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https://www.readbyqxmd.com/read/28334592/using-an-electronic-perioperative-documentation-tool-to-identify-returns-to-operating-room-ror-in-a-tertiary-care-academic-medical-center
#1
Robert R Cima, Sarah R Dhanorker, Christopher L Ostendorf, Mfonabasi Ntekpe, Raghu V Mudundi, Elizabeth B Habermann, Claude Deschamps
BACKGROUND: The metric "Unplanned returns to operating room (ROR)" is being tracked in surgical quality dashboards; 70% of unplanned RORs may be related to surgical complications. With increasing regionalization of trauma and complex surgical care at tertiary care academic centers, it is unclear if a simple ROR metric is a valid assessment of surgical quality at such centers. METHOD: A real-time electronic tool was used to identify all RORs-planned and unplanned-in a high-volume, high-complexity academic surgical practice at Mayo Clinic-Rochester within 45 days of the index operation...
March 2017: Joint Commission Journal on Quality and Patient Safety
https://www.readbyqxmd.com/read/28333315/transcutaneous-brow-shaping-a-straightforward-and-precise-method-to-lift-and-shape-the-eyebrows
#2
Mario Pelle-Ceravolo, Matteo Angelini
Background: The height of the eyebrow is less crucial aesthetically than is the relationship between the lateral and medial portions of the brow. Although various surgical procedures are effective in raising the brow, the authors maintain that transcutaneous brow shaping (TBS) is the only technique that enables precise shaping of the brow and correction of minor asymmetries. Objectives: The authors described their experiences with direct TBS alone or in conjunction with blepharoplasty and facelift...
March 16, 2017: Aesthetic Surgery Journal
https://www.readbyqxmd.com/read/28331887/android-application-for-determining-surgical-variables-in-brain-tumor-resection-procedures
#3
Rohan C Vijayan, Reid C Thompson, Lola B Chambless, Peter J Morone, Le He, Logan W Clements, Rebekah H Griesenauer, Hakmook Kang, Michael I Miga
The fidelity of image-guided neurosurgical procedures is often compromised due to the mechanical deformations that occur during surgery. In recent work, a framework was developed to predict the extent of this brain shift in brain-tumor resection procedures. The approach uses preoperatively determined surgical variables to predict brain shift and then subsequently corrects the patient's preoperative image volume to more closely match the intraoperative state of the patient's brain. However, a clinical workflow difficulty with the execution of this framework is the preoperative acquisition of surgical variables...
January 2017: Journal of Medical Imaging
https://www.readbyqxmd.com/read/28330704/an-update-on-non-extremity-soft-tissue-sarcomas
#4
S J Ford, L M Almond, A Gronchi
The management of soft tissue sarcoma is challenging and varied. Centralisation of management in high volume specialist centres has revolutionised outcomes. Surgery remains the mainstay of treatment and is currently the only potentially curative therapy. Retroperitoneal soft tissue sarcoma presents a particular challenge to the surgical oncologist and the concept of extended resection to include surrounding expendable organs taken en bloc with the tumour has now largely been adopted. The use of neoadjuvant and adjuvant therapies for retroperitoneal soft tissue sarcoma is still to be established, although they are employed on a case-specific basis...
March 19, 2017: Clinical Oncology: a Journal of the Royal College of Radiologists
https://www.readbyqxmd.com/read/28330690/subclinical-leaflet-thrombosis-in-surgical-and-transcatheter-bioprosthetic-aortic-valves-an-observational-study
#5
Tarun Chakravarty, Lars Søndergaard, John Friedman, Ole De Backer, Daniel Berman, Klaus F Kofoed, Hasan Jilaihawi, Takahiro Shiota, Yigal Abramowitz, Troels H Jørgensen, Tanya Rami, Sharjeel Israr, Gregory Fontana, Martina de Knegt, Andreas Fuchs, Patrick Lyden, Alfredo Trento, Deepak L Bhatt, Martin B Leon, Raj R Makkar
BACKGROUND: Subclinical leaflet thrombosis of bioprosthetic aortic valves after transcatheter valve replacement (TAVR) and surgical aortic valve replacement (SAVR) has been found with CT imaging. The objective of this study was to report the prevalence of subclinical leaflet thrombosis in surgical and transcatheter aortic valves and the effect of novel oral anticoagulants (NOACs) on the subclinical leaflet thrombosis and subsequent valve haemodynamics and clinical outcomes on the basis of two registries of patients who had CT imaging done after TAVR or SAVR...
March 19, 2017: Lancet
https://www.readbyqxmd.com/read/28330424/tentorial-meningioma-supplied-by-a-marginal-tentorial-artery-arising-from-the-superior-cerebellar-artery-anatomic-and-technical-considerations
#6
Stéphanie Lenck, Kentaro Watanabe, Jean-Pierre Saint-Maurice, Moujahed Labidi, Marc-Antoine Labeyrie, Sébastien Froelich, Emmanuel Houdart
Background and importance The marginal tentorial artery runs over the free edge of the tentorium. Different origins have been described, always involving branches of the carotid artery. We report the superior cerebellar artery as an unknown origin of this artery. We developed our strategy in a case of a tentorial meningioma mainly supplied by this artery. Clinical presentation A 53-year-old man was admitted in our institution for the surgical treatment of a large tentorial and petroclival meningioma. A 2D conventional angiogram was insufficient to detect the tumoral blush...
January 1, 2017: Interventional Neuroradiology
https://www.readbyqxmd.com/read/28329918/-endoscopic-ultrasound-guided-biliary-drainage
#7
REVIEW
Hyeong Seok Nam, Dae Hwan Kang
The therapeutic role of endoscopic ultrasound (EUS) has continued to evolve in recent years. EUS-guided biliary drainage (EUS-BD) can be performed as an effective alternative to percutaneous drainage or surgical options when conventional Endoscopic retrograde cholangiopancreatography fails or is not possible. Depending on the access and exit routes of the stent, multiple approaches to EUS-BD have been proposed. Each patient should receive an individualized approach based on the patient's condition, anatomy, and endoscopist's experience, with an appropriate backup prepared...
March 25, 2017: Korean Journal of Gastroenterology, Taehan Sohwagi Hakhoe Chi
https://www.readbyqxmd.com/read/28329200/clinical-trends-in-surgical-minimally-invasive-and-transcatheter-aortic-valve-replacement%C3%A2
#8
Tom C Nguyen, Matthew D Terwelp, Vinod H Thourani, Yelin Zhao, Nidal Ganim, Carson Hoffmann, Monica Justo, Anthony L Estrera, Richard W Smalling, Prakash Balan, Joseph Lamelas
OBJECTIVES: Transcatheter aortic valve replacement (TAVR) and minimally invasive aortic valve replacement (MIAVR) have emerged as alternatives to surgical aortic valve replacement (SAVR) via traditional sternotomy. However, their effect on clinical practice remains unclear. The study's objective is to describe clinical trends between TAVR, MIAVR and SAVR in patients with severe aortic stenosis (AS). METHODS: This retrospective observational study analyzed trends in isolated severe aortic valve replacement (AVR) among three high volume TAVR, MIAVR and SAVR centres in the United States...
February 20, 2017: European Journal of Cardio-thoracic Surgery
https://www.readbyqxmd.com/read/28329173/mitral-valve-repair-for-secondary-mitral-regurgitation-in-non-ischaemic-dilated-cardiomyopathy-is-associated-with-left-ventricular-reverse-remodelling-and-increase-of-forward-flow
#9
Vasileios Kamperidis, Suzanne E van Wijngaarden, Philippe J van Rosendael, William Kok Fai Kong, Madelien V Regeer, Frank van der Kley, Georgios Sianos, Nina Ajmone Marsan, Jeroen J Bax, Victoria Delgado
Aims: It remains unclear whether surgical or transcatheter mitral valve repair for secondary mitral regurgitation (MR) in patients with non-ischaemic cardiomyopathy reverse the underlying left ventricular (LV) pathophysiology. We hypothesized that mitral valve repair improves LV systolic function and forward flow and induces LV reverse remodelling in this group of patients. Methods and results: Seventy-six patients (65 ± 14 years old, 43% male) with non-ischaemic cardiomyopathy and moderate to severe chronic secondary MR treated successfully with transcatheter or surgical mitral valve repair were evaluated...
February 23, 2017: European Heart Journal Cardiovascular Imaging
https://www.readbyqxmd.com/read/28329138/small-intestinal-submucosa-tricuspid-valve-tube-graft-shows-growth-potential-remodelling-and-physiological-valve-function-in-a-porcine-model%C3%A2
#10
Diana M Ropcke, Christine Ilkjaer, Marcell J Tjornild, Soren N Skov, Steffen Ringgaard, Vibeke E Hjortdal, Sten L Nielsen
OBJECTIVES: Tricuspid valve reconstruction using small intestinal submucosal extracellular matrix (ECM) designed as a tube graft is possible in severe valve pathology. Using cardiac magnetic resonance imaging (MRI) and digital photograph imaging, valves were evaluated after 6 months in a porcine model. METHODS: Ten 60 kg pigs received a tricuspid valve tube graft. A baseline MRI was performed after 2 weeks ( n  = 8). A follow-up MRI was performed in three of five 6 months' survivors to assess function and haemodynamics of the tricuspid tube graft...
February 27, 2017: Interactive Cardiovascular and Thoracic Surgery
https://www.readbyqxmd.com/read/28329111/hypoplastic-left-heart-syndrome-a-novel-surgical-strategy-for-small-volume-centres-%C3%A2
#11
Margaux Pontailler, Régis Gaudin, Marien Lenoir, Ayman Haydar, Diala Kraiche, Damien Bonnet, Pascal Vouhé, Olivier Raisky
OBJECTIVES: We describe in a prospective study, a novel surgical technique for the management of hypoplastic left heart syndrome inspired by the hybrid Norwood approach. METHODS: This new neonatal palliation comprises replacement of the patent ductus arteriosus (PDA) and aortic arch plasty with a pulmonary homograft associated with the banding of both pulmonary arteries and atrial septectomy, under cardiopulmonary bypass without aortic clamping and cardioplegia...
February 17, 2017: European Journal of Cardio-thoracic Surgery
https://www.readbyqxmd.com/read/28329100/long-term-cardiovascular-changes-following-creation-of-arteriovenous-fistula-in-patients-with-end-stage-renal-disease
#12
Yogesh N V Reddy, Masaru Obokata, Patrick G Dean, Vojtech Melenovsky, Karl A Nath, Barry A Borlaug
Aims: Short-term studies have reported left ventricular (LV) dilatation following surgical creation of arteriovenous fistulas (AVF) or arteriovenous grafts (AVGs), but chronic cardiac structural and functional changes have not been examined or related to clinical outcomes following AVF/AVG. We sought to characterize the long-term changes in cardiac structure and function in patients undergoing shunt creation for haemodialysis. Methods and results: A retrospective analysis was performed of patients undergoing echocardiography before and after surgical AVF/AVG creation for the initiation of haemodialysis...
March 6, 2017: European Heart Journal
https://www.readbyqxmd.com/read/28328863/surgical-outcomes-of-laparoscopic-versus-open-liver-resection-for-hepatocellular-carcinoma-for-various-resection-extent
#13
Junhua Chen, Hongyu Li, Fei Liu, Bo Li, Yonggang Wei
Although the number of laparoscopic liver resections (LRRs) has increased, studies of surgical outcomes in comparison with the conventional open approach are limited. The purpose of this study was to analyze the surgical outcomes (safety and efficacy) of LLR versus open liver resection (OLR) for hepatocellular carcinoma (HCC).We collected data on all patients who received liver resection for HCC between April 2015 and September 2016 in our institution, and retrospectively investigated the demographic and perioperative data, and also surgical outcomes...
March 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28328641/a-formula-for-planning-and-predicting-postoperative-mammoplasty-results
#14
Mary G Smithson, Sherry S Collawn, Mina S Mousa, Carly M Bramel
PURPOSE: For women with macromastia, reduction mammoplasty is a safe and effective solution to increasing quality of life through alleviating pain and improving aesthetics. This study developed a way to combine a surgeon's view of breast measurement (volume) with a patient's view of breast measurement (distance between nipple and notch, inframammary fold, or midline) to provide patients with a better understanding of expected surgical outcomes after breast reduction with a medial superior pedicle...
March 21, 2017: Annals of Plastic Surgery
https://www.readbyqxmd.com/read/28328564/variation-in-national-acgme-case-log-data-for-pediatric-orthopaedic-fellowships-are-fellow-coding-practices-responsible
#15
Philip K McClure, Marcella Woiczik, Lori Karol, Wudbhav N Sankar
BACKGROUND: The introduction of the 80-hour work week for Accreditation Council for Graduate Medical Education (ACGME) accredited fellowship programs initiated many efforts to optimize surgical training. One particular area of interest is on recording and tracking surgical experiences. The current standard is logging cases based on Current Procedural Terminology codes, which are primarily designed for billing. Proposed guidelines from the ACGME regarding logging exist, but their implementation is unknown, as is the variation in case volume across fellowship programs...
March 21, 2017: Journal of Pediatric Orthopedics
https://www.readbyqxmd.com/read/28328561/does-orientation-of-the-femoral-head-affect-acetabular-development-an-experimental-study-in-lamb
#16
Luis Moraleda, Christian Bravo, Francisco Forriol, Javier Albiñana
BACKGROUND: Derotational osteotomy of the proximal femur has proved to be effective in the treatment of residual acetabular dysplasia. However, the reason why this osteotomy is effective remains debatable. The purpose of this study is to investigate if an alteration of femoral head orientation affects acetabular growth. METHODS: A proximal femoral osteotomy was performed in 21 lambs aged 3 months: 5 varus osteotomies (110 degrees), 4 valgus osteotomies (150 degrees), and 12 derotation osteotomies...
March 21, 2017: Journal of Pediatric Orthopedics
https://www.readbyqxmd.com/read/28328555/association-of-pediatric-cardiac-surgical-volume-and-mortality-after-cardiac-ecmo
#17
Cindy S Barrett, Titus T Chan, Jacob Wilkes, Susan L Bratton, Ravi R Thiagarajan
Centers with higher surgical and ECMO volume have improved survival for children undergoing pediatric cardiac surgery and ECMO respectively. We examined the relationship between both cardiac surgical and cardiac ECMO volumes, with survival. Using data from the Pediatric Health Information System, we reviewed patients who underwent ECMO during the hospitalization for cardiac surgery or heart transplantation from January 2003- June 2014. Among 106,967 patients in 43 centers undergoing a Risk Adjustment for Congenital Heart Surgery-1 (RACHS) 1-6 procedure (n =104,951) and/or cardiac transplantation (n=2016), 2...
March 20, 2017: ASAIO Journal: a Peer-reviewed Journal of the American Society for Artificial Internal Organs
https://www.readbyqxmd.com/read/28327941/degree-of-vascular-encasement-in-sphenoid-wing-meningiomas-predicts-postoperative-ischemic-complications
#18
D Jay McCracken, Raymond A Higginbotham, Jason H Boulter, Yuan Liu, John A Wells, Sameer H Halani, Amit M Saindane, Nelson M Oyesiku, Daniel L Barrow, Jeffrey J Olson
BACKGROUND: Sphenoid wing meningiomas (SWMs) can encase arteries of the circle of Willis, increasing their susceptibility to intraoperative vascular injury and severe ischemic complications. OBJECTIVE: To demonstrate the effect of circumferential vascular encasement in SWM on postoperative ischemia. METHODS: A retrospective review of 75 patients surgically treated for SWM from 2009 to 2015 was undertaken to determine the degree of circumferential vascular encasement (0°-360°) as assessed by preoperative magnetic resonance imaging (MRI)...
January 28, 2017: Neurosurgery
https://www.readbyqxmd.com/read/28327417/appositional-bone-graft-tunneled-technical-note
#19
Roberto Almeida de Azevedo, Felipe Seoane Matos, Leonardo Morais Godoy Figueiredo
INTRODUCTION: A satisfactory positioning of the dental implants is very important in the cosmetic and functional outcome in this treatment for edentulous. Insertion of an endosseous implant in the correct positioning requires sufficient bone volume. Therefore, bone-grafting procedures are becoming increasingly common, especially for the augmentation of horizontally deficient ridges. PRESENTATION OF CASE: Many patients have been treated with this technique of appositional Bone Graft Tunneled at our clinic since 2005...
February 20, 2017: International Journal of Surgery Case Reports
https://www.readbyqxmd.com/read/28325619/effects-of-online-cone-beam-computed-tomography-with-active-breath-control-in-determining-planning-target-volume-during-accelerated-partial-breast-irradiation
#20
Y Li, R Zhong, X Wang, P Ai, F Henderson, N Chen, F Luo
PURPOSE: To test if active breath control during cone-beam computed tomography (CBCT) could improve planning target volume during accelerated partial breast radiotherapy for breast cancer. METHODS: Patients who were more than 40 years old, underwent breast-conserving dissection and planned for accelerated partial breast irradiation, and with postoperative staging limited to T1-2 N0 M0, or postoperative staging T2 lesion no larger than 3cm with a negative surgical margin greater than 2mm were enrolled...
March 18, 2017: Cancer Radiothérapie: Journal de la Société Française de Radiothérapie Oncologique
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