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High Risk Surgery

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https://www.readbyqxmd.com/read/28445566/variation-in-outcomes-at-bariatric-surgery-centers-of-excellence
#1
Andrew M Ibrahim, Amir A Ghaferi, Jyothi R Thumma, Justin B Dimick
Importance: In the United States, reports about perioperative complications associated with bariatric surgery led to the establishment of accreditation criteria for bariatric centers of excellence and many bariatric centers obtaining accreditation. Currently, most bariatric procedures occur at these centers, but to what extent they uniformly provide high-quality care remains unknown. Objective: To describe the variation in surgical outcomes across bariatric centers of excellence and the geographic availability of high-quality centers...
April 26, 2017: JAMA Surgery
https://www.readbyqxmd.com/read/28445244/outcomes-after-primary-infliximab-treatment-failure-in-inflammatory-bowel-disease
#2
Sine Buhl, Casper Steenholdt, Maria Rasmussen, Märta K Borghede, Jørn Brynskov, Ole Ø Thomsen, Mark A Ainsworth
BACKGROUND: Primary infliximab treatment failure is common in patients with inflammatory bowel disease and represents a challenge to clinicians. Treatment options are limited. This study assessed the prognosis, defined as surgery-free survival, in patients with primary infliximab treatment failure as compared to patients without primary failure (initial responders). Furthermore, this study assessed the specter of medical therapies used after primary infliximab treatment failure along with treatment outcomes...
April 25, 2017: Inflammatory Bowel Diseases
https://www.readbyqxmd.com/read/28445106/tension-free-inlay-repair-of-large-hiatal-hernias-using-dual-sided-composite-ptfe-eptfe-meshes-in-laparoscopic-surgery-for-gastroesophageal-reflux-disease
#3
Alexander M Prusa, Ivan Kristo, Erwin Rieder, Claudia Ringhofer, Reza Asari, Johannes Miholic, Sebastian F Schoppmann
BACKGROUND: Patients with gastroesophageal reflux disease (GERD) also frequently suffer from concomitant hiatal hernia. It has been described that a preoperative hiatal hernia of ≥3 cm is associated with a more than threefold relative risk for reflux symptom recurrence after fundoplication without mesh reinforcement. In this report, we describe our experience with the implantation of dual-sided composite PTFE/ePTFE meshes in a tension-free fashion during laparoscopic antireflux surgery (LARS)...
April 26, 2017: Journal of Laparoendoscopic & Advanced Surgical Techniques. Part A
https://www.readbyqxmd.com/read/28444664/endocrine-complications-of-surgical-treatment-of-thyroid-cancer-an-update
#4
Pedro Iglesias, Juan José Díez
Postoperative hypoparathyroidism (HypoPT) and hypothyroidism (HypoT) are the main endocrine complications after the surgical treatment for thyroid cancer. Postsurgical HypoPT can be transient, protracted or permanent. Its frequency varies according to the underlying cervical pathology, surgical technique, and mainly the experience of the surgeon. Risk factors for HypoPT include aggressiveness of the tumor, extent of surgery, the presence of parathyroid gland in the pathologic specimen, and surgeon experience...
April 25, 2017: Experimental and Clinical Endocrinology & Diabetes
https://www.readbyqxmd.com/read/28444641/correlation-of-preoperative-roma-scores-with-clinical-stage-in-epithelial-ovarian-cancer-patients
#5
Q-L Li, C-J Wang, P Qi, Y-X Zhang
PURPOSE: The significance of the Risk of Ovarian Malignancy Algorithm (ROMA) in differentiating benign and malignant ovarian lesions has been evidenced. In our clinical work, we found that advanced ovarian cancer were accompanied commonly with high ROMA scores. Thus, this study aimed to clarify the performance of ROMA in different disease stage of epithelial ovarian cancer (EOC) prior to surgery. METHODS: Carbohydrate antigen (CA125) and human epididymis protein 4 (HE4) levels and ROMA scores in 221 patients with FIGO stage I, II or III/IV stage EOC were analyzed...
April 25, 2017: Clinical & Translational Oncology
https://www.readbyqxmd.com/read/28444280/association-of-postoperative-high-sensitivity-troponin-levels-with-myocardial-injury-and-30-day-mortality-among-patients-undergoing-noncardiac-surgery
#6
P J Devereaux, Bruce M Biccard, Alben Sigamani, Denis Xavier, Matthew T V Chan, Sadeesh K Srinathan, Michael Walsh, Valsa Abraham, Rupert Pearse, C Y Wang, Daniel I Sessler, Andrea Kurz, Wojciech Szczeklik, Otavio Berwanger, Juan Carlos Villar, German Malaga, Amit X Garg, Clara K Chow, Gareth Ackland, Ameen Patel, Flavia Kessler Borges, Emilie P Belley-Cote, Emmanuelle Duceppe, Jessica Spence, Vikas Tandon, Colin Williams, Robert J Sapsford, Carisi A Polanczyk, Maria Tiboni, Pablo Alonso-Coello, Atiya Faruqui, Diane Heels-Ansdell, Andre Lamy, Richard Whitlock, Yannick LeManach, Pavel S Roshanov, Michael McGillion, Peter Kavsak, Matthew J McQueen, Lehana Thabane, Reitze N Rodseth, Giovanna A Lurati Buse, Mohit Bhandari, Ignacia Garutti, Michael J Jacka, Holger J Schünemann, Olga Lucía Cortes, Pierre Coriat, Nazari Dvirnik, Fernando Botto, Shirley Pettit, Allan S Jaffe, Gordon H Guyatt
Importance: Little is known about the relationship between perioperative high-sensitivity troponin T (hsTnT) measurements and 30-day mortality and myocardial injury after noncardiac surgery (MINS). Objective: To determine the association between perioperative hsTnT measurements and 30-day mortality and potential diagnostic criteria for MINS (ie, myocardial injury due to ischemia associated with 30-day mortality). Design, Setting, and Participants: Prospective cohort study of patients aged 45 years or older who underwent inpatient noncardiac surgery and had a postoperative hsTnT measurement...
April 25, 2017: JAMA: the Journal of the American Medical Association
https://www.readbyqxmd.com/read/28444177/single-centre-experience-with-transapical-transcatheter-mitral-valve-implantation%C3%A2
#7
Gry Dahle, Kjell-Arne Rein, Arnt E Fiane
OBJECTIVES: A transcatheter heart valve technique can be used in failed mitral valve repairs with annuloplasty rings, deterioriated bioprostheses and in mitral annular calcification, all serving as 'docking stations' for balloon-expandable valves. Specially designed transcatheter mitral valve platforms are used in ongoing studies for native mitral valve regurgitation. We present our single centre experience with transcatheter mitral valve implantation-transapical approach procedures in eleven patients...
April 21, 2017: Interactive Cardiovascular and Thoracic Surgery
https://www.readbyqxmd.com/read/28443721/evaluation-of-surgical-outcomes-with-photoselective-greenlight-xps-laser-vaporization-of-the-prostate-in-high-medical-risk-men-with-benign-prostatic-enlargement-a-multicenter-study
#8
Emad Sabri Rajih, Côme Tholomier, Pierre-Alain Hueber, Abdullah M Alenizi, Roger Valdivieso, Mounsif Azizi, Ricardo R Gonzalez, Greg Eure, Lewis Kriteman, Mahmood A Hai, Kevin Christopher Zorn
Objective To evaluate the safety and short-term outcomes of photoselective vaporization of the prostate using GreenLight XPSTM in treatment of high medical risk men. Methods A multicenter retrospective analysis of 941 men who underwent photoselective vaporization of the prostate between August 2010 and August 2014 was performed. Patients were considered high medical risk if they had an American Society of Anesthesiologists physical status score ≥ 3. Postoperative adverse events, unexpected postoperative medical provider visits after intervention, and functional urinary outcomes were examined...
April 26, 2017: Journal of Endourology
https://www.readbyqxmd.com/read/28443269/epidemiology-and-risk-assessment-of-pediatric-venous-thromboembolism
#9
REVIEW
Arash Mahajerin, Stacy E Croteau
The incidence of diagnosed venous thromboembolism (VTE) has been increasing concurrent with advances in technology and medical care that enhance our ability to treat pediatric patients with critical illness or complex multiorgan system dysfunction. Although the overall incidence of VTE is estimated at 0.07-0.49 per 10,000 children, higher rates are observed in specific populations including hospitalized children, those with central venous catheters (CVCs) or patients convalescing from a major surgery. While the absolute number of pediatric VTE events may seem trivial compared to adults, the increasing incidence, associated with increased mortality and morbidity, the availability of novel therapies, and the impact on the cost of care have made investigation of VTE risk factors and prevention strategies a high priority...
2017: Frontiers in Pediatrics
https://www.readbyqxmd.com/read/28443231/clinical-characteristics-and-risk-factors-analysis-of-lung-metastasis-of-benign-giant-cell-tumor-of-bone
#10
Yongkun Yang, Zhen Huang, Xiaohui Niu, Hairong Xu, Yuan Li, Weifeng Liu
Pulmonary metastasis of benign giant cell tumor of bone is very rare, and its biological behavior is difficult to predict. In the present study, we analyzed the clinical characteristics of and related risk factors for pulmonary metastasis of this tumor. Forty-six patients with lung metastasis were analyzed. In total, 60.9% of the primary tumors were located around the knee joint. The Campanacci stage of all tumors was stage 3. Surgery of the primary tumor included curettage in 37 patients, resection in 8, and amputation in 1...
June 2017: Journal of Bone Oncology
https://www.readbyqxmd.com/read/28443222/analysis-of-hospital-volume-and-factors-influencing-economic-outcomes-in-cancer-surgery-results-from-a-population-based-study-in-korea
#11
Jung-A Lee, So-Young Kim, Keeho Park, Eun-Cheol Park, Jong-Hyock Park
OBJECTIVES: To evaluate associations between hospital volume, costs, and length of stay (LOS), and clinical and demographic outcome factors for five types of cancer resection. The main dependent variables were cost and LOS; the primary independent variable was volume. METHODS: Data were obtained from claims submitted to the Korean National Health Insurance scheme. We identified patients who underwent the following surgical procedures: pneumonectomy, colectomy, mastectomy, cystectomy, and esophagectomy...
February 2017: Osong Public Health and Research Perspectives
https://www.readbyqxmd.com/read/28442802/study-of-prevalence-of-sexually-transmitted-infections-human-immunodeficiency-virus-and-condom-use-among-male-to-female-transgender-a-retrospective-analysis-from-a-tertiary-care-hospital-in-chennai
#12
Subhash Dasarathan, S Kalaivani
CONTEXT: A "Transgender" person is one who dresses as, desires to be, has undergone surgery to become or identifies with opposite sex. They have a higher risk of sexually transmitted infection (STI) due to a combination of biological and social reasons. They have risky sexual behaviors but low-risk perception. AIMS: The aim of this study is to determine the prevalence of STI/human immunodeficiency virus (HIV) in transgender (TG) and association with condom use. SETTINGS AND DESIGN: A retrospective study of 82 male-to-female TGs attending our sexually transmitted disease (STD) clinic from 2011 to 2014 was undertaken...
January 2017: Indian Journal of Sexually Transmitted Diseases
https://www.readbyqxmd.com/read/28442169/cochlear-implantation-in-children-with-anomalous-cochleovestibular-anatomy
#13
REVIEW
Ana Sofia Melo, Jorge Martins, João Silva, Jorge Quadros, António Paiva
OBJECTIVE: The aim of the study is to assess the audiological and surgical outcome after cochlear implantation in children with inner ear malformation and to compare them with a group of congenitally deaf children implantees without inner ear malformation. INTRODUCTION: Children with profound sensorineural deafness with malformations of the inner ear represent a challenge, accounting to 5-15% of congenital sensorineural deafness. These cases were originally regarded as a contraindication for cochlear implant surgery...
April 22, 2017: Auris, Nasus, Larynx
https://www.readbyqxmd.com/read/28442139/intraoperative-ultrasound-assisted-approach-for-endoscopic-treatment-of-vesicoureteral-reflux-in-children
#14
Elisa Zambaiti, Maria Sergio, Alessandra Casuccio, Sergio Salerno, Marcello Cimador
PURPOSE: Despite minimal invasiveness and high success rate, guidelines still prescribe voiding Cystourethrogram (VCUG) after endoscopic treatment for vesicoureteral reflux (VUR) in children. The aim of this paper was to analyze whether intraoperative ultrasound (IO-US) could improve surgical accuracy and perioperative counseling, thus potentially decreasing the need for postoperative VCUG. METHODS: We selected children treated for moderate to high grade VUR, renal scarring or repeated infections under antibiotic prophylaxis from January to December 2015...
April 18, 2017: Journal of Pediatric Surgery
https://www.readbyqxmd.com/read/28442012/-preoperatiove-airway-bacterial-colonization-the-missing-link-between-non-small-cell-lung-cancer-following-lobectomy-and-postoperative-pneumonia
#15
Ke Gao, Yutian Lai, Jian Huang, Yifan Wang, Xiaowei Wang, Guowei Che
BACKGROUND: Surgical procedure is the main method of treating lung cancer. Meanwhile, postoperative pneumonia (POP) is the major cause of perioperative mortality in lung cancer surgery. The preoperative pathogenic airway bacterial colonization is an independent risk factor causing postoperative pulmonary complications (PPC). This cross-sectional study aimed to explore the relationship between preoperative pathogenic airway bacterial colonization and POP in lung cancer and to identify the high-risk factors of preoperative pathogenic airway bacterial colonization...
April 20, 2017: Zhongguo Fei Ai za Zhi, Chinese Journal of Lung Cancer
https://www.readbyqxmd.com/read/28441803/-factors-for-lymph-node-metastasis-and-survival-rate-in-papillary-thyroid-microcarcinoma-from-a-large-cohort-of-3-607-cases-series
#16
L Xu, Y N Xu, J D Wang
Objective: To investigate high-risk factors for lymph node metastasis (LNM) and 10-year survival rate in patients with papillary thyroid microcarcinoma (PTMC). Methods: We retrospectively analyzed the clinical data of 3 607 patients with PTMC received surgery in our hospital from January 2005 to December 2015. Univariate and multivariate analyses were performed to identify the factors associated with metastasis and 10-year survival rate of the patients was calculated. Results: The patients accepted an average follow-up of 68 months, with follow-up from 18 to 138 months...
April 7, 2017: Zhonghua Er Bi Yan Hou Tou Jing Wai Ke za Zhi, Chinese Journal of Otorhinolaryngology Head and Neck Surgery
https://www.readbyqxmd.com/read/28441687/c-arm-positioning-is-a-significant-source-of-radiation-in-spine-surgery
#17
Elizabeth W Reiser, Rupen Desai, Sarah A Byrd, Harrison Farber, Deborah Chi, Cary S Idler, Robert E Isaacs
STUDY DESIGN: Prospective chart review. OBJECTIVE: It is well-known that radiation exposure during minimally invasive spine procedures can be substantial. Less interest has focused on setup radiation exposure before incision, including preoperative images used for surgical approach. The present study seeks to better quantify the significance of setup radiation in the total radiation exposure of minimally invasive spine surgery. SUMMARY OF BACKGROUND DATA: Radiographic localization is necessary in minimally invasive spine procedures to visualize anatomy, but increased radiation exposure is associated with health risks...
May 1, 2017: Spine
https://www.readbyqxmd.com/read/28441307/90-day-readmission-after-lumbar-spinal-fusion-surgery-in-new-york-state-between-2005-and-2014-a-10-year-analysis-of-a-statewide-cohort
#18
Ali A Baaj, Gernot Lang, Wei-Chun Hsu, Mauricio J Avila, Jialin Mao, Art Sedrakyan
STUDY DESIGN: Retrospective cohort study. OBJECTIVE: To assess 90-day readmission and evaluate risk factors associated with readmission after lumbar fusion in New York State. SUMMARY OF BACKGROUND DATA: Readmission is becoming an important metric for quality and efficiency of healthcare. Readmission and its predictors following spine surgery are overall poorly understood and limited evidence is available specifically in lumbar fusion. METHODS: The New York Statewide Planning and Research Cooperative System (SPACRS) was utilized to capture patients undergoing lumbar fusion from 2005-2014...
April 24, 2017: Spine
https://www.readbyqxmd.com/read/28440518/-choice-of-bariatric-and-metabolic-surgical-procedures
#19
Hui Liang, Shibo Lin, Wei Guan
Bariatric and metabolic surgery has become the clinical hot topic of the treatment of metabolic syndromes including obesity and diabetes mellitus, but how to choose the appropriate surgical procedure remains the difficult problem in clinical practice. Clinical guidelines of American Society for Metabolic and Bariatric Surgery(ASMBS)(version 2013) introduced the procedures of bariatric and metabolic surgery mainly including biliopancreatic diversion with duodenal switch(BPD-DS), laparoscopic adjustable gastric banding (LAGB), laparoscopic Roux-en-Y gastric bypass (LRYGB) and laparoscopic sleeve gastrectomy(LSG)...
April 25, 2017: Zhonghua Wei Chang Wai Ke za Zhi, Chinese Journal of Gastrointestinal Surgery
https://www.readbyqxmd.com/read/28440517/-efficacy-and-future-of-endoscopic-bariatric-surgery-in-the-treatment-of-obesity-and-metabolic-diseases
#20
Shangjia Huang, Junchang Zhang, Zhiyong Dong, Cunchuan Wang
The emerging endoscopic technologies are proved to be effective treatments for obesity in selected patients and to offer the potential advantages of reduced invasiveness, reversibility and repeatability. From the view of operation principle, endoscopic technologies can be classified as restrictive procedure, malabsorption procedure and endoscopic revision of gastric bypass. Restrictive procedures include intragastric balloon, aspiration therapy, endoscopic sleeve gastroplasty (ESG) and transoral gastroplasty...
April 25, 2017: Zhonghua Wei Chang Wai Ke za Zhi, Chinese Journal of Gastrointestinal Surgery
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