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Postoperative managment

Takeshi Urade, Hidehiro Sawa, Koichi Murata, Yasuhiko Mii, Yoshiteru Iwatani, Ryoko Futai, Shohei Abe, Tsuyoshi Sanuki, Yukiko Morinaga, Daisuke Kuroda
Omental abscess due to a spilled gallstone is extremely rare after laparoscopic cholecystectomy. Herein, we report a 68-year-old man who presented with left upper abdominal pain after laparoscopic cholecystectomy for gangrenous cholecystitis. Seven months prior to admission, gallbladder perforation with spillage of pigment gallstones and bile occurred during laparoscopic cholecystectomy. The spilled gallstones were retrieved through vigorous peritoneal lavage. Abdominal computed tomography showed a 3 × 2...
March 21, 2018: Clinical Journal of Gastroenterology
Seong Hee Kim, Chan Hee Jin, In Taek Hwang, Jun Sook Park, Jung Hwan Shin, Dae Woon Kim, Yong Soo Seo, Jee Nah Sohn, Yun Seok Yang
Objective: The present study aimed to determine the differences in outcomes between natural orifice transluminal endoscopic surgery-assisted vaginal hysterectomy (NAVH) and conventional laparoscopy-assisted vaginal hysterectomy (LAVH). Methods: We retrospectively reviewed the charts of patients who between July 2012 and September 2015, were diagnosed as having benign uterine disease such as uterine myoma, endometriosis, or adenomyosis and managed via NAVH or LAVH in a single-center (Eulji University Hospital)...
March 2018: Obstetrics & Gynecology Science
Andrew R Summers, Travis Philipp, Jacob D Mikula, Kenneth R Gundle
Metastatic bone disease affects approximately 300,000 people in the United States, and the burden is rising. These patients experience significant morbidity and decreased survival. The management of these patients requires coordinated care among a multidisciplinary team of physicians, including orthopaedic surgeons. This article reviews the role of radiation therapy after orthopaedic stabilization of impending or realized pathologic extremity fractures. Orthopaedic surgeons have an opportunity to benefit patients with metastatic bone disease by referring them for consideration of post-operative radiation therapy...
December 14, 2017: Orthopedic Reviews
Sun Ki Kim, Won Yeong Seo, Hee Joong Kim, Jeong Joon Yoo
Background: This retrospective study was performed to determine whether postoperative intravenous ferric carboxymaltose reduces transfusion amounts without influencing clinical outcomes in patients that have undergone hip surgery. Methods: Between May 2014 and April 2016, the authors adopted a new perioperative blood management protocol involving the administration of intravenous ferric carboxymaltose after hip surgeries. One-to-one matching between the 150 patients treated during this period with 150 patients treated before initiation of the new protocol was performed by propensity scoring for age, sex, diagnosis, and type of hip surgery...
March 2018: Clinics in Orthopedic Surgery
Sang Jun Song, Cheol Hee Park, Hu Liang, Sang Jun Kim
Noise in the knee joint is a common symptom that often leads to outpatient clinic visits. However, there have been no previous review articles regarding noise around the knee despite its high prevalence. We will review the noise characteristics according to sound nature and onset as well as factors for differentiation between physiological and pathological noises. In addition, we will describe causes of the physiological and pathological noises and management of noise in the knee. An appropriate review of the characteristics of noise, its pathophysiology, and factors for differentiation between physiological and pathological noises can facilitate patient guidance...
March 2018: Clinics in Orthopedic Surgery
Prakash Hebbulse Shivalingaiah, Pradeep Kumar, Suyash Bajoria
Adrenal schwannomas are very rare tumors accounting for only 0.2% of the adrenal tumors. These are very difficult to diagnose preoperatively and usually present as incidental non-secreting adrenal masses in asymptomatic patients or in patients with non-specific complaints. Computed tomography (CT) and magnetic resonance imaging (MRI) are required to aid the diagnosis, but adrenal schwannomas cannot be distinguishably confirmed on the basis of imaging alone. Histopathological examination (HPE) is essential for accurate diagnosis...
March 2018: Indian Journal of Surgical Oncology
Anish Jacob Cherian, Pooja Ramakant, Rekha Pai, Marie Therese Manipadam, S Elanthenral, Anuradha Chandramohan, Julie Hephzibah, David Mathew, Dhukabandhu Naik, Thomas V Paul, Simon Rajaratnam, Nihal Thomas, M J Paul, Deepak Thomas Abraham
We conducted this study to evaluate the demography, clinical presentation, management and outcomes of medullary thyroid carcinoma (MTC) from the Indian context. This was a retrospective study of patients with MTC managed between January 2008 and December 2016. All pertinent data was collected and the results were analysed using STATA (v.13.1). MTC accounted for 90/2022 (4.45%) patients managed with thyroid cancer during the study period. The mean age of presentation was 40 years (range 14-70 years) with 47 males and 43 females...
March 2018: Indian Journal of Surgical Oncology
Tanuj Dada, Dewang Angmo, Shibal Bhartiya, Karthikeya Ramananda
We describe a novel technique to bleb needling by injecting subconjunctival ologen through an intraocular lens (IOL) delivery system to modulate wound healing in a failing filter. Bleb needling with 26G needle was performed, followed by subconjunctival injection of a biodegradable collagen implant using an IOL delivery system with cartridge in two eyes with a failing filter and high intraocular pressure (IOP). Postoperatively, the bleb was diffusely elevated, and the IOP was maintained between 10 and 14 mmHg at 6 weeks, 3 and 6 months follow-up...
January 2018: Oman Journal of Ophthalmology
Chintan Malhotra, Arun Kumar Jain, Nikhil Aggarwal
A 70-year-old patient who underwent uneventful primary implantation of Auro K Pro (a Type I Boston Keratoprosthesis-based device), developed infiltrates in the deep stroma of the carrier corneal graft and exudates on the optic stem of the keratoprosthesis assembly, 6 weeks postoperatively, which subsequently progressed to endophthalmitis. Vitreous tap was positive for a panfungal polymerase chain reaction, although corneal scrapings for both Gram stain and KOH wet mount yielded negative results. Aggressive management with systemic, topical, intravitreal, and intrastromal antifungal agents resulted in an initial resolution, but residual inflammatory vitreous membranes persisted...
January 2018: Oman Journal of Ophthalmology
Nicholas Parkhouse, Isabella Joy de Vere Hunt
This report discusses in detail the case of a patient who underwent a scar revision procedure to have her characteristic self-harm scars altered. A detailed insight into the patient's perspective was gained through semistructured interviews conducted at 6 weeks and 6 months postoperatively. The interviews found that an equally if not more conspicuous scar that was distinct from those created from self-harm had a pronounced psychological benefit for the patient. This article calls for more active management of the psychological sequelae of self-harm scars, with the need to facilitate access to surgical treatment in certain cases...
March 21, 2018: BMJ Case Reports
Jessa E Miller, Neal C Al-Attar, Owen H Brown, Gabrielle G Shaughness, Natalja P Rosculet, Anca Avram, David T Hughes
BACKGROUND: After initial surgical treatment of differentiated thyroid cancer (DTC) residual lymph node metastases are often found at the time of radioactive iodine (131-I) therapy. Recurrence of DTC is due to persistent disease not removed at initial surgery and that did not respond to 131-I treatment. This study aims to determine locations of, and reasons for, residual nodal metastases detected by 131-I scans with SPECT/CT obtained prior to radioiodine therapy following surgical treatment of DTC...
March 21, 2018: Thyroid: Official Journal of the American Thyroid Association
Sarah N Yu, Jiho Han, Koji Takeda, Jonathan N Ginns, Paul A Kurlansky, Arthur R Garan, Melana Yuzefpolskaya, Veli K Topkara, Paolo C Colombo, Yoshifumi Naka, Hiroo Takayama
INTRODUCTION: Device thrombosis is one of the most devastating complications of HeartMate II left ventricular assist devices. The purpose of this study is to assess the anatomical properties that the inflow and outflow computed tomography angiography provides in assessing for left ventricular assist device thrombosis, as well as their impact on clinical management and postoperative outcomes. METHODS: Between April 2010 and December 2016, 22 patients who received a HeartMate II left ventricular assist device implantation were readmitted for suspected device thrombosis and underwent a computed tomography angiography for workup...
March 1, 2018: International Journal of Artificial Organs
K C Zhang, L Chen
Different proficiency in minimally invasive surgery has great impact on efficacy of minimally invasive surgery. Therefore, great importance should be attached to the standardization of minimally invasive surgery. Accurate preoperative staging plays a prerequisite role which emphasizes multiple diagnostic strategies. Precise intraoperative procedure plays an essential role which should be performed according to the evidence-based expert consensus and guideline. Standardized postoperative management plays a crucial role which includes ex vivo lymph node dissection, registry of complication and follow-up and establishment of medical database...
April 1, 2018: Zhonghua Wai Ke za Zhi [Chinese Journal of Surgery]
Ippokratis Pountos, Peter V Giannoudis
The fixation of impending or pathologic fractures is challenging and their successful management can have a favourable impact on the quality of life of the patient. The progression of the metastatic bone disease can cause significant pain and disability but also could result in the loosening and subsequent failure of the implants. To prevent the additional local growth, postoperative radiotherapy is often recommended, and many patients receive endocrine or chemotherapy Areas Covered: Several reports support the antineoplastic drugs to bone cement as an adjuvant to improve implant stability as well as to prevent local cancer progression and failure of reconstructive devices used to treat patients with pathologic fractures...
March 21, 2018: Expert Review of Medical Devices
Melanie Lumbers
The appropriate choice of postoperative dressing supports effective wound healing by providing a moist wound environment and reducing the risk of surgical site infection and blistering. Wound management is complex and practitioners need to consider the location of the wound, method of wound closure, expected exudate level and length of time the dressing needs to remain in place when selecting a product. The correct dressing selection will have a positive impact wound healing and the patient's quality of life...
March 22, 2018: British Journal of Nursing: BJN
Wei An, Aisaiti Ainiwaer, Patiguli Wusiman, Gulibusitan Ali, Adili Moming
PURPOSE: The study proposed to determine the superiority between different fixation methods in the mandibular angle fractures (MAFs) and to evaluate best option for surgeon and patient. METHODS: A systematic review was conducted according to PRISMA guidelines, examining Medline-Ovid, Embase, and Pubmed databases. The quality of studies was assessed, and the odds risk (OR) with its corresponding 95% confidence interval (CI) was assessed to measure the effect size...
March 20, 2018: Journal of Craniofacial Surgery
Adam Kaiser, Adam Semanoff, Louis Christensen, Rory Sadoff, Jody C DiGiacomo
PURPOSE: To evaluate submental intubation compared with secure airways of patients who have sustained significant maxillofacial trauma. PATIENTS AND METHODS: Patient series of 3 patients who underwent submental intubation prior to open reduction internal fixation of fractures associated with the mid and lower face. All of these patients were initially orally intubated, and then converted to submental intubation prior to the reparative procedure. Detailed description of the procedure is discussed in each patient...
March 20, 2018: Journal of Craniofacial Surgery
A A Polyantsev, A V Bykov, A A Polyantsev, V V Kotrunov, A G Zimin, Yu A Dyachkova
AIM: To analyze the errors and complications of surgical care in patients with the first episode of spontaneous pneumothorax at different hospitals. MATERIAL AND METHODS: From 2005 to 2015 three hundreds and seventeen patients with the first episode of spontaneous pneumothorax have been treated at the thoracic department of Volgograd State Medical University. Patients were divided into 2 groups: 79 of them underwent thoracotomy while in 238 cases minimally invasive technologies were applied...
2018: Khirurgiia
R Dumont, F Puleo, J Collignon, N Meurisse, M Chavez, L Seidel, P Gast, M Polus, C Loly, Ph Delvenne, P Meunier, R Hustinx, A Deroover, O Detry, E Louis, Ph Martinive, D Van Daele
BACKGROUND AND STUDY AIMS: The current standard of care for resectable pancreatic ductal adenocarcinoma (PDAC) is surgery-first followed by adjuvant chemotherapy. We review our single center experience in a PDAC cohort managed by the surgery-first strategy. We then compare our data to those of Belgian and international literature. PATIENTS METHODS: We reviewed a series of 83 consecutive resectable patients with PDAC, treated by the surgery-first approach in a Belgian Academic Hospital between 2007 and 2013...
October 2017: Acta Gastro-enterologica Belgica
David L Chan, Matthew Dixon, Calvin H L Law, Serge Koujanian, Kaitlyn A Beyfuss, Simron Singh, Sten Myrehaug, Julie Hallet
BACKGROUND: Neuroendocrine tumors (NETs) have a uniquely indolent biology. Management focuses on tumor and hormonal burden reduction. Data on cytoreduction with extrahepatic disease remain limited. OBJECTIVE: We sought to define the outcomes of cytoreduction for metastatic NETs with extrahepatic metastases. METHODS: Patients undergoing cytoreductive surgery for grade 1 or 2 NETs with extrahepatic metastases (with or without intrahepatic disease) were identified from an institutional database (2003-2014)...
March 20, 2018: Annals of Surgical Oncology
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