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Intraoperative assessment

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https://www.readbyqxmd.com/read/28342705/comparison-of-20-mannitol-and-3-hypertonic-saline-on-intracranial-pressure-and-systemic-hemodynamics
#1
Navdeep Sokhal, Girija Prasad Rath, Arvind Chaturvedi, Manmohan Singh, Hari Hara Dash
Mannitol and hypertonic saline (HS) are most commonly used hyperosmotic agents for intraoperative brain relaxation. We compared the changes in ICP and systemic hemodynamics after infusion of equiosmolar solutions of both agents in patients undergoing craniotomy for supratentorial tumors. Forty enrolled adults underwent a standard anesthetic induction. Apart from routine monitoring parameters, subdural ICP with Codmann catheter and cardiac indices by Vigileo monitor, were recorded. The patients were randomized to receive equiosmolar solutions of either 20% mannitol (5ml/kg) or 3% HS (5...
March 22, 2017: Journal of Clinical Neuroscience: Official Journal of the Neurosurgical Society of Australasia
https://www.readbyqxmd.com/read/28338504/ventilation-with-high-or-low-tidal-volume-with-peep-does-not-influence-lung-function-after-spinal-surgery-in-prone-position-a-randomized-controlled-trial
#2
Sarah Soh, Jae-Kwang Shim, Yoon Ha, Young-Sam Kim, Hyelin Lee, Young-Lan Kwak
BACKGROUND: Spinal surgery in the prone position is accompanied by increased intrathoracic pressure and decreased respiratory compliance. This study investigated whether intraoperative lung protective mechanical ventilation improved lung function evaluated with pulmonary function tests in patients at risk of postoperative pulmonary complications (PPCs) after major spinal surgery in the prone position. METHODS: Seventy-eight patients at potential risk of PPCs were randomly assigned to the protective group (tidal volume; 6 mL/kg predicted body weight, 6 cm H2O positive end-expiratory pressure with recruitment maneuvers) or the conventional group (10 mL/kg predicted body weight, no positive end-expiratory pressure)...
March 23, 2017: Journal of Neurosurgical Anesthesiology
https://www.readbyqxmd.com/read/28338438/learning-brain-aneurysm-microsurgical-skills-in-a-human-placenta-model-predictive-validity
#3
Marcelo Magaldi Ribeiro de Oliveira, Carlos Eduardo Ferrarez, Taise Mosso Ramos, Jose Augusto Malheiros, Arthur Nicolato, Carla Jorge Machado, Mauro Tostes Ferreira, Fellype Borges de Oliveira, Cecília Félix Penido Mendes de Sousa, Pollyana Helena Vieira Costa, Sebastiao Gusmao, Giuseppe Lanzino, Rolando Del Maestro
OBJECTIVE Surgery for brain aneurysms is technically demanding. In recent years, the process to learn the technical skills necessary for these challenging procedures has been affected by a decrease in the number of surgical cases available and progressive restrictions on resident training hours. To overcome these limitations, surgical simulators such as cadaver heads and human placenta models have been developed. However, the effectiveness of these models in improving technical skills is unknown. This study assessed concurrent and predictive validity of brain aneurysm surgery simulation in a human placenta model compared with a "live" human brain cadaveric model...
March 24, 2017: Journal of Neurosurgery
https://www.readbyqxmd.com/read/28333776/transcanal-endoscopic-ear-surgery-for-middle-ear-cholesteatoma
#4
Eran Glikson, Ruth Yousovich, Jobran Mansour, Michael Wolf, Lela Migirov, Yisgav Shapira
OBJECTIVE: To evaluate the clinical parameters, outcomes, and complications of transcanal endoscopic ear surgeries for middle ear cholesteatoma. STUDY DESIGN: Retrospective study. SETTING: Tertiary university-affiliated medical center. PATIENTS: Adult patients (age >18) who underwent transcanal endoscopic ear surgeries for cholesteatoma, between March 2009 and March 2015. INTERVENTION: Transcanal endoscopic surgery was indicated when the cholesteatoma did not extend posterior to the anterior limb of the lateral semicircular canal...
March 22, 2017: Otology & Neurotology
https://www.readbyqxmd.com/read/28332067/preoperative-chronic-sinusitis-as-significant-cause-of-postoperative-infection-and-implant-loss-after-sinus-augmentation-from-a-lateral-approach
#5
Ayako Kozuma, Masanori Sasaki, Katsuhiro Seki, Takeshi Toyoshima, Hiroyuki Nakano, Yoshihide Mori
OBJECTIVES: Among intra/postoperative complications of sinus augmentation from a lateral approach, postoperative infection and implant loss are particularly important because they have irreversible consequences. The purpose of this study was to determine the causes of postoperative infection and implant loss after a lateral approach and to determine the appropriate prophylaxis and therapy. MATERIALS AND METHODS: In total, 109 patients (121 sinuses, 252 implants) were included in this study...
March 22, 2017: Oral and Maxillofacial Surgery
https://www.readbyqxmd.com/read/28331493/feasibility-and-safety-of-pressurized-intraperitoneal-aerosol-chemotherapy-for-peritoneal-carcinomatosis-a-retrospective-cohort-study
#6
Martin Hübner, Hugo Teixeira Farinha, Fabian Grass, Anita Wolfer, Patrice Mathevet, Dieter Hahnloser, Nicolas Demartines
Background. Pressurized intraperitoneal aerosol chemotherapy (PIPAC) has been introduced as a novel repeatable treatment for peritoneal carcinomatosis. The available evidence from the pioneer center suggests good tolerance and high response rates, but independent confirmation is needed. A single-center cohort was analyzed one year after implementation for feasibility and safety. Methods. PIPAC was started in January 2015, and every patient was entered into a prospective database. This retrospective analysis included all consecutive patients operated until April 2016 with emphasis on surgical feasibility and early postoperative outcomes...
2017: Gastroenterology Research and Practice
https://www.readbyqxmd.com/read/28331239/evaluation-of-a-marker-clip-system-in-sonographically-guided-core-needle-biopsy-for-breast-cancer-localization-before-and-after-neoadjuvant-chemotherapy
#7
R Schulz-Wendtland, P Dankerl, M R Bani, P A Fasching, K Heusinger, M P Lux, S M Jud, C Rauh, C M Bayer, M G Schrauder, M W Beckmann, M Uder, B Brehm, C R Loehberg
Introduction The placement of intramammary marker clips has proven to be helpful for tumor localization in patients undergoing neoadjuvant chemotherapy and breast-conserving surgery. The purpose of our study was to investigate the feasibility of using a clip marker system for breast cancer localization and its influence on the imaging assessment of treatment responses after neoadjuvant chemotherapy. Patients and Methods Between March and June 2015, a total of 25 patients (n = 25), with a suspicion of invasive breast cancer with diameters of at least 2 cm (cT2), underwent preoperative sonographically guided core needle biopsy using a single-use breast biopsy system (HistoCore™) and intramammary clip marking using a directly adapted clip system based on the established O-Twist Marker™, before their scheduled preoperative neoadjuvant chemotherapy...
February 2017: Geburtshilfe und Frauenheilkunde
https://www.readbyqxmd.com/read/28329451/preliminary-experience-with-the-use-of-an-extracellular-matrix-to-augment-the-native-pulmonary-valve-during-repair-of-tetralogy-of-fallot
#8
Anil Dharmapuram, Nagarajan Ramadoss, Sudeep Verma, Vejendla Gouthami, Ivatury Rao
BACKGROUND: During repair of tetralogy of Fallot (TOF), when a transannular patch is needed in case of a small annulus and dysplastic pulmonary valve, we chose to reconstruct the right ventricular outflow tract by augmenting the divided anterior leaflet with an extracellular matrix (ECM) patch to produce a competent valve. In this study, we present our preliminary experience and early outcomes. METHODS: From March 2013 to December 2015, of the 206 patients who underwent primary repair of TOF, 52 required a transannular incision...
March 2017: World Journal for Pediatric & Congenital Heart Surgery
https://www.readbyqxmd.com/read/28329384/custodiol-versus-cold-calafiore-for-elective-cardiac-arrest-in-isolated-aortic-valve-replacement-a-propensity-matched-analysis-of-7263-patients%C3%A2
#9
Alexandro Hoyer, Sven Lehmann, Meinhard Mende, Thilo Noack, Philipp Kiefer, Martin Misfeld, Farhad Bakhtiary, Friedrich Wilhelm Mohr
OBJECTIVES: This study was designed to assess the impact of crystalloid cardioplegia (CCP) and blood cardioplegia (BCP) on short- and long-term outcome after isolated aortic valve replacement (AVR). METHODS: A total of 7263 patients undergoing AVR at our institution between November 1994 and June 2015 were identified. CCP (Custodiol ® ) was used in 83% ( n  = 5998) and intermittent cold BCP in 1007 patients (14%). For 4790 patients, propensity scores were calculated from baseline data, risk factors, comorbidities and characteristics of the disease, resulting in 825 pairs...
March 3, 2017: European Journal of Cardio-thoracic Surgery
https://www.readbyqxmd.com/read/28329295/flow-dynamics-assessment-of-mitral-valve-surgery-by-intraoperative-vector-flow-mapping
#10
Koichi Akiyama, Naotoshi Nakamura, Keiichi Itatani, Yoshifumi Naito, Mao Kinoshita, Masaru Shimizu, Saeko Hamaoka, Hideya Kato, Hiroaki Yasumoto, Yasufumi Nakajima, Toshiki Mizobe, Satoshi Numata, Hitoshi Yaku, Teiji Sawa
OBJECTIVES: We assessed vortex patterns and energy loss in left ventricular flow in patients who underwent mitral valve repair or replacement with bioprosthetic valves. METHODS: Vector flow mapping was performed before and after the procedure in 15 and 17 patients who underwent repair and replacement, respectively. The preprocedure mitral-septal angle was measured in all patients. Relationships between vortex patterns or energy loss change (ELC) and annuloplasty ring or bioprosthetic valve sizes or the effect of mitral leaflet resection in the repair group were statistically analysed...
February 22, 2017: Interactive Cardiovascular and Thoracic Surgery
https://www.readbyqxmd.com/read/28329210/right-atrium-positioning-for-exposure-of-right-pulmonary-veins-during-off-pump-atrial-fibrillation-ablation
#11
Grzegorz Suwalski, Robert Emery, Jakub Mróz, Kamil Kaczejko, Leszek Gryszko, Andrzej Cwetsch, Andrzej Skrobowski
OBJECTIVES: Concomitant surgical ablation of atrial fibrillation (AF) is recommended for patients undergoing off-pump coronary revascularization in the presence of this arrhythmia. Achievement of optimal visualization of pulmonary veins while maintaining stable haemodynamic conditions is crucial for proper completion of the ablation procedure. This study evaluates the safety and feasibility of right atrial positioning using a suction-based cardiac positioner as opposed to compressive manoeuvres for exposure during off-pump surgical ablation for AF...
March 3, 2017: Interactive Cardiovascular and Thoracic Surgery
https://www.readbyqxmd.com/read/28329178/intraoperative-coronary-revision-but-not-coronary-pattern-is-associated-with-mortality-after-arterial-switch-operation%C3%A2
#12
Matteo Trezzi, Angelo Polito, Antonio Albano, Sonia B Albanese, Enrico Cetrano, Adriano Carotti
OBJECTIVES: We sought to determine differences in baseline characteristics and clinical outcomes in a consecutive series of patients undergoing arterial switch operation (ASO), assessing the effect of coronary anatomy on postoperative mortality, both overall and adjusted for surgical era. METHODS: From January 2000 to May 2015, 283 consecutive patients underwent ASO for transposition of the great arteries. A total of 103 patients (36.4%) had an associated ventricular septal defect and 23 (8...
March 18, 2017: European Journal of Cardio-thoracic Surgery
https://www.readbyqxmd.com/read/28328832/clinico-radiological-diagnosis-and-grading-of-rapidly-progressive-osteoarthritis-of-the-hip
#13
Ancuţa Zazgyva, Simona Gurzu, István Gergely, Ioan Jung, Ciprian O Roman, Tudor S Pop
Due to the current lack of standard definitions for rapidly progressive osteoarthritis of the hip (RPOH) in the literature, this observational study aimed to describe new diagnostic criteria and a grading system for the disease.From a consecutive series of patients undergoing total hip replacement, 2 groups were selected: 1 with RPOH and 1 with primary hip osteoarthritis (POH), and their clinical, paraclinical, and demographic data were compared. The newly proposed clinico-radiological diagnostic criteria are based on characteristics of pain, joint mobility, and radiological assessment...
March 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28328732/reliable-method-for-avoiding-malrotation-deformity-after-intramedullary-nailing-of-comminuted-femur-fractures-clinical-validation-of-a-previously-described-technique
#14
Ashoke Sathy, Jonathan C Barnwell, Sean N Shahrestani, Daniel Moore
OBJECTIVES: To evaluate a previously described technique using the inherent anteversion of intramedullary nail (IMN) to avoid malrotation in comminuted femur fractures and describe the use of magnetic resonance imaging (MRI) as an alternative method for assessing postoperative femoral version. DESIGN: Prospective consecutive cohort study. SETTING: Level I trauma center. PATIENT/PARTICIPANTS: Twenty-five consecutive patients with comminuted femur fractures (Winquist III/IV, OTA/AO 32-B/32-C) treated by a single surgeon with IMN between September 1, 2011, and February 28, 2015...
April 2017: Journal of Orthopaedic Trauma
https://www.readbyqxmd.com/read/28328638/complications-after-reduction-mammaplasty-a-comparison-of-wise-pattern-inferior-pedicle-and-vertical-scar-superomedial-pedicle
#15
Adeyemi A Ogunleye, Ofelia Leroux, Norman Morrison, Aviva B Preminger
Reduction mammaplasty is a commonly-performed procedure among plastic surgeons. Although several methods exist, the Wise pattern/inferior pedicle (IP) technique is the most widely used. The vertical scar/superomedial pedicle (SP) technique has gained acceptance for its shorter scar and more durable projection results, but some hesitation remains with its use in larger volume reductions.The incidence of complications in 124 consecutively performed breast reductions (246 breasts) at a single institution using either the Wise pattern/IP technique or vertical scar/SP technique, as well as risk factors associated with them, was determined...
March 21, 2017: Annals of Plastic Surgery
https://www.readbyqxmd.com/read/28327941/degree-of-vascular-encasement-in-sphenoid-wing-meningiomas-predicts-postoperative-ischemic-complications
#16
D Jay McCracken, Raymond A Higginbotham, Jason H Boulter, Yuan Liu, John A Wells, Sameer H Halani, Amit M Saindane, Nelson M Oyesiku, Daniel L Barrow, Jeffrey J Olson
BACKGROUND: Sphenoid wing meningiomas (SWMs) can encase arteries of the circle of Willis, increasing their susceptibility to intraoperative vascular injury and severe ischemic complications. OBJECTIVE: To demonstrate the effect of circumferential vascular encasement in SWM on postoperative ischemia. METHODS: A retrospective review of 75 patients surgically treated for SWM from 2009 to 2015 was undertaken to determine the degree of circumferential vascular encasement (0°-360°) as assessed by preoperative magnetic resonance imaging (MRI)...
January 28, 2017: Neurosurgery
https://www.readbyqxmd.com/read/28327900/awake-craniotomy-vs-craniotomy-under-general-anesthesia-for-perirolandic-gliomas-evaluating-perioperative-complications-and-extent-of-resection
#17
Chikezie I Eseonu, Jordina Rincon-Torroella, Karim ReFaey, Young M Lee, Jasvinder Nangiana, Tito Vivas-Buitrago, Alfredo Quiñones-Hinojosa
BACKGROUND: A craniotomy with direct cortical/subcortical stimulation either awake or under general anesthesia (GA) present 2 approaches for removing eloquent region tumors. With a reported higher prevalence of intraoperative seizures occurring during awake resections of perirolandic lesions, oftentimes, surgery under GA is chosen for these lesions. OBJECTIVE: To evaluate a single-surgeon's experience with awake craniotomies (AC) vs surgery under GA for resecting perirolandic, eloquent, motor-region gliomas...
March 15, 2017: Neurosurgery
https://www.readbyqxmd.com/read/28327889/hemodynamic-changes-after-unilateral-revascularization-for-moyamoya-disease-serial-assessment-by-quantitative-magnetic-resonance-angiography
#18
Tackeun Kim, Jae Seung Bang, O-Ki Kwon, Gyojun Hwang, Jeong Eun Kim, Hyun-Seung Kang, Won-Sang Cho, Cheolkyu Jung, Chang Wan Oh
BACKGROUND: Ultrasonic flow meters and quantitative magnetic resonance angiography quantitatively assess flow during hemodynamic evaluation of cerebral ischemia. Although their reliability and reproducibility have been verified, their clinical impact in moyamoya disease has rarely been reported. OBJECTIVE: To investigate flow measurement outcomes in moyamoya disease patients pre- and postoperatively through a retrospective observational study. METHODS: We evaluated 41 patients undergoing their first revascularization surgery who were followed ≥6 mo...
January 2, 2017: Neurosurgery
https://www.readbyqxmd.com/read/28326444/quantitative-radiographic-assessment-of-the-anatomic-attachment-sites-of-the-anterior-and-posterior-complexes-of-the-proximal-tibiofibular-joint
#19
Daniel Cole Marchetti, Jorge Chahla, Gilbert Moatshe, Erik L Slette, Robert F LaPrade
PURPOSE: Quantitative guidelines for radiographic identification of the anterior and posterior ligaments of the proximal tibiofibular joint have not been well defined. The purpose of this study was to provide reproducible, quantitative descriptions of radiographic landmarks identifying the anterior and posterior ligament complexes of the proximal tibiofibular joint. It was hypothesized that consistent quantitative data regarding the radiographic location of the anterior and posterior proximal tibiofibular joint ligament complexes could be identified...
March 21, 2017: Knee Surgery, Sports Traumatology, Arthroscopy: Official Journal of the ESSKA
https://www.readbyqxmd.com/read/28326425/bilateral-pelvic-discontinuity-a-unique-condition-characterized-by%C3%A2-high-failure-rates-of-current-treatment
#20
John R Martin, Ian Barrett, Rafael J Sierra, David G Lewallen, Daniel J Berry
BACKGROUND: Bilateral pelvic discontinuity is characterized by complete dissociation of the superior and inferior pelvis secondary to bone loss or fracture. The end result is a freely mobile inferior pelvis at the level of each discontinuity which presents a significant reconstruction challenge. This clinical entity has not been described previously, and the results of surgical treatment are not known. METHODS: We retrospectively reviewed all identified cases of pelvic discontinuity (PD) treated with revision THA at one institution...
December 2016: Arthroplasty Today
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