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https://www.readbyqxmd.com/read/29150035/thoracic-surgery-considerations-in-obese-patients
#1
REVIEW
Douglas Z Liou, Mark F Berry
The obesity epidemic in the United States has increased greatly over the past several decades, and thoracic surgeons are likely to see obese patients routinely in their practices. Obesity has direct deleterious health effects such as metabolic disorder and cardiovascular disease, and is associated with many cancers. Obese patients who need thoracic surgery pose practical challenges to many of the routine elements in perioperative management. Preoperative assessment of obesity-related comorbid conditions and risk stratification for surgery, thorough intraoperative planning for anesthesia and surgery, and postoperative strategies to optimize pulmonary hygiene and mobility minimize the risk of adverse outcomes...
February 2018: Thoracic Surgery Clinics
https://www.readbyqxmd.com/read/29146268/surgical-apgar-score-predicts-30-day-morbidity-in-elderly-patients-who-undergo-non-laparoscopic-gynecologic-surgery-a-retrospective-analysis
#2
Kazumi Kurata, Yoko Chino, Akiko Shinagawa, Tetsuji Kurokawa, Yoshio Yoshida
INTRODUCTION: The aim of this study was to determine whether a preoperative health status index and intraoperative data could predict perioperative morbidity and mortality in women over the age of 65 years undergoing surgery for gynecologic disorders. METHODS: The medical records of 68 female patients who were ≥65 years of age and who underwent surgery under general anesthesia in our institute from January 2014 to December 2015 were retrospectively reviewed. Preoperative data were extracted from a database and included comorbidities, American Society of Anesthesiologists physiological status classification, the Charlson Comorbidity Index, the Subjective Global Assessment 2011 revision, the subjects' risk of falling, body mass index, and age...
November 13, 2017: International Journal of Surgery
https://www.readbyqxmd.com/read/29145723/statin-initiation-and-renal-outcomes-following-isolated-coronary-artery-bypass-grafting-a-meta-analysis
#3
Yushu Wang, Sui Zhu, Rongsheng DU, Juteng Zhou, Yucheng Chen, Qing Zhang
BACKGROUND: The effects of preoperative statin therapy (PST) on renal outcomes in patients with isolated coronary artery bypass grafting (CABG) are in controversial. This study aimed to assess the effects of preoperative statin use on postoperative renal outcomes in patients undergoing isolated CABG. METHODS: PubMed, EMBASE, and Cochrane Library were searched for studies published up to February 2017. Pooled odds ratio (OR) and its corresponding 95% confidence interval (95% CI) were calculated...
November 16, 2017: Journal of Cardiovascular Surgery
https://www.readbyqxmd.com/read/29145281/cup-revision-involving-retention-of-a-fixed-but-malpositioned-acetabular-component-in-patients-with-poor-general-conditions
#4
Weiping Su, Min Zeng, Yihe Hu, Jianxi Zhu, Long Wang, Jie Xie
This study evaluated the surgical technique and outcomes of cup revision involving retention of a fixed but malpositioned acetabular component in patients with poor general conditions.Between 2007 and 2013, we performed cup revision on 12 hips while retaining a fixed (either cemented or uncemented) but malpositioned acetabular component. Indications for this technique were: malpositioned but fixed acetabular shell; sufficient space for the insertion of the prosthesis; and patients with poor general conditions...
November 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29144626/super-selective-robot-assisted-partial-nephrectomy-using-near-infrared-flurorescence-versus-early-unclamping-of-the-renal-artery-results-of-a-prospective-matched-pair-analysis
#5
Cecilia Lanchon, Valentin Arnoux, Gaëlle Fiard, Jean-Luc Descotes, Jean-Jacques Rambeaud, Jean-Benjamin Lefrancq, Delphine Poncet, Nicolas Terrier, Camille Overs, Quentin Franquet, Jean-Alexandre Long
INTRODUCTION: Super-selective clamping of tumor-specific segmental arteries was developed to eliminate ischemia of the remnant kidney while limiting hemorrhage during partial nephrectomy. The objective is to evaluate the benefice of super-selective clamping on renal functional outcome, compared to early-unclamping of the renal artery. MATERIALS AND METHODS: From March 2015 to July 2016, data from 30 patients undergoing super-selective robot-assisted PN (RAPN) for a solitary tumor by a single surgeon were prospectively collected...
November 19, 2017: International Braz J Urol: Official Journal of the Brazilian Society of Urology
https://www.readbyqxmd.com/read/29143893/the-role-of-systemic-therapy-in-resectable-gastric-and-gastro-oesophageal-junction-cancer
#6
REVIEW
Elizabeth Cartwright, David Cunningham
Approximately 20% of patients with cancer of the stomach or gastro-oesophageal junction (GOJ) present with resectable disease. Long-term outcome after surgery alone in these patients is poor, and a combined treatment approach is the standard of care. The two approaches to managing patients with cancer of the GOJ are perioperative chemotherapy or preoperative chemoradiotherapy. Based upon the most recent evidence, patients treated with a perioperative approach and deemed suitable for a triplet regimen should be considered for pre- and post-operative FLOT (5-fluorouracil [5-FU], leucovorin, oxaliplatin and docetaxel) and those suitable for a doublet regimen should be considered for a fluoropyrimidine/platinum combination such as capecitabine and oxaliplatin...
November 16, 2017: Current Treatment Options in Oncology
https://www.readbyqxmd.com/read/29143088/the-association-of-preoperative-hematocrit-and-transfusion-with-mortality-in-patients-undergoing-elective-non-cardiac-surgery
#7
Rodney A Gabriel, Anthony I Clark, Albert P Nguyen, Ruth S Waterman, Ulrich H Schmidt
BACKGROUND: Patients with anemia frequently undergo surgery, as it is unclear at what threshold clinicians should consider delaying surgery for preoperative anemia optimization. The primary objective of this study was to determine whether there is an association of varying degrees of anemia and transfusion with 30-day mortality. METHODS: This is a retrospective cohort study using the American College of Surgeons National Surgical Quality Improvement Program database from 2011 to 2013...
November 15, 2017: World Journal of Surgery
https://www.readbyqxmd.com/read/29142836/preoperative-intraoperative-and-postoperative-anesthetic-prospective-for-thyroid-surgery-what-s-new
#8
REVIEW
I-Cheng Lu, I-Hua Lin, Che-Wei Wu, Hsiu-Ya Chen, Yi-Chu Lin, Feng-Yu Chiang, Pi-Ying Chang
The aim of this review is to analyze what's new on anesthetic prospective to perioperative management for thyroid surgery. For recent decades intraoperative neuromonitoring (IONM) during thyroid and parathyroid surgery has obtained more and more popularity. New modality of anesthetic technique was also developed to incorporate into surgical teamwork. For example, the precise position of EMG tube and optimal use of neuromuscular blocking agents (NMBAs) play key roles in successful IONM system. Special focus is paid to following issues: (I) preoperative airway evaluation and pre-op preparation; (II) anesthetic managements including advanced intubation tools, NMBAs and sugammadex; and (III) post-op adverse events such as pain and postoperative nausea vomiting...
October 2017: Gland Surgery
https://www.readbyqxmd.com/read/29141613/determinants-of-patient-satisfaction-following-reconstructive-shoulder-surgery
#9
Sascha J Baettig, Karl Wieser, Christian Gerber
BACKGROUND: Obtaining patient satisfaction is a key goal of surgical treatment. It was the purpose of this study to identify pre-, peri- and postoperative factors determining patient satisfaction after shoulder surgery, quantify their relative importance and thereby allow the surgeon to focus on parameters, which will influence patient satisfaction. METHODS: We retrospectively reviewed 505 patients, who underwent either rotator cuff repair (n = 216) or total shoulder arthroplasty (n = 289)...
November 15, 2017: BMC Musculoskeletal Disorders
https://www.readbyqxmd.com/read/29141566/perioperative-levels-of-adiponectin-and-oxidative-stress-in-patients-undergoing-laparoscopic-abdominal-surgery-for-cancer
#10
Cosimo Chelazzi, Gianluca Villa, Paola Mancinelli, Matteo Becatti, Maria Boddi, Mirella Coppo, Stefano Romagnoli
BACKGROUND: Low circulating levels of adiponectin are associated with the occurrence of infection after surgery in patients with cancer. Data are lacking on whether surgical stress is associated with a reduction in circulating levels of adiponectin. Furthermore, the relationships between oxidative stress and postoperative complications have not been investigated. OBJECTIVE: The aim of this study was to evaluate the pre-, intra-, and postoperative levels of adiponectin in patients who underwent major abdominal surgery for malignancy and their association with postoperative complications...
November 14, 2017: Anti-inflammatory & Anti-allergy Agents in Medicinal Chemistry
https://www.readbyqxmd.com/read/29141380/-the-analysis-of-anesthetic-management-for-renal-cell-carcinoma-with-associated-inferior-vena-cava-tumor-thrombus
#11
H Zeng, X Y Rong, Y Wang, X Y Guo
Objective: To explore the key points of anesthetic management for renal cell carcinoma combined with inferior vena cava (IVC) tumor thrombus. Methods: Twenty-seven cases of renal cell carcinoma with inferior vena cava (IVC) tumor thrombus underwent radical nephrectomy and inferior caval venous thrombectomy were reviewed retrospectively during January 2014 to January 2017 in our hospital.Analyzed data includs demographics, classification of tumor, perioperative anesthetic management and monitoring approaches, IVC clamping time , vital signs during cardiopulmonary bypass(CPB), estimated blood loss (EBL), usage of blood products, hospitalization time and ICU time , as well as postoperative outcomes...
November 14, 2017: Zhonghua Yi Xue za Zhi [Chinese medical journal]
https://www.readbyqxmd.com/read/29140834/prognostic-factors-in-patients-with-metastatic-spinal-cord-compression-secondary-to-melanoma-a-systematic-review
#12
Nicholas J Hadden, Jerome R D McIntosh, Samuel Jay, Paula J Whittaker
Melanoma is one of the most common primary tumours associated with metastatic spinal cord compression (MSCC). The aim of this review is to identify prognostic factors specifically for MSCC secondary to melanoma. A systematic search of literature was performed in MEDLINE, Embase and the Cochrane Library to identify studies reporting prognostic factors for patients with MSCC secondary to melanoma. Two studies, involving a total of 39 patients, fulfilled the inclusion criteria. The variables associated with increased survival were receiving postoperative radiotherapy, receiving chemotherapy, perioperative lactate dehydrogenase level less than or equal to 8...
November 14, 2017: Melanoma Research
https://www.readbyqxmd.com/read/29140542/perioperative-von-willebrand-factor-dynamics-are-associated-with-liver-regeneration-and-predict-outcome-after-liver-resection
#13
Patrick Starlinger, David Pereyra, Stefanie Haegele, Paul Braeuer, Lukas Oehlberger, Florian Primavesi, Andreas Kohler, Florian Offensperger, Thomas Reiberger, Arnulf Ferlitsch, Barbara Messner, Guido Beldi, Stefan Staettner, Christine Brostjan, Thomas Gruenberger
Von Willebrand Factor (vWF) was found to mediate platelet influx during the early phase of liver regeneration in mice. Further, increased vWF-antigen (vWF-Ag) levels were shown to be predictive for outcome of patients with chronic liver disease. Accordingly, we aimed to assess the relevance of perioperative vWF-Ag dynamics in terms of liver regeneration and clinical outcome in patients undergoing liver resection (LR). Accordingly, we observed that vWF-Ag and its activity - estimated via ristocetin cofactor measurement - increased immediately after induction of liver regeneration and was associated with platelet accumulation within the liver...
November 15, 2017: Hepatology: Official Journal of the American Association for the Study of Liver Diseases
https://www.readbyqxmd.com/read/29140418/perioperative-management-of-the-obese-surgical-patient
#14
L H Lang, K Parekh, B Y K Tsui, M Maze
Introduction: The escalation in the prevalence of obesity throughout the world has led to an upsurge in the number of obese surgical patients to whom perioperative care needs to be delivered. Sources of data: After determining the scope of the review, the authors used PubMed with select phrases encompassing the words in the scope. Both preclinical and clinical reports were considered. Areas of agreement: There were no controversies regarding preoperative management and the intraoperative care of the obese surgical patient...
November 13, 2017: British Medical Bulletin
https://www.readbyqxmd.com/read/29139021/perioperative-complications-and-mortality-in-patients-with-urothelial-carcinoma-and-end-stage-renal-disease-undergoing-one-stage-complete-urinary-tract-extirpation
#15
Yun-Ching Huang, Ying-Hsu Chang, Alan W Shindel, Yin-Lun Chang, Jian-Hui Lin, Dong-Ru Ho, Chih-Shou Chen
BACKGROUND: Complete urinary tract extirpation (CUTE) is a complex procedure with substantial risk for perioperative complications. The association between clinical characteristics and the risk of major postoperative complications has not been systematically investigated. OBJECTIVE: The aim of this study was to analyze the incidence and risks for major perioperative complications after CUTE. METHODS: Respective chart review of 81 patients with urothelial carcinoma (UC) who were treated with one-stage CUTE between January 2004 and December 2015...
November 14, 2017: Annals of Surgical Oncology
https://www.readbyqxmd.com/read/29137576/perioperative-assessment-of-older-surgical-patients-using-a-frailty-index-feasibility-and-association-with-adverse-post-operative-outcomes
#16
H Lin, N M Peel, I A Scott, D L Vardesh, P Sivalingam, R L McBride, J J Morong, M J Nelson, R E Hubbard
This study aimed to examine the feasibility of using a frailty index (FI) based on comprehensive geriatric assessment (CGA), to assess the level of frailty in older surgical patients preoperatively and to evaluate the association of FI-CGA with poorer postoperative outcomes. Two hundred and forty-six patients aged ≥70 years undergoing intermediate- to high-risk surgery in a tertiary hospital were recruited. Frailty was assessed using a 57-item FI-CGA form, with fit, intermediate frail, and frail patients defined as FI ≤0...
November 2017: Anaesthesia and Intensive Care
https://www.readbyqxmd.com/read/29136737/-research-progress-on-early-diagnosis-reasonable-prevention-and-treatment-of-symptomatic-spinal-epidural-hematoma-following-spinal-surgery
#17
X W Ye, S S Liu, P H Zeng, B L Liu
Symptomatic spinal epidural hematoma (SSEH) following spinal surgery is rare but one of the serious complications. SSEH can leave devastating neurological consequences if missing the optimal timing for treatment. The early diagnosis of SSEH is critical to the neurologic recovery, and MRI examination can help to check the location and the scope of the hematoma and provide imaging information for surgical operation. The risk factors of SSEH can be divided into preoperative factors, intraoperative factors and postoperative factors...
November 1, 2017: Zhonghua Wai Ke za Zhi [Chinese Journal of Surgery]
https://www.readbyqxmd.com/read/29135994/perioperative-risk-factors-for-postoperative-pneumonia-after-major-oral-cancer-surgery-a-retrospective-analysis-of-331-cases
#18
Jieyun Xu, Jing Hu, Pei Yu, Weiwang Wang, Xingxue Hu, Jinsong Hou, Silian Fang, Xiqiang Liu
OBJECTIVE: Postoperative pneumonia (POP) is common and results in prolonged hospital stays, higher costs, increased morbidity and mortality. However, data on the incidence and risk factors of POP after oral and maxillofacial surgery are rare. This study aims to identify perioperative risk factors for POP after major oral cancer (OC) surgery. METHODS: Perioperative data and patient records of 331 consecutive subjects were analyzed in the period of April 2014 to March 2016...
2017: PloS One
https://www.readbyqxmd.com/read/29135700/safety-outcomes-following-spine-and-cranial-neurosurgery-evidence-from-the-national-surgical-quality-improvement-program
#19
Andrew K Rock, Charles F Opalak, Kathryn G Workman, William C Broaddus
BACKGROUND: The American College of Surgeons National Surgical Quality Improvement Program (ACS-NSQIP) was used to establish predictors for 30-day postoperative complications following spine and cranial neurosurgery. MATERIALS AND METHODS: The ACS-NSQIP participant use files were queried for neurosurgical cases between 2005 and 2015. Prevalence of postoperative complications following neurosurgery was determined. Nested multivariable logistic regression analysis was used to identify demographic, comorbidity, and perioperative characteristics associated with any complication and mortality for spine and cranial surgery...
November 10, 2017: Journal of Neurosurgical Anesthesiology
https://www.readbyqxmd.com/read/29128486/lower-dose-of-sufentanil-does-not-enhance-fast-track-significantly-a-randomized-study
#20
Rajesh Bhavsar, Pia Katarina Ryhammer, Jacob Greisen, Carl-Johan Jakobsen
OBJECTIVE: Adjustment in the doses of opioids has been a focus of interest for achieving better fast-track conditions in cardiac anesthesia, but relatively sparse information exists on the potential effect of psychologic and behavioral factors, such as stress, anxiety, and type of personality, on anesthesia requirements and patient turnover in the cardiac recovery unit (CRU); to the authors' knowledge, this particular focus has not been systematically investigated. In this randomized study, the authors tested the hypothesis that low-dose sufentanil, compared with a standard dose, can improve fast-track parameters and the overall quality of recovery...
August 9, 2017: Journal of Cardiothoracic and Vascular Anesthesia
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