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Postoperative management

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https://www.readbyqxmd.com/read/28449481/procalcitonin-as-preoperative-marker-for-surgery-in-advanced-parapneumonic-empyema
#1
Claudio Caviezel, Philipp Schuetz, Stephan Gerdes, Franco Gambazzi
BACKGROUND: The optimal time point for surgical management of advanced parapneumonic empyema in need of open pleurectomy and decortication remains unclear. We hypothesized that surgical outcomes will be better when procalcitonin (PCT) levels have dropped to normal ranges as evidence for resolution of the underlying pneumonia. METHODS: We retrospectively analyzed outcomes of 38 patients with advanced parapneumonic empyema who underwent open decortication and pleurectomy with available preoperative PCT (pPCT) values...
March 2017: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/28449475/a-non-randomized-retrospective-observational-study-on-the-subcutaneous-esophageal-reconstruction-after-esophagectomy-is-it-feasible-in-high-risk-patients
#2
Jae Ho Chung, Sung Ho Lee, Eunjue Yi, Jae Seung Jung, Jung Wook Han, Tae Sik Kim, Ho Sung Son, Kwang Taik Kim
BACKGROUND: Esophageal reconstruction after esophagectomy is a complex procedure with high morbidity and mortality. Anastomotic leakage is more severe and frequent in patients with preoperative comorbidities and may present with septic conditions. Considering the possibility of an easier management of such cases, we evaluated the safety and feasibility of subcutaneous esophageal reconstruction in patients with high operative risks. METHODS: We performed a non-randomized retrospective observational study on the 75 (subcutaneous: 21, intrathoracic: 54) esophageal cancer patients who underwent esophageal reconstruction either through subcutaneous or intrathoracic route between January 2003 and February 2015...
March 2017: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/28449307/the-efficacy-of-non-narcotic-analgesics-on-postoperative-endodontic-pain-a-systematic-review-and-meta-analysis
#3
REVIEW
Armin Shirvani, Sayna Shamszadeh, Mohammad Jafar Eghbal, Saeed Asgary
The objective of this review was to evaluate the efficacy of non-narcotic analgesics including non-steroidal anti-inflammatory drugs (NSAIDs) and/or paracetamol in the treatment of postoperative endodontic pain. Additionally, we aimed to examine the possible association of study covariates on the pain scores using meta-regression analysis. An electronic search was performed in 2016. After data extraction and quality assessment of the included studies (n=27, representing 2188 patients), meta-analysis was performed using a random-effect inverse-variance method...
April 27, 2017: Journal of Oral Rehabilitation
https://www.readbyqxmd.com/read/28449052/implementation-of-a-postoperative-outpatient-care-pathway-for-delayed-hyponatremia-following-transsphenoidal-surgery
#4
Michael A Bohl, Shahjehan Ahmad, William L White, Andrew S Little
BACKGROUND: After transsphenoidal surgery, delayed hyponatremia (DH) is the leading cause of 30-d unplanned hospital readmissions. OBJECTIVE: To determine the impact of a DH care pathway on 30-d readmissions after transsphenoidal surgery. METHODS: Data from before and after DH care pathway implementation were retrospectively reviewed. Patient demographics and clinical characteristics were compared. Readmission causes, clinical pathway failures, sodium trends, and symptoms were evaluated...
April 25, 2017: Neurosurgery
https://www.readbyqxmd.com/read/28448298/anesthetic-consideration-for-neuromuscular-diseases
#5
Jeffery A Katz, Glenn S Murphy
PURPOSE OF REVIEW: The aim of this review is to examine data relating to perioperative management of the patient with neuromuscular disorders RECENT FINDINGS: Patients with pre-existing neuromuscular disorders are at risk for a number of postoperative complications that are related to anesthetic drugs that are administered intraoperatively. Careful preoperative assessment is necessary to reduce morbidity and mortality. In particular, the risk of postoperative respiratory failure and need for long-term ventilation should be reviewed with patients...
April 26, 2017: Current Opinion in Anaesthesiology
https://www.readbyqxmd.com/read/28447494/subtotal-resection-of-vestibular-schwannoma-evaluation-with-ki-67-measurement-magnetic-resonance-imaging-and-long-term-observation
#6
Giannicola Iannella, Marco de Vincentiis, Cira Di Gioia, Raffaella Carletti, Benedetta Pasquariello, Alessandra Manno, Diletta Angeletti, Ersilia Savastano, Giuseppe Magliulo
Purpose The aim of this study was to compare the postoperative clinical and radiological data of patients with vestibular schwannomas who were initially managed by near total resection (NTR) or subtotal resection (STR). The Ki-67 analysis results were compared with tumor regrowth to determine the presence of a correlation between this proliferative index and postoperative tumor regrowth. Study Design Seventeen adult patients (7 male, 10 female) were retrospectively reviewed. Nine (52.9%) and eight (47.1%) patients underwent NTR and STR, respectively...
January 1, 2017: Journal of International Medical Research
https://www.readbyqxmd.com/read/28447322/successful-hepatectomy-for-hepatic-abscess-with-chronic-granulomatous-disease-a-case-report
#7
Ryo Muranushi, Makoto Suzuki, Kenichiro Araki, Norio Kubo, Sayaka Otake, Yutaka Nishida, Takashi Ishige, Hirokazu Arakawa, Hiroyuki Kuwano, Ken Shirabe
BACKGROUND: Chronic granulomatous disease (CGD), a rare inherited disorder, is characterized by impaired ability of phagocytic cells to kill certain bacteria and fungi. Although liver abscess is a common manifestation of CGD, its optimal management in these patients is unknown. Here, we present a case of successful hepatectomy for hepatic abscess in a patient with CGD. CASE PRESENTATION: An adolescent patient with previously diagnosed CGD presented to the pediatrics department of our institution with fever...
December 2017: Surgical Case Reports
https://www.readbyqxmd.com/read/28447315/neglected-hip-dislocation-an-unusual-presentation-its-management-and-review-of-the-literature
#8
Sandeep Kumar, Anshul Dahuja, M S Narula, Sangam Garg, Rashmeet Kaur
Neglected traumatic posterior hip dislocation is not an uncommon condition seen in developing countries. Its treatment is fraught with great difficulties and controversies. Here we present a 31-year-old female patient presented to our hospital 2 years after sustaining an accident. She had gone through multiple treatments for her dislocated hip without any success. After arrival to our hospital, patient managed by constrained total hip replacement (THR). Her Harris hip score improved from 48 (preoperative) to 81 (postoperative)...
April 26, 2017: Strategies in Trauma and Limb Reconstruction
https://www.readbyqxmd.com/read/28447227/the-efficacy-of-serratus-anterior-plane-block-in-analgesia-for-thoracotomy-a-retrospective-study
#9
Korgün Ökmen, Burcu Metin Ökmen
PURPOSE: A multimodal analgesic approach is necessary for post-thoracotomy pain, which can be severe. Intravenous access, central and peripheral nerve blocks are frequently used. The aim of this study was to evaluate the efficacy of serratus anterior plane block (SAPB) in the management of post-thoracotomy pain. METHODS: A total of 40 patients who underwent thoracotomy between January 2014 and January 2016 were retrospectively analyzed. The patients were divided into two groups: Group M (intravenous patient-controlled analgesia morphine; n = 20) and Group S (intravenous patient-controlled analgesia morphine + SAPB; n = 20)...
April 26, 2017: Journal of Anesthesia
https://www.readbyqxmd.com/read/28445777/five-year-follow-up-after-laparoscopic-large-nerve-resection-for-deep-infiltrating-sciatic-nerve-endometriosis
#10
Marc Possover
STUDY OBJECTIVE: To report neurologic follow-up of patients after laparoscopic large resection of deep infiltrating endometriosis of the sciatic nerve. DESIGN: Prospective clinical case series (Canadian Task Force classification I). SETTING: Tertiary referral unit specializing in advanced gynecologic surgery and neuropelveology. PATIENTS: All data for patients who underwent laparoscopic surgery for endometriosis of the sciatic nerve between 2004 and 2016 (N = 259) were documented prospectively...
April 23, 2017: Journal of Minimally Invasive Gynecology
https://www.readbyqxmd.com/read/28445357/the-challenges-of-augmentation-mastopexy-in-the-massive-weight-loss-patient-technical-considerations
#11
Demetrius M Coombs, Udayan Srivastava, Dalit Amar, J Peter Rubin, Jeffrey A Gusenoff
BACKGROUND: Augmentation mastopexy in the massive weight loss population is challenging because of poor skin elasticity and lack of inframammary support. Despite several large studies of augmentation mastopexy in the literature, few data exist regarding this unique patient population. The authors examine early postoperative ptosis, implant malposition, and strategies to optimize outcomes. METHODS: A retrospective review of massive weight loss patients who underwent augmentation mastopexy from 2003 to 2011 was performed to record age, body mass index, implant characteristics, postoperative ptosis, and implant malposition...
May 2017: Plastic and Reconstructive Surgery
https://www.readbyqxmd.com/read/28445352/consensus-review-of-optimal-perioperative-care-in-breast-reconstruction-enhanced-recovery-after-surgery-eras-society-recommendations
#12
Claire Temple-Oberle, Melissa A Shea-Budgell, Mark Tan, John L Semple, Christiaan Schrag, Marcio Barreto, Phillip Blondeel, Jeremy Hamming, Joseph Dayan, Olle Ljungqvist
BACKGROUND: Enhanced recovery following surgery can be achieved through the introduction of evidence-based perioperative maneuvers. This review aims to present a consensus for optimal perioperative management of patients undergoing breast reconstructive surgery and to provide evidence-based recommendations for an enhanced perioperative protocol. METHODS: A systematic review of meta-analyses, randomized controlled trials, and large prospective cohorts was conducted for each protocol element...
May 2017: Plastic and Reconstructive Surgery
https://www.readbyqxmd.com/read/28445273/staged-management-of-open-lisfranc-injury-experience-from-14-patients
#13
Wenqi Gu, Zhongmin Shi
There are still controversies on the management and outcome of open Lisfranc injury in available studies. This study evaluates the staged management of Lisfranc injury and its complications.Patients who received a staged strategy for open Lisfranc injury were reviewed.One patient with degloving injury suffered from partial skin and hallux necrosis which was treated by debridement, hallux amputation, definitive internal fixation, and local flap transfer on the 12th day after first stage management. A definitive internal fixation and simultaneous skin graft or flap coverage were performed in another 3 patients with soft tissue defects...
April 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28445263/acupuncture-for-enhancing-early-recovery-of-bowel-function-in-cancer-protocol-for-a-systematic-review
#14
Yi-Hua Liu, Yang Ye, Jia-Bin Zheng, Xue-Qian Wang, Ying Zhang, Hong-Sheng Lin
BACKGROUND: Cancer patients undergoing surgical procedure often suffer from bowel dysfunction and postoperative ileus (POI). Cancer management for early recovery of bowel function is still a challenging topic. Acupuncture has been commonly used in a variety of gastrointestinal diseases. The aim of this study is to evaluate the effects of acupuncture therapy to reduce the duration of POI and enhance bowel function in cancer patients. METHODS: We will systematically screen all randomized controlled trials (RCTs) published through electronically and hand searching...
April 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28445203/considerations-for-refractive-surgery-in-the-glaucoma-patient
#15
Meleha Ahmad, Isaac Chocron, Anurag Shrivastava
PURPOSE OF REVIEW: Given the popularity of keratorefractive surgery, and an aging populous of patients who have undergone these procedures, there is an increasing need for updated management protocols. This is particularly relevant for patients with chronic progressive diseases such as glaucoma, due to the variety of related diagnostic and management challenges inherent to these diseases. Here, we will review the current literature to provide an update on the management of patients with glaucoma who are undergoing, or have had laser ablative refractive surgery...
April 25, 2017: Current Opinion in Ophthalmology
https://www.readbyqxmd.com/read/28444664/endocrine-complications-of-surgical-treatment-of-thyroid-cancer-an-update
#16
Pedro Iglesias, Juan José Díez
Postoperative hypoparathyroidism (HypoPT) and hypothyroidism (HypoT) are the main endocrine complications after the surgical treatment for thyroid cancer. Postsurgical HypoPT can be transient, protracted or permanent. Its frequency varies according to the underlying cervical pathology, surgical technique, and mainly the experience of the surgeon. Risk factors for HypoPT include aggressiveness of the tumor, extent of surgery, the presence of parathyroid gland in the pathologic specimen, and surgeon experience...
April 25, 2017: Experimental and Clinical Endocrinology & Diabetes
https://www.readbyqxmd.com/read/28444541/reverse-shoulder-arthroplasty-for-massive-irreparable-rotator-cuff-tears-and-cuff-tear-arthropathy-a-systematic-review
#17
REVIEW
S Petrillo, U G Longo, R Papalia, V Denaro
PURPOSE: To report the outcomes and complications of reverse shoulder arthroplasty (RSA) in massive irreparable rotator cuff tears (MIRCT) and cuff tear arthropathy (CTA). METHODS: A systematic review of the literature contained in Medline, Cochrane, EMBASE, Google Scholar and Ovid databases was conducted on May 1, 2016, according to PRISMA guidelines. The key words "reverse total shoulder arthroplasty" or "reverse total shoulder prostheses" with "rotator cuff tears"; "failed rotator cuff surgery"; "massive rotator cuff tears"; "irreparable rotator cuff tears"; "cuff tear arthropathy"; "outcomes"; "complications" were matched...
April 25, 2017: Musculoskeletal Surgery
https://www.readbyqxmd.com/read/28443268/complicated-postoperative-course-after-pulmonary-artery-sling-repair-and-slide-tracheoplasty
#18
Angelika Weber, Birgit Donner, Marie-Hélène Perez, Stefano Di Bernardo, Daniel Trachsel, Kishore Sandu, Nicole Sekarski
Pulmonary artery sling (PAS) is a rare congenital condition in which the left pulmonary artery (LPA) arises from the right pulmonary artery, and then passes between the trachea and the esophagus to reach the left lung, thereby forming a sling around the airway. It is often associated with intrinsic tracheal stenosis due to complete cartilaginous rings. Therapeutic management nowadays consists of one-stage reimplantation of the LPA and tracheoplasty with cardiopulmonary bypass support. Here, we present a 7-week-old boy with PAS and long-segment tracheal stenosis (LSTS) who underwent surgical intervention consisting of reimplantation of the LPA and slide tracheoplasty...
2017: Frontiers in Pediatrics
https://www.readbyqxmd.com/read/28442859/digital-myopericytoma-a-case-report-and-systematic-literature-review
#19
Alexander Morzycki, Nadim Joukhadar, Amanda Murphy, Jason Williams
A myopericytoma (MP) is an exceedingly rare perivascular tumor of unknown etiology. Given their potential for mimicry and malignancy, MP tumors pose a unique challenge for surgeons and may be overlooked on differential diagnosis. We present a case report of an otherwise healthy 33-year-old right-hand dominant male who presented to our outpatient clinic with a 2-month history of painless swelling and erythema of the pulp of his left index finger. Subsequent plain film X-ray showed near-complete bony destruction of his distal phalanx...
April 2017: Journal of Hand and Microsurgery
https://www.readbyqxmd.com/read/28442856/functional-outcome-of-fixation-of-complex-intra-articular-distal-radius-fractures-with-a-variable-angle-distal-radius-volar-rim-plate
#20
M Spiteri, W Ng, J Matthews, D Power
Aim To evaluate the outcome of these complex fractures using a volar approach and the DePuy Synthes variable-angle 2.4-mm distal radius rim plate. This plate is precontoured to the volar rim for placement distal to the watershed line allowing purchase of the rim fragment of the lunate facet. Its low profile and smooth edges are designed to minimize flexor tendon irritation. Method We report on a consecutive series of far distal AO-23B3 and AO-23C3 fractures treated using this plate in a tertiary hand center between November 2011 and May 2014...
April 2017: Journal of Hand and Microsurgery
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