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https://www.readbyqxmd.com/read/29777454/improved-outcomes-in-394-pancreatic-cancer-resections-the-impact-of-enhanced-recovery-pathway
#1
Vandana Agarwal, Martin Jose Thomas, Riddhi Joshi, Vikram Chaudhari, Manish Bhandare, Abhishek Mitra, Ashwin deSouza, Reshma Ambulkar, Shailesh V Shrikhande
BACKGROUND: Enhanced recovery (ER) pathway reduces morbidity and accelerates recovery. It is associated with reduced postoperative stay, morbidity, and costs. Feasibility and safety of ER programme has not been studied in developing countries. The objectives were to assess compliance with Enhanced Recovery After Surgery (ERAS) elements and to assess outcomes in pancreatic surgery. METHODS: Prospective study conducted from February 2014 to December 2016, following elective pancreatic cancer surgery...
May 18, 2018: Journal of Gastrointestinal Surgery: Official Journal of the Society for Surgery of the Alimentary Tract
https://www.readbyqxmd.com/read/29777280/primary-draining-vein-stenting-for-obstructive-total-anomalous-pulmonary-venous-connection-in-neonates-with-right-atrial-isomerism-and-functional-single-ventricle-improves-outcome
#2
Masataka Kitano, Takaya Hoashi, Takashi Kakuta, Kazuto Fujimoto, Akira Miyake, Ken-Ichi Kurosaki, Hazime Ichikawa, Isao Shiraishi
For neonates with right atrial isomerism (RAI), functional single ventricle (f-SV), and obstructive total anomalous pulmonary venous connection (TAPVC), primary TAPVC repair (TAPVCR) has a poor outcome. At our hospital, the survival rate at 1 year of such neonates undergoing primary TAPVCR between 1999 and 2010 (TAPVCR group) was 30% (3/10). Most deceased cases suffered from capillary leak syndrome and unstable pulmonary resistance after the surgeries. We sought to determine whether less invasive primary draining vein stenting (DVS) improved the outcome of these neonates...
May 18, 2018: Pediatric Cardiology
https://www.readbyqxmd.com/read/29774939/-feasibility-and-preliminary-technical-experience-of-single-incision-plus-one-port-laparoscopic-total-gastrectomy-combined-with-%C3%AF-shaped-esophagojejunal-anastomosis-in-surgical-treatment-of-gastric-cancer
#3
Guangsheng Du, Enlai Jiang, Yuan Qiu, Wensheng Wang, Shuai Wang, Yunbo Li, Ke Peng, Xiang Li, Hua Yang, Weidong Xiao
OBJECTIVE: To explore the feasibility, safety, and preliminary technical experience of single incision plus one port laparoscopic total gastrectomy combined with π-shaped esophagojejunal anastomosis (SILT-π) in the surgical treatment of gastric cancer. METHODS: Clinical data of 5 gastric cancer patients undergoing SILT-π operation at the Department of General Surgery, The Second Affiliated Hospital of the Army Medical University from August to October 2017 were retrospectively analyzed...
May 25, 2018: Zhonghua Wei Chang Wai Ke za Zhi, Chinese Journal of Gastrointestinal Surgery
https://www.readbyqxmd.com/read/29761863/surgical-treatment-of-esophageal-cancer-in-the-era-of-multimodality-management
#4
REVIEW
Alicia S Borggreve, B Feike Kingma, Serg A Domrachev, Mikhail A Koshkin, Jelle P Ruurda, Richard van Hillegersberg, Flavio R Takeda, Lucas Goense
Over the last decades, the treatment of resectable esophageal cancer has evolved into a multidisciplinary process in which all players are essential for treatment to be successful. Medical oncologists and radiation oncologists have been increasingly involved since the implementation of neoadjuvant therapy, which has been shown to improve survival. Although esophagectomy is still considered the cornerstone of curative treatment for locally advanced esophageal cancer, it remains associated with considerable postoperative morbidity, despite promising results of minimally invasive techniques...
May 15, 2018: Annals of the New York Academy of Sciences
https://www.readbyqxmd.com/read/29757371/outcomes-of-total-anomalous-pulmonary-venous-drainage-repair-in-neonates-with-univentricular-circulation
#5
Matthew S Yong, Michael Z L Zhu, Yves d'Udekem, Igor E Konstantinov
Survival after surgery for isolated total anomalous pulmonary venous drainage has improved in the current era. However, outcomes of total anomalous pulmonary venous drainage repair in patients with univentricular circulation are associated with high mortality. Furthermore, outcomes of surgery in neonates with univentricular circulation are rarely reported among larger studies. Hence, we reviewed our experience (n = 19) with this population at a single institution (between 1986 and 2015) to identify specific subgroups with high mortality...
May 10, 2018: Interactive Cardiovascular and Thoracic Surgery
https://www.readbyqxmd.com/read/29755298/addressing-female-genital-mutilation-cutting-fgm-c-in-the-era-of-clitoral-reconstruction-plastic-surgery
#6
REVIEW
Hannes Sigurjonsson, Malin Jordal
Purpose of the Review: The aim of this review is to give an overview of the recent evidence on clitoral reconstruction and other relevant reconstructive plastic surgery measures after female genital mutilation/cutting (FGM/C). Recent Findings: Recent publications present refinements and modifications of the surgical technique of clitoral reconstruction along with reconstruction of the labia majora and clitoral hood. Novel approaches with reposition of the clitoral nerve, anchoring of the labia majora, fat grafting, and full thickness mucosa grafts have been introduced...
2018: Current Sexual Health Reports
https://www.readbyqxmd.com/read/29754619/enhanced-recovery-after-surgery-protocols-rationale-and-components
#7
REVIEW
Kyle L Kleppe, Jacob A Greenberg
Enhanced recovery after surgery (ERAS) protocols are spreading throughout various fields in surgery. ERAS protocols involve the implementation of evidence-based elements of care that are applied throughout the entire perioperative period to facilitate optimal recovery for the patient. ERAS protocols have been associated with improvements in quality of care, patient-reported and operative outcomes, and patient safety as well as reductions in cost. Thus, ERAS protocols have led to an overall improvement in health care value for the patient and the health care system...
June 2018: Surgical Clinics of North America
https://www.readbyqxmd.com/read/29754385/four-year-evolution-of-a-thrombophylaxis-protocol-in-an-enhanced-recovery-after-surgery-eras-program-recent-results-in-485-patients
#8
Marie-Cécile Blanchet, Vincent Frering, Benoît Gignoux, Yann Matussière, Philippe Oudar, Romain Noël, Alban Mirabaud
"Enhanced recovery after surgery" (ERAS) protocols may reduce morbidity, length of hospital stay (LOS), and costs. During the 4-year evolution of a bariatric ERAS protocol, we found that administration of thrombophylaxis selectively to high-risk morbidly obese patients (assessed postoperatively by Caprini score ≥ 3) undergoing omega loop gastric bypass ("mini" gastric bypass) or sleeve gastrectomy resulted in safe outcomes. Both procedures proved equally effective with this protocol...
May 12, 2018: Obesity Surgery
https://www.readbyqxmd.com/read/29753581/preoperative-risk-score-for-the-prediction-of-mortality-after-repair-of-ruptured-abdominal-aortic-aneurysms
#9
Brandon T Garland, Patrick J Danaher, Sarasi Desikan, Nam T Tran, Elina Quiroga, Niten Singh, Benjamin W Starnes
OBJECTIVE: Even in the ruptured endovascular aneurysm repair first era, there are still patients who will not survive their ruptured abdominal aortic aneurysm (rAAA). All previously published mortality risk scores include intraoperative variables and are not helpful with the decision to operate or in providing preoperative patient and family counseling. The purpose of this study was to develop a practical preoperative risk score to predict mortality after repair of rAAA. METHODS: Data of all patients with rAAA presenting between January 1, 2002, and October 31, 2013, were collected...
May 9, 2018: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/29752858/enhanced-recovery-after-surgery-in-children-promising-evidence-based-multidisciplinary-care
#10
Kyle O Rove, John C Edney, Megan A Brockel
Enhanced recovery after surgery (ERAS) is a multimodal approach to the care of the surgical patient focused on reducing the stress response and associated physiologic changes that accompany surgery. Over the past 20 years, ERAS programs have been found to result in reduced LOS and complications in adult patients. Despite abundant adult literature describing implementation and outcomes of enhanced recovery programs, pediatric data in this area is sparse. This educational review describes the history and elements of ERAS protocols, reviews the available evidence in adult and pediatric populations, compares and contrasts ERAS with the PSH, and offers strategies for implementation and ideas for future directions of ERAS in children...
May 12, 2018: Paediatric Anaesthesia
https://www.readbyqxmd.com/read/29752602/clinicopathological-features-and-prognosis-of-primary-gists-with-tumor-rupture-in-the-real-world
#11
Toshirou Nishida, Haruhiko Cho, Seiichi Hirota, Toru Masuzawa, Gaku Chiguchi, Toshimasa Tsujinaka
BACKGROUND: Patients with ruptured gastrointestinal stromal tumor (GIST) are recommended for imatinib adjuvant therapy; however, their clinicopathological features and prognosis in the era of imatinib are unknown. PATIENTS AND METHODS: The study cohort included 665 patients with histologically proven primary GISTs who underwent R0 or R1 surgery between 2003 and 2007; the validation cohort included 182 patients between 2000 and 2014. The definitions of tumor rupture in the study included perforation at tumor site, tumor fracture, piecemeal resection including open biopsy, and macroscopic injuries to the pseudocapsule...
May 11, 2018: Annals of Surgical Oncology
https://www.readbyqxmd.com/read/29752505/jean-louis-petit-1674-1750-a-pioneer-anatomist-and-surgeon-and-his-contribution-to-orthopaedic-surgery-and-trauma-surgery
#12
REVIEW
Konstantinos Markatos, Georgios Androutsos, Marianna Karamanou, Georgios Tzagkarakis, Maria Kaseta, Andreas Mavrogenis
PURPOSE: The purpose of this review is to summarize the life and work of Jean-Louis Petit, his inventions, his discoveries, and his impact on the evolution of surgery of his era. METHOD: A thorough search of the literature was undertaken in PubMed and Google Scholar as well as in physical books in libraries to summarize current and classic literature on Petit. RESULTS: Jean-Louis Petit (1674-1750) was an eminent anatomist and surgeon of his era with an invaluable contribution to clinical knowledge, surgical technique, and instrumentation as well as innovative therapeutic modalities and basic scientific discoveries...
May 11, 2018: International Orthopaedics
https://www.readbyqxmd.com/read/29750324/enhanced-recovery-after-surgery-programs-for-laparoscopic-abdominal-surgery-a-systematic-review-and-meta-analysis
#13
REVIEW
Zhengyan Li, Qingchuan Zhao, Bin Bai, Gang Ji, Yezhou Liu
BACKGROUND: Enhanced recovery after surgery (ERAS) protocols or laparoscopic technique has been applied in various surgical procedures. However, the clinical efficacy of combination of the two methods still remains unclear. Thus, our aim was to assess the role of ERAS protocols in laparoscopic abdominal surgery. METHODS: We performed a systematic literature search in various databases from January 1990 to October 2017. The results were analyzed according to predefined criteria...
May 10, 2018: World Journal of Surgery
https://www.readbyqxmd.com/read/29750321/improved-outcomes-of-enhanced-recovery-after-surgery-eras-protocol-for-radical-cystectomy-with-addition-of-a-multidisciplinary-care-process-in-a-us-comprehensive-cancer-care-center
#14
Sephalie Y Patel, Rosemarie E Garcia Getting, Brandon Alford, Karim Hussein, Braydon J Schaible, David Boulware, Jae K Lee, Scott M Gilbert, Julio M Powsang, Wade J Sexton, Philippe E Spiess, Michael A Poch
INTRODUCTION: Although enhanced recovery after surgery (ERAS) components include both anesthesia and surgical care processes, it is unclear whether a multidisciplinary approach to implementing ERAS care processes improves clinical outcomes. The addition of multidisciplinary care with anesthesiology-related components to an existing ERAS protocol for radical cystectomy at a US comprehensive cancer center provided an opportunity to compare short- and long-term outcomes. METHODS: We retrospectively compared the outcomes of 116 consecutive patients who underwent cystectomy after implementation of a multidisciplinary ERAS protocol with those of a historical control group of 143 consecutive patients who had been treated with a surgical ERAS protocol...
May 10, 2018: World Journal of Surgery
https://www.readbyqxmd.com/read/29749920/evolution-of-the-graded-repair-of-csf-leaks-and-skull-base-defects-in-endonasal-endoscopic-tumor-surgery-trends-in-repair-failure-and-meningitis-rates-in-509-patients
#15
Andrew Conger, Fan Zhao, Xiaowen Wang, Amalia Eisenberg, Chester Griffiths, Felice Esposito, Ricardo L Carrau, Garni Barkhoudarian, Daniel F Kelly
OBJECTIVE The authors previously described a graded approach to skull base repair following endonasal microscopic or endoscope-assisted tumor surgery. In this paper they review their experience with skull base reconstruction in the endoscopic era. METHODS A retrospective review of a single-institution endonasal endoscopic patient database (April 2010-April 2017) was undertaken. Intraoperative CSF leaks were graded based on size (grade 0 [no leak], 1, 2, or 3), and repair technique was documented across grades...
May 11, 2018: Journal of Neurosurgery
https://www.readbyqxmd.com/read/29748884/predictors-of-residual-disease-after-breast-conservation-surgery
#16
Lisa J Findlay-Shirras, Oussama Outbih, Charlene N Muzyka, Katie Galloway, Pamela C Hebbard, Maged Nashed
INTRODUCTION: Breast-conserving therapy is the standard of care for early-stage breast cancer. In the era of multimodality therapy, the debate on the value of revision surgery for compromised margins continues, and high re-excision rates persist despite updated guidelines. Our study sought to identify the local re-excision rate for compromised margins after lumpectomy, and identify predictors of residual disease at re-excision. METHODS: This population-based retrospective cohort study included women with breast cancer who underwent a lumpectomy between 2009 and 2012 in Manitoba, with close (≤ 2 mm) or positive margins that led to re-excision...
May 10, 2018: Annals of Surgical Oncology
https://www.readbyqxmd.com/read/29747091/effect-of-herbal-medicine-daikenchuto-on-oral-and-enteral-caloric-intake-after-liver-transplantation-a-multicenter-randomized-controlled-trial
#17
Toshimi Kaido, Masahiro Shinoda, Yukihiro Inomata, Takahito Yagi, Nobuhisa Akamatsu, Yasutsugu Takada, Hideki Ohdan, Tsuyoshi Shimamura, Yasuhiro Ogura, Susumu Eguchi, Hidetoshi Eguchi, Satoshi Ogata, Tomoharu Yoshizumi, Toshihiko Ikegami, Michio Yamamoto, Satoshi Morita, Shinji Uemoto
OBJECTIVE: Postoperative early oral or enteral intake is a crucial element of the Enhanced Recovery After Surgery (ERAS) protocol. However, normal food intake or enteral feeding cannot be started early in the presence of coexisting bowel dysfunction in patients undergoing liver transplantation (LT). The aim of this multicenter, randomized, double-blinded, placebo-controlled trial was to determine the enhancement effects of the Japanese herbal medicine Daikenchuto (DKT) on oral/enteral caloric intake in patients undergoing LT...
March 20, 2018: Nutrition
https://www.readbyqxmd.com/read/29746417/implementing-enhanced-recovery-after-surgery-eras-program-on-a-specialty-nursing-unit
#18
Kendra Tezber, Cesar Aviles, Misty Eller, Allyson Cochran, David Iannitti, Dionisios Vrochides, Garth McClune
Implementing Enhanced Recovery After Surgery (ERAS) guidelines is an effective method to standardize patient care, improve patient outcomes, and develop quality improvement projects. Completing the required ERAS Implementation Program provided by the International ERAS Society enabled the hepatopancreaticobiliary surgery team at Carolinas HealthCare System to successfully implement evidence-based practice changes for pancreaticoduodenectomy patients on an acuity-adjustable unit resulting in improved care and cost reduction...
May 10, 2018: Journal of Nursing Administration
https://www.readbyqxmd.com/read/29744679/current-status-of-enhanced-recovery-after-surgery-eras-protocol-in-gastrointestinal-surgery
#19
REVIEW
Michał Pędziwiatr, Judene Mavrikis, Jan Witowski, Alexandros Adamos, Piotr Major, Michał Nowakowski, Andrzej Budzyński
Enhanced Recovery After Surgery (ERAS) is an evidence-based paradigm shift in perioperative care, proven to lower both recovery time and postoperative complication rates. The role of ERAS in several surgical disciplines was reviewed. In colorectal surgery, ERAS protocol is currently well established as the best care. In gastric surgery, 2014 saw an establishment of ERAS protocol for gastrectomies with resulting meta-analysis showing ERAS effectiveness. ERAS has also been shown to be beneficial in liver surgery with many centers starting implementation...
May 9, 2018: Medical Oncology
https://www.readbyqxmd.com/read/29744672/efficacy-and-safety-of-neoadjuvant-treatment-with-bevacizumab-liposomal-doxorubicin-cyclophosphamide-and-paclitaxel-combination-in-locally-regionally-advanced-her2-negative-grade-iii-at-premenopausal-status-breast-cancer-a-phase-ii-study
#20
Ekaterini C Tampaki, Athanasios Tampakis, Constantinos E Alifieris, Dimitrios Krikelis, Anastasia Pazaiti, Michalis Kontos, Dimitrios T Trafalis
BACKGROUND: In the era of personalized therapy, targeted treatment in specific patient populations is mandated. OBJECTIVE: We evaluated the efficacy and safety of neoadjuvant treatment on locally advanced breast cancer (LABC) with a monoclonal agent against vascular endothelial growth factor (VEGF), bevacizumab plus chemotherapy combination of liposomal doxorubicin, cyclophosphamide and paclitaxel (PLAC-B). METHODS: Patients enrolled were at premenopausal status and characterized by human epidermal growth factor receptor 2 (HER2)-negative, hormone-receptor positive (estrogen receptor/progesterone receptor-positive [ER/PR+]) or triple-negative (TNBC), LABC (T > 3 cm), with high-grade ductal carcinoma...
May 9, 2018: Clinical Drug Investigation
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