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Clavien-Dindo Classification

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https://www.readbyqxmd.com/read/28809096/pancreatico-jejunostomy-decreases-post-operative-pancreatic-fistula-incidence-and-severity-after-central-pancreatectomy
#1
Frédéric Borel, Mehdi Ouaissi, Aude Merdrignac, Aurelien Venara, Valéria De Franco, Laurent Sulpice, Antoine Hamy, Nicolas Regenet
BACKGROUNDS: Central pancreatectomy (CP) is an alternative to pancreaticoduodenectomy and distal pancreatectomy in benign tumours of pancreatic isthmus management. It is known for a high post-operative pancreatic fistula (POPF) rate. The purpose of this study was to compare POPF incidence between pancreatico-jejunostomy (PJ) and pancreatico-gastrostomy (PG). METHODS: Fifty-eight patients (mean age 53.9 ± 1.9 years) who underwent a CP in four French University Hospitals from 1988 to 2011 were analysed...
August 15, 2017: ANZ Journal of Surgery
https://www.readbyqxmd.com/read/28806303/does-a-combination-of-laparoscopic-approach-and-full-fast-track-multimodal-management-decrease-postoperative-morbidity-a-multicenter-randomized-controlled-trial
#2
Léon Maggiori, Eric Rullier, Jérémie H Lefevre, Jean-Marc Régimbeau, Stéphane Berdah, Mehdi Karoui, Jérome Loriau, Arnaud Alvès, Eric Vicaut, Yves Panis
OBJECTIVE: The aim of this study was to assess whether association of laparoscopic approach and full fast track multimodal (FFT) management can reduce postoperative morbidity after colorectal cancer surgery, as compared to laparoscopic approach with limited fast-track program (LFT). SUMMARY OF BACKGROUND DATA: Recent advances in colorectal cancer surgery are introduction of laparoscopy and FFT implementation. METHODS: Patients eligible for elective laparoscopic colorectal cancer surgery were randomized into 2 groups: FFT or LFT care (with only early oral intake and mobilization starting on Day 1)...
August 11, 2017: Annals of Surgery
https://www.readbyqxmd.com/read/28801697/low-hartmann-s-procedure-or-intersphincteric-proctectomy-for-distal-rectal-cancer-a-retrospective-comparative-cohort-study
#3
Emma Westerduin, Gijsbert D Musters, Anna A W van Geloven, Marinke Westerterp, Erwin van der Harst, Willem A Bemelman, Pieter J Tanis
PURPOSE: Two non-restorative options for low rectal cancer not invading the sphincter are the low Hartmann's procedure (LH) or intersphincteric proctectomy (IP). The aim of this study was to compare postoperative morbidity with emphasis on pelvic abscesses after LH and IP. METHODS: All patients that had LH or IP for low rectal cancer were included in three centres between 2008 and 2014 in this retrospective cohort study. Follow-up was performed for at least 12 months...
August 11, 2017: International Journal of Colorectal Disease
https://www.readbyqxmd.com/read/28796646/defining-benchmarks-for-transthoracic-esophagectomy-a-multicenter-analysis-of-total-minimally-invasive-esophagectomy-in-low-risk-patients
#4
Henner M Schmidt, Susanne S Gisbertz, Johnny Moons, Ioannis Rouvelas, Juha Kauppi, Andrew Brown, Emanuele Asti, Misha Luyer, Sjoerd M Lagarde, Felix Berlth, Annouck Philippron, Christiane Bruns, Arnulf Hölscher, Paul M Schneider, Dimitri A Raptis, Mark I van Berge Henegouwen, Philippe Nafteux, Magnus Nilsson, Jari Räsanen, Francesco Palazzo, Ernest Rosato, Stuart Mercer, Luigi Bonavina, Grard Nieuwenhuijzen, Bas P L Wijnhoven, Wolfgang Schröder, Piet Pattyn, Peter P Grimminger, Christian A Gutschow
OBJECTIVE: To define "best possible" outcomes in total minimally invasive transthoracic esophagectomy (ttMIE). BACKGROUND: TtMIE, performed by experts in patients with low comorbidity, may serve as a benchmark procedure for esophagectomy. PATIENTS AND METHODS: From a cohort of 1057 ttMIE, performed over a 5-year period in 13 high-volume centers for esophageal surgery, we selected a study group of 334 patients (31.6%) that fulfilled criteria of low comorbidity (American Society of Anesthesiologists score ≤2, WHO/ECOG score ≤1, age ≤65 years, body mass index 19-29 kg/m)...
August 7, 2017: Annals of Surgery
https://www.readbyqxmd.com/read/28789662/predictive-factors-of-prolonged-mechanical-ventilation-overall-survival-and-quality-of-life-in-patients-with-post-thymectomy-myasthenic-crisis
#5
Kun-Kun Li, Kai Qian, Yong-Geng Feng, Wei Guo, Qun-You Tan, Bo Deng
BACKGROUND: Thymectomy is the primary approach for the treatment of myasthenia gravis (MG). This retrospective study aimed to identify the clinical and demographical features that may impact the duration of mechanical ventilation (DMV), the long-term survival, and the quality of life (QOL) in patients with post-thymectomy myasthenic crisis (PTMC). METHODS: We reviewed the patients who suffered from PTMC from June 2008 to November 2015. Cox proportional hazard regression analysis was used to identify potential prognostic factors that may impact DMV and long-term survival...
August 8, 2017: World Journal of Surgical Oncology
https://www.readbyqxmd.com/read/28758757/-colorectal-cancer-in-senior-patients-are-we-doing-it-well
#6
D Kostrouch, L Martínek, J Hoch
INTRODUCTION: Geriatric patients form a significant part of patients with colorectal cancer and their numbers will probably continue to increase. Analysis of the quality of care provided to seniors and the results from their treatment are currently gaining more attention. The aim of this study was to compare how often standard oncological therapy is administered to seniors with colorectal cancer and to compare their results with younger patients along with complications of the therapy...
2017: Rozhledy V Chirurgii: Měsíčník Československé Chirurgické Společnosti
https://www.readbyqxmd.com/read/28753862/validation-of-the-clavien-dindo-grading-system-in-urology-by-the-european-association-of-urology-guidelines-ad-hoc-panel
#7
REVIEW
Dionysios Mitropoulos, Walter Artibani, Chandra Shekhar Biyani, Jørgen Bjerggaard Jensen, Morgan Rouprêt, Michael Truss
CONTEXT: Since 2012 uniformed reporting of complications after urological procedures has been advocated by the European Association of Urology (EAU) guidelines. The Clavien-Dindo grading system was recommended to report the outcomes of urologic procedures. OBJECTIVE: To validate the Clavien-Dindo grading system in urology. DESIGN, SETTING, AND PARTICIPANTS: Members of the EAU working group compiled a list of case scenarios including those with minor and major complications...
March 7, 2017: European Urology Focus
https://www.readbyqxmd.com/read/28751944/complications-in-mandibular-midline-distraction
#8
Jan Pieter de Gijt, Atilla Gül, Eppo B Wolvius, Karel G H van der Wal, Maarten J Koudstaal
Mandibular midline distraction (MMD) is a relatively new surgical technique for correction of transverse discrepancies of the mandible. This study assesses the amount and burden of complications in MMD. A retrospective cohort study was performed on patients who underwent MMD between 2002 and 2014. Patients with congenital deformities or a history of radiation therapy in the area of interest were excluded. Patient records were obtained and individually assessed for any complications. Complications were graded using the Clavien-Dindo classification system (CDS)...
September 2017: Craniomaxillofacial Trauma & Reconstruction
https://www.readbyqxmd.com/read/28748381/is-it-safe-to-perform-lumbar-spine-surgery-on-patients-over-eighty-five
#9
Houssam Bouloussa, Abdulmajeed Alzakri, Soufiane Ghailane, Claudio Vergari, Simon Mazas, Jean-Marc Vital, Pierre Coudert, Olivier Gille
PURPOSE: The purpose of this study was to evaluate the safety and tolerance of lumbar spine surgery in patients over 85. MATERIALS AND METHODS: Patients over 85 years of age with LSS who underwent decompression surgery with or without fusion between February 2011 and July 2014 were included. Comorbidities, autonomy (Activities of Daily Life and Braden scales), surgical parameters and complications (Clavien-Dindo classification) were collected. A telephone survey was performed to assess survival and patients' satisfaction at last follow-up...
July 26, 2017: International Orthopaedics
https://www.readbyqxmd.com/read/28737104/severe-postoperative-complications-may-be-related-to-mesenteric-traction-syndrome-during-open-esophagectomy
#10
R Ambrus, L B Svendsen, N H Secher, J P Goetze, K Rünitz, M P Achiam
BACKGROUND: During abdominal surgery, traction of the mesenterium provokes mesenteric traction syndrome, including hypotension, tachycardia, and flushing, along with an increase in plasma prostacyclin (PGI2). We evaluated whether postoperative complications are related to mesenteric traction syndrome during esophagectomy. METHODS: Flushing, hemodynamic variables, and plasma 6-keto-PGF1α were recorded during the abdominal part of open ( n = 25) and robotically assisted ( n = 25) esophagectomy...
March 1, 2017: Scandinavian Journal of Surgery: SJS
https://www.readbyqxmd.com/read/28726497/prognosis-prediction-for-postoperative-esophageal-cancer-patients-using-onodera-s-prognostic-nutritional-index
#11
Hideo Matsumoto, Yuko Okamoto, Akimasa Kawai, Daisuke Ueno, Hisako Kubota, Haruaki Murakami, Masaharu Higashida, Toshihiro Hirai
PURPOSE: Preoperative nutritional status may impact surgical outcome and prognosis. We evaluated the predictive value of Onodera's prognostic nutritional index (O's-PNI) of surgical outcome following esophagectomy in esophageal cancer patients. PATIENTS AND METHODS: In total, 144 patients undergoing esophagectomy for esophageal cancer from April 2010 to May 2015 were evaluated, retrospectively. Eighty-four patients were enrolled in this study. O's-PNIs were calculated before surgery, discharge, and 1, 2, and 6 mo after discharge...
July 20, 2017: Nutrition and Cancer
https://www.readbyqxmd.com/read/28726145/robotic-gastric-bypass-may-lead-to-fewer-complications-compared-with-laparoscopy
#12
Dimitrios Stefanidis, Savannah B Bailey, Timothy Kuwada, Connie Simms, Keith Gersin
BACKGROUND: Robotic technology leads to improved visualization and precision over laparoscopy but also higher cost of care. The benefits of this technology to patient outcomes are controversial. Our objective was to assess whether the application of robotic surgery to Roux-en-Y gastric bypass (RYGB) would lead to improved patient outcomes. METHODS: A prospectively collected database at a bariatric center of excellence was reviewed for all RYGB procedures performed by one surgeon between 2007 and 2015...
July 19, 2017: Surgical Endoscopy
https://www.readbyqxmd.com/read/28719890/effect-of-neoadjuvant-nab-paclitaxel-plus-gemcitabine-therapy-on-overall-survival-in-patients-with-borderline-resectable-pancreatic-cancer-a-prospective-multicenter-phase-ii-trial-nac-ga-trial
#13
Ken-Ichi Okada, Toshio Shimokawa, Seiko Hirono, Manabu Kawai, Masayuki Sho, Sohei Satoi, Ippei Matsumoto, Hidetoshi Eguchi, Yoshiaki Murakami, Suguru Yamada, Mariko Doi, Hiroki Yamaue
We conducted a prospective multicenter phase II trial of patients with borderline resectable pancreatic carcinoma to investigate the efficacy of neoadjuvant nab-paclitaxel plus gemcitabine therapy on overall survival (OS). The clinical trial primarily evaluated OS time from the first day of protocol therapy as a primary endpoint. The secondary endpoints were recurrence-free survival from the first day of protocol therapy, safety of the protocol therapy (adverse effect), morbidity based on the Clavien Dindo classification of more than III, response rate, preoperative/postoperative tumor marker (CA 19-9, CEA), rate of normalization, reduction rate of the maximum standardized uptake value on positron emission tomography-computed tomography (limited to institutions where positron emission tomography-computed tomography was available), chemotherapeutic effect grade based on Evans' classification, resection rate, R0 resection rate, surgical data (operative time, blood loss, transfusion, postoperative hospital day), overall morbidity rates (reoperation, rate of readmission, mortality), patient rate in postoperative adjuvant therapy (entry rate, completion rate), dose intensity, quality of life regarding fatigue and malaise assessed by the questionnaire of FACIT-F (Japanese version), and peripheral sensory neuropathy assessed by the questionnaire of the FACT/GOG-NTX subscale (version 4; Japanese version)...
July 19, 2017: Oncology
https://www.readbyqxmd.com/read/28711516/the-influence-of-metabolic-syndrome-in-the-outcomes-of-colorectal-cancer-patients
#14
André Goulart, Ana Varejão, Fernanda Nogueira, Sandra Martins, António Mesquita-Rodrigues, Nuno Sousa, Pedro Leão
AIMS: Determine the influence of metabolic syndrome and its different components in the outcomes of colorectal cancer surgery at 30days. MATERIALS AND METHODS: Prospective study that included all patients submitted to elective colorectal cancer surgery between August 2015 and August 2016 at Hospital de Braga. Clinical and laboratory parameters evaluated pre-operatively were: central obesity, blood pressure, fasting glucose, triglycerides levels and HDL cholesterol levels...
July 8, 2017: Diabetes & Metabolic Syndrome
https://www.readbyqxmd.com/read/28699003/sarcopenia-is-an-independent-predictor-of-complications-after-colorectal-cancer-surgery
#15
Ryota Nakanishi, Eiji Oki, Shun Sasaki, Kosuke Hirose, Tomoko Jogo, Keitaro Edahiro, Shotaro Korehisa, Daisuke Taniguchi, Kensuke Kudo, Junji Kurashige, Masahiko Sugiyama, Yuichiro Nakashima, Kippei Ohgaki, Hiroshi Saeki, Yoshihiko Maehara
PURPOSE: The significance of sarcopenia after colorectal cancer (CRC) resection has only been discussed with relatively small samples or short follow-up periods. This study aimed to clarify the clinical significance of sarcopenia in a large-sample study. METHODS: We retrospectively analyzed the relationship between sarcopenia and clinical factors, surgical outcomes, and the survival in 494 patients who underwent CRC surgery between 2004 and 2013. Sarcopenia was defined based on the sex-specific skeletal muscle mass index measured by preoperative computed tomography...
July 11, 2017: Surgery Today
https://www.readbyqxmd.com/read/28697151/eus-guided-gastrojejunostomy-versus-laparoscopic-gastrojejunostomy-an-international-collaborative-study
#16
Manuel Perez-Miranda, Amy Tyberg, Daniel Poletto, Ernesto Toscano, Monica Gaidhane, Amit P Desai, Nikhil A Kumta, Lea Fayad, Jose Nieto, Marc Barthet, Raj Shah, Brian C Brauer, Reem Z Sharaiha, Michel Kahaleh
INTRODUCTION: Endoscopic ultrasound-guided gastrojejunostomy (EUS-GJ) with placement of a lumen-apposing metal stent is a minimally invasive and efficacious procedure for gastric outlet obstruction (GOO) patients not amenable to surgery. Laparoscopic gastrojejunostomy (Lap-GJ) has traditionally been the standard of care. No direct comparison between EUS-GJ and Lap-GJ has been described. Our aim was to compare the clinical outcomes, success rate, and adverse events (AE) of EUS-GJ with Lap-GJ...
July 10, 2017: Journal of Clinical Gastroenterology
https://www.readbyqxmd.com/read/28679184/influence-of-hiv-virus-in-the-hospital-stay-and-the-occurrence-of-postoperative-complications-classified-according-to-the-clavien-dindo-classification-and-in-comparison-with-the-charlson-comorbidity-index-in-patients-subjected-to-urologic-and-general-surgery
#17
Dimitrios Dimitroulis, Georgios Karaolanis, Ioannis Katafigiotis, Ioannis Anastasiou, Viktoria-Varvara Palla, Athanasios Kontos, Mordechai Duvdevani, Konstantinos Kontzoglou
OBJECTIVES: From the first time that human immunodeficiency virus (HIV) was discovered, till today both the quality of life and survival expectancy of HIV-infected patients have markedly improved. As the life expectancy of these patients increases due to the use of highly active anti-retroviral therapy (HAART) also increases the number of HIV-positive patient to be subjected to an operation. Different studies have examined the occurrence of complications in this particular group of patients and their possible susceptibility to infections or other complications that could lead to increased hospital stay, morbidity and mortality with controversial results...
June 30, 2017: Archivio Italiano di Urologia, Andrologia
https://www.readbyqxmd.com/read/28678010/-prognostic-factors-in-renal-cancer-with-venous-thrombus-survival-analysis
#18
Angela Pascual-Fernández, Jesús Calleja-Escudero, Cristina Gómez de Segura, Laura Pesquera-Ortega, James Taylor, José Antonio Fajardo, Javier González de Zárate, Jesús Monllor-Gisbert, José Ramón Cortiñas-González
OBJECTIVES: To analyze surgery for renal cancer with venous thrombus at different levels, perioperative complications and prognostic factors associated to overall, cancer-specific and disease-free survival. MATERIAL AND METHODS: Retrospective analysis of 42 cases of renal cancer with venous thrombus performed between 2005 and 2015. The level reached by the thrombus was established according to the Mayo Clinic classification. Postoperative complications were staged according to Clavien-Dindo classification...
July 2017: Archivos Españoles de Urología
https://www.readbyqxmd.com/read/28673871/rectal-shaving-using-plasma-energy-in-deep-infiltrating-endometriosis-of-the-rectum-four-years-of-experience
#19
Noémie Marty, Salma Touleimat, Salwa Moatassim-Drissa, Jenny Claude Millochau, Aurélie Vallee, Emanuela Stochino Loi, Eulalie Desnyder, Horace Roman
STUDY OBJECTIVE: To evaluate postoperative complications, digestive function and fertility outcomes in patients managed by rectal shaving using plasma energy in deep infiltrating endometriosis of the rectum. DESIGN: A single-center retrospective cohort study using data recorded prospectively. DESIGN CLASSIFICATION: Canadian Task Force classification II-2. SETTINGS: Department of Gynecology and Obstetrics of Rouen University Hospital (France)...
June 30, 2017: Journal of Minimally Invasive Gynecology
https://www.readbyqxmd.com/read/28667547/transversus-abdominis-plane-tap-block-versus-thoracic-epidural-analgesia-tea-in-laparoscopic-colon-surgery-in-the-eras-program
#20
Basilio Pirrera, Vincenzo Alagna, Andrea Lucchi, Pierluigi Berti, Carlo Gabbianelli, Giacomo Martorelli, Lorella Mozzoni, Federico Ruggeri, Alessandro Ingardia, Giuseppe Nardi, Gianluca Garulli
AIM: The enhanced recovery after surgery (ERAS) pathway and laparoscopic approach had been proven beneficial for patients and should now be considered as a standard of care in colorectal surgery. Multimodal analgesia is the gold standard in the ERAS program with the use of thoracic epidural analgesia (TEA). Few data are available on Transversus abdominis plane (TAP) blocks in laparoscopic colorectal surgery and ERAS pathway. The aim of this study is to evaluate the efficacy of TAP block compared to TEA in the management of postoperative pain and the impact on the recurrence of postoperative nausea, vomiting and ileus in laparoscopic colorectal surgery in the ERAS program...
July 1, 2017: Surgical Endoscopy
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