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https://www.readbyqxmd.com/read/28743102/incidence-of-delirium-after-cardiac-surgery-protocol-for-the-delirium-cs-canada-cross-sectional-cohort-study
#1
(no author information available yet)
BACKGROUND: Delirium is a recognized complication of cardiac surgery and is the focus of increasing attention owing to its negative effect on postoperative outcomes. However, little is known about the actual incidence of delirium following cardiac surgery, with published rates ranging widely, from 3%-78%. We describe the protocol for the DELIRIUM-CS Canada study, which will use validated and easily implementable bedside tools to determine the incidence of postoperative delirium in a contemporary cardiac surgery population...
July 13, 2017: CMAJ Open
https://www.readbyqxmd.com/read/28742702/trends-on-axillary-surgery-in-nondistant-metastatic-breast-cancer-patients-treated-between-2011-and-2015-a-dutch-population-based-study-in-the-acosog-z0011-and-amaros-era
#2
Ingrid G M Poodt, Pauline E R Spronk, Guusje Vugts, Thijs van Dalen, M T F D Vrancken Peeters, Marjolijn L Rots, Anne Kuijer, Grard A P Nieuwenhuijzen, Robert-Jan Schipper
OBJECTIVES: To evaluate patterns of care in axillary surgery for Dutch clinical T1-4N0M0 (cT1-4N0M0) breast cancer patients and to assess the effect of the American College for Surgeons Oncology Group (ACOSOG)-Z0011 and After Mapping of the Axilla: Radiotherapy Or Surgery (AMAROS) trial on axillary surgery patterns in Dutch cT1-2N0M0 sentinel node positive breast cancer patients. BACKGROUND: Since publication of the ACOSOG-Z0011 and AMAROS trial, omitting a completion axillary lymph node dissection (cALND) in sentinel node positive breast cancer patients is proposed in selected patients...
July 24, 2017: Annals of Surgery
https://www.readbyqxmd.com/read/28742442/analysis-of-variability-in-intraoperative-fluid-administration-for-colorectal-surgery-an-argument-for-goal-directed-fluid-therapy
#3
Timothy D Quinn, Ethan Y Brovman, Richard D Urman
BACKGROUND: Fluid therapy in the perioperative period varies greatly between anesthesia providers and may have a negative impact on surgical outcomes. METHODS: We conducted a retrospective analysis of 705 elective colorectal cases consisting of colectomies, ileocolic resections, and low anterior resections at an academic institution from January 1, 2010 to May 29, 2015, collected by our electronic medical record before implementation of Enhanced Recovery After Surgery (ERAS(®)) pathways...
July 25, 2017: Journal of Laparoendoscopic & Advanced Surgical Techniques. Part A
https://www.readbyqxmd.com/read/28742435/the-role-of-transversus-abdominis-plane-blocks-in-eras-pathways-for-open-and-laparoscopic-colorectal-surgery
#4
Alexander J Kim, Robert Jason Yong, Richard D Urman
INTRODUCTION: The concepts of Enhanced Recovery After Surgery (ERAS(®)) have steadily increased in usage, with benefits in patient outcomes and hospital length of stay. One important component of successful implementation of ERAS protocol is optimized pain control, via the multimodal approach, which includes neuraxial or regional anesthesia techniques and reduction of opioid use as the primary analgesic. Transversus abdominis plane (TAP) block is one such regional anesthesia technique, and it has been widely studied in abdominal surgery...
July 25, 2017: Journal of Laparoendoscopic & Advanced Surgical Techniques. Part A
https://www.readbyqxmd.com/read/28742434/use-of-regional-anesthesia-techniques-analysis-of-institutional-enhanced-recovery-after-surgery-protocols-for-colorectal-surgery
#5
Erik M Helander, Michael P Webb, Meghan Bias, Edward E Whang, Alan D Kaye, Richard D Urman
INTRODUCTION: Principles of enhanced recovery after surgery (ERAS(®)) protocols are well established, with the primary goal of optimizing perioperative care and recovery. The use of multimodal analgesia is a key component of these protocols, including regional analgesia techniques such as thoracic epidural analgesia (TEA), transversus abdominis plane (TAP), rectus sheath blocks or continuous wound infiltration (CWI)/catheters, and spinal anesthesia. We compare and contrast regional anesthesia approaches in different institutional colorectal surgery ERAS protocols...
July 25, 2017: Journal of Laparoendoscopic & Advanced Surgical Techniques. Part A
https://www.readbyqxmd.com/read/28742427/a-comparison-of-multimodal-analgesic-approaches-in-institutional-eras-protocols-for-colorectal-surgery-pharmacological-agents
#6
Erik M Helander, Michael P Webb, Meghan Bias, Edward E Whang, Alan D Kaye, Richard D Urman
INTRODUCTION: Enhanced recovery after surgery (ERAS(®)) protocols are the cornerstone of improved recovery after colorectal surgery. Their implementation leads to reduced morbidity and shorter hospital stays while attenuating the surgical stress response. Multimodal analgesia is an important part of ERAS protocols. We compared and contrasted protocols from 15 institutions to test our hypothesis that there is a fundamental consensus among them. MATERIALS AND METHODS: ERAS protocols for open and laparoscopic colorectal surgery were compared from 15 different healthcare facilities...
July 25, 2017: Journal of Laparoendoscopic & Advanced Surgical Techniques. Part A
https://www.readbyqxmd.com/read/28741973/characteristics-of-functional-impairment-in-patients-with-long-standing-rheumatoid-arthritis-based-on-range-of-motion-of-joints-baseline-data-from-a-multicenter-prospective-observational-cohort-study-to-evaluate-the-effectiveness-of-joint-surgery-in-the-treat
#7
Toshihisa Kojima, Hajime Ishikawa, Sakae Tanaka, Nobuhiko Haga, Keiichiro Nishida, Masao Yukioka, Jun Hashimoto, Hisaaki Miyahara, Yasuo Niki, Tomoatsu Kimura, Hiromi Oda, Shuji Asai, Koji Funahashi, Masayo Kojima, Naoki Ishiguro
OBJECTIVE: To explore the characteristics of functional impairment in patients with established rheumatoid arthritis (RA) based on the range of motion (ROM) of joints in a prospective observational study of RA patients undergoing joint surgery. METHODS: We collected data on demographics, Health Assessment Questionnaire Disability Index (HAQ-DI), and the ROM of large joints including the shoulder, elbow, wrist, hip, knee, and ankle. Associations between the ROM of each joint and disability in the eight HAQ-DI categories were determined using receiver operating characteristic (ROC) and logistic regression analyses...
July 25, 2017: Modern Rheumatology
https://www.readbyqxmd.com/read/28740949/good-surgeon-a-search-for-meaning
#8
REVIEW
Andrey L Akopov, Dmitri Y Artioukh
The art and philosophy of surgery are not as often discussed as scientific discoveries and technological advances in the modern era of surgery. Although these are difficult to teach and pass on to the next generations of surgeons they are no less important for training good surgeons and maintaining their high standards. The authors of this review and opinion article tried to define what being a good surgeon really means and to look into the subject by analysing the essential conditions for being a good surgeon and the qualities that such a specialist should possess...
2017: Turk J Surg
https://www.readbyqxmd.com/read/28738942/in-the-modern-era-of-ct-do-blunt-trauma-patients-with-markers-for-blunt-bowel-or-mesenteric-injury-still-require-exploratory-laparotomy
#9
Katelyn Young, Melina Benson, Andrew Higgins, James Dove, Marie Hunsinger, Mohsen Shabahang, Joseph Blansfield, Denise Torres, Kenneth Widom, Jeffrey Wild
After blunt trauma, certain CT markers, such as free intraperitoneal air, strongly suggest bowel perforation, whereas other markers, including free intraperitoneal fluid without solid organ injury, may be merely suspicious for acute injury. The present study aims to delineate the safety of nonoperative management for markers of blunt bowel or mesenteric injury (BBMI) that are suspicious for significant bowel injury after blunt trauma. This was a retrospective review of adult blunt trauma patients with abdominopelvic CT scans on admission to a Level I trauma center between 2012 and 2014...
July 1, 2017: American Surgeon
https://www.readbyqxmd.com/read/28738031/perioperative-care-implementation-evidence-based-practice-for-patients-with-pancreaticoduodenectomy-using-the-enhanced-recovery-after-surgery-guidelines-%C3%A2
#10
Cesar Aviles, Marilyn Hockenberry, Dionisios Vrochides, David Iannitti, Allyson Cochran, Kendra Tezber, Misty Eller, Janet Desamero
BACKGROUND: Pancreatic adenocarcinoma is an aggressive cancer that carries a poor prognosis. Pancreaticoduodenectomy (PD) offers the only potential cure, but the associated morbidity is high. The Enhanced Recovery After Surgery (ERAS) evidence-based guidelines for perioperative care for PD can be used to reduce variations in practice.
. OBJECTIVES: The primary aim was to evaluate the feasibility of the ERAS guidelines for patients undergoing PD. Secondary aims were to assess length of stay (LOS), readmission within 30 days, 30-day mortality, and total surgical complication rates...
August 1, 2017: Clinical Journal of Oncology Nursing
https://www.readbyqxmd.com/read/28735799/prior-knee-arthroscopy-does-not-influence-long-term-total-knee-arthroplasty-outcomes-and-survivorship
#11
Anthony Viste, Matthew P Abdel, Matthieu Ollivier, Kristin C Mara, Aaron J Krych, Daniel J Berry
BACKGROUND: Arthroscopic knee surgery frequently precedes total knee arthroplasty (TKA). There have been mixed data on the effect of prior arthroscopic surgery on results of TKA. The purpose of this study was to compare the 10-year Knee Society Score (KSS), survivorship, and complications of TKA in a cohort of patients who had a previous knee arthroscopy to a control cohort. METHODS: A retrospective review of 1315 TKAs who underwent a primary TKA between 2003 and 2004 was performed...
July 8, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28735683/pain-management-in-penile-prosthetic-surgery-a-review-of-the-literature
#12
REVIEW
Lael Reinstatler, Kevin Shee, Martin S Gross
INTRODUCTION: The literature on perioperative pain control and management in inflatable penile prosthesis placement is not firmly established. Because inflatable penile prosthesis placement is an elective procedure, pain can be one of the many issues that influence patient decision making. Pain control also presents a unique challenge to providers in an era of widespread opiate abuse. AIM: To review published data on pain management before, during, and after penile prosthetic surgery...
July 20, 2017: Sexual Medicine Reviews
https://www.readbyqxmd.com/read/28735268/early-surgery-and-neurodevelopmental-outcomes-of-children-born-extremely-preterm
#13
Rodney W Hunt, Leah M Hickey, Alice C Burnett, Peter J Anderson, Jeanie Ling Yoong Cheong, Lex W Doyle, Rodney W Hunt
OBJECTIVES: To (1) compare the neurodevelopmental outcomes at 8 years of age of children born extremely preterm (EP) who underwent surgical procedures during the course of their initial hospital admission with those who did not and (2) compare the outcomes across eras, from 1991 to 2005. DESIGN: Prospective observational cohort studies conducted over three different eras (1991-1992, 1997 and 2005). Surviving EP children, who required surgical intervention during the primary hospitalisation, were assessed for general intelligence (IQ) and neurosensory status at 8 years of age...
July 22, 2017: Archives of Disease in Childhood. Fetal and Neonatal Edition
https://www.readbyqxmd.com/read/28735068/primary-metastatic-breast-cancer-in-the-era-of-targeted-therapy-prognostic-impact-and-the-role-of-breast-tumour-surgery
#14
Jana Barinoff, Marcus Schmidt, Andreas Schneeweiss, Winfried Schoenegg, Marc Thill, Stella Keitel, Claus R Lattrich, Axel Hinke, Andreas Kutscheidt, Christian Jackisch
BACKGROUND: Except for meeting the individual palliative need, the benefit of breast surgery in primary metastatic breast cancer (PMBC), also known as de novo metastatic breast cancer, on long-term outcomes remains controversial. Twenty-four hundred and one patients with metastatic breast cancer, enrolled between 2000 and 2011 in two prospective non-interventional studies on targeted therapy, were screened with respect to this question. METHODS: One study investigated trastuzumab therapy for human epidermal growth factor receptor 2 (HER2)-positive metastatic breast cancer in addition to mainly first-line chemotherapy...
July 20, 2017: European Journal of Cancer
https://www.readbyqxmd.com/read/28734658/kidney-transplantation-a-new-era-of%C3%A2-laparoscopic-living-donor-nephrectomy-in%C3%A2-indonesia
#15
Albertus Marcelino, Chaidir Arif Mochtar, Irfan Wahyudi, Agus Rizal Hamid
BACKGROUND: Since its introduction in 1995, laparoscopic living donor nephrectomy (LLDN) has been a standard procedure in many transplantation centers worldwide. In 2011, LLDN was performed for the first time in Indonesia and became a standard procedure at our institution. The aim of this study is to evaluate the first 250 cases of LLDN at our institution. METHODS: Retrospective analyses were conducted of the first 250 cases of LLDN. All operations were performed between November 2011 and July 2015 at Cipto Mangunkusumo Hospital, Jakarta...
July 19, 2017: Asian Journal of Surgery
https://www.readbyqxmd.com/read/28733926/perioperative-management-of-endocrine-insufficiency-after-total-pancreatectomy-for-neoplasia
#16
REVIEW
Ajay V Maker, Raashid Sheikh, Vinita Bhagia
PURPOSE: Indications for total pancreatectomy (TP) have increased, including for diffuse main duct intrapapillary mucinous neoplasms of the pancreas and malignancy; therefore, the need persists for surgeons to develop appropriate endocrine post-operative management strategies. The brittle diabetes after TP differs from type 1/2 diabetes in that patients have absolute deficiency of insulin and functional glucagon. This makes glucose management challenging, complicates recovery, and predisposes to hospital readmissions...
July 21, 2017: Langenbeck's Archives of Surgery
https://www.readbyqxmd.com/read/28731996/-pancreatitis-genes-and-islet-cells-auto-transplant-updates-and-new-horizons
#17
Edgardo D Rivera Rivera
Pancreatitis is an inflammation of the pancreas that can progress from an acute presentation to an acute recurring presentation and eventually to chronic pancreatitis, which is characterized by irreversible morphological changes and scarring of the pancreas. The entity known as hereditary pancreatitis has been recognized in the literature for years and certainly the discovery of the PRSS1 gene in 1996 marked the beginning of a new era of genetic discoveries associated with the disease. Since then, multiple genes have been described as the causing agents of pancreatitis or disease modifiers, some of the most important ones being the PRSS1, SPINK1, CFTR, CASR, CTRC, CLDN2, and CPA1...
April 2017: Revista de Gastroenterología del Perú: órgano Oficial de la Sociedad de Gastroenterología del Perú
https://www.readbyqxmd.com/read/28731875/management-of-complex-spine-surgery
#18
Massimo Lamperti, Boris Tufegdzic, Rafi Avitsian
PURPOSE OF REVIEW: The main objective of this article is to present the updated data regarding the perioperative management of patients undergoing major spine surgery in an era where the surgical techniques are changing and there is a high demand for these surgeries in older and high-risk patients. RECENT FINDINGS: Preoperative assessment and stabilization is now more structured protocol and it is based on a multidisciplinary approach to the patient. The Enhanced Recovery After Surgery (ERAS) programs and the Perioperative Surgical Home on major spine surgery are not yet fully evidence based but it seems that the use of a perioperative optimization of patients and use of a drugs' bundle is more effective than using single drugs or interventions on the postoperative pain reduction and faster recovery from surgery...
July 20, 2017: Current Opinion in Anaesthesiology
https://www.readbyqxmd.com/read/28730799/a-historical-overview-of-laryngeal-carcinoma-and-the-first-total-laryngectomies
#19
Marianna Karamanou, Kostas Markatos, Maria Lymperi, Emmanouil Agapitos, George Androutsos
Laryngeal cancer was a well known entity since antiquity and its treatment evolved through several phases. The lack of knowledge in anatomy and pathology as well as the absence of anesthesia and proper instrumentation made the treatment almost impossible. Ancient physicians were performing laryngotomy or tracheotomy in an attempt to prevent the suffocation symptoms produced by tumoral masses. In 19th century the invention of laryngoscope and the advent of pathology and anesthesiology encouraged surgeons to operate on man...
May 2017: Journal of B.U.ON.: Official Journal of the Balkan Union of Oncology
https://www.readbyqxmd.com/read/28730776/institutional-variations-in-nutritional-aspects-of-enhanced-recovery-pathways-after-elective-surgery-for-colon-cancer
#20
Fotios Seretis, Panagiota Kaisari, Kasun Wanigasooriya, Edward Rawstorne, Charalampos Seretis
PURPOSE: Perioperative nutritional optimisation is one of the key aspects of the Enhanced Recovery after Surgery (ERAS) pathway after elective colorectal cancer resections. Despite the general acceptance of ERAS as a safe and cost-effective perioperative care bundle, significant variations in terms of nutritional support exist among colorectal units. METHODS: To assess these variations, we performed a cross-sectional online survey among colorectal surgical residents within a UK region...
May 2017: Journal of B.U.ON.: Official Journal of the Balkan Union of Oncology
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