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https://www.readbyqxmd.com/read/28215039/impact-of-surgical-experience-on-management-and-outcome-of-pancreatic-surgery-performed-in-high-and-low-volume-centers
#1
Marco Stella, Massimiliano Bissolati, Daniele Gentile, Alessandro Arriciati
Pancreaticoduodenectomy (PD) is one of the procedures in general surgery with the highest rate of life-threatening complications. The positive impact of the volume-outcome ratio on outcomes and mortality in pancreatic surgery (PS) has led to policy-level efforts toward centralization of care for PS that is currently under evaluation by some Regional Health Services. The role of the surgeon's experience and training is still under debate. The aim of this paper is to compare the outcomes of PS by the same surgeon in a high volume (HV) and in a low volume (LV) hospital to assess whether a specific training in PS could outdo the benefits of hospital volume...
February 18, 2017: Updates in Surgery
https://www.readbyqxmd.com/read/28214956/banding-the-sleeve-improves-weight-loss-in-midterm-follow-up
#2
Jodok M Fink, Natalie Hoffmann, Simon Kuesters, Gabriel Seifert, Claudia Laessle, Torben Glatz, Ulrich T Hopt, W Konrad Karcz, Goran Marjanovic
INTRODUCTION: Laparoscopic sleeve gastrectomy (LSG) can achieve excellent weight loss, yet sleeve dilatation with concomitant weight regain proves to be a relevant issue. Hence, additional restriction might improve results after LSG. METHODS: In a retrospective matched-pair analysis, 42 patients who underwent banded LSG (BLSG) using a MiniMizer® ring between January 2012 and October 2014 were analysed regarding weight loss, complications and comorbidity. Median follow-up was 3 years...
February 18, 2017: Obesity Surgery
https://www.readbyqxmd.com/read/28214950/surgery-for-metastatic-tumors-of-the-pancreas
#3
Taisuke Yagi, Daisuke Hashimoto, Katsunobu Taki, Kensuke Yamamura, Akira Chikamoto, Masaki Ohmuraya, Toru Beppu, Hideo Baba
Metastatic lesion of the pancreas originated from other organs is uncommon. The aim of this report was to evaluate the outcome of surgery in patients with isolated metastases to the pancreas. Nine patients underwent pancreatic resection for metastatic malignant disease from 2000 to 2015 at the Department of Gastroenterological Surgery of the Kumamoto University Hospital. The primary lesion was renal cell carcinoma in 7 cases, colon cancer in 1 and malignant melanoma in 1. The median interval from the initial operation to pancreatic resection was 138 months...
December 2017: Surgical Case Reports
https://www.readbyqxmd.com/read/28214914/the-impact-of-bitter-taste-receptor-genetics-on-culturable-bacteria-in-chronic-rhinosinusitis
#4
D I Rom, J M Christensen, R Alvarado, R Sacks, R J Harvey
BACKGROUND: Extra-oral bitter taste receptors have been associated with innate bacterial defence mechanisms. Genetic variation in T2R38 functionality has been shown to be associated with susceptibility to upper respiratory tract infections and chronic rhinosinusitis (CRS). We sought to independently assess the influence of bitter taste receptor genotype on the presence of culturable bacteria in the sinuses. METHODOLOGY: A cross-sectional analysis of patients with CRS undergoing surgery was performed...
February 19, 2017: Rhinology
https://www.readbyqxmd.com/read/28214786/cost-effectiveness-of-risk-reducing-surgeries-in-preventing-hereditary-breast-and-ovarian-cancer
#5
Michael G Schrauder, Lisa Brunel-Geuder, Lothar Häberle, Marius Wunderle, Juliane Hoyer, André Reis, Rüdiger Schulz-Wendtland, Matthias W Beckmann, Michael P Lux
OBJECTIVES: Risk-reducing surgeries are a feasible option for mitigating the risk in individuals with inherited susceptibility to cancer, but are the procedures cost-effective in the current health-care system in Germany? This study compared the health-care costs for bilateral risk-reducing mastectomy (BRRM) and risk-reducing (bilateral) salpingo-oophorectomy (RRSO) with cancer treatment costs that could potentially be prevented. PATIENTS AND METHODS: The analysis is based on interdisciplinary consultations with individuals with a high familial risk for breast and ovarian cancer at the University Breast Center for Franconia (Germany) between 2009 and 2013 (370 consultations; 44 patients with BRCA1 mutations and 26 with BRCA2 mutations)...
February 16, 2017: Breast: Official Journal of the European Society of Mastology
https://www.readbyqxmd.com/read/28214762/paracaecal-hernia-a-case-report-on-the-evolving-role-of-laparoscopy
#6
Ammar Tayaran, Haider Abdulrasool, Hai T Bui
A paracaecal hernia, a type of pericaecal hernias, is a rare cause of small intestinal obstruction. Failure of early recognition and reduction of this type of internal hernia may lead to strangulation of the herniated intestine. There has been a number of case reports in the literature about the different types of pericaecal hernias, however the anatomy of these hernias is still poorly understood and the management is still evolving. We are presenting a 75year old woman, who presented clinically and radiologically with distal small intestinal obstruction...
January 17, 2017: International Journal of Surgery Case Reports
https://www.readbyqxmd.com/read/28214508/surgical-management-of-pericardial-diseases
#7
REVIEW
Douglas R Johnston
Disease of the pericardium represents a relatively rare indication for cardiac surgery, and there exist no widely accepted guidelines for surgical management. As such, the surgical approach to the pericardium has relied largely on institutional experience with a slow evolution based on published studies. In particular, management of pericardial constriction has varied widely from surgeon to surgeon and institution to institution, in large part due to a perception of inherent high risk to the procedure. This review covers the current practice of surgery for disease of the pericardium, with particular focus on the evolution of indications for pericardiectomy, new applications in inflammatory or relapsing pericarditis, and the progressive refinement in surgical technique and operative planning which have led to significantly improved outcomes in experienced centers...
January 2017: Progress in Cardiovascular Diseases
https://www.readbyqxmd.com/read/28214486/robotic-inferior-vena-cava-surgery
#8
Victor J Davila, Cristine S Velazco, William M Stone, Richard J Fowl, Haidar M Abdul-Muhsin, Erik P Castle, Samuel R Money
OBJECTIVE: Inferior vena cava (IVC) surgery is uncommon and has traditionally been performed through open surgical approaches. Renal cell carcinoma with IVC extension generally requires vena cavotomy and reconstruction. Open removal of malpositioned IVC filters (IVCF) is occasionally required after endovascular retrieval attempts have failed. As our experience with robotic surgery has advanced, we have applied this technology to surgery of the IVC. We reviewed our institution's experience with robotic surgical procedures involving the IVC to determine its safety and efficacy...
March 2017: Journal of Vascular Surgery. Venous and Lymphatic Disorders
https://www.readbyqxmd.com/read/28214485/outcome-of-peripheral-venous-reconstructions-during-tumor-resection
#9
Philip Y Sun, Mark D Fleming, Kendall Stauffer, Manju Kalra, Gustavo Oderich, Thomas Bower, Peter Gloviczki, Randall R DeMartino
OBJECTIVE: Peripheral venous reconstruction surgery may be necessary for appropriate oncologic resection; however, the operative approach and surgical outcomes are not well described. We report our experience with these complex reconstructions to identify best practice. METHODS: We retrospectively reviewed all adult patients who underwent peripheral vein reconstruction for tumor resection at Mayo Clinic, Rochester (2000-2015). Patients were classified into three subgroups by the location: iliac (IL), lower extremity (LE), and upper extremity (UE)...
March 2017: Journal of Vascular Surgery. Venous and Lymphatic Disorders
https://www.readbyqxmd.com/read/28214482/catheter-directed-ultrasound-assisted-thrombolysis-is-a-safe-and-effective-treatment-for-pulmonary-embolism-even-in-high-risk-patients
#10
Kristen A Lee, Andrew Cha, Mark H Kumar, Combiz Rezayat, Clifford M Sales
OBJECTIVE: We sought to assess the early success and safety of catheter-directed, ultrasound-assisted (CDUA) thrombolysis for acute pulmonary embolism (PE) in patients deemed to be "high risk" for thrombolytic therapy. METHODS: A retrospective evaluation of patients who underwent CDUA pulmonary thrombolysis in our practice during 39 months is reported. There were 91 patients considered, all of whom presented with acute PE as diagnosed by computed tomography angiography...
March 2017: Journal of Vascular Surgery. Venous and Lymphatic Disorders
https://www.readbyqxmd.com/read/28214280/current-guidelines-do-not-sufficiently-discriminate-venous-thromboembolism-risk-in-urology
#11
Kristen McAlpine, Rodney H Breau, Ranjeeta Mallick, Sonya Cnossen, Ilias Cagiannos, Christopher Morash, Marc Carrier, Luke T Lavallée
PURPOSE: Venous thromboembolism (VTE) is the leading cause of noncancer death following major cancer surgery. Current thromboprophylaxis guidelines do not address procedure-specific risk of venous thromboembolism for urological patients. This project was created to determine the risk and timing of VTE after major urological surgery and to evaluate if surgical procedure was an independent risk factor for VTE after adjusting for previously established risk factors. MATERIAL AND METHODS: The American College of Surgeons׳ National Surgical Quality Improvement Program was used to create a cohort of patients who received major abdominal or pelvic urologic surgery between 2006 and 2014...
February 14, 2017: Urologic Oncology
https://www.readbyqxmd.com/read/28214166/sleeve-gastrectomy-in-the-elderly-a-case-control-study-with-long-term-follow-up-of-3-years
#12
Andrés Navarrete, Ricard Corcelles, Gabriel Diaz Del Gobbo, Sofía Perez, Josep Vidal, Antonio Lacy
BACKGROUND: Advanced age is considered to be a relative contraindication to bariatric surgery because of increased perioperative risk and suboptimal excess weight loss. OBJECTIVES: The aim of this study was to analyze the safety and effectiveness of the sleeve gastrectomy (SG) procedure in a cohort of elderly patients (aged≥60 yr) compared with younger patients (aged<60 yr). SETTING: Hospital clinic, Barcelona, Spain. METHODS: A retrospective analysis of all cases of SG in patients≥60 years old between January 2006 and December 2012 was performed...
December 14, 2016: Surgery for Obesity and related Diseases: Official Journal of the American Society for Bariatric Surgery
https://www.readbyqxmd.com/read/28213877/improved-control-of-hypertension-following-laparoscopic-fundoplication-for-gastroesophageal-reflux-disease
#13
Zhiwei Hu, Meiping Chen, Jimin Wu, Qing Song, Chao Yan, Xing Du, Zhonggao Wang
This study aims to determine whether successful laparoscopic fundoplication for gastroesophageal reflux disease (GERD) can improve the control of hypertension. We conducted an observational study of GERD patients with hypertension. The esophageal and gastroesophageal symptoms of these patients were successfully treated with laparoscopic fundoplication, as measured by the reduced GERD symptoms and proton pump inhibitor consumption. A hypertension control scale was used to classify the use of antihypertensive medications and the quality of blood pressure control before and after anti-reflux surgery...
February 17, 2017: Frontiers of Medicine
https://www.readbyqxmd.com/read/28213856/inferior-vena-cava-system-anomalies-surgical-implications
#14
REVIEW
Javier González, Jeffrey J Gaynor, Luis F Albéniz, Gaetano Ciancio
PURPOSE OF REVIEW: The inferior vena cava (IVC) system is the major venous collecting blood network of the human body. This structure is formed in a complicated series of developmental stages between the fourth and eighth weeks of intrauterine life. Alterations in the developing process of the IVC system give rise to an array of different congenital variants or developmental anomalies. RECENT FINDINGS: IVC anomalies are uncommon, usually of little physiological consequence, and mostly discovered incidentally during cross-sectional imaging in otherwise healthy individuals...
February 2017: Current Urology Reports
https://www.readbyqxmd.com/read/28213788/three-different-approaches-to-the-inferior-mesenteric-artery-during-robotic-d3-lymphadenectomy-for-rectal-cancer
#15
Songphol Malakorn, Tarik Sammour, Brian Bednarski, Yi-Qian Nancy You, George J Chang
BACKGROUND: In rectal cancer surgery, proximal ligation of the inferior mesenteric artery (IMA) with radical lymphadenectomy is the accepted standard of care.1 Our purpose is to describe three different standardized technical approaches for the management of the IMA during D3 lymphadenectomy.2 METHODS: Operative videos of three robotic D3 lymphadenectomy procedures for rectal cancer were reviewed and annotated with schematic anatomical descriptions for clarification. RESULTS: There are three methods for the management of the IMA during D3 lymphadenectomy for rectal cancer...
February 17, 2017: Annals of Surgical Oncology
https://www.readbyqxmd.com/read/28213720/feasibility-of-single-incision-thoracoscopic-surgery-using-a-modified-chest-wall-pulley-for-primary-spontaneous-pneumothorax-a-propensity-score-matching-analysis
#16
Kenji Tsuboshima, Machiko Nagata, Teppei Wakahara, Yasumi Matoba, Yoshimasa Maniwa
PURPOSE: Recently, single-incision thoracoscopic surgery (SITS) has been recognized as a favorable treatment choice for primary spontaneous pneumothorax (PSP) compared with conventional three-port video-assisted thoracoscopic surgery (VATS). However, conventional SITS bullectomy often results in collisions with surgical devices. Therefore, we devised a method of SITS using a chest wall pulley for lung excision (PulLE) and modified PulLE (mPulLE) system, which substitutes threads to eliminate such collisions...
February 17, 2017: Surgery Today
https://www.readbyqxmd.com/read/28213667/point-of-care-testing-for-coagulation-function-coaguchek-%C3%A2-xs-system-versus-standard-laboratory-testing-in-pediatric-patients-with-normal-and-abnormal-coagulation-function
#17
Hiromi Kako, Vidya T Raman, Dmitry Tumin, Julie Rice, Joseph D Tobias
PURPOSE: Intraoperative abnormalities of coagulation function may occur for various reasons. In most scenarios, treatment is directed by laboratory parameters. Unfortunately, standard laboratory testing may take 1-2 h. The purpose of the current study was to evaluate a point-of-care testing device (CoaguChek(®) XS System) in pediatric patients. METHODS: Patients ranging in age from 2 to 18 years, undergoing posterior spinal fusion (PSF) or cardiac surgery using cardiopulmonary bypass (CPB) were eligible for inclusion...
February 17, 2017: Journal of Anesthesia
https://www.readbyqxmd.com/read/28213639/prechiasmatic-sulcus-and-optic-strut-an-anatomic-study-in-dry-skulls
#18
Vasiliki Kanellopoulou, Evgenia Efthymiou, Vasiliki Thanopoulou, Dimitra Kozompoli, Dimitrios Mytilinaios, Maria Piagkou, Elizabeth O Johnson
BACKGROUND: Although safe surgical access to the cavernous sinus is related to understanding the anatomical and ethnic variants of the prechiasmatic sulcus and the optic strut, there remains a paucity of studies of the morphology and the bony relationships in the region. The present study provides a systematic morphological and morphometric analysis of the sulcal region and the optic strut anatomy and their relations in a Greek population. METHODS: The interoptic distance, length of planum sphenoidale, sulcal length and sulcal angle was determined in 96 Greek adult dry skulls...
February 17, 2017: Acta Neurochirurgica
https://www.readbyqxmd.com/read/28213057/utilization-of-sentinel-lymph-node-biopsy-for-uterine-cancer
#19
Jason D Wright, Stephanie Cham, Ling Chen, William M Burke, June Y Hou, Ana I Tergas, Vrunda Desai, Jim C Hu, Cande V Ananth, Alfred I Neugut, Dawn L Hershman
BACKGROUND: To limit the potential short and long-term morbidity of lymphadenectomy, sentinel lymph node (SLN) biopsy has been proposed for endometrial cancer. The principle of SLN biopsy relies on removal of a small number of lymph nodes that are the first drainage basins from a tumor and thus the most likely to harbor tumor cells. While the procedure may reduce morbidity, efficacy data is limited and little is known about how commonly the procedure is performed. OBJECTIVE: We examined the patterns and predictors of use of SLN biopsy and outcomes of the procedure in women with endometrial cancer who underwent hysterectomy...
February 14, 2017: American Journal of Obstetrics and Gynecology
https://www.readbyqxmd.com/read/28212976/functional-lumen-imaging-probe-for-the-management-of-esophageal-disorders-expert-review-from-the-clinical-practice-updates-committee-of-the-aga-institute
#20
REVIEW
Ikuo Hirano, John E Pandolfino, Guy E Boeckxstaens
The functional luminal imaging probe is a Food and Drug Administration-approved measurement tool used to measure simultaneous pressure and diameter to guide management of various upper gastrointestinal disorders. Additionally, this tool is also approved to guide therapy during bariatric procedures and specialized esophageal surgery. Although it has been commercially available since 2009 as the endolumenal functional lumen imaging probe (EndoFLIP), the functional luminal imaging probe has had limited penetrance into clinical settings outside of specialized centers...
March 2017: Clinical Gastroenterology and Hepatology
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