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Postoperative managment

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https://www.readbyqxmd.com/read/29141380/-the-analysis-of-anesthetic-management-for-renal-cell-carcinoma-with-associated-inferior-vena-cava-tumor-thrombus
#1
H Zeng, X Y Rong, Y Wang, X Y Guo
Objective: To explore the key points of anesthetic management for renal cell carcinoma combined with inferior vena cava (IVC) tumor thrombus. Methods: Twenty-seven cases of renal cell carcinoma with inferior vena cava (IVC) tumor thrombus underwent radical nephrectomy and inferior caval venous thrombectomy were reviewed retrospectively during January 2014 to January 2017 in our hospital.Analyzed data includs demographics, classification of tumor, perioperative anesthetic management and monitoring approaches, IVC clamping time , vital signs during cardiopulmonary bypass(CPB), estimated blood loss (EBL), usage of blood products, hospitalization time and ICU time , as well as postoperative outcomes...
November 14, 2017: Zhonghua Yi Xue za Zhi [Chinese medical journal]
https://www.readbyqxmd.com/read/29140870/a-retrospective-assessment-of-postoperative-bleeding-complications-in-anticoagulated-patients-following-mohs-micrographic-surgery
#2
Robert E Eilers, Alina Goldenberg, Natasha L Cowan, Pallavi Basu, Shang I Brian Jiang
BACKGROUND: A significant number of patients undergoing Mohs micrographic surgery (MMS) for skin cancer are treated with oral anticoagulants. The incidence of postoperative complications associated with new classes of oral anticoagulants remains largely unknown. OBJECTIVE: To determine the incidence of postoperative complications in patients undergoing MMS on both traditional oral anticoagulants and new novel oral anticoagulants. MATERIALS AND METHODS: A single-center retrospective chart review was performed for all patients treated with oral anticoagulants who underwent MMS between July 1, 2012 and June 30, 2015 at University of California, San Diego...
November 14, 2017: Dermatologic Surgery: Official Publication for American Society for Dermatologic Surgery [et Al.]
https://www.readbyqxmd.com/read/29140418/perioperative-management-of-the-obese-surgical-patient
#3
L H Lang, K Parekh, B Y K Tsui, M Maze
Introduction: The escalation in the prevalence of obesity throughout the world has led to an upsurge in the number of obese surgical patients to whom perioperative care needs to be delivered. Sources of data: After determining the scope of the review, the authors used PubMed with select phrases encompassing the words in the scope. Both preclinical and clinical reports were considered. Areas of agreement: There were no controversies regarding preoperative management and the intraoperative care of the obese surgical patient...
November 13, 2017: British Medical Bulletin
https://www.readbyqxmd.com/read/29139021/perioperative-complications-and-mortality-in-patients-with-urothelial-carcinoma-and-end-stage-renal-disease-undergoing-one-stage-complete-urinary-tract-extirpation
#4
Yun-Ching Huang, Ying-Hsu Chang, Alan W Shindel, Yin-Lun Chang, Jian-Hui Lin, Dong-Ru Ho, Chih-Shou Chen
BACKGROUND: Complete urinary tract extirpation (CUTE) is a complex procedure with substantial risk for perioperative complications. The association between clinical characteristics and the risk of major postoperative complications has not been systematically investigated. OBJECTIVE: The aim of this study was to analyze the incidence and risks for major perioperative complications after CUTE. METHODS: Respective chart review of 81 patients with urothelial carcinoma (UC) who were treated with one-stage CUTE between January 2004 and December 2015...
November 14, 2017: Annals of Surgical Oncology
https://www.readbyqxmd.com/read/29138592/dose-related-beneficial-and-harmful-effects-of-gabapentin-in-postoperative-pain-management-post-hoc-analyses-from-a-systematic-review-with-meta-analyses-and-trial-sequential-analyses
#5
REVIEW
Maria Louise Fabritius, Jørn Wetterslev, Ole Mathiesen, Jørgen B Dahl
Background: During the last 15 years, gabapentin has become an established component of postoperative pain treatment. Gabapentin has been employed in a wide range of doses, but little is known about the optimal dose, providing the best balance between benefit and harm. This systematic review with meta-analyses aimed to explore the beneficial and harmful effects of various doses of gabapentin administered to surgical patients. Materials and methods: Data in this paper were derived from an original review, and the subgroup analyses were predefined in an International Prospective Register of Systematic Reviews published protocol: PROSPERO (ID: CRD42013006538)...
2017: Journal of Pain Research
https://www.readbyqxmd.com/read/29137619/percutaneous-medial-hemi-epiphysiodesis-using-a-transphyseal-screw-for-caput-valgum-associated-with-developmental-dysplasia-of-the-hip
#6
Chang Ho Shin, Wan Kee Hong, Doo Jae Lee, Won Joon Yoo, In Ho Choi, Tae-Joon Cho
BACKGROUND: The purpose of this study was to evaluate the radiologic outcome of percutaneous medial hemi-epiphysiodesis using a transphyseal screw for the management of caput valgum associated with developmental dysplasia of the hip (DDH). METHODS: Eighteen hips (18 patients) having caput valgum treated with screw hemi-epiphysiodesis were followed for more than 2 years, and were included in this study. The mean age at the time of the index operation was 8.3 years (range, 4...
November 14, 2017: BMC Musculoskeletal Disorders
https://www.readbyqxmd.com/read/29137414/salvage-lymph-node-dissection-after-68-ga-psma-or-18-f-fec-pet-ct-for-nodal-recurrence-in-prostate-cancer-patients
#7
Annika Herlemann, Alexander Kretschmer, Alexander Buchner, Alexander Karl, Stefan Tritschler, Lina El-Malazi, Wolfgang P Fendler, Vera Wenter, Harun Ilhan, Peter Bartenstein, Christian G Stief, Christian Gratzke
The management of patients with biochemical recurrence (BCR) after definitive treatment for prostate cancer remains controversial. Our aim was to determine survival rates and complications of salvage lymph node dissection (sLND) in patients with recurrent prostate cancer after radical prostatectomy, while evaluating biochemical response (BR) with two different positron emission tomography/computed tomography (PET/CT) tracers used for preoperative imaging. sLND was performed in 104 patients diagnosed with isolated nodal recurrence on either (18)F-fluoroethylcholine ((18)F-FEC) or (68)Ga-PSMA-HBED-CC ((68)Ga-PSMA) PET/CT...
October 13, 2017: Oncotarget
https://www.readbyqxmd.com/read/29137249/endoscopic-retrograde-cholangiopancreatography-versus-laparoscopic-exploration-for-common-bile-duct-stones-in-post-cholecystectomy-patients-a-retrospective-study
#8
Xiaohong Wang, Chenguang Dai, Zhonghua Jiang, Lili Zhao, Min Wang, Limei Ma, Xueming Tan, Li Liu, Xiang Wang, Zhining Fan
Background and Objective: Common bile duct (CBD) stones are common in patients even after cholecystectomy. Besides endoscopic retrograde cholangiography (ERCP), laparoscopic common bile duct exploration (LCBDE) is also applied. This study aims to compare clinical indications, therapeutic benefits and complications for these two managements. Methods: From October 2012 to February 2015, 1072 consecutive patients were diagnosed as choledocholithiasis in our single hospital...
October 10, 2017: Oncotarget
https://www.readbyqxmd.com/read/29137063/gallstone-ileus-displaying-the-typical-rigler-triad-and-an-occult-second-ectopic-stone-a-case-report
#9
Li Wang, Ping Dong, Yi Zhang, Bole Tian
RATIONALE: Gallstone ileus is a rare complication of cholecystolithiasis. It has a female predominance and can result in high mortality rates. PATIENT CONCERNS: A 71-year-old woman complaining of recurrent vomiting and vague epigastralgia for > 2 weeks presented to our department. DIAGNOSIS: Based on her physical examination, laboratory test results and radiographic findings (the typical Rigler's triad), she was diagnosed with gallstone ileus caused by multiple ectopic stones...
November 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29136737/-research-progress-on-early-diagnosis-reasonable-prevention-and-treatment-of-symptomatic-spinal-epidural-hematoma-following-spinal-surgery
#10
X W Ye, S S Liu, P H Zeng, B L Liu
Symptomatic spinal epidural hematoma (SSEH) following spinal surgery is rare but one of the serious complications. SSEH can leave devastating neurological consequences if missing the optimal timing for treatment. The early diagnosis of SSEH is critical to the neurologic recovery, and MRI examination can help to check the location and the scope of the hematoma and provide imaging information for surgical operation. The risk factors of SSEH can be divided into preoperative factors, intraoperative factors and postoperative factors...
November 1, 2017: Zhonghua Wai Ke za Zhi [Chinese Journal of Surgery]
https://www.readbyqxmd.com/read/29135868/endoscopic-transcanal-transpromontorial-approach-for-vestibular-schwannoma-resection-a-case-series
#11
Cameron C Wick, Demetri Arnaoutakis, Samuel L Barnett, Alejandro Rivas, Brandon Isaacson
OBJECTIVE: To demonstrate successful surgical management of vestibular schwannomas via an exclusively endoscopic transcanal transpromontorial approach (EETTA). PATIENTS: Four patients with vestibular schwannomas. INTERVENTIONS: Surgical excision via EETTA. MAIN OUTCOMES: Technique refinements, tumor access, complete tumor removal, and patient morbidity. RESULTS: Three tumors were Koos grade I and one tumor was Koos grade II...
December 2017: Otology & Neurotology
https://www.readbyqxmd.com/read/29135862/management-of-sigmoid-sinus-associated-pulsatile-tinnitus-a-systematic-review-of-the-literature
#12
Alan C Wang, Avery N Nelson, Cassandra Pino, Peter F Svider, Robert S Hong, Eleanor Chan
OBJECTIVES: Although studies demonstrate 4 to 20% of patients with pulsatile tinnitus (PT) have associated sigmoid sinus anomalies, no consensus exists regarding optimal management. Our objective was to perform a systematic review exploring surgical and endovascular intervention of PT caused by sigmoid sinus anomalies. DATA SOURCES/EXTRACTION: A systematic review was performed using the Preferred Reporting Systems for Systematic Reviews and Meta-Analysis guidelines for reporting of results, with a target population encompassing patients with PT and either sigmoid sinus diverticulum or sigmoid wall dehiscence...
December 2017: Otology & Neurotology
https://www.readbyqxmd.com/read/29135810/can-urodynamic-parameters-predict-sling-revision-for-voiding-dysfunction-in-women-undergoing-synthetic-midurethral-sling-placement
#13
Brian J Linder, Emanuel C Trabuco, John B Gebhart, Christopher J Klingele, John A Occhino, Daniel S Elliott, Deborah J Lightner
OBJECTIVE: The objective of the study was to evaluate the utility of urodynamic studies performed before primary midurethral sling placement for stress urinary incontinence in predicting the need for subsequent sling release for voiding dysfunction. METHODS: The health records of women managed with primary synthetic midurethral sling placement at Mayo Clinic (Rochester, MN) from January 1, 2002, to December 31, 2012, were reviewed. The primary outcome was surgical sling release for postoperative voiding dysfunction (ie, prolonged retention, elevated postvoid residual volumes with new voiding symptoms, or de novo onset or worsening of overactive bladder symptoms)...
November 13, 2017: Female Pelvic Medicine & Reconstructive Surgery
https://www.readbyqxmd.com/read/29135804/surgical-management-of-tumors-involving-meckel-s-cave-and-cavernous-sinus-role-of-an-extended-middle-fossa-and-lateral-sphenoidectomy-approach
#14
Daniel Q Sun, Arnold H Menezes, Matthew A Howard, Bruce J Gantz, David M Hasan, Marlan R Hansen
OBJECTIVE: To study the indications and outcomes of lateral sphenoidectomy as part of a combined skull base approach in the treatment of tumors involving Meckel's cave (MC) and cavernous sinus (CS). STUDY DESIGN: Retrospective patient series. SETTING: Tertiary referral center. PATIENTS: Twenty-two consecutive patients (mean age: 45 yr, range: 16-76) who underwent transzygomatic, extended middle fossa approaches for tumors involving MC and CS...
November 13, 2017: Otology & Neurotology
https://www.readbyqxmd.com/read/29135497/pancreatic-chymotrypsin-activity-rather-than-amylase-level-better-predicts-postoperative-pancreatic-fistula
#15
Suguru Yamashita, Takeaki Ishizawa, Kazuhiro Mori, Kazuteru Monden, Yugo Kuriki, Mako Kamiya, Junichi Kaneko, Nobuhisa Akamatsu, Junichi Arita, Yoshihiro Sakamoto, Kiyoshi Hasegawa, Yasuteru Urano, Norihiro Kokudo
OBJECTIVE: To assess the predictive value of chymotrypsin activity in pancreatic juice on clinically relevant postoperative pancreatic fistula (CR-POPF) after pancreatic resection, since pancreatic peptidases rather than glycolytic enzymes play a pivotal role in causing tissue damage due to pancreatic leakage. BACKGROUND: The risk of CR-POPF has been estimated based on amylase level in abdominal drainage fluid. METHODS: Eighty-one consecutive patients underwent pancreatoduodenectomy, and postoperative pancreatic juice and drainage fluids were collected for 14 days...
November 13, 2017: Annals of Surgery
https://www.readbyqxmd.com/read/29135409/double-inlay-plus-ventral-onlay-buccal-mucosa-graft-for-simultaneous-penile-and-bulbar-urethral-stricture
#16
Luciano A Favorito, Paulo P Conte, Ulisses G Sobrinho, Rodrigo G Martins, Tomas Accioly
OBJECTIVES: Buccal mucosa grafts and fascio-cutaneous flaps are frequently used in long anterior urethral strictures (1). The inlay and onlay buccal mucosa grafts are easier to perform, do not need urethral mobilization and generally have good long-term results (2-4). In the present video, we present a case where we used a double buccal mucosa graft technique in a simultaneous penile and bulbar urethral stricture. MATERIALS AND METHODS: A 54 year-old male patient was submitted to appendectomy where a urethral catheter was used for two days in May 2015...
November 17, 2017: International Braz J Urol: Official Journal of the Brazilian Society of Urology
https://www.readbyqxmd.com/read/29135272/-protecting-the-inferior-alveolar-nerve-coronectomy-of-lower-third-molars-review
#17
József Szalma, Edina Lempel
Coronectomy of lower impacted wisdom teeth is the partial removal of third molars, aiming to avoid inferior alveolar nerve injuries. The coronectomy procedure has several crucial points, such as the pulpal, periapical preoperative conditions of the tooth, the way of crown sectioning and decoronation, the wound closure and the length of patients' follow up. In addition it is important to identify and manage possible intraoperative or postoperative complications correctly. According to the literature, the complication rate of coronectomy is usually lower, than that of total teeth removal, furthermore considering inferior alveolar nerve injuries, coronectomy is significantly the safer procedure...
November 2017: Orvosi Hetilap
https://www.readbyqxmd.com/read/29135138/-laparoscopic-radical-cystectomy-innovations-and-classics
#18
D V Perlin, I V Aleksandrov, V P Zipunnikov, M Popova
INTRODUCTION: Radical cystectomy remains the gold-standard treatment for muscle-invasive bladder cancer. To combine the advantages of minimally invasive interventions and the well-established open surgery, we attempted to reproduce as accurately as possible the technique of open radical cystectomy using a laparoscopic procedure. MATERIALS AND METHODS: The study comprised 35 patients (27 men and 8 women) with invasive bladder cancer who underwent laparoscopic radical cystectomy (LRC) between April 2013 and March 2016...
October 2017: Urologii︠a︡
https://www.readbyqxmd.com/read/29134517/subcutaneous-ketamine-for-postoperative-pain-relief-in-rwanda-a-randomized-clinical-trial
#19
Calen Sacevich, Benjamin Semakuba, William P McKay, Shefali Thakore, Theogene Twagirumugabe, John Nyiligira
PURPOSE: Postoperative pain control is often inadequate in low-income countries such as Rwanda, prompting the search for an inexpensive improvement. A randomized controlled trial was conducted to study the use of subcutaneous ketamine for the management of postoperative pain in patients undergoing major surgery in Kigali, Rwanda. METHODS: Fifty-nine patients undergoing major abdominal, head and neck, plastic, or gynecological surgeries were studied. In addition to standard care, patients received five subcutaneous injections of ketamine 1 mg·kg(-1) (ketamine group, n = 30) or normal saline (placebo group, n = 29) during the postoperative period...
November 13, 2017: Canadian Journal of Anaesthesia, Journal Canadien D'anesthésie
https://www.readbyqxmd.com/read/29134423/perioperative-respiratory-complications-current-evidence-and-strategy-discussed-in-2017-ja-symposium
#20
K Hirota, M Yamakage, S Hashimoto, T Asai, S Isono
Respiratory management during general anesthesia aims to safely secure the airway and maintain adequate ventilation to deliver oxygen to the vital organs, maintaining homeostasis even during surgery. Despite its clinical importance, anesthesiologists often encounter difficulties in properly managing respiration during the perioperative period, leading to severe respiratory complications. In this year's JA symposium, 5 editorial board members of Journal of Anesthesia (JA) who are experts in the field of respiratory management in anesthesia discussed the following topics: quitting smoking before surgery: exposure to passive smoke is damaging to children, ventilator-associated pneumonia, high inspiratory oxygen concentration and lung injury, aspiration pneumonia, and postoperative respiratory management strategy in patients with obstructive sleep apnea...
November 13, 2017: Journal of Anesthesia
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