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Intraoperative assessment

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https://www.readbyqxmd.com/read/29776982/variable-effectiveness-of-stepwise-implementation-of-nudge-type-interventions-to-improve-provider-compliance-with-intraoperative-low-tidal-volume-ventilation
#1
Vikas N O'Reilly-Shah, George S Easton, Craig S Jabaley, Grant C Lynde
BACKGROUND: Identifying mechanisms to improve provider compliance with quality metrics is a common goal across medical disciplines. Nudge interventions are minimally invasive strategies that can influence behavioural changes and are increasingly used within healthcare settings. We hypothesised that nudge interventions may improve provider compliance with lung-protective ventilation (LPV) strategies during general anaesthesia. METHODS: We developed an audit and feedback dashboard that included information on both provider-level and department-level compliance with LPV strategies in two academic hospitals, two non-academic hospitals and two academic surgery centres affiliated with a single healthcare system...
May 18, 2018: BMJ Quality & Safety
https://www.readbyqxmd.com/read/29776768/-topical-anesthesia-without-the-use-of-an-anesthesiologist-in-adult-outpatient-cataract-surgery-assessment-of-selection-criteria-on-consultation-report-of-248-cases
#2
M Pepin, E Rineau, A Caignard, S Leruez, P Gohier
INTRODUCTION: This work aims to evaluate selection criteria used during the cataract surgery scheduling visit, to choose whether or not there will be an anesthesiologist available during the surgery, depending upon the patient's comorbidities. MATERIALS AND METHODS: Retrospective study performed in 2016 in Angers university medical center. Two groups were established on the cataract surgery scheduling visit, based on patients' comorbidities and vital signs (blood pressure, heart rate)...
May 15, 2018: Journal Français D'ophtalmologie
https://www.readbyqxmd.com/read/29775162/validation-of-prone-intraoperative-measurements-of-global-spinal-alignment
#3
Max Vaynrub, Brandon P Hirsch, Jared Tishelman, Dennis Vasquez-Montes, Aaron J Buckland, Thomas J Errico, Themistocles S Protopsaltis
OBJECTIVE Verifying the adequacy of surgical correction of adult spinal sagittal deformity (SSD) leads to improved postoperative alignment and clinical outcomes. Traditionally, surgeons relied on intraoperative measurements of lumbar lordosis (LL) correction. However, T-1 pelvic angle (TPA) and its component angles more reliably predict postoperative alignment. While TPA is readily measured on standing radiographs, intraoperative radiographs offer poor resolution of the bicoxofemoral axis. A method to recreate this radiographic landmark by extrapolating preoperative measurements has been described...
May 18, 2018: Journal of Neurosurgery. Spine
https://www.readbyqxmd.com/read/29774943/-progress-in-prophylatic-hyperthermic-intraperitoneal-chemotherapy-for-advanced-gastric-carcinoma
#4
Xinhua Chen, Jun Luo, Hao Liu, Yuehong Chen, Yanfeng Hu, Tuanjie Li, Tian Lin, Yu Zhu, Mingli Zhao, Hao Chen, Guoxin Li, Jiang Yu
Advanced gastric cancer (AGC) has a high recurrence rate (especially peritoneal relapse) and a poor prognosis. Systematic chemotherapy or targeted therapy have not been able to significantly reduce the major cause of an unfavorable prognosis, namely the high peritoneal AGC recurrence rate post-surgery. Further studies concerning the application of hyperthermic intraperitoneal chemotherapy (HIPEC) post curative surgery for AGC patients, namely the prophylactic HIPEC (P-HIPEC), have involved a prophylactic approach to prevent peritoneal relapse following curative gastrectomy in high-risk patients...
May 25, 2018: Zhonghua Wei Chang Wai Ke za Zhi, Chinese Journal of Gastrointestinal Surgery
https://www.readbyqxmd.com/read/29774873/-application-of-intraoperative-mri-combined-with-neuronavigation-in-microsurgical-resection-for-insular-glioma
#5
Quanwei Zhou, Li Xia, Kejun He, Sheng Yan, Xiaoping Xu, Xixi Li, Zhengsong Huang, Nu Zhang
To evaluate the value of intraoperative magnetic resonance imaging (iMRI) combined with neuronavigation for the resection of insular gliomas.
 Methods: From August 2014 to October 2017 in the First Hospital Affiliated to Sun Yat-sen University, clinical data of 41 patients with insular glioma, who underwent the surgery assisted with 3.0T iMRI and neuronavigation, were analyzed retrospectively, and the resection extent, complications and prognosis were evaluated.
 Results: Subtotal tumor resection was achieved in 21 patients and partial resection was done in 20 after iMRI scanning...
April 28, 2018: Zhong Nan da Xue Xue Bao. Yi Xue Ban, Journal of Central South University. Medical Sciences
https://www.readbyqxmd.com/read/29774809/robotic-partial-nephrectomy-for-a-peripheral-renal-tumor
#6
Caleb A Cooper, Cheuk Fan Shum, Chandru P Sundaram
Partial nephrectomy (PN) is the preferred surgical treatment for T1 renal tumors whenever technically feasible. When properly performed, it allows preservation of nephron mass without compromising oncologic outcomes. This reduces the postoperative risk of renal insufficiency, which translates into better overall survival for the patients. PN can be technically challenging, because it requires the surgeon to complete the tasks of tumor excision, hemostasis and renorrhaphy, all within an ischemic time of preferably below 30 minutes...
May 2018: Journal of Endourology
https://www.readbyqxmd.com/read/29774184/a-systematic-review-of-clinical-value-of-three-dimensional-printing-in-renal-disease
#7
Zhonghua Sun, Dongting Liu
The aim of this systematic review is to analyse current literature related to the clinical value of three-dimensional (3D) printed models in renal disease. A literature search of PubMed and Scopus databases was performed to identify studies reporting the clinical application and usefulness of 3D printed models in renal disease. Fifteen studies were found to meet the selection criteria and were included in the analysis. Eight of them provided quantitative assessments with five studies focusing on dimensional accuracy of 3D printed models in replicating renal anatomy and tumour, and on measuring tumour volume between 3D printed models and original source images and surgical specimens, with mean difference less than 10%...
April 2018: Quantitative Imaging in Medicine and Surgery
https://www.readbyqxmd.com/read/29774157/risk-assessment-of-choledocholithiasis-prior-to-laparoscopic-cholecystectomy-and-its-management-options
#8
Ausra Aleknaite, Gintaras Simutis, Juozas Stanaitis, Jonas Valantinas, Kestutis Strupas
Background: Accurate risk evaluation of choledocholithiasis prior to laparoscopic cholecystectomy is essential to determine optimal management strategy. Objective: Our study aimed to evaluate the accuracy of separate predictors and Vilnius University Hospital Index (VUHI = A/30 + 0.4 × B; A = total bilirubin concentration (µmol/l), B = common bile duct (CBD) diameter (mm) measured by ultrasound) diagnosing choledocholithiasis and to assess different management strategies (cholecystectomy with intraoperative cholangiography and endoscopic retrograde cholangiopancreatography (ERCP))...
April 2018: United European Gastroenterology Journal
https://www.readbyqxmd.com/read/29774091/sensitive-molecular-detection-of-small-nodal-metastasis-in-uterine-cervical-cancer-using-hpv16-e6-ck19-muc1-cancer-biomarkers
#9
Vanessa Samouëlian, Nawel Mechtouf, Eric Leblanc, Guillaume B Cardin, Valérie Lhotellier, Denis Querleu, Françoise Révillion, Francis Rodier
Metastatic nodal involvement is a critical prognostic factor in uterine cervical cancer (UCC). To improve current methods of detecting UCC metastases in lymph nodes (LNs), we used quantitative PCR (qPCR) to assess mRNA expression of potential metastatic biomarkers. We found that expression of HPV16-E6, cytokeratin19 (CK19), and mucin1 (MUC1) is consistently upregulated in tumors and metastatic tissues, supporting a role for these genes in UCC progression. These putative biomarkers were able to predict the presence of histologically positive metastatic LNs with respective sensitivities and specificities of 82% and 99% (CK19), 76% and 95% (HPV16-E6), and 76% and 78% (MUC1)...
April 24, 2018: Oncotarget
https://www.readbyqxmd.com/read/29773484/the-effect-of-a-single-intraoperative-dose-of-intravenous-dexamethasone-8-mg-on-post-cesarean-delivery-analgesia-a-randomized-controlled-trial
#10
U Ituk, K Thenuwara
BACKGROUND: A single perioperative dose of dexamethasone has been shown to improve postoperative analgesia and reduce opioid consumption. However, this analgesic and opioid sparing effect has not been well assessed as part of a multimodal analgesic regimen in women post-cesarean delivery. METHODS: Healthy women having cesarean delivery under spinal anesthesia were randomly assigned to receive intravenous dexamethasone 8 mg or placebo after delivery and clamping of the umbilical cord...
March 26, 2018: International Journal of Obstetric Anesthesia
https://www.readbyqxmd.com/read/29773240/perioperative-risk-factors-that-predict-complications-of-radial-forearm-free-flaps-in-oral-and-maxillofacial-reconstruction
#11
C Wang, G Fu, F Liu, L Liu, M Cao
The aim of the study was to find out what perioperative risk factors predicted complications in patients having reconstructions with radial forearm free flaps (RFFF). We organised a retrospective study of 169 patients (mean (range) age 54 (22-86) years, 100 of whom were female) who had oral and maxillofacial tumours resected, and reconstructed with RFFF, from January 2011-December 2016. We recorded predictive variables, subdivided into: personal and clinical (sex, age, weight, coexisting conditions, history of smoking, radiotherapy, and primary lesions); haemodynamic (perioperative concentrations of haemoglobin and albumin, blood loss, blood transfusion, urinary output (ml), and rate (ml/kg/hour), and infusion rates for crystalloids and colloids (ml/kg/hour, and volumes given intraoperatively and postoperatively for 24hours); and anaesthetic and surgical (American Society of Anesthesiologists(ASA) grade, visual analogue pain score (VAS), and duration of tourniquet and operation)...
May 14, 2018: British Journal of Oral & Maxillofacial Surgery
https://www.readbyqxmd.com/read/29772562/using-neuroimaging-to-uncover-awareness-in-brain-injured-and-anesthetized-patients
#12
Mackenzie Graham, Adrian M Owen, Charles Weijer, Lorina Naci
We cast a novel perspective on two distinct populations: patients who become accidentally intraoperatively aware after receiving general anesthesia and severely brain-injured patients who are diagnosed as being in a vegetative state. In both cases, patients are behaviorally non-responsive -and on this basis presumed to lack consciousness- yet, retain covert awareness. In both contexts, detecting consciousness is highly challenging, yet highly important for ensuring adequate patient care. Although great strides have been made in the development of depth-of-anesthesia monitors, these monitors have significant limitations...
June 1, 2018: Frontiers in Bioscience (Scholar Edition)
https://www.readbyqxmd.com/read/29770885/does-near-infrared-nir-fluorescence-angiography-modify-operative-strategy-during-emergency-procedures
#13
Emilie Liot, Michela Assalino, Nicolas Christian Buchs, Boris Schiltz, Jonathan Douissard, Philippe Morel, Frédéric Ris
INTRODUCTION: Bowel viability can be difficult to evaluate during emergency surgery. Near-infrared (NIR) fluorescence angiography allows an intraoperative assessment of organ perfusion during elective surgery and might help to evaluate intestinal perfusion during emergency procedures. The aim of this study was to assess if NIR modified operative strategy during emergency surgery. MATERIALS AND METHODS: From July 2014 to December 2015, we prospectively evaluated all consecutive patients, who had NIR assessment during emergency surgery...
May 16, 2018: Surgical Endoscopy
https://www.readbyqxmd.com/read/29770618/peritoneal-cancer-index-as-a-predictor-of-survival-in-advanced-stage-serous-epithelial-ovarian-cancer-a-prospective-study
#14
Alaa A Elzarkaa, Waleed Shaalan, Doaa Elemam, Hassan Mansour, Mahmoud Melis, Eduard Malik, Amr A Soliman
OBJECTIVE: A numerical score, the peritoneal cancer index (PCI), was developed to reflect the extent of tumor growth in gastric and colorectal cancers and to tailor treatment. This study aimed to examine the value of the PCI score in advanced epithelial ovarian cancer (EOC) regarding completeness of surgical cytoreduction and survival. METHODS: This was a prospective observational cohort study. Patients with primary serous EOC at International Federation of Gynecology and Obstetrics (FIGO) stages IIIB or higher were included...
March 8, 2018: Journal of Gynecologic Oncology
https://www.readbyqxmd.com/read/29770250/the-usefulness-of-indocyanine-green-during-surgery-for-hypervascular-posterior-fossa-tumors
#15
Takahiro Shinya, Hideki Nagamine, Ken-Ichi Sugawara, Shogo Ishiuchi
Background: Cerebral hemangioblastomas are benign tumors with abundant blood flow that occur mainly in the posterior fossa. Tumor removal en bloc is important in surgical treatment because of the risk of bleeding; however, it is actually rather difficult in practice. Therefore, we propose a surgical strategy for visualizing hypervascular tumors of the posterior fossa utilizing indocyanine green (ICG). Case Description: Case 1 involved a 48-year-old male with a history of von Hippel-Lindau (VHL) disease...
2018: Surgical Neurology International
https://www.readbyqxmd.com/read/29768387/optimal-reconstruction-methods-after-distal-gastrectomy-for-gastric-cancer-a-systematic-review-and-network-meta-analysis
#16
Zhaolun Cai, Ye Zhou, Chenxiao Wang, Yiqiong Yin, Yuan Yin, Chaoyong Shen, Xiaonan Yin, Zhixin Chen, Bo Zhang
BACKGROUND: The choice of anastomosis methods including Billroth I, Billroth II, and Roux-en-Y after a distal gastrectomy is still controversial. The conventional meta-analyses assessing 2 alternative treatments were not powered to compare differences in clinical outcomes. To guide treatment decisions in patients with gastric cancer (GC) after distal gastrectomy, we did a systematic review and network meta-analysis to identify the best reconstruction method. METHODS: We systematically searched PubMed, EMBASE, the Cochrane Library for randomized controlled trials comparing the outcomes of Billroth I, Billroth II, or Roux-en-Y reconstruction after distal subtotal gastrectomy for patients with GC, then we performed a direct meta-analysis and Bayesian network meta-analysis to pooled odds ratios (OR) or weighted mean differences (WMD) with 95% credible intervals (CrI) with random effects model...
May 2018: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29766779/technetium-99m-based-radiopharmaceuticals-in-sentinel-lymph-node-biopsy-gynecologic-oncology-perspective
#17
Kamil Zalewski, Malgorzata Benke, Bartlomiej Mirocha, Jakub Radziszewski, Magdalena Chechlinska, Magdalena Kowalewska
Technetium (99mTc)-radiolabeled colloids are popular tracers used to map lymphatic vessels and regional lymph nodes (LNs). The regional LN status is a significant determinant of cancer stage and patient prognosis, and strongly influences treatment. Regional LN dissection has become part of surgical treatment. However, not all patients with LN involvement benefit from extensive lymphadenectomy in terms of prolonged survival. Moreover, overtreatment of patients with localized disease carries unnecessary risk of complications...
May 15, 2018: Current Pharmaceutical Design
https://www.readbyqxmd.com/read/29766302/technique-safety-and-feasibility-of-eus-guided-radiofrequency-ablation-in-unresectable-pancreatic-cancer
#18
Filippo Scopelliti, Antonio Pea, Rita Conigliaro, Giovanni Butturini, Isabella Frigerio, Paolo Regi, Alessandro Giardino, Helga Bertani, Marina Paini, Paolo Pederzoli, Roberto Girelli
BACKGROUND AND AIMS: Radiofrequency ablation (RFA) is a well-recognized local ablative technique applied in the treatment of different solid tumors. Intraoperative RFA has been used for non-metastatic unresectable pancreatic ductal adenocarcinoma (PDAC), showing increased overall survival in retrospective studies. A novel RFA probe has recently been developed, allowing RFA under endoscopic ultrasound (EUS) guidance. Aim of the present study was to assess the feasibility and safety of EUS-guided RFA for unresectable PDACs...
May 15, 2018: Surgical Endoscopy
https://www.readbyqxmd.com/read/29764687/intraoperative-aortic-root-pressure-study-for-quantitative-assessment-of-aortic-regurgitation-during-valve-sparing-root-replacement-a-preliminary-report
#19
Yuki Ikeno, Hiroshi Tanaka, Yutaka Okita
No abstract text is available yet for this article.
April 17, 2018: Journal of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/29764445/current-practices-of-cytoreductive-surgery-and-hyperthermic-intraperitoneal-chemotherapy-in-the-treatment-of-peritoneal-surface-malignancies-an-international-survey-of-oncologic-surgeons
#20
Heon Jong Yoo, Jenny J Hong, Young Bok Ko, Mina Lee, Youjin Kim, Hye Young Han, Yong Jung Song, Myong Cheol Lim, Sang-Yoon Park
BACKGROUND: The goal of the study was to investigate the current clinical practices among oncologic surgeons regarding cytoreductive surgery (CRS) with intraoperative hyperthermic intraperitoneal chemotherapy (HIPEC). METHODS: From September to October 2016, an online questionnaire surveyed the oncologic surgeons by email. The questionnaire included 20 multiple-choice questions of the following: eligibility for the CRS with HIPEC procedure, perioperative staging and surgery skill, assessment of residual tumors, and method used for intraperitoneal HIPEC...
May 15, 2018: World Journal of Surgical Oncology
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