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Intraoperative death

Miguel A Carbajo, Enrique Luque-de-León, José M Jiménez, Javier Ortiz-de-Solórzano, Manuel Pérez-Miranda, María J Castro-Alija
BACKGROUND: Excellent results have been reported with mini-gastric bypass. We adopted and modified the one-anastomosis gastric bypass (OAGB) concept. Herein is our approach, results, and long-term follow-up (FU). METHODS: Initial 1200 patients submitted to laparoscopic OAGB between 2002 and 2008 were analyzed after a 6-12-year FU. Mean age was 43 years (12-74) and body mass index (BMI) 46 kg/m(2) (33-86). There were 697 (58 %) without previous or simultaneous abdominal operations, 273 (23 %) with previous, 203 (17 %) with simultaneous, and 27 (2 %) performed as revisions...
October 25, 2016: Obesity Surgery
Fujian Ji, Xuedong Fang, Junnan Jiang, Yuanyu Wu, Ye Feng, Huiling Guo
OBJECTIVE: To evaluate the value of en-bloc mesogastric excision (EME) in the treatment of advanced gastric cancer. METHODS: A retrospective analysis on clinical data of 98 gastric cancer patients who underwent total gastrectomy in China-Japan Union Hospital of Jilin University from January 2013 to December 2015 was carried out, including EME group of 48 cases (according to the mesangial space) and D2 radical group of 50 cases(D2 lymphadenectomy according to the vascular markers)...
October 25, 2016: Zhonghua Wei Chang Wai Ke za Zhi, Chinese Journal of Gastrointestinal Surgery
Chulananda Goonasekera, Kamal Ali, Ann Hickey, Lekshmi Sasidharan, Malcolm Mathew, Mark Davenport, Anne Greenough
BACKGROUND: Mortality following surgical repair of congenital diaphragmatic hernia (CDH) remains high. The volume and type of perioperative intravenous fluid administered, baro-trauma, oxygen toxicity, and the duration of anesthesia are thought to affect outcome in surgical populations. AIMS: The aim of this retrospective observational study was to determine whether the perioperative volume or type of fluids and/or the duration of anesthesia were associated with postoperative mortality and if mortality was predicted by the oxygenation index (OI) prior to or following CDH surgical repair...
October 25, 2016: Paediatric Anaesthesia
Ethan A Winkler, Harjus Birk, Michael Safaee, John K Yue, John F Burke, Jennifer A Viner, Melike Pekmezci, Arie Perry, Manish K Aghi, Mitchel S Berger, Michael W McDermott
Ependymomas are rare neuroepithelial tumors which may arise anywhere along the ventricular system. Tumors arising in the fourth ventricle present unique challenges. Complete tumor resection favors prolonged survival, but may result in inadvertent injury of surrounding neural structures-such as cranial nerve (CN) nuclei. Here, our institutional experience with surgical resection of fourth ventricular ependymomas is described. A single institution, retrospective analysis of consecutive case series of adult surgically resected fourth ventricular ependymomas with the bilateral telovelar approach...
October 24, 2016: Journal of Neuro-oncology
Pavel S Roshanov, Bram Rochwerg, Ameen Patel, Omid Salehian, Emmanuelle Duceppe, Emilie P Belley-Côté, Gordon H Guyatt, Daniel I Sessler, Yannick Le Manach, Flavia K Borges, Vikas Tandon, Andrew Worster, Alexandra Thompson, Mithin Koshy, Breagh Devereaux, Frederick A Spencer, Robert D Sanders, Erin N Sloan, Erin E Morley, James Paul, Karen E Raymer, Zubin Punthakee, P J Devereaux
BACKGROUND: The effect on cardiovascular outcomes of withholding angiotensin-converting enzyme inhibitors or angiotensin II receptor blockers in chronic users before noncardiac surgery is unknown. METHODS: In this international prospective cohort study, the authors analyzed data from 14,687 patients (including 4,802 angiotensin-converting enzyme inhibitor/angiotensin II receptor blocker users) at least 45 yr old who had in-patient noncardiac surgery from 2007 to 2011...
October 24, 2016: Anesthesiology
Saleem I Abdulrauf, Peter Vuong, Ritesh Patel, Raghu Sampath, Ahmed M Ashour, Lauren M Germany, Jonathon Lebovitz, Colt Brunson, Yuvraj Nijjar, J Kyle Dryden, Maheen Q Khan, Mihaela G Stefan, Evan Wiley, Ryan T Cleary, Connor Reis, Jodi Walsh, Paula Buchanan
OBJECTIVE Risk of ischemia during aneurysm surgery is significantly related to temporary clipping time and final clipping that might incorporate a perforator. In this study, the authors attempted to assess the potential added benefit to patient outcomes of "awake" neurological testing when compared with standard neurophysiological testing performed under general anesthesia. The procedure is performed after the induction of conscious sedation, and for the neurological testing, the patient is fully awake. METHODS The authors conducted an institutional review board-approved prospective study of clipping unruptured intracranial aneurysms (UIAs) in 30 consecutive adult patients who underwent awake clipping...
October 21, 2016: Journal of Neurosurgery
Paul Vespa, Daniel Hanley, Joshua Betz, Alan Hoffer, Johnathan Engh, Robert Carter, Peter Nakaji, Chris Ogilvy, Jack Jallo, Warren Selman, Amanda Bistran-Hall, Karen Lane, Nichol McBee, Jeffery Saver, Richard E Thompson, Neil Martin
BACKGROUND AND PURPOSE: Intracerebral hemorrhage (ICH) is a devastating disease without a proven therapy to improve long-term outcome. Considerable controversy about the role of surgery remains. Minimally invasive endoscopic surgery for ICH offers the potential of improved neurological outcome. METHODS: We tested the hypothesis that intraoperative computerized tomographic image-guided endoscopic surgery is safe and effectively removes the majority of the hematoma rapidly...
October 6, 2016: Stroke; a Journal of Cerebral Circulation
Jae Hwan Oh, Sung Chan Park, Min Jung Kim, Byung Kwan Park, Jong Hee Hyun, Hee Jin Chang, Kyung Su Han, Dae Kyung Sohn
PURPOSE: To evaluate the feasibility of transanal total mesorectal excision (TME) in patients with rectal cancer. METHODS: This study enrolled 12 patients with clinically node negative rectal cancer located 4-12 cm from the anal verge who underwent transanal endoscopic TME with the assistance of single port laparoscopic surgery between September 2013 and August 2014. The primary endpoint was TME quality; secondary endpoints included number of harvested lymph nodes and postoperative complications within 30 days (NCT01938027)...
October 2016: Annals of Surgical Treatment and Research
Youlong Wang, Wenbin Ji, Xi Zhang, Jingwang Tan
BACKGROUND: Liver resection or enucleation has been the basic treatment for liver hemangioma. However, there were few reports about laparoscopic surgery (LS) of hemangioma. The intention of this study is to explore the indication and efficacy of LS for laparoscopic hepatectomy (LH) and develop an opinion of these modern developments. PATIENTS AND METHODS: Forty-four patients with LH underwent LS, with hemihepatic vascular occlusion (HVO group n = 24) or modified vascular occlusion (MVO group n = 20), and were retrospectively reviewed, including patients' demography, surgical technique, tumor size and location, blood loss, operation time, complications, modes of hepatic vascular occlusion and changes in postoperative liver function, and the difference in patients demography and operative outcome between HVO and MVO groups were compared as well...
October 18, 2016: Journal of Laparoendoscopic & Advanced Surgical Techniques. Part A
Dmitri Bezinover, Shigekazu Sugino, Yuka Imamura-Kawasawa, Matthew S Bell, Zakiyah Kadry, Piotr K Janicki
We describe a case of fulminant intraoperative thrombosis during deceased donor liver transplantation. Despite significant medical bleeding, the patient suddenly developed diffuse thrombosis in all chambers of the heart and pulmonary vasculature resulting in intraoperative death. The patient's postmortem genetic analysis demonstrated a deleterious missense mutation in a coagulation pathway gene, SERPINC1, which codes for antithrombin III. The level of antithrombin III was not available to directly prove the causality of thrombosis, but our findings suggest that this mutation, in combination with antifibrinolytic administration in a hypercoagulable cirrhotic patient, might have contributed to the development of this catastrophic thrombotic event...
October 5, 2016: A & A Case Reports
Martijn L Dijkstra, Peter C J M Goverde, Andrew Holden, Clark J Zeebregts, Michel M P J Reijnen
PURPOSE: To show feasibility of the covered endovascular repair of the aortic bifurcation (CERAB) technique in conjunction with chimney grafts in aortic side branches for complex aortoiliac occlusive disease. METHODS: Two European centers and one facility located in New Zealand participated in a retrospective observational study that enrolled 14 consecutive patients (mean age 61.2±8.9 years; 11 men) treated with CERAB in conjunction with chimney graft(s) between December 2012 and May 2015...
October 14, 2016: Journal of Endovascular Therapy
A Molina Raya, A García Navarro, C San Miguel Méndez, M Domínguez Bastante, M T Villegas Herrera, K Granero, A Becerra Massare, J M Villar Del Moral, M Expósito, Y Fundora Suárez
OBJECTIVE: The aim of this work was to determine the impact of obesity on the morbidity and mortality of liver transplantation (LT) recipients. METHODS: A single-center, observational-cohort, retrospective study was conducted in patients undergoing LT from January 2008 to December 2014 to compare complications and survival between those with body mass index (BMI) <35 kg/m(2) and those with BMI ≥35 kg/m(2). RESULTS: The study included 170 patients: 162 (95...
September 2016: Transplantation Proceedings
Paulo Gabriel Melo Brandão, Francisco Ricardo Lobo, Serginando Laudenir Ramin, Yasser Sakr, Mauricio Nassau Machado, Suzana Margareth Lobo
Objective: α-2-agonists cause sympathetic inhibition combined with parasympathetic activation and have other properties that could be beneficial during cardiac anesthesia. We evaluated the effects of dexmedetomidine as an anesthetic adjuvant compared to a control group during cardiac surgery. Methods: We performed a retrospective analysis of prospectively collected data from all adult patients (> 18 years old) undergoing cardiac surgery. Patients were divided into two groups, regarding the use of dexmedetomidine as an adjuvant intraoperatively (DEX group) and a control group who did not receive α-2-agonist (CON group)...
May 2016: Brazilian Journal of Cardiovascular Surgery
Yu I Patyutko, N E Kudashkin, A G Kotel'nikov, O V Chistyakova
AIM: to determine the indications and to evaluate early and long-term outcomes of total pancreatectomy for pancreatic cancer. MATERIAL AND METHODS: Treatment of 29 patients who underwent one- and two-stage pancreatectomy for different malignancies was analyzed. RESULTS: Median of surgery duration and intraoperative blood loss was 280 min and 2200 ml respectively. Postoperative complications were observed in 9 (31%) patients. There were 2 (6...
2016: Khirurgiia
Tao Wang, Yang Liu
OBJECTIVE: To retrospectively analyze the results of surgical resection in patients with pulmonary hamartoma (PH) in the Peoples Liberation Army (PLA) General Hospital during the past 30 years. MATERIALS AND METHODS: We retrospectively enrolled 226 patients with PH who underwent surgical resection in the PLA General Hospital between January 1980 and January 2010, including tumors of pulmonary parenchyma (n = 216) and endobronchial tumors (n = 10). The type of operation include tumor enucleation (n = 103), wedge resection (n = 103), and lobectomy (n = 20)...
October 2016: Journal of Cancer Research and Therapeutics
Carlos M Mery, R Michael Nieto, Luis E De León, Shaine A Morris, Wei Zhang, John L Colquitt, Iki Adachi, Lauren C Kane, Jeffrey S Heinle, E Dean McKenzie, Charles D Fraser
BACKGROUND: Predictors for single ventricle palliation (SVP) or successful biventricular repair (BVR) in patients with borderline left-side heart structures are not well defined. The goal was to evaluate the role of echocardiography and intracardiac exploration in determining feasibility of BVR. METHODS: All neonates surgically treated from 1995 to 2015 with mitral valve (MV), aortic valve, or left ventricle end-diastolic dimension z score of -2 or less for whom management was controversial were included...
October 4, 2016: Annals of Thoracic Surgery
Jiaquan Zhu, James Meza, Atsuko Kato, Arezou Saedi, Devin Chetan, Rachel Parker, Christopher A Caldarone, Brian W McCrindle, Glen S Van Arsdell, Osami Honjo
BACKGROUND: We hypothesized that mean pulmonary artery pressure (PAP) detected on a pulmonary flow study may predict medium-term survival and right ventricular systolic pressure (RVSP) in patients with pulmonary atresia (PA), ventricular septal defect (VSD), and major aortopulmonary collateral arteries (MAPCAs). METHODS: Fifty patients with PA/VSD/MAPCAs underwent unifocalization between 2000 and 2013, and 40 of these patients had a pulmonary flow study since 2003...
August 31, 2016: Journal of Thoracic and Cardiovascular Surgery
Li Lian Foo, Sook Hui Chaw, Lucy Chan, Dharmendra Ganesan, Ravindran Karuppiah
Tension pneumocephalus is rare but has been well documented following trauma and neurosurgical procedures. It is a surgical emergency as it can lead to neurological deterioration, brainstem herniation and death. Unlike previous cases where tension pneumocephalus developed postoperatively, we describe a case of intraoperative tension pneumocephalus leading to sudden, massive open brain herniation out of the craniotomy site. The possible causative factors are outlined. It is imperative to rapidly identify possible causes of acute intraoperative brain herniation, including tension pneumocephalus, and institute appropriate measures to minimize neurological damage...
September 27, 2016: Revista Brasileira de Anestesiologia
Jayant S Vaidya, Frederik Wenz, Max Bulsara, Jeffrey S Tobias, David J Joseph, Christobel Saunders, Chris Brew-Graves, Ingrid Potyka, Stephen Morris, Hrisheekesh J Vaidya, Norman R Williams, Michael Baum
BACKGROUND: Based on our laboratory work and clinical trials we hypothesised that radiotherapy after lumpectomy for breast cancer could be restricted to the tumour bed. In collaboration with the industry we developed a new radiotherapy device and a new surgical operation for delivering single-dose radiation to the tumour bed - the tissues at highest risk of local recurrence. We named it TARGeted Intraoperative radioTherapy (TARGIT). From 1998 we confirmed its feasibility and safety in pilot studies...
September 2016: Health Technology Assessment: HTA
Felix J Hüttner, Rosa Klotz, Alexis Ulrich, Markus W Büchler, Markus K Diener
BACKGROUND: Pancreatic cancer remains one of the five leading causes of cancer deaths in industrialized nations. For adenocarcinomas in the head of the gland and premalignant lesions, partial pancreaticoduodenectomy represents the standard treatment for resectable tumours. The gastro- or duodenojejunostomy after partial pancreaticoduodenectomy can be reestablished via either an antecolic or a retrocolic route. The debate about the more favourable technique for bowel reconstruction is ongoing...
September 30, 2016: Cochrane Database of Systematic Reviews
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