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hemostasis and surgery

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https://www.readbyqxmd.com/read/28081351/the-effect-of-methylprednisolone-treatment-on-fibrinolysis-thecoagulation-system-and-blood-loss-in-cardiac-surgery
#1
Leila Ebrahimi, Maryam Kheirandish, Mahnoosh Foroughi
BACKGROUND/AIM: The purpose of this study was to examine steroid pretreatment in order to decrease postoperative coagulopathy disorders and bleeding. MATERIALS AND METHODS: In this randomized double-blinded study, the efficacy of low versus high doses of methylprednisolone on the coagulation system and postoperative bleeding was compared in patients who were undergoing cardiac surgery with cardiopulmonary bypass (CPB). The platelet response to agonists, D-dimer concentration, tissue plasminogen activator (tPA), plasminogen activator inhibitor (PAI-1) antigens, and platelet receptors CD42b, CD62P, and CD41a were evaluated...
December 20, 2016: Turkish Journal of Medical Sciences
https://www.readbyqxmd.com/read/28079982/recombinant-soluble-apyrase-apt102-inhibits-thrombosis-and-intimal-hyperplasia-in-vein-grafts-without-adversely-affecting-hemostasis-or-re-endothelialization
#2
Y Ji, O Adeola, T L Strawn, S S Jeong, R Chen, W P Fay
BACKGROUND: Occlusion of vein grafts (VGs) after bypass surgery due to thrombosis and intimal hyperplasia (IH) is a major clinical problem. Apyrases are enzymes that scavenge extracellular ATP and ADP and promote adenosine formation at sites of vascular injury and hence have potential to inhibit vein graft pathology. OBJECTIVES: We examined the effects of recombinant soluble human apyrase, APT102, on platelets, smooth muscle cells (SMCs), and endothelial cells (ECs) in vitro and thrombosis and IH in murine VGs...
January 12, 2017: Journal of Thrombosis and Haemostasis: JTH
https://www.readbyqxmd.com/read/28076477/pediatric-liver-transplantation-with-ex-situ-liver-transection-and-the-application-of-the-human-fibrinogen-and-thrombin-sponge-in-the-wound-area
#3
Fernando Pompeu Piza Vicentine, Adriano Miziara Gonzalez, Ramiro Anthero de Azevedo, Barbara Burza Benini, Marcelo Moura Linhares, Gaspar de Jesus Lopes-Filho, Jose Luiz Martins, Alcides Augusto Salzedas-Netto
Background: Surgical strategy to increase the number of liver transplants in the pediatric population is the ex-situ liver transection (reduction or split). However, it is associated with complications such as hemorrhage and leaks. The human fibrinogen and thrombin sponge is useful for improving hemostasis in liver surgery. Aim: Compare pediatric liver transplants with ex-situ liver transection (reduction or split) with or without the human fibrinogen and thrombin sponge...
November 2016: Arquivos Brasileiros de Cirurgia Digestiva: ABCD, Brazilian Archives of Digestive Surgery
https://www.readbyqxmd.com/read/28072750/upper-gastrointestinal-ectopic-variceal-bleeding-treated-with-various-endoscopic-modalities-case-reports-and-literature-review
#4
Sang Woo Park, Eunae Cho, Chung Hwan Jun, Sung Kyu Choi, Hyun Soo Kim, Chang Hwan Park, Jong Sun Rew, Sung Bum Cho, Hee Joon Kim, Mingui Han, Kyu Man Cho
RATIONALE: Ectopic variceal bleeding is a rare (2-5%) but fatal gastrointestinal bleed in patients with portal hypertension. Patients with ectopic variceal bleeding manifest melena, hematochezia, or hematemesis, which require urgent managements. Definitive therapeutic modalities of ectopic varices are not yet standardized because of low incidence. Various therapeutic modalities have been applied on the basis of the experiences of experts or availability of facilities, with varying results...
January 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28070049/-common-factors-for-ischemic-cerebral-stroke-in-coronary-artery-bypass-grafting-in-patients-with-concomitant-carotid-and-coronary-artery-severe-stenosis
#5
Lei Huang, Feng Kuang, Zhonggui Shan, Yiquan Lai, Hongwei Guo
To analyze two common factors for perioperative ischemic stroke in patients with concomitant carotid and coronary artery severe stenosis and to improve the therapeutic effect.
 Methods: A total of 44 patients with multi-vessel coronary artery disease combined with carotid stenosis, who admitted to the Department of Cardiac Surgery, the First Affiliated Hospital of Xiamen University from 2008 to 2014, were enrolled in this study. Among them, 32 cases were male, 12 cases was female. All patients received coronary artery bypass grafting after treatment of neck diseases...
December 28, 2016: Zhong Nan da Xue Xue Bao. Yi Xue Ban, Journal of Central South University. Medical Sciences
https://www.readbyqxmd.com/read/28064382/early-assessment-of-feasibility-and-technical-specificities-of-transoral-robotic-surgery-using-the-da-vinci-xi
#6
Philippe Gorphe, Jean Von Tan, Sophie El Bedoui, Dana M Hartl, Anne Auperin, Quentin Qassemyar, Antoine Moya-Plana, François Janot, Morbize Julieron, Stephane Temam
The latest generation Da Vinci(®) Xi™ Surgical System Robot released has not been evaluated to date in transoral surgery for head and neck cancers. We report here the 1-year results of a non-randomized phase II multicentric prospective trial aimed at assessing its feasibility and technical specificities. Our primary objective was to evaluate the feasibility of transoral robotic surgery using the da Vinci(®) Xi™ Surgical System Robot. The secondary objective was to assess peroperative outcomes. Twenty-seven patients, mean age 62...
January 7, 2017: Journal of Robotic Surgery
https://www.readbyqxmd.com/read/28061892/hydrochloric-acid-enhanced-radiofrequency-ablation-for-treating-a-large-hepatocellular-carcinoma-with-spontaneous-rapture-a-case-report
#7
Jin-Hua Huang, John N Morelli, Fei Ai, Ru-Hai Zou, Yang-Kui Gu, Fei Gao, Tian-Qi Zhang, Wang Yao, Xiong-Ying Jiang, Yan-Yang Zhang
BACKGROUND: A ruptured hepatocellular carcinoma (HCC) is often fatal. In addition to surgery and transarterial embolization, radiofrequency ablation (RFA) might be another option for treating a ruptured HCC. Unfortunately, conventional RFA has a limited ablation zone; as such, it is rarely used to treat ruptured tumors. CASE PRESENTATION: This case was a 60-year-old man who had a large, ruptured HCC in which hydrochloric acid (HCl)-enhanced RFA successfully controlled the bleeding and made the tumor completely necrotic...
January 7, 2017: Chinese Journal of Cancer
https://www.readbyqxmd.com/read/28058213/face-transplantation-anesthetic-challenges
#8
REVIEW
Aparna Dalal
Face transplantation is a complex vascular composite allotransplantation (VCA) surgery. It involves multiple types of tissue, such as bone, muscles, blood vessels, nerves to be transferred from the donor to the recipient as one unit. VCAs were added to the definition of organs covered by the Organ Procurement and Transplantation Network Final Rule and National Organ Transplant Act. Prior to harvest of the face from the donor, a tracheostomy is usually performed. The osteotomies and dissection of the midface bony skeleton may involve severe hemorrhagic blood loss often requiring transfusion of blood products...
December 24, 2016: World Journal of Transplantation
https://www.readbyqxmd.com/read/28045745/avoiding-complications-in-endoscopic-skull-base-surgery
#9
Jannis Constantinidis, Iordanis Konstantinidis
PURPOSE OF REVIEW: Endoscopic skull base surgery has become an established approach for the removal of tumors and cerebrospinal fluid fistulae repair. Compared with external approaches, it provides better aesthetic results and quality of life postoperatively. However, as it becomes popular and expands its indications possible complications should be reassessed in terms of incidence and variability in order to confirm its efficacy and safety. This article reviews the recent literature describing the main categories of possible complications suggesting strategies to minimize their incidence...
December 23, 2016: Current Opinion in Otolaryngology & Head and Neck Surgery
https://www.readbyqxmd.com/read/28039639/a-novel-procedure-for-introducing-large-sheet-type-surgical-material-with-a-self-expanding-origami-structure-using-a-slim-trocar-chevron-pleats-procedure
#10
Yuen Nakase, Kei Nakamura, Akira Sougawa, Tomoyuki Nagata, Satoshi Mochizuki, Shouzo Kitai, Seishirou Inaba
BACKGROUND: Large sheet-type surgical materials (e.g., absorbable hemostat, adhesion barrier membranes, and flat surgical mesh) are difficult to introduce into a corporeal cavity using a 5-mm trocar; however, laparoscopic surgeries that use mainly 5-mm trocars are increasing. Furthermore, it is necessary not only to introduce but also to secure the applied surgical material and expand it from the original surgical site. To address these challenges, we developed a novel procedure for introducing such surgical materials into a corporeal cavity using a 5-mm trocar and a self-expanding origami structure, called the "chevron pleats procedure (CPP)"...
December 30, 2016: Surgical Endoscopy
https://www.readbyqxmd.com/read/28034889/alteration-of-blood-clotting-and-lung-damage-by-protamine-are-avoided-using-the-heparin-and-polyphosphate-inhibitor-uhra
#11
Manu Thomas Kalathottukaren, Libin Abraham, Piyushkumar R Kapopara, Benjamin F L Lai, Rajesh A Shenoi, Federico I Rosell, Edward M Conway, Edward L G Pryzdial, James H Morrissey, Charles A Haynes, Jayachandran N Kizhakkedathu
Anticoagulant therapy associated bleeding and pathological thrombosis, pose serious risks to hospitalized patients. Both complications could be mitigated by developing new therapeutics that safely neutralize anticoagulant activity and inhibit activators of the intrinsic blood clotting pathway, such as polyphosphate (polyP) and extracellular nucleic acids. The latter strategy could reduce the use of anticoagulants, potentially decreasing bleeding events. However, previously described cationic inhibitors of polyP and extracellular nucleic acids, exhibit both non-specific binding and adverse effects on blood clotting that limit their use...
December 29, 2016: Blood
https://www.readbyqxmd.com/read/28032179/madelung-s-disease-revision-of-59-surgical-cases
#12
Cristina Isabel Calvo Pinto, Pedro João Marques Cardoso Carvalho, Manuel Maia Oliveira Correia
BACKGROUND: Madelung's disease (MD) is a rare disease, more common in Mediterranean countries and associated with alcohol abuse. However, MD etiology remains not completely understood. OBJECTIVE: The aim of this study was to investigate clinical features, treatment options and outcomes in patients with MD treated in our plastic surgery department. METHODS: We retrospectively reviewed 59 cases of MD operated on between 2004 and 2013. Demographic information, location of the deposits, associated pathology and habits, number and type of surgeries performed, surgical complications and disease evolution were analyzed...
December 28, 2016: Aesthetic Plastic Surgery
https://www.readbyqxmd.com/read/28027059/avoiding-complications-in-endoscopic-skull-base-surgery
#13
Jannis Constantinidis, Iordanis Konstantinidis
PURPOSE OF REVIEW: Endoscopic skull base surgery has become an established approach for the removal of tumors and cerebrospinal fluid fistulae repair. Compared with external approaches, it provides better aesthetic results and quality of life postoperatively. However, as it becomes popular and expands its indications possible complications should be reassessed in terms of incidence and variability in order to confirm its efficacy and safety. This article reviews the recent literature describing the main categories of possible complications suggesting strategies to minimize their incidence...
February 2017: Current Opinion in Otolaryngology & Head and Neck Surgery
https://www.readbyqxmd.com/read/28018108/heparin-bridge-therapy-and-post-polypectomy-bleeding
#14
Toshiyuki Kubo, Kentaro Yamashita, Kei Onodera, Tomoya Iida, Yoshiaki Arimura, Masanori Nojima, Hiroshi Nakase
AIM: To identify risk factors for post-polypectomy bleeding (PPB), focusing on antithrombotic agents. METHODS: This was a case-control study based on medical records at a single center. PPB was defined as bleeding that occurred 6 h to 10 d after colonoscopic polypectomy and required endoscopic hemostasis. As risk factors for PPB, patient-related factors including anticoagulants, antiplatelets and heparin bridge therapy as well as polyp- and procedure-related factors were evaluated...
December 7, 2016: World Journal of Gastroenterology: WJG
https://www.readbyqxmd.com/read/28012768/laparoscopic-radical-prostatectomy-with-a-remote-controlled-robot
#15
Clément-Claude Abbou, András Hoznek, Laurent Salomon, Leif Eric Olsson, Adrian Lobontiu, Fabien Saint, Antony Cicco, Patrick Antiphon, Dominique Chopin
PURPOSE: Robotics in surgery is a recent innovation. This technology offers a number of attractive features in laparoscopy. It overcomes the difficulties with fixed port sites by restoring all 6 degrees of freedom at the instrument tips, provides new possibilities for miniaturization of surgical tasks and allows remote controlled surgery. We investigated the applicability of remote controlled robotic surgery to laparoscopic radical prostatectomy. MATERIALS AND METHODS: Our previous experience with laparoscopic prostatectomy served as a basis for adapting robotic surgery to this procedure...
December 21, 2016: Journal of Urology
https://www.readbyqxmd.com/read/28012690/embolization-for-bleeding-after-hepatic-radiofrequency-ablation
#16
Jong Woo Kim, Ji Hoon Shin, Pyo Nyun Kim, Yong Moon Shin, Hyung Jin Won, Gi-Young Ko, Hyun-Ki Yoon
PURPOSE: To evaluate safety and clinical efficacy of embolization for management of bleeding after hepatic radiofrequency (RF) ablation. MATERIALS AND METHODS: From January 2000 to December 2014, 5,196 patients with 9,743 tumors underwent 8,303 RF ablation sessions. Of these patients, 62 experienced bleeding after hepatic RF ablation; 15 patients (12 men and 3 women; mean age 62 y; range, 49-76 y) underwent embolization and composed the final study cohort. Tumors were hepatocellular carcinomas in 13 (87%) patients and metastatic adenocarcinomas from colorectal cancer in 2 (13%) patients...
December 21, 2016: Journal of Vascular and Interventional Radiology: JVIR
https://www.readbyqxmd.com/read/28011314/idarucizumab-praxbind%C3%A2-the-first-reversal-agent-for-a-direct-oral-anticoagulant
#17
EDITORIAL
Shannon W Finks, Kelly C Rogers
Idarucizumab is a humanized monoclonal antibody fragment engineered to specifically neutralize the effects of the oral direct thrombin inhibitor dabigatran in order to restore hemostasis. FDA approval for idarucizumab, under the brand name Praxbind®, was granted in October 2015 for the reversal of dabigatran in settings of emergent life-threatening bleeding episodes or in the case when an emergent surgery or urgent procedure is needed to reverse its anticoagulant effects.(1) This article summarizes pertinent and clinical information regarding idarucizumab and other reversal agents currently under investigation...
December 20, 2016: American Journal of Medicine
https://www.readbyqxmd.com/read/28008465/five-year-results-of-laparoscopic-sleeve-gastrectomy-for-the-treatment-of-severe-obesity
#18
David Nocca, Marcelo Loureiro, El Mehdi Skalli, Marius Nedelcu, Audrey Jaussent, Melanie Deloze, Patrick Lefebvre, Jean Michel Fabre
BACKGROUND: Since 2011, the most used bariatric technique in France has been the sleeve gastrectomy. There are still few studies exploring the medium and long-term results of this technique. OBJECTIVE: To describe medium-long-term (5 years) results of a cohort of CHU Montpellier experience in sleeve gastrectomy for morbid obesity. METHODS: All patients that underwent laparoscopic sleeve gastrectomy (LSG) from January 2005 to June 2013 were included in this study...
December 23, 2016: Surgical Endoscopy
https://www.readbyqxmd.com/read/27979486/platelet-rich-plasma-a-biomimetic-approach-to-enhancement-of-surgical-wound-healing
#19
Joseph S Fernandez-Moure, Jeffrey L Van Eps, Fernando J Cabrera, Zonia Barbosa, Guillermo Medrano Del Rosal, Bradley K Weiner, Warren A Ellsworth, Ennio Tasciotti
Platelets are small anucleate cytoplasmic cell bodies released by megakaryocytes in response to various physiologic triggers. Traditionally thought to be solely involved in the mechanisms of hemostasis, platelets have gained much attention due to their involvement wound healing, immunomodulation, and antiseptic properties. As the field of surgery continues to evolve so does the need for therapies to aid in treating the increasingly complex patients seen. With over 14 million obstetric, musculoskeletal, and urological and gastrointestinal surgeries performed annually, the healing of surgical wounds continues to be of upmost importance to the surgeon and patient...
January 2017: Journal of Surgical Research
https://www.readbyqxmd.com/read/27955644/a-randomized-controlled-trial-on-effects-of-different-hemostatic-sponges-in-posterior-spinal-fusion-surgeries
#20
Derong Xu, Zhinan Ren, Xin Chen, Qianyu Zhuang, Lin Sheng, Shugang Li
BACKGROUND: Spinal fusion surgery is associated with significant blood loss, which may result in potential clinical complications, it is necessary to take safe and effective measures to reduce blood loss in surgery. We perform this study to assess the impact of three different hemostatic materials on perioperative blood loss. METHODS: We performed a Randomized Controlled Trial research and recruited patients with lumbar disease into the study between November 2013 and March 2015...
December 12, 2016: BMC Surgery
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