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Liver surgery anesthesia

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https://www.readbyqxmd.com/read/29156640/clinical-beneficial-effects-of-using-crystalloid-only-in-recipients-of-living-donor-liver-transplantation
#1
Chia-Jung Huang, Kwok-Wai Cheng, Chao-Long Chen, Shao-Chun Wu, Tsung-Hsiao Shih, Sheng-Chun Yang, Sin-Ei Juang, Ying-En Lee, Chiu-En Huang, Bruno Jawan, Chih-Hsien Wang
OBJECTIVE: Liver transplantation (LT) is a major surgery associated with intraoperative massive fluid shift, which is usually replaced by crystalloid, 5% albumin (colloid) and blood products. We studied 15 patients from 477 consecutive recipients of adult living donor liver transplantation. Each patient received crystalloid only during LT. Whether LT provides any clinical benefit is not clear and must be determined. METHODS AND PATIENTS: The anesthesia records of 477 adult LDLT were reviewed retrospectively...
November 20, 2017: International Journal of Environmental Research and Public Health
https://www.readbyqxmd.com/read/29138380/-three-patients-with-gastric-cancer-who-underwent-surgery-during-ramucirumab-treatment
#2
Hayato Omori, Sadayuki Kawai, Rie Makuuchi, Tomoyuki Irino, Masanori Tokunaga, Yutaka Tanizawa, Etsuro Bando, Taiichi Kawamura, Hirofumi Yasui, Masanori Terashima
According to the REGARD and RAINBOW trials, ramucirumab(RAM)was introduced as second-line therapy for advanced or metastatic gastric cancer. RAM may impair wound healing due to the inhibition of angiogenesis; details on the postoperative course of patients who underwent surgery during RAM treatment remain unclear. Between 2011 and 2016, 93 patients with incurable gastric cancer were treated with RAM in our institute. Among them, 3 patients underwent surgery after RAM treatment. Case 1: A 74-year-old man with liver metastasis from gastric cancer was treated with a paclitaxel(PTX)plus RAM regimen...
November 2017: Gan to Kagaku Ryoho. Cancer & Chemotherapy
https://www.readbyqxmd.com/read/29108324/age-adjusted-charlson-comorbidity-index-score-as-predictor-of-survival-of-patients-with-digestive-system-cancer-who-have-undergone-surgical-resection
#3
Yaohua Tian, Zhong Jian, Beibei Xu, Hui Liu
Comorbidities have considerable effects on survival outcomes. The primary objective of this retrospective study was to examine the association between age-adjusted Charlson comorbidity index (ACCI) score and postoperative in-hospital mortality in patients with digestive system cancer who have undergone surgical resection of their cancers. Using electronic hospitalization summary reports, we identified 315,464 patients who had undergone surgery for digestive system cancer in top-rank (Grade 3A) hospitals in China between 2013 and 2015...
October 3, 2017: Oncotarget
https://www.readbyqxmd.com/read/29045240/prediction-of-thromboembolic-complications-after-liver-resection-for-cholangiocarcinoma-is-there-a-place-for-thromboelastometry
#4
Annabel Blasi, Victor Molina, Santiago Sanchez-Cabús, Jaume Balust, J Carlos Garcia-Valdecasas, Pilar Taura
: Postoperative venous thromboembolism has a poor prognosis in patients with cancer. We aimed to investigate the utility of thromboelastometry in detecting the risk of postoperative venous thromboembolism in patients with cholangiocarcinoma. We prospectively included patients submitted to liver resection for cholangiocarcinoma at our hospital between May 2011 and July 2014. Patients undergoing major hepatectomy for adult living donor transplantation in the same time period served as a control group. Thromboelastometry was performed before anesthesia...
October 17, 2017: Blood Coagulation & Fibrinolysis: An International Journal in Haemostasis and Thrombosis
https://www.readbyqxmd.com/read/28992877/perioperative-fluid-management-in-major-hepatic-resection-an-integrative-review
#5
REVIEW
Osamu Yoshino, Marcos Vinicius Perini, Christopher Christophi, Laurence Weinberg
BACKGROUND: Fluid intervention and vasoactive pharmacological support during hepatic resection depend on the preference of the attending clinician, institutional resources, and practice culture. Evidence-based recommendations to guide perioperative fluid management are currently limited. Therefore, we provide a contemporary clinical integrative overview of the fundamental principles underpinning fluid intervention and hemodynamic optimization for adult patients undergoing major hepatic resection...
October 15, 2017: Hepatobiliary & Pancreatic Diseases International: HBPD INT
https://www.readbyqxmd.com/read/28985713/patients-with-glycogen-storage-diseases-undergoing-anesthesia-a-case-series
#6
Carmelina Gurrieri, Juraj Sprung, Toby N Weingarten, Mary E Warner
BACKGROUND: Glycogen storage diseases are rare genetic disorders of glycogen synthesis, degradation, or metabolism regulation. When these patients are subjected to anesthesia, perioperative complications can develop, including hypoglycemia, rhabdomyolysis, myoglobinuria, acute renal failure, and postoperative fatigue. The objective of this study was to describe the perioperative course of a cohort of patients with glycogen storage diseases. METHODS: This is a retrospective review of patients with glycogen storage diseases undergoing anesthetic care at our institution from January 1, 1990, through June 30, 2015 to assess perioperative management and outcomes...
October 6, 2017: BMC Anesthesiology
https://www.readbyqxmd.com/read/28922227/incidence-and-risk-factors-of-coagulation-profile-derangement-after-liver-surgery-implications-for-the-use-of-epidural-analgesia-a-retrospective-cohort-study
#7
Pierre Jacquenod, Grégoire Wallon, Mathieu Gazon, Benjamin Darnis, Pierre Pradat, Victor Virlogeux, Olivier Farges, Frédéric Aubrun
BACKGROUND: Hepatic surgery is a major abdominal surgery. Epidural analgesia may decrease the incidence of postoperative morbidities. Hemostatic disorders frequently occur after hepatic resection. Insertion or withdrawal (whether accidental or not) of an epidural catheter during coagulopathic state may cause an epidural hematoma. The aim of the study is to determine the incidence of coagulopathy after hepatectomy, interfering with epidural catheter removal, and to identify the risk factors related to coagulopathy...
September 14, 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28858130/effect-of-bispectral-index-guided-anesthesia-on-consumption-of-anesthetics-and-early-postoperative-cognitive-dysfunction-after-liver-transplantation-an-observational-study
#8
Ying-Hao Cao, Ping Chi, Yan-Xing Zhao, Xi-Chen Dong
The objective of this study was to summarize the incidence of postoperative cognitive dysfunction (POCD) after 7days following liver transplantation (LT), and to evaluate the effectiveness of bispectral index (BIS) guided anesthetic intervention in reducing POCD. Additional serum concentrations of S100β and neuron-specific enolase (NSE) were detected during surgery to determine whether they were reliable predictors of POCD.Patients who underwent LT at Beijing YouAn Hospital Affiliated to Capital University of Medical Science from January 2014 to December 2015 were enrolled...
September 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28833618/intra-operative-predictors-of-postoperative-takotsubo-syndrome-in-liver-transplant-recipients-an-exploratory-case-control-study
#9
Stephen Aniskevich, Ryan M Chadha, Prith Peiris, Cemal Burcin Taner, Klaus L Torp, Colleen S Thomas, Maria L Yataco, Sher-Lu Pai
INTRODUCTION: Takotsubo syndrome (TTS), also known as Takotsubo cardiomyopathy or stress-induced cardiomyopathy, has been described following a variety of surgeries and disease states. The relationship between intra-operative anesthesia management and the development of this syndrome has never been fully elucidated. OBJECTIVES: The primary objective of this study was to determine the relationship of multiple intra-operative factors on the pathogenesis of TTS. METHODS: A single-center retrospective review of all liver transplants performed at Mayo Clinic Florida from January 2005 to December 2014...
August 22, 2017: Clinical Transplantation
https://www.readbyqxmd.com/read/28757837/hypoxic-hepatitis-during-the-perioperative-period-in-patients-with-severe-pulmonary-disease-and-cor-pulmonale
#10
Hyuckgoo Kim, Sang-Jin Park, Deokhee Lee
Hypoxic hepatitis (HH) is characterized by marked and transient elevations in liver enzyme levels in the absence of other potential causes of liver injury. Although rare, it can occur in the presence of hemodynamic instability and hypoxemia in patients with cor pulmonale. We report two cases of perioperative HH in patients with severe pulmonary disease and cor pulmonale. The first case is of a patient with cor pulmonale who underwent hemiarthroplasty for a femur fracture. Transient hypotension developed during spinal anesthesia and severe hypoxemia were observed in the postoperative period...
July 2017: Saudi Journal of Anaesthesia
https://www.readbyqxmd.com/read/28693245/effects-of-remifentanil-on-hemodynamics-liver-function-and-icam-1-expression-in-liver-cancer-patients-undergoing-surgery
#11
Qi Jiang, Xiuling Song, Zheng Chen, Conghui Wang, Huiyu Luo
The objective of the present study was to investigate the effects of remifentanil on hemodynamics, liver function, and expression of intercellular adhesion molecule-1 (ICAM-1) in patients with liver cancer undergoing surgery. A total of 60 patients who underwent liver cancer resection in The First People's Hospital of Xiangyang, Hubei University of Medicine from January 2014 to January 2016 were selected, including 33 males and 27 females, with an average age of 54.12±4.77 years. Patients were randomly divided into the control group and experimental group (n=30 each)...
July 2017: Oncology Letters
https://www.readbyqxmd.com/read/28678075/patients-undergoing-orthotopic-liver-transplantation-require-lower-concentrations-of-the-volatile-anesthetic-sevoflurane
#12
Joanna Baron-Stefaniak, Viola Götz, Andreas Allhutter, Judith Schiefer, Thomas Hamp, Peter Faybik, Gabriela Berlakovich, David M Baron, Walter Plöchl
BACKGROUND: Sevoflurane is a volatile anesthetic commonly used to maintain anesthesia in patients with end-stage liver disease (ESLD) undergoing orthotopic liver transplantation (OLT). Growing evidence suggests that patients with ESLD have decreased anesthetic requirements compared to patients with preserved liver function. The potency of volatile anesthetics is expressed as the minimum alveolar concentration (MAC). In this prospective, blinded study, we compared the MAC of sevoflurane among patients with ESLD undergoing OLT and patients with normal liver function undergoing major abdominal surgery...
September 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28675358/living-donor-liver-transplantation
#13
REVIEW
Birkan Bozkurt, Murat Dayangac, Yaman Tokat
In 50 years after the first liver transplantation, the medical world has witnessed the liver transplantation to become one of the widely recognized and leading branches of surgery. In this period, liver transplantation combined with surgical technique, patient selection, advancements in anesthesia and postoperative care and increased experience has become the most effective treatment option in treatment of several acute and chronic liver diseases. Yet, the worldwide organ restriction and associated high mortality rates in organ transplantation waiting list has compelled referring to living donors in order to expand the donor pool...
May 2017: Chirurgia
https://www.readbyqxmd.com/read/28671280/impact-of-obstructive-sleep-apnea-in-transsphenoidal-pituitary-surgery-an-analysis-of-inpatient-data
#14
Sei Y Chung, Michael J Sylvester, Varesh R Patel, Michael Zaki, Soly Baredes, James K Liu, Jean Anderson Eloy
OBJECTIVES/HYPOTHESIS: Although previous studies have reported increased perioperative complications among obstructive sleep apnea (OSA) patients undergoing any surgery requiring general anesthesia, there is a paucity of literature addressing the impact of OSA on postoperative transsphenoidal surgery (TSS) complications. The aim of this study was to analyze postoperative outcomes in transsphenoidal pituitary surgery patients with OSA. Secondarily, we examined patient characteristics and comorbidities...
July 3, 2017: Laryngoscope
https://www.readbyqxmd.com/read/28654556/patient-controlled-intravenous-analgesia-with-combination-of-dexmedetomidine-and-sufentanil-on-patients-after-abdominal-operation-a-prospective-randomized-controlled-blinded-multicenter-clinical-study
#15
Yongtao Gao, Xiaoming Deng, Hongbing Yuan, Yufang Leng, Tiezheng Zhang, Xuzhong Xu, Suming Tian, Jun Fang, Wen Ouyang, Xinming Wu
OBJECTIVE: To investigate the effect of combination of dexmedetomidine and sufentanil on patient-controlled intravenous analgesia (PCIA) in patients after abdominal operation and to assess the safety and validity of this treatment. METHODS: This is a prospective, randomized controlled, blinded, multicenter clinical study. A total of 210 patients from 9 clinical research centers underwent selective abdominal operation with general anesthesia were enrolled in the study, including laparoscopic-assisted abdominal operation on stomach, intestines or open surgery on stomach, intestines, kidneys and liver, ASA status I-II...
June 16, 2017: Clinical Journal of Pain
https://www.readbyqxmd.com/read/28621689/age-adjusted-charlson-comorbidity-index-score-as-predictor-of-survival-of-patients-with-digestive-system-cancer-who-have-undergone-surgical-resection
#16
Yaohua Tian, Zhong Jian, Beibei Xu, Hui Liu
Comorbidities have considerable effects on survival outcomes. The primary objective of this retrospective study was to examine the association between age-adjusted Charlson comorbidity index (ACCI) score and postoperative in-hospital mortality in patients with digestive system cancer who have undergone surgical resection of their cancers. Using electronic hospitalization summary reports, we identified 315,464 patients who had undergone surgery for digestive system cancer in top-rank (Grade 3A) hospitals in China between 2013 and 2015...
June 7, 2017: Oncotarget
https://www.readbyqxmd.com/read/28585138/assessment-of-complications-after-liver-surgery-two-novel-grading-systems-applied-to-patients-undergoing-hepatectomy
#17
Li-Ning Xu, Bo Yang, Gui-Ping Li, De-Wei Gao
Although quality assessment is gaining increasing attention, there is still no consensus on how to define and grade postoperative complications. The absence of a definition and a widely accepted ranking system to classify surgical complications has hampered proper interpretation of the surgical outcome. This study aimed to define and search the simple and reproducible classification of complications following hepatectomy based on two therapy-oriented severity grading system: Clavien-Dindo classification of surgical complications and Accordion severity grading of postoperative complications...
June 2017: Journal of Huazhong University of Science and Technology. Medical Sciences
https://www.readbyqxmd.com/read/28421732/comparison-of-absolute-fluid-restriction-versus-relative-volume-redistribution-strategy-in-low-central-venous-pressure-anesthesia-in-liver-resection-surgery-a-randomized-controlled-trial
#18
Jan Zatloukal, Richard Pradl, Jakub Kletečka, Tomáš Skalický, Václav Liška, Jan Benes
BACKGROUND: Lowering central venous pressure (CVP) can decrease blood loss during liver resection and it is associated with improved outcomes. Multiple CVP reducing maneuvers have been described, but direct comparison of their effectiveness and safety has never been performed. METHODS: Patients undergoing resections of 2 or more liver segments were equally randomized to absolute fluid restriction (AR, N = 17) or relative volume redistribution group (RR, N = 17)...
April 19, 2017: Minerva Anestesiologica
https://www.readbyqxmd.com/read/28412755/randomized-clinical-trial-comparing-the-effects-of-sevoflurane-and-propofol-on-carbon-dioxide-embolism-during-pneumoperitoneum-in-laparoscopic-hepatectomy
#19
Yu Hong, Yu Xin, Fei Yue, He Qi, Cai Jun
Laparoscopic hepatectomy carries a high risk of gas embolism due to the extensive hepatic transection plane and large hepatic vena cava. Here, we compared the influence of inhaled and intravenous anesthetics on gas embolism during laparoscopic hepatectomy. Fifty patients undergoing laparoscopic hepatectomy were divided into two groups to receive sevoflurane anesthesia (group S, n = 25) or intravenous propofol anesthesia (group p, n = 25). During the operation, gas emboli were detected by transesophageal echocardiography and graded according to their size...
April 18, 2017: Oncotarget
https://www.readbyqxmd.com/read/28378083/minor-laparoscopic-liver-resection-toward-1-day-surgery
#20
Nicola de'Angelis, Benjamin Menahem, Philippe Compagnon, Jean Claude Merle, Francesco Brunetti, Alain Luciani, Daniel Cherqui, Alexis Laurent
BACKGROUND: Technical advances in laparoscopy and enhanced recovery after surgery programs have progressively decreased the need for hospitalization. The present study aimed to explore the feasibility and safety of an early discharge protocol after minor laparoscopic liver resection (LLR). METHODS: The study sample consisted of patients with both benign and malignant hepatic lesions involving no more than two hepatic segments who underwent minor LLR and were discharged within 24 h...
November 2017: Surgical Endoscopy
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