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https://www.readbyqxmd.com/read/28214321/pr%C3%A3-und-perioperative-aspekte-der-versorgung-dermatochirurgischer-patienten
#1
Cornelia S L Müller, Wakiko Hubner, Sigrid Thieme-Ruffing, Claudia Pföhler, Thomas Vogt, Thomas Volk, Barbara C Gärtner, Patric Bialas
Die Dermatochirurgie nimmt hinsichtlich vieler Punkte eine Sonderstellung unter den operativen Fächern ein. Hierzu gehört in erster Linie die Tatsache, dass bis auf wenige Ausnahmen fast alle Eingriffe traditionell in Lokal- bzw. Regionalanästhesie und oft auch in räumlich-infrastruktureller Trennung von den großen Zentral-Operationssälen stattfinden können. Die peri- und postoperative Überwachung obliegt dabei dem dermatochirurgischen Operationsteam. Das sui generis kleinere OP-Team hat somit eine ganze Reihe perioperativer Notwendigkeiten zu beachten, um die sich in den "großen" chirurgischen Fächern eine Vielzahl verschiedener beteiligter Fachgruppen gemeinsam kümmern...
February 2017: Journal der Deutschen Dermatologischen Gesellschaft, Journal of the German Society of Dermatology: JDDG
https://www.readbyqxmd.com/read/28214316/pre-and-perioperative-aspects-of-dermatosurgery
#2
Cornelia S L Müller, Wakiko Hubner, Sigrid Thieme-Ruffing, Claudia Pföhler, Thomas Vogt, Thomas Volk, Barbara C Gärtner, Patric Bialas
Dermatosurgery occupies an exceptional position among all surgical disciplines. Above all, this includes the fact that, with very few exceptions, the vast majority of surgical interventions can be performed under local or regional anesthesia, usually in smaller procedure rooms that are spatially separated from larger operating suites. Thus, peri- and postinterventional patient monitoring is the responsibility of the dermatosurgeon and his team. Though inherently smaller, this team still has to observe numerous perioperative requirements that - in larger surgical specialties - would be attended to by a host of various specialists working in concert...
February 2017: Journal der Deutschen Dermatologischen Gesellschaft, Journal of the German Society of Dermatology: JDDG
https://www.readbyqxmd.com/read/28213790/optical-see-through-cancer-vision-goggles-enable-direct-patient-visualization-and-real-time-fluorescence-guided-oncologic-surgery
#3
Suman B Mondal, Shengkui Gao, Nan Zhu, LeMoyne Habimana-Griffin, Walter J Akers, Rongguang Liang, Viktor Gruev, Julie Margenthaler, Samuel Achilefu
BACKGROUND: The inability to visualize the patient and surgical site directly, limits the use of current near infrared fluorescence-guided surgery systems for real-time sentinel lymph node biopsy and tumor margin assessment. METHODS: We evaluated an optical see-through goggle augmented imaging and navigation system (GAINS) for near-infrared, fluorescence-guided surgery. Tumor-bearing mice injected with a near infrared cancer-targeting agent underwent fluorescence-guided, tumor resection...
February 17, 2017: Annals of Surgical Oncology
https://www.readbyqxmd.com/read/28213776/the-importance-of-drug-induced-sedation-endoscopy-d-i-s-e-techniques-in-surgical-decision-making-conventional-versus-target-controlled-infusion-techniques-a-prospective-randomized-controlled-study-and-a-retrospective-surgical-outcomes-analysis
#4
Andrea De Vito, Vanni Agnoletti, Gianluca Zani, Ruggero Massimo Corso, Giovanni D'Agostino, Elisabetta Firinu, Chiara Marchi, Ying-Shuo Hsu, Stefano Maitan, Claudio Vicini
Drug-Induced Sedation Endoscopy (DISE) consists of the direct observation of the upper airways during sedative-induced sleep, allowing the identification of the sites of pharyngeal collapse, which is the main pathological event in Obstructive Sleep Apnea (OSA). The Authors have compared Target Controlled Infusion (TCI) sedation endoscopy (TCI-DISE) technique to conventional DISE (CDISE), performed by a manual bolus injection of sedative agent, to recreate accurately and safely snoring and apnea patterns comparable to natural sleep...
February 17, 2017: European Archives of Oto-rhino-laryngology
https://www.readbyqxmd.com/read/28213744/intraductal-papillary-neoplasm-originating-from-an-anomalous-bile-duct
#5
Harufumi Maki, Taku Aoki, Takeaki Ishizawa, Mariko Tanaka, Takashi Sakatani, Yoshifumi Beck, Kiyoshi Hasegawa, Yoshihiro Sakamoto, Norihiro Kokudo
An 82-year-old woman who had been suffering from repeated obstructive jaundice for 7 years was referred to our hospital. Although endoscopic aspiration of the mucin in the common bile duct had been temporally effective, origin of the mucin production had not been detectable. The patient thus had been forced to be on long-term follow-up without curative resection. Endoscopic retrograde cholangioscopy on admission revealed massive mucin in the common bile duct. In addition, an anomalous bile duct located proximal to the gallbladder was identified...
February 17, 2017: Clinical Journal of Gastroenterology
https://www.readbyqxmd.com/read/28213624/oligometastatic-colorectal-cancer-is-single-site-bony-colorectal-metastasis-a-treatable-condition
#6
Noel Cassar, Adrian Ben Cresswell, Brendan Moran
INTRODUCTION: A potentially resectable bony metastasis in the context of oligometastatic colorectal cancer is uncommon. Bony metastases are usually considered a late event with poor prognosis and generally associated with liver and/or lung metastases. INDEX CASE: A previously healthy 33-year-old gentleman, with no family history of colorectal cancer, presented with rectal bleeding and at colonoscopy had a biopsy-proven adenocarcinoma of the rectum, 7 cm from the anal verge...
February 17, 2017: International Journal of Colorectal Disease
https://www.readbyqxmd.com/read/28213166/influence-of-clamping-stress-and-duration-on-the-trauma-of-liver-tissue-during-surgery-operation
#7
Jin Wang, Qing-Yuan Yu, Wei Li, Bing-Rui Wang, Zhong-Rong Zhou
BACKGROUND: Tissue grasping damage often occurs in minimally invasive surgery, which would increase the postoperative recovery time and the risk of surgical complications. The purpose of this study was to evaluate the relationship between liver tissue trauma and compression stress magnitude and duration during tissue clamping operation. METHODS: The clamping experiments of liver tissues in vivo were conducted by using a universal soft tissue mechanical testing machine under different clamping stress magnitudes and durations...
February 10, 2017: Clinical Biomechanics
https://www.readbyqxmd.com/read/28212124/extracranial-meningioma-presenting-as-an-eyebrow-mass
#8
Do Hun Lee, Ho Seup Sim, Jae Ha Hwang, Kwang Seog Kim, Sam Yong Lee
Meningiomas originate in the central nervous system and are the most common intracranial benign tumor. However, although rarely, they can develop extracranially. Primary extracranial meningiomas are frequently misdiagnosed, resulting in inappropriate clinical management. The most common sites of extracranial meningiomas include the skull, scalp, orbit, nose, paranasal sinuses, middle ear, neck, and skin. A 77-year-old woman presented with a mass on her left eyebrow. Computed tomography revealed an enhancing soft tissue mass in the left frontal area...
February 16, 2017: Journal of Craniofacial Surgery
https://www.readbyqxmd.com/read/28211877/fresh-frozen-amniotic-membrane-for-conjunctival-reconstruction-after-excision-of-neoplastic-and-presumed-neoplastic-conjunctival-lesions
#9
U Agraval, P Rundle, I G Rennie, S Salvi
PurposeSuspicious neoplastic conjunctival lesions often require wide excision with tumour-free margins, leaving significant conjunctival defects requiring reconstruction. In this study we report the results of using fresh frozen amniotic membrane grafts (AMG) after wide excision of potentially malignant lesions.MethodsRetrospective review of 53 patients; between January 2011 and April 2014. Conjunctival lesions were excised with a non-touch technique (2 mm margin) and sent for histopathological analysis. The surgical margins were treated with cryotherapy and a fresh frozen AMG was used to cover the defect...
February 17, 2017: Eye
https://www.readbyqxmd.com/read/28210945/mr-imaging-evaluation-of-the-postoperative-meniscus
#10
REVIEW
A Russo, R Capasso, C Varelli, A Laporta, M Carbone, G D'Agosto, S Giovine, M Zappia, A Reginelli
MR imaging has been widely evaluated in the assessment of patients with recurrent or residual symptoms following meniscal surgery. Importantly, the causes of such symptoms may relate to failure or complication of the surgical procedure, a possible recurrent or residual meniscal tear, or may be related to other causes of joint symptoms, including tears of the contralateral meniscus, or local hyaline cartilage, or marrow abnormalities subjacent to or distant to the meniscal surgical site. The complex diagnostic issues involved in the MR imaging evaluation of the postoperative meniscus were identified in early MR imaging studies...
February 16, 2017: Musculoskeletal Surgery
https://www.readbyqxmd.com/read/28210852/treatment-of-rectovaginal-fistula-with-gracilis-muscle-flap-transposition-long-term-follow-up
#11
Seong Oh Park, Ki Yong Hong, Kyo Joo Park, Hak Chang, Jin Yong Shin, Seung-Yong Jeong
PURPOSE: Rectovaginal fistulas are difficult to treat completely, especially when patients present with a history of multiple surgeries and radiation therapy. We aimed to evaluate the efficacy of gracilis muscle flap transposition to treat rectovaginal fistula. METHODS: We performed a retrospective chart review of all gracilis muscle transposition cases and other procedures between January 2009 and July 2016. RESULTS: Total 53 cases were reviewed...
February 16, 2017: International Journal of Colorectal Disease
https://www.readbyqxmd.com/read/28210559/pyoderma-gangrenosum-following-autologous-breast-reconstruction
#12
Prateush Singh, Sami H Tuffaha, Sanford H Robbins, Steven C Bonawitz
Pyoderma gangrenosum (PG) is an uncommon disorder characterized by the development of painful cutaneous ulceration, commonly precipitated by dermal injury at surgical sites. It is a diagnostic challenge as it manifests as necrotizing wounds which are commonly misdiagnosed as postoperative wound infection or ischemia. We discuss the clinical features and histopathological findings that allow for rapid identification of PG following autologous breast reconstruction and suggest an algorithm to aid diagnosis.
February 2017: Gland Surgery
https://www.readbyqxmd.com/read/28210555/breast-reconstruction-with-absorbable-mesh-sling-dynamic-infrared-thermography-of-skin-envelope
#13
Yoko Hashimoto, Naoki Watanabe, Takeshi Yuasa, Yoshinori Suzuki, Hiroshi Saisho
BACKGROUND: To immediate reconstruct ptosis breasts, we used polyglactin (Vicryl; Ethicon Inc., Somerville, NJ, USA) mesh as an inferolateral sling. However, Vicryl mesh is absorbable and losing function as a supporting structure. We doubt about the stability of the blood supply to the inferior part of the flap when it is in direct contact with inner implant. In this study, we examine the complications and the safety of the skin flap of this absorbable mesh sling (AMS) procedure. METHODS: The outcomes of 80 cases were examined, and the 1-year safety record of 40 cases was assessed...
February 2017: Gland Surgery
https://www.readbyqxmd.com/read/28210405/titanium-clamps-for-a-simple-low-profile-autologous-osteosynthesis-in-the-reconstruction-of-posttraumatic-craniofacial-convexital-skeletal-disruption
#14
Amos Olufemi Adeleye, Toluyemi Adefolarin Malomo
Attempts at reconstruction of posttraumatic craniofacial defects (PTCDs) can be a challenge in low-resource practice areas of the world where the needed biomaterials are logistically beyond reach. A simple low-profile technique of autologous osteosynthesis for PTCD using the titanium clamps is presented in this report. In addition, a 6-year prospective database on a consecutive cohort of patients who underwent this procedure was analyzed for clinical, functional, and aesthetic outcomes, both in-hospital and at midterm follow-up...
March 2017: Craniomaxillofacial Trauma & Reconstruction
https://www.readbyqxmd.com/read/28210084/risk-factors-for-intraoperative-perforation-during-endoscopic-submucosal-dissection-of-superficial-esophageal-squamous-cell-carcinoma
#15
Masaaki Noguchi, Tomonori Yano, Tomoji Kato, Tomohiro Kadota, Maomi Imajoh, Hiroyuki Morimoto, Shozo Osera, Atsushi Yagishita, Tomoyuki Odagaki, Yusuke Yoda, Yasuhiro Oono, Hiroaki Ikematsu, Kazuhiro Kaneko
AIM: To identify the risk factors and clarify the subsequent clinical courses. METHODS: This study retrospectively analyzed consecutive patients with esophageal squamous cell carcinoma (ESCC) treated using endoscopic submucosal dissection (ESD) between April 2008 and October 2012. We divided the ESCC lesions into perforation cases and non-perforation cases, and compared characteristics and endoscopic findings between the two groups. "Intraoperative perforation" was defined as the detection of a perforation site during ESD and the presence of mediastinal emphysema...
January 21, 2017: World Journal of Gastroenterology: WJG
https://www.readbyqxmd.com/read/28209490/surgical-site-infection-in-gynecologic-surgery-pathophysiology-and-prevention
#16
REVIEW
Holly L Steiner, Eric A Strand
Surgical site infections (SSIs) represent a well-known cause of patient morbidity as well as added healthcare costs. In gynecologic surgery, particularly hysterectomy, SSIs are often the result of a number of risk factors that may or may not be modifiable. As both the Centers for Medicaid and Medicare Services and the Joint Commission on the Accreditation of Healthcare Organizations have identified SSIs as a patient safety priority, gynecologic surgeons continue to seek out the most effective interventions for SSI prevention...
February 13, 2017: American Journal of Obstetrics and Gynecology
https://www.readbyqxmd.com/read/28209455/port-site-metastases-after-robotic-radical-cystectomy-a-systematic-review-and-management-options
#17
REVIEW
Pramit Khetrapal, Wei Shen Tan, Benjamin Lamb, Senthil Nathan, Tim Briggs, Arjun Shankar, Navin Ramachandran, Alex Freeman, Anita Mitra, John D Kelly
BACKGROUND: Port-site metastases (PSMs) are a rare occurrence after robotic surgery. For robot-assisted radical cystectomy (RARC), isolated cases have been reported but management has not been previously described. We present a case of PSM that occurred after RARC and report the results of our systematic review of previously reported PSMs and describe the treatment options. Search Criteria and Methods: We describe a case of a PSM in a 55-year-old man who had undergone intracorporeal RARC...
June 29, 2016: Clinical Genitourinary Cancer
https://www.readbyqxmd.com/read/28209451/assessment-of-operating-room-airflow-using-air-particle-counts-and-direct-observation-of-door-openings
#18
Jonathan Teter, Isabella Guajardo, Tamrah Al-Rammah, Gedge Rosson, Trish M Perl, Michele Manahan
BACKGROUND: The role of the operating room (OR) environment has been thought to contribute to surgical site infection rates. The quality of OR air, disruption of airflow, and other factors may increase contamination risks. We measured air particulate counts (APCs) to determine if they increased in relation to traffic, door opening, and other common activities. METHODS: During 1 week, we recorded APCs in 5-minute intervals and movement of health care workers. Trained observers recorded information about traffic, door openings, job title of the opener, and the reason for opening...
February 13, 2017: American Journal of Infection Control
https://www.readbyqxmd.com/read/28209418/sporadic-desmoid-tumors-in-the-pediatric-population-a-single-center-experience-and-review-of-the-literature
#19
Vered Shkalim Zemer, Helen Toledano, Liora Kornreich, Enrique Freud, Eli Atar, Smadar Avigad, Galina Feinberg-Gorenshtein, Suzana Fichman, Josephine Issakov, Tal Dujovny, Isaac Yaniv, Shifra Ash
BACKGROUND/PURPOSE: We present our long experience with desmoid tumors in children. METHODS: Data were retrospectively collected from 17 children/adolescents treated for sporadic desmoid tumors at a tertiary pediatric hospital in 1988-2016. There were 10 girls and 7 boys aged 1-17years. Tumor sites included head and neck, trunk, extremity, and groin. Eight patients underwent radical resection, with complete remission in 7 and local relapse in one which was treated with chemotherapy...
February 4, 2017: Journal of Pediatric Surgery
https://www.readbyqxmd.com/read/28209197/accuracy-and-generalizability-of-using-automated-methods-for-identifying-adverse-events-from-electronic-health-record-data-a-validation-study-protocol
#20
Christian M Rochefort, David L Buckeridge, Andréanne Tanguay, Alain Biron, Frédérick D'Aragon, Shengrui Wang, Benoit Gallix, Louis Valiquette, Li-Anne Audet, Todd C Lee, Dev Jayaraman, Bruno Petrucci, Patricia Lefebvre
BACKGROUND: Adverse events (AEs) in acute care hospitals are frequent and associated with significant morbidity, mortality, and costs. Measuring AEs is necessary for quality improvement and benchmarking purposes, but current detection methods lack in accuracy, efficiency, and generalizability. The growing availability of electronic health records (EHR) and the development of natural language processing techniques for encoding narrative data offer an opportunity to develop potentially better methods...
February 16, 2017: BMC Health Services Research
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