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Intraoperative assessment

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https://www.readbyqxmd.com/read/27921171/computed-tomography-and-magnetic-resonance-fusion-imaging-in-cholesteatoma-preoperative-assessment
#1
Agustín Campos, Federico Mata, Rosa Reboll, María Luisa Peris, Jorge Basterra
The purpose of this study is to describe a method for developing fusion imaging for the preoperative evaluation of cholesteatoma. In 33 patients diagnosed with cholesteatoma, a high-resolution temporal bone computed tomography (CT) scan without intravenous contrast and propeller diffusion-weighted magnetic resonance imaging (MRI) were performed. Both studies were then sent to the BrainLAB work station, where the images were fused to obtain a morphological and color map. Intraoperative findings coincided with fusion CT-MRI imaging in all but two patients...
December 5, 2016: European Archives of Oto-rhino-laryngology
https://www.readbyqxmd.com/read/27920491/interactive-navigation-guided-ophthalmic-plastic-surgery-navigation-enabling-of-telescopes-and-their-use-in-endoscopic-lacrimal-surgeries
#2
Mohammad Javed Ali, Swati Singh, Milind N Naik, Swathi Kaliki, Tarjani Vivek Dave
PURPOSE: The aims of this study were to report the preliminary experience of using telescopes, which were enabled for navigation guidance, and their utility in complex endoscopic lacrimal surgeries. METHODS: Navigation enabling of the telescope was achieved by using the AxiEM™ malleable neuronavigation shunt stylet. Image-guided dacryolocalization was performed in five patients using the intraoperative image-guided StealthStation™ system in the electromagnetic mode...
2016: Clinical Ophthalmology
https://www.readbyqxmd.com/read/27920230/troubleshooting-for-bleeding-in-thoracoscopic-anatomic-pulmonary-resection
#3
Hitoshi Igai, Mitsuhiro Kamiyoshihara, Takashi Ibe, Natsuko Kawatani, Fumi Osawa, Ryohei Yoshikawa
INTRODUCTION: The objective of this study was to evaluate intraoperative vessel injury and assess troubleshooting during thoracoscopic anatomic pulmonary resection. METHODS: Between April 2012 and March 2016, 240 patients underwent thoracoscopic anatomic lung resection, 26 of whom were identified as having massive bleeding intraoperatively. We analyzed the injured vessel and the hemostatic procedure employed, then compared the perioperative outcomes in patients with (n = 26) and without (n = 214) vessel injury...
December 5, 2016: Asian Cardiovascular & Thoracic Annals
https://www.readbyqxmd.com/read/27919430/carbon-dioxide-insufflation-deflects-airborne-particles-from-an-open-surgical-wound-model
#4
P Kokhanenko, G Papotti, J E Cater, A C Lynch, J A van der Linden, C J T Spence
BACKGROUND: Surgical site infections remain a significant burden on healthcare systems and may benefit from new countermeasures. AIM: To assess the merits of open surgical wound CO2 insufflation via a gas diffuser to reduce airborne contamination, and to determine the distribution of CO2 in and over a wound. METHODS: An experimental approach with engineers and clinical researchers was employed to measure the gas flow pattern and motion of airborne particles in a model of an open surgical wound in a simulated theatre setting...
November 21, 2016: Journal of Hospital Infection
https://www.readbyqxmd.com/read/27918736/predictive-factors-of-difficulty-in-lower-third-molar-extraction-a-prospective-cohort-study
#5
J Alvira-González, R Figueiredo, E Valmaseda-Castellón, C Quesada-Gómez, C Gay-Escoda
BACKGROUND: Several publications have measured the difficulty of third molar removal, trying to establish the main risk factors, however several important preoperative and intraoperative variables are overlooked. MATERIAL AND METHODS: A prospective cohort study comprising a total of 130 consecutive lower third molar extractions was performed. The outcome variables used to measure the difficulty of the extraction were operation time and a 100mm visual analogue scale filled by the surgeon at the end of the surgical procedure...
December 6, 2016: Medicina Oral, Patología Oral y Cirugía Bucal
https://www.readbyqxmd.com/read/27918332/isoflurane-impairs-motor-function-recovery-by-increasing-neuroapoptosis-and-degeneration-during-spinal-ischemia-reperfusion-injury-in-rats
#6
Shih-Yuan Fang, Jung-Shun Lee, Jun-Neng Roan, Yu-Chuan Tsai, Chen-Fuh Lam
BACKGROUND: Spinal cord ischemia (SCI) leads to variable degrees of neurologic deficit in patients undergoing major cardiovascular surgery. The effect of intraoperative neuroprotection against SCI and the subsequent ischemia-reperfusion injury is still limited. Because isoflurane is a commonly used anesthetic agent during major operation, and its neuroprotective and neurotoxicity effects have both been discussed, this study aimed to investigate the effect of isoflurane on the spinal cord's functional recovery in a rat model of cord ischemia...
December 1, 2016: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/27917649/percutaneous-externally-assembled-laparoscopic-peal-versus-laparoendoscopic-single-site-less-nephrectomy-in-a-porcine-model-a-prospective-randomized-blinded-study
#7
Mohamed Keheila, Jim Ken-Chie Shen, Daniel Faaborg, Patrick Yang, Salim Cheriyan, Samuel R Abourbih, Nazih Khater, Michael Hill, D Duane Baldwin
OBJECTIVE: To compare the outcomes between Laparoendoscopic single-site (LESS) and a novel Percutaneous Externally Assembled Laparoscopic (PEAL) nephrectomy in an in vivo porcine model. MATERIALS AND METHODS: Ten female farm pigs were randomized to LESS nephrectomy (5) or PEAL nephrectomy (5). Operative times, estimated blood loss, intraoperative and postoperative complications were compared. The surgeons used a Likert scale to grade difficulty of peritoneal access, port placement, tool assembly, hilar dissection, closure, and overall difficulty of surgery...
December 4, 2016: Journal of Endourology
https://www.readbyqxmd.com/read/27917264/systemic-to-pulmonary-artery-pressure-ratio-as-a-predictor-of-patient-outcome-following-liver-transplantation
#8
Annette Rebel, Dung Nguyen, Brooke Bauer, Paul A Sloan, Amy DiLorenzo, Zaki-Udin Hassan
AIM: To assess the value of the mean systemic-to-pulmonary artery pressure (MAP/mPAP) ratio for predicting outcomes following orthotopic liver transplant (OLT). METHODS: A retrospective data analysis was performed and data (mean arterial blood pressure, mean pulmonary artery pressure and Cardiac Index) were collected at several points during OLT. Outcomes evaluated were duration of postoperative endotracheal intubation [ET; minutes after intensive care unit (ICU) arrival], length of ICU stay, total hospitalization and frequency of immediate postoperative complications...
November 18, 2016: World Journal of Hepatology
https://www.readbyqxmd.com/read/27916578/patellar-component-design-influences-size-selection-and-coverage
#9
Charlie C Yang, Douglas A Dennis, Patrick G Davenport, Raymond H Kim, Todd M Miner, Derek R Johnson, Peter J Laz
BACKGROUND: Patellofemoral (PF) complications following total knee arthroplasty continue to occur. Outcomes are influenced by implant design, size and alignment in addition to patient factors. The objective of this study was to assess the effect of implant design, specifically round versus oval dome patellar components, on size selected and bony coverage in a population of 100 patients. METHODS: Intraoperative assessments of patella component size were performed using surgical guides for round and oval designs...
December 1, 2016: Knee
https://www.readbyqxmd.com/read/27916314/intraoperative-ultrasound-guidance-in-breast-conserving-surgery-shows-superiority-in-oncological-outcome-long-term-cosmetic-and-patient-reported-outcomes-final-outcomes-of-a-randomized-controlled-trial-cobalt
#10
J H Volders, M H Haloua, N M A Krekel, V L Negenborn, R H E Kolk, A M F Lopes Cardozo, A M Bosch, L M de Widt-Levert, H van der Veen, H Rijna, A H M Taets van Amerongen, K Jóźwiak, S Meijer, M P van den Tol
BACKGROUND: The multicenter randomized controlled COBALT trial demonstrated that ultrasound-guided breast-conserving surgery (USS) results in a significant reduction of margin involvement (3.1% vs. 13%) and excision volumes compared to palpation-guided surgery (PGS). The aim of the present study was to determine long term oncological and patient-reported outcomes including quality of life (QoL), together with their progress over time. METHODS: 134 patients with T1-T2 breast cancer were randomized to USS (N = 65) or PGS (N = 69)...
November 23, 2016: European Journal of Surgical Oncology
https://www.readbyqxmd.com/read/27916237/transesophageal-speckle-tracking-echocardiography-improves-right-ventricular-systolic-function-assessment-in-the-perioperative-setting
#11
Nicholas W Markin, Mohammed Chamsi-Pasha, Jiangtao Luo, Walker R Thomas, Tara R Brakke, Thomas R Porter, Sasha K Shillcutt
BACKGROUND: Perioperative evaluation of right ventricular (RV) systolic function is important to follow intraoperative changes, but it is often not possible to assess with transthoracic echocardiographic (TTE) imaging, because of surgical field constraints. Echocardiographic RV quantification is most commonly performed using tricuspid annular plane systolic excursion (TAPSE), but it is not clear whether this method works with transesophageal echocardiographic (TEE) imaging. This study was performed to evaluate the relationship between TTE and TEE TAPSE distances measured with M-mode imaging and in comparison with speckle-tracking TTE and TEE measurements...
December 1, 2016: Journal of the American Society of Echocardiography
https://www.readbyqxmd.com/read/27915405/long-term-functional-outcomes-and-knee-alignment-of-computer-assisted-navigated-total-knee-arthroplasty
#12
V Sardana, J M Burzynski, M Khan, N Stone, B S Weening, P K Zalzal
INTRODUCTION: This retrospective study examined the relationship between the mechanical axis throughout a functional arc of motion and functional outcome scores in patients undergoing computer-assisted navigation-based total knee arthroplasty (CAN-TKA) at 6-year follow-up. MATERIALS AND METHODS: The Stryker eNact Precision Knee Navigation System was utilized to obtain pre- and postoperative alignment measurements throughout the functional arc of motion. Patients were contacted via telephone and asked to complete the Short Form-12 and Western Ontario and McMaster Universities, which have been demonstrated to be reliable, valid, and sensitive assessment tools in this patient population...
December 3, 2016: Musculoskeletal Surgery
https://www.readbyqxmd.com/read/27915065/assessment-of-white-matter-transgression-during-neuroendoscopic-procedures-using-dti-fiber-tracking
#13
Sergio García, Jordina Rincon-Torroella, Arnau Benet, Laura Oleaga, José Juan González Sánchez
BACKGROUND: Presurgical planning allows anticipating intraoperative difficulties, increasing efficiency, and reducing risks. Neuroendoscopy is a minimally invasive technique whose related complications have been focused on cortical function and surface vessels injury. However, white matter disruption has been insufficiently acknowledged. OBJECTIVE: To present a new surgical planning method based on diffusion tensor image that allows quantifying subcortical transgression and optimizing neuroendoscopic trajectories...
November 30, 2016: World Neurosurgery
https://www.readbyqxmd.com/read/27914840/coracoclavicular-stabilization-using-a-suture-button-device-for-neer-type-iib-lateral-clavicle-fractures
#14
Chul-Hyun Cho, Jae-Hoon Jung, Beom-Soo Kim
BACKGROUND: The purpose of this study was to evaluate the radiologic and clinical outcomes of coracoclavicular (CC) stabilization using a suture button device for Neer type IIB lateral clavicle fractures. METHODS: Eighteen consecutive patients with Neer type IIB fractures were treated with CC stabilization using a TightRope device (Arthrex, Naples, FL, USA). The mean follow-up period was 46.6 months (range, 24-75 months). Radiologic outcomes were assessed using serial plain radiographs...
November 30, 2016: Journal of Shoulder and Elbow Surgery
https://www.readbyqxmd.com/read/27914764/enhanced-recovery-pathway-in-patients-undergoing-distal-pancreatectomy-a-case-matched-study
#15
Nicolò Pecorelli, Giovanni Capretti, Gianpaolo Balzano, Renato Castoldi, Marianna Maspero, Luigi Beretta, Marco Braga
BACKGROUND: Enhanced recovery (ER) pathways have improved outcomes across multiple surgical specialties, but reports concerning their application in distal pancreatectomy (DP) are lacking. The aim of this study was to assess compliance with an ER protocol and its impact on short-term outcomes in patients undergoing DP. METHODS: Prospectively collected data were reviewed. One hundred consecutive patients undergoing DP were treated within an ER pathway comprising 18 care elements...
November 30, 2016: HPB: the Official Journal of the International Hepato Pancreato Biliary Association
https://www.readbyqxmd.com/read/27912973/micro-ureteroscopy-for-the-treatment-of-distal-ureteral-calculi-in-children
#16
Mehmet Mazhar Utanğaç, Ahmet Ali Sancaktutar, Abdulkadir Tepeler
OBJECTIVE: The objective of this study was to demonstrate the efficacy and safety of micro-ureteroscopy (micro-URS) in the management of distal ureteral stones in the pediatric population. MATERIALS AND METHODS: A total of 11 children, who had undergone micro-URS between September 2015 and April 2016 with the indication of distal ureteral calculi in two referral centers, were retrospectively evaluated. The procedures were performed with the patient in the lithotomy position under general anesthesia using the standard URS technique with a micro-ureteroscope that has a caliber of 4...
November 17, 2016: Journal of Pediatric Surgery
https://www.readbyqxmd.com/read/27906740/a-new-method-of-measuring-the-occipitocervical-angle-that-could-be-applied-as-an-intraoperative-indicator-during-occipitocervical-fusion
#17
Shingo Nagashima, Masateru Nagae, Yuji Arai, Hitoshi Tonomura, Ryota Takatori, Tsuyoshi Sukenari, Hiroyoshi Fujiwara, Koshiro Sawada, Yasuo Mikami, Toshikazu Kubo
STUDY DESIGN: A method for measuring occipitocervical angle. OBJECTIVE: To develop a new method of measurement for assessing the occipitocervical angle using intraoperative fluoroscopic imaging, and to examine its reliability. SUMMARY OF BACKGROUND DATA: To avoid postoperative complications following occipitocervical fusion, it is vital to obtain a suitable fusion angle between the occipital bone and the upper cervical spine. MATERIALS AND METHODS: The subjects were 30 cases with occipito-atlanto-axial lesions and 30 healthy volunteers...
November 30, 2016: Clinical Spine Surgery
https://www.readbyqxmd.com/read/27906739/posterior-vertebral-column-resection-with-intraoperative-manual-retraction-for-the-treatment-of-posttubercular-kyphosis-in-upper-thoracic-spine-or-cervicothoracic-junction
#18
Yuqiao Chen, Guohua Lü, Bing Wang, Lei Li, Lei Kuang
STUDY DESIGN: This is a case-series. OBJECTIVE: To evaluate the clinical and radiologic outcomes of posterior vertebral column resection (PVCR) for treatment of posttubercular kyphosis in upper thoracic spine and cervicothoracic junction (CTJ). SUMMARY OF BACKGROUND DATA: Surgical management of severe posttubercular kyphosis in upper thoracic spine or CTJ is challenging. A new technique that combines PVCR and intraoperative manual traction in a single procedure, was developed to maximize the correction rate and minimize the risk of dural buckling and spinal cord injury...
November 30, 2016: Clinical Spine Surgery
https://www.readbyqxmd.com/read/27906705/arterial-pressure-variation-in-elective-noncardiac-surgery-identifying-reference-distributions-and-modifying-factors
#19
Michael R Mathis, Samuel A Schechtman, Milo C Engoren, Amy M Shanks, Aleda Thompson, Sachin Kheterpal, Kevin K Tremper
BACKGROUND: Assessment of need for intravascular volume resuscitation remains challenging for anesthesiologists. Dynamic waveform indices, including systolic and pulse pressure variation, are demonstrated as reliable measures of fluid responsiveness for mechanically ventilated patients. Despite widespread use, real-world reference distributions for systolic and pulse pressure variation values have not been established for euvolemic intraoperative patients. The authors sought to establish systolic and pulse pressure variation reference distributions and assess the impact of modifying factors...
December 1, 2016: Anesthesiology
https://www.readbyqxmd.com/read/27906546/persistent-hemifacial-spasm-after-microvascular-decompression-a-risk-assessment-model
#20
Aalap Shah, Michael Horowitz
OBJECTIVE: Microvascular decompression (MVD) for hemifacial spasm (HFS) provides resolution of disabling symptoms such as eyelid twitching and muscle contractions of the entire hemiface. The primary aim of this study was to evaluate the predictive value of patient demographics and spasm characteristics on long-term outcomes, with or without intraoperative lateral spread response (LSR) as an additional variable in a risk assessment model. METHODS: A retrospective study was undertaken to evaluate the associations of pre-operative patient characteristics, as well as intraoperative LSR and need for a staged procedure on the presence of persistent or recurrent HFS at the time of hospital discharge and at follow-up...
December 1, 2016: British Journal of Neurosurgery
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