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https://www.readbyqxmd.com/read/27921992/the-hubble-trial-haemorrhoidal-artery-ligation-hal-versus-rubber-band-ligation-rbl-for-symptomatic-second-and-third-degree-haemorrhoids-a-multicentre-randomised-controlled-trial-and-health-economic-evaluation
#1
Steven Brown, Jim Tiernan, Katie Biggs, Daniel Hind, Neil Shephard, Mike Bradburn, Allan Wailoo, Abualbishr Alshreef, Lizzie Swaby, Angus Watson, Simon Radley, Oliver Jones, Paul Skaife, Anil Agarwal, Pasquale Giordano, Marc Lamah, Mark Cartmell, Justin Davies, Omar Faiz, Karen Nugent, Andrew Clarke, Angus MacDonald, Phillip Conaghan, Paul Ziprin, Rohit Makhija
BACKGROUND: Optimal surgical intervention for low-grade haemorrhoids is unknown. Rubber band ligation (RBL) is probably the most common intervention. Haemorrhoidal artery ligation (HAL) is a novel alternative that may be more efficacious. OBJECTIVE: The comparison of HAL with RBL for the treatment of grade II/III haemorrhoids. DESIGN: A multicentre, parallel-group randomised controlled trial. PERSPECTIVE: UK NHS and Personal Social Services...
November 2016: Health Technology Assessment: HTA
https://www.readbyqxmd.com/read/27921277/surgery-for-acute-exacerbation-of-chronic-mesenteric-ischemia-a-case-report
#2
Shinji Abe, Tomoji Yamakawa, Hideaki Kawashima, Makoto Yoshida, Setsuji Takanashi, Motoya Kashiyama, Masahiro Ishigooka, Yasushige Shingu, Yoshiro Matsui
BACKGROUND: Chronic mesenteric ischemia (CMI) is a rare disease; however, symptomatic CMI has a risk of acute exacerbation without timely revascularization. CASE PRESENTATION: A 54-year-old man who had had postprandial pain for 6 months was admitted to our hospital because of vomiting and diarrhea. Although the celiac and superior mesenteric arteries were occluded at the proximal portion, contrast enhancement of the bowel wall was good in contrast-enhanced computed tomography (CECT)...
December 2016: Surgical Case Reports
https://www.readbyqxmd.com/read/27921183/conversion-in-laparoscopic-colorectal-surgery-are-short-term-outcomes-worse-than-with-open-surgery
#3
E Gorgun, C Benlice, M A Abbas, L Stocchi, F H Remzi
BACKGROUND: The aim of the present study was to compare the perioperative outcomes in patients who underwent planned open colectomy to those who were converted to an open. METHODS: All patients who underwent elective colectomy were identified from the American College of Surgeons National Surgical Quality Improvement Program using procedure-targeted database (2012-2014). Patients were divided into two groups: open (planned) versus converted. Perioperative outcomes were compared...
December 5, 2016: Techniques in Coloproctology
https://www.readbyqxmd.com/read/27920698/a-case-of-en-bloc-excision-of-a-chest-wall-leiomyosarcoma-and-closure-of-the-defect-with-non-cross-linked-collagen-matrix-egis-%C3%A2
#4
Marco Rastrelli, Saveria Tropea, Romina Spina, Alessandra Costa, Roberto Stramare, Simone Mocellin, Maria Giuseppina Bonavina, Carlo Riccardo Rossi
Sarcomas arising from the chest wall account for less than 20% of all soft tissue sarcomas, and at this site, primitive tumors are the most frequent to occur. Leiomyosarcoma is a malignant smooth muscle tumor and the best outcomes are achieved with wide surgical excision. Although advancements have been made in treatment protocols, leiomyosarcoma remains one of the more difficult soft tissue sarcoma to treat. Currently, general local control is obtained with surgical treatment with wide negative margins. We describe the case of a 50-year-old man who underwent a chest wall resection involving a wide portion of the pectoralis major and minor muscle, the serratus and part of the second, third and fourth ribs of the left side...
September 2016: Case Reports in Oncology
https://www.readbyqxmd.com/read/27920582/surgeons-early-experience-with-the-acessa%C3%A2-procedure-gaining-proficiency-with-new-technology
#5
Kelli M Braun, Mark Sheridan, Erin Z Latif, Lexy Regush, Anet Maksymowicz, Laura Weins, Mohamed A Bedaiwy, Nerissa Tyson, Marilyn J Davidson, Barry H Sanders
PURPOSE: Successful adoption of a new surgical procedure varies among practicing surgeons, and skill acquisition depends on the surgeon's innate ability, the complexity of the technique, and training. We report intraoperative and near-term postoperative outcomes from the Acessa procedure conducted by minimally invasive gynecologic surgeons new to Acessa, and report the surgeons' experiences during the training period. PATIENTS AND METHODS: The study was designed as a postmarket, prospective, single-arm, multicenter analysis of operative and early postoperative outcomes after proctored surgical training with the Acessa device and procedure (laparoscopic ultrasound-guided radiofrequency volumetric thermal ablation of symptomatic fibroids) in premenopausal, menstruating women as conducted in community and university hospitals in the USA and Canada...
2016: International Journal of Women's Health
https://www.readbyqxmd.com/read/27920089/world-endometriosis-society-consensus-on-the-classification-of-endometriosis
#6
Neil P Johnson, Lone Hummelshoj, G David Adamson, Jörg Keckstein, Hugh S Taylor, Mauricio S Abrao, Deborah Bush, Ludwig Kiesel, Rulla Tamimi, Kathy L Sharpe-Timms, Luk Rombauts, Linda C Giudice
STUDY QUESTION: What is the global consensus on the classification of endometriosis that considers the views of women with endometriosis? SUMMARY ANSWER: We have produced an international consensus statement on the classification of endometriosis through systematic appraisal of evidence and a consensus process that included representatives of national and international, medical and non-medical societies, patient organizations, and companies with an interest in endometriosis...
December 5, 2016: Human Reproduction
https://www.readbyqxmd.com/read/27919972/clinical-burden-of-c-reactive-protein-albumin-ratio-before-curative-surgery-for-patients-with-gastric-cancer
#7
Yuji Toiyama, Tadanobu Shimura, Hiromi Yasuda, Hiroyuki Fujikawa, Yoshiki Okita, Minako Kobayashi, Masaki Ohi, Shigeyuki Yoshiyama, Jyunichiro Hiro, Toshimitsu Araki, Yasuhiro Inoue, Yasuhiko Mohri, Masato Kusunoki
To assess the relationship of C-reactive protein/albumin ratio (CAR) to outcomes and surgical site infection (SSI) in gastric cancer (GC) treated with curative intent, we retrospectively assessed 384 patients with GC for CAR, SSIs, disease-free survival (DFS), overall survival (OS) and other factors. We found SSIs in 42 patients (10.9%). Pathological T-stage, TNM classification, body mass index, duration of surgery, blood loss and preoperative CAR were significantly associated with SSIs; in multivariate analyses, CAR [hazard ratio (HR)=2...
December 2016: Anticancer Research
https://www.readbyqxmd.com/read/27919847/using-on-site-liver-3-d-reconstruction-and-volumetric-calculations-in-split-liver-transplantation
#8
Trevor W Reichman, Brittany Fiorello, Ian Carmody, Humberto Bohorquez, Ari Cohen, John Seal, David Bruce, George E Loss
BACKGROUND: Split liver transplantation increases the number of grafts available for transplantation. Pre-recovery assessment of liver graft volume is essential for selecting suitable recipients. The purpose of this study was to determine the ability and feasibility of constructing a 3-D model to aid in surgical planning and to predict graft weight prior to an in situ division of the donor liver. METHODS: Over 11 months, 3-D volumetric reconstruction of 4 deceased donors was performed using Pathfinder Scout© liver volumetric software...
December 2016: Hepatobiliary & Pancreatic Diseases International: HBPD INT
https://www.readbyqxmd.com/read/27919768/proximal-femoral-fractures-in-centenarians-a-retrospective-analysis-of-39-patients
#9
A Morice, N Reina, G Gracia, P Bonnevialle, J-M Laffosse, K Wytrykowski, E Cavaignac, N Bonnevialle
BACKGROUND: A corollary of the current population ageing in France is an increase in proximal femoral fractures (PFFs), particularly among centenarians. The outcomes of PFF in centenarians in France are unknown. We therefore conducted a retrospective study of centenarians with PFFs both to assess: 1) assess clinical outcomes according to geriatric and trauma scores, 2) and to determine whether routine surgery is warranted. HYPOTHESIS: Morbidity and mortality in a single-centre cohort of centenarians with surgically treated PFFs are consistent with previous reports...
December 2, 2016: Orthopaedics & Traumatology, Surgery & Research: OTSR
https://www.readbyqxmd.com/read/27919767/internal-fixation-of-intra-capsular-proximal-femoral-fractures-in-patients-older-than-80-years-still-relevant-multivariate-analysis-of-a-prospective-multicentre-cohort
#10
Nicolas Reina, Paul Bonnevialle, Brice Rubens Duval, Philippe Adam, François Loubignac, Thierry Favier, Philippe Massin
BACKGROUND: Arthroplasty is now widely used to treat intra-capsular proximal femoral fractures (PFFs) in older patients, even when there is little or no displacement. However, whether arthroplasty is associated with lower mortality and complication rates in non-displaced or mildly displaced PFFs is unknown. The objectives of this prospective study were: 1) to evaluate early mortality rates with the two treatment methods, 2) to identify risk factors for complications, 3) and to identify predictors of functional decline...
December 2, 2016: Orthopaedics & Traumatology, Surgery & Research: OTSR
https://www.readbyqxmd.com/read/27919430/carbon-dioxide-insufflation-deflects-airborne-particles-from-an-open-surgical-wound-model
#11
P Kokhanenko, G Papotti, J E Cater, A C Lynch, J A van der Linden, C J T Spence
BACKGROUND: Surgical site infections remain a significant burden on healthcare systems and may benefit from new countermeasures. AIM: To assess the merits of open surgical wound CO2 insufflation via a gas diffuser to reduce airborne contamination, and to determine the distribution of CO2 in and over a wound. METHODS: An experimental approach with engineers and clinical researchers was employed to measure the gas flow pattern and motion of airborne particles in a model of an open surgical wound in a simulated theatre setting...
November 21, 2016: Journal of Hospital Infection
https://www.readbyqxmd.com/read/27919285/a-randomised-patient-assessor-blinded-sham-controlled-trial-of-external-non-invasive-peripheral-nerve-stimulation-for-chronic-neuropathic-pain-following-peripheral-nerve-injury-en-pens-trial-study-protocol-for-a-randomised-controlled-trial
#12
Selina Johnson, Andreas Goebel, Roberta Richey, Emily Holmes, Dyfrig Hughes
BACKGROUND: Eight percent of people in the UK are estimated to have persistent (chronic) neuropathic pain, and for many there is no effective treatment. Medications are the most common first-line treatment but often have limited benefit or adverse events. Surgical treatments, such as spinal cord stimulation, are then often considered. External non-invasive peripheral nerve stimulation (EN-PENS) is a form of electrical stimulation that involves placing a pen-shaped electrode onto the skin, which can be easily self-administered by patients...
December 6, 2016: Trials
https://www.readbyqxmd.com/read/27919113/analysis-of-flap-weight-and-postoperative-complications-based-on-flap-weight-in-patients-undergoing-microsurgical-breast-reconstruction
#13
Gretl Lam, Katie E Weichman, Patrick L Reavey, Stelios C Wilson, Jamie P Levine, Pierre B Saadeh, Robert J Allen, Mihye Choi, Nolan S Karp, Vishal D Thanik
Background Higher body mass index (BMI) has been shown to increase postoperative complications in autologous breast reconstruction. However, the correlation with flap weight is unknown. Here, we explore the relationship of flap weights and complication rates in patients undergoing microvascular breast reconstruction. Methods Retrospective chart review identified all patients undergoing microvascular breast reconstruction with abdominally based flaps at a single institution between November 2007 and April 2013...
December 5, 2016: Journal of Reconstructive Microsurgery
https://www.readbyqxmd.com/read/27918335/consensus-bundle-on-prevention-of-surgical-site-infections-after-major-gynecologic-surgery
#14
Joseph E Pellegrini, Paloma Toledo, David E Soper, William C Bradford, Deborah A Cruz, Barbara S Levy, Lauren A Lemieux
Surgical site infections are the most common complication of surgery in the United States. Of surgeries in women of reproductive age, hysterectomy is one of the most frequently performed, second only to cesarean birth. Therefore, prevention of surgical site infections in women undergoing gynecologic surgery is an ideal topic for a patient safety bundle. The primary purpose of this safety bundle is to provide recommendations that can be implemented into any surgical environment in an effort to reduce the incidence of surgical site infection...
December 1, 2016: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/27918333/effectiveness-of-epidural-analgesia-continuous-surgical-site-analgesia-and-patient-controlled-analgesic-morphine-for-postoperative-pain-management-and-hyperalgesia-rehabilitation-and-health-related-quality-of-life-after-open-nephrectomy-a-prospective-randomized
#15
Xavier Capdevila, Sebastien Moulard, Christian Plasse, Jean-Luc Peshaud, Nicolas Molinari, Christophe Dadure, Sophie Bringuier
BACKGROUND: There is no widely recognized effective technique to optimally reduce pain scores and prevent persistent postoperative pain after nephrectomy. We compared continuous surgical site analgesia (CSSA), epidural analgesia (EA), and a control group (patient-controlled analgesic morphine) in patients undergoing open nephrectomy. METHODS: Sixty consecutive patients were randomized to be part of EA, CSSA, or control groups postoperatively for 72 hours. All patients received patient-controlled analgesic morphine, if needed...
December 1, 2016: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/27918144/a-novel-rat-tail-discitis-model-using-bioluminescent-staphylococcus-aureus
#16
Phillip A Bostian, Jonathan M Karnes, Shari Cui, Lisa J Robinson, Scott D Daffner, Michelle R Witt, Sanford E Emery
Management of spondylodiscitis is a challenging clinical problem requiring medical and surgical treatment strategies. The purpose of this study was to establish a rat model of spondylodiscitis that utilizes bioluminescent Staphylococcus aureus, thus permitting in-vivo surveillance of infection intensity. Inocula of the bioluminescent S. aureus strain XEN36 were created in concentrations of 10(2) CFU/0.1 mL, 10(4) CFU/0.1 mL, and 10(6) CFU/0.1 mL. Three groups of rats were injected with the bacteria in the most proximal intervertebral tail segment...
December 5, 2016: Journal of Orthopaedic Research: Official Publication of the Orthopaedic Research Society
https://www.readbyqxmd.com/read/27917852/results-of-bronchoscopic-excision-in-typical-carcinoid-tumors-of-the-lung-in-turkey
#17
Hilal Boyacı, Mustafa Çörtük, Şule Gül, Elif Tanrıverdi, Mehmet Akif Özgül, Hüseyin Erhan Dinçer, Erdoğan Çetinkaya
Aim Carcinoid tumors of the lung are the tumors originating from the neuroendocrine cells. Surgical excision remains the gold standard for the treatment. Treatment with interventional bronchoscopic excision has also been reported as an alternative option in typical carcinoid tumors of the lung. The aim of this study was to present results and outcomes in patients who were bronchoscopically treated and followed-up. Methods Data of 14 patients, who had undergone bronchoscopic excision due to typical carcinoid tumor of the lung between April 2008 and July 2015 were retrospectively evaluated...
February 1, 2017: Medicinski Glasnik
https://www.readbyqxmd.com/read/27917662/validating-a-benchmarking-tool-for-audit-of-early-outcomes-after-operations-for-head-and-neck-cancer
#18
D Tighe, I Sassoon, M McGurk
INTRODUCTION In 2013 all UK surgical specialties, with the exception of head and neck surgery, published outcome data adjusted for case mix for indicator operations. This paper reports a pilot study to validate a previously published risk adjustment score on patients from separate UK cancer centres. METHODS A case note audit was performed of 1,075 patients undergoing 1,218 operations for head and neck squamous cell carcinoma under general anaesthesia in 4 surgical centres. A logistic regression equation predicting for all complications, previously validated internally at sites A-C, was tested on a fourth external validation sample (site D, 172 operations) using receiver operating characteristic curves, Hosmer-Lemeshow goodness of fit analysis and Brier scores...
December 5, 2016: Annals of the Royal College of Surgeons of England
https://www.readbyqxmd.com/read/27917649/percutaneous-externally-assembled-laparoscopic-peal-versus-laparoendoscopic-single-site-less-nephrectomy-in-a-porcine-model-a-prospective-randomized-blinded-study
#19
Mohamed Keheila, Jim Ken-Chie Shen, Daniel Faaborg, Patrick Yang, Salim Cheriyan, Samuel R Abourbih, Nazih Khater, Michael Hill, D Duane Baldwin
OBJECTIVE: To compare the outcomes between Laparoendoscopic single-site (LESS) and a novel Percutaneous Externally Assembled Laparoscopic (PEAL) nephrectomy in an in vivo porcine model. MATERIALS AND METHODS: Ten female farm pigs were randomized to LESS nephrectomy (5) or PEAL nephrectomy (5). Operative times, estimated blood loss, intraoperative and postoperative complications were compared. The surgeons used a Likert scale to grade difficulty of peritoneal access, port placement, tool assembly, hilar dissection, closure, and overall difficulty of surgery...
December 4, 2016: Journal of Endourology
https://www.readbyqxmd.com/read/27916400/the-therapeutic-effect-of-patient-specific-implants-in-cranioplasty
#20
Thomas Zegers, Mariel Ter Laak-Poort, David Koper, Bernd Lethaus, Peter Kessler
OBJECTIVE: Patient specific implants have been used for the reconstruction of large skull bone defects. Several therapeutic effects have been suggested in current literature but were never objectified. The aim of the current study was to evaluate the change in quality of life, pain, aesthetics, and the surgical and medical outcomes after reconstruction of large skull bone defects with titanium or polyetheretherketone (PEEK) implants. METHODS: We retrospectively evaluated 29 consecutive patients receiving a patient specific skull implant between November 2004 and December 2015...
November 2, 2016: Journal of Cranio-maxillo-facial Surgery
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