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https://www.readbyqxmd.com/read/28103418/three-hundred-and-sixty-eight-consecutive-pancreaticoduodenetomies-with-zero-mortality
#1
Seiji Oguro, Jiro Yoshimoto, Hiroshi Imamura, Yoichi Ishizaki, Seiji Kawasaki
BACKGROUND/PURPOSE: Only a limited number of reports have documented zero mortality in consecutive pancreaticoduodenetomy series. The aim of this study is to review and verify our management aiming to eliminate mortality after pancreaticoduodenetomy. METHODS: Three hundred sixty-eight consecutive patients undergoing pancreaticoduodenetomy between 2002 and 2015 were retrospectively reviewed. During this period, in order to enhance the safety of pancreaticoduodenetomy, we have employed a consistent strategy consisting of early ligation of the inferior pancreatoduodenal artery, mucosal sutureless pancreaticojejunostomy combined with external pancreatic duct stenting, conditional two-stage pancreaticojejunostomy, jejunal decompression using tube jejunostomy, application of an omental flap to cover the stump of the gastroduodenal artery, and careful postoperative drain management...
January 19, 2017: Journal of Hepato-biliary-pancreatic Sciences
https://www.readbyqxmd.com/read/28103372/the-effect-of-epidural-levobupivacaine-and-fentanyl-on-stress-response-and-pain-management-in-patients-undergoing-percutaneous-nephrolithotomy
#2
A Ahiskalioglu, O Ahiskalioglu, A Dostbil, C Abdullah, A Megnet, M Celik, I Ilker, K Husnu
Objective: The perioperative stress response of patients who were scheduled to have percutaneous nephrolithotomy under epidural anaesthesia with opioids and local anaesthetics has not been investigated in detail yet. Our hypothesis is that the stress response following percutaneous nephrolithotomy can be lessened by epidural analgesia. Methods: A total of 48 patients, between 18-65 years of age and ASA I-II, for whom elective percutaneous nephrolithotomy was planned, were randomly divided into two groups namely: Group GA (n = 24): general anaesthesia by sevoflurane and fentanyl and postoperative intravenous PCA; Group GE (n = 24): epidural anaesthesia and general anaesthesia together with postoperative epidural analgesia (0...
March 14, 2016: West Indian Medical Journal
https://www.readbyqxmd.com/read/28103143/video-assisted-thoracic-surgical-lobectomy-for-lung-cancer-description-of-a-learning-curve
#3
Fei Yao, Jian Wang, Ju Yao, Fangrong Hang, Shiqi Cao, Yongke Cao
BACKGROUND: Video-assisted thoracic surgical (VATS) lobectomy is gaining popularity in the treatment of lung cancer. The aim of this study is to investigate the learning curve of VATS lobectomy by using multidimensional methods and to compare the learning curve groups with respect to perioperative clinical outcomes. METHODS: We retrospectively reviewed a prospective database to identify 67 consecutive patients who underwent VATS lobectomy for lung cancer by a single surgeon...
January 19, 2017: Journal of Laparoendoscopic & Advanced Surgical Techniques. Part A
https://www.readbyqxmd.com/read/28102450/hidden-blood-loss-and-the-influential-factors-after-percutaneous-kyphoplasty-surgery
#4
Yao-Sen Wu, Hui Zhang, Wen-Hao Zheng, Zhen-Hua Feng, Ze-Xin Chen, Yan Lin
PURPOSE: Percutaneous kyphoplasty (PKP) is a minimally invasive procedure for the treatment of osteoporotic vertebral compression fractures (OVCFs). It is generally considered that there is little blood loss during the surgery. However, a significant perioperative hidden blood loss (HBL) is neglected. This study was to examine the amount of HBL and determine the influential factors during PKP. METHODS: From January 2015 to January 2016, 115 patients with OVCFs who were scheduled to have a PKP were enrolled in this study...
January 19, 2017: European Spine Journal
https://www.readbyqxmd.com/read/28101946/repeat-hepatectomy-is-independently-associated-with-favorable-long-term-outcome-in-patients-with-colorectal-liver-metastases
#5
Christopher P Neal, Gael R Nana, Michael Jones, Vaux Cairns, Wee Ngu, John Isherwood, Ashley R Dennison, Giuseppe Garcea
Up to three-quarters of patients undergoing liver resection for colorectal liver metastases (CRLM) develop intrahepatic recurrence. Repeat hepatic resection appears to provide the optimal chance of cure for these patients. The aim of this study was to analyze short- and long-term outcomes following index and repeat hepatectomy for CRLM. Clinicopathological data were obtained from a prospectively maintained database. Perioperative variables and outcomes were compared using the Chi-squared test. Variables associated with long-term survival following index and second hepatectomy were identified by Cox regression analyses...
January 19, 2017: Cancer Medicine
https://www.readbyqxmd.com/read/28100529/children-and-parental-anxiolysis-in-paediatric-ambulatory-surgery-a-randomized-controlled-study-comparing-0-3%C3%A2-mg-kg-1-midazolam-to-tablet-computer-based-interactive-distraction
#6
C Marechal, J Berthiller, S Tosetti, B Cogniat, H Desombres, L Bouvet, B Kassai, D Chassard, M de Queiroz Siqueira
BACKGROUND: The operating theatre, anaesthesia induction and separation from parents create fear and anxiety in children. Anxiety leads to adverse behavioral changes appearing and sometimes persisting during the postoperative period. Our aim was to compare the effects of midazolam (0.3 mg kg(-)(1): MDZ) for premedication with age-appropriate tablet game apps (TAB) on children anxiety during and after ambulatory surgery. METHODS: A randomized controlled trial was conducted from May 16th, 2013 to March 25th, 2014 at the Children Hospital of Lyon...
February 2017: British Journal of Anaesthesia
https://www.readbyqxmd.com/read/28100154/one-year-follow-up-after-hybrid-thoracoabdominal-aortic-repair
#7
Rob A van de Graaf, Frank Grüne, Sanne E Hoeks, Sander Ten Raa, Robert Jan Stolker, Hence J M Verhagen, Felix van Lier
BACKGROUND: Compared to open thoracoabdominal aortic aneurysm (TAAA) repair, hybrid repair is thought to be less invasive with better perioperative outcomes. Due to the extent of the operation and long recovery period, studying perioperative results may not be sufficient for evaluation of the true treatment effect. The aim of this study is to evaluate 1-year mortality and morbidity in patients with TAAA undergoing hybrid repair. METHODS: In a retrospective cohort study, all medical records of patients undergoing hybrid repair for TAAA at the Erasmus University Medical Center between January 2007 and January 2015 were studied...
January 2017: Vascular and Endovascular Surgery
https://www.readbyqxmd.com/read/28099324/interaction-of-isoflurane-tumor-necrosis-factor-%C3%AE-and-%C3%AE-amyloid-on-long-term-potentiation-in-rat-hippocampal-slices
#8
Ran Zhou, Philip Bickler
BACKGROUND: The relationship between inhalational anesthetics such as isoflurane and cognitive impairment in the elderly is controversial. Both β-amyloid peptide (Aβ), associated with Alzheimer disease, and tumor necrosis factor-α (TNF-α), a proinflammatory stress-related peptide, impair the synaptic function. We hypothesized that transient exposure to isoflurane and these peptides would impair synaptic function, manifest as a depression of long-term potentiation (LTP) and paired pulse facilitation (PPF), in the rat hippocampus...
February 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28099277/benefits-of-comprehensive-rehabilitation-therapy-in-thymectomy-for-myasthenia-gravis-a-propensity-score-matching-analysis
#9
Vincenzo Ambrogi, Tommaso Claudio Mineo
OBJECTIVE: To demonstrate the effectiveness of a comprehensive program of rehabilitation therapy in patients undergoing thymectomy for myasthenia gravis (MG). DESIGN: From 2005 to 2010, 46 consecutive patients affected by MG underwent a rehabilitation program both before and after thymectomy. We matched each patient with a "control patient" who underwent thymectomy within the period 1999 to 2004 with no preoperative rehabilitation, who had the closest propensity score matching...
February 2017: American Journal of Physical Medicine & Rehabilitation
https://www.readbyqxmd.com/read/28097876/the-relationship-of-perfectionism-with-psychological-symptoms-in-cancer-patients-and-the-contributing-role-of-hyperarousability-and-coping
#10
Claudia Trudel-Fitzgerald, Josée Savard, Lisa-Maria Slim, Renée-Claude Roy, Gordon L Flett, Paul L Hewitt, Hans Ivers
OBJECTIVE: Significant levels of anxiety, depression and insomnia symptoms are found in cancer patients. Perfectionism, arousability and coping have been associated with these psychological symptoms in the general population but their role among cancer patients remains to be assessed. This study examined the longitudinal relationships between perfectionism and psychological symptoms (anxiety, depression, insomnia), and the intermediate role of the arousability trait and coping strategies...
January 18, 2017: Psychology & Health
https://www.readbyqxmd.com/read/28097314/complications-of-bilateral-neck-dissection-in-thyroid-cancer-from-a-single-high-volume-center
#11
Caitlin McMullen, Daniel Rocke, Jeremy Freeman
Importance: The morbidity of bilateral lateral neck dissection (BLND) for thyroid cancers has not been described in detail. This study delineates the specific complications arising from BLND for thyroid cancers at a single high-volume center. Objective: To determine the morbidity associated with BLNDs for differentiated thyroid cancers at our institution. Design, Setting, and Participants: This was a retrospective review of medical records performed to identify patients having undergone BLNDs for thyroid cancers by a single surgeon at an academic, tertiary medical center in Toronto, Ontario, Canada, from 1988 to 2015...
January 12, 2017: JAMA Otolaryngology—Head & Neck Surgery
https://www.readbyqxmd.com/read/28096581/role-of-preemptive-tapentadol-in-reduction-of-postoperative-analgesic-requirements-after-laparoscopic-cholecystectomy
#12
Ghanshyam Yadav, Gaurav Jain, Abhishek Samprathi, Annavi Baghel, Dinesh Kumar Singh
BACKGROUND AND AIMS: Poorly managed acute postoperative pain may result in prolonged morbidity. Various pharmacotherapies have targeted this, but research on an ideal preemptive analgesic continues, taking into account drug-related side effects. Considering the better tolerability profile of tapentadol, we assessed its role as a preemptive analgesic in the reduction of postoperative analgesic requirements, after laparoscopic cholecystectomy. MATERIAL AND METHODS: In a prospective-double-blinded fashion, sixty patients posted for above surgery, were randomized to receive tablet tapentadol 75 mg (Group A) or starch tablets (Group B) orally, an hour before induction of general anesthesia...
October 2016: Journal of Anaesthesiology, Clinical Pharmacology
https://www.readbyqxmd.com/read/28096572/current-and-emerging-treatments-for-hypercholesterolemia-a-focus-on-statins-and-proprotein-convertase-subtilisin-kexin-type-9-inhibitors-for-perioperative-clinicians
#13
REVIEW
Terrence L Trentman, Steven G Avey, Harish Ramakrishna
Statins are a mainstay of hyperlipidemia treatment. These drugs inhibit the enzyme 3-hydroxy-3-methylglutaryl coenzyme A reductase and have beneficial effects on atherosclerosis including plaque stabilization, reduction of platelet activation, and reduction of plaque proliferation and inflammation. Statins also have a benefit beyond atherosclerotic plaque, including anticoagulation, vasodilatation, antioxidant effects, and reduction of mediators of inflammation. In the perioperative period, statins appear to contribute to improved outcomes via these mechanisms...
October 2016: Journal of Anaesthesiology, Clinical Pharmacology
https://www.readbyqxmd.com/read/28094478/fluid-management-in-cardiac-surgery-patients-pitfalls-challenges-and-solutions
#14
Elena Bignami, Marcello Guarnieri, Marco Gemma
Fluid administration is a powerful tool for hemodynamic stabilization as it increases preload and improves cardiac function in fluid-responsive patients. However, there are various types of fluid to choose from. The use of colloids and crystalloids in non-cardiac Intensive Care Units (ICU) has been reported, showing controversial results. Many trials on sepsis in a non-cardiac ICU setting show that colloids, in particular hydroxyethyl starches and gelatins, might have a detrimental effect on kidney function, and on major outcomes such as mortality...
January 17, 2017: Minerva Anestesiologica
https://www.readbyqxmd.com/read/28092285/perioperative-%C3%AE-blockers-in-patients-undergoing-noncardiac-surgery-scientific-misconduct-and-clinical-guidelines
#15
Dhauna Karam, Rohit Arora
BACKGROUND: β-blocker use in perioperative period of noncardiac surgeries has been a topic of debate since many years. Earlier studies conducted in the 90s showed decreased cardiac adverse events and improved postoperative outcomes with β-blocker use. Based on this, the ACCF and ESC published guidelines strongly supporting β-blocker use. But contemporaneous studies conducted revealed conflicting evidence and have also proven some of the earlier studies to be fraudulent. Although ACCF guidelines have been updated to partially reflect the changes, ESC guidelines continue to support β-blocker use...
January 10, 2017: American Journal of Therapeutics
https://www.readbyqxmd.com/read/28092065/impact-of-celecoxib-on-inflammation-during-cancer-surgery-a-randomized-clinical-trial
#16
Jonathan G Hiller, Shienny Sampurno, Rosemary Millen, Niketh Kuruvilla, Kwok M Ho, Rob Ramsay, Bernhard Riedel
PURPOSE: During cancer surgery, prostaglandin-mediated inflammation may promote and activate micrometastatic disease with a consequent increase in long-term cancer recurrence. Cyclooxygenase-2 inhibitors, known to have anti-proliferative properties, may offset such perioperative perturbation. We investigated the effectiveness of these agents to minimize inflammatory changes during cancer surgery. METHODS: Following ethics approval, 32 patients who were to undergo major intracavity cancer surgery were enrolled in this prospective, randomized, clinical trial...
January 13, 2017: Canadian Journal of Anaesthesia, Journal Canadien D'anesthésie
https://www.readbyqxmd.com/read/28091703/bolus-application-of-landiolol-and-esmolol-comparison-of-the-pharmacokinetic-and-pharmacodynamic-profiles-in-a-healthy-caucasian-group
#17
Günther Krumpl, Ivan Ulc, Michaela Trebs, Pavla Kadlecová, Juri Hodisch
PURPOSE: The aim of this prospective study was to compare in non-Asian subjects the pharmacokinetics (PK), pharmacodynamics (PD), safety, and tolerability of two short-acting cardioselective β1-adrenergic antagonists, landiolol and esmolol, after administration of three different bolus dosages. MATERIALS AND METHODS: We conducted a single-center, prospective, double-blinded, randomized study in three cross-over periods with 12 healthy subjects (7 women and 5 men, mean age of 24...
January 13, 2017: European Journal of Clinical Pharmacology
https://www.readbyqxmd.com/read/28089722/perioperative-allogenic-blood-transfusion-in-renal-cell-carcinoma-risk-factors-and-effect-on-long-term-outcomes
#18
Francesco Soria, Michela de Martino, Carmen V Leitner, Marco Moschini, Shahrokh F Shariat, Tobias Klatte
BACKGROUND: We sought to create a preoperative model to predict the risk of perioperative blood transfusion (PBT) in patients with renal cell carcinoma (RCC) undergoing nephrectomy and to evaluate the effect of PBT on long-term outcomes. PATIENTS AND METHODS: The present retrospective study included 648 consecutive patients who had undergone radical or partial nephrectomy for RCC at a single institution. The risk factors for PBT were analyzed using logistic regression analysis...
December 29, 2016: Clinical Genitourinary Cancer
https://www.readbyqxmd.com/read/28089474/what-happened-to-the-complication-the-importance-of-acs-nsqip-pediatric-in-optimizing-quality-improvement-initiatives-for-resident-education
#19
Bennett W Calder, Joseph V Sakran, Christian J Streck, Robert A Cina
OBJECTIVE: Morbidity and Mortality (M&M) conference is considered the golden hour of surgical education. Most training programs lack standardized methods to evaluate self-reported outcomes and contributions to resident education. The purpose of this study was to determine whether residents underreport pediatric postoperative complications thereby limiting a comprehensive educational opportunity and the ability to adequately perform quality improvement during M&M conference. DESIGN: A retrospective analysis of resident reports submitted to the M&M committee at an academic medical center was conducted over 1 year...
January 12, 2017: Journal of Surgical Education
https://www.readbyqxmd.com/read/28089468/obtain-a-outcome-benefits-of-tranexamic-acid-in-hip-arthroplasty-a%C3%A2-randomized-double-blinded-controlled-trial
#20
Andrew Fraval, Peter Effeney, Lena Fiddelaers, Belinda Smith, Ben Towell, Phong Tran
BACKGROUND: We examined whether the blood conserving effect of tranexamic acid (TXA) in total hip arthroplasty using the direct anterior approach, translates to an effect on functional outcomes in the perioperative period. METHODS: We conducted a single-center, randomized, double-blinded, placebo-controlled trial. One hundred one patients were randomized to receive either TXA or an equivalent volume of normal saline. The primary outcome measure was thigh swelling...
December 8, 2016: Journal of Arthroplasty
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