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scoring laparotomy

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https://www.readbyqxmd.com/read/29221835/impact-of-surgical-approach-and-patient-factors-on-hospital-consumer-assessment-of-healthcare-providers-and-systems-hcahps-survey-scoring-in-gynecologic-surgery
#1
Sumer Wallace, Kristine T Hanson, Sean C Dowdy, Elizabeth B Habermann
OBJECTIVE: We sought to compare the Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) survey responses of women who underwent gynecologic surgery at our institution across patient factors and surgical approach. METHODS: We identified patients with returned HCAHPS surveys following an inpatient laparoscopic surgery or laparotomy in gynecologic surgery from 10/1/2012-9/30/2015. Exclusions included patient age<18years, discharge by a service other than Gynecologic Surgery, or refusal of Minnesota research authorization...
December 5, 2017: Gynecologic Oncology
https://www.readbyqxmd.com/read/29218669/laparoscopy-as-a-useful-selection-tool-for-patients-with-prior-surgery-and-peritoneal-metastases-suitable-for-multimodality-treatment-strategies
#2
Philipp von Breitenbuch, Thomas Boerner, Tonia Jeiter, Pompiliu Piso, Hans J Schlitt
BACKGROUND: Complete macroscopic cytoreduction in patients with peritoneal carcinomatosis (PC) is the basic requirement for long-term survival. Diagnostic laparoscopy (DL) can be difficult and of limited clinical value secondary to postoperative or tumor-induced adhesions. The aim of this study was to evaluate the role of DL in patients with prior surgery and PC. METHODS: The database of the surgical department of the University Medical Center of Regensburg was reviewed (9/2010-10/2014) selecting for DL in patients with PC...
December 7, 2017: Surgical Endoscopy
https://www.readbyqxmd.com/read/29217906/liquid-paraffin-vs-hyaluronic-acid-in-preventing-intraperitoneal-adhesions
#3
Hanish Kataria, Vinod Prem Singh
Adhesion formation after abdominal and pelvic operations remains a challenging problem. Role of adjuvant barriers have been studied but there is no comparative study between liquid paraffin and hyaluronic acid as a barrier method. Hence, we planned to compare the effectiveness of 0.4 % hyaluronic acid and liquid paraffin in the prevention of postoperative intraperitoneal adhesions in rats. This prospective, randomized and controlled study was conducted in 60 adult Wistar albino rats. Surgical trauma by caecal abrasion and 1 g talcum powder was used in the rat model to induce adhesion formation...
December 2017: Indian Journal of Surgery
https://www.readbyqxmd.com/read/29217904/comparison-of-the-short-term-outcomes-of-laparoscopic-and-open-resections-for-colorectal-cancer-in-patients-with-a-history-of-prior-median-laparotomy
#4
Young Wan Kim, Ik Yong Kim
This study aimed to investigate the short-term outcomes of laparoscopic resection in comparison with those of open resection for colorectal cancer in patients with a history of prior median laparotomy (PML). Eighty-seven consecutive patients (87/1121, 7.8 %) with a history of PML who underwent major colorectal cancer resection were enrolled (laparoscopy, n = 40; open, n = 47). The conversion rate to open surgery was 25 % (n = 10). The laparoscopy group had a higher proportion of female patients (57...
December 2017: Indian Journal of Surgery
https://www.readbyqxmd.com/read/29194011/rapid-source-control-laparotomy-is-there-a-mortality-benefit-in-septic-shock
#5
James Vogler, Leslie Hart, Sharon Holmes, Jason Sciaretta, John Mihran Davis
BACKGROUND: In the 1990s, damage control laparotomy (DCL) became a proved approach to treat intra-abdominal injuries caused by trauma. In the ensuing two decades, this approach has been applied to non-traumatic abdominal processes as well. Although the benefits of DCL are clear, the benefit of rapid source-control laparotomy (RSCL) for non-traumatic abdominal diseases is much less clear. However, two recent cohort analyses identified significant increases in the mortality rate with RCSL compared with primary fascial closure (PFC)...
December 1, 2017: Surgical Infections
https://www.readbyqxmd.com/read/29192372/prediction-of-resectability-in-pseudomyxoma-peritonei-with-a-new-ct-score
#6
Morgane Bouquot, Anthony Dohan, Etienne Gayat, Maxime Barat, Olivier Glehen, Marc Pocard, Pascal Rousset, Clarisse Eveno
BACKGROUND: Curative treatment of pseudomyxoma peritonei (PMP) is complete cytoreductive surgery (CRS) with hyperthermic intraperitoneal chemotherapy (HIPEC). OBJECTIVE: The aim of this study was to build and evaluate a preoperative imaging score to predict resectability. PATIENTS AND METHODS: Between 2007 and 2014, all PMP patients in two tertiary reference centers who underwent laparotomy with intent to undergo CRS and HIPEC were included in this study retrospectively...
November 30, 2017: Annals of Surgical Oncology
https://www.readbyqxmd.com/read/29180196/laparotomy-causes-loss-of-peritoneal-mesothelium-prevented-by-humidified-co2-insufflation-in-rats
#7
Jean K Marshall, Noel Tait, Jan van der Linden
INTRODUCTION: Avoiding tissue desiccation is a common recommendation to reduce postoperative complications following open abdominal surgery, although difficult to achieve delicately without damaging the peritoneal mesothelium. Insufflation of humidified-warm CO2 into the abdomen during open abdominal surgery is proposed as an invisible, effortless way to prevent desiccation. We hypothesized that desiccation during open abdominal surgery would cause loss of peritoneal mesothelium that would be prevented by insufflation of humidified-warm CO2...
December 2017: Journal of Surgical Research
https://www.readbyqxmd.com/read/29180180/primary-repair-for-pediatric-colonic-injury-are-there-differences-among-adult-and-pediatric-trauma-centers
#8
Muhammad Khan, Faisal Jehan, Terence O'Keeffe, Viraj Pandit, Narong Kulvatunyou, Andrew Tang, Lynn Gries, Bellal Joseph
BACKGROUND: Management of colonic injuries (colostomy [CO] versus primary anastomosis [PA]) among pediatric patients remains controversial. The aim of this study was to assess outcomes in pediatric trauma patient with colonic injury undergoing operative intervention. METHODS: The National Trauma Data Bank (2011-2012) was queried including patients with isolated colonic injury undergoing exploratory laparotomy with PA or CO with age ≤18 y. Missing value analysis was performed...
December 2017: Journal of Surgical Research
https://www.readbyqxmd.com/read/29174960/the-uptake-of-transdermal-fentanyl-in-a-pregnant-sheep-model
#9
Gabrielle C Musk, C S Melanie Catanchin, Haruo Usuda, Eleanor Woodward, Matthew W Kemp
OBJECTIVE: To evaluate the maternal and foetal uptake of transdermal fentanyl patch applied to the groin of pregnant sheep following surgery. STUDY DESIGN: Prospective series. ANIMALS: A group of 16 singleton pregnant sheep underwent anaesthesia for laparotomy, hysterotomy and instrumentation of the foetus. Of these ewes 10 (101 ± 12 days of gestation) were used to evaluate the maternal uptake of transdermal fentanyl, and the efficacy of the drug in the postoperative period (n = 10)...
May 26, 2017: Veterinary Anaesthesia and Analgesia
https://www.readbyqxmd.com/read/29159605/outcomes-of-emergency-laparotomy-el-care-protocol-at-tertiary-care-center-from-low-middle-income-country-lmic
#10
Nitin Vashistha, Dinesh Singhal, Sandeep Budhiraja, Bharat Aggarwal, Raj Tobin, Kamal Fotedar
BACKGROUND: Emergency laparotomy mortality ranges between 10 and 20% in best of Western healthcare systems and is currently a major focus for quality improvement programs. In contrast, emergency surgery scenario in LMIC is largely undefined, often neglected and complex (large burden of diseases but only limited capacity for adequate treatment). We evaluated the efficacy of 'EL care protocol' aimed at cost-effective optimal utilization of best available local expertise and infrastructure...
November 20, 2017: World Journal of Surgery
https://www.readbyqxmd.com/read/29142183/worse-preoperative-status-based-on-inflammation-and-host-immunity-is-a-risk-factor-for-surgical-site-infections-in-colorectal-cancer-surgery
#11
Masano Sagawa, Kazuhiko Yoshimatsu, Hajime Yokomizo, Yuki Yano, Sachiyo Okayama, Takebumi Usui, Kentaro Yamaguchi, Shunichi Shiozawa, Takeshi Shimakawa, Takao Katsube, Hiroyuki Kato, Yoshihiko Naritaka
OBJECTIVE: The modified Glasgow Prognostic Score (mGPS) is an inflammation-based measure of malnutrition that reflects a state of cachexia in cancer patients. We evaluated mGPS as an index to predict surgical site infection (SSI) incidence in patients undergoing colorectal cancer surgery. SUBJECTS AND METHODS: We retrospectively analyzed 351 patients who underwent colon cancer resection. Factors correlated with the incidence of SSIs were identified by logistic analysis and stepwise selection...
2017: Journal of Nippon Medical School, Nippon Ika Daigaku Zasshi
https://www.readbyqxmd.com/read/29134253/the-role-of-the-neutrophil-lymphocyte-ratio-nlr-and-the-crp-albumin-ratio-car-in-predicting-mortality-following-emergency-laparotomy-in-the-over-80-age-group
#12
G Simpson, R Saunders, J Wilson, C Magee
INTRODUCTION: Emergency laparotomy in the elderly is an increasingly common procedure which carries high morbidity and mortality. Risk prediction tools, although imperfect, can help guide management decisions. Novel markers of surgical outcomes may contribute to these scoring systems. The neutrophil:lymphocyte ratio (NLR) and CRP:albumin ratio (CAR) have been associated with outcomes in malignancy and sepsis. We assessed the use of ratio NLR and CAR as prognostic indicators in patients over the age of 80 undergoing emergency laparotomy...
November 13, 2017: European Journal of Trauma and Emergency Surgery: Official Publication of the European Trauma Society
https://www.readbyqxmd.com/read/29129378/transvaginal-natural-orifice-transluminal-endoscopic-surgery-a%C3%A2-new-approach-to-myomectomy
#13
Jan Baekelandt
OBJECTIVE: To demonstrate a new approach for performing a myomectomy via transvaginal natural-orifice transluminal endoscopic surgery (vNOTES) as an alternative to laparoscopic myomectomy. DESIGN: Stepwise explanation of the technique with the use of original video footage. SETTING: Hospital. PATIENT(S): Eight patients were treated transvaginally for intramural, subserosal, and pedunculated myomas. INTERVENTION(S): In case of a posterior myoma, a 2...
November 9, 2017: Fertility and Sterility
https://www.readbyqxmd.com/read/29100217/nontraumatic-emergency-laparotomy-surgical-principles-similar-to-trauma-need-to-be-adopted
#14
Deepak Singh-Ranger, Edmund Leung, Mei-Ling Lau-Robinson, Sean Ramcharan, James Francombe
OBJECTIVES: In 2011, the Royal College of Surgeons published Emergency Surgery: Standards for Unscheduled Care in response to variable clinical outcomes for emergency surgery. The purpose of this study was to examine whether different treatment modalities would alter survival. METHODS: All patients who underwent emergency laparotomy between April 2011 and December 2012 at Warwick Hospital (Warwick, UK) were included retrospectively. Information relating to their demographics; preoperative score; primary pathology; timing of surgery; intraoperative details; and postoperative outcome, including 30-day mortality, were collated for statistical analysis...
November 2017: Southern Medical Journal
https://www.readbyqxmd.com/read/29079463/a-multicenter-study-evaluating-the-effect-of-ulipristal-acetate-during-myomectomy
#15
Ally Murji, Marta Wais, Sabrina Lee, Alice Pham, Melissa Tai, Grace Liu
STUDY OBJECTIVE: To compare surgical experience at myomectomy between patients with fibroids pretreated with ulipristal acetate versus no pretreatment. DESIGN: Prospective, observational, multicenter study of myomectomy procedures by any route (hysteroscopic, laparoscopic or laparotomy). DESIGN CLASSIFICATION: Canadian Task Force Classification II-2. SETTING: Five university-affiliated hospitals including tertiary care and community sites...
October 24, 2017: Journal of Minimally Invasive Gynecology
https://www.readbyqxmd.com/read/29078870/repeat-computed-tomography-is-highly-sensitive-in-determining-need-for-delayed-exploration-in-blunt-abdominal-trauma
#16
Magdalene Brooke, Gregory P Victorino
BACKGROUND: Computed tomography (CT) imaging has an established role in the initial evaluation of blunt abdominal trauma. What is less clear is the role of CT in guiding delayed exploration in patients initially managed nonoperatively after blunt trauma. We hypothesized that a repeat CT would accurately identify the need for an exploratory laparotomy in this patient population. MATERIALS AND METHODS: From 2005 to 2014, we reviewed all blunt abdominal trauma patients at our institution who received an admission CT scan...
November 2017: Journal of Surgical Research
https://www.readbyqxmd.com/read/29067426/effect-of-robotic-assisted-vs-conventional-laparoscopic-surgery-on-risk-of-conversion-to-open-laparotomy-among-patients-undergoing-resection-for-rectal-cancer-the-rolarr-randomized-clinical-trial
#17
RANDOMIZED CONTROLLED TRIAL
David Jayne, Alessio Pigazzi, Helen Marshall, Julie Croft, Neil Corrigan, Joanne Copeland, Phil Quirke, Nick West, Tero Rautio, Niels Thomassen, Henry Tilney, Mark Gudgeon, Paolo Pietro Bianchi, Richard Edlin, Claire Hulme, Julia Brown
Importance: Robotic rectal cancer surgery is gaining popularity, but limited data are available regarding safety and efficacy. Objective: To compare robotic-assisted vs conventional laparoscopic surgery for risk of conversion to open laparotomy among patients undergoing resection for rectal cancer. Design, Setting, and Participants: Randomized clinical trial comparing robotic-assisted vs conventional laparoscopic surgery among 471 patients with rectal adenocarcinoma suitable for curative resection conducted at 29 sites across 10 countries, including 40 surgeons...
October 24, 2017: JAMA: the Journal of the American Medical Association
https://www.readbyqxmd.com/read/29055895/the-pattern-of-paediatric-blast-injury-in-afghanistan
#18
Daniel C Thompson, R J Crooks, J C Clasper, A Lupu, S A Stapley, D J Cloke
INTRODUCTION: Between 2009 and 2015, 3746 children died, and 7904 were injured as a result of armed conflict within Afghanistan. Improvised explosive devices (IEDs) and explosive remnants of war accounted for 29% of child casualties in 2015. The aim of this study was to review the burden of paediatric blast injuries admitted to Camp Bastion, Afghanistan, and to investigate the hypothesis that children suffer proportionally more head injuries than adults. METHOD: A retrospective analysis was undertaken of prospectively collected data derived from the UK Joint Theatre Trauma Registry of ambulant paediatric (aged 2-15 years) admissions with blast injuries at the Role 3 Field Hospital, Camp Bastion from June 2006 to March 2013...
October 21, 2017: Journal of the Royal Army Medical Corps
https://www.readbyqxmd.com/read/29032252/a-comparison-of-industry-leading-energy-devices-for-use-in-gynecologic-laparoscopy-articulating-enseal-versus-ligasure-energy-devices
#19
Linda-Dalal J Shiber, Daniel N Ginn, Ambareen Jan, Jeremy T Gaskins, Shan M Biscette, Resad Pasic
OBJECTIVE: To compare two laparoscopic bipolar electrosurgical devices used in total laparoscopic hysterectomy (TLH). An articulating advanced bipolar device (ENSEAL® G2, Ethicon) and an electrothermal bipolar vessel sealer (LigasureTM, Covidien) were analyzed for difference in surgeon perception of ease of instrument use and workload using the raw-Task Load Index (RTLX) scale. Secondarily, differences in operative time, estimated blood loss (EBL), and perioperative complication rates between the two devices were examined...
October 12, 2017: Journal of Minimally Invasive Gynecology
https://www.readbyqxmd.com/read/29031928/the-role-of-purified-clostridium-difficile-glucosylating-toxins-in-disease-pathogenesis-utilizing-a-murine-cecum-injection-model
#20
Yongrong Zhang, Zhiyong Yang, Si Gao, Therwa Hamza, Harris G Yfantis, Michael Lipsky, Hanping Feng
Most pathogenic Clostridium difficile produce two major exotoxins TcdA and TcdB, in the absence of which the bacterium is non-pathogenic. While it is important to investigate the role of each toxin in the pathogenesis of C. difficile infection (CDI) using isogenic strains, it is impossible to precisely control the expression levels of individual toxins and exclude bacterial factors that may contribute to the toxins' effects during infection. In this study, we utilized an acute intestinal disease model by injecting purified toxins directly into mouse cecum after a midline laparotomy...
October 12, 2017: Anaerobe
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