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Perioperative postoperative preoperative

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https://www.readbyqxmd.com/read/27906739/posterior-vertebral-column-resection-with-intraoperative-manual-retraction-for-the-treatment-of-posttubercular-kyphosis-in-upper-thoracic-spine-or-cervicothoracic-junction
#1
Yuqiao Chen, Guohua Lü, Bing Wang, Lei Li, Lei Kuang
STUDY DESIGN: This is a case-series. OBJECTIVE: To evaluate the clinical and radiologic outcomes of posterior vertebral column resection (PVCR) for treatment of posttubercular kyphosis in upper thoracic spine and cervicothoracic junction (CTJ). SUMMARY OF BACKGROUND DATA: Surgical management of severe posttubercular kyphosis in upper thoracic spine or CTJ is challenging. A new technique that combines PVCR and intraoperative manual traction in a single procedure, was developed to maximize the correction rate and minimize the risk of dural buckling and spinal cord injury...
November 30, 2016: Clinical Spine Surgery
https://www.readbyqxmd.com/read/27906717/spectrum-of-postoperative-complications-in-pulmonary-hypertension-and-obesity-hypoventilation-syndrome
#2
Roop K Kaw
PURPOSE OF REVIEW: The purpose of this review is to identify chronic pulmonary conditions which may often not be recognized preoperatively especially before elective noncardiac surgery and which carry the highest risk of perioperative morbidity and mortality. RECENT FINDINGS: This review discusses some of the most recent studies that highlight the perioperative complications, and their prevention and management strategies. SUMMARY: Pulmonary hypertension is a well recognized risk factor for postoperative complications after cardiac surgery but the literature surrounding noncardiac surgery is sparse...
November 30, 2016: Current Opinion in Anaesthesiology
https://www.readbyqxmd.com/read/27903406/morphology-of-the-posteromedial-fragment-in-pertrochanteric-fractures-a-three-dimensional-computed-tomography-analysis
#3
Gaurav Sharma, Kiran Kumar Gn, Kavin Khatri, Ravijot Singh, Shivanand Gamanagatti, Vijay Sharma
BACKGROUND: In this study we describe the morphology of the posteromedial fragment in pertrochanteric fractures using 3D CT scans and answer two questions 1) Do differences exist between the 3D CT appearances of posteromedial fragments and the depictions made in the AO classification 2) Does the posteromedial fragment affect stability in pertrochanteric fractures, in terms of fracture collapse? METHODS: Preoperative CT scans of eight 31-A1 and fifty 31-A2 fractures were analysed...
November 17, 2016: Injury
https://www.readbyqxmd.com/read/27902826/association-of-a-frailty-screening-initiative-with-postoperative-survival-at-30-180-and-365-days
#4
Daniel E Hall, Shipra Arya, Kendra K Schmid, Mark A Carlson, Pierre Lavedan, Travis L Bailey, Georgia Purviance, Tammy Bockman, Thomas G Lynch, Jason M Johanning
Importance: As the US population ages, the number of operations performed on elderly patients will likely increase. Frailty predicts postoperative mortality and morbidity more than age alone, thus presenting opportunities to identify the highest-risk surgical patients and improve their outcomes. Objective: To examine the effect of the Frailty Screening Initiative (FSI) on mortality and complications by comparing the surgical outcomes of a cohort of surgical patients treated before and after implementation of the FSI...
November 30, 2016: JAMA Surgery
https://www.readbyqxmd.com/read/27902607/perioperative-complications-following-preoperative-cessation-of-antithrombotic-agents-for-total-knee-arthroplasty-a-retrospective-study
#5
Jin-Young Hwang, Sohee Oh, Chong-Soo Kim, Jee-Eun Chang, Seong-Won Min
The number of elderly patients undergoing total knee arthroplasty (TKA) has steadily increased. Elderly patients undergoing TKA usually have underlying diseases, and some of them take antithrombotic agents for the prevention or treatment of these co-morbidities, including cardiovascular, cerebrovascular, or thromboembolic diseases. When these patients are scheduled to undergo TKA, preoperative cessation of antithrombotic agents is considered on the basis of its risks and benefits. This study was aimed to evaluate the impact of discontinuing antithrombotic agents for primary total knee arthroplasty (TKA) on perioperative complications...
November 2016: Medicine (Baltimore)
https://www.readbyqxmd.com/read/27901452/perioperative-characteristics-of-dogs-undergoing-open-versus-laparoscopic-assisted-cystotomy-for-treatment-of-cystic-calculi-89-cases-2011-2015
#6
Ameet Singh, Katie Hoddinott, Shauna Morrison, Michelle L Oblak, Brigitte A Brisson, Adam T Ogilvie, Gabrielle Monteith, John D Denstedt
OBJECTIVE To compare perioperative characteristics of dogs with cystic calculi treated via open versus laparoscopic-assisted cystotomy (LAC). DESIGN Retrospective case series. ANIMALS 89 client-owned dogs that underwent open cystotomy (n = 39) or LAC (50). PROCEDURES Medical records of dogs that underwent cystotomy between 2011 and 2015 were reviewed. History, signalment, surgery date, results of physical examination, results of preoperative diagnostic testing, details of surgical treatment, duration of surgery, perioperative complications, treatment costs, and duration of hospitalization were recorded...
December 15, 2016: Journal of the American Veterinary Medical Association
https://www.readbyqxmd.com/read/27901350/blood-transfusion-requirement-and-not-preoperative-anaemia-is-associated-with-perioperative-complications-following-intracorporeal-robotic-assisted-radical-cystectomy
#7
Wei Shen Tan, Benjamin Wilfrid Lamb, Pramit Khetrapal, Mae-Yen Tan, Melanie El Tan, Ashwin Sridhar, Elizabeth Cervi, Simon Rodney, Gerald Busuttil, Senthil Nathan, John Hines, Greg Shaw, Anna Mohammed, Hilary Baker, Timothy P Briggs, Andrew Klein, Toby Richards, John D Kelly
OBJECTIVES: To assess the prevalence of preoperative anaemia and the impact of preoperative anaemia and blood transfusion requirement on 30- and 90-day complications in a cohort of patients undergoing robotic assisted radical cystectomy with intracorporeal urinary diversion (iRARC). PATIENTS & METHODS: IRARC was performed on 166 patients between June 2011-March 2016. Prospective data was collected for patient demographics, clinical and pathological characteristics, perioperative variables, transfusion requirements and hospital length of stay...
November 30, 2016: Journal of Endourology
https://www.readbyqxmd.com/read/27900630/current-delivery-of-hyperthermic-intraperitoneal-chemotherapy-with-cytoreductive-surgery-cs-hipec-and-perioperative-practices-an-international-survey-of-high-volume-surgeons
#8
Allison H Maciver, Eisar Al-Sukhni, Jesus Esquivel, Joseph J Skitzki, John M Kane, Valerie A Francescutti
BACKGROUND: Cytoreductive surgery and heated intraperitoneal chemotherapy (CS/HIPEC) is performed for selected indications at a limited number of specialized centers worldwide. Currently there is no standardized approach to the perioperative care process. We sought to capture current practices in the perioperative management of patients who undergo CS/HIPEC at high-volume centers. METHODS: Surgeon members of the American Society of Peritoneal Surface Malignancies working at high-volume CS/HIPEC centers (>10 cases/year) were invited to complete an online survey...
November 29, 2016: Annals of Surgical Oncology
https://www.readbyqxmd.com/read/27898510/the-effect-of-implementation-of-preoperative-and-postoperative-care-elements-of-a-perioperative-surgical-home-model-on-outcomes-in-patients-undergoing-hip-arthroplasty-or-knee-arthroplasty
#9
Thomas R Vetter, Joydip Barman, James M Hunter, Keith A Jones, Jean-Francois Pittet
BACKGROUND: The Perioperative Surgical Home (PSH) seeks to remedy the currently highly fragmented and expensive perioperative care in the United States. The 2 specific aims of this health services research study were to assess the association between the preoperative and postoperative elements of an initial PSH model and a set of (1) clinical, quality, and patient safety outcomes and (2) operational and financial outcomes, in patients undergoing total hip arthroplasty (THA) or total knee arthroplasty (TKA)...
November 28, 2016: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/27894845/thromboelastography-demonstrates-perioperative-hypercoagulability-in-hepato-pancreato-biliary-patients-and-supports-routine-administration-of-preoperative-and-early-postoperative-venous-thromboembolism-chemoprophylaxis
#10
Anh-Thu Le, Jennifer W Harris, Erin Maynard, Sean P Dineen, Ching-Wei D Tzeng
BACKGROUND: We hypothesized hepato-pancreato-biliary (HPB) surgery patients are more likely to be hypercoagulable than hypocoagulable, and that bleeding risks from VTE chemoprophylaxis are low. This study sought to use thromboelastography (TEG) to compare coagulation profiles with bleeding/thrombotic events in HPB patients receiving standardized perioperative chemoprophylaxis. METHODS: Consecutive patients undergoing HPB resections by three surgeons at one institution (January 2014-December 2015) received preoperative and early postoperative VTE chemoprophylaxis and were evaluated with TEGs...
November 25, 2016: HPB: the Official Journal of the International Hepato Pancreato Biliary Association
https://www.readbyqxmd.com/read/27894155/increased-lower-extremity-venous-stasis-may-contribute-to-deep-venous-thrombosis-formation-after-microsurgical-breast-reconstruction-an-ultrasonographic-study
#11
Arash Momeni, Michael G Tecce, Michael A Lanni, Shagun Aggarwal, Christopher Pannucci, Stephen J Kovach, Suhail K Kanchwala, Liza C Wu, Joseph M Serletti
Background Despite guideline-compliant prophylaxis, an increased rate of deep venous thrombosis (DVT) formation has been reported following autologous versus implant-based breast reconstruction. We hypothesized that tight abdominal fascia closure might decrease lower extremity venous return and promote venous stasis. Methods An observational crossover study of patients who underwent autologous breast reconstruction using transverse rectus abdominis musculocutaneous/deep inferior epigastric artery perforator flaps was conducted...
November 28, 2016: Journal of Reconstructive Microsurgery
https://www.readbyqxmd.com/read/27888814/diaphragmatic-dysfunction-after-thoracic-operations
#12
Henning Gaissert, Susan R Wilcox
The perioperative management of diaphragmatic weakness and phrenic nerve dysfunction is complex, due to varied etiologies and clinical presentations. The factors leading to diaphragmatic weakness may culminate after the operation with transient or persistent respiratory failure. This review discusses diaphragmatic disorders and postoperative respiratory failure caused by unilateral or bilateral diaphragmatic impairment. The origins of neuromuscular weakness involving the diaphragm are diverse, and often lie within the domains of different medical specialties, with only a portion of the condition related to surgical intervention...
November 26, 2016: Thoracic and Cardiovascular Surgeon
https://www.readbyqxmd.com/read/27887932/assessing-national-provision-of-care-variability-in-bariatric-clinical-care-pathways
#13
Dana A Telem, Saniea F Majid, Kinga Powers, Eric DeMaria, John Morton, Daniel B Jones
BACKGROUND: The American Society for Metabolic and Bariatric Surgery (ASMBS) Quality Improvement and Patient Safety (QIPS) Committee hypothesized that collecting and sharing clinical pathways could provide a valuable resource to new and existing bariatric programs. OBJECTIVE: To shed light on the variability in practice patterns across the country by analyzing pathways. SETTING: United States Centers of Excellence METHODS: From June 2014 to April 2015, clinical pathways pertaining to preoperative, intraoperative, and postoperative management of bariatric patients were solicited from the ASMBS executive council (EC), QIPS committee members, and state chapter presidents...
August 3, 2016: Surgery for Obesity and related Diseases: Official Journal of the American Society for Bariatric Surgery
https://www.readbyqxmd.com/read/27886686/preoperative-versus-postoperative-initiation-of-warfarin-therapy-in-patients-undergoing-total-hip-and-knee-arthroplasty
#14
REVIEW
Cara Cipriano, Nicholas Erdle, Kai Li, Brian Curtin
The optimal strategy for postoperative deep venous thrombosis prophylaxis remains controversial in hip and knee arthroplasty. Warfarin causes transient hypercoagulability; however, the optimal timing of treatment remains unclear. We evaluated the effects of preoperative versus postoperative warfarin therapy with a primary endpoint of perioperative change in hemoglobin. Warfarin was dosed according to a standard nomogram. No difference in perioperative hemoglobin change was observed. The preoperative group demonstrated higher INRs...
January 2017: Orthopedic Clinics of North America
https://www.readbyqxmd.com/read/27885960/high-dose-tranexamic-acid-reduces-intraoperative-and-postoperative-blood-loss-in-posterior-lumbar-interbody-fusion
#15
Junichi Kushioka, Tomoya Yamashita, Shinya Okuda, Takafumi Maeno, Tomiya Matsumoto, Ryoji Yamasaki, Motoki Iwasaki
OBJECTIVE Tranexamic acid (TXA), a synthetic antifibrinolytic drug, has been reported to reduce blood loss in orthopedic surgery, but there have been few reports of its use in spine surgery. Previous studies included limitations in terms of different TXA dose regimens, different levels and numbers of fused segments, and different surgical techniques. Therefore, the authors decided to strictly limit TXA dose regimens, surgical techniques, and fused segments in this study. There have been no reports of using TXA for prevention of intraoperative and postoperative blood loss in posterior lumbar interbody fusion (PLIF)...
November 25, 2016: Journal of Neurosurgery. Spine
https://www.readbyqxmd.com/read/27885355/applying-the-mini-open-anterolateral-lumbar-interbody-fusion-with-self-anchored-stand-alone-polyetheretherketone-cage-in-lumbar-revision-surgery
#16
Lei Kuang, Yuqiao Chen, Lei Li, Guohua Lü, Bing Wang
The author retrospectively studied twenty-two patients who underwent revision lumbar surgeries using ALLIF with a self-anchored stand-alone polyetheretherketone (PEEK) cage. The operation time, blood loss, and perioperative complications were evaluated. Oswestry disability index (ODI) scores and visual analog scale (VAS) scores of leg and back pain were analyzed preoperatively and at each time point of postoperative follow-up. Radiological evaluation including fusion, disc height, foraminal height, and subsidence was assessed...
2016: BioMed Research International
https://www.readbyqxmd.com/read/27879576/analysis-of-sagittal-parameters-in-patients-undergoing-one-or-two-level-closing-wedge-osteotomy-for-correcting-thoracolumbar-kyphosis-secondary-to-ankylosing-spondylitis
#17
Wen-Bin Hua, Yu-Kun Zhang, Yong Gao, Xian-Zhe Liu, Shu-Hua Yang, Xing-Huo Wu, Jing Wang, Cao Yang
STUDY DESIGN: Retrospective analysis of clinical records. OBJECTIVE: To assess and compare the improvement in sagittal balance after one- or two-level closing wedge osteotomy for correcting thoracolumbar kyphosis secondary to ankylosing spondylitis (AS). SUMMARY OF BACKGROUND DATA: Closing wedge osteotomy represents a common approach to correct kyphosis in AS. While several reports have described the outcomes of one- or two-level closing wedge osteotomy in terms of sagittal parameters, data comparing the outcomes of these procedures are scarce...
November 22, 2016: Spine
https://www.readbyqxmd.com/read/27878812/perioperative-blood-transfusion-does-it-influence-survival-and-cancer-progression-in-metastatic-spine-tumor-surgery
#18
Aye Sandar Zaw, Shashidhar B Kantharajanna, Karthikeyan Maharajan, Barry Tan, Balamurugan Vellayappan, Naresh Kumar
BACKGROUND: Despite advances in surgical techniques for spinal metastases, there is often substantial blood loss, resulting in patients requiring blood transfusion during the perioperative period. Allogeneic blood transfusion (ABT) has been the main replenishment method for lost blood. However, the impact of ABT on cancer-related outcomes has been controversial in various studies. We aimed to evaluate the influence of perioperative ABT on disease progression and survival in patients undergoing metastatic spinal tumor surgery (MSTS)...
November 22, 2016: Transfusion
https://www.readbyqxmd.com/read/27876305/new-prostate-cancer-grading-system-predicts-long-term-survival-following-surgery-for-gleason-score-8-10-prostate-cancer
#19
Won Sik Ham, Heather J Chalfin, Zhaoyong Feng, Bruce J Trock, Jonathan I Epstein, Carling Cheung, Elizabeth Humphreys, Alan W Partin, Misop Han
BACKGROUND: The newly proposed five-tiered prostate cancer grading system (PCGS) divides Gleason score (GS) 8-10 disease into GS 8 and GS 9-10 on the basis of biochemical recurrence (BCR) following radical prostatectomy (RP) as an outcome. However, BCR does not necessarily portend worse survival outcomes. OBJECTIVE: To assess the significance of distinguishing GS 8 versus 9-10 disease in terms of long-term survival outcomes for both the preoperative setting using biopsy (Bx) GS and the postoperative setting with RP GS...
November 19, 2016: European Urology
https://www.readbyqxmd.com/read/27876194/predictive-factors-of-overall-and-major-postoperative-complications-after-partial-nephrectomy-results-from-a-multicenter-prospective-study-the-record-1-project
#20
A Mari, A Antonelli, R Bertolo, G Bianchi, M Borghesi, V Ficarra, C Fiori, M Furlan, S Giancane, N Longo, V Mirone, G Morgia, F Porpiglia, B Rovereto, R Schiavina, S Serni, C Simeone, A Volpe, M Carini, A Minervini
INTRODUCTION AND OBJECTIVES: To analyze postoperative complications and to assess for significant predictive factors during partial nephrectomy (PN) using a large multicenter dataset. METHODS: Patients who underwent PN for clinical T1 renal tumors at 19 urological Italian centers (Registry of Conservative Renal Surgery [RECORd] project) were evaluated between 2009 and 2012. Anthropometric data, comorbidities and perioperative outcomes were analyzed. Complications were divided as intra- and postoperative, medical and surgical, as appropriate...
November 5, 2016: European Journal of Surgical Oncology
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