee, Jun-Ho Choe, Jung-Han Kim, Jee Soo Kim
PURPOSE: The da Vinci surgical robot system was developed to overcome the weaknesses of endoscopic surgery. However, whether robotic surgery is superior to endoscopic surgery remains uncertain. Therefore, the purpose of this study was to compare the surgical and oncologic outcomes between endoscopic and robotic thyroidectomy using bilateral axillo-breast approach (BABA). METHODS: Between January 2008 and June 2015, papillary thyroid carcinoma patients who underwent thyroidectomy with central neck dissection using endoscopic (n = 480) or robotic (n = 705) BABA were primarily reviewed...
October 24, 2016: Langenbeck's Archives of Surgery
Valentine Nfonsam, Hassan Aziz, Viraj Pandit, Mazhar Khalil, Jana Jandova, Bellal Joseph
INTRODUCTION: Optimization of surgical outcomes after colectomy continues to be actively studied, but most studies group right-sided and left-sided colectomies together. The aim of our study was to determine whether the complication rate differs between right-sided and left-sided colectomies for cancer. METHODS: We identified patients who underwent laparoscopic colectomy for colon cancer between 2005 and 2010 in the American College of Surgeons National Surgical Quality Improvement Program database and stratified cases by right and left side...
2016: Cancer Treatment Communications
Tomokazu Yoshioka, Hisashi Sugaya, Shigeki Kubota, Mio Onishi, Akihiro Kanamori, Yoshiyuki Sankai, Masashi Yamazaki
The knee range of motion is an important outcome of total knee arthroplasty (TKA). According to previous studies, the knee range of motion temporarily decreases for approximately 1 month after TKA due to postoperative pain and quadriceps dysfunction following surgical invasion into the knee extensor mechanism. We describe our experience with a knee-extension training program based on a single-joint hybrid assistive limb (HAL-SJ, Cyberdyne Inc., Tsukuba, Japan) during the acute recovery phase after TKA. HAL-SJ is a wearable robot suit that facilitates the voluntary control of knee joint motion...
2016: Case Reports in Orthopedics
L A Peterson, J K Canner, L J Cheskin, G P Prokopowicz, M A Schweitzer, T H Magnuson, K E Steele
OBJECTIVE: To investigate the association between adverse surgical outcomes following bariatric surgery and proxy measures of vitamin D (VitD) status (season and latitude) in the Nationwide Inpatient Sample (NIS). BACKGROUND: Obesity is an independent risk factor for VitD deficiency (25(OH)D < 20 ng ml(-1)). VitD deficiency compounds the chronic inflammation of obesity, increasing the risk of adverse outcomes following bariatric surgery. Epidemiology has long used season and latitude as proxies for group VitD, as VitD status is largely determined by sun exposure, which is greatest during summer and at the Equator...
December 2015: Obesity Science & Practice
Shafi Mussa, Nigel E Drury, John Stickley, Natasha E Khan, Timothy J Jones, David J Barron, William J Brawn
OBJECTIVES: Despite the challenges of surgical management of congenital heart disease, excellent outcomes are being achieved. Newly appointed congenital heart surgeons may have limited first operator experience for many complex conditions but are expected to achieve similar outcomes. A strategy of routine mentorship from more experienced surgeons may be the key to enabling new surgeons to become proficient while maintaining excellent outcomes for patients. METHODS: The arterial switch operation (ASO) is a technically demanding but relatively commonly performed, reproducible, and easily visualized neonatal procedure, making it valuable for mentoring newly appointed congenital heart surgeons...
October 23, 2016: European Journal of Cardio-thoracic Surgery
Christian Doose, Maximilian Kütting, Sandrine Egron, Pejman Farhadi Ghalati, Christoph Schmitz, Marc Utzenrath, Alexander Sedaghat, Buntaro Fujita, Thomas Schmitz-Rode, Stephan Ensminger, Ulrich Steinseifer
OBJECTIVES: Bioprosthetic aortic heart valves are increasingly implanted in younger patients. Therefore, a strategy for potential valve failure should be developed before implanting the 'first valve'. The goal of this in vitro study was to provide insight into the effects of the design of a bioprosthesis on a valve-in-valve implanted Sapien XT valve. METHODS: The hydrodynamic performance of a 23-mm Sapien XT valve implanted in Vascutek Aspire, Edwards Perimount, Medtronic Mosaic and St...
October 23, 2016: European Journal of Cardio-thoracic Surgery
Satoshi Shiono, Takehiro Okumura, Narikazu Boku, Tomoyuki Hishida, Yasuhisa Ohde, Yukinori Sakao, Katsuo Yoshiya, Ichinosuke Hyodo, Keita Mori, Haruhiko Kondo
OBJECTIVES: Although wedge resection is the most common surgical procedure for pulmonary metastases from colorectal cancer, there are few reports about segmentectomy for colorectal metastasectomy. METHODS: This was a subset analysis of a Japanese nationwide retrospective study of resected pulmonary metastases from colorectal cancer. The study included 553 patients who underwent segmentectomies (n = 98) or wedge resections (n = 455) without preoperative chemotherapy between January 2004 and December 2008...
October 23, 2016: European Journal of Cardio-thoracic Surgery
Nishant Ganesh Kumar, Adil A Faqih, Michael P Feng, Richard S Miller, Richard A Pierce, Kenneth W Sharp, Michael D Holzman, Benjamin K Poulose
INTRODUCTION: Ventral hernia repair (VHR) is a commonly performed surgical procedure. Unfortunately, long term prospective information about quality of life and outcomes after VHR has been challenging to obtain. Decoupling follow up from clinical visits via patient reported outcomes (PROs) has been proposed as a means of achieving better long term assessments after VHR. The Americas Hernia Society Quality Collaborative (AHSQC) is a national quality improvement (QI) effort in hernia repair which uses PROs to obtain long term follow up...
October 20, 2016: Journal of the American College of Surgeons
Nahid Punjani, Jennifer Winick-Ng, Blayne Welk
OBJECTIVE: To determine if post-operative urinary retention and urinary tract infections (UTI) were predictors of future mesh complications requiring surgical intervention after midurethral sling (MUS). METHODS: Administrative data in Ontario, Canada between 2002 and 2013 was used to identify all women who underwent a mesh-based MUS. The primary outcome was revision of the transvaginal mesh sling (including mesh erosion/removal, fistula or urethrolysis). Two potential risk factors were analyzed: post-operative retention (within 30 days of procedure) and number of post-operative emergency room visits or hospital admissions for UTI symptoms...
October 20, 2016: Urology
Francesco Nappi, Cristiano Spadaccio, Antonio Nenna, Mario Lusini, Massimiliano Fraldi, Christophe Acar, Massimo Chello
OBJECTIVE: The symmetry of mitral valve tethering and regional left ventricle wall dysfunction are reported to play a fundamental role in the outcomes and long-term durability of surgical repair in ischemic mitral regurgitation (IMR). We recently demonstrated in a randomized clinical trial (the Papillary Muscle Approximation trial) the superiority of papillary muscle approximation (PMA) in combination with standard restrictive annuloplasty (RA) in severe IMR over annuloplasty alone in terms of adverse left ventricular remodeling and mitral regurgitation (MR) recurrence...
September 24, 2016: Journal of Thoracic and Cardiovascular Surgery
Zsila S Sadighi, Jennifer Zabrowski, Frederick A Boop, Alberto Broniscer, Amar Gajjar, Raja B Khan
BACKGROUND: We studied the outcomes of movement disorders that were associated with childhood thalamic tumors. METHODS: We retrospectively reviewed 83 children with thalamic tumors treated at our institution from 1996 to 2013 to document the incidence and outcome of movement disorders. Magnetic resonance imaging was used to analyze the involvement of thalamic nuclei, and three instruments were used to rate the severity of the disorders. RESULTS: Nine (11%) patients had one or more of the following movement disorders: postural tremor, resting tremor, ballism, dystonia, myoclonus, and athetosis...
August 22, 2016: Pediatric Neurology
Ashvarya Mangla, Saurabh Gupta
Transcatheter aortic valve replacement (TAVR) has rapidly emerged as the standard of care for severe symptomatic aortic stenosis in patients whose comorbidities put them at prohibitive risk for surgical aortic valve replacement (SAVR). Several trials have demonstrated superior outcomes with TAVR compared to medical management alone. TAVR has also shown favorable outcomes in patients at high risk for SAVR. TAVR can be associated with significant vascular complications, which adversely impact outcomes, and operators should be cognizant of their early recognition and appropriate management...
September 2016: Indian Heart Journal
Vasileios Charalampakis, Abd A Tahrani, Ahmed Helmy, Janesh K Gupta, Rishi Singhal
One of the most effective methods to tackle obesity and its related comorbidities is bariatric surgery. Polycystic ovary syndrome (PCOS) and endometrial hyperplasia (EH), which are associated with increased risk of endometrial carcinoma, have been identified as potentially new indications for bariatric surgery. PCOS is the most common endocrine disorder in women in the reproductive age and is associated with several components of the metabolic syndrome such as obesity, insulin resistance and hypertension. EH is a pre-cancerous condition which arises in the presence of chronic exposure to estrogen unopposed by progesterone such as both in PCOS and obesity...
October 17, 2016: European Journal of Obstetrics, Gynecology, and Reproductive Biology
Ming Tu, Qin Lu, Penglei Zhu, Weiming Zheng
BACKGROUND: Pituitary apoplexy is a rare disease caused by a sudden hemorrhage into or infarction of the pituitary gland. Its optimal management remains controversial. The aim of this study was to compare the outcomes of surgical and non-surgical treatments for pituitary apoplexy. METHODS: A systematic literature search was performed of MedLine, EmBase, the Cochrane Library, and the Web of Science for articles published between January 1992 and September 2014. Studies of the outcomes in consecutive patients that compared surgical intervention with non-surgical treatment for pituitary apoplexy were included...
November 15, 2016: Journal of the Neurological Sciences
Madan M Maddali, Nishant R Arora, John Valliattu, Pranav S Kandachar, Francois Lacour-Gayet
Intraoperative transesophageal echocardiography is an established modality for confirming the preoperative diagnosis, assess adequacy of surgical repair, identify residual problems, and help improve the outcome after operation. Despite the multitude of advantages, intraoperative transesophageal echocardiography can affect the hemodynamic parameters in small neonates and children. A severe transient electromechanical dissociation caused by the anteflexion of a transesophageal echocardiography probe during a total anomalous pulmonary venous connection repair in an infant is reported...
November 2016: Annals of Thoracic Surgery
Sai Yendamuri
This case report describes the surgical management of a giant mediastinal teratoma. Perioperative considerations and operative approach to effect good outcomes are described.
November 2016: Annals of Thoracic Surgery
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