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quality preoperative care

Amar Parkash Kataria, Joginder Pal Attri, Ramita Kashyap, Leena Mahajan
BACKGROUND: The advent of laparoscopic surgeries has proved to be beneficial for both patient and surgeon although increased morbidity may result from hemodynamic changes associated with laryngoscopy, intubation, and pneumoperitoneum (PNP). AIM: The present study was prospective, randomized, double-blind conducted to evaluate the efficacy of dexmdetomidine and fentanyl in attenuation of pressor responses to laryngoscopy, intubation, and PNP in laparoscopic cholecystectomy (LC)...
September 2016: Anesthesia, Essays and Researches
Zeinab M Alawadi, Isabel M Leal, Juan R Flores, Julie L Holihan, Blake E Henchcliffe, Thomas O Mitchell, Tien C Ko, Mike K Liang, Lillian S Kao
BACKGROUND: The purpose of this study was to identify issues important to patients in their decision-making, expectations, and satisfaction when seeking treatment for a ventral hernia. STUDY DESIGN: An exploratory qualitative study was conducted of adult patients with ventral hernias seeking care at a safety-net hospital. Two semi-structured interviews were conducted with each patient: prior to and 6 -months following surgical consultation. Interviews were audiotaped, transcribed, and coded using latent content analysis until data saturation was achieved...
October 11, 2016: Journal of the American College of Surgeons
Hui Lu, Hu Yang, Hui Shen, Ganmin Ye, Xiang-Jin Lin
Corticosteroid injections for hand tendinitis can lead to a rare significant complication of tendon spontaneous rupture. However, only sporadic cases were reported in the literature before. This study was designed to gauge the clinical effect of tendon repair in patients of tendon spontaneous rupture after corticosteroid injection and analyze our experience.This was a retrospective observational study of 13 patients (8 women and 5 men) operated between July 2011 and December 2015 for tendon spontaneous rupture after corticosteroid injection...
October 2016: Medicine (Baltimore)
Joseph C Dort, D Gregory Farwell, Merran Findlay, Gerhard F Huber, Paul Kerr, Melissa A Shea-Budgell, Christian Simon, Jeffrey Uppington, David Zygun, Olle Ljungqvist, Jeffrey Harris
Importance: Head and neck cancers often require complex, labor-intensive surgeries, especially when free flap reconstruction is required. Enhanced recovery is important in this patient population but evidence-based protocols on perioperative care for this population are lacking. Objective: To provide a consensus-based protocol for optimal perioperative care of patients undergoing head and neck cancer surgery with free flap reconstruction. Evidence Review: Following endorsement by the Enhanced Recovery After Surgery (ERAS) Society to develop this protocol, a systematic review was conducted for each topic...
October 13, 2016: JAMA Otolaryngology—Head & Neck Surgery
Andrés M Bur, Jason A Brant, Carolyn L Mulvey, Elizabeth A Nicolli, Robert M Brody, John P Fischer, Steven B Cannady, Jason G Newman
Importance: Unplanned hospital readmission is costly and in recent years has become a focus of health care legislation intended to reduce health care expenditures. Greater understanding of which perioperative complications are associated with hospital readmission after surgery for head and neck cancer is needed to reduce unplanned readmissions. Objective: To determine which clinical risk factors and complications are associated with 30-day unplanned readmission after surgery for malignant neoplasms of the head and neck...
October 13, 2016: JAMA Otolaryngology—Head & Neck Surgery
Ross Alexander Chesham, Sivaramkumar Shanmugam
BACKGROUND: Knee osteoarthritis (OA) is a leading cause of disability in older adults (≥60) in the UK. If nonsurgical management fails and if OA severity becomes too great, knee arthroplasty is a preferred treatment choice. Preoperative physiotherapy is often offered as part of rehabilitation to improve postoperative patient-based outcomes. OBJECTIVES: Systematically review whether preoperative physiotherapy improves postoperative, patient-based outcomes in older adults who have undergone total knee arthroplasty (TKA) and compare study interventions to best-practice guidelines...
October 13, 2016: Physiotherapy Theory and Practice
S Frees, A C Schenk, P Rubenwolf, C Ziesel, W Jaeger, J W Thüroff, R Stein
PURPOSE: To evaluate stool habits and associated quality of life (QoL) in a matched pair analysis of patients who underwent continent cutaneous diversion using the ileocecal segment [Mainz pouch I (MzPI)] with an intussuscepted ileal nipple as efferent segment with those receiving an ileal conduit (IC) after radical cystectomy. METHODS: We identified 250 patients who underwent radical cystectomy and urinary diversion (UD) with either MzPI with an ileal nipple or IC in our database...
October 12, 2016: World Journal of Urology
C Raspé, L Flöther, R Schneider, M Bucher, P Piso
Due to the significantly improved outcome and quality of life of patients with different tumor entities after cytoreductive surgery (CRS) and HIPEC, there is an increasing number of centers performing CRS and HIPEC procedures. As this procedure is technically challenging with potential high morbidity and mortality, respectively, institutional experience also in the anesthetic and intensive care departments is essential for optimal treatment and prevention of adverse events. Clinical pathways have to be developed to achieve also good results in more comorbid patients with border line indications and extensive surgical procedures...
September 28, 2016: European Journal of Surgical Oncology
Gleb Medvedev, Charles Wang, Mathew Cyriac, Richard Amdur, Joseph O'Brien
STUDY DESIGN: Retrospective cohort study of the American College of Surgeons National Surgical Quality Improvement Program database from 2011 to 2012. OBJECTIVE: Minimizing the morbidity of posterior cervical fusion can be improved with identification of patient risk factors. SUMMARY OF BACKGROUND DATA: Posterior cervical fusion is an effective technique for treating a variety of pathology. Stability and neurological improvement have been well documented...
October 1, 2016: Spine
Jennifer B Oliver, Kiana Kashef, Angela M Bader, Darin J Correll
STUDY OBJECTIVE: Acute postoperative pain may transition to persistent/chronic pain in up to 50% or more of patients after certain surgeries. Despite this concern, it is unclear that patients' preprocedure understanding and expectations are aligned with these potential outcomes. This study was designed to evaluate the extent of this alignment and the potential impact on the quality of risk/benefit discussions before procedures. DESIGN: Prospective survey. SETTING: A large, tertiary care preoperative assessment clinic...
November 2016: Journal of Clinical Anesthesia
Rachid Badaoui, Youssef Alami Chentoufi, Abdelhakim Hchikat, Lionel Rebibo, Ivan Popov, Abdennaceur Dhahri, Ghada Antoun, Jean-Marc Regimbeau, Emmanuel Lorne, Hervé Dupont
STUDY OBJECTIVE: The development of outpatient surgery was one of the major goals of public health policy in 2010. The purpose of this observational prospective study was to evaluate the feasibility of laparoscopic sleeve gastrectomy (SG) in an ambulatory setting. DESIGN: Study design was a prospective prospective observational, nonrandomized study, registered ( identifier: NCT01513005), with institutional review board approval and written informed consent...
November 2016: Journal of Clinical Anesthesia
Sara L Zettervall, Klaas H J Ultee, Peter A Soden, Sarah E Deery, Katie E Shean, Alexander B Pothof, Mark Wyers, Marc L Schermerhorn
OBJECTIVE: Renal complications after repair of abdominal aortic aneurysms (AAAs) have been associated with increased morbidity and mortality. However, limited data have assessed risk factors for renal complications in the endovascular era. This study aimed to identify predictors of renal complications after endovascular AAA repair (EVAR) and open repair. METHODS: Patients who underwent EVAR or open repair of a nonruptured infrarenal AAA between 2011 and 2013 were identified in the National Surgical Quality Improvement Project Targeted Vascular module...
September 26, 2016: Journal of Vascular Surgery
Jared A Shenson, Jennifer N Craig, Sarah L Rohde
OBJECTIVE: Total laryngectomy (TL) is a high-cost procedure with patients at risk for significant postoperative health care use. Face-to-face preoperative counseling provided by speech-language pathologists is a relatively inexpensive intervention that may improve care quality and decrease costs. We evaluated if preoperative counseling for patients undergoing TL was associated with differences in length of stay (LOS), use of the emergency department (ED), or unplanned readmissions within 30 days of discharge...
September 27, 2016: Otolaryngology—Head and Neck Surgery
Julia Hamonet-Torny, Daniel Le Bellego, Elisabeth Jasper, Annie-Laure Suc, Laurent Fourcade
OBJECTIVE: The réseau enfance et handicap du grand Sud-Ouest (REHSO) as founded in November 2015 to promote pediatric PRM on this territory and to standardize the practices within the establishments participant. MATERIAL/PATIENTS AND METHODS: In May 2015, a study on the management of surgical projects in disabled children was realised by a questionnaire sent to the structures of pediatric PRM of the West. In June 2015, a working group composed by 17 surgeons, pediatrician and MPR practitioners discussed about their different practices and built a consensus on the steps to lead during a surgical project in disabled children...
September 2016: Annals of Physical and Rehabilitation Medicine
Johannes Sarnthein, Lennart Stieglitz, Pierre-Alain Clavien, Luca Regli
BACKGROUND: To improve the transparency of the local health care system, treatment cost was recently referenced to disease related groups. Treatment quality must be legally documented in a patient registry, in particular for the highly specialized treatments provided by neurosurgery departments. METHODS: In 2013 we have installed a patient registry focused on cranial neurosurgery. Surgeries are characterized by indication, treatment, location and other specific neurosurgical parameters...
2016: PloS One
Samuel E Dixon, Shelia A Haas, Audrey Klopp, Judy Carlson
BACKGROUND: The lack of a preoperative screening tool to detect obstructive sleep apnea (OSA) may lead to an increase in postoperative complications. AIM: The aim of the study was to implement a prescreening tool to identify diagnosed or undiagnosed OSA before a surgical procedure. SETTING: The study was conducted in the surgical admission center and postanesthesia care unit at a military treatment facility in Hawaii. PARTICIPANTS: Participants of the study included military personnel, military family members, veterans, and veteran beneficiaries...
October 2016: Journal of Perianesthesia Nursing: Official Journal of the American Society of PeriAnesthesia Nurses
Randa K Elmallah, Morad Chughtai, Anton Khlopas, Manoshi Bhowmik-Stoker, Kevin J Bozic, Steven M Kurtz, Michael A Mont
BACKGROUND: With the implementation of the Patient Protection and Affordable Care Act, cost-effectiveness analyses are becoming increasingly important for resource allocation, and particularly for the justification of costly procedures, such as total knee and total hip arthroplasties (TKAs and THAs). Therefore, using the Short Form-6D (SF-6D) utility values, the purpose of this study was to determine (1) the quality-adjusted life years (QALYs) gained and (2) and the cost-effectiveness of undergoing THA and TKA...
August 20, 2016: Journal of Arthroplasty
George Molina, Bridget A Neville, Stuart R Lipsitz, Lorri Gibbons, Ashley Kay Childers, Atul A Gawande, William R Berry, Alex B Haynes
BACKGROUND: Surgical procedures in the United States are increasingly performed in the ambulatory setting, including freestanding ambulatory surgery centers (ASCs). However, there is a lack of research and tracking of surgical outcomes in this setting. MATERIALS AND METHODS: We analyzed data from a state all-payer claims database to produce a retrospective cohort study on the rate of acute care use (emergency department [ED] visits and inpatient admissions) within 7 d after operations performed in freestanding ASCs in South Carolina...
October 2016: Journal of Surgical Research
Denis Querleu, François Planchamp, Luis Chiva, Christina Fotopoulou, Desmond Barton, David Cibula, Giovanni Aletti, Silvestro Carinelli, Carien Creutzberg, Ben Davidson, Philip Harter, Lene Lundvall, Christian Marth, Philippe Morice, Arash Rafii, Isabelle Ray-Coquard, Andrea Rockall, Cristiana Sessa, Ate van der Zee, Ignace Vergote, Andreas du Bois
OBJECTIVES: The surgical management of advanced ovarian cancer involves complex surgery. Implementation of a quality management program has a major impact on survival. The goal of this work was to develop a list of quality indicators (QIs) for advanced ovarian cancer surgery that can be used to audit and improve the clinical practice. This task has been carried out under the auspices of the European Society of Gynaecologic Oncology (ESGO). METHODS: Quality indicators were based on scientific evidence and/or expert consensus...
September 2016: International Journal of Gynecological Cancer
Taren Roughead, Darreul Sewell, Christopher J Ryerson, Jolene H Fisher, Alana M Flexman
Preoperative fasting is important to avoid morbidity and surgery delays, yet recommendations available on the Internet may be inaccurate. Our objectives were to describe the characteristics and recommendations of Internet resources on preoperative fasting and assess the quality and readability of these websites. We searched the Internet for common search terms on preoperative fasting using Google® search engines from 4 English-speaking countries (Canada, the United States, Australia, and the United Kingdom)...
September 16, 2016: Anesthesia and Analgesia
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