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Perioperative postoperative preoperative

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https://www.readbyqxmd.com/read/28212907/improving-preoperative-throughput
#1
Jennifer Franklin, Tony Franklin
Preoperative throughput is an important piece in achieving the perioperative goal for first case on time starts. An inefficient preoperative (preop) department can delay surgery starts and impact the patient flow throughout the day. Research is abundant in applying lean six sigma principles in the operating room, however there are minimal studies that specifically apply these tools in the preop. The perioperative process includes the preop, operating room, and the postoperative departments. All areas have to run like a well-oiled machine to improve performance and achieve positive outcomes...
February 2017: Journal of Perianesthesia Nursing: Official Journal of the American Society of PeriAnesthesia Nurses
https://www.readbyqxmd.com/read/28211285/can-local-infiltration-analgesia-increase-satisfaction-in-postoperative-short-term-pain-control-in-total-knee-arthroplasty
#2
David Barastegui, I Robert, E Palau, S Haddad, M Reverte-Vinaixa, L Lorente, M Cots
BACKGROUND: One of the major challenges to total knee arthroplasty (TKA) is optimal pain control. Effective analgesia is capital in fast-track surgery programs to allow patient's early functional outcomes. OBJECTIVES: Compare length of stay (LOS) short-term pain control, and patients' satisfaction at 1 month between local infiltration analgesia (LIA) combined with femoral nerve block (FNB) and FNB only in patients undergoing TKA. PATIENTS AND METHODS: Two hundred and fifty-four patients were included in a randomized prospective study and distributed in two groups...
January 2017: Journal of Orthopaedic Surgery
https://www.readbyqxmd.com/read/28209144/modified-enhanced-recovery-after-surgery-eras-protocols-for-patients-with-obstructive-colorectal-cancer
#3
Dai Shida, Kyoko Tagawa, Kentaro Inada, Keiichi Nasu, Yasuji Seyama, Tsuyoshi Maeshiro, Sachio Miyamoto, Satoru Inoue, Nobutaka Umekita
BACKGROUND: Enhanced recovery after surgery (ERAS) protocols are now well-known to be useful for elective colorectal surgery, as they result in shorter hospital stays without adversely affecting morbidity. However, the efficacy and safety of ERAS protocols for patients with obstructive colorectal cancer have yet to be clarified. METHODS: We evaluated 122 consecutive resections for obstructive colorectal cancer performed between July 2008 and November 2012 at Tokyo Metropolitan Bokutoh Hospital...
February 16, 2017: BMC Surgery
https://www.readbyqxmd.com/read/28203539/cost-effectiveness-of-robotic-mitral-valve-surgery
#4
Emmanuel Moss, Michael E Halkos
Significant technological advances have led to an impressive evolution in mitral valve surgery over the last two decades, allowing surgeons to safely perform less invasive operations through the right chest. Most new technology comes with an increased upfront cost that must be measured against postoperative savings and other advantages such as decreased perioperative complications, faster recovery, and earlier return to preoperative level of functioning. The Da Vinci robot is an example of such a technology, combining the significant benefits of minimally invasive surgery with a "gold standard" valve repair...
January 2017: Annals of Cardiothoracic Surgery
https://www.readbyqxmd.com/read/28203408/determinants-of-prolonged-intensive-care-unit-stay-in-patients-after-cardiac-surgery-a-prospective-observational-study
#5
Theodore Kapadohos, Epameinondas Angelopoulos, Ioannis Vasileiadis, Serafeim Nanas, Anastasia Kotanidou, Andreas Karabinis, Katerina Marathias, Christina Routsi
BACKGROUND: Prolonged intensive care unit (ICU) stay of patients after cardiac surgery has a major impact on overall cost and resource utilization. The aim of this study was to identify perioperative factors which prolong stay in ICU. METHODS: All adult patients from a single, specialized cardiac center who were admitted to the ICU after cardiac surgery during a 2-month period were included. Demographic and clinical characteristics, comorbidities, preoperative use of drugs, intraoperative variables, and postoperative course were recorded...
January 2017: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/28199450/association-between-smoking-status-preoperative-exhaled-carbon-monoxide-levels-and-postoperative-surgical-site-infection-in-patients-undergoing-elective-surgery
#6
Margaret B Nolan, David P Martin, Rodney Thompson, Darrell R Schroeder, Andrew C Hanson, David O Warner
Importance: Cigarette smoking is a risk factor for many perioperative complications, including surgical site infection (SSI). The duration of abstinence from smoking required to reduce this risk is unknown. Objectives: To evaluate if abstinence from smoking on the day of surgery is associated with a decreased frequency of SSI in patients who smoke cigarettes and to confirm that smoking is significantly independently associated with SSI when adjustment is made for potentially relevant covariates, such as body mass index...
February 15, 2017: JAMA Surgery
https://www.readbyqxmd.com/read/28192644/perioperative-antibiotics-for-prevention-of-acute-endophthalmitis-after-cataract-surgery
#7
REVIEW
Emily W Gower, Kristina Lindsley, Samantha E Tulenko, Afshan A Nanji, Ilya Leyngold, Peter J McDonnell
BACKGROUND: Endophthalmitis is a severe inflammation of the anterior or posterior (or both) chambers of the eye that may be sterile or associated with infection. It is a potentially vision-threatening complication of cataract surgery. Prophylactic measures for endophthalmitis are targeted against various sources of infection. OBJECTIVES: To evaluate the effects of perioperative antibiotic prophylaxis for endophthalmitis following cataract surgery compared with no prophylaxis or other form of prophylaxis...
February 13, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28190720/endarterectomy-versus-stenting-in-patients-with-prior-ipsilateral-carotid-artery-stenting
#8
Isibor J Arhuidese, Besma Nejim, Susruth Chavali, Satinderjit Locham, Tammam Obeid, Caitlin W Hicks, Mahmoud B Malas
OBJECTIVE: In-stent restenosis is a recognized complication of carotid angioplasty and stenting (CAS), and it is associated with an increased risk of stroke. Few case series have reported outcomes separately following carotid endarterectomy (CEA) and CAS for the treatment of in-stent restenosis. In this study, we perform an evaluation of redo-CAS vs CEA in a large contemporary cohort of patients who underwent prior ipsilateral CAS. METHODS: We studied all patients in the Vascular Quality Initiative (VQI) database, who underwent CEA or CAS between January 1, 2003, and April 30, 2016, after prior ipsilateral CAS...
February 9, 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/28190669/insurance-status-affects-postoperative-morbidity-and-complication-rate-after-shoulder-arthroplasty
#9
Xinning Li, David R Veltre, Antonio Cusano, Paul Yi, David Sing, Joel J Gagnier, Josef K Eichinger, Andrew Jawa, Asheesh Bedi
BACKGROUND: Shoulder arthroplasty is an effective procedure for managing patients with shoulder pain secondary to end-stage arthritis. Insurance status has been shown to be a predictor of patient morbidity and mortality. The current study evaluated the effect of patient insurance status on perioperative outcomes after shoulder replacement surgery. METHODS: Data between 2004 and 2011 were obtained from the Nationwide Inpatient Sample. Analysis included patients undergoing shoulder arthroplasty (partial, total, and reverse) procedures determined by International Classification of Disease, 9th Revision procedure codes...
February 10, 2017: Journal of Shoulder and Elbow Surgery
https://www.readbyqxmd.com/read/28190568/predictable-factors-of-deep-venous-thrombosis-in-patients-undergoing-spine-surgery
#10
Terumasa Ikeda, Hiroshi Miyamoto, Kazuki Hashimoto, Masao Akagi
BACKGROUND: DVT is one of the major postoperative complications of joint replacement surgery of the lower extremity which can cause catastrophic complications such as pulmonary embolism. However, little is known about the incidence of DVT after spine surgery. The purpose of this study was to examine predictable factors of DVT after spine surgery. METHODS: This study included 194 patients who underwent spine surgery (104 males, 90 females, mean age 65.7 years). Postoperative DVT was detected using duplex ultrasonography (DUS)...
February 9, 2017: Journal of Orthopaedic Science: Official Journal of the Japanese Orthopaedic Association
https://www.readbyqxmd.com/read/28190547/surgical-outcomes-of-chronic-descending-dissections-type-i-versus-iii-debakey
#11
Ivancarmine Gambardella, Mario Gaudino, Christopher Lau, Monica Munjal, Mohamed Elsayed, Leonard N Girardi
BACKGROUND: We evaluated the results of open operation for the treatment of descending thoracic aneurysm (DTA) and thoracoabdominal aortic aneurysm (TAAA) in patients with DeBakey type I versus type III chronic aortic dissection. METHODS: We reviewed our institutional aortic database and compared the results of open repair in patients with type I versus type III chronic aortic dissection. Between 1997 and 2015, 726 patients underwent open DTA or TAAA repair at our institution...
February 9, 2017: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/28186431/application-of-three-dimensional-visualization-technology-in-laparoscopic-partial-nephrectomy-of-renal-tumor-a-comparative-study
#12
Zhi Wang, Lin Qi, Peng Yuan, Xiongbing Zu, Wei Chen, Zhenzhen Cao, Yuan Li, Long Wang
PURPOSE: To compare the effectiveness and safety of individualized three-dimensional visualization technology (3DVT) on surgical planning and perioperative outcomes in laparoscopic partial nephrectomy (LPN) for renal cell carcinoma (RCC) with routine computed tomography (CT) examination in the treatment of renal tumor. METHODS: From May 2015 to March 2016, a total of 94 patients with cT1 RCC who underwent surgical treatment in our department were analyzed retrospectively...
February 10, 2017: Journal of Laparoendoscopic & Advanced Surgical Techniques. Part A
https://www.readbyqxmd.com/read/28185641/enhanced-recovery-after-surgery-in-gastric-resections
#13
Marcos Bruna Esteban, Peter Vorwald, Sonia Ortega Lucea, Jose Manuel Ramírez Rodríguez
INTRODUCTION: Enhanced recovery after surgery is a modality of perioperative management with the purpose of improving results and providing a faster recovery of patients. This kind of protocol has been applied frequently in colorectal surgery, presenting less available experience and evidence in gastric surgery. METHODS: According to the RICA guidelines published in 2015, a review of the bibliography and the consensus established in a multidisciplinary meeting in Zaragoza on the 9th of October 2015, we present a protocol that contains the basic procedures of fast-track for resective gastric surgery...
February 6, 2017: Cirugía Española
https://www.readbyqxmd.com/read/28185289/effect-of-epidural-compared-to-patient-controlled-intravenous-analgesia-on-outcomes-for-patients-undergoing-liver-resection-for-neoplastic-disease
#14
Shelby Allen, Amy DeRoche, Lu Adams, Karen Valerie Slocum, Clancy J Clark, Nora F Fino, Perry Shen
BACKGROUND: Epidural analgesia is routinely used for postoperative pain control following abdominal surgeries, yet data regarding the safety and efficacy of epidural analgesia is controversial. METHODS: Pain-related and clinical perioperative data were extracted and correlated with baseline clinicopathologic data and method of analgesia (epidural vs. intravenous patient-controlled analgesia) in patients who underwent hepatectomy from 2012 to 2014. Chronic pain was defined by specific narcotic requirements preoperatively...
February 10, 2017: Journal of Surgical Oncology
https://www.readbyqxmd.com/read/28184260/perioperative-management-of-left-ventricular-diastolic-dysfunction-and-heart-failure-an-anesthesiologist-s-perspective
#15
REVIEW
Taeha Ryu, Seok-Young Song
Anesthesiologists frequently see asymptomatic patients with diastolic dysfunction or heart failure for various surgeries. These patients typically show normal systolic function but abnormal diastolic parameters in their preoperative echocardiographic evaluations. The symptoms that are sometimes seen are similar to those of chronic obstructive pulmonary disease. Patients with diastolic dysfunction, and even with diastolic heart failure, have the potential to develop a hypertensive crisis or pulmonary congestion...
February 2017: Korean Journal of Anesthesiology
https://www.readbyqxmd.com/read/28184249/atlantoaxial-rotatory-fixation-as-a-rare-complication-from-head-positioning-in-otologic-surgery-report-of-two-cases-in-young-children
#16
Hiroshi Sakaida, Koji Akeda, Akihiro Sudo, Kazuhiko Takeuchi
BACKGROUND: Atlantoaxial rotatory fixation is a condition in which the first and second vertebrae of the cervical spine become interlocked in a rotated position. This condition can result in serious consequences and thus have a significant impact on patients, especially when diagnosis and treatment are delayed. Some cases of atlantoaxial rotatory fixation have been described in association with otologic surgery or plastic surgery involving the ear. We present the cases of two pediatric patients who developed atlantoaxial rotatory fixation following otologic surgery and we review the relevant literature...
2017: Patient Safety in Surgery
https://www.readbyqxmd.com/read/28183563/effect-of-basal-insulin-dosage-on-blood-glucose-concentration-in-ambulatory-surgery-patients-with-type-2-diabetes
#17
Linda J Demma, Karen T Carlson, Elizabeth W Duggan, John Gordon Morrow, Guillermo Umpierrez
STUDY OBJECTIVE: Among patients with type 2 diabetes treated with insulin, perioperative hyperglycemia and hypoglycemia may cause undesirable symptoms, surgery delay or cancellation, or unexpected hospitalization. Our objective was to compare preoperative glargine dosing regimens on perioperative glycemic control in patients undergoing ambulatory surgery. DESIGN: Observational study. SETTING: Pre- and postoperative holding areas. PATIENTS: One hundred fifty patients with type 2 diabetes using a once daily, evening insulin glargine regimen undergoing ambulatory surgery were included...
February 2017: Journal of Clinical Anesthesia
https://www.readbyqxmd.com/read/28179349/does-rectus-sheath-block-analgesia-alter-levels-of-the-oxidative-stress-biomarker-glutathione-peroxidase-a-randomised-trial-of-patients-with-cancer-and-benign-disease
#18
Martin Purdy, Jari Kärkkäinen, Merja Kokki, Maarit Anttila, Samuli Aspinen, Petri Juvonen, Hannu Kokki, Kari Pulkki, Tuomo Rantanen, Matti Eskelinen
AIM: To evaluate whether the overall satisfaction, as measured by numeric rating scale (NRS), regarding rectus sheath block (RSB) analgesia is associated with the plasma glutathione peroxidase (GPX1) level. The second end-point of the study was to evaluate the differences in GPX1 levels in patients with and without RSB analgesia, with special emphasis on benign or malign disease status. PATIENTS AND METHODS: Initially, 56 patients were randomized to the placebo group (n=12) and to one of three active RSB analgesia groups: single-dose (n=16), repeated-dose (n=12) and continuous infusion (n=16) groups...
2017: Anticancer Research
https://www.readbyqxmd.com/read/28179095/exclusive-neoadjuvant-chemotherapy-in-locally-advanced-resectable-gastric-and-gastro-esophageal-junction-adenocarcinoma
#19
Eugenio Fernandez, Wulfran Cacheux, Jean-Louis Frossard, Thibaud Koessler, Magali Abou, Michael Moniez, Olivier Huber, Giacomo Puppa, Arnaud Roth
BACKGROUND: Perioperative chemotherapy improves the prognosis of patients with locoregionally advanced resectable gastric and gastro-esophageal junction adenocarcinoma. Nevertheless, only 50% of operated patients could receive the postoperative component chemotherapy. An exclusive preoperative chemotherapy is therefore an interesting strategy. We report the clinical course of patients with operable gastric and gastroesophageal junction adenocarcinoma treated with an intention of exclusive preoperative chemotherapy...
January 16, 2017: Digestive and Liver Disease
https://www.readbyqxmd.com/read/28178645/surgery-induced-monocytic-myeloid-derived-suppressor-cells-expand-regulatory-t-cells-in-lung-cancer
#20
Jun Wang, Liu Yang, Lu Yu, Yi-Yin Wang, Rui Chen, Jing Qian, Zhi-Peng Hong, Xiao-San Su
While monocytic myeloid-derived suppressor cells (M-MDSCs) have been reported to induce the development of regulatory T cells (Treg), little is known about their correlation with Treg during perioperative period. Here, we demonstrated that the M-MDSCs expressing CD11b+CD33+HLA-DR-CD14+ in lung cancer patients after thoractomy significantly increased in comparison with preoperation, and their accumulation linearly correlated with an increase in Treg. Surgery-induced M-MDSCs, in addition to have high arginase activity, were more efficient in suppressing T-cell proliferation...
February 2, 2017: Oncotarget
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