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Postoperative management

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https://www.readbyqxmd.com/read/28107271/perioperative-care-of-the-patient-with-the-total-artificial-heart
#1
Jill Yaung, Francisco A Arabia, Michael Nurok
Advanced heart failure continues to be a leading cause of morbidity and mortality despite improvements in pharmacologic therapy. High demand for cardiac transplantation and shortage of donor organs have led to an increase in the utilization of mechanical circulatory support devices. The total artificial heart is an effective biventricular assist device that may be used as a bridge to transplant and that is being studied for destination therapy. This review discusses the history, indications, and perioperative management of the total artificial heart with emphasis on the postoperative concerns...
January 19, 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28106674/open-surgical-release-of-posttraumatic-elbow-contracture-in-children-and-adolescents
#2
Samantha L Piper, Lisa L Lattanza, Tony S Shen, Lindley B Wall, Charles A Goldfarb
BACKGROUND: Posttraumatic elbow contractures in children and adolescents are challenging to manage, and studies investigating surgical treatment are limited by the rarity of this condition. Small case series have shown variable gains in immediate and long-term elbow arc of motion after open surgical release. We reviewed our experience with open surgical release of posttraumatic elbow contracture in patients <21 years old at 2 institutions. METHODS: A retrospective chart review identified patients who underwent posttraumatic open elbow contracture release by 2 surgeons at 2 institutions between 2006 and 2013...
January 18, 2017: Journal of Pediatric Orthopedics
https://www.readbyqxmd.com/read/28106659/adenoid-cystic-carcinoma-evaluation-and-management-progress-with-optimism
#3
Patrick J Bradley
PURPOSE OF REVIEW: Adenoid cystic carcinoma (ACC) when diagnosed presents several diagnostic and treatment challenges. The standard treatment of surgery and postoperative radiotherapy has remained the standard of care for the past 3 decades. The purpose of this review is to update what's been reported and what's new since the last review in 2004. RECENT FINDINGS: As accurate a histological diagnosis and staging of disease should be achieved prior to commencing any treatment...
January 18, 2017: Current Opinion in Otolaryngology & Head and Neck Surgery
https://www.readbyqxmd.com/read/28106608/a-perioperative-systems-design-to-improve-intraoperative-glucose-monitoring-is-associated-with-a-reduction-in-surgical-site-infections-in-a-diabetic-patient-population
#4
Jesse M Ehrenfeld, Jonathan P Wanderer, Maxim Terekhov, Brian S Rothman, Warren S Sandberg
BACKGROUND: Diabetic patients receiving insulin should have periodic intraoperative glucose measurement. The authors conducted a care redesign effort to improve intraoperative glucose monitoring. METHODS: With approval from Vanderbilt University Human Research Protection Program (Nashville, Tennessee), the authors created an automatic system to identify diabetic patients, detect insulin administration, check for recent glucose measurement, and remind clinicians to check intraoperative glucose...
January 19, 2017: Anesthesiology
https://www.readbyqxmd.com/read/28105620/-effect-of-a-clinical-pathway-in-patients-with-crohn-s-disease-complicated-with-intestinal-obstruction
#5
Zhen Guo, Lei Cao, Jianfeng Gong, Yi Li, Lili Gu, Weiming Zhu, Jieshou Li
OBJECTIVE: To evaluate the effect of a clinical pathway for Crohn disease (CD) complicated with intestinal obstruction. METHODS: CD patients complicated with intestinal obstruction in Inflammatory Bowel Disease(IBD) Center of Jinling Hospital were enrolled. One hundred and nineteen CD patients from March 2014 to September 2015 received treatment with the clinical pathway (CP), which was developed based on medical evidence and experience of the IBD center in February 2014, as CP group...
January 25, 2017: Zhonghua Wei Chang Wai Ke za Zhi, Chinese Journal of Gastrointestinal Surgery
https://www.readbyqxmd.com/read/28105137/applicability-of-rapid-intraoperative-parathyroid-hormone-assay-through-fine-needle-aspiration-to-identify-parathyroid-tissue-in-thyroid-surgery
#6
Xue-Hai Bian, Shi-Jie Li, Le Zhou, Chun-Hai Zhang, Guang Zhang, Yan-Tao Fu, Hui Sun
Hypoparathyroidism is a frequent and serious complication of thyroid surgery. Identification and preservation of the parathyroid glands are key factors in managing hypoparathyroidism. The aim of the present study was to investigate the efficacy of rapid intraoperative parathyroid hormone (rIO-PTH) assay levels through fine needle aspiration (FNA) in identifying parathyroids as a parameter in thyroid surgery. rIO-PTH assay through FNA and frozen section examination were performed on 194 suspected parathyroids anatomical structures from 50 consecutive patients undergoing thyroidectomy (rIO-PTH group)...
December 2016: Experimental and Therapeutic Medicine
https://www.readbyqxmd.com/read/28104466/age-related-differences-pre-intra-and-postcholecystectomy
#7
Hadia Maqsood, Kalpesh Patel, Hamid Ferdosi, Anne M Sill, Bin Wu, Thomas Buddensick, Amanda Sautter, Haroon Shaukat, Gisela Sulkowski, Dusty Marie Narducci, Mustafa Siddique, Farin Kamangar, Gopal C Kowdley, Steven C Cunningham
BACKGROUND: Cholecystectomy (CCY) is increasingly performed in older individuals. We sought to examine age-related differences in pre-, intra-, and postoperative factors at a community hospital, using a very large, single-institution cholecystectomy database. MATERIALS AND METHODS: A retrospective review of 6868 patients who underwent CCY from 2001 to 2013 was performed. ROC analysis identified the optimal age cutoff when complications reached a significant inflection point (<55 and >55 years)...
January 16, 2017: International Journal of Surgery
https://www.readbyqxmd.com/read/28104293/debriefing-decreases-mental-workload-in-surgical-crisis-a-randomized-controlled-trial
#8
Sylvain Boet, Bharat Sharma, Ashlee-Ann Pigford, Emily Hladkowicz, Neil Rittenhouse, Teodor Grantcharov
BACKGROUND: Mental workload is the amount of mental effort involved in performing a particular task. Crisis situations may increase mental workload, which can subsequently negatively impact operative performance and patient safety. This study aims to measure the impact of learning through debriefing and a systematic approach to crisis on trainees' mental workload in a simulated surgical crisis. METHODS: Twenty junior surgical residents participated in a high-fidelity, simulated, postoperative crisis in a surgical ward environment (pretest)...
January 16, 2017: Surgery
https://www.readbyqxmd.com/read/28104274/the-role-of-radiation-therapy-in-the-management-of-sinonasal-and-ventral-skull-base-malignancies
#9
REVIEW
Kyle Wang, Adam M Zanation, Bhishamjit S Chera
Sinonasal and ventral skull base malignancies are rare tumors that arise in a complex anatomic location juxtaposed with critically important normal tissues. The standard treatment paradigm for most histologies has been surgery followed by postoperative radiation therapy. Because of their propensity to present at an advanced stage and the presence of nearby critical structures, patients are at risk for severe radiation-induced long-term toxicity. Recent advances in radiotherapy technique have improved the therapeutic ratio between tumor control and normal tissue toxicity...
January 16, 2017: Otolaryngologic Clinics of North America
https://www.readbyqxmd.com/read/28104228/the-efficacy-of-posterior-plating-and-anterior-column-screw-fixation-in-the-management-of-t-shaped-acetabular-fractures-cart-analysis-of-prospective-cohort-study
#10
A S Hammad, T A El-Khadrawe, A H Waly, G A Abu-Sheasha
T-shaped acetabular fractures are challenging injuries. The goal of surgical treatment is to achieve a stable and a concentric reduction of the femoral head under the anatomically reduced weight-bearing dome. There is an ongoing debate about the ideal approach and fixation method for T-shaped fractures. In this study, a group of 34 patients with T-shaped acetabular fractures were treated by posterior plating and anterior column screw. All patients, were followed for at least two years or until hip replacement...
January 9, 2017: Injury
https://www.readbyqxmd.com/read/28104115/pretransplant-serum-hyaluronic-acid-can-be-a-biomarker-as-a-prognostic-predictor-in-adult-to-adult-living-donor-liver-transplantation
#11
S Mizuno, B C Das, Y Iizawa, H Kato, Y Murata, A Tanemura, N Kuriyama, Y Azumi, M Kishiwada, M Usui, H Sakurai, S Isaji
OBJECTIVE: The goal of this study was to evaluate whether pretransplant serum hyaluronic acid (HA) levels can predict outcomes after adult-to-adult living donor liver transplantation (LDLT). METHODS: In study I, 21 patients who underwent LDLT (March 2002-February 2004) were divided into 2 groups: the H-I group (HA ≥500 ng/mL; n = 12) and the L-I group (HA <500 ng/mL; n = 9). The influence of pretransplantation HA levels on short-term surgical outcome was investigated...
January 2017: Transplantation Proceedings
https://www.readbyqxmd.com/read/28103707/predictors-of-patient-reported-function-and-pain-outcomes-in-operative-ankle-fractures
#12
Daniel M Dean, Bryant S Ho, Albert Lin, Daniel Fuchs, George Ochenjele, Bradley Merk, Anish R Kadakia
BACKGROUND: Risk factors associated with short-term functional outcomes in patients with operative ankle fractures have been established. However, no previous studies have reported the association between these risk factors and functional outcomes outside of the first postoperative year. We identified predictors of functional and pain outcomes in patients with operative ankle fractures using the Patient Reported Outcomes Measurement System (PROMIS) physical function (PF) and pain interference (PI) measures...
January 1, 2017: Foot & Ankle International
https://www.readbyqxmd.com/read/28103662/-strangulation-of-the-penis-by-four-metallic-washers
#13
Yuto Matsushita, Hiroshi Furuse, Rikiya Matsumoto, Takayuki Sugiyama, Masao Nagata, Atsushi Otsuka, Seiichiro Ozono
We report here a case of strangulation of the penis. A 69-year-old male visited our hospital suffering from a swollen penis and dysuria after installation of four metallic washers to the penis. He had mischievously put them on his penis four days before and subsequently was unable to remove them. We found erosion on the surface of the penis, reduction in blood flow by ultrasonography, and high C-reactive protein levels. Because we could not remove washers by blood removal from glans penis or ring cutter, we performed percutaneous cystostomy and then cut the washers with an electric grinder under general anesthesia...
December 2016: Hinyokika Kiyo. Acta Urologica Japonica
https://www.readbyqxmd.com/read/28103418/three-hundred-and-sixty-eight-consecutive-pancreaticoduodenetomies-with-zero-mortality
#14
Seiji Oguro, Jiro Yoshimoto, Hiroshi Imamura, Yoichi Ishizaki, Seiji Kawasaki
BACKGROUND/PURPOSE: Only a limited number of reports have documented zero mortality in consecutive pancreaticoduodenetomy series. The aim of this study is to review and verify our management aiming to eliminate mortality after pancreaticoduodenetomy. METHODS: Three hundred sixty-eight consecutive patients undergoing pancreaticoduodenetomy between 2002 and 2015 were retrospectively reviewed. During this period, in order to enhance the safety of pancreaticoduodenetomy, we have employed a consistent strategy consisting of early ligation of the inferior pancreatoduodenal artery, mucosal sutureless pancreaticojejunostomy combined with external pancreatic duct stenting, conditional two-stage pancreaticojejunostomy, jejunal decompression using tube jejunostomy, application of an omental flap to cover the stump of the gastroduodenal artery, and careful postoperative drain management...
January 19, 2017: Journal of Hepato-biliary-pancreatic Sciences
https://www.readbyqxmd.com/read/28103372/the-effect-of-epidural-levobupivacaine-and-fentanyl-on-stress-response-and-pain-management-in-patients-undergoing-percutaneous-nephrolithotomy
#15
A Ahiskalioglu, O Ahiskalioglu, A Dostbil, C Abdullah, A Megnet, M Celik, I Ilker, K Husnu
Objective: The perioperative stress response of patients who were scheduled to have percutaneous nephrolithotomy under epidural anaesthesia with opioids and local anaesthetics has not been investigated in detail yet. Our hypothesis is that the stress response following percutaneous nephrolithotomy can be lessened by epidural analgesia. Methods: A total of 48 patients, between 18-65 years of age and ASA I-II, for whom elective percutaneous nephrolithotomy was planned, were randomly divided into two groups namely: Group GA (n = 24): general anaesthesia by sevoflurane and fentanyl and postoperative intravenous PCA; Group GE (n = 24): epidural anaesthesia and general anaesthesia together with postoperative epidural analgesia (0...
March 14, 2016: West Indian Medical Journal
https://www.readbyqxmd.com/read/28103161/nurses-practice-in-preventing-postoperative-wound-infections-an-observational-study
#16
S Ding, F Lin, A P Marshall, B M Gillespie
OBJECTIVE: Surgical site infections (SSIs) are serious postoperative complications that may lead to undesired patient outcomes. Previous research has used survey and chart audit methods to describe wound care practices. However, little research has been published using contemporaneous observations to describe the surgical wound management practices of nurses. The aim of this study was to prospectively describe surgical nurses' postoperative wound care practices and the extent to which observed surgical wound practices aligned with evidence-based guideline recommendations...
January 2, 2017: Journal of Wound Care
https://www.readbyqxmd.com/read/28102622/successful-surgical-management-of-congenital-kasabach-merritt-syndrome
#17
Sébastien Pascal, Quentin Bettex, Nicolas Andre, Philippe Petit, Dominique Casanova, Nathalie Degardin
Since the first description of Kasabach-Merritt syndrome (KMS) in 1940, many treatments have been proposed combining pharmacologic and non-pharmacologic approaches, which can be effective on the pathology but can have adverse and unpredictable side-effects with long-term use. Herein we describe the solely surgical treatment of Kasabach-Merritt syndrome in a neonate with a severe and rapidly progressive thrombocytopenia. The patient's condition normalized at 7 days postoperatively, with rapid increase in platelet count and normalization of d-dimer concentration...
January 2017: Pediatrics International: Official Journal of the Japan Pediatric Society
https://www.readbyqxmd.com/read/28101639/laparoscopic-hysteropexy-10%C3%A2-years-experience
#18
Helen Jefferis, Natalia Price, Simon Jackson
INTRODUCTION AND HYPOTHESIS: Uterine prolapse is common and has traditionally been treated by vaginal hysterectomy. Increasingly, women are seeking uterine-preserving alternatives. Laparoscopic hysteropexy offers resuspension of the uterus using polypropylene mesh. We report on 10 years' experience with this technique. METHODS: All hysteropexy procedures in our unit since 2006 were reviewed. Primary outcome was safety of hysteropexy, as assessed by intraoperative and major postoperative complications...
January 18, 2017: International Urogynecology Journal
https://www.readbyqxmd.com/read/28101224/impact-of-chromosome-17q-deletion-in-the-primary-lesion-of-colorectal-cancer-on-liver-metastasis
#19
Masaya Kawai, Hiromitsu Komiyama, Masaki Hosoya, Haruna Okubo, Tomoaki Fujii, Norihiko Yokoyama, Chiyo Sato, Takae Ueyama, Atsushi Okuzawa, Michitoshi Goto, Yutaka Kojima, Makoto Takahashi, Kiichi Sugimoto, Shun Ishiyama, Shinya Munakata, Dai Ogura, Shin-Ichiro Niwa, Yuichi Tomiki, Takumi Ochiai, Kazuhiro Sakamoto
Colorectal cancer is a prevalent malignancy worldwide, and investigations are required to elucidate the underlying carcinogenic mechanisms. Amongst these mechanisms, de novo carcinogenesis and the adenoma to carcinoma sequence, are the most understood. Metastasis of colorectal cancer to the liver often results in fatality, therefore, it is important for any associated risk factors to be identified. Regarding the treatment of the disease, it is important to manage not only the primary colorectal tumor, but also the liver metastases...
December 2016: Oncology Letters
https://www.readbyqxmd.com/read/28101168/ct-guided-125-i-seed-implantation-for-inoperable-retroperitoneal-sarcoma-a-technique-for-delivery-of-local-tumor-brachytherapy
#20
Biao Yang, Wen-Hao Guo, Ting Lan, Fang Yuan, Guan-Jian Liu, Rui-Yu Zan, Xin You, Qiao-Yue Tan, Zheng-Yin Liao
Radical surgery is currently the first treatment of choice for retroperitoneal soft tissue sarcoma (RSTS). However, the prognosis of RSTS remains poor due to ineffective local control and a high incidence of metastasis after surgical resection. Brachytherapy has been shown to safely provide local radiotherapy for numerous types of cancer when used alone or in combination with surgical resection, but has not been well characterized in the management of RSTS. The aim of this study was to evaluate CT-guided 125I seed implantation for local control and pain relief in the treatment of inoperable RSTS...
December 2016: Experimental and Therapeutic Medicine
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