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Surgical outcomes

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https://www.readbyqxmd.com/read/29783184/postoperative-outcomes-in-patients-with-a-do-not-resuscitate-dnr-order-undergoing-elective-procedures
#1
Ethan Y Brovman, Elisa C Walsh, Brittany N Burton, Christine E Kuo, Charlotta Lindvall, Rodney A Gabriel, Richard D Urman
STUDY OBJECTIVE: Do-not-resuscitate (DNR) status has been shown to be an independent risk factor for mortality in the post-operative period. Patients with DNR orders often undergo elective surgeries to alleviate symptoms and improve quality of life, but there are limited data on outcomes for informed decision making. DESIGN: Retrospective cohort study. SETTING: A multi-institutional setting including operating room, postoperative recovery area, inpatient wards, and the intensive care unit...
May 18, 2018: Journal of Clinical Anesthesia
https://www.readbyqxmd.com/read/29783006/technique-of-whole-sellar-stereotactic-radiosurgery-for-cushing-s-disease-results-from-a-multicenter-international-cohort-study
#2
Matthew J Shepard, Gautam U Mehta, Zhiyuan Xu, Hideyuki Kano, Nathaniel Sisterson, Yan-Hua Su, Michal Krsek, Ahmed M Nabeel, Amr El-Shehaby, Khaled A Kareem, Nuria Martinez-Moreno, David Mathieu, Brendan J McShane, Kevin Blas, Douglas Kondziolka, Inga Grills, John Y Lee, Roberto Martinez-Alvarez, Wael A Reda, Roman Liscak, Cheng-Chia Lee, L Dade Lunsford, Mary Lee Vance, Jason P Sheehan
BACKGROUND: Stereotactic radiosurgery (SRS) is used to manage patients with Cushing's disease (CD) who have failed surgical/medical management. As many patients with recurrent/persistent CD lack an identifiable adenoma on neuro-imaging, whole-sellar SRS has been increasingly employed. We therefore sought to define the outcomes of patients undergoing whole-sellar SRS. METHODS: An international, multicenter, retrospective cohort-design was used to define clinical/endocrine outcomes for patients undergoing whole-sellar SRS for CD...
May 18, 2018: World Neurosurgery
https://www.readbyqxmd.com/read/29782983/an-in-vivo-biocompatibility-study-of-surgical-meshes-made-from-bacterial-cellulose-modified-with-chitosan
#3
Joanna Piasecka-Zelga, Piotr Zelga, Joanna Szulc, Justyna Wietecha, Danuta Ciechańska
Bacterial cellulose modified with chitosan (MBC) is an innovative biomaterial used in regenerative medicine which may potentially improve treatment outcomes mesh for hernia repair surgery by facilitating better absorption in native tissue with less risk of mesh-related infections. The aim of the present study was to evaluate the biocompatibility of mesh based on MBC, and determine whether immunological reactions occur due to hypersensitivity to the implants. Forty five Imp:WIST rats were randomly assigned to be implanted with one of three mesh types: simple polypropylene mesh (n = 15), mesh modified by bacterial cellulose only (n = 15) and MBC mesh (n = 15) and evaluated after one and three months following intramuscular implantation...
May 18, 2018: International Journal of Biological Macromolecules
https://www.readbyqxmd.com/read/29782913/statewide-collaborative-to-reduce-surgical-site-infection-results-of-the-hawaii-surgical-unit-based-safety-program
#4
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/29782812/what-variables-are-associated-with-the-outcome-of-arthroscopic-lysis-and-lavage-surgery-for-internal-derangement-of-the-temporomandibular-joint
#5
Tyler H Haeffs, Lindsay N D'Amato, Shehryar N Khawaja, David A Keith, Steven J Scrivani
PURPOSE: Arthroscopic lysis and lavage surgery (AS) is an effective modality that can decrease pain and increase maximum interincisal opening (MIO) in patients with internal derangement (ID) of the temporomandibular joint (TMJ). However, some patients remain in pain or have limited mandibular range of motion despite AS. The purpose of this study was to determine the effectiveness, prevalence of adverse effects, and predictors of response to TMJ AS in patients with TMJ arthralgia and ID...
April 26, 2018: Journal of Oral and Maxillofacial Surgery
https://www.readbyqxmd.com/read/29782691/mass-spectrometry-in-the-palm-of-your-hand-future-applications-of-in-vivo-tissue-analysis
#6
Simon A Fox, Camile S Farah
Assessment and diagnosis of oral mucosal disorders continues to present clinical challenges with conventional methodologies being time consuming and hampered by subjectivity. These considerations also apply to surgical excision of malignant and potentially malignant lesions where accurate assessment of margins is critical to patient outcomes. These clinical needs are driving the development of new technologies which can enable rapid diagnosis based upon characteristic molecular profiles identified through clinical science...
May 21, 2018: Oral Diseases
https://www.readbyqxmd.com/read/29782518/objective-assessment-of-flap-volume-changes-and-aesthetic-results-after-adjuvant-radiation-therapy-in-patients-undergoing-immediate-autologous-breast-reconstruction
#7
Yujin Myung, Yousung Son, Tae-Hyun Nam, Eunyoung Kang, Eun-Kyu Kim, In Ah Kim, Keun-Yong Eom, Chan Yeong Heo, Jae Hoon Jeong
BACKGROUND: The use of immediate breast reconstruction and adjuvant radiation therapy is increasing in breast cancer patients. This study aimed to analyze the aesthetic outcome and changes in flap volume in patients with breast cancer undergoing radiation therapy of the surgical site after immediate autologous tissue reconstruction. METHODS: Immediate abdominal free flap breast reconstruction following unilateral mastectomy was performed in 42 patients; 21 patients received adjuvant radiation (study group) and 21 patients did not (control group)...
2018: PloS One
https://www.readbyqxmd.com/read/29782451/the-efficacy-of-regional-anesthesia-techniques-to-control-postoperative-pain-after-total-knee-arthroplasty
#8
Cecilia Otten, Karen S Dunn
BACKGROUND: Choosing the most effective type of anesthesia for controlling postoperative pain is paramount for improving patient outcomes and patient satisfaction. Most often, the type of anesthesia selected is dependent on the duration and type of surgical procedure and anesthesiologist/surgeon preference. Using a combination of regional anesthesia techniques, however, remains the cornerstone of multimodal analgesia for postoperative pain management after total knee arthroplasty. PURPOSE: The purpose of this study was to determine what regional anesthesia techniques and/or combinations of regional anesthesia techniques provided the best postoperative pain control in patients who had undergone a total knee arthroplasty...
May 2018: Orthopaedic Nursing
https://www.readbyqxmd.com/read/29782433/stabilization-of-single-incision-laparoscopic-cholecystectomy-by-needle-puncture-and-bendable-retractor
#9
Kodai Takahashi, Eiji Kanehira, Aya Kamei, Takashi Tanida, Kazunori Sasaki
BACKGROUND: A recent meta-analysis and systematic review suggested that single-incision laparoscopic cholecystectomy (SILC) had a higher procedure failure rate with more blood loss and that it required a longer surgical time than conventional laparoscopic cholecystectomy. Herein, we introduce our experience with the needlescopic grasper-assisted and bendable retractor-assisted SILC technique and evaluate its safety and sustainability. METHODS: The present retrospective cohort study included 407 Japanese patients who underwent needlescopic grasper-assisted and bendable retractor-assisted SILC between January 2012 and April 2017 at our institution...
May 18, 2018: Surgical Laparoscopy, Endoscopy & Percutaneous Techniques
https://www.readbyqxmd.com/read/29782405/the-impact-of-anesthesia-influenced-process-measure-compliance-on-length-of-stay-results-from-an-enhanced-recovery-after-surgery-for-colorectal-surgery-cohort
#10
Michael C Grant, Claro M Pio Roda, Joseph K Canner, Philip Sommer, Daniel Galante, Deborah Hobson, Susan Gearhart, Christopher L Wu, Elizabeth Wick
BACKGROUND: Process measure compliance has been associated with improved outcomes in enhanced recovery after surgery (ERAS) programs. Herein, we sought to assess the impact of compliance with measures directly influenced by anesthesiology in an ERAS for colorectal surgery cohort. METHODS: From January 2013 to April 2015, data from 1140 consecutive patients were collected for all patients before (pre-ERAS) and after (ERAS) implementation of an ERAS program. Compliance with 9 specific process measures directly influenced by the anesthesiologist or acute pain service was analyzed to determine the impact on hospital length of stay (LOS)...
May 17, 2018: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/29782389/development-of-a-novel-self-administered-cognitive-assessment-tool-and-normative-data-for-older-adults
#11
Raphael J Monsch, Amélie C Burckhardt, Manfred Berres, Alessandra E Thomann, Michael M Ehrensperger, Luzius A Steiner, Nicolai Goettel
BACKGROUND: Preexisting cognitive impairment in surgical patients is one of the leading risk factors for adverse cognitive outcomes such as postoperative delirium and postoperative cognitive dysfunction. We developed a self-administered tablet computer application intended to assess the individual risk for adverse postoperative cognitive outcomes. This cross-sectional study aimed to establish normative data for the tool. MATERIALS AND METHODS: Healthy volunteers aged 65 years and above were administered the Mini-Mental State Examination, Geriatric Depression Scale, and Consortium to Establish a Registry for Alzheimer's Disease-Neuropsychological Assessment Battery to assess cognitive health...
May 18, 2018: Journal of Neurosurgical Anesthesiology
https://www.readbyqxmd.com/read/29782365/utilization-of-an-alternative-docetaxel-based-intraperitoneal-chemotherapy-regimen-in-patients-with-ovarian-fallopian-tube-or-primary-peritoneal-carcinoma-a-continued-need-for-ovarian-cancer-patients
#12
David A Becker, Charles A Leath, Christen L Walters-Haygood, Brentley Q Smith, Kerri S Bevis
OBJECTIVE: The objective of this study was to report the tolerability and toxicity of a regimen consisting of intravenous (IV) docetaxel and intraperitoneal (IP) cisplatin and paclitaxel with granulocyte colony-stimulating factor support. MATERIALS AND METHODS: We conducted a retrospective cohort study of patients with surgical stage II-IV epithelial ovarian, fallopian tube or primary peritoneal carcinoma treated with an outpatient IP chemotherapy regimen consisting of docetaxel 75 mg/m IV and cisplatin 75 mg/m IP day 1 followed by paclitaxel 60 mg/m IP day 8 every 21 days...
May 18, 2018: American Journal of Clinical Oncology
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/29782301/lymphangioma-circumscriptum-post-radiotherapy-for-penile-cancer-treated-with-co%C3%A2-laser
#14
Dietmar Schulz, Andreas Lein, Ancuta Proca Nicula, Katrin Schierle, Caius Solovan
Lymphangioma circumscriptum (LC) is a rare, benign condition, predominantly characterized by the malformation of lymphatic skin vessels. Its onset may be congenital or due to secondary causes such as radiotherapy, infections, or surgical procedures. We present the case of a 55-year-old patient with a pathologic history of squamous cell carcinoma of the penis followed by radical penectomy. Due to metastasis to the locoregional lymph nodes, the entire affected area was subsequently treated with radiation therapy, receiving a total dose of 55...
April 2018: Acta Dermatovenerologica Croatica: ADC
https://www.readbyqxmd.com/read/29782068/comparison-of-outcomes-following-culture-directed-vs-non-culture-directed-antibiotics-in-treatment-of-acute-exacerbations-of-chronic-rhinosinusitis
#15
Carol H Yan, Navarat Tangbumrungtham, Ximena A Maul, Yifei Ma, Jayakar V Nayak, Peter H Hwang, Zara M Patel
BACKGROUND: Acute exacerbations in patients with chronic rhinosinusitis (CRS) are often treated with courses of systemic antibiotics. Poor correlation between microbiologic culture results and the sinus microbiome in CRS has caused increased debate as to the relevance of culture-directed antibiotics. There is currently sparse data comparing outcomes of culture-directed antibiotics vs non-culture-directed antibiotics for treatment of CRS. METHODS: This work reports a retrospective review...
May 21, 2018: International Forum of Allergy & Rhinology
https://www.readbyqxmd.com/read/29781928/interface-fungal-keratitis-after-descemet-stripping-automated-endothelial-keratoplasty-a-review-of-the-literature-with-a-focus-on-outcomes
#16
Elizabeth McElnea, Billy Power, Conor Murphy
PURPOSE: To examine the management and associated outcomes of reported cases of interface fungal infection after Descemet stripping automated endothelial keratoplasty (EK). METHODS: A literature review identified reports of interface fungal infection after Descemet stripping automated EK. Data retrieved from the same included patient demographics, surgical procedure undertaken, donor rim culture result, clinical course, and outcome. A review of the relevant literature was also conducted...
May 16, 2018: Cornea
https://www.readbyqxmd.com/read/29781910/superior-baseplate-inclination-is-associated-with-instability-after-reverse-total-shoulder-arthroplasty
#17
Robert Z Tashjian, Brook I Martin, Cassandra A Ricketts, Heath B Henninger, Erin K Granger, Peter N Chalmers
BACKGROUND: Instability is the most common complication after reverse total shoulder arthroplasty (rTSA). In the native glenohumeral joint, in addition to full dislocations, more subtle forms of instability exist. However, the incidence of more subtle forms of instability, the factors associated with instability, and the effect of instability on validated outcome scores after rTSA remain poorly understood. QUESTIONS/PURPOSES: (1) After rTSA, what is the risk of instability, including more subtle forms of subjective instability? (2) What are the factors associated with instability? (3) Are more subtle forms of instability associated with lower American Shoulder and Elbow Surgeons (ASES) functional outcome scores than those patients without instability? METHODS: A total of 168 rTSAs were performed during the study period...
May 17, 2018: Clinical Orthopaedics and related Research
https://www.readbyqxmd.com/read/29781856/neoumbilicoplasty-with-a-pedicled-deep-inferior-epigastric-perforator-island-flap
#18
Matthew A DelMauro, Louis-Joseph Auguste, Peter T Korn
Management of the umbilicus is a common dilemma at the time of abdominoplasty and abdominal wall reconstruction. It is not uncommon for underlying pathologies, such as hernias and surgical scars, to result in a disfigured or obliterated native umbilicus or make the blood supply to the umbilical stalk unreliable. In these scenarios, the umbilicus is often sacrificed. Staged neoumbilical reconstruction may be offered and typically utilizes a small skin flap and full-thickness skin graft (Ann Plast Surg 2009;63:358-360)...
May 17, 2018: Annals of Plastic Surgery
https://www.readbyqxmd.com/read/29781853/the-use-of-pedicled-perforator-flaps-in-chest-reconstruction-a-systematic-review-of-outcomes-and-reliability
#19
Anne-Sophie Florczak, Benoit Chaput, Christian Herlin, Pascal Rousseau, Eric Watier, Nicolas Bertheuil
BACKGROUND: In recent years, pedicled perforator flaps have revolutionized plastic surgery by reducing donor site morbidity and ensuring larger and deeper reconstructions with local pedicled cutaneous flaps. The aim of the study was to make a systematic review of perforator pedicled propeller flaps (PPPFs) in chest reconstruction. METHODS: Pubmed and Cochrane databases were searched from 1989 to October 2016 for articles describing the use of PPPFs in chest reconstruction...
May 17, 2018: Annals of Plastic Surgery
https://www.readbyqxmd.com/read/29781783/clinical-and-radiological-outcome-of-non-surgical-management-of-thoracic-and-lumbar-spinal-fracture-dislocations-a-historical-analysis-in-the-era-of-modern-spinal-surgery
#20
Andrei Fernandes Joaquim, Gregory D Schroeder, Alpesh A Patel, Alexander R Vaccaro
CONTEXT: It is well established that traumatic spinal dislocations (AO Type C injuries) should be surgically treated. However, no recent comparative study of surgical versus non-surgical management of type C injuries was found attesting the superiority of surgical treatment. OBJECTIVE: Due to the lack of information about the natural history of non-surgical management of type C injuries, we evaluated the outcome of historical conservative treatment of type C injuries...
May 21, 2018: Journal of Spinal Cord Medicine
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