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https://www.readbyqxmd.com/read/28530629/-laparoendoscopic-single-site-less-ureteral-reimplantation
#1
Pedro M Cabrera Castillo, Felipe Cáceres Jiménez
OBJECTIVE: To present in detail our surgical technique and to show our initial experience with ureteral reimplantation using the transumbilical LESS approach to treat patients with ureteral stenosis secondary to various diseases and surgical complications. METHODS: We performed 7 ureteral reimplantations from February 2012, using the multichannel Richard- Wolf (KeyPort) platform placed transumbilical by a small 2-2,5 cm transversal incision. We always use a 3.5 mm minilaparoscopy accessory trocar in the right iliac fossa, that is crucial to perform the laparoscopic suturing safely for the patient and in an optimal time...
May 2017: Archivos Españoles de Urología
https://www.readbyqxmd.com/read/28501106/concurrent-endocrine-and-other-surgical-procedures-an-institutional-experience
#2
Rachel Morris, Tina W F Yen, Kara Doffek, Azadeh A Carr, Stuart D Wilson, Douglas B Evans, Tracy S Wang
INRODUCTION: The number of endocrine procedures, specifically parathyroidectomy, thyroidectomy, and adrenalectomy, being performed is increasing. There is a paucity of literature on the feasibility of combining these procedures with other surgical procedures. Therefore, the aim of this study was to determine the effect of performing concurrent surgical procedures on postoperative outcomes. METHODS: This is a single institution retrospective review of multiple prospectively maintained databases of patients who underwent elective thyroidectomy, parathyroidectomy, and/or adrenalectomy in combination with another procedure...
May 1, 2017: Journal of Surgical Research
https://www.readbyqxmd.com/read/28481976/electronically-available-comorbidities-should-be-used-in-surgical-site-infection-risk-adjustment
#3
Sarah S Jackson, Surbhi Leekha, Laurence S Magder, Lisa Pineles, Deverick J Anderson, William E Trick, Keith F Woeltje, Keith S Kaye, Timothy J Lowe, Anthony D Harris
Background: Healthcare-associated infections such as surgical site infections (SSI) are used by Centers for Medicare and Medicaid Services (CMS) as pay-for-performance metrics. Risk adjustment allows a fairer comparison of SSI rates across hospitals. Until 2016, Centers for Disease Control and Prevention (CDC) risk adjustment models for pay-for-performance SSI did not adjust for patient comorbidities. New 2016 CDC models only adjust for body mass index and diabetes. Methods: We performed a multicenter retrospective cohort study of patients undergoing surgical procedures at 28 US hospitals...
May 6, 2017: Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America
https://www.readbyqxmd.com/read/28481445/optimising-fertility-outcomes-for-women-with-early-stage-cervical-cancer-when-less-is-more
#4
Efterpi Tingi, Emma J Crosbie, Gemma Owens
Radical hysterectomy and pelvic lymphadenectomy is standard management for early-stage cervical cancer. Radical trachelectomy achieves equivalent oncological outcomes to hysterectomy thus providing an alternative for women who wish to preserve their fertility (Xu et al. Acta Obstet Gynecol Scand 2011; 90: 1200-09). Trachelectomy offers the potential for pregnancy but poor obstetric sequelae, including second trimester miscarriage, preterm premature rupture of membranes (PPROM) and preterm delivery are common, likely due to reduced mechanical support from a shortened cervix and ascending infection...
May 8, 2017: BJOG: An International Journal of Obstetrics and Gynaecology
https://www.readbyqxmd.com/read/28470415/perioperative-complications-following-colpocleisis-with-and-without-concomitant-vaginal-hysterectomy
#5
Katarzyna Bochenska, Alix Leader-Cramer, Margaret Mueller, Bhumy Davé, Alexandria Alverdy, Kimberly Kenton
INTRODUCTION AND HYPOTHESIS: Pelvic organ prolapse is common in the elderly population and may be surgically treated with colpocleisis. We aimed to identify and compare surgical characteristics and 30-day perioperative complications in patients who underwent colpocleisis with and without concomitant vaginal hysterectomy (VH) using the American College of Surgeons National Surgical Quality Improvement Program (ACS-NSQIP) database. METHODS: Women who underwent vaginal closure procedures from 2006 to 2014 were identified utilizing Current Procedural Terminology (CPT) codes for LeFort colpocleisis (57120) and vaginectomy (57110)...
May 3, 2017: International Urogynecology Journal
https://www.readbyqxmd.com/read/28459228/risk-factors-for-surgical-site-infection-after-hysterectomy
#6
Hale Göksever Çelik, Engin Çelik, Gökçe Turan, Kerem Doğa Seçkin, Ali Gedikbaşı
INTRODUCTION: The aim of the study was to define the clinical and laboratory characteristics of patients who had surgical site infection (SSI) after hysterectomy. METHODOLOGY: This study was a retrospective cohort study. The patient data of 840 subjects who had undergone any type of hysterectomy and reported SSI after surgery were obtained from the archives of a tertiary referral center. The different types of hysterectomy procedures performed on these patients included total abdominal hysterectomy (TAH), laparoscopic hysterectomy (LH), and vaginal hysterectomy (VH)...
April 30, 2017: Journal of Infection in Developing Countries
https://www.readbyqxmd.com/read/28444984/abdominal-adhesions-in-gynaecologic-surgery-after-caesarean-section-a-longitudinal-population-based-register-study
#7
Susanne Hesselman, Ulf Högberg, Eva-Britta Råssjö, Erica Schytt, Mats Löfgren, Maria Jonsson
OBJECTIVE: The aim of the study was to evaluate the association between abdominal adhesions at time of gynaecologic surgery and a history of caesarean delivery, and to investigate obstetric factors contributing to adhesion formation after caesarean section (CS). DESIGN: Longitudinal population based register study. SETTING: Sweden. POPULATION: Women undergoing benign hysterectomy and/or adnexal surgery in Sweden, 2000-2014, with a previous delivery during 1973-2013 (N=15,479)...
April 26, 2017: BJOG: An International Journal of Obstetrics and Gynaecology
https://www.readbyqxmd.com/read/28430689/perioperative-outcomes-of-robotic-assisted-hysterectomy-compared-with-open-hysterectomy
#8
Bhargavi Gali, Jamie N Bakkum-Gamez, David J Plevak, Darrell Schroeder, Timothy O Wilson, Christopher J Jankowski
BACKGROUND: Increasing numbers of robotic hysterectomies (RH) are being performed. To provide ventilation (with pneumoperitoneum and steep Trendelenburg position) for these procedures, utilization of lung protective strategies with limiting airway pressures and tidal volumes is difficult. Little is known about the effects of intraoperative mechanical ventilation and high peak airway pressures on perioperative complications. We performed a retrospective review to determine whether patients undergoing RH had increased pulmonary complications compared to total abdominal hysterectomy (TAH)...
April 19, 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28414995/case-report-of-an-intracaval-leiomyomatosis-10-months-after-complete-hysterectomy
#9
Hannah Maria Schäfer, Andrej Isaak, Lorenz Gürke
INTRODUCTION: Intravenous leiomyomatosis (IVL) is a rare smooth muscle tumor, usually found in women with tumors of the reproductive organs, such as uterus myomatosous. Surgically, this case belies the call for sternotomy and two-stage surgery in caval IVL extending to the right atrium: we suggest one-stage median laparotomy as a minimal procedure with maximal benefit. PRESENTATION OF CASE: We present the case of a 60-year-old postmenopausal woman with suspected intravenous leiomyomatosis of the right internal iliac vein...
March 31, 2017: International Journal of Surgery Case Reports
https://www.readbyqxmd.com/read/28404551/endocervical-gastric-type-adenocarcinoma-an-unrelated-hpv-tumour-difficulties-in-screening-and-diagnosis
#10
Priscila Carneiro Lima, Julio Teixeira, Guilherme Nogueira Aires, Liliana De Angelo Andrade
Gastric-type adenocarcinoma of the cervix (GAS) is an uncommon and aggressive tumour unrelated to human papillomavirus (HPV) infection with distinctive histological and immunohistochemical characteristics. GAS may be associated with lobular endocervical glandular hyperplasia (LEGH), another unusual lesion. We report a case of a 59-year-old woman with screening cytology 'AGC-Neo' and cervical conisation exhibiting cervical intraepithelial neoplasia grade 1, extensive LEGH and canal sampling with abundant mucinous cells...
April 11, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/28363438/reducing-surgical-site-infections-after-hysterectomy-metronidazole-plus-cefazolin-compared-with-cephalosporin%C3%A2-alone
#11
Sara R Till, Daniel M Morgan, Ali A Bazzi, Mark D Pearlman, Zaid Abdelsattar, Darrell A Campbell, Shitanshu Uppal
BACKGROUND: Organisms that are isolated from vaginal cuff infections and pelvic abscesses after hysterectomy frequently include anaerobic vaginal flora. Metronidazole has outstanding coverage against nearly all anaerobic species, which is superior to both cefazolin and second-generation cephalosporins. Cefazolin plus metronidazole has been demonstrated to reduce infectious morbidity compared with either cefazolin or second-generation cephalosporins in other clean-contaminated procedures, which include both as colorectal surgery and cesarean delivery...
March 28, 2017: American Journal of Obstetrics and Gynecology
https://www.readbyqxmd.com/read/28355765/-liposuction-combined-with-lymphatico-venous-anastomosis-for-treatment-of-secondary-lymphedema-of-the-lower-limbs-a-report-of-49-cases
#12
K Chang, S Xia, Y G Sun, J F Xin, W B Shen
Objective: To study the clinical effects of liposuction combined with lymphatico-venous anastomosis for treatment of secondary lymphedema of the lower limbs. Methods: A retrospective analysis was performed for 49 patients who had undergone liposuction combined with lymphatico-venous anastomosis to treat secondary lymphedema of the lower limbs at Department of Lymph Surgery, Beijing Shijitan Hospital from November 2013 to February 2015.All patients were female aging from 31 to 70 years with median age of (52±10)years...
April 1, 2017: Zhonghua Wai Ke za Zhi [Chinese Journal of Surgery]
https://www.readbyqxmd.com/read/28347618/implementation-of-hysterectomy-pathway-impact-on-complications
#13
Faina Linkov, Amin Sanei-Moghaddam, Robert P Edwards, Paula J Lounder, Naveed Ismail, Sharon L Goughnour, Chaeryon Kang, Suketu M Mansuria, John T Comerci
OBJECTIVE: Hysterectomy is one of the most common surgical procedures in the United States. For women who need hysterectomy, it is important to ensure that minimally invasive hysterectomy procedures are used appropriately to reduce surgical complications and improve value of care. Although we previously demonstrated a reduction in total abdominal hysterectomy rates after the implementation of hysterectomy pathway treatment algorithm in 2012, this study focuses on exploring the effect of pathways implementation on surgical outcomes...
March 24, 2017: Women's Health Issues: Official Publication of the Jacobs Institute of Women's Health
https://www.readbyqxmd.com/read/28290977/actinomyces-related-tubo-ovarian-abscess-in-a-poorly-controlled-type-ii-diabetic-with-a-copper-intrauterine-device
#14
Ashley L Sawtelle, Nicole P Chappell, Caela R Miller
BACKGROUND: The historic association of Actinomyces israelii infection with intrauterine devices (IUDs) has long been recognized. In recent years, the risk of developing pelvic inflammatory disease with a copper or levonorgestrel IUD has been less than 1% in women who are low risk for sexually transmitted infections. IUD-related pelvic infections secondary to actinomyces have largely vanished from contemporary practice. CASE: A 49-year-old using a copper IUD for contraception with poorly controlled type II diabetes mellitus was admitted for suspected tubo-ovarian abscess on the basis of abdominopelvic pain, leukocytosis, and computed tomography findings...
March 2017: Military Medicine
https://www.readbyqxmd.com/read/28264580/-ethical-aspects-of-uterus-transplantation
#15
Roman Chmel, Marta Nováčková, Zlatko Pastor, Jan Matěcha, Miloš Čekal, Jiří Froněk
Uterus transplantation is an experimental treatment method with an ambition to become accepted treatment modality for women with absolute uterine factor infertility. The only legal alternative for these women to get parenthood is adoption which is accepted by most world societies and countries. Surrogate pregnancy is connected with many medical, ethical, legal, religious and social controversies in the great part of the world.Donors (in living donation), recipients, partners and also unborn children must be incorporated into the analysis of ethical risks and benefits of uterus transplantation...
2017: Casopís Lékar̆ů C̆eských
https://www.readbyqxmd.com/read/28264207/hemostatic-resuscitation-in-peripartum-hysterectomy-pre-and-postmassive-transfusion-protocol-initiation
#16
Eryn H Dutta, Aaron T Poole, Faranak Behnia, Holly E Dunn, Shannon M Clark, Luis D Pacheco, George R Saade, Gary D V Hankins
Background Massive transfusion protocols (MTPs) have been examined in trauma. The exact ratio of packed red blood cells (PRBC) to other blood replacement components in hemostatic resuscitation in obstetrics has not been well defined. Objective The objective of this study was to evaluate hemostatic resuscitation in peripartum hysterectomy comparing pre- and postinstitution of a MTP. Study Design We conducted a retrospective, descriptive study of women undergoing peripartum hysterectomies from January 2002 to January 2015 who received ≥ 4 units of PRBC...
March 6, 2017: American Journal of Perinatology
https://www.readbyqxmd.com/read/28260596/robotic-assisted-laparoscopic-hysterectomy-for-women-with-endometrial-cancer
#17
Suzanne Forsyth Herling, Ann M Møller, Connie Palle, Anja Grynnerup, Thordis Thomsen
INTRODUCTION: Robotic-assisted laparoscopic hysterectomy (RALH) has become a widely used approach for women with endometrial cancer and has replaced laparotomy. It has been questioned if the increased costs are justified by superior surgical outcomes. The aim of the present study was to examine the frequency, types and severity of post-operative complications after total abdominal hysterectomy (TAH) and RALH using the Clavien-Dindo classification of surgical outcomes. METHODS: A non-randomised, controlled before and after study of 360 women was conducted; 202 underwent RALH and 158 TAH (historical controls)...
March 2017: Danish Medical Journal
https://www.readbyqxmd.com/read/28250728/case-report-of-ovarian-torsion-mimicking-ovarian-cancer-as-an-uncommon-late-complication-of-laparoscopic-supracervical-hysterectomy
#18
Michał Ciebiera, Arkadiusz Baran, Aneta Słabuszewska-Jóźwiak, Grzegorz Jakiel
Laparoscopic supracervical hysterectomy (LSH) is an example of a partial hysterectomy, performed due to benign gynaecological complaints. Better endoscopic instruments and operational techniques have led to a great reduction in the number of abdominal hysterectomies. It is believed that LSH is a safe and minimally invasive hysterectomy technique. The Cochrane Database meta-analysis proves the benefits of minimally invasive surgery compared with abdominal gynaecological surgery, including decreased pain, surgical-site infections and hospital stay, quicker return to activity, and fewer postoperative adhesions...
December 2016: Przeglad Menopauzalny, Menopause Review
https://www.readbyqxmd.com/read/28209490/surgical-site-infection-in-gynecologic-surgery-pathophysiology-and%C3%A2-prevention
#19
REVIEW
Holly L Steiner, Eric A Strand
Surgical-site infections (SSIs) represent a well-known cause of patient morbidity as well as added health care costs. In gynecologic surgery, particularly hysterectomy, SSIs are often the result of a number of risk factors that may or may not be modifiable. As both the Centers for Medicaid and Medicare Services and the Joint Commission on the Accreditation of Healthcare Organizations have identified SSIs as a patient safety priority, gynecologic surgeons continue to seek out the most effective interventions for SSI prevention...
February 14, 2017: American Journal of Obstetrics and Gynecology
https://www.readbyqxmd.com/read/28192735/risk-factors-for-postoperative-urinary-tract-infection-following-midurethral-sling-procedures
#20
Melike Doganay, Sabri Cavkaytar, Mahmut Kuntay Kokanali, Irfan Ozer, Orhan Seyfi Aksakal, Salim Erkaya
OBJECTIVE: To identify the potential risk factors for urinary tract infections following midurethral sling procedures. STUDY DESIGN: 556 women who underwent midurethral sling procedure due to stress urinary incontinence over a four-year period were reviewed in this retrospective study. Of the study population, 280 women underwent TVT procedures and 276 women underwent TOT procedures. Patients were evaluated at 4-8 weeks postoperatively and were investigated for the occurrence of a urinary tract infection...
April 2017: European Journal of Obstetrics, Gynecology, and Reproductive Biology
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