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https://www.readbyqxmd.com/read/28329584/reusing-surgical-instruments-during-mohs-micrographic-surgery-safe-from-infection-but-not-free-from-risk
#1
Tatyana A Petukhova, Thomas H King, Kenny J Omlin, Daniel B Eisen
We report several scenarios of compromise in patient safety owing to the re-use of mis-assigned patient's surgical instruments in Mohs micrographic surgery.We discuss the breaks in universal protocols that others may experience in their practices and describe corrective measures that our institutions employed to avoid such future events.There is a lack of publication in the literature on the topic of mis-assigned instrument use in Mohs surgery. We believe that the  practice of re-using instruments is cost-effective and therefore common...
October 15, 2016: Dermatology Online Journal
https://www.readbyqxmd.com/read/28329210/right-atrium-positioning-for-exposure-of-right-pulmonary-veins-during-off-pump-atrial-fibrillation-ablation
#2
Grzegorz Suwalski, Robert Emery, Jakub Mróz, Kamil Kaczejko, Leszek Gryszko, Andrzej Cwetsch, Andrzej Skrobowski
OBJECTIVES: Concomitant surgical ablation of atrial fibrillation (AF) is recommended for patients undergoing off-pump coronary revascularization in the presence of this arrhythmia. Achievement of optimal visualization of pulmonary veins while maintaining stable haemodynamic conditions is crucial for proper completion of the ablation procedure. This study evaluates the safety and feasibility of right atrial positioning using a suction-based cardiac positioner as opposed to compressive manoeuvres for exposure during off-pump surgical ablation for AF...
March 3, 2017: Interactive Cardiovascular and Thoracic Surgery
https://www.readbyqxmd.com/read/28329156/medtronic-duran-ancore-versus-edwards-mc3-rings-for-tricuspid-annuloplasty
#3
Seok In Lee, Ho Jin Kim, Joon Bum Kim, Sung-Ho Jung, Suk Jung Choo, Cheol Hyun Chung, Jae Won Lee
OBJECTIVES: Ring annuloplasty is now regarded as the standard surgical technique for the correction of tricuspid regurgitation (TR). However, comparative research on the durability of commercially available annuloplasty rings is limited. We reviewed early and late surgical results of tricuspid annuloplasty using the Duran AnCore and Edwards MC3 rings. METHODS: From our institutional prospective cardiac surgical database, we identified 581 adult patients (55.9 ± 12...
February 17, 2017: Interactive Cardiovascular and Thoracic Surgery
https://www.readbyqxmd.com/read/28329049/surgical-treatment-of-pulmonary-atresia-with-major-aortopulmonary-collateral-arteries-in-83-consecutive-patients%C3%A2
#4
Oleksandr D Babliak, Yaroslav B Mykychak, Oleksandra O Motrechko, Illya M Yemets
OBJECTIVES: This article reports the safety and efficacy of a morphology-based algorithm for the surgical management of pulmonary atresia and ventricular septal defect with major aortopulmonary collateral arteries. METHODS: A total of 83 patients were operated from 2007 to 2014 using 3 surgical approaches: one-stage total repair, one-stage unifocalization with central shunt and delayed total repair and multistage unifocalization with subsequent total repair. Patients were divided into 2 groups depending on the surgical strategy used to choose the surgical approach...
March 2, 2017: European Journal of Cardio-thoracic Surgery
https://www.readbyqxmd.com/read/28328863/surgical-outcomes-of-laparoscopic-versus-open-liver-resection-for-hepatocellular-carcinoma-for-various-resection-extent
#5
Junhua Chen, Hongyu Li, Fei Liu, Bo Li, Yonggang Wei
Although the number of laparoscopic liver resections (LRRs) has increased, studies of surgical outcomes in comparison with the conventional open approach are limited. The purpose of this study was to analyze the surgical outcomes (safety and efficacy) of LLR versus open liver resection (OLR) for hepatocellular carcinoma (HCC).We collected data on all patients who received liver resection for HCC between April 2015 and September 2016 in our institution, and retrospectively investigated the demographic and perioperative data, and also surgical outcomes...
March 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28328640/we-are-going-to-name-names-and-call-you-out-improving-the-team-in-the-academic-operating-room-environment
#6
Richard Bodor, Brian J Nguyen, Kevin Broder
INTRODUCTION: Communication failures between multidisciplinary teams can impact efficiency, performance, and morale. Academic operating rooms (ORs) often have surgical, anesthesia, and nursing teams, each teaching multiple trainees. Incorrectly identifying name and "rank" (postgraduate year [PGY]) of resident trainees can disrupt performance evaluations and team morale and even potentially impair delivery of quality care when miscommunication errors proliferate. METHODS: Our OR-based survey asked 50 participants (18 surgeons, 14 anesthesiologists, and 18 nursing members), to recall basic identification data including provider names and PGY levels from their recent collaborating OR teams...
March 21, 2017: Annals of Plastic Surgery
https://www.readbyqxmd.com/read/28328630/fluorescein-isothiocyanate-a-novel-application-for-lymphatic-surgery
#7
Lisa Spiguel, Christiana Shaw, Adam Katz, Lifei Guo, Hung-Chi Chen, Bernard T Lee, Dhruv Singhal
The Lymphatic Microsurgical Preventing Healing Approach (LYMPHA) procedure entails performing a lymphovenous bypass (LVB) at the time of axillary lymph node dissection to reduce lymphedema risk. The two most common fluorophores utilized in LVB are blue dye and indocyanine green. We developed a novel application of fluorescein isothiocyanate for intraoperative lymphatic mapping. Our goal is to demonstrate the safety and efficacy of fluorescein isothiocyanate for this application. We reviewed a prospectively collected database on breast cancer patients who underwent LYMPHA from March to September 2015...
March 21, 2017: Annals of Plastic Surgery
https://www.readbyqxmd.com/read/28328569/mid-term-follow-up-of-minimally-invasive-multivessel-coronary-artery-bypass-grafting-is-the-early-learning-phase-detrimental
#8
Maria Lorena Rodriguez, Harry R Lapierre, Benjamin Sohmer, David Glineur, Marc Ruel
OBJECTIVE: Minimally invasive coronary artery bypass grafting (MICS CABG) through a small left thoracotomy is a novel technique for surgical coronary revascularization, which is increasingly being adopted around the world. This study aimed to describe the characteristics and mid-term outcomes of a series of MICS CABG to identify areas for improvement. METHODS: A prospective longitudinal study was performed on the 306 MICS CABG patients operated on by a single surgeon from 2005 to 2015...
March 22, 2017: Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery
https://www.readbyqxmd.com/read/28328500/the-role-of-haptic-feedback-in-robotic-assisted-retinal-microsurgery-systems-a-systematic-review
#9
Julia A Griffin, Weihang Zhu, Chang S Nam
Retinal microsurgery is one of the most technically difficult surgeries since it is performed at the threshold of human capability. If certain retinal conditions are left untreated, they can lead to severe damage, including irreversible blindness. Thus, techniques for reliable retinal microsurgery operations are critical. Recent research shows promise for improving surgical safety by implementing various types of sensory input and output. Sensory information is used to inform the surgeon about the environment inside the eye in real time...
January 2017: IEEE Transactions on Haptics
https://www.readbyqxmd.com/read/28327997/lumbar-fusion-for-degenerative-disease-a-systematic-review-and-meta-analysis
#10
Daniel Yavin, Steven Casha, Samuel Wiebe, Thomas E Feasby, Callie Clark, Albert Isaacs, Jayna Holroyd-Leduc, R John Hurlbert, Hude Quan, Andrew Nataraj, Garnette R Sutherland, Nathalie Jette
BACKGROUND: Due to uncertain evidence, lumbar fusion for degenerative indications is associated with the greatest measured practice variation of any surgical procedure. OBJECTIVE: To summarize the current evidence on the comparative safety and efficacy of lumbar fusion, decompression-alone, or nonoperative care for degenerative indications. METHODS: A systematic review was conducted using PubMed, MEDLINE, EMBASE, and the Cochrane Central Register of Controlled Trials (up to June 30, 2016)...
March 17, 2017: Neurosurgery
https://www.readbyqxmd.com/read/28325504/buttressing-of-the-eea-stapler-during-gastrojejunal-anastomosis-decreases-rate-of-bleeding-related-complications-for-laparoscopic-gastric-bypass
#11
Zachary A Ichter, Lindsay Voeller, Homero Rivas, Habib Khoury, Dan Azagury, John M Morton
BACKGROUND: Bariatric surgery is a well-tolerated and effective treatment for severe obesity. Newer surgical techniques and equipment have improved safety standards surrounding bariatric surgery. In particular, buttressing of the staple line in sleeve gastrectomy has decreased rates of clinically significant postoperative bleeding. The present study investigates the effectiveness of buttressing the circular stapled anastomosis during laparoscopic Roux-en-Y gastric bypass (LRYGB). SETTING: Academic, accredited hospital...
January 11, 2017: Surgery for Obesity and related Diseases: Official Journal of the American Society for Bariatric Surgery
https://www.readbyqxmd.com/read/28325424/surgical-treatment-of-carpal-boss-by-simple-resection-results-in-25%C3%A2-cases-at-a-mean-of-8%C3%A2-years-follow-up
#12
S Roulet, G Bacle, E Marteau, J Laulan
Carpal boss is a symptomatic bony protrusion on the dorsal surface of the wrist at the base of the 2nd and/or 3rd metacarpal. The goal of this study was to assess the reliability and safety of simply resecting the exostosis. From 1994 to 2014, 29 cases of carpal boss were treated by simple resection. Twenty-five of these patients were subsequently assessed by telephone questionnaire at a mean of 8 years' follow-up (range 1.1 to 20 years). There were no cases of recurrence; however, 1 patient reported carpometacarpal instability requiring fusion, 5 years after surgery...
April 2017: Hand Surgery and Rehabilitation
https://www.readbyqxmd.com/read/28325266/stage-i-small-cell-lung-cancer-a-new-potential-option-for-stereotactic-ablative-radiation-therapy-a-review-of-literature
#13
REVIEW
Filippo Alongi, Stefano Arcangeli, Berardino De Bari, Niccolò Giaj-Levra, Alba Fiorentino, Rosario Mazzola, Marco Trovò
Small cell lung cancer (SCLC) is relative rare histology in lung cancer patients. The standard treatment, in patients with an intra-thoracic disease, is represented by the use of concurrent chemo-radiotherapy; while patients with early SCLC stage, surgical resection could be recommended. Stereotactic body radiotherapy (SBRT) is a recently introduced technique allowing the delivery of very high radiation doses to limited target volumes and it is considered the standard approach in the treatment of not operable stage I Non Small-Cell Lung Cancer (NSCLC)...
April 2017: Critical Reviews in Oncology/hematology
https://www.readbyqxmd.com/read/28325090/using-stents-in-the-management-of-malignant-bowel-obstruction-the-current-situation-and-future-progress
#14
Alessandro Fugazza, Piera Alessia Galtieri, Alessandro Repici
The use of self-expanding metal stents (SEMS) has been considered an effective and safe alternative to emergency surgery as bridge to surgery or for palliation in advanced colorectal cancer even though more recent data have raised concerns on both early and long-term outcomes when patients are treated with bridge to surgery indications. Areas covered: A comprehensive literature review of articles on endoscopic management of malignant bowel obstruction was performed. Indication, technique, outcomes, benefits and risks of these treatments in acute malignant colonic obstruction were reviewed...
March 22, 2017: Expert Review of Gastroenterology & Hepatology
https://www.readbyqxmd.com/read/28324919/victorian-trabeculectomy-audit
#15
Jennifer C Fan Gaskin, Sukhpal S Sandhu, Mark J Walland
IMPORTANCE: This study highlights the efficacy and safety of trabeculectomy in Victoria, Australia. BACKGROUND: Trabeculectomy is currently the gold- standard in glaucoma surgery. However, its role has been increasingly questioned due to its associated risks and complications. This audit aimed to assess the efficacy and safety of trabeculectomy surgery in the state of Victoria, Australia. DESIGN: A cross-sectional, retrospective, and voluntary state- wide audit of trabeculectomy surgery by individual surgeons in 2012 with 24-months follow-up...
March 21, 2017: Clinical & Experimental Ophthalmology
https://www.readbyqxmd.com/read/28323799/a-prospective-randomized-trial-to-assess-oral-versus-intravenous-antibiotics-for-the-treatment-of-postoperative-wound-infection-after-extremity-fractures-poviv-study
#16
William T Obremskey, Andrew H Schmidt, Robert V OʼToole, Jennifer DeSanto, Saam Morshed, Paul Tornetta, Clinton K Murray, Clifford B Jones, Daniel O Scharfstein, Tara J Taylor, Anthony R Carlini, Renan C Castillo
Patients surgically treated for infection after extremity fractures are typically discharged with a 6- to 12-week antibiotic regimen. Intravenous (IV) antibiotics are associated with significant cost and potential complications of deep vein thrombosis, line clotting, and sepsis. Many of the pathogens that cause musculoskeletal infection have both oral (PO) and IV antibiotic options with adequate bioavailability and antibacterial effect, yet IV antibiotics remain the standard of care absent evidence that PO options are clinically as efficacious...
April 2017: Journal of Orthopaedic Trauma
https://www.readbyqxmd.com/read/28323709/single-stage-transpedicular-vertebrectomy-and-expandable-cage-placement-for-treatment-of-unstable-mid-and-lower-lumbar-burst-fractures
#17
Jong-Il Choi, Bum-Joon Kim, Sung-Kon Ha, Sang-Dae Kim, Dong-Jun Lim, Se-Hoon Kim
STUDY DESIGN: Retrospective clinical and radiographic study. OBJECTIVE: To examine the efficacy and safety of vertebrectomy and expandable cage placement by a single-stage posterior approach for unstable mid and lower lumbar burst fractures (below the L3). SUMMARY OF BACKGROUND DATA: Patients with unstable mid and lower lumbar burst fractures require surgical treatment to relieve pain, address paralysis, and stabilize the spine to prevent further segmental deformity...
April 2017: Clinical Spine Surgery
https://www.readbyqxmd.com/read/28323707/comparison-of-radiofrequency-targeted-vertebral-augmentation-with-balloon-kyphoplasty-for-the-treatment-of-vertebral-compression-fractures-2-year-results
#18
Rahel Bornemann, Tom R Jansen, Koroush Kabir, Peter H Pennekamp, Brit Stüwe, Dieter C Wirtz, Robert Pflugmacher
STUDY DESIGN: A retrospective study. OBJECTIVES: The aim of this study was the evaluation of the safety and effectiveness of radiofrequency-targeted vertebral augmentation (RF-TVA) in comparison with balloon kyphoplasty (BK) for the treatment of acute painful vertebral compression fractures (VCFs) on the basis of matched pairs. SUMMARY OF BACKGROUND: Vertebroplasty and BK are the common surgical interventions for the treatment of VCF. Both are effective and safe but pose some risks such as adjacent fractures and cement leakage...
April 2017: Clinical Spine Surgery
https://www.readbyqxmd.com/read/28323706/comparison-of-open-versus-percutaneous-pedicle-screw-fixation-using-the-sextant-system-in-the-treatment-of-traumatic-thoracolumbar-fractures
#19
Hongwei Wang, Yue Zhou, Changqing Li, Jun Liu, Liangbi Xiang
STUDY DESIGN: We retrospectively reviewed 100 patients who were posterior stabilized without graft fusion. Using the Sextant system, 22 patients underwent minimally invasive short-segment 4-pedicle screw fixation (MIF4) and 39 patients underwent minimally invasive short-segment combined with intermediate screws fixation, that is, 6-pedicle screw fixation (MIF6). The conventional open posterior short-segment 4-pedicle screw fixation (OPF4) technique was used in 39 patients. OBJECTIVE: To evaluate the feasibility, safety, and efficacy of percutaneous pedicle screw fixation using the Sextant system in the treatment of traumatic thoracolumbar fractures compared with the conventional open posterior short-segment pedicle screw fixation technique...
April 2017: Clinical Spine Surgery
https://www.readbyqxmd.com/read/28323671/codeine-and-opioid-metabolism-implications-and-alternatives-for-pediatric-pain-management
#20
Vidya Chidambaran, Senthilkumar Sadhasivam, Mohamed Mahmoud
PURPOSE OF REVIEW: Use of perioperative opioids for surgical pain management of children presents clinical challenges because of concerns of serious adverse effects including life-threatening respiratory depression. This is especially true for children with history of obstructive sleep apnea. This review will explore current knowledge of clinically relevant factors and genetic polymorphisms that affect opioid metabolism and postoperative outcomes in children. RECENT FINDINGS: Within the past several years, an increasing number of case reports have illustrated clinically important respiratory depression, anoxic brain injuries and even death among children receiving appropriate weight-based dosages of codeine and other opioids for analgesia at home setting particularly following tonsillectomy...
March 18, 2017: Current Opinion in Anaesthesiology
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