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https://www.readbyqxmd.com/read/27890439/a-japanese-nationwide-multicenter-survey-on-perioperative-complications-of-corrective-fusion-for-elderly-patients-with-adult-spinal-deformity
#1
Yu Yamato, Yukihiro Matsuyama, Kazuhiro Hasegawa, Yoichi Aota, Tsutomu Akazawa, Takahiro Iida, Kazumasa Ueyama, Koki Uno, Tokumi Kanemura, Noriaki Kawakami, Toshiaki Kotani, Masashi Takaso, Jun Takahashi, Masato Tanaka, Hiroshi Taneichi, Taichi Tsuji, Hideo Hosoe, Joji Mochida, Takachika Shimizu, Ikuho Yonezawa, Kota Watanabe, Morio Matsumoto
BACKGROUND: Recently, corrective fusion surgery for patients with adult spinal deformity (ASD) has become common in Japan. This study aimed to clarify the status of surgeries for ASD in Japan, focusing on perioperative complications. A nationwide multicenter survey gathering information on surgically treated ASD patients was conducted by the committee for Adult Spinal Deformity of the Japanese Scoliosis Society. METHODS: This study was a review of retrospectively collected data from 18 spine scoliosis centers belonging to the Japanese Scoliosis Society...
November 24, 2016: Journal of Orthopaedic Science: Official Journal of the Japanese Orthopaedic Association
https://www.readbyqxmd.com/read/27876563/preoperative-optimization-of-the-heart-failure-patient-undergoing-cardiac-surgery
#2
REVIEW
Maxime Pichette, Mark Liszkowski, Anique Ducharme
Heart failure patients who undergo cardiac surgery are exposed to significant perioperative complications and high mortality. We herein review the literature concerning preoperative optimization of these patients. Salient findings are that end-organ dysfunction and medication should be optimized before surgery. Specifically: (1) reversible causes of anemia should be treated and a preoperative hemoglobin level of 100 g/L obtained; (2) renal function and volume status should be optimized; (3) liver function must be carefully evaluated; (4) nutritional status should be assessed and cachexia treated to achieve a preoperative albumin level of at least 30 g/L and a body mass index > 20; and (5) medication adjustments performed, such as withholding inhibitors of the renin-angiotensin-aldosterone system before surgery and continuing, but not starting, β-blockers...
August 6, 2016: Canadian Journal of Cardiology
https://www.readbyqxmd.com/read/27853881/a-suspected-case-of-rocuronium-sugammadex-complex-induced-anaphylactic-shock-after-cesarean-section
#3
Masakazu Yamaoka, Miki Deguchi, Kiichiro Ninomiya, Toshiaki Kurasako, Mutsuko Matsumoto
An anaphylactic reaction during a cesarean section occurs rarely, and rocuronium is thought to be one of the common agents causing perioperative anaphylaxis. Here we report an anaphylactic shock after cesarean section that is suggested to be induced by the rocuronium-sugammadex complex. A 36-year-old primigravida underwent an elective cesarean section under general anesthesia due to placenta previa. While the operation was completed uneventfully, she developed anaphylactic shock following sugammadex administration...
November 16, 2016: Journal of Anesthesia
https://www.readbyqxmd.com/read/27822310/anaphylactic-shock-during-cement-implantation-of-a-total-hip-arthroplasty-in-a-patient-with-underlying-mastocytosis-case-report-of-a-rare-intraoperative-complication
#4
Anita Ten Hagen, Pieter Doldersum, Tom van Raaij
BACKGROUND: Cemented total hip arthroplasty (THA) is a safe and common procedure. In rare cases life threatening bone cement implantation syndrome (BCIS) may occur, which is commonly caused by pulmonary embolism (PE). CASE PRESENTATION: We describe the rare case of a 70-year old patient who underwent an elective total hip replacement. Before surgery he was diagnosed with underlying systemic indolent mastocytosis, a rare pathological disorder that may result in anaphylaxis after massive systemic mast cell activation...
2016: Patient Safety in Surgery
https://www.readbyqxmd.com/read/27797797/infrarenal-aortic-clamp-reviving-a-patient-from-acute-surgical-haemorrhagic-shock-a-novel-management-technique
#5
Ranjith Kumar, M V S Satya Prakash, Subhasree Das, Ramanitharan Manikandan
Surgical management of renal cell carcinoma extending into the inferior vena cava (IVC) is almost always accompanied by massive intraoperative blood loss and associated complications. It is a widely recognised problem, and its active management is essential in improving the perioperative morbidity and mortality. We share our experience with a similar case of open radical nephrectomy with massive blood loss of twice the circulating volume in a duration of <8 surgical hours. Although we emphasise the goals of securing haemostasis, restoration of circulating volume, and efficient management by replacing blood components, in the present case, despite the above-mentioned goals being fulfilled, we were unable to extricate the patient from haemorrhagic shock by conventional means and therefore resorted to desperate measures, namely the novel approach of infrarenal aortic clamping along with higher than recommended vasopressor support...
October 19, 2016: BMJ Case Reports
https://www.readbyqxmd.com/read/27789318/mortality-risk-for-ruptured-abdominal-aortic-aneurysm-in-women
#6
Paola De Rango, Gioele Simonte, Alessandra Manzone, Luca Farchioni, Enrico Cieri, Fabio Verzini, Gianbattista Parlani, Giacomo Isernia, Massimo Lenti
BACKGROUND: Sex differences in presentation and outcomes of abdominal aortic aneurysms (AAA) with increased mortality rates in women are suggested. This study aimed to assess mortality risk after repair of ruptured AAA (rAAA) in women in the endovascular abdominal aortic repair (EVAR) era. METHODS: Patients treated between 2006 and 2015 for rAAA were included in a prospective database. Characteristics at presentation and outcomes were compared between women and men...
October 24, 2016: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/27757433/pan-spinal-infection-a-case-series-and-review-of-the-literature
#7
Chien Yew Kow, Patrick Chan, Greg Etherington, Lu Ton, Susan Liew, Allen C Cheng, Jeffrey V Rosenfeld
BACKGROUND: Panspinal infection usually presents with fever, back pain, neurological deficit, and in advanced cases multi-organ failure and septic shock. The choice of treatment for panspinal infection is challenging because these patients are usually medically unstable with severe neurological compromise. The objective of this study is to review management and long term outcomes for patients with panspinal infection. METHODS: A retrospective review of patients with panspinal infection treated in our center over a 5-year period [Jan 2010-Dec 2014] and a review of the current published literatures was undertaken...
September 2016: Journal of Spine Surgery (Hong Kong)
https://www.readbyqxmd.com/read/27738458/long-term-outcomes-of-surgical-treatment-with-in-situ-graft-reconstruction-for-secondary-aorto-enteric-fistula
#8
Munetaka Hashimoto, Hitoshi Goto, Daijirou Akamatsu, Takuya Shimizu, Ken Tsuchida, Keiichiro Kawamura, Yuta Tajima, Michihisa Umetsu
Objectives: The optimal surgical management for secondary aorto-enteric fistula (sAEF) is controversial. Here, we report the long-term outcomes of a surgical treatment with in situ graft reconstruction for sAEF that was performed at our hospital. Methods: Between 2009 and 2012, 10 consecutive patients (8 males, 2 females, mean age 75.9 years) with sAEF were surgically treated with in situ graft reconstruction. Perioperative and long-term outcomes were reviewed retrospectively by medical records. Results: Clinical manifestations, including gastrointestinal bleeding, shock, sepsis, and back and abdominal pain, were observed during the treatment of the patients...
2016: Annals of Vascular Diseases
https://www.readbyqxmd.com/read/27737442/association-of-clinical-risk-factors-and-postoperative-complications-with-unplanned-hospital-readmission-after-head-and-neck-cancer-surgery
#9
Andrés M Bur, Jason A Brant, Carolyn L Mulvey, Elizabeth A Nicolli, Robert M Brody, John P Fischer, Steven B Cannady, Jason G Newman
Importance: Unplanned hospital readmission is costly and in recent years has become a focus of health care legislation intended to reduce health care expenditures. Greater understanding of which perioperative complications are associated with hospital readmission after surgery for head and neck cancer is needed to reduce unplanned readmissions. Objective: To determine which clinical risk factors and complications are associated with 30-day unplanned readmission after surgery for malignant neoplasms of the head and neck...
October 13, 2016: JAMA Otolaryngology—Head & Neck Surgery
https://www.readbyqxmd.com/read/27703633/anaphylactic-shock-caused-by-intramuscular-injection-of-midazolam-during-the-perioperative-period-a-case-report
#10
Kyu Nam Kim, Dong Won Kim, Yeong Hun Sin, Soo Kyung Lee
Although anaphylactic shock during the perioperative period is rare, it can be lethal due to severe cardiovascular and respiratory collapse. Midazolam is generally used as premedication for relieving anxiety about the operation, and the danger of anaphylactic shock after intramuscular injection is not widely recognized. We report the first case of anaphylactic shock occurring during the perioperative period after intramuscular injection of midazolam. Since anaphylactic shock after intramuscular injection can be of slow onset, the operation should be delayed if an anaphylactic reaction is suspected, even if the symptoms are limited...
October 2016: Korean Journal of Anesthesiology
https://www.readbyqxmd.com/read/27702437/endovascular-repair-versus-open-surgery-in-patients-with-ruptured-abdominal-aortic-aneurysms-12-year-review
#11
Gloria María Novo Martínez, Marta Ballesteros Pomar, Elena Menéndez Sánchez, Eliezer Santos Alcántara, Inés Rodríguez Fernández, Andrés Manuel Zorita Calvo
INTRODUCTION: Rupture of abdominal aortic aneurysm is still a difficult challenge for the vascular surgeon due to the high perioperative mortality. The aim of our study is to describe the characteristics of the population as well as to compare morbidity and mortality in patients undergoing open surgery or endovascular repair in our center. METHODS: Database with 82 rAAA between January 2002-December 2014, studying two cohorts, open surgery and endovascular repair...
October 1, 2016: Cirugía Española
https://www.readbyqxmd.com/read/27680814/g3-intraoperative-haemodynamic-monitoring-during-high-risk-caesarean-section-a-comparison-between-bioreactance-nicom-r-and-pressure-waveform-analysis-lidcorapidr-preliminary-results
#12
D Vinayagam, S Bampoe, B Thilaganathan, A Khalil
BACKGROUND: Intraoperative haemodynamic monitoring is carried out in high-risk surgical patients, often using invasive methods, including pulmonary artery catheterisation. Early goal-directed therapy in high-risk surgical patients reduces tissue hypoxia, organ failure and improves outcomes. Significant maternal morbidity arises as a result of perioperative haemorrhage. At present, heart rate and brachial blood pressure are used as proxy markers to aid in fluid resuscitation, however, we know that these exhibit minimal change during early stages of shock, and are poor indicators of the adequacy of therapeutic intervention...
August 2016: Journal of Maternal-fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/27615585/patients-experience-of-adolescent-idiopathic-scoliosis-surgery-a-phenomenological-analysis
#13
Cheryl Honeyman, Jean Davison
Background Adolescent idiopathic scoliosis is a three-dimensional curvature of the spine of unknown cause that occurs in often otherwise fit young people. A complex surgical procedure is required for the most severe curves. Quantitative literature suggests scoliosis surgery improves patients' lives, while qualitative literature focuses on patients' concerns rather than their experience. Aims To explore how adolescents interpret their perioperative experience. Method Six participants, aged 15-18, were interviewed and transcripts were analysed...
September 12, 2016: Nursing Children and Young People
https://www.readbyqxmd.com/read/27583584/protocolized-care-for-early-shock-resuscitation
#14
Matthew Goodwin, Kaori Ito, Arielle H Gupta, Emanuel P Rivers
PURPOSE OF REVIEW: Protocolized care for early shock resuscitation (PCESR) has been intensely examined over the last decade. The purpose is to review the pathophysiologic basis, historical origin, clinical applications, components and outcome implications of PCESR. RECENT FINDINGS: PCESR is a multifaceted systems-based approach that includes early detection of high-risk patients and interventions to rapidly reverse hemodynamic perturbations that result in global or regional tissue hypoxia...
October 2016: Current Opinion in Critical Care
https://www.readbyqxmd.com/read/27570158/influence-of-specialty-training-and-trainee-involvement-on-perioperative-outcomes-of-esophagectomy
#15
Zeyad Khoushhal, Joseph Canner, Eric Schneider, Miloslawa Stem, Elliott Haut, Benedetto Mungo, Anne Lidor, Daniela Molena
BACKGROUND: Hospitals' and surgeons' volume-outcome relationship have been reported in several esophagectomy studies with an inverse association of mortality and volume. The purpose of our study was to evaluate the outcomes of esophagectomy in the United States relative to the surgeon's specialty. METHODS: This was a retrospective analysis using the American College of Surgeons National Surgical Quality Improvement Program database (2006 to 2013). All patients (18 years of age and older) who underwent esophagectomy were divided into 2 groups according to whether the operation was performed by a general surgeon (GS) or a cardiothoracic surgeon (CTS)...
December 2016: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/27555148/triple-a-to-triple-s-from-diagnosis-to-anesthetic-management-of-allgrove-syndrome
#16
Mridul Dhar, Nimisha Verma, Ram Badan Singh, Vishal Krishna Pai
INTRODUCTION: Allgrove syndrome (AS) is a rare autosomal recessive disorder characterized by achalasia cardia, alacrimia, and adrenocorticotropic hormone-resistant adrenal insufficiency which is sometimes associated with autonomic dysfunction. It has also been referred to as the triple A syndrome in view of the cardinal symptoms described above. First described by Allgrove et al in 1978, the disorder usually presents mostly during the first decade of life. These patients have the threat of adrenal crisis, shock, and hypoglycemia and are usually on steroid supplementation...
September 2016: Journal of Clinical Anesthesia
https://www.readbyqxmd.com/read/27503783/characterization-of-perioperative-infection-risk-among-patients-undergoing-radical-cystectomy-results-from-the-national-surgical-quality-improvement-program
#17
William P Parker, Matthew K Tollefson, Courtney N Heins, Kristine T Hanson, Elizabeth B Habermann, Harras B Zaid, Igor Frank, R Houston Thompson, Stephen A Boorjian
OBJECTIVES: To evaluate the incidence, risk factors, and timing of infections following radical cystectomy (RC). METHODS: The American College of Surgeons National Surgical Quality Improvement Project database was queried to identify patients undergoing RC for bladder cancer from 2006 to 2013. Characteristics including year of surgery, age, sex body mass index, diabetes, smoking, renal function, steroid usage, preoperative albumin, preoperative hematocrit, perioperative blood transfusion (PBT), and operative time were assessed for association with the risk of infection within 30 days of RC using multivariable logistic regression...
December 2016: Urologic Oncology
https://www.readbyqxmd.com/read/27468187/bleeding-after-endoscopic-submucosal-dissection-risk-factors-and-preventive-methods
#18
REVIEW
Yosuke Kataoka, Yosuke Tsuji, Yoshiki Sakaguchi, Chihiro Minatsuki, Itsuko Asada-Hirayama, Keiko Niimi, Satoshi Ono, Shinya Kodashima, Nobutake Yamamichi, Mitsuhiro Fujishiro, Kazuhiko Koike
Endoscopic submucosal dissection (ESD) has become widely accepted as a standard method of treatment for superficial gastrointestinal neoplasms because it enables en block resection even for large lesions or fibrotic lesions with minimal invasiveness, and decreases the local recurrence rate. Moreover, specimens resected in an en block fashion enable accurate histological assessment. Taking these factors into consideration, ESD seems to be more advantageous than conventional endoscopic mucosal resection (EMR), but the associated risks of perioperative adverse events are higher than in EMR...
July 14, 2016: World Journal of Gastroenterology: WJG
https://www.readbyqxmd.com/read/27450075/retroperitoneoscopy-technique-assisted-percutaneous-nephrolithotomy-for-complexity-horseshoe-kidney-with-renal-stones
#19
Kehua Jiang, Kun Tang, Hua Xu, Hongbo Chen, Zhiqiang Chen
OBJECTIVE: To assess the safety and efficacy of retroperitoneoscopy technique-assisted percutaneous nephrolithotomy (PCNL) used in the treatment of complexity horseshoe kidney (HSK) with renal stones. METHODS: Between January 2012 and April 2015, 5 patients with renal stones in complexity HSK underwent retroperitoneoscopy technique-assisted PCNL. The perioperative data analyzed, included operation time, blood loss, incidence of complication rate, the stone-free rate (SFR), and so on...
2016: Urologia Internationalis
https://www.readbyqxmd.com/read/27366079/direct-thrombolysis-of-multiple-thrombi-in-both-right-and-left-heart-atrium-in-a-patient-on-extracorporeal-membrane-oxygenation-support-following-urgent-double-lung-transplantation-a-case-report
#20
Lukas Pollert, Zuzana Prikrylova, Jan Berousek, Frantisek Mosna, Robert Lischke
BACKGROUND: Lung transplantation is considered an established treatment for patients with end-stage chronic respiratory failure. Patients with acute respiratory failure requiring respiratory support with invasive mechanical ventilation while awaiting lung transplantation are at high risk of death. Extracorporeal membrane oxygenation (ECMO) has been proposed as an alternative bridging strategy to mechanical ventilation. The shear stress created by the mechanical pumps causes changes in the hematological system in almost all patients treated with ECMO...
2016: Therapeutics and Clinical Risk Management
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