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https://www.readbyqxmd.com/read/28718038/reappraisal-of-staging-laparoscopy-for-patients-with-pancreatic-adenocarcinoma-a-contemporary-analysis-of-1001-patients
#1
Zhi Ven Fong, Donna Marie L Alvino, Carlos Fernández-Del Castillo, Winta T Mehtsun, Ilaria Pergolini, Andrew L Warshaw, David C Chang, Keith D Lillemoe, Cristina R Ferrone
BACKGROUND: Recent advances in imaging and the increasing use of neoadjuvant therapy puts the contemporary utility of staging laparoscopy for patients with pancreatic adenocarcinoma (PDAC) into question. This study aimed to develop a prognostic score to optimize prevention of an unnecessary laparotomy and minimize the rate for unnecessary laparoscopy. METHODS: Clinicopathologic data were evaluated for all patients undergoing surgical intervention for PDAC between 2001 and 2015, who were stratified into group 1 (2001-2008) and group 2 (2009-2014)...
July 17, 2017: Annals of Surgical Oncology
https://www.readbyqxmd.com/read/28706891/evaluation-of-botulinum-toxin-type-a-effectiveness-in-preventing-postoperative-intraperitoneal-adhesions
#2
Mehmet Dokur, Erdal Uysal
PURPOSE: Postoperative intraperitoneal adhesions (PIAs) are one of the most important problems surgeons have to face after laparotomies. In this study, we aimed to evaluate the effectiveness of local application of botulinum toxin type A (BoNT-A) in various dosages on the prevention of intra-abdominal adhesions in rats with experimental intra-abdominal adhesions. METHODS: Forty Wistar Albino female rats were randomly separated into 4 groups. The 4 groups were determined as follows: Control (group 1, n = 10); Sham (group 2, n = 10); 10-µg/kg low-dose BoNT-A (group 3, n = 10) and 30-µg/kg high-dose BoNT-A (group 4, n = 10)...
July 2017: Annals of Surgical Treatment and Research
https://www.readbyqxmd.com/read/28706425/procalcitionin-as-a-diagnostic-marker-to-distinguish-upper-and-lower-gastrointestinal-perforation
#3
Yang Gao, Kai-Jiang Yu, Kai Kang, Hai-Tao Liu, Xing Zhang, Rui Huang, Jing-Dong Qu, Si-Cong Wang, Rui-Jin Liu, Yan-Song Liu, Hong-Liang Wang
AIM: To assess the accuracy of serum procalcitionin (PCT) as a diagnostic marker in verifying upper and lower gastrointestinal perforation (GIP). METHODS: This retrospective study included 46 patients from the surgical intensive care unit (ICU) of the Second Affiliated Hospital of Harbin Medical University who were confirmed to have GIP between June 2013 and December 2016. Demographic and clinical patient data were recorded on admission to ICU. Patients were divided into upper (n = 19) and lower (n = 27) GIP groups according to the perforation site (above or below Treitz ligament)...
June 28, 2017: World Journal of Gastroenterology: WJG
https://www.readbyqxmd.com/read/28700426/coexisting-primary-ovarian-and-omental-hydatid-disease-mimicking-an-ovarian-neoplasm-a-case-report
#4
Emre E Tas, Gulin F Yegin Akcay, Fatma Yildirim, Filiz Yavuz
Hydatid disease is a parasitic infection that most commonly affects the liver and lungs, although the disease can arise in any part of the body. Cysts may mimic many benign and malignant conditions. The diagnosis cannot be confirmed preoperatively in all cases. A 44-yr-old menopausal woman was admitted to the department of gynecology with complaints of abdominal distention. A fixed abdominopelvic mass was identified. Radiology revealed a 20-cm mass with branched septations and solid components. CA-125 level was 55 kU/L, and Risk of Malignancy Index-2 score was 880...
July 11, 2017: International Journal of Gynecological Pathology
https://www.readbyqxmd.com/read/28694568/the-role-of-routine-measurement-of-intra-abdominal-pressure-in-preventing-abdominal-compartment-syndrome
#5
G Raghavendra Prasad, J V Subba Rao, Amtul Aziz, T M Rashmi
INTRODUCTION: Abdomen, a closed compartment, is prone to raised intra-abdominal pressure (IAP) in the postoperative period. After a critical value of ≥ 15 cm of water, IAP produces abdominal compartment syndrome (ACS). ACS leads to reduced venous return, reduced cardiac output, and domino effect of organ dysfunction, leading to death. Hence, it is the need of hour to monitor IAP to pick up intra-abdominal hypertension (IAH) and ACS. This routine facilitates early institution of treatment measures...
July 2017: Journal of Indian Association of Pediatric Surgeons
https://www.readbyqxmd.com/read/28682130/the-front-line-general-surgery-consultant-as-a-new-model-of-emergency-care
#6
A P Navarro, Ejo Hardy, B Oakley, E Mohamed, N T Welch, S L Parsons
INTRODUCTION Emergency general surgery services in England are undergoing rapid structural change with the aim of improving care. In our centre, the key issues identified were high numbers of admissions, inappropriate referrals, prolonged waiting times, delayed senior input and poor patient satisfaction. A new model was launched in January 2015 to address these issues: the surgical triage unit (STU). This study assesses the success of the new service. METHODS All emergency general surgical admissions during a five-month period before introduction of the STU were compared with those of a comparable five-month period after its introduction...
July 6, 2017: Annals of the Royal College of Surgeons of England
https://www.readbyqxmd.com/read/28679359/bilateral-thoracic-paravertebral-block-for-immediate-postoperative-pain-relief-in-the-pacu-a-prospective-observational-study
#7
Fei Liu, HuanKai Zhang, Yunxia Zuo
BACKGROUND: To investigate the feasibility, effectiveness and safety of bilateral thoracic paravertebral block (TPVB) in the post anesthesia care unit (PACU) for pain relief in participants after laparotomy. METHODS: A single shot of bilateral TPVB with 25 ml of 0.2% ropivacaine and 5 mg dexamethasone in combination for both sides at the 8th thoracic transverse level (T8) was performed on 201 participants who complained moderate to severe pain on arrival to PACU after laparotomy...
July 5, 2017: BMC Anesthesiology
https://www.readbyqxmd.com/read/28678652/postoperative-c-reactive-protein-concentration-and-clinical-outcome-comparison-of-open-cystectomy-to-robot-assisted-laparoscopic-cystectomy-with-extracorporeal-or-intracorporeal-urinary-diversion-in-a-prospective-study
#8
Pernille Skjold Kingo, Rikke Nørregaard, Michael Borre, Jørgen Bjerggaard Jensen
OBJECTIVE: This study aimed to compare clinical outcome and postoperative systemic inflammatory response using C-reactive protein (CRP) levels, to quantify the degree of tissue injury in open mini-laparotomy cystectomy (OMC) versus robot-assisted laparoscopic cystectomy with extracorporeal (RALC-EUD) or intracorporeal urinary diversion (RALC-IUD). MATERIALS AND METHODS: From September 2012 to September 2015, 309 patients diagnosed with bladder cancer underwent radical cystectomy with urinary diversion...
July 5, 2017: Scandinavian Journal of Urology
https://www.readbyqxmd.com/read/28673214/randomised-comparison-of-three-types-of-continuous-anterior-abdominal-wall-block-after-midline-laparotomy-for-gynaecological-oncology-surgery
#9
P J Cowlishaw, P J Kotze, L Gleeson, N Chetty, L E Stanbury, P J Harms
Effective analgesia after midline laparotomy surgery is essential for enhanced recovery programs. We compared three types of continuous abdominal wall block for analgesia after midline laparotomy for gynaecological oncology surgery. We conducted a single-centre, double-blind randomised controlled trial. Ninety-four patients were randomised into three groups to receive two days of programmed intermittent boluses of ropivacaine (18 ml 0.5% ropivacaine every four hours) via either a transversus abdominis plane (TAP) catheter, posterior rectus sheath (PRS) catheter, or a subcutaneous (SC) catheter...
July 2017: Anaesthesia and Intensive Care
https://www.readbyqxmd.com/read/28669786/post-operative-outcomes-among-pediatric-and-adolescent-patients-undergoing-mini-laparotomy-vs-laparoscopy-in-the-management-of-adnexal-lesions
#10
Gylynthia Trotman, Christine Foley, Janelle Taylor, Sameer DeSale, Veronica Gomez-Lobo
STUDY OBJECTIVE: To compare institutional experience in the postoperative recovery in children and adolescents undergoing laparoscopy versus mini-laparotomy in the management of benign adnexal cystic lesions. DESIGN: Retrospective Cohort. SETTING: Tertiary care children's hospital. PARTICIPANTS: Patients ages 6 -21 who underwent surgical management for benign adnexal lesions. MAIN OUTCOME MEASURES: Comparison of operative times, size of lesions, pain scores, patient length of stay after mini-laparotomy versus laparoscopy...
June 29, 2017: Journal of Pediatric and Adolescent Gynecology
https://www.readbyqxmd.com/read/28661101/-sex-differences-in-physiological-responses-to-pain-throughout-surgical-procedures
#11
Ariel Ronen, Tzippy Shochat, Leonid Eidelman
BACKGROUND: Recent research has shown that women and men respond differently to pain, and that biological mechanisms partially moderate sex-related differences in pain sensitivity. Previous pain studies regarding the relationship between pain and physiological aspects, such as brain function and hormone levels, have demonstrated gender differences. In this study we examined whether male and female autonomic reactivity patterns to pain, defined as increases in heart rate and blood pressure, differ throughout anesthetized abdominal surgical procedures...
June 2017: Harefuah
https://www.readbyqxmd.com/read/28635237/-comparison-of-the-short-term-and-long-term-outcomes-of-laparoscopic-surgery-and-open-surgery-for-early-stage-cervical-cancer
#12
H Y He, Z J Yang, D Y Zeng, D S Yao, J T Fan, R F Zhao, J Q Zhang, X X Hu, Z Lin, Y M Jiang, L Li
Objective: To evaluate the short-term and long-term outcomes after laparoscopic surgery compared with traditional laparotomy in cases of stage ⅠA2-ⅡA2 cervical cancer. Methods: We conducted a retrospective study on the clinical data of 1 863 patients diagnosed as FIGO stages ⅠA2-ⅡA2 cervical cancer in 6 third-grade class-A hospitals in Guangxi province between January 2007 and May 2014. One thousand and seventy-one received laparoscopy, and 792 received laparotomy. T-test, U-test and χ(2) test were used to compare the short-term and long-term outcomes...
June 23, 2017: Zhonghua Zhong Liu za Zhi [Chinese Journal of Oncology]
https://www.readbyqxmd.com/read/28634840/self-inflicted-abdominal-stab-wounds-have-a-higher-rate-of-non-therapeutic-laparotomy-laparoscopy-and-a-lower-risk-of-injury
#13
Nikolay Bugaev, Kevin McKay, Janis L Breeze, Sandra S Arabian, Reuven Rabinovici
BACKGROUND: The profile and management of self-inflicted abdominal stab wounds (SI-ASW) patients is still obscure. METHODS: The National Trauma Data Bank (2012) was queried for adults with abdominal stab wounds (n = 9544). Patients with SI-ASW (n = 1724) and non-SI-ASW (n = 7820) were compared. Predictors for non-therapeutic laparotomy/laparoscopy (non-TL) in SI-ASW patients were identified. RESULTS: SI-ASW patients were older, had more females and behavioral disorders, similar physiology, but a lower Injury Severity Score...
June 20, 2017: World Journal of Surgery
https://www.readbyqxmd.com/read/28629766/laparoscopic-assisted-approach-for-penetrating-abdominal-trauma-a-solution-for-multiple-bowel-injuries
#14
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/28628713/robotic-versus-laparoscopic-distal-pancreatectomy-a-propensity-score-matched-study
#15
Rong Liu, Qu Liu, Zhi-Ming Zhao, Xiang-Long Tan, Yuan-Xing Gao, Guo-Dong Zhao
BACKGROUND: Robotic distal pancreatectomy (RDP) is considered a safe and feasible alternative to laparoscopic distal pancreatectomy (LDP). However, previous studies have some limitations including small sample size and selection bias. This study aimed to evaluate whether the robotic approach has advantages over laparoscopic surgery in distal pancreatectomy. METHODS: Demographics and perioperative outcomes among patients undergoing RDP (n = 102) and LDP (n = 102) between January 2011 and December 2015 were reviewed...
June 19, 2017: Journal of Surgical Oncology
https://www.readbyqxmd.com/read/28624984/the-senhance%C3%A2-surgical-robotic-system-senhance-for-total-hysterectomy-in-obese-patients-a-pilot-study
#16
Salvatore Gueli Alletti, C Rossitto, S Cianci, E Perrone, S Pizzacalla, G Monterossi, G Vizzielli, S Gidaro, G Scambia
This pilot study was aimed to value the feasibility and safety of Senhance Robotic Platform for hysterectomy in obese patients. Ten obese patients (30 < BMI < 40) underwent elective Senhance total extrafascial hysterectomy with bilateral salpingo-oophorectomy at the Division of Gynecologic Oncology of "Policlinico A. Gemelli" Foundation, Rome, Italy. Perioperative and postoperative outcomes data were recorded. The median age was 60 years (range 51-75) and the median BMI was 33.3 kg/m(2) (range 30...
June 17, 2017: Journal of Robotic Surgery
https://www.readbyqxmd.com/read/28624032/epidural-analgesia-for-traumatic-rib-fractures-is-associated-with-worse-outcomes-a-matched-analysis
#17
Katherine M McKendy, Lawrence F Lee, Kerianne Boulva, Dan L Deckelbaum, David S Mulder, Tarek S Razek, Jeremy R Grushka
BACKGROUND: The optimal method of pain control for patients with traumatic rib fractures is unknown. The aim of this study was to determine the effect of epidural analgesia on respiratory complications and in-hospital mortality in patients with rib fractures. METHODS: Adult patients at a level I trauma center with ≥1 rib fracture from blunt trauma were included (2004-2013). Those with a blunt-penetrating mechanism, traumatic brain injury, or underwent a laparotomy or thoracotomy were excluded...
June 15, 2017: Journal of Surgical Research
https://www.readbyqxmd.com/read/28617056/an-evaluation-of-quality-of-life-in-women-with-endometriosis-who-underwent-primary-surgery-a-6-month-follow-up-in-sabah-women-children-hospital-sabah-malaysia
#18
Ahmad M F, Hussin Narwani, Ahmad Shuhaila
Endometriosis is a complex disease primarily affecting women of reproductive age worldwide. The management goals are to improve the quality of life (QoL), alleviate the symptoms and prevent severe disease. This prospective cohort study was to assess the QoL in women with endometriosis that underwent primary surgery. A pre- and post-operative questionnaire via ED-5Q and general VAS score used for the evaluation for endometrial-like pain such as dysmenorrhoea and dyspareunia. A total of 280 patients underwent intervention; 224 laparoscopically and 56 via laparotomy mostly with stage II disease with ovarian endometriomas...
June 15, 2017: Journal of Obstetrics and Gynaecology: the Journal of the Institute of Obstetrics and Gynaecology
https://www.readbyqxmd.com/read/28608019/the-benefits-of-a-wound-protector-in-preventing-incisional-surgical-site-infection-in-elective-open-digestive-surgery-a-large-scale-cohort-study
#19
Keita Itatsu, Yukihiro Yokoyama, Gen Sugawara, Satoaki Kamiya, Masaki Terasaki, Atsushi Morioka, Shinsuke Iyomasa, Kazuhisa Shirai, Masahiko Ando, Masato Nagino
BACKGROUND: The objective of this study was to evaluate the benefits of wound protectors (WPs) in preventing incisional surgical site infection (I-SSI) in open elective digestive surgery using data from a large-scale, multi-institutional cohort study. METHODS: Patients who had elective digestive surgery for malignant neoplasms between November 2009 and February 2011 were included. The protective value of WPs against I-SSI was evaluated. RESULTS: A total of 3201 patients were analyzed...
June 12, 2017: World Journal of Surgery
https://www.readbyqxmd.com/read/28601315/age-related-mortality-in-blunt-traumatic-hemorrhagic-shock-the-killers-and-the-life-savers
#20
John O Hwabejire, Christine E Nembhard, Tolulope A Oyetunji, Theodros Seyoum, Mayowa P Abiodun, Suryanarayana M Siram, Edward E Cornwell, Wendy R Greene
BACKGROUND: There are sparse data on the association between age and mortality in hemorrhagic shock (HS). We examined this association in this study. MATERIALS AND METHODS: The Glue Grant database was analyzed. Patients aged ≥16 y with blunt traumatic HS were stratified into eight age groups (16-24, 25-34, 35-44, 45-54, 55-64, 65-74, 75-84, and ≥85 y) to identify the mortality inflection point. Subsequently, patients were restratified into young age (16-44 y), middle age (45-64 y), and elderly (≥65 y)...
June 1, 2017: Journal of Surgical Research
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