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https://www.readbyqxmd.com/read/28732186/assessing-the-impact-of-surgeon-experience-on-urinary-continence-recovery-after-robot-assisted-radical-prostatectomy-results-of-four-high-volume-surgeons
#1
Nicola Fossati, Ettore Di Trapani, Giorgio Gandaglia, Paolo Dell'Oglio, Paolo Umari, Nicolò Maria Buffi, Giorgio Guazzoni, Alexander Mottrie, Franco Gaboardi, Francesco Montorsi, Alberto Briganti, Nazareno Suardi
PURPOSE: To test the impact of surgeon experience on urinary continence (UC) recovery after robot-assisted radical prostatectomy (RARP). MATERIALS AND METHODS: The study included 1477 consecutive patients treated with RARP by four surgeons between 2006 and 2014. UC recovery was defined as being completely dry over a 24-hour period at follow-up. Surgeon experience was coded as the total number of RARP performed by the surgeon before the patient's operation. Multivariable analysis tested the association between surgeon experience and UC recovery...
July 21, 2017: Journal of Endourology
https://www.readbyqxmd.com/read/28731946/treatment-minimization-in-older-patients-with-early-stage-breast-cancer
#2
Tara M Hansen, Richard C Zellars
The management of early-stage breast cancer in older patients is complex and requires a careful balance of the risk of cancer death with the competing risks of comorbidities and treatment-related toxicity in women with largely favorable disease. As the US population continues to age, oncologists will increasingly encounter this clinical challenge. Several strategies involving each core component of breast cancer therapy have been investigated to minimize treatment in these patients while still maintaining acceptable outcomes...
July 2017: Cancer Journal
https://www.readbyqxmd.com/read/28731497/the-effect-of-frailty-on-short-term-outcomes-after-head-and-neck-cancer-surgery
#3
Carrie L Nieman, Karen T Pitman, Anthony P Tufaro, David W Eisele, Kevin D Frick, Christine G Gourin
OBJECTIVE: To determine the relationship between frailty and comorbidity, in-hospital mortality, postoperative complications, length of hospital stay (LOS), and costs in head and neck cancer (HNCA) surgery. STUDY DESIGN: Cross-sectional analysis. METHODS: Discharge data from the Nationwide Inpatient Sample for 159,301 patients who underwent ablative surgery for a malignant oral cavity, laryngeal, hypopharyngeal, or oropharyngeal neoplasm in 2001 to 2010 was analyzed using cross-tabulations and multivariate regression modeling...
July 21, 2017: Laryngoscope
https://www.readbyqxmd.com/read/28729780/best-practices-for-robotic-surgery-programs
#4
Stephanie J Estes, David Goldenberg, Joshua S Winder, Ryan M Juza, Jerome R Lyn-Sue
BACKGROUND AND OBJECTIVES: Robotic surgical programs are increasing in number. Efficient methods by which to monitor and evaluate robotic surgery teams are needed. METHODS: Best practices for an academic university medical center were created and instituted in 2009 and continue to the present. These practices have led to programmatic development that has resulted in a process that effectively monitors leadership team members; attending, resident, fellow, and staff training; credentialing; safety metrics; efficiency; and case volume recommendations...
April 2017: JSLS: Journal of the Society of Laparoendoscopic Surgeons
https://www.readbyqxmd.com/read/28729770/enumeration-and-molecular-characterization-of-circulating-tumor-cell-using-an-in-vivo-capture-system-in-squamous-cell-carcinoma-of-head-and-neck
#5
Haidong Zhang, Shanchun Gong, Yaqun Liu, Longjun Liang, Shuangba He, Qingxiang Zhang, Mingyuan Si, Zhenkun Yu
OBJECTIVE: Detection rate and isolation yield of circulating tumor cell (CTC) are low in squamous cell carcinoma of head and neck (SCCHN) with in vitro approaches due to limited sample volumes. In this study, we applied the CellCollector to capture CTC in vivo from peripheral blood. METHODS: In total, the study included 22 cases with 37 times of detection. All of the patients were newly diagnosed with locally advanced or metastatic SCCHN, including laryngocarcinoma (40...
June 2017: Chinese Journal of Cancer Research, Chung-kuo Yen Cheng Yen Chiu
https://www.readbyqxmd.com/read/28728713/lung-cancer-screening-and-its-impact-on-surgical-volume
#6
REVIEW
Andrew P Dhanasopon, Anthony W Kim
Lung cancer screening has demonstrated a reduction in lung cancer mortality by 20%. Annual low-dose computed tomography examination in high-risk individuals is now recommended by multiple national health care organizations and is covered under Medicare and Medicaid services. The impact of this public health intervention is projected to increase the case load for the thoracic surgery workforce.
August 2017: Surgical Clinics of North America
https://www.readbyqxmd.com/read/28728709/counterclockwise-maxillomandibular-advancement-surgery-and-disc-repositioning-can-condylar-remodeling-in-the-long-term-follow-up-be-predicted
#7
L R Gomes, L H Cevidanes, M R Gomes, A C Ruellas, D P Ryan, B Paniagua, L M Wolford, J R Gonçalves
This study investigated predictive risk factors of condylar remodeling changes after counterclockwise maxillomandibular advancement (CCW-MMA) and disc repositioning surgery. Forty-one female patients (75 condyles) treated with CCW-MMA and disc repositioning had cone beam computed tomography (CBCT) scans taken pre-surgery, immediately after surgery, and at an average 16 months post-surgery. Pre- and post-surgical three-dimensional models were superimposed using automated voxel-based registration on the cranial base to evaluate condylar displacements after surgery...
July 17, 2017: International Journal of Oral and Maxillofacial Surgery
https://www.readbyqxmd.com/read/28727832/neurosurgeon-academic-impact-is-associated-with-clinical-outcomes-after-clipping-of-ruptured-intracranial-aneurysms
#8
Naif M Alotaibi, George M Ibrahim, Justin Wang, Daipayan Guha, Muhammad Mamdani, Tom A Schweizer, R Loch Macdonald
BACKGROUND: Surgeon-dependent factors such as experience and volume are associated with patient outcomes. However, it is unknown whether a surgeon's research productivity could be related to outcomes. The main aim of this study is to investigate the association between the surgeon's academic productivity and clinical outcomes following neurosurgical clipping of ruptured aneurysms. METHODS: We performed a post-hoc analysis of 3567 patients who underwent clipping of ruptured intracranial aneurysms in the randomized trials of tirilazad mesylate from 1990 to 1997...
2017: PloS One
https://www.readbyqxmd.com/read/28727768/benign-and-tumor-parenchyma-metabolomic-profiles-affect-compensatory-renal-growth-in-renal-cell-carcinoma-surgical-patients
#9
Barak Rosenzweig, Nimrod D Rubinstein, Ed Reznik, Roman Shingarev, Krishna Juluru, Oguz Akin, James J Hsieh, Edgar A Jaimes, Paul Russo, Katalin Susztak, Jonathan A Coleman, A Ari Hakimi
BACKGROUND AND OBJECTIVES: Pre-operative kidney volume is an independent predictor of glomerular filtration rate in renal cell carcinoma patients. Compensatory renal growth (CRG) can ensue prior to nephrectomy in parallel to tumor growth and benign parenchyma loss. We aimed to test whether renal metabolite abundances significantly associate with CRG, suggesting a causative relationship. DESIGN, SETTING, PARTICIPANTS, AND MEASUREMENTS: Tissue metabolomics data from 49 patients, with a median age of 60 years, were previously collected and the pre-operative fold-change of their contra to ipsi-lateral benign kidney volume served as a surrogate for their CRG...
2017: PloS One
https://www.readbyqxmd.com/read/28727718/quantity-of-disc-removal-and-radiological-outcomes-of-percutaneous-endoscopic-lumbar-discectomy
#10
Ji Han Heo, Chi Heon Kim, Chun Kee Chung, Yunhee Choi, Young-Geun Seo, Dong Hoi Kim, Sung Bae Park, Jung Hyeon Moon, Won Heo, Jong-Myung Jung
BACKGROUND: Herniated intervertebral disc disease (HIVD) is a common cause of lower back and leg pain. Percutaneous endoscopic lumbar discectomy (PELD) is indicated when non-surgical treatments such as medication and interventions are intractable. Ruptured discs and loose fragments inside discs are removed during PELD. Nerve root decompression is usually assessed by visualizing the free movement of the traversing nerve root or epidural fat, the free passage of a probe into the epidural space, the depression of the annulus, and the removal of the expected ruptured discs and loose fragments based on preoperative magnetic resonance images (MRI)...
July 2017: Pain Physician
https://www.readbyqxmd.com/read/28726166/safety-of-laparoscopic-distal-gastrectomy-for-gastric-cancer-when-performed-by-trainee-surgeons-with-little-experience-in-performing-open-gastrectomy
#11
Chizu Kameda, Masato Watanabe, Nobuhiro Suehara, Yusuke Watanabe, Kazuyoshi Nishihara, Toru Nakano, Masafumi Nakamura
PURPOSE: This study aimed to evaluate the surgical outcomes and clinical safety of laparoscopic distal gastrectomy (LDG) when performed by trainee surgeons with little prior experience in performing open gastrectomy, under the guidance of trainer surgeons. METHODS: From January 2008 until March 2015, 17 trainee surgeons and 5 trainer surgeons performed LDGs to treat 371 patients with clinical stage T1-T3 gastric cancer. Of these patients, 140 and 231 underwent LDG performed by trainee surgeons and trainer surgeons, respectively...
July 19, 2017: Surgery Today
https://www.readbyqxmd.com/read/28726139/assessing-trends-in-laparoscopic-colostomy-reversal-and-evaluating-outcomes-when-compared-to-open-procedures
#12
Kevin Y Pei, Kimberly A Davis, Yawei Zhang
BACKGROUND: Laparoscopic colostomy reversal has emerged as a viable option for Hartmann's reversal but the trends in national adoption and postoperative complications are unknown. This study evaluates the practice trends for laparoscopic colostomy and compares complications, length of stay, and operative times between laparoscopic and open colostomy reversal. METHODS: All patients who had open or laparoscopic colostomy reversal surgery (current procedure codes: 44227 and 44626) between 2005 and 2014 were identified from the American College of Surgeons National Surgical Quality Improvement Program...
July 19, 2017: Surgical Endoscopy
https://www.readbyqxmd.com/read/28724387/risk-factors-for-acute-surgical-site-infections-after-lumbar-surgery-a-retrospective-study
#13
Qi Lai, Quanwei Song, Runsheng Guo, Haidi Bi, Xuqiang Liu, Xiaolong Yu, Jianghao Zhu, Min Dai, Bin Zhang
BACKGROUND: Currently, many scholars are concerned about the treatment of postoperative infection; however, few have completed multivariate analyses to determine factors that contribute to the risk of infection. Therefore, we conducted a multivariate analysis of a retrospectively collected database to analyze the risk factors for acute surgical site infection following lumbar surgery, including fracture fixation, lumbar fusion, and minimally invasive lumbar surgery. METHODS: We retrospectively reviewed data from patients who underwent lumbar surgery between 2014 and 2016, including lumbar fusion, internal fracture fixation, and minimally invasive surgery in our hospital's spinal surgery unit...
July 19, 2017: Journal of Orthopaedic Surgery and Research
https://www.readbyqxmd.com/read/28724133/a-nationwide-analysis-of-cost-variation-for-autologous-free-flap-breast-reconstruction
#14
Jessica I Billig, Yiwen Lu, Adeyiza O Momoh, Kevin C Chung
Importance: Cost variation among hospitals has been demonstrated for surgical procedures. Uncovering these differences has helped guide measures taken to reduce health care spending. To date, the fiscal consequence of hospital variation for autologous free flap breast reconstruction is unknown. Objective: To investigate factors that influence cost variation for autologous free flap breast reconstruction. Design, Setting, and Participants: A secondary cross-sectional analysis was performed using the Healthcare Cost and Utilization Project National Inpatient Sample database from 2008 to 2010...
July 19, 2017: JAMA Surgery
https://www.readbyqxmd.com/read/28723879/suppression-of-sympathetic-nerve-sprouting-by-local-administration-of-an-%C3%AE-antagonist-around-the-dorsal-root-ganglion-in-a-lumbar-radiculopathy-model
#15
Izaya Ogon, Tsuneo Takebayashi, Tsuyoshi Miyakawa, Takehito Iwase, Katsumasa Tanimoto, Yoshinori Terashima, Syunsuke Jimbo, Takeshi Kobayashi, Noritsugu Tohse, Toshihiko Yamashita
STUDY DESIGN: Animal experimental study with intervention OBJECTIVE.: The purpose of this study was to elucidate whether local administration of an α-antagonist around the dorsal root ganglion (DRG) suppressed sympathetic nerve sprouting, from the acute to the chronic pain development phase, in a lumbar radiculopathy model using immunohistochemical methods. SUMMARY OF BACKGROUND DATA: The abnormal sympathetic-somatosensory interaction may underlie some forms of neuropathic pain...
July 18, 2017: Spine
https://www.readbyqxmd.com/read/28723837/minimum-effective-volume-of-lidocaine-for-ultrasound-guided-costoclavicular-block
#16
Thitipan Sotthisopha, Maria Francisca Elgueta, Artid Samerchua, Prangmalee Leurcharusmee, Worakamol Tiyaprasertkul, Aida Gordon, Roderick J Finlayson, De Q Tran
BACKGROUND AND OBJECTIVES: This dose-finding study aimed to determine the minimum effective volume in 90% of patients (MEV90) of lidocaine 1.5% with epinephrine 5 μg/mL for ultrasound-guided costoclavicular block. METHODS: Using an in-plane technique and a lateral-to-medial direction, the block needle was positioned in the middle of the 3 cords of the brachial plexus in the costoclavicular space. The entire volume of lidocaine was deposited in this location. Dose assignment was carried out using a biased-coin-design up-and-down sequential method, where the total volume of local anesthetic administered to each patient depended on the response of the previous one...
July 19, 2017: Regional Anesthesia and Pain Medicine
https://www.readbyqxmd.com/read/28723765/perioperative-management-of-intracardiac-leiomyomatosis-an-observational-cohort-study
#17
Jiaying Xu, Min Wei, Qi Miao, Bin Zhu, Chunhua Yu, Yuguang Huang
Intracardiac leiomyomatosis (ICLM) is a rare condition in which the benign tumor extends into the right heart chambers through inferior vena cava. The best surgical approach still remains unclear.We present a retrospective cohort of 36 patients diagnosed with ICLM in Peking Union Medical College Hospital between 2002 and 2016.The mean patient age was 44.5 (range 25-55) years. The clinical manifestations were various, including shortness of breath, chest tightness, edema of the lower extremities, palpitations, syncope, etc...
July 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28723699/intraoperative-bleeding-in-patients-with-osteogenesis-imperfecta-type-iii-treated-by-fassier-duval-femoral-rodding-analysis-of-risk-factors
#18
Pietro Persiani, Maria V Pesce, Lorena Martini, Filippo M Ranaldi, Patrizia D'Eufemia, Anna Zambrano, Mauro Celli, Ciro Villani
The surgical treatment of osteogenesis imperfecta (OI) is negatively influenced by clinical features such as osteoporosis, limb deformities and bone changes caused by bisphosphonate therapy. Blood loss during femoral nailing surgeries in patients with OI is a serious problem. Platelet anomalies have been associated with an elevation of the serum pyrophosphate originating from the platelets during clotting, even if the causality with the platelet dysfunction has not yet been established. To identify predictive risk factors regarding intraoperative bleeding, a retrospective analysis was conducted on 23 patients aged between 6 and 13 years, affected by OI type III, who were treated to correct femoral deformities or to perform an osteosynthesis for femoral shaft fractures, using the Fassier-Duval telescopic nail...
July 18, 2017: Journal of Pediatric Orthopedics. Part B
https://www.readbyqxmd.com/read/28723490/renal-preservation-and-partial-nephrectomy-patient-and-surgical-factors
#19
REVIEW
Lorenzo Marconi, Mihir M Desai, Vincenzo Ficarra, Francesco Porpiglia, Hendrik Van Poppel
CONTEXT: Optimization of the partial nephrectomy (PN) procedure in terms of preservation of functional outcomes is of special importance. OBJECTIVE: To review the most important patient and surgical factors that may influence the three elements that ultimately define the preservation of renal function (RF) after PN: preoperative RF, quantity of parenchyma preserved, and nephron recovery from ischemic insult. EVIDENCE ACQUISITION: A nonsystematic review of the literature was conducted...
December 15, 2016: European Urology Focus
https://www.readbyqxmd.com/read/28722695/cardiac-cycle-efficiency-and-dicrotic-pressure-variations-new-parameters-for-fluid-therapy-a-pilot-observational-study
#20
Antonio Messina, Salvatore M Romano, Eleonora Bonicolini, Davide Colombo, Gianmaria Cammarota, Marco Chiostri, Francesco Della Corte, Paolo Navalesi, Didier Payen, Stefano Romagnoli
BACKGROUND: During a fluid challenge, the changes in cardiac performance and peripheral circulatory tone are closely related to the position of the ventricle on the Frank-Starling curve. Some patients have a good haemodynamic response to a fluid challenge, others hardly any response. The early haemodynamic effects of a fluid challenge could predict the final response before the entire fluid volume has been administered. OBJECTIVE: To assess whether a multivariate logistic regression model, including pulse pressure variation (PPV), cardiac cycle efficiency (CCE), arterial elastance and the difference between the dicrotic pressure and both systolic and mean arterial pressure (SAP - Pdic and MAP - Pdic) can predict cardiac responsiveness early during a fluid challenge in comparison with the standard procedure described elsewhere...
June 19, 2017: European Journal of Anaesthesiology
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