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Intraoperative assessment

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https://www.readbyqxmd.com/read/29331663/a-multi-center-randomized-trial-to-evaluate-hematologic-toxicities-after-hyperthermic-intraperitoneal-chemotherapy-with-oxaliplatin-or-mitomycin-in-patients-with-appendiceal-tumors
#1
Edward A Levine, Konstantinos I Votanopoulos, Perry Shen, Greg Russell, Joyce Fenstermaker, Paul Mansfield, David Bartlett, John H Stewart
BACKGROUND: Appendiceal cancer is a rare disease, which has proven difficult to study in prospective trials. Cytoreductive surgery with HIPEC is an established therapy for peritoneal dissemination from appendiceal cancer. The optimal chemotherapeutic agent to use in the HIPEC is not clear. Mitomycin has long been the utilized, however our previous phase I experience, and European retrospective studies suggest oxaliplatin as an alternative. Therefore, we initiated a multicenter randomized trial to compare mitomycin to oxaliplatin HIPEC for appendiceal cancer...
January 10, 2018: Journal of the American College of Surgeons
https://www.readbyqxmd.com/read/29330874/safety-of-high-current-stimulation-for-intermittent-intraoperative-neural-monitoring-in-thyroid-surgery-a-porcine-model
#2
I-Cheng Lu, Pi-Ying Chang, Gregory W Randolph, Hsiu-Ya Chen, Kuang-Yi Tseng, Yi-Chu Lin, Feng-Yu Chiang, Che-Wei Wu
OBJECTIVES: During monitored thyroidectomy, displacement of the recurrent laryngeal nerve (RLN) or vagus nerve (VN) in some complicated cases can increase the risk of injury. Although increasing the stimulus current can facilitate nerve mapping and localization, the safety of a high-current stimulus remains unknown. Therefore, this study evaluated the safety of a high-current stimulus in a porcine model. METHODS: Short-duration (1 minute), high-current (3, 5, 10, 15, 20, 25, and 30 mA at 4Hz) stimulus pulses were repeatedly applied to the RLN or VN in six anesthetized piglets...
January 13, 2018: Laryngoscope
https://www.readbyqxmd.com/read/29330639/changes-in-tissue-and-cerebral-oxygenation-following-spinal-anesthesia-in-infants-a-prospective-study
#3
Alexander B Froyshteter, Dmitry Tumin, Emmett E Whitaker, David P Martin, Mumin Hakim, Hina Walia, Tarun Bhalla, Joseph D Tobias
Use of spinal anesthesia (SA) in children may address concerns about potential neurocognitive effects of general anesthesia. We used near-infrared spectroscopy (NIRS) to assess the effects of SA on cerebral and tissue oxygenation in 19 patients aged 7 ± 3 months. Prior to SA placement, NIRS monitors were placed on the forehead (cerebral) and the thigh (tissue). Intraoperative cerebral and tissue saturation were 73 ± 7 and 80 ± 11%, respectively, before SA placement. NIRS measurements were monitored every minute for 30 min after SA placement and modeled using mixed-effects linear regression...
January 12, 2018: Journal of Anesthesia
https://www.readbyqxmd.com/read/29330599/infraorbital-foramen-localization-in-orbitozygomatic-fractures-a-ct-study-with-intraoperative-finding
#4
Mohammad Waheed El-Anwar, Ahmed Hassan Sweed
OBJECTIVE: The aim of this study was to assess the infraorbital foramen (IOF) using CT in patients with Zygomaticomaxillary complex (ZMC) fractures (midface fracture). PATIENTS AND METHODS: This prospective study was carried out on 49 patients had ZMC fractures (98 sides) and 27 patients (54 sides) with craniomaxillofacial fractures rather than fractured ZMC as a control. Using CT, position of IOF was documented on 3D view in relation to inferior orbital rim, tooth root relation and finally with a novel imaginary line passing between anterior nasal spine and whitnall tubercle...
January 12, 2018: European Archives of Oto-rhino-laryngology
https://www.readbyqxmd.com/read/29329787/outcomes-of-multisegmental-transforaminal-enlarged-decompression-plus-posterior-pedicle-screw-fixation-for-multilevel-lumbar-spinal-canal-stenosis-associated-with-lumbar-instability
#5
Chao Sun, Wei Ji Tian, Hui Xin Liu, Ping Guo Guan
PURPOSE: The aim of this study was to evaluate the clinical and radiologic results of multisegmental transforaminal enlarged decompression (TED) plus posterior pedicle screw fixation in the treatment of multilevel lumbar spinal canal stenosis (LSCS) with lumbar instability (MLSCSI). METHODS: 113 patients with MLSCSI underwent surgery were recruited in this study. All patients were suffering from symptoms typical of degenerative LSCS and treated with either TED plus fusion (TEDF group) or conventional laminectomy plus fusion (CLF group)...
January 9, 2018: International Journal of Surgery
https://www.readbyqxmd.com/read/29328887/macroscopic-rotator-cuff-tendinopathy-and-histopathology-do-not-predict-repair-outcomes-of-rotator-cuff-tears
#6
Paul M Sethi, Chirag D Sheth, Leo Pauzenberger, Mary Beth R McCarthy, Mark P Cote, Emma Soneson, Seth Miller, Augustus D Mazzocca
BACKGROUND: Numerous studies have identified factors that may affect the chances of rotator cuff healing after surgery. Intraoperative tendon quality may be used to predict healing and to determine type of repair and/or consideration of augmentation. There are no data that correlate how gross tendon morphology and degree of tendinopathy affect patient outcome or postoperative tendon healing. Purpose/Hypothesis: The purposes of this study were to (1) compare the gross appearance of the tendon edge during arthroscopic rotator cuff repair with its histological degree of tendinopathy and (2) determine if gross appearance correlated with postoperative repair integrity...
January 1, 2018: American Journal of Sports Medicine
https://www.readbyqxmd.com/read/29328750/adaptation-of-a-tool-to-assess-non-technical-skills-of-scrub-practitioners-in-denmark
#7
Anna Sofie Mundt, Lene Spanager, Helle Teglgaard Lyk-Jensen, Doris Østergaard
The aim of this study was to adapt the Scottish tool, Scrub Practitioners List of Intraoperative Non-Technical Skills, to Danish organisation and culture. With an explorative and qualitative approach, four group interviews with scrub practitioners, surgeons and anaesthesia staff were conducted. The main differences found were related to communication and teamwork regarding scrub practitioners focus on the team and speaking up. Differences in the non-technical skills described in the behavioural markers are perhaps explained by cultural differences between Scotland and Denmark...
September 2017: Journal of Perioperative Practice
https://www.readbyqxmd.com/read/29327650/transesophageal-echocardiography-use-in-diagnosis-and-management-of-embolized-intravascular-foreign-bodies
#8
James Taylor Herbert, Miklos David Kertai
The increasing use of endovascular interventions coupled with the large number of published case series detailing complications attest to the likelihood that anesthesiologists will encounter a case of intravascular foreign body embolization during their careers. Transesophageal echocardiography is essential to the diagnosis and management of traumatic and intravascular foreign bodies embolized to the heart because it can identify not only the foreign body but also hemodynamically significant lesions to radiolucent anatomic structures prior to and during surgical exploration...
October 1, 2017: Seminars in Cardiothoracic and Vascular Anesthesia
https://www.readbyqxmd.com/read/29327555/-anterior-versus-posterior-approach-for-multilevel-cervical-spondylotic-myelopathy-a-meta-analysis
#9
Jing-Yang You, Yong Zheng, Ming Chen, Jiang-Rong Fan
OBJECTIVE: To assess the clinical effectiveness and safety of anterior versus posterior approach for multilevel cervical spondylotic myelopathy. METHODS: The following databases were searched: the Cochrane Library, PubMed, EM base, OVID, CBM, Wanfang Data, CNKI. Relevant journals were manually searched for randomized controlled trials or clinical controlled trials(CCTs) that investigated the clinical effectiveness and safety of anterior and posterior approach for multilevel cervical spondylotic myelopathy...
January 25, 2017: Zhongguo Gu Shang, China Journal of Orthopaedics and Traumatology
https://www.readbyqxmd.com/read/29327310/c-reactive-protein-on-postoperative-day-1-is-a-reliable-predictor-of-pancreas-specific-complications-after-pancreaticoduodenectomy
#10
Théophile Guilbaud, David Jérémie Birnbaum, Coralie Lemoine, Mircea Chirica, Olivier Risse, Stéphane Berdah, Edouard Girard, Vincent Moutardier
BACKGROUND: Postoperative pancreatic fistula and pancreas-specific complications have a significant influence on patient management and outcomes after pancreatoduodenectomy. The aim of the study was to assess the value of serum C-reactive protein on the postoperative day 1 as early predictor of pancreatic fistula and pancreas-specific complications. METHODS: Between 2013 and 2016, 110 patients underwent pancreaticoduodenectomy. Clinical, biological, intraoperative, and pathological characteristics were prospectively recorded...
January 4, 2018: Journal of Gastrointestinal Surgery: Official Journal of the Society for Surgery of the Alimentary Tract
https://www.readbyqxmd.com/read/29326812/endovascular-laser-treatment-of-incompetent-saphenous-veins-using-the-1470%C3%A2-nm-diode-laser-and-radial-fiber
#11
Georgios Vourliotakis, Georgios Sahsamanis, Paschalis Evagelidis, Christina Aivatidi
Objectives: To assess the technical success, complications, and patients' quality of life (QoL) after treatment of chronic venous disease (CVD) using the 1470 nm radial fiber laser. Methods: A total of 170 patients with chronic venous disease, classified as C2 to C4 according to CEAP classification, were treated for incompetent greater (GSV) and small (SSV) saphenous veins, using the 1470 nm radial fiber laser and application of tumescent anesthesia. Additional phlebectomies were performed through stab microincisions, while 11 patients further underwent sclerotherapy intraoperatively...
January 2018: Annals of Medicine and Surgery
https://www.readbyqxmd.com/read/29326764/a-prospective-study-to-evaluate-the-management-of-sub-trochanteric-femur-fractures-with-long-proximal-femoral-nail
#12
M Kumar, V Akshat, A Kanwariya, M Gandhi
Introduction: Sub-trochanteric fractures of the femur remains one of the most challenging fractures faced by orthopaedic surgeons. This study was done to analyse the management and complications of sub-trochanteric fractures using long proximal femoral nail (PFN). Materials and Methods: This was a prospective study of 50 patients with sub-trochanteric fractures of femur who were treated with long PFN at a tertiary care center from July 2012 to June 2016. The fractures were classified according to Seinsheimer classification...
November 2017: Malaysian Orthopaedic Journal
https://www.readbyqxmd.com/read/29325966/role-of-intraoperative-ultrasound-to-extend-the-application-of-minimally-invasive-surgery-for-treatment-of-recurrent-gynecological-cancer
#13
Floriana Mascilini, Lorena Quagliozzi, Francesca Moro, Maria Cristina Moruzzi, Valerio Gallotta, Salvatore Gueli Alletti, Giovanni Scambia, Antonia Carla Testa, Anna Fagotti
STUDY OBJECTIVE: To describe the potential role of intraoperative ultrasound (IOUS) in the detection and localization of recurrent disease in gynecological cancer patients during minimally invasive surgery (MIS). DESIGN: A prospective cohort study (Canadian Task Force II-1). SETTING: A University hospital. PATIENTS: From November 2015 to February 2017, 51 gynecological cancer patients with isolated recurrent disease and candidate for secondary cytoreductive surgery (SCS) were treated by MIS...
January 8, 2018: Journal of Minimally Invasive Gynecology
https://www.readbyqxmd.com/read/29325837/outcomes-of-total-knee-arthroplasty-in-degenerative-osteoarthritic-knee-with-genu-recurvatum
#14
Seung-Suk Seo, Chang-Wan Kim, Chang-Rack Lee, Jin-Hyuk Seo, Do-Hun Kim, Ok-Gul Kim
BACKGROUND: This study aimed to assess the incidence of genu recurvatum without neuromuscular disorders in knees that underwent navigation-assisted total knee arthroplasty (TKA), to evaluate short-term radiologic and clinical results of navigation-assisted TKA in genu recurvatum, and to evaluate differences in results according to the degree of pre-operative hyperextension and type of implant and insert. METHODS: This study retrospectively reviewed 510 knees that underwent navigation-assisted TKA from January 2005 to December 2011...
January 9, 2018: Knee
https://www.readbyqxmd.com/read/29324494/myocardial-protection-by-glucose-insulin-potassium-in-moderate-to-high-risk-patients-undergoing-elective-on-pump-cardiac-surgery-a-randomized-controlled-trial
#15
Christoph Ellenberger, Tornike Sologashvili, Lukas Kreienbühl, Mustafa Cikirikcioglu, John Diaper, Marc Licker
BACKGROUND: Low cardiac output syndrome is a main cause of death after cardiac surgery. We sought to assess the impact of glucose-insulin-potassium (GIK) to enhance myocardial protection in moderate- to high-risk patients undergoing on-pump heart surgery. METHODS: A randomized controlled trial was performed in adult patients (Bernstein-Parsonnet score >7) scheduled for elective aortic valve replacement and/or coronary artery bypass surgery. Patients were randomized to GIK (20 IU of insulin, 10 mEq of potassium chloride in 50 mL of glucose 40%) or saline infusion given over 60 minutes on anesthetic induction...
January 9, 2018: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/29324489/comparing-methods-for-cardiac-output-intraoperatively-doppler-derived-cardiac-output-measured-with-3-dimensional-echocardiography-is-not-interchangeable-with-cardiac-output-by-pulmonary-catheter-thermodilution
#16
Karin Graeser, Mikhail Zemtsovski, Klaus F Kofoed, Matilde Winther-Jensen, Jens C Nilsson, Jesper Kjaergaard, Hasse Møller-Sørensen
BACKGROUND: Estimation of cardiac output (CO) is essential in the treatment of circulatory unstable patients. CO measured by pulmonary artery catheter thermodilution is considered the gold standard but carries a small risk of severe complications. Stroke volume and CO can be measured by transesophageal echocardiography (TEE), which is widely used during cardiac surgery. We hypothesized that Doppler-derived CO by 3-dimensional (3D) TEE would agree well with CO measured with pulmonary artery catheter thermodilution as a reference method based on accurate measurements of the cross-sectional area of the left ventricular outflow tract...
January 9, 2018: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/29323065/emerging-role-of-preputial-vascular-pattern-and-postoperative-microvessel-density-in-cases-of-proximal-hypospadias-a-pilot-study
#17
Vishrut Narang, Amita Sen, Minakshi Bhardwaj
INTRODUCTION: Understanding of anatomical vascular patterns and anatomy of prepuce is critical for a good outcome in hypospadias surgery. A well-vascularized neourethral and preputial flaps used for repair are exceptionally important for a successful outcome, especially in cases of proximal hypospadias undergoing one-stage procedures. OBJECTIVE: To evaluate the vascular anatomy of prepuce in cases of proximal hypospadias and to evaluate microvessel density (MVD) by immunohistochemistry and its correlation with postoperative complications...
October 2017: Indian Journal of Pathology & Microbiology
https://www.readbyqxmd.com/read/29322021/the-role-and-timing-of-parathyroid-hormone-determination-after-total-thyroidectomy
#18
REVIEW
Ioanna G Mazotas, Tracy S Wang
Postoperative hypocalcemia is a common complication of total thyroidectomy resulting from manipulation, resection, or devascularization of the parathyroid glands. Parathyroid hormone (PTH) levels assessed in the perioperative period have been used to predict development of hypocalcemia. Articles examining the role of PTH measurement in the perioperative period following total or completion thyroidectomy are reviewed. Focus is placed on the timing of PTH measurement and the ability to predict which patients will develop hypocalcemia requiring supplementation...
December 2017: Gland Surgery
https://www.readbyqxmd.com/read/29322020/a-reappraisal-of-vascular-anatomy-of-the-parathyroid-gland-based-on-fluorescence-techniques
#19
REVIEW
Samira Mercedes Sadowski, Jordi Vidal Fortuny, Frederic Triponez
Identification of the parathyroid glands (PGs) during thyroid surgery may prevent their inadvertent surgical removal and prevent postoperative hypoparathyroidism. However, identification of the PGs does not guarantee their function, and their vascular supply needs to be preserved as well. The recent introduction of intraoperative indocyanine green (ICG) fluorescent angiography of the PGs during thyroid surgery allows for the appraisal of the vascular anatomy and evaluation of PG function. The use of this tool could lead to a significant reduction in the rate of postoperative hypoparathyroidism, as it allows surgeons to adapt their surgical technique for the preservation of the PGs...
December 2017: Gland Surgery
https://www.readbyqxmd.com/read/29319718/effects-of-periarticular-injection-on-analgesic-effects-and-nsaid-use-in-total-knee-arthroplasty-and-total-hip-arthroplasty
#20
Wen-Rui Ban, Ery-Ang Zhang, Lei-Feng Lv, Xiao-Qian Dang, Chen Zhang
OBJECTIVES: This study examined periarticular multimodal drug injection and the use of nonsteroidal anti-inflammatory drugs for an early analgesic effect after total knee arthroplasty and total hip arthroplasty. Patient satisfaction and benefits from the treatment were also assessed. METHODS: A total of 110 patients who were scheduled to undergo total knee arthroplasty and 86 patients who were scheduled to undergo total hip arthroplasty were divided into two groups, the study group and the control group...
December 2017: Clinics
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