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https://www.readbyqxmd.com/read/28193800/cardiovascular-and-ventilatory-consequences-of-laparoscopic-surgery
#1
Tamara M Atkinson, George D Giraud, Brandon M Togioka, Daniel B Jones, Joaquin E Cigarroa
Although laparoscopic surgery accounts for >2 million surgical procedures every year, the current preoperative risk scores and guidelines do not adequately assess the risks of laparoscopy. In general, laparoscopic procedures have a lower risk of morbidity and mortality compared with operations requiring a midline laparotomy. During laparoscopic surgery, carbon dioxide insufflation may produce significant hemodynamic and ventilatory consequences such as increased intraabdominal pressure and hypercarbia. Hemodynamic insults secondary to increased intraabdominal pressure include increased afterload and preload and decreased cardiac output, whereas ventilatory consequences include increased airway pressures, hypercarbia, and decreased pulmonary compliance...
February 14, 2017: Circulation
https://www.readbyqxmd.com/read/28073188/effects-of-obesity-surgery-laparoscopic-sleeve-gastrectomy-technique-on-lower-urinary-tract-symptoms-depression-and-quality-of-life-of-males-prospective-study
#2
Fatih Uruç, Serkan Akan, Bekir Aras, Çaglar Yıldırım, Aytaç Sahin, Ozgur Haki Yuksel, Mehmet Timuçin Aydın, Ayhan Verit
PURPOSE: Technically, obesity weakens the pelvic base muscles by causing an increase in the intraabdominal pressure and intravesical pressure due to increasing fat and it triggers the occurrence of lower urinary tract symptoms. However it is believed that weight loss will cause recovery of these symptoms. Our purpose in this study is to research about the effects of the weight loss achieved by using especially the Laparoscopic Sleeve Gastrectomy (LSG) technique of bariatric surgery which is being more and more widely used today...
December 30, 2016: Archivio Italiano di Urologia, Andrologia
https://www.readbyqxmd.com/read/27995452/an-optimal-approach-for-laparoscopic-d3-lymphadenectomy-plus-complete-mesocolic-excision-d3-cme-for-right-sided-colon-cancer
#3
Daxing Xie, Chaoran Yu, Chun Gao, Hasan Osaiweran, Junbo Hu, Jianping Gong
BACKGROUND: It is common knowledge that high ligation of blood vessels at the D3 level and complete mesocolic excision (CME) are two critical points of right hemicolectomy for right colon cancer (RCC). (1-5) To date, a safe strategy for completing these two procedures under laparoscopic surgery has not been extensively described. The authors provide a video to demonstrate laparoscopic right hemicolectomy (D3 + CME) with an optimal mesentery-defined approach. By identifying three "tri-junctions," this approach facilitates dissection of the entire mesocolon along the embryologic planes as far centrally as possible and enables the high tie of feeding vessels at bifurcation...
December 19, 2016: Annals of Surgical Oncology
https://www.readbyqxmd.com/read/27966324/the-effect-of-pneumoperitoneum-on-intravascular-fibrinolytic-activity-in-rats
#4
Kürşat Dikmen, Asiye Uğraş Dikmen, Hasan Bostancı, Ahmet Karamercan, Münci Yağcı, Murat Akın, Bülent Aytaç
BACKGROUND/AIM: Venous stasis during pneumoperitoneum in laparoscopic surgery is closely related to fibrin synthesis and deposition. The etiologic factors underlying fibrinolysis or hypercoagulability are not clearly defined. This study aimed to determine the effects of pneumoperitoneum time and pressure on coagulation cascade and the fibrinolytic pathway. MATERIALS AND METHODS: After the pneumoperitoneum model was established in rats, PAI-1, tPA, TAFI, D-dimer, and fibrinogen activities were evaluated in different time periods under different pressures in groups including 6 rats...
November 17, 2016: Turkish Journal of Medical Sciences
https://www.readbyqxmd.com/read/27830178/diaphragmatic-hernia-after-living-donor-right-hepatectomy-proposal-for-a-screening-protocol
#5
Scott M Livingstone, Axel Andres, A M James Shapiro, Norman N Kneteman, David L Bigam
BACKGROUND: Living donor hepatectomy (LDH) is increasingly being used to improve access to liver transplantation for those with end-stage liver disease. Although recipient outcomes are equivalent, donor complication rates range from 10% to 41%. A rare, but potentially serious complication is occurrence of a diaphragmatic hernia (DH), of which 9 cases have been reported so far in the literature. The purpose of this work was to review the clinical impact of DH post-LDH, including risk factors (RF) in hope of mitigating impact...
July 2016: Transplantation Direct
https://www.readbyqxmd.com/read/27826465/collagenopathies-implications-for-abdominal-wall-reconstruction-a-systematic-review
#6
Bridget Harrison, Kyle Sanniec, Jeffrey E Janis
BACKGROUND: The etiology of hernia formation is strongly debated and includes mechanical strain, prior surgical intervention, abnormal embryologic development, and increased intraabdominal pressure. Although the most common inciting cause in ventral hernias is previous abdominal surgery, many other factors contribute. We explore this etiology through an examination of the current literature and existing evidence on patients with collagen vascular diseases, such as Ehlers-Danlos syndrome...
October 2016: Plastic and Reconstructive Surgery. Global Open
https://www.readbyqxmd.com/read/27810147/outcomes-in-pediatric-patients-with-abdominal-compartment-syndrome-following-urgent-exploratory-laparotomy
#7
S Thomas, D Kriplani, C Crane, S O Dehom, G Oei, J Baerg, C Wright, Y Xu, J C Ejike
BACKGROUND/PURPOSE: Abdominal compartment syndrome (ACS) is a serious condition with high mortality in critically ill children. Our objectives were to characterize the incidence of ACS in pediatric patients who underwent urgent exploratory laparotomy and to compare outcomes of patients with and without ACS. METHODS: This retrospective review examined pediatric patients (0-18years) who underwent urgent exploratory laparotomy over a 2-year period. Primary outcome was mortality; secondary outcomes were achievement of primary fascial closure and necessity of bowel resection...
October 14, 2016: Journal of Pediatric Surgery
https://www.readbyqxmd.com/read/27767980/hemorheological-factors-can-be-informative-in-comparing-treatment-possibilities-of%C3%A2-abdominal-compartment-syndrome
#8
Norbert Nemeth, Katalin Peto, Adam Deak, Viktoria Sogor, Gabor Varga, Bence Tanczos, Klaudia Balog, Adrienn Csiszko, Zoltan Godo, Zsolt Szentkereszty
BACKGROUND: Abdominal compartment syndrome (ACS) is a life-threatening condition, of which pathomechanism hasn't been completely clarified, yet. Furthermore, surgical therapy still needs optimization. OBJECTIVE: We aimed to investigate microcirculatory and micro-rheological alterations in ACS, using various temporary abdominal closure methods, including three settings of vacuum-assisted closure technique (negative pressure wound therapy, NPWT). METHODS: On anesthetized pigs, by intraabdominally placed and filled-up silicone bags, intraabdominal pressure at 30 mmHg was maintained for 3 hours, and afterwards, decompressive laparotomy happened...
2016: Clinical Hemorheology and Microcirculation
https://www.readbyqxmd.com/read/27727026/best-practice-for-perioperative-management-of-patients-with-cytoreductive-surgery-and-hipec
#9
REVIEW
C Raspé, L Flöther, R Schneider, M Bucher, P Piso
Due to the significantly improved outcome and quality of life of patients with different tumor entities after cytoreductive surgery (CRS) and HIPEC, there is an increasing number of centers performing CRS and HIPEC procedures. As this procedure is technically challenging with potential high morbidity and mortality, respectively, institutional experience also in the anesthetic and intensive care departments is essential for optimal treatment and prevention of adverse events. Clinical pathways have to be developed to achieve also good results in more comorbid patients with border line indications and extensive surgical procedures...
September 28, 2016: European Journal of Surgical Oncology
https://www.readbyqxmd.com/read/27687373/effect-of-depth-of-neuromuscular-blockade-on-the-abdominal-space-during-pneumoperitoneum-establishment-in-laparoscopic-surgery
#10
Javier Barrio, Carlos L Errando, Guillermo San Miguel, Boris I Salas, Juan Raga, José L Carrión, Jaime García-Ramón, Juan Gallego
STUDY OBJECTIVE: To evaluate the effect of neuromuscular blockade (NMB) upon the abdominal space during pneumoperitoneum establishment in laparoscopic surgery, comparing moderate NMB and deep NMB. DESIGN: Prospective, randomized, crossover clinical trial. SETTING: Operating room. PATIENTS: Seventy-six American Society of Anesthesiologists 1 to 2 patients scheduled for elective laparoscopic surgery. INTERVENTIONS: Two independent evaluations were performed at the establishment of pneumoperitoneum for a preset intraabdominal pressures (IAPs) of 8 and 12 mm Hg, both during moderate NMB (train-of-four count, 1-3) and deep NMB (posttetanic count, <5)...
November 2016: Journal of Clinical Anesthesia
https://www.readbyqxmd.com/read/27628003/thromboembolic-prophylaxis-for-morbidly-obese-patients-undergoing-bariatric-surgery
#11
Jaime Ruiz-Tovar, Carolina Llavero
Obesity itself is associated with an increased risk of thromboembolic events. Moreover, most bariatric procedures actually are performed by laparoscopic approach, implying an increased intraabdominal pressure during the surgical procedure that may favor the development of thrombus. Therefore, bariatric surgery is considered a high-risk procedure for thromboembolic events. Actual recommendations are to include low molecular weight heparins (LMWH) and compression stockings in the primary prophylaxis of thromboembolic events...
September 15, 2016: Advances in Experimental Medicine and Biology
https://www.readbyqxmd.com/read/27551733/diagnosis-of-intraabdominal-fluid-extravasation-after-hip-arthroscopy-with-point-of-care-ultrasonography-can-identify-patients-at-an-increased-risk-for-postoperative-pain
#12
Stephen C Haskins, Natasha A Desai, Kara G Fields, Jemiel A Nejim, Stephanie Cheng, Struan H Coleman, Danyal H Nawabi, Bryan T Kelly
BACKGROUND: Intraabdominal fluid extravasation (IAFE) after hip arthroscopy has historically been diagnosed in catastrophic circumstances with abdominal compartment syndrome requiring diuresis or surgical decompression. A previous retrospective study found the prevalence of symptomatic IAFE requiring diuresis or decompression to be 0.16%, with risk factors including surgical procedure and high pump pressures. IAFE can be diagnosed rapidly by using point-of-care ultrasound (POCUS) via the Focused Assessment With Sonography for Trauma (FAST) examination, which is a well-established means to detect free fluid with high specificity and sensitivity...
March 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/27550441/prostheses-size-dependency-of-the-mechanical-response-of-the-herniated-human-abdomen
#13
R Simón-Allué, B Hernández-Gascón, L Lèoty, J M Bellón, E Peña, B Calvo
BACKGROUND: Hernia repairs still exhibit clinical complications, i.e. recurrence, discomfort and pain and mesh features are thought to be highly influent. The aim of this study is to evaluate the impact of the defect size and mesh type in an herniated abdominal wall using numerical models. METHODS: To do so, we have started from a FE model based on a real human abdomen geometry obtained by MRI, where we have provoked an incisional hernia of three different sizes...
August 22, 2016: Hernia: the Journal of Hernias and Abdominal Wall Surgery
https://www.readbyqxmd.com/read/27545995/anesthetic-and-operative-considerations-for-laparoscopic-liver-resection
#14
Michael E Egger, Vijaya Gottumukkala, Jonathan J Wilks, Jose Soliz, Matthias Ilmer, Jean Nicolas Vauthey, Claudius Conrad
We enumerate the broad range of anesthetic considerations that affect the outcome of patients undergoing laparoscopic liver resection. Key elements for excellent outcomes after laparoscopic liver resection are careful patient selection and risk stratification, appropriate monitoring, techniques to reduce blood loss and transfusion, and active recovery management. Although some of these key elements are the same for open liver operation, there are specific anesthetic considerations of which both the surgical and anesthesia teams must be aware to achieve optimal patient outcomes after laparoscopic liver resection...
August 18, 2016: Surgery
https://www.readbyqxmd.com/read/27515323/the-effect-of-pneumoperitoneum-on-the-cross-sectional-areas-of-internal-jugular-vein-and-subclavian-vein-in-laparoscopic-cholecystectomy-operation
#15
Hüseyin Ulaş Pınar, Rafi Doğan, Ümmü Mine Konuk, Egemen Çifci, Enes Duman, Erdal Karagülle, Emin Türk, Ömer Karaca
BACKGROUND: Increased central venous pressure secondary to an increase in intraabdominal pressure has been reported during laparoscopic surgery. However, no study has yet determined the effect of pneumoperitoneum on cross-sectional area (CSA) of central veins by ultrasonography during laparoscopic cholecystectomy. Herein, we aimed to quantify changes in CSAs of internal jugular (IJV) and subclavian veins (SCV) by ultrasonography during this surgery. METHODS: This study included 60 ASA I-II patients scheduled for laparoscopic cholecystectomy surgery under general anesthesia...
2016: BMC Anesthesiology
https://www.readbyqxmd.com/read/27514086/-prophylaxis-of-complications-of-laparoscopic-cholecystectomy-in-patients-with-the-ischemic-heart-disease
#16
D S Vasyhlchenko, V I Desyateryk, S O Sheyko, T I Zverevych
Results of examination and surgical tratment of 56 patients, suffering chronic calculous cholecystitis with concomitant schemic heart disease, were analyzed. In all the patients a laparoscopic cholecystectomy was performed. Monitoring of cardiovascular compli- cations was estimated with the help of a Helter recording of EGG intraoperatively and in the early postoperative period. Depending on a kind of preoperative preparation done, the patients were divided on two groups: those, to whom cardioprotection using a Vasopro preparation was conducted, and those without cardioprotection...
March 2016: Klinichna Khirurhiia
https://www.readbyqxmd.com/read/27513406/comparison-of-the-effects-of-peep-levels-on-respiratory-mechanics-and-elimination-of-volatile-anesthetic-agents-in-patients-undergoing-laparoscopic-cholecystectomy-a-prospective-randomized-clinical-trial
#17
Hüsnü Mert Arinalp, Nurten Bakan, Gülşah Karaören, Ömer Torun Şahin, Emre Çeliksoy
BACKGROUND/AIM: In laparoscopic procedures, intraabdominal carbon dioxide (CO2) insufflation can cause decreased compliance, increased airway resistance, and impaired ventilation-perfusion ratios. We aimed to investigate the effects of intraoperative positive end-expiratory pressure (PEEP) treatment on respiratory dynamics and elimination time of volatile anesthetic agents. MATERIALS AND METHODS: In the present study, 75 ASA I-II patients were randomized into 3 groups to receive 0 cmH2O PEEP (group I), 5 cmH2O PEEP (group II), or 8 cmH2O PEEP (group III)...
2016: Turkish Journal of Medical Sciences
https://www.readbyqxmd.com/read/27511333/evaluation-of-intraabdominal-hypertension-and-genitofemoral-nerve-motor-conduction
#18
Özlem Boybeyi, Elem İnal, Yasemin Dere Günal, Mustafa Kemal Aslan, Gülümser Aydin, Tutku Soyer
BACKGROUND/AIM: The aim of this study was to electrophysiologically evaluate the effect of increased intraabdominal pressure (IAP) on genitofemoral nerve (GFN) motor conduction. MATERIALS AND METHODS: Seven Wistar albino rats were included. After anesthetization, latency and duration of GFN conduction was recorded with a needle-probe at rest. IAP was increased to 15 mmHg by insufflating atmospheric air with a percutaneous intraperitoneal needle. At 30 min of IAP, GFN motor conduction was recorded...
2016: Turkish Journal of Medical Sciences
https://www.readbyqxmd.com/read/27462389/umbilical-hernia-in-patients-with-liver-cirrhosis-a-surgical-challenge
#19
REVIEW
Julio C U Coelho, Christiano M P Claus, Antonio C L Campos, Marco A R Costa, Caroline Blum
Umbilical hernia occurs in 20% of the patients with liver cirrhosis complicated with ascites. Due to the enormous intraabdominal pressure secondary to the ascites, umbilical hernia in these patients has a tendency to enlarge rapidly and to complicate. The treatment of umbilical hernia in these patients is a surgical challenge. Ascites control is the mainstay to reduce hernia recurrence and postoperative complications, such as wound infection, evisceration, ascites drainage, and peritonitis. Intermittent paracentesis, temporary peritoneal dialysis catheter or transjugular intrahepatic portosystemic shunt may be necessary to control ascites...
July 27, 2016: World Journal of Gastrointestinal Surgery
https://www.readbyqxmd.com/read/27336748/-primary-omental-torsion-in-preschool-girls-case-report
#20
P Novák, V Vacek, R Vondráková
INTRODUCTION: Primary omental torsion is a rare finding in cases of suspected acute abdomen. It is more common in children. Secondary omental torsion is typical for adults. CASE REPORT: The authors describe two cases where pain in the right upper abdominal quadrant was caused by primary torsion of the omental corner due to increased intraabdominal pressure: after a strong cough in one girl and after a workout in the other. Primary omental torsion usually mimics acute appendicitis with clinical findings in the right lower abdominal quadrant, especially in obese children...
December 0: Rozhledy V Chirurgii: Měsíčník Československé Chirurgické Společnosti
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