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https://www.readbyqxmd.com/read/28634629/medical-malpractice-claims-in-laparoscopic-gynecologic-surgery-a-dutch-overview-of-20-years
#1
Evelien M Sandberg, Esmée M Bordewijk, Désirée Klemann, Sara R C Driessen, Andries R H Twijnstra, Frank Willem Jansen
BACKGROUND: The success of newly introduced surgical techniques is generally primarily assessed by surgical outcome measures. However, data on medical liability should concomitantly be used to evaluate provided care as they give a unique insight into substandard care from patient's point of view. The aim of this study was to analyze the number and type of medical claims after laparoscopic gynecologic procedures since the introduction of advanced laparoscopy two decades ago. Secondly, our objective was to identify trends and/or risk factors associated with these claims...
June 20, 2017: Surgical Endoscopy
https://www.readbyqxmd.com/read/28629766/laparoscopic-assisted-approach-for-penetrating-abdominal-trauma-a-solution-for-multiple-bowel-injuries
#2
Oleh Yevhenovych Matsevych, Modise Zacharia Koto, Colleen Aldous
BACKGROUND: Therapeutic laparoscopy (TL) for penetrating abdominal trauma (PAT) is controversial because the management of multiple bowel injuries is challenging and the conversion rate is high. However, the laparoscopic-assisted approach (LAA) allows easy management of multiple bowel injuries but not investigated in a trauma setting. The aim of this study was to investigate its role in management of multiple bowel injuries and to compare LAA with therapeutic laparoscopy performed fully laparoscopically (FTL)...
June 16, 2017: International Journal of Surgery
https://www.readbyqxmd.com/read/28626383/an-alternative-approach-to-the-terminal-management-of-ogilvie-syndrome
#3
Daniel Galban, Joshua J Baiel
Ogilvie syndrome is defined as colonic pseudo-obstruction due to nonmechanical causes. Mortality of nearly 50% is associated with perforation of the distended, pseudo-obstructed colon. While conservative medical therapy has proven to be beneficial in a majority of cases, >3% of patients have significant distention or perforation of the colon that warrants surgical resection. The case of a 48-year-old male with progressive abdominal discomfort and distention 12 days following knee replacement surgery is presented...
May 2017: Case Reports in Gastroenterology
https://www.readbyqxmd.com/read/28625067/colonic-obstruction-secondary-to-actinomyces
#4
Manuel Alfonso Jiménez Moreno, Isabel Sánchez Pedrique, Estíbaliz Obregón Martínez
Actinomycosis is an uncommon granulomatous infection by Gram-positive anaerobic bacteria of the genus Actinomyces. A. israelii is a major human pathogen. The most frequent locations for colonization are cervicofacial (50%), abdominal (20%) and thoracic (15-20%). The abdominal actinomycosis predisposing factors include recent surgery, trauma and neoplasias. Certain cases have been associated with the intrauterine contraception device (IUD).
June 19, 2017: Revista Española de Enfermedades Digestivas
https://www.readbyqxmd.com/read/28623471/the-effect-of-intravenous-lidocaine-infusion-on-bispectral-index-during-major-abdominal-surgery
#5
Patrick Bazin, James Padley, Matthew Ho, Jennifer Stevens, Erez Ben-Menachem
Intraoperative lidocaine infusion has become widely accepted as an adjunct to general anesthesia where its use has been associated with opioid-sparing and enhanced recovery. The aims of this study were to determine whether or not intravenous (IV) lidocaine infusion (a) has an anesthetic sparing effect during major colorectal procedures and (b) if it also affects level of hypnosis as measured by bispectral index (BIS). Twenty-five patients undergoing laparotomy for resection of colorectal tumours were randomized to receive either IV lidocaine (1...
June 16, 2017: Journal of Clinical Monitoring and Computing
https://www.readbyqxmd.com/read/28622175/predictors-prognosis-and-management-of-new-clinically-important-atrial-fibrillation-after-noncardiac-surgery-a-prospective-cohort-study
#6
Pablo Alonso-Coello, Deborah Cook, Shou Chun Xu, Alben Sigamani, Otavio Berwanger, Soori Sivakumaran, Homer Yang, Denis Xavier, Luz Ximena Martinez, Pedro Ibarra, Purnima Rao-Melacini, Janice Pogue, Kelly Zarnke, Pilar Paniagua, Jack Ostrander, Salim Yusuf, P J Devereaux
BACKGROUND: Despite the frequency of new clinically important atrial fibrillation (AF) after noncardiac surgery and its increased association with the risk of stroke at 30 days, there are limited data informing their prediction, association with outcomes, and management. METHODS: We used the data from the PeriOperative ISchemic Evaluation trial to determine, in patients undergoing noncardiac surgery, the association of new clinically important AF with 30-day outcomes, and to assess management of these patients...
July 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28621185/-acute-abdominal-syndrome-caused-by-benign-ovarian-tumors
#7
Ali Alzubi, István Zöllei, Katalin Intzédy
The acute abdomen is a life threatening condition, its proper diagnosis and treatment is a great challenge until today in surgery. The authors aim to present the diagnostic difficulties in four cases of acute abdomen caused by large benign ovarian tumors. Vast majority of benign ovarian tumors are recognized accidentally through physical examination, X-ray and ultrasonography of the pelvis, abdominal operation is carried out for other reasons or investigations for acute abdominal pain. The case history, physical examination and radiological procedures do not always lead to the correct diagnosis...
June 2017: Magyar Sebészet
https://www.readbyqxmd.com/read/28619688/single-port-laparoscopy-in-gynecologic-oncology-seven-years-of-experience-at-a-single-institution
#8
Laura Moulton, Amelia M Jernigan, Caitlin Carr, Lindsey Freeman, Pedro F Escobar, Chad M Michener
BACKGROUND: Single port laparoscopy has gained popularity within minimally invasive gynecologic surgery for its feasibility, cosmetic outcomes and safety. However, within gynecologic oncology, there is limited data regarding short-term adverse outcomes and long term hernia risk in patients undergoing single port laparoscopic surgery. OBJECTIVE: To describe short-term outcomes and hernia rates in patients after single port laparoscopy in a gynecologic oncology practice...
June 12, 2017: American Journal of Obstetrics and Gynecology
https://www.readbyqxmd.com/read/28618654/comparison-of-honey-and-dextrose-solution-on-post-operative-peritoneal-adhesion-in-rat-model
#9
Vafa Baradaran Rahimi, Reza Shirazinia, Narges Fereydouni, Parvin Zamani, Sousan Darroudi, Amir Hossein Sahebkar, Vahid Reza Askari
BACKGROUND: Peritoneal adhesion between abdominal organs is a complication of surgery. It causes major complications like pain, bowel obstruction, infertility and increases risk of death. Honey is known to have anti-inflammatory and antioxidant properties potentially relevant for adhesive protection. METHODS: Thirty rats were divided into five groups: negative control without any surgical procedure (normal group), control group treated with normal saline, experimental group I treated with 1ml of 10% honey, experimental group II treated with honey at half concentration of group I (honey0...
June 10, 2017: Biomedicine & Pharmacotherapy, Biomédecine & Pharmacothérapie
https://www.readbyqxmd.com/read/28614043/antibiotics-vs-appendectomy-for-acute-uncomplicated-appendicitis-in-adults-review-of-the-evidence-and-future-directions
#10
Jared M Huston, Lillian S Kao, Phillip K Chang, James M Sanders, Sara Buckman, Charles A Adams, Christine S Cocanour, Sarah E Parli, Julia Grabowski, Jose Diaz, Jeffrey M Tessier, Therese M Duane
BACKGROUND: Acute appendicitis is the most common abdominal surgical emergency in the United States, with a lifetime risk of 7%-8%. The treatment paradigm for complicated appendicitis has evolved over the past decade, and many cases now are managed by broad-spectrum antibiotics. We determined the role of non-operative and operative management in adult patients with uncomplicated appendicitis. METHODS: Several meta-analyses have attempted to clarify the debate. Arguably the most influential is the Appendicitis Acuta (APPAC) Trial...
June 14, 2017: Surgical Infections
https://www.readbyqxmd.com/read/28604376/aortic-surgery-and-laparoscopy-still-a-future-in-the-endovascular-surgery-era
#11
Pierfrancesco Veroux, Vincenzo Ardita, Alessia Giaquinta, Alberto Davì, Giusi Basile, Massimiliano Veroux
Laparoscopic surgery (LS) is the minimally invasive alternative to open surgery and endovascular approach for treating major aortic diseases. Only few reports in the literature describe the long-term outcomes of the laparoscopic approach for major vascular diseases. Furthermore, the widespread use of endovascular techniques has limited the use of LS to wellselected patients. This review evaluated the results of LS for aortic disease and compared the clinical outcomes of laparoscopic technique with those of open and endovascular surgery...
2017: Annali Italiani di Chirurgia
https://www.readbyqxmd.com/read/28602897/lower-extremity-ischemia-after-abdominal-aortic-aneurysm-repair
#12
C A Behrendt, A Dayama, E S Debus, F Heidemann, N M Matolo, T Kölbel, N Tsilimparis
OBJECTIVE: Treatment reality of abdominal aortic aneurysm (AAA) is changing. Up to date, approximately 65% of intact AAA and 30% of ruptured AAA are treated endovascularly. As most comparative studies focus upon mortality and few major complications, some outcomes as lower extremity ischemia (LEI) after invasive AAA repair are often underreported. However, there is evidence for a worse outcome of patients suffering from this kind of complication. METHODS: Using the American College of Surgeons National Surgical Quality Improvement Program (NSQIP) vascular surgery targeted module from 2011 to 2014, we identified all patients undergoing endovascular aortic repair (EVAR) and open aortic repair (OAR) for AAA to illuminate the incidence and outcome of LEI after AAA repair...
June 7, 2017: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/28602526/resident-operative-experience-at-independent-academic-medical-centers-a-comparison-to-the-national-cohort
#13
Amit R T Joshi, Amber W Trickey, Benjamin T Jarman, Kara J Kallies, Robert Josloff, Jonathan M Dort, Ravi Kothuru
PURPOSE: Independent Academic Medical Centers (IAMCs) comprise one-third of U.S. general surgery training programs. It is unclear whether IAMCs offer qualitatively or quantitatively different operative experiences than the national cohort. We analyzed a large representative sample of IAMCs to compare operative volume and variety, with a focus on low-volume procedures. METHODS: Accreditation Council for Graduate Medical Education Program Case Reports from 27 IAMCs were collected and analyzed for 3 academic years (2012-2015)...
June 8, 2017: Journal of Surgical Education
https://www.readbyqxmd.com/read/28602158/effect-of-perioperative-goal-directed-hemodynamic-therapy-on-postoperative-recovery-following-major-abdominal-surgery-a-systematic-review-and-meta-analysis-of-randomized-controlled-trials
#14
Yanxia Sun, Fang Chai, Chuxiong Pan, Jamie Lee Romeiser, Tong J Gan
BACKGROUND: Goal-directed hemodynamic therapy (GDHT) has been used in the clinical setting for years. However, the evidence for the beneficial effect of GDHT on postoperative recovery remains inconsistent. The aim of this systematic review and meta-analysis was to evaluate the effect of perioperative GDHT in comparison with conventional fluid therapy on postoperative recovery in adults undergoing major abdominal surgery. METHODS: Randomized controlled trials (RCTs) in which researchers evaluated the effect of perioperative use of GDHT on postoperative recovery in comparison with conventional fluid therapy following abdominal surgery in adults (i...
June 12, 2017: Critical Care: the Official Journal of the Critical Care Forum
https://www.readbyqxmd.com/read/28601334/variation-in-readmission-expenditures-after-high-risk-surgery
#15
Bruce L Jacobs, Chang He, Benjamin Y Li, Alex Helfand, Naveen Krishnan, Tudor Borza, Amir A Ghaferi, Brent K Hollenbeck, Jonathan E Helm, Mariel S Lavieri, Ted A Skolarus
BACKGROUND: The Hospital Readmissions Reduction Program reduces payments to hospitals with excess readmissions for three common medical conditions and recently extended its readmission program to surgical patients. We sought to investigate readmission intensity as measured by readmission cost for high-risk surgeries and examine predictors of higher readmission costs. MATERIALS AND METHODS: We used the Healthcare Cost and Utilization Project's State Inpatient Database to perform a retrospective cohort study of patients undergoing major chest (aortic valve replacement, coronary artery bypass grafting, lung resection) and major abdominal (abdominal aortic aneurysm repair [open approach], cystectomy, esophagectomy, pancreatectomy) surgery in 2009 and 2010...
June 1, 2017: Journal of Surgical Research
https://www.readbyqxmd.com/read/28601319/a-carboxymethylcellulose-heparin-combination-for-the-prevention-of-surgical-adhesions
#16
James R Docherty, P Aiden McCormick
BACKGROUND: Adhesions are a major clinical problem after abdominal surgery. Despite decades of research, therapies to prevent adhesion formation are suboptimal. MATERIALS AND METHODS: We have investigated combinations of carboxymethylcellulose (CMC) and heparin at preventing surgical adhesions in two rat models of adhesion formation. The first was the well-established cecal abrasion model, and the second was a model developed in our laboratory, the avascular mesenteric knot model...
June 1, 2017: Journal of Surgical Research
https://www.readbyqxmd.com/read/28595819/risk-factors-and-prediction-model-for-inpatient-surgical-site-infection-after-major-abdominal-surgery
#17
Aslam Ejaz, Carl Schmidt, Fabian M Johnston, Steve M Frank, Timothy M Pawlik
BACKGROUND: Surgical site infections (SSIs) are a common source of postoperative morbidity and a marker of surgical quality. The ability to predict the incidence of SSIs is limited and most models have poor predictive value. We sought to identify risk factors associated with SSIs and develop a prediction model for SSIs after major abdominal surgery. METHODS: A total of 1744 patients undergoing pancreatic, hepatobiliary, and colorectal resections between January 1, 2010 and August 31, 2013 at Johns Hopkins Hospital were identified...
May 11, 2017: Journal of Surgical Research
https://www.readbyqxmd.com/read/28593407/feasibility-of-real-time-location-systems-in-monitoring-recovery-after-major-abdominal-surgery
#18
Robert D Dorrell, Sarah A Vermillion, Clancy J Clark
BACKGROUND: Early mobilization after major abdominal surgery decreases postoperative complications and length of stay, and has become a key component of enhanced recovery pathways. However, objective measures of patient movement after surgery are limited. Real-time location systems (RTLS), typically used for asset tracking, provide a novel approach to monitoring in-hospital patient activity. The current study investigates the feasibility of using RTLS to objectively track postoperative patient mobilization...
June 7, 2017: Surgical Endoscopy
https://www.readbyqxmd.com/read/28593406/laparoscopic-liver-surgery-towards-a-day-case-management
#19
Hadrien Tranchart, David Fuks, Panagiotis Lainas, Martin Gaillard, Ibrahim Dagher, Brice Gayet
BACKGROUND: Ambulatory surgery (AS) is a contemporary subject of interest. The feasibility and safety of AS for solid abdominal organs are still dubious. In the present study, we aimed at defining potential surgical criteria for AS by analyzing a large database of patients who underwent laparoscopic liver surgery (LLS) in two French expert centers. METHODS: This study was performed using prospectively filled databases including patients that underwent pure LLS between 1998 and 2015...
June 7, 2017: Surgical Endoscopy
https://www.readbyqxmd.com/read/28593266/wireless-monitoring-program-of-patient-centered-outcomes-and-recovery-before-and-after-major-abdominal-cancer-surgery
#20
Virginia Sun, Sinziana Dumitra, Nora Ruel, Byrne Lee, Laleh Melstrom, Kurt Melstrom, Yanghee Woo, Stephen Sentovich, Gagandeep Singh, Yuman Fong
Importance: A combined subjective and objective wireless monitoring program of patient-centered outcomes can be carried out in patients before and after major abdominal cancer surgery. Objective: To conduct a proof-of-concept pilot study of a wireless, patient-centered outcomes monitoring program before and after major abdominal cancer surgery. Design, Setting, and Participants: In this proof-of-concept pilot study, patients wore wristband pedometers and completed online patient-reported outcome surveys (symptoms and quality of life) 3 to 7 days before surgery, during hospitalization, and up to 2 weeks after discharge...
June 7, 2017: JAMA Surgery
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