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Intraoperative assessment

Michael Z L Zhu, Andrew Martin, Andrew D Cochrane, Julian A Smith, Amanda G Thrift, Gerard K Harrop, Jennifer P Ngo, Roger G Evans
Background: Acute kidney injury (AKI) is common after cardiac surgery and profoundly affects postoperative mortality and morbidity. There are no validated methods to assess risk of AKI intraoperatively. Methods: We determined the association between postoperative AKI and intraoperative urinary oxygen tension (PO2), measured via a fiber optic probe in the tip of the urinary catheter, in 65 patients undergoing high-risk cardiac surgery requiring cardiopulmonary bypass (CPB)...
March 14, 2018: Nephrology, Dialysis, Transplantation
Junichi Tokuda, Laurent Chauvin, Brian Ninni, Takahisa Kato, Franklin King, Kemal Tuncali, Nobuhiko Hata
Patient-mounted needle guide devices for
 percutaneous ablations are vulnerable to patient motion. The objective of this study is to develop and evaluate a software system for MRI-compatible patient-mounted needle guide device that can adaptively compensate for the displacement of the device due to the patient motion using a novel image-based automatic device-to-image registration.
 Materials and Methods. We developed a software system for an MRI-compatible patient-mounted needle guide device for percutaneous ablations...
March 16, 2018: Physics in Medicine and Biology
Toru Imai, Junhui Shi, Terence T W Wong, Lei Li, Liren Zhu, Lihong V Wang
Ultraviolet photoacoustic microscopy (UV-PAM) is a promising intraoperative tool for surgical margin assessment (SMA), one that can provide label-free histology-like images with high resolution. In this study, using a microlens array and a one-dimensional (1-D) array ultrasonic transducer, we developed a high-throughput multifocal UV-PAM (MF-UV-PAM). Our new system achieved a 1.6  ±  0.2  μm lateral resolution and produced images 40 times faster than the previously developed point-by-point scanning UV-PAM...
March 2018: Journal of Biomedical Optics
Jamil Manji, Al-Rahim R Habib, Ameen A Amanian, Saad Alsaleh, Andrew Thamboo, Amin R Javer
PURPOSE: Synechiae formation in the middle meatus is the most common complication of functional endoscopic sinus surgery (FESS). Our objectives were to determine the incidence of synechiae occurring in a cohort of patients that have undergone FESS and identify characteristics associated with the development of synechiae postoperatively. METHODS: A retrospective chart review was conducted of CRS patients, with or without nasal polyposis, that had undergone bilateral FESS in the past...
March 15, 2018: European Archives of Oto-rhino-laryngology
Xiaopeng Yang, Jae Do Yang, Hee Chul Yu, Younggeun Choi, Kwangho Yang, Tae Beom Lee, Hong Pil Hwang, Sungwoo Ahn, Heecheon You
BACKGROUND AND OBJECTIVE: Manual tracing of the right and left liver lobes from computed tomography (CT) images for graft volumetry in preoperative surgery planning of living donor liver transplantation (LDLT) is common at most medical centers. This study aims to develop an automatic system with advanced image processing algorithms and user-friendly interfaces for liver graft volumetry and evaluate its accuracy and efficiency in comparison with a manual tracing method. METHODS: The proposed system provides a sequential procedure consisting of (1) liver segmentation, (2) blood vessel segmentation, and (3) virtual liver resection for liver graft volumetry...
May 2018: Computer Methods and Programs in Biomedicine
Rafael Arboleda Salazar, Jane Heggie, Piotr Wolski, Eric Horlick, Mark Osten, Massimiliano Meineri
BACKGROUND: Twenty percent of patients born with congenital heart disease present with right ventricular outflow tract abnormalities. These patients require multiple surgical procedures in their lifetime. Transcatheter pulmonary valve replacement (TPVR) has become a viable alternative to conventional pulmonary valve and right ventricular outflow tract surgery in pediatric and adult populations. In this retrospective review, we analyze the perioperative management of adult patients who underwent TPVR in our center...
March 14, 2018: Anesthesia and Analgesia
V S Klimov, V V Kel'makov, N V Chishchina, A V Evsyukov
AIM: The study aim was to evaluate the effectiveness of intraoperative monitoring of motor evoked potentials (MEPs) for predicting changes in the neurological status of patients with cervical spinal cord tumors in the early postoperative period. MATERIAL AND METHODS: The study included 74 patients with intradural cervical spinal cord tumors who were operated on using motor evoked potential monitoring in the period from 2013 to 2016. There were 29 (39%) males and 46 (61%) females...
2018: Zhurnal Voprosy Neĭrokhirurgii Imeni N. N. Burdenko
E N Eskina, K K Davtyan
Presently ReLEx Smile as a method of vision correction in refractive surgery is becoming increasingly popular in Russia and abroad. PURPOSE: to develop an algorithm for planning the surgery and choosing its parameters, and to assess the efficacy, safety and predictability of the results in the 6-month follow-up period. MATERIAL AND METHODS: The study involved 80 patients (159 eyes) with myopia of various degrees with a mean age of 33±6 years (25 to 44 years old)...
2018: Vestnik Oftalmologii
Tadayuki Yoshitake, Michael G Giacomelli, Liza M Quintana, Hilde Vardeh, Lucas C Cahill, Beverly E Faulkner-Jones, James L Connolly, Daihung Do, James G Fujimoto
Rapid histopathological evaluation of fresh, unfixed human tissue using optical sectioning microscopy would have applications to intraoperative surgical margin assessment. Microscopy with ultraviolet surface excitation (MUSE) is a low-cost optical sectioning technique using ultraviolet illumination which limits fluorescence excitation to the specimen surface. In this paper, we characterize MUSE using high incident angle, water immersion illumination to improve sectioning. Propidium iodide is used as a nuclear stain and eosin yellow as a counterstain...
March 14, 2018: Scientific Reports
Yuji Otsuki, Hirofumi Konn, Keisa Takeda, Masahiko Koike
Obturator hernia (OH) is a rare condition that accounts for 0.073-1% of abdominal hernias and 0.48% of bowel obstructions. OH frequently occurs in elderly women, with an incidence that increases with age. The only treatment for OH is surgical intervention, and the approaches used vary greatly. Consequently, a well-defined consensus has not yet emerged. We assessed the efficiency and safety of the midline extraperitoneal approach for OH. Six patients with OH repaired using the midline extraperitoneal approach at KKR Sapporo Medical Center between April 2011 and January 2016 were included in the study...
March 14, 2018: Keio Journal of Medicine
Mohamed Omar, Maximilian Petri, Nael Hawi, Christian Krettek, Jörg Eberhard, Emmanouil Liodakis
PURPOSE: The aim of this study was to assess the diagnostic accuracy of swab polymerase chain reaction (PCR) compared with tissue culture as the current gold standard. METHODS: Forty-one consecutive patients were prospectively enrolled undergoing revision arthroplasty due to septic and aseptic reasons. Infection classification was done according to the criteria of the Musculoskeletal Infection Society. Intraoperatively, tissue samples of the periprosthetic membrane were collected for culture analysis, and swabs were taken from the accessible implant surface to perform 16S ribosomal RNA PCR...
January 2018: Journal of Orthopaedic Surgery
Adisa Kursumovic, Jenny C Kienzler, Gerrit J Bouma, Richard Bostelmann, Michael Heggeness, Claudius Thome, Larry E Miller, Martin Barth
STUDY DESIGN: Post hoc analysis of a randomized controlled trial. OBJECTIVE: To characterize the morphology and clinical relevance of vertebral endplate changes (VEPC) following limited lumbar discectomy with or without implantation of a bone-anchored annular closure device (ACD). SUMMARY OF BACKGROUND DATA: Implantation of an ACD following limited lumbar discectomy has shown promise in reducing the risk of recurrent herniation in patients with large annular defects...
March 13, 2018: Spine
Gaëtan-Romain Joliat, Ismail Labgaa, Emilie Uldry, Nicolas Demartines, Nermin Halkic
OBJECTIVE: Hepatocellular carcinomas (HCC) can infrequently rupture and cause hemorrhage. Little is known on recurrence rate (RR) and overall survival (OS) in case of ruptured HCC. This study aimed to assess RR, time to recurrence, and OS of operated ruptured HCC. PATIENTS AND METHODS: All operated patients with HCC (1999-2015) were reviewed. Patient demographics, perioperative details, and postoperative outcomes of ruptured HCC were recorded. RR, time to recurrence, and OS were calculated...
March 13, 2018: European Journal of Gastroenterology & Hepatology
Yana Mikhaylov, Brielle Weinstein, Travis P Schrank, Jennifer D Swartz, Jason P Ulm, Milton B Armstrong, Kevin O Delaney
BACKGROUND: Ketorolac tromethamine (Toradol) is an effective a nonsteroidal anti-inflammatory drug and a powerful analgesic for patients undergoing breast surgery. However, the potential for postoperative bleeding has not yet been explored specifically in women undergoing implant-based breast reconstruction. There is concern that an increased risk of bleeding exists in this population due to the lack of tissue apposition as a result of implant placement. We therefore seek to assess the associated risk of bleeding complication in implant-based breast reconstruction at our academic institution...
March 13, 2018: Annals of Plastic Surgery
Jia-Ping Pan, Xu-Can Wang, Ming-Hong Huang
OBJECTIVE: To investigate the characteristics and clinical treatment of avulsion fracture of the lateral edge of tibial plateau(segond fracture) in knee joint injuries. METHODS: From January 2011 and December 2015, 29 patients with Segond fracture were treated with minimally invasive arthroscopy technology in intra-articular injuries combined with double anchor nail fixation in avulsion fracture of the lateral edge of tibial plateau, including 17 males and 12 females with an average age of 41 years old ranging from 27 to 62 years old...
February 25, 2018: Zhongguo Gu Shang, China Journal of Orthopaedics and Traumatology
Atsushi Oba, Yoshihiro Mise, Hiromichi Ito, Makiko Hiratsuka, Yosuke Inoue, Takeaki Ishizawa, Junichi Arita, Kiyoshi Matsueda, Yu Takahashi, Akio Saiura
BACKGROUND: Clinical implication of disappearing liver metastases (DLMs) from colorectal cancer after chemotherapy needs to be reviewed in the era of modern imaging studies. METHODS: Between 2010 and 2015, 184 patients underwent curative hepatectomy for colorectal liver metastases following preoperative chemotherapy. The sites of metastases detected on pre-chemotherapy CE-CT were examined post-chemotherapy using CE-CT, gadolinium ethoxybenzyl diethylenetriamine pentaacetic acid-enhanced magnetic resonance imaging (EOB-MRI), and contrast-enhanced intraoperative ultrasonography (CE-IOUS)...
March 10, 2018: HPB: the Official Journal of the International Hepato Pancreato Biliary Association
You-Zhi Cai, Chi Zhang, Ri-Long Jin, Tong Shen, Peng-Cheng Gu, Xiang-Jin Lin, Jian-De Chen
BACKGROUND: Due to the highly organized tissue and avascular nature of the rotator cuff, rotator cuff tears have limited ability to heal after the tendon is reinserted directly on the greater tubercle of the humerus. Consequently, retears are among the most common complications after rotator cuff repair. Augmentation of rotator cuff repairs with patches has been an active area of research in recent years to reduce retear rate. HYPOTHESIS: Graft augmentation with 3D collagen could prevent retears of the repaired tendon and improve tendon-bone healing in moderate to large rotator cuff tears...
March 1, 2018: American Journal of Sports Medicine
Roshan P Shah, Leanna MacLean, Wayne G Paprosky, Scott Sporer
BACKGROUND: Radiostereometric analysis (RSA) accurately assesses arthroplasty implant performance and is routinely used for research purposes. Because of its efficacy in detecting implant failure in research subjects, we deployed the use of RSA beads for routine surveillance in all elective total hip and total knee arthroplasty patients. METHODS: We retrospectively compared 143 patients who received RSA beads intraoperatively with 343 patients who did not receive RSA beads...
March 12, 2018: Journal of the American Academy of Orthopaedic Surgeons
Christopher P Childers, Amy Showen, Teryl Nuckols, Melinda Maggard-Gibbons
OBJECTIVE: The aim of this study was to systematically review the risks and benefits of interventions designed to reduce intraoperative costs. SUMMARY BACKGROUND DATA: Episode-based payments shift financial risk from insurers onto hospitals and providers. The operating room (OR) is a resource dense environment and there is growing interest in identifying ways to reduce intraoperative costs while maintaining patient safety. METHODS: We searched PubMed, Cochrane, and CINAHL for articles published between 2001 and March 2017 that assessed interventions designed to reduce intraoperative costs...
March 12, 2018: Annals of Surgery
Kai Huang, Bu-Qing Chang, Chao-Jiang Yu, Xiao Gao, Yun-Chang Jiang, Hu Feng
OBJECTIVE: To investigate the clinical outcomes of anterior corpectomy combined with anterior intervertebral decompression and fusion for multilevel cervical spondylotic myelopathy. METHODS: The clinical data of 28 patients with multilevel cervical spondylotic myelopathy who underwent surgery from October 2012 to June 2014 were retrospectively analyzed. There were 18 males and 10 females, aged from 45 to 77 years old with an average of (60.11±9.37) years. Three levels were involved in 27 cases, while four levels were involved in 1 case...
January 25, 2018: Zhongguo Gu Shang, China Journal of Orthopaedics and Traumatology
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