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https://www.readbyqxmd.com/read/29783184/postoperative-outcomes-in-patients-with-a-do-not-resuscitate-dnr-order-undergoing-elective-procedures
#1
Ethan Y Brovman, Elisa C Walsh, Brittany N Burton, Christine E Kuo, Charlotta Lindvall, Rodney A Gabriel, Richard D Urman
STUDY OBJECTIVE: Do-not-resuscitate (DNR) status has been shown to be an independent risk factor for mortality in the post-operative period. Patients with DNR orders often undergo elective surgeries to alleviate symptoms and improve quality of life, but there are limited data on outcomes for informed decision making. DESIGN: Retrospective cohort study. SETTING: A multi-institutional setting including operating room, postoperative recovery area, inpatient wards, and the intensive care unit...
May 18, 2018: Journal of Clinical Anesthesia
https://www.readbyqxmd.com/read/29783003/non-malignant-sequelae-following-unconfined-power-morcellation-%C3%A2-%C3%A2-%C3%A2-%C3%A2-%C3%A2-%C3%A2-%C3%A2-%C3%A2-%C3%A2-%C3%A2-%C3%A2-%C3%A2
#2
Hao M Zhang, Lee A Christianson, Claire L Templeman, Scott E Lentz
STUDY OBJECTIVE: To identify the incidence of repeat surgery and subsequent findings following the performance of unconfined uterine power morcellation. DESIGN: A retrospective descriptive study (Canadian Task Force II-2) SETTING: Southern California Kaiser Permanente Medical Centers PATIENTS: Women (n=5154) who underwent laparoscopic supra-cervical hysterectomy (LSH) with unconfined power morcellation. MEASUREMENTS AND MAIN RESULTS: Of the 5154 cases, 279 (5...
May 18, 2018: Journal of Minimally Invasive Gynecology
https://www.readbyqxmd.com/read/29781944/early-comparative-outcomes-of-carbon-fiber-reinforced-polymer-plate-in-the-fixation-of-distal-femur-fractures
#3
Phillip M Mitchell, Adam K Lee, Cory A Collinge, Bruce H Ziran, Kate G Hartley, A Alex Jahangir
OBJECTIVE: To evaluate the early clinical results of distal femur fractures treated with carbon fiber reinforced - polyetheretherketone (CFR-PEEK) plates compared to stainless steel (SS) lateral locking plates. DESIGN: Retrospective comparative cohort study SETTING:: ACS Level I trauma center. PATIENTS/PARTICIPANTS: Twenty-two patients (11 SS, 11 CFR-PEEK) with closed distal femur fractures treated by a single surgeon over a 6-year period...
May 16, 2018: Journal of Orthopaedic Trauma
https://www.readbyqxmd.com/read/29781911/what-is-the-frequency-of-early-dissociation-of-bipolar-cups-and-what-factors-are-associated-with-dissociation
#4
Young-Kyun Lee, Chan Ho Park, Yong-Chan Ha, Kyung-Hoi Koo
BACKGROUND: Dissociation between a prosthetic cup and femoral head is a rare complication of bipolar hemiarthroplasty that usually occurs during closed reduction of a dislocated bipolar cup. The dissociation usually results in reoperation because closed reduction is challenging. To our knowledge, no study has reported on the frequency of bipolar cup-femoral head dissociation, and risk factors for dissociation are unknown. QUESTIONS/PURPOSES: The purposes of this study were (1) to evaluate the frequency of dissociation of prosthetic femoral heads from bipolar cups during manual reduction of a dislocated bipolar hemiarthroplasty; and (2) to explore in a preliminary fashion any prosthesis or patient factors that may be associated with dissociation...
May 17, 2018: Clinical Orthopaedics and related Research
https://www.readbyqxmd.com/read/29779908/fixation-of-lung-apex-in-spontaneous-pneumothorax-is-safe-and-efficient-in-decrease-recurrences
#5
Wendy Yang, Pei-Yeh Chang, Ai-Hua Yeh, Yung-Ching Ming, Jeng Chang Chen, Jin-Yao Lai
BACKGROUND: Video-assisted thoracoscopic bullectomy with pleurodesis is widely used to treat spontaneous pneumothorax. However, 1%-3% of patients experience postoperative complications that may require reoperation, such as bleeding or prolonged air leaks, and 3%-7% of patients require a repeat thoracoscopic bullectomy due to recurrence. Therefore, a modified procedure with improved outcomes is required. METHODS: Between January 1, 2011 and December 31, 2015, 196 patients with spontaneous pneumothorax underwent thoracoscopic bullectomy and pleurodesis with or without fixation of the lung apex to the chest wall...
May 3, 2018: Pediatrics and Neonatology
https://www.readbyqxmd.com/read/29779683/strabismus-strabismus-surgery-and-reoperation-rate-in-the-united-states-analysis-from-the-iris-registry
#6
Michael X Repka, Flora Lum, Bhavya Burugapalli
PURPOSE: To describe the rates of strabismus, strabismus surgery, and strabismus surgery reoperations among all age groups in the United States. DESIGN: Retrospective analysis of electronic health record data. PARTICIPANTS: Patients from the IRIS (Intelligent Research in Sight) Registry. METHODS: Description of the types and rates of strabismus and strabismus surgery from 2013 to 2016 with subgroups by age, sex, race/ethnicity, and region of the United States...
May 17, 2018: Ophthalmology
https://www.readbyqxmd.com/read/29779677/distinguishing-fecal-appendicular-peritonitis-from-purulent-appendicular-peritonitis
#7
M Mariage, C Sabbagh, T Yzet, H Dupont, A NTouba, J M Regimbeau
INTRODUCTION: Fecal appendicular peritonitis (FAP) is a poorly studied, rare form of acute appendicitis, corresponding to peritoneal inflammation with the presence of feces secondary to ruptured appendix. The purpose of this study was to describe FAP and to compare FAP with purulent appendicular peritonitis (PAP). PATIENTS AND METHODS: This single-center, retrospective study was conducted in consecutive patients to compare the FAP group and the PAP group. The primary endpoint was the 30-day postoperative morbidity and mortality according to the Clavien-Dindo classification...
April 9, 2018: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29779588/meta-analysis-comparing-transcatheter-and-surgical-treatments-of-paravalvular-leaks
#8
Tatiana Busu, Fahad Alqahtani, Vinay Badhwar, Chris C Cook, Charanjit S Rihal, Mohamad Alkhouli
Percutaneous paravalvular leak (PVL) closure has emerged as a feasible alternative to redo valve surgery. However, comparative data on percutaneous and surgical treatment of PVL are scarce. We performed a systematic review and a meta-analysis of studies on percutaneous and surgical treatments of PVL. Of the 2,267 studies screened, 22 eligible studies were analyzed. Primary end points were technical success, 30-day mortality, stroke, and length of stay. Secondary end points were 1-year mortality, readmission for heart failure, reoperation, and symptomatic improvement at follow-up...
April 20, 2018: American Journal of Cardiology
https://www.readbyqxmd.com/read/29778855/myocardial-strain-in-prediction-of-outcomes-after-surgery-for-severe-mitral-regurgitation
#9
Hyue Mee Kim, Goo-Yeong Cho, In-Chang Hwang, Hong-Mi Choi, Jun-Bean Park, Yeonyee E Yoon, Hyung-Kwan Kim
OBJECTIVES: We investigated whether global longitudinal strain (GLS) is a better predictor of clinical events after surgery for mitral regurgitation (MR) than conventional parameters. BACKGROUND: The optimal timing for surgery is guided by left ventricular (LV) dimension or left ventricular ejection fraction (LVEF), even though normal LVEF can mask depressed LV systolic function in severe mitral MR. METHODS: From 2006 to 2016, 506 patients (age 58...
May 11, 2018: JACC. Cardiovascular Imaging
https://www.readbyqxmd.com/read/29778818/the-fate-of-the-tricuspid-valve-following-the-transatrial-closure-of-the-ventricular-septal-defect
#10
Raffaele Giordano, Massimiliano Cantinotti, Luigi Di Tommaso, Giuseppe Comentale, Andrea Tozzi, Emanuele Pilato, Gabriele Iannelli, Gaetano Palma
BACKGROUND: The transatrial repair of the ventricular septal defect (VSD) requires an adequate exposure of its rim. We retrospectively evaluated the impact of adopting the tricuspid valve incision (TVI) technique, either with detachment or radial incision, on the postoperative outcome of children undergoing surgical VSD repair. METHODS: From January 2008 to September 2017 we retrospectively enrolled 141 patients, divided into two groups: 97 patients were subjected to TVI (68...
May 17, 2018: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/29778596/anterior-vs-posterior-approach-for-thoracic-corpectomy-an-analysis-of-risk-factors-outcomes-and-complications
#11
Ryan G Chiu, Jonathan Hobbs, Darian R Esfahani, Saavan Patel, David Rosenberg, Clayton L Rosinski, Akash S Patel, Anisse N Chaker, Ankit I Mehta
BACKGROUND: Thoracic corpectomies are performed for various reasons including spinal deformity, trauma, neoplasms, and infection. Regardless of indication, both anterior and posterior approaches are surgical options, selected based on pathology, anatomy, patient characteristics, and surgical experience. Risk profiles and outcomes for these procedures are poorly characterized, however, and the choice between the two approaches remains inconclusive. OBJECTIVE: To compare risk factors and complications for adult patients undergoing anterior and posterior thoracic corpectomies...
May 17, 2018: World Neurosurgery
https://www.readbyqxmd.com/read/29778591/complications-of-antibiotic-cement-spacers-used-for-shoulder-infections
#12
Edward G McFarland, Jorge Rojas, Jeremy Smalley, Amrut U Borade, Jacob Joseph
BACKGROUND: Our aim was to evaluate complications related to commercially available antibiotic cement spacers used in the treatment of shoulder infections. METHODS: We performed a retrospective review of commercially available antibiotic spacers implanted in 53 patients (60 spacers) between April 2009 and October 2017 as part of a 2-stage treatment plan for infection at the site of a shoulder arthroplasty (n = 39), other (non-arthroplasty) shoulder surgery (n = 8), or primary shoulder infection without previous surgery (n = 6)...
May 16, 2018: Journal of Shoulder and Elbow Surgery
https://www.readbyqxmd.com/read/29778274/outcomes-of-tibia-shaft-fractures-caused-by-low-energy-gunshot-wounds
#13
Charles A Su, Mai P Nguyen, Jeffrey A O'Donnell, Heather A Vallier
BACKGROUND: The purpose of this project was to compare the rates of infections, nonunions, malunions, and secondary operations in tibia fractures resultant from low energy GSWs versus those seen in open and closed tibia fractures resultant from blunt trauma. A secondary objective was to assess the utility of using the traditional Gustilo-Anderson classification system for open fractures to describe fractures secondary to low energy GSW. METHODS: A retrospective review of 327 patients with tibia shaft fractures was conducted at our level I trauma center...
May 16, 2018: Injury
https://www.readbyqxmd.com/read/29777881/single-incision-laparoscopic-versus-conventional-laparoscopic-right-colectomy-a-systematic-review-and-meta-analysis
#14
REVIEW
Boye Dong, Zuyang Luo, Jiabao Lu, Yang Yang, Yixian Song, Jie Cao, Wanglin Li
BACKGROUND: Single-incision laparoscopic surgery has gained widespread attention because of its potential benefits such as less skin incision and faster recovery. Up to now, only one meta-analysis (performed in 2013; including 9 studies, a total of 585 cases) compared single-incision laparoscopic right colectomy (SILRC) with conventional laparoscopic right colectomy (CLRC). An updated meta-analysis was undertaken to explore more convinced comparative findings between SILRC and CLRC. MATERIALS AND METHODS: The search for studies that compared SILRC with CLRC was done on PubMed, Embase, Web of Science, and the Cochrane Library...
May 16, 2018: International Journal of Surgery
https://www.readbyqxmd.com/read/29777672/valvectomy-versus-replacement-for-the-surgical-treatment-of-tricuspid-endocarditis
#15
Adam N Protos, Jaimin R Trivedi, William M Whited, Michael P Rogers, Ugochukwu Owolabi, Kendra J Grubb, Kristen Sell-Dottin, Mark S Slaughter
BACKGROUND: Optimal surgical treatment of infective tricuspid endocarditis is debatable, especially in the setting of inherent social and pathologic concerns. This study seeks to compare tricuspid valve repair, replacement, and excision for the treatment of infective endocarditis METHODS: A single center cardiac surgery database was queried between 2012 and 2016 to identify patients >18 years who underwent tricuspid valve surgery for infective endocarditis. Patients were divided into 3 groups based on the type of tricuspid valve surgery: valvectomy, repair, or replacement and evaluated to identify differences between the pre-op factors and outcomes including mortality, length of stay, and complications...
May 16, 2018: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/29777670/the-impact-of-mitral-disease-etiology-on-operative-mortality-following-mitral-valve-operations
#16
J Scott Rankin, Maria Grau-Sepulveda, David M Shahian, A Marc Gillinov, Rakesh Suri, James S Gammie, Steven F Bolling, Patrick M McCarthy, Vinod H Thourani, Niv Ad, Sean M O'Brien, Jeffrey P Jacobs, Vinay Badhwar
BACKGROUND: The patho-etiology of mitral regurgitation (MR) has been suggested as a mediator of outcomes following mitral valve (MV) operations, particularly in ischemic functional mitral regurgitation (IMR). This study examined the independent association of MV etiology with mortality. METHODS: Using the Society of Thoracic Surgeons Database, all patients undergoing mitral valve replacement or repair from 2011-2014 were assessed. Patients who underwent concomitant surgical ablation, septal defect closure, tricuspid valve repair, or coronary artery bypass grafting were included...
May 16, 2018: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/29777669/repair-of-thoracic-and-thoracoabdominal-mycotic-aneurysms-and-infected-aortic-grafts-using-allograft
#17
Joel S Corvera, David Blitzer, Hannah Copeland, Daniel Murphy, Philip J Hess, Saila T Pillai, John W Fehrenbacher
BACKGROUND: Mycotic aneurysm of the thoracic or thoracoabdominal aorta and infection of thoracic or thoracoabdominal aortic grafts are challenging problems with high mortality. In-situ reconstruction with cryopreserved allograft(CPA) avoids placement of prosthetic material in an infected field and avoids suppressive antibiotics or autologous tissue coverage. METHODS: Fifty consecutive patients with infection of a thoracic or thoracoabdominal aortic graft or mycotic aneurysm underwent resection and replacement with CPA from 2006 to 2016...
May 16, 2018: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/29777492/redo-proximal-thoracic-aortic-surgery-challenges-and-controversies
#18
Athanasios Antoniou, Mohamad Bashir, Amer Harky, Carmelo Di Salvo
Reoperations on the proximal thoracic aorta represent a challenge. The mortality rate is at least three times higher than it is for the initial surgery and the complications after such procedures occur with disappointingly high frequency, leading to substantial morbidity and delayed recovery. This article aims to present the early and the late outcomes of these kinds of operations, to identify the causes for failure of the primary surgery, to underline the critical points during the perioperative management of those patients and finally to emphasize on the rapid evolution and advent of techniques over the last few years...
May 18, 2018: General Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/29777268/defunctioning-stomas-result-in-significantly-more-short-term-complications-following-low-anterior-resection-for-rectal-cancer
#19
Andrew Emmanuel, Ezzat Chohda, Christo Lapa, Andrew Miles, Amyn Haji, Joe Ellul
BACKGROUND: Studies suggest that defunctioning stomas reduce the rate of anastomotic leakage and urgent reoperations after anterior resection. Although the magnitude of benefit appears to be limited, there has been a trend in recent years towards routinely creating defunctioning stomas. However, little is known about post-operative complication rates in patients with and without a defunctioning stoma. We compared overall short-term post-operative complications after low anterior resection in patients managed with a defunctioning stoma to those managed without a stoma...
May 17, 2018: World Journal of Surgery
https://www.readbyqxmd.com/read/29776853/outcomes-of-a-fixed-bearing-medial-cemented-unicondylar-knee-arthroplasty-design-survival-analysis-and-functional-score-of-460-cases
#20
Philip Winnock de Grave, Justine Barbier, Thomas Luyckx, Alexander Ryckaert, Paul Gunst, Luc Van den Daelen
BACKGROUND: Unicompartmental knee arthroplasty (UKA) is an alternative to total knee arthroplasty in isolated medial osteoarthritis (OA). However, despite satisfactory reports on the clinical performance, UKA revision rates are still concerning. This retrospective study reports on the long-term survivorship, functional outcomes, and reasons for revision in fixed-bearing UKA implant. METHODS: Between 2005 and 2013, 460 consecutive patients were treated with medial UKA in one center using a fixed-bearing UKA system...
April 24, 2018: Journal of Arthroplasty
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