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https://www.readbyqxmd.com/read/28625021/antibiotic-prophylaxis-for-elective-hysterectomy
#1
REVIEW
Reuben Olugbenga Ayeleke, Selma Mourad, Jane Marjoribanks, Karim A Calis, Vanessa Jordan
BACKGROUND: Elective hysterectomy is commonly performed for benign gynaecological conditions. Hysterectomy can be performed abdominally, laparoscopically, or vaginally, with or without laparoscopic assistance. Antibiotic prophylaxis consists of administration of antibiotics to reduce the rate of postoperative infection, which otherwise affects 40%-50% of women after vaginal hysterectomy, and more than 20% after abdominal hysterectomy. No Cochrane review has systematically assessed evidence on this topic...
June 18, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28622340/antibiotic-prophylaxis-for-surgical-site-infections-as-a-risk-factor-for-infection-with-clostridium-difficile
#2
Aubrey Balch, Aaron M Wendelboe, Sara K Vesely, Dale W Bratzler
OBJECTIVE: We aimed to measure the association between 2013 guideline concordant prophylactic antibiotic use prior to surgery and infection with Clostridium difficile. DESIGN: We conducted a retrospective case-control study by selecting patients who underwent a surgical procedure between January 1, 2012 and December 31, 2013. SETTING: Large urban community hospital. PATIENTS: Cases and controls were patients age 18+ years who underwent an eligible surgery (i...
2017: PloS One
https://www.readbyqxmd.com/read/28619688/single-port-laparoscopy-in-gynecologic-oncology-seven-years-of-experience-at-a-single-institution
#3
Laura Moulton, Amelia M Jernigan, Caitlin Carr, Lindsey Freeman, Pedro F Escobar, Chad M Michener
BACKGROUND: Single port laparoscopy has gained popularity within minimally invasive gynecologic surgery for its feasibility, cosmetic outcomes and safety. However, within gynecologic oncology, there is limited data regarding short-term adverse outcomes and long term hernia risk in patients undergoing single port laparoscopic surgery. OBJECTIVE: To describe short-term outcomes and hernia rates in patients after single port laparoscopy in a gynecologic oncology practice...
June 12, 2017: American Journal of Obstetrics and Gynecology
https://www.readbyqxmd.com/read/28611000/the-sterility-of-selected-operative-sites-during-total-laparoscopic-hysterectomy
#4
Marie E Shockley, Benjamin Beran, Heather Nutting, Katrin Arnolds, Michael L Sprague, Stephen Zimberg
STUDY OBJECTIVE: To describe the type and quantity of bacteria found intraoperatively on the abdomen, vagina, surgical gloves, instrument tips, and uterus at distinct time points during total laparoscopic hysterectomy (TLH). DESIGN: Observational study (Canadian Task Force classification III) SETTING: Academic affiliated hospital PATIENTS: 31 women undergoing TLH for benign indications in 2016 INTERVENTIONS: After antibiotic prophylaxis and chlorhexidine preparation, swabs were collected from the vaginal fornices and abdomen...
June 10, 2017: Journal of Minimally Invasive Gynecology
https://www.readbyqxmd.com/read/28599164/impact-of-power-morcellator-removal-on-hysterectomy-practice-patterns
#5
Adrianne Wesol, Shauna Woolley
OBJECTIVE: This study was a quality improvement project investigating patterns of hysterectomy practice including changes in surgical techniques and patient outcomes after manufacturer withdrawal of a laparoscopic power morcellator from our hospitals in July 2014. STUDY DESIGN: This time-series pre and post retrospective review examined data from electronic health records, comparing one year when a laparoscopic power morcellator was available (Year 1, mid-2013 to mid-2014) to one year after withdrawal (Year 2, mid-2014 to mid-2015)...
May 21, 2017: European Journal of Obstetrics, Gynecology, and Reproductive Biology
https://www.readbyqxmd.com/read/28591973/-the-application-of-internal-iliac-artery-balloon-occlusion-in-pernicious-placenta-previa
#6
Xiao-Rong Qi, Xing-Hui Liu, Yong You, Xiao-Dong Wang, Rong Zhou, Ai-Yun Xing, Li Zhang, Gang Ning, Fu-Min Zhao, Kai-Ming Li
OBJECTIVES: To evaluate the clinical application value of internal iliac artery balloon occlusion in pernicious placenta previa. METHODS: We retrospectively reviewed the medical records of the patients of pernicious placenta previa in a single center from Jan, 2010 to Jan, 2015. The patients were divided into two groups, internal iliac artery balloon occlusion group and the control group without endovascular intervention. Blood loss in operation, volume of transfused blood products, caesarean hysterectomy, operating time, hospital days after operation and postoperative morbidity were compared between the two groups...
July 2016: Sichuan da Xue Xue Bao. Yi Xue Ban, Journal of Sichuan University. Medical Science Edition
https://www.readbyqxmd.com/read/28579181/estrogen-replacement-reduces-risk-and-increases-survival-times-of-women-with-hepatocellular-carcinoma
#7
Manal M Hassan, Gehan Botrus, Reham Abdel-Wahab, Robert A Wolff, Donghui Li, David Tweardy, Alexandria T Phan, Ernest Hawk, Milind Javle, Ju-Seog Lee, Harrys A Torres, Asif Rashid, Renato Lenzi, Hesham M Hassabo, Yasmin Abaza, Ahmed S Shalaby, Sahin Lacin, Jeffrey Morris, Yehuda Z Patt, Christopher I Amos, Saira A Khaderi, John A Goss, Prasun K Jalal, Ahmed O Kaseb
BACKGROUND & AIMS: Environmental factors have been identified that affect risk of hepatocellular carcinoma (HCC), but little is known about the effects of sex hormones on liver cancer development or outcome. We investigated whether menopause hormone therapy (MHT) affects risk, age at onset, or outcome of HCC. METHODS: We performed a case-control study of 234 female patients treated for HCC at a tertiary medical center and with 282 healthy women (controls), from January 1, 2004 through May 31, 2015...
June 1, 2017: Clinical Gastroenterology and Hepatology
https://www.readbyqxmd.com/read/28577182/economic-burden-of-cancer-among-patients-with-surgical-resections-of-the-lung-rectum-liver-and-uterus-results-from-a-us-hospital-database-claims-analysis
#8
Iftekhar Kalsekar, Chia-Wen Hsiao, Hang Cheng, Sashi Yadalam, Brian Po-Han Chen, Laura Goldstein, Andrew Yoo
OBJECTIVES: To determine hospital resource utilization, associated costs and the risk of complications during hospitalization for four types of surgical resections and to estimate the incremental burden among patients with cancer compared to those without cancer. METHODS: Patients (≥18 years old) were identified from the Premier Research Database of US hospitals if they had any of the following types of elective surgical resections between 1/2008 and 12/2014: lung lobectomy, lower anterior resection of the rectum (LAR), liver wedge resection, or total hysterectomy...
December 2017: Health Economics Review
https://www.readbyqxmd.com/read/28558661/uterus-preserving-surgery-versus-hysterectomy-in-the-treatment-of-refractory-postpartum-haemorrhage-in-two-tertiary-maternity-units-in-cameroon-a-cohort-analysis-of-perioperative-outcomes
#9
Julius Sama Dohbit, Pascal Foumane, Elie Nkwabong, Christelle Ogolong Kamouko, Joel Noutakdie Tochie, Bernard Otabela, Emile Mboudou
BACKGROUND: Little evidence exists on the efficacy and safety of the different surgical techniques used in the treatment of postpartum haemorrhage (PPH). We aimed to compare uterus preserving surgery (UPS) versus hysterectomy for refractory PPH in terms of perioperative outcomes in a sub-Saharan African country with a known high maternal mortality ratio due to PPH. METHODS: This was a retrospective cohort study comparing the perioperative outcomes of all women managed by UPS (defined as surgical interventions geared at achieving haemostasis while conserving the uterus) versus hysterectomy (defined as surgical resection of the uterus to achieve haemostasis) for PPH refractory to standard medical management in two tertiary hospitals in Cameroon from January 2004 to December 2014...
May 30, 2017: BMC Pregnancy and Childbirth
https://www.readbyqxmd.com/read/28530629/-laparoendoscopic-single-site-less-ureteral-reimplantation
#10
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
#11
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
#12
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
#13
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
#14
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
#15
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
#16
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
#17
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
#18
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
#19
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
#20
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
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