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postoperative fatigue

Gerald Paul Fitzgerald, John Joseph Coughlan, Zahir Satti, Samer Arnous
A 23-year-old Asian student presented to our service with a 1-month history of fever, weight loss of 10 kg, night sweats, fatigue and general malaise. He was previously well with no significant medical or family history. He had a low-grade pyrexia and cardiac auscultation revealed a diastolic murmur consistent with 'tumour plop'. He had no sequelae of endocarditis. He had low-grade pyrexia of 37.7°C, and ECG showed sinus tachycardia at 130 bpm. He had raised inflammatory markers and was started on broad spectrum antibiotics...
March 9, 2018: BMJ Case Reports
Zhuming Yin, Liqiang Liu, Bingjian Xue, Jincai Fan, Wenlin Chen, Zheng Liu
INTRODUCTION: Prosthesis-assisted penile reconstruction has been performed extensively to restore a cosmetically acceptable phallus. However, a large number of patients will undergo revision surgery for various prosthesis-related complications. AIM: To develop a 1-stage prosthesis-free dynamic cavernosa reconstruction method using bilateral innervated gracilis muscles and to investigate the feasibility and reliability of the surgical design. METHODS: 10 fresh cadavers were dissected to assess the availability of bilateral gracilis muscles for functional cavernosa rebuilding...
March 7, 2018: Sexual Medicine
Stepan Fedorko, Klaus Zweckberger, Andreas W Unterberg
OBJECTIVE Pineal region tumors are a rare and heterogeneous group of lesions. The optimal therapeutic approach is currently a topic of controversy, particularly in light of the potential operative risks and complications. The potential beneficial effects of surgery have already been described, but information about neurological outcome and, in particular, health-related quality of life (HRQOL) is still lacking in the literature. The aim of this study was to assess the therapeutic effect of resection of pineal region lesions, emphasizing grade of tumor resection, neurological outcome, quality of life, and the necessity of additional shunt procedures...
March 2, 2018: Journal of Neurosurgery
Shuntaro Yoshimura, Kazuhiko Mori, Yukinori Yamagata, Susumu Aikou, Koichi Yagi, Masato Nishida, Hiroharu Yamashita, Sachiyo Nomura, Yasuyuki Seto
BACKGROUND: The aim of this retrospective study was to assess postoperative quality of life (QOL) after robot-assisted radical transmediastinal esophagectomy, defined as a nontransthoracic esophagectomy with radical mediastinal lymphadenectomy combining a robotic transhiatal approach and a video-assisted cervical approach. The results were compared to those of transthoracic esophagectomy. METHODS: In this study, all consecutive patients who underwent robot-assisted radical transmediastinal esophagectomy or transthoracic esophagectomy for esophageal cancer at University of Tokyo between January 2010 and December 2014 were included...
March 1, 2018: Surgical Endoscopy
Gayathri Naganathan, Nalin Kumar Amin
INTRODUCTION: Raoultella Planticola is a gram negative, aerobic, rod bacteria found in water and soil and is rarely reported to cause infections in humans. This case study is the first of its kind in reporting R. planticola appendicitis. PRESENTATION OF CASE: We report a case of a woman presenting with a two-day history of increased weakness, fatigue and anorexia, localized pain to the right lower quadrant, and elevated white blood cell count. CT results demonstrated acute uncomplicated appendicitis which was managed via laparoscopic appendectomy...
February 9, 2018: International Journal of Surgery Case Reports
Mariela Dore, Paloma Triana Junco, Carlos De La Torre, Alejandra Vilanova-Sánchez, Monserrat Bret, Gaspar Gonzalez, Vanesa Nuñez Cerezo, Javier Jimenez Gomez, Jose Luis Encinas, Francisco Hernandez, Leopoldo Martínez Martínez, Manuel Lopez Santamaria
Introduction  Minimally invasive repair for pectus excavatum (MIRPE) is controversial in extremely severe cases of pectus excavatum (PE) and an open repair is usually favored. Our aim is to describe a case of a patient with an extremely severe PE that underwent a minimally invasive approach. Case report  An 8-year-old girl with severe sternum depression was assessed. She had a history of exercise intolerance, nocturnal dyspnea, fatigue, and shortness of breath. Chest computed tomography showed that sternum depression was posterior to the anterior vertebral column; therefore, Haller and correction index could not be measured...
January 2018: European Journal of Pediatric Surgery Reports
Hye Jin Kim, Gyu-Seog Choi, Jun Seok Park, Soo Yeun Park, Chun Seok Yang, Hee Jae Lee
AIM: Quality of life (QoL) and functional outcomes are at risk of being impaired after rectal surgery, but there has been no thorough QoL assessment according to surgical approach in a large, prospective study. We have investigated the impact of laparoscopic and robotic total mesorectal excision (TME) on quality of life (QoL) and functional outcomes. METHODS: Patients undergoing laparoscopic or robotic TME for rectal cancer between 2009 and 2013 were prospectively included in this questionnaire-based survey of QoL, together withvariations in urinary and sexual function...
February 20, 2018: Colorectal Disease: the Official Journal of the Association of Coloproctology of Great Britain and Ireland
D H M Jacobs, G Speijer, A L Petoukhova, E M A Roeloffzen, M Straver, A Marinelli, U Fisscher, A G Zwanenburg, J Merkus, C A M Marijnen, M E Mast, P C M Koper
BACKGROUND AND PURPOSE: We investigated the acute toxicity of accelerated partial breast irradiation using external beam (EB-APBI) or intraoperative radiotherapy (IORT) techniques in elderly breast cancer patients. MATERIALS AND METHODS: Women ≥ 60 years with unifocal breast tumors of ≤ 30 mm were eligible for this prospective multi-center cohort study. IORT was applied with electrons following lumpectomy (23.3 Gy). EB-APBI was delivered using 3D-CRT or IMRT in 10 daily fractions of 3...
February 19, 2018: Breast Cancer Research and Treatment
Tyler Hall, Natalie Warnes, Kristine Kuchta, Stephanie Novak, Herbert Hedberg, John G Linn, Stephen Haggerty, Woody Denham, Raymond J Joehl, Michael Ujiki
BACKGROUND: The aim of this study is to investigate patient centered quality of life (QOL) outcomes in patients undergoing laparoscopic paraesophageal hernia repair (LPEHR). STUDY DESIGN: We prospectively followed patients who underwent laparoscopic paraesophageal hernia repair between 2009 - 2016. QOL outcomes were measured using Short Form-36 (SF-36), GERD-HRQL, Reflux Symptom Index, and Dysphagia score surveys administered pre-operatively and at 3 weeks, 6 months, 1 year, and 2 years post- operatively...
February 14, 2018: Journal of the American College of Surgeons
Kuai-Le Zhao, Yi Xia, Yun-Hai Li, Yun Chen, Qi Liu, Jun-Hua Zhang, Jia-Ying Deng, Ta-Shan Ai, Han-Ting Zhu, Harun Badakhshi
BACKGROUND: This study was performed to assess the efficacy and feasibility of definitive chemoradiotherapy consisting of weekly doses of combined paclitaxel and carboplatin concurrent with radiation therapy, followed by 2 cycles of consolidation chemotherapy for advanced esophageal carcinoma. METHODS: Eligibility criteria included local, advanced, newly diagnosed and postoperative local regional lymph node metastasis; Eastern Cooperative Oncology Group (ECOG) score ≤ 2; and adequate organ function...
February 12, 2018: International Journal of Clinical Oncology
Takashi Onoe, Asuka Tanaka, Kohei Ishiyama, Kentaro Ide, Hirotaka Tashiro, Hideki Ohdan
BACKGROUND: Portopulmonary hypertension (PPH) is a relatively rare but well-recognized complication of end-stage liver disease. Moderate or severe PPH (mean pulmonary artery pressure [mPAP] ≥ 35 mmHg) is usually a contraindication for liver transplantation due to high operation-related mortality. Here, we report on a patient with moderate PPH whose condition was successfully managed with a phosphodiesterase type 5 (PDE5) inhibitor (tadalafil) and prostaglandin E1, who experienced rapid improvement of PPH after living-donor liver transplantation (LDLT)...
February 7, 2018: Surgical Case Reports
P Studer, T Horn, A Haynes, D Candinas, V M Banz
BACKGROUND: Long-term quality of life (QoL) after liver resection is becoming increasingly important, as improvements in operative methods and perioperative care have decreased morbidity and mortality rates. In this study, postoperative QoL after resection of benign or malignant liver tumours was evaluated. METHODS: In this single-centre study, QoL was evaluated prospectively using the European Organisation for Research and Treatment of Cancer QLQ-C30 and the liver-specific QLQ-LMC21 module before, and 1, 3, 6 and 12 months after open or laparoscopic liver surgery...
February 2018: British Journal of Surgery
Varun R Kshettry, Gurston Nyquist, James J Evans
Surgery for craniopharyngiomas can be challenging due to the involvement of multiple critical neurovascular structures. The expanded endoscopic endonasal approach can provide superior access to suprasellar craniopharyngiomas, particularly with retrochiasmatic extension and significant hypothalamic involvement. We describe the surgical technique used to treat a 30-year-old patient who presented with 4 weeks of worsening vision, fatigue, and memory loss. His vision was counting fingers at 1 feet on the right and 20/800 on the left with a temporal hemianopsia...
February 2018: Journal of Neurological Surgery. Part B, Skull Base
Tatsuya Matsumoto, Masayoshi Nakanishi, Mahito Miyamae, Koji Takao, Tomohiko Fukunaga, Eigo Otsuji
A 63-year-old man with bloody stools, anal incompetence, and feeling of fatigue was diagnosed as having a RAS mutanttype rectal cancer with abscess and rectovesical fistula. Computed tomography revealed that the tumor had invaded the seminal vesicle, prostate, and bladder and formed an abscess. In addition, his general condition was poor. Thus, we evaluated the lesion as unresectable. His nutritional status improved, and the infection was controlled after colostomy. Then, we performed chemotherapy with 5-fluorouracil, Leucovorin, and oxaliplatin(FOLFOX)plus bevacizumab...
November 2017: Gan to Kagaku Ryoho. Cancer & Chemotherapy
Line Toft Tengberg
Critically ill acute high-risk abdominal surgery patients represent a major challenge to health care providers, with the typical patient being elderly and frail, and with severe and multiple comorbidities. The mortality rate in this population is high, and the postoperative course is characterized by complications, prolonged hospitalisation and considerable risk of permanent disability. With an ageing population, the number of elderly patients, as well as challenges concerning treatment will arise, calling for a coordinated effort both nationally and internationally to enhance treatment in this vulnerable patient group...
February 2018: Danish Medical Journal
Satoshi Yoshiji, Kimitaka Shibue, Toshihito Fujii, Takeshi Usui, Keisho Hirota, Daisuke Taura, Mayumi Inoue, Masakatsu Sone, Akihiro Yasoda, Nobuya Inagaki
RATIONALE: Unilateral adrenalectomy as part of surgical resection of renal cell carcinoma (RCC) is not thought to increase the risk of chronic adrenal insufficiency, as the contralateral adrenal gland is assumed to be capable of compensating for the lost function of the resected gland. However, recent studies have indicated that adrenalectomy might cause irreversible impairment of the adrenocortical reserve. We describe a case of chronic primary adrenal insufficiency in a 68-year-old man who previously underwent unilateral adrenonephrectomy, which was complicated by severe postoperative adrenal stress that involved cardiopulmonary disturbance and systemic infection...
December 2017: Medicine (Baltimore)
Hiba Ezzeddine, Ahmad Husari, Hussein Nassar, Mariam Kanso, Ghina El Nounou, Mohamad Khalife, Walid Faraj
BACKGROUND: Liposuction is one of the most commonly performed aesthetic procedures. It is performed worldwide as an outpatient procedure. However, the complications are underestimated and underreported by caregivers. We present a case of delayed diagnosis of bilothorax secondary to liver and gallbladder injury after tumescent liposuction. METHODS: A 26-year-old female patient was transferred to our emergency department from an aesthetic clinic with worsening dyspnea, tachypnea and fatigue...
January 31, 2018: Aesthetic Plastic Surgery
Line Rokkedal Jønsson, Lina Holm Ingelsrud, Line Toft Tengberg, Thomas Bandholm, Nicolai Bang Foss, Morten Tange Kristensen
BACKGROUND: Acute high-risk abdominal (AHA) surgery is associated with high mortality, multiple postoperative complications and prolonged hospital stay. Further development of strategies for enhanced recovery programs following AHA surgery is needed. The aim of this study was to describe physical performance and barriers to independent mobilization among patients who received AHA surgery (postoperative days [POD] 1-7). METHODS: Patients undergoing AHA surgery were consecutively enrolled from a university hospital in Denmark...
February 2018: Canadian Journal of Surgery. Journal Canadien de Chirurgie
Ahmet Kemalettin Koltka, Mehmet İlhan, Achmet Ali, Ali Fuat Kaan Gök, Nükhet Sivrikoz, Teoman Hakan Yanar, Mustafa Kayıhan Günay, Cemalettin Ertekin
BACKGROUND: Fatigue and sleep deprivation can affect rational decision-making and motor skills, which can decrease medical performance and quality of patient care. The aim of the present study was to investigate the association between times of the day when laparoscopic general surgery under general anesthesia was performed and their adverse outcomes. METHODS: All laparoscopic cholecystectomies and appendectomies performed at the emergency surgery department of a tertiary university hospital from 01...
January 2018: Ulusal Travma Ve Acil Cerrahi Dergisi, Turkish Journal of Trauma & Emergency Surgery: TJTES
Adam T Stearns, Lee Malcomson, Grant Punnett, Haytham Abudeeb, Omer Aziz, Chelliah R Selvasekar, Paul E Fulford, Malcolm S Wilson, Andrew G Renehan, Sarah T O'Dwyer
BACKGROUND: Cytoreductive surgery (CRS) and hyperthermic intraperitoneal chemotherapy (HIPEC) are an established treatment for pseudomyxoma peritonei (PMP), but it is a major surgical procedure and may be associated with long-term morbidity. To date, health-related quality-of-life (HRQL) data among survivors are lacking. METHODS: A two-period qualitative study investigated patients undergoing CRS-HIPEC for PMP at a national peritoneal tumor center between 2003 and 2011...
January 8, 2018: Annals of Surgical Oncology
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