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Intraoperative assessment

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https://www.readbyqxmd.com/read/29149156/survival-analysis-of-occipital-nerve-stimulator-leads-placed-under-fluoroscopic-guidance-with-and-without-ultrasonography
#1
James H Jones, Alison Brown, Daniel Moyse, Wenjing Qi, Lance Roy
BACKGROUND: Electrical stimulation of the greater occipital nerves is performed to treat pain secondary to chronic daily headaches and occipital neuralgia. The use of fluoroscopy alone to guide the surgical placement of electrodes near the greater occipital nerves disregards the impact of tissue planes on lead stability and stimulation efficacy. OBJECTIVE: We hypothesized that occipital neurostimulator (ONS) leads placed with ultrasonography combined with fluoroscopy would demonstrate increased survival rates and times when compared to ONS leads placed with fluoroscopy alone...
November 2017: Pain Physician
https://www.readbyqxmd.com/read/29148922/feasibility-and-safety-of-using-thoracic-and-lumbar-cortical-bone-trajectory-pedicle-screws-in-spinal-constructs-in-children-technical-note
#2
Jonathan N Sellin, Jeffrey S Raskin, Kristen A Staggers, Alison Brayton, Valentina Briceño, Amee J Moreno, Andrew Jea
Thoracic and lumbar cortical bone trajectory pedicle screws have been described in adult spine surgery. They have likewise been described in pediatric CT-based morphometric studies; however, clinical experience in the pediatric age group is limited. The authors here describe the use of cortical bone trajectory pedicle screws in posterior instrumented spinal fusions from the upper thoracic to the lumbar spine in 12 children. This dedicated study represents the initial use of cortical screws in pediatric spine surgery...
November 17, 2017: Journal of Neurosurgery. Pediatrics
https://www.readbyqxmd.com/read/29147633/a-unique-case-of-carotid-splaying-by-a-cervical-vagal-neurofibroma-and-the-role-of-neuroradiology-in-surgical-management
#3
Sally A Itawi, Mark Buehler, Robert E Mrak, Tarek R Mansour, Yacine Medhkour, Azedine Medhkour
Carotid splaying, also known as the Lyre sign, is a widening of the carotid bifurcation due to the displacement of the internal carotid artery and the external carotid artery just distal to the point of divergence. This phenomenon is classically exhibited by highly vascularized carotid body tumors and, in rare cases, by cervical sympathetic chain schwannomas. Demonstration of the Lyre sign by a cervical vagal neurofibroma, however, is a unique occurrence that has not been previously documented in the literature...
September 7, 2017: Curēus
https://www.readbyqxmd.com/read/29146395/correlation-between-intraoperative-proximal-segment-rotation-and-post-sagittal-split-ramus-osteotomy-relapse-a-three-dimensional-cone-beam-computed-tomography-study
#4
B-J Choi, B-S Lee, Y-D Kwon, J-W Lee, S-U Yun, K-S Ryu, J-Y Ohe
This study evaluated the effects of proximal segment rotation and the extent of mandibular setback on post-sagittal split ramus osteotomy (SSRO) relapse using three-dimensional (3D) analysis. Thirty-one patients diagnosed with a skeletal class III malocclusion who underwent SSRO alone were enrolled in this study. The movements of the mandibular condyles were assessed using cone beam computed tomography (CBCT) and a 3D imaging program at ≤1 month before the operation (T0), 1 week after the operation (T1), and 6 months (T2) and 1year (T3) postoperative...
November 13, 2017: International Journal of Oral and Maxillofacial Surgery
https://www.readbyqxmd.com/read/29146268/surgical-apgar-score-predicts-30-day-morbidity-in-elderly-patients-who-undergo-non-laparoscopic-gynecologic-surgery-a-retrospective-analysis
#5
Kazumi Kurata, Yoko Chino, Akiko Shinagawa, Tetsuji Kurokawa, Yoshio Yoshida
INTRODUCTION: The aim of this study was to determine whether a preoperative health status index and intraoperative data could predict perioperative morbidity and mortality in women over the age of 65 years undergoing surgery for gynecologic disorders. METHODS: The medical records of 68 female patients who were ≥65 years of age and who underwent surgery under general anesthesia in our institute from January 2014 to December 2015 were retrospectively reviewed. Preoperative data were extracted from a database and included comorbidities, American Society of Anesthesiologists physiological status classification, the Charlson Comorbidity Index, the Subjective Global Assessment 2011 revision, the subjects' risk of falling, body mass index, and age...
November 13, 2017: International Journal of Surgery
https://www.readbyqxmd.com/read/29146164/magnetic-resonance-imaging-validation-of-tibial-tubercle-transfer-distance-in-the-fulkerson-osteotomy-a-clinical-and-cadaveric-study
#6
Joseph N Liu, Douglas N Mintz, Joseph T Nguyen, Jacqueline M Brady, Sabrina M Strickland, Beth E Shubin Stein
PURPOSE: To validate the medialization and anteriorization distances, and the osteotomy angle of anteromedialization tibial tubercle osteotomies using postoperative axial imaging. METHODS: From March 2004 to August 2015, 117 consecutive patients who underwent anteromedialization osteotomies of the tibial tubercle by a single surgeon were identified. Only patients with pre- and postoperative magnetic resonance imaging (MRI) studies were included. Using MRI multiplanar reformats, distances that the tibial tubercle was translated medially (medialization) and anteriorly (anteriorization) were measured...
November 13, 2017: Arthroscopy: the Journal of Arthroscopic & related Surgery
https://www.readbyqxmd.com/read/29143993/how-to-measure-size-of-tubal-ectopic-pregnancy-on-ultrasound-scan
#7
K Rajah, V Goodhart, K P Zamora, T Amin, E Jauniaux, D Jurkovic
OBJECTIVE: To identify the preoperative ultrasound measurements for assessing the size of tubal ectopic pregnancy which correlate best with the findings at surgery. METHODS: We conducted a prospective study of all women with a conclusive transvaginal ultrasound diagnosis of tubal ectopic pregnancy over a 10-month period. In each case, we measured the total size of the ectopic pregnancy by placing the calipers on the outer edges of the visible trophoblastic tissue...
November 16, 2017: Ultrasound in Obstetrics & Gynecology
https://www.readbyqxmd.com/read/29143240/dynamic-infrared-thermography-dirt-for-assessment-of-skin-blood-perfusion-in-cranioplasty-a-proof-of-concept-for-qualitative-comparison-with-the-standard-indocyanine-green-video-angiography-icga
#8
P Rathmann, C Chalopin, D Halama, P Giri, J Meixensberger, D Lindner
PURPOSE: Complications in wound healing after neurosurgical operations occur often due to scarred dehiscence with skin blood perfusion disturbance. The standard imaging method for intraoperative skin perfusion assessment is the invasive indocyanine green video angiography (ICGA). The noninvasive dynamic infrared thermography (DIRT) is a promising alternative modality that was evaluated by comparison with ICGA. METHODS: The study was carried out in two parts: (1) investigation of technical conditions for intraoperative use of DIRT for its comparison with ICGA, and (2) visual and quantitative comparison of both modalities in a proof of concept on nine patients...
November 15, 2017: International Journal of Computer Assisted Radiology and Surgery
https://www.readbyqxmd.com/read/29142748/intraoperative-prediction-of-the-two-axillary-lymph-node-macrometastases-threshold-in-patients-with-breast-cancer-using-a-one-step-nucleic-acid-cytokeratin-19-amplification-assay
#9
Victoria Fung, Stan Kohlhardt, Patricia Vergani, Gregory J Zardin, Norman R Williams
The aim of the present study was to assess the sensitivity, specificity and practicality of using a one-step nucleic acid amplification (OSNA) assay during breast cancer staging surgery to predict and discriminate between at least 2 involved nodes and more than 2 involved nodes and facilitate the decision to provide axillary conservation in the presence of a low total axillary node tumour burden. A total of 700 consecutive patients, not treated with neo-adjuvant chemotherapy, received intraoperative sentinel lymph node (SLN) analysis using OSNA for cT1-T3 cN0 invasive breast cancer...
November 2017: Molecular and Clinical Oncology
https://www.readbyqxmd.com/read/29140418/perioperative-management-of-the-obese-surgical-patient
#10
L H Lang, K Parekh, B Y K Tsui, M Maze
Introduction: The escalation in the prevalence of obesity throughout the world has led to an upsurge in the number of obese surgical patients to whom perioperative care needs to be delivered. Sources of data: After determining the scope of the review, the authors used PubMed with select phrases encompassing the words in the scope. Both preclinical and clinical reports were considered. Areas of agreement: There were no controversies regarding preoperative management and the intraoperative care of the obese surgical patient...
November 13, 2017: British Medical Bulletin
https://www.readbyqxmd.com/read/29139243/wide-field-spectrally-resolved-quantitative-fluorescence-imaging-system-toward-neurosurgical-guidance-in-glioma-resection
#11
Yijing Xie, Maria Thom, Michael Ebner, Victoria Wykes, Adrien Desjardins, Anna Miserocchi, Sebastien Ourselin, Andrew W McEvoy, Tom Vercauteren
In high-grade glioma surgery, tumor resection is often guided by intraoperative fluorescence imaging. 5-aminolevulinic acid-induced protoporphyrin IX (PpIX) provides fluorescent contrast between normal brain tissue and glioma tissue, thus achieving improved tumor delineation and prolonged patient survival compared with conventional white-light-guided resection. However, commercially available fluorescence imaging systems rely solely on visual assessment of fluorescence patterns by the surgeon, which makes the resection more subjective than necessary...
November 2017: Journal of Biomedical Optics
https://www.readbyqxmd.com/read/29139193/higher-doses-of-intraoperative-analgesia-are-associated-with-lower-levels-of-persistent-pain-and-less-analgesic-consumption-six-months-after-total-hip-arthroplasty
#12
F von Dincklage, A Jakuscheit, J Weth, G Lichtner, C Jurth, B Rehberg-Klug
BACKGROUND: Persistent postoperative pain is a major health problem affecting nearly 30% of all patients undergoing total hip arthroplasty. Previous studies have demonstrated an association between the intensity of acute postoperative pain and persistent pain, but this association might be an epiphenomenon of insufficient intraoperative analgesia. In this study, we investigated the association between the intraoperative level of analgesia and the persistent postoperative pain 6 months after surgery...
November 14, 2017: European Journal of Pain: EJP
https://www.readbyqxmd.com/read/29139105/preoperative-medical-therapy-before-surgery-for-uterine-fibroids
#13
REVIEW
Anne Lethaby, Lucian Puscasiu, Beverley Vollenhoven
BACKGROUND: Uterine fibroids occur in up to 40% of women aged over 35 years. Some are asymptomatic, but up to 50% cause symptoms that warrant therapy. Symptoms include anaemia caused by heavy menstrual bleeding, pelvic pain, dysmenorrhoea, infertility and low quality of life. Surgery is the first choice of treatment. In recent years, medical therapies have been used before surgery to improve intraoperative and postoperative outcomes. However, such therapies tend to be expensive.Fibroid growth is stimulated by oestrogen...
November 15, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/29138533/comparison-of-visual-outcomes-after-bilateral-implantation-of-a-diffractive-trifocal-intraocular-lens-and-blended-implantation-of-an-extended-depth-of-focus-intraocular-lens-with-a-diffractive-bifocal-intraocular-lens
#14
André Lins de Medeiros, André Gustavo de Araújo Rolim, Antonio Francisco Pimenta Motta, Bruna Vieira Ventura, César Vilar, Mário Augusto Pereira Dias Chaves, Pedro Carlos Carricondo, Wilson Takashi Hida
Purpose: The purpose of this study was to compare the visual outcomes and subjective visual quality between bilateral implantation of a diffractive trifocal intraocular lens, Alcon Acrysof IQ(®) PanOptix(®) TNFT00 (group A), and blended implantation of an extended depth of focus lens, J&J Tecnis Symfony(®) ZXR00 with a diffractive bifocal intraocular lens, J&J Vision Tecnis(®) ZMB00 (group B). Methods: This prospective, nonrandomized, consecutive, comparative study included the assessment of 40 eyes in 20 patients implanted with multifocal intraocular lens...
2017: Clinical Ophthalmology
https://www.readbyqxmd.com/read/29138078/is-there-an-indication-of-intraoperative-mri-in-subtotal-resection-of-glioblastoma-a-multicenter-retrospective-comparative-analysis
#15
Jan Coburger, Javier Segovia von Riehm, Oliver Ganslandt, Christian Rainer Wirtz, Mirjam Renovanz
INTRODUCTION: Surgery in patients with highly eloquent glioblastoma (GB) remains challenging. OBJECTIVE: To evaluate influence of use of iMRI on extent of resection (EoR), clinical outcome and survival in GB-patients with preoperatively intended subtotal resection (STR). METHODS: We performed a retrospective assessment in 3 neurosurgical centers(2008-2013). All patients with primary GB, unilocular growth, and adjuvant radiochemotherapy in whom a STR was intended were included...
November 11, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/29137921/intraoperative-definition-of-bottom-of-sulcus-dysplasia-using-intraoperative-ultrasound-and-single-depth-electrode-recording-a-technical-note
#16
Dorothea Miller, Patrick Carney, John S Archer, Gregory J Fitt, Graeme D Jackson, Kristian J Bulluss
Bottom of sulcus dysplasias (BOSDs) are localized focal cortical dysplasias (FCDs) centred on the bottom of a sulcus that can be highly epileptogenic, but difficult to delineate intraoperatively. We report on a patient with refractory epilepsy due to a BOSD, successfully resected with the aid of a multimodal surgical approach using neuronavigation based on MRI and PET, intraoperative ultrasound (iUS) and electrocorticography (ECoG) using depth electrodes. The lesion could be visualized on iUS showing an increase in echogenicity at the grey-white matter junction...
November 11, 2017: Journal of Clinical Neuroscience: Official Journal of the Neurosurgical Society of Australasia
https://www.readbyqxmd.com/read/29137681/influence-of-tourniquet-use-in-primary-total-knee-arthroplasty-with-drainage-a-prospective-randomised-controlled-trial
#17
Kai Zhou, Tingxian Ling, Haoyang Wang, Zongke Zhou, Bin Shen, Jing Yang, Pengde Kang, Fuxing Pei
BACKGROUND: We aimed to compare the effect of tourniquet use or lack of it on recovery following uncomplicated primary total knee arthroplasty (TKA). METHODS: In a prospective randomised double-blinded study, 150 patients undergoing primary TKA were assigned to either a tourniquet or non-tourniquet group. At the early phase, 3 and 6 months after surgery, an independent observer assessed the primary outcome measure (i.e. total blood loss) and secondary outcome measures (i...
November 14, 2017: Journal of Orthopaedic Surgery and Research
https://www.readbyqxmd.com/read/29137093/an-incidental-encounter-of-a-rare-high-take-off-right-coronary-artery-a-case-report
#18
Xicheng Deng, Peng Huang, Wenjuan Chen, Xiaohui Yang, Qianjun Liu, Yunbin Xiao, Cheng He
RATIONALE: High take-off of the coronary arteries is a rare cardiac anatomic anomaly, which may occur independently or with other congenital heart defects. In the clinical setting, it is noteworthy as a cause of sudden cardiac death. Further, it is vital to identify such anomalies to avoid intraoperative catastrophes in surgeries for congenital heart defects. PATIENT CONCERNS: A II/6 systolic heart murmur on physical examination was incidentally found in a 9-year-old boy; he was confirmed to have a secundum-type atrial septal defect on echocardiography...
November 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29136624/value-of-intraoperative-cytological-and-pathological-sentinel-lymph-node-diagnosis-in-fertility-sparing-trachelectomy-for-early-stage-cervical-cancer
#19
Kenzo Sonoda, Hideaki Yahata, Kaoru Okugawa, Eisuke Kaneki, Tatsuhiro Ohgami, Masafumi Yasunaga, Shingo Baba, Yoshinao Oda, Hiroshi Honda, Kiyoko Kato
BACKGROUND AND OBJECTIVES: Trachelectomy, a fertility-sparing surgery for early-stage cervical cancer, can be performed only when there is no extrauterine extension present. Therefore, identifying the sentinel lymph nodes (SLNs) and using them to obtain an intraoperative pathologic diagnosis can provide information on the feasibility and safety of trachelectomy. Our aim was to assess the value of an intraoperative SLN diagnosis. METHODS: We retrospectively analyzed the accuracy of intraoperative imprint cytology and frozen-section examination in 201 patients at our institution in whom trachelectomy was planned...
November 15, 2017: Oncology
https://www.readbyqxmd.com/read/29136212/neoadjuvant-and-adjuvant-therapy-for-stage-iii-non-small-cell-lung-cancer
#20
Shun-Ichi Watanabe, Kazuo Nakagawa, Kenji Suzuki, Kazuya Takamochi, Hiroyuki Ito, Jiro Okami, Keiju Aokage, Hisashi Saji, Hiroshige Yoshioka, Yoshitaka Zenke, Tadashi Aoki, Yasuhiro Tsutani, Morihito Okada
The treatments for advanced non-small cell lung cancer (NSCLC) should control both local and microscopic systemic disease, because the 5-year survival of patients with Stage III NSCLC who underwent surgical resection alone has been dismal. One way to improve surgical outcome is the administration of chemotherapy before or after the surgical procedure. During the last two decades, many clinical studies have focused on developing optimal adjuvant or neoadjuvant chemotherapy regimens that can be combined with surgical treatment and/or radiotherapy...
November 9, 2017: Japanese Journal of Clinical Oncology
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