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Surgical care quality

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https://www.readbyqxmd.com/read/29785406/fluid-extravasation-in-shoulder-arthroscopic-surgery-a-systematic-review
#1
REVIEW
Muzammil Memon, Jeffrey Kay, Arian Gholami, Nicole Simunovic, Olufemi R Ayeni
Background: Arthroscopic surgery of the shoulder joint has become increasingly more common given its advantages over open surgery; however, one rare but potentially life-threatening complication is fluid extravasation into the surrounding tissues, causing edema, respiratory compromise, abnormal results on laboratory blood tests, and possibly death. Currently, no systematic review exists that summarizes the existing clinical research on this topic. Purpose: To perform a systematic review on fluid extravasation as a complication of shoulder arthroscopic surgery, specifically assessing clinical presentation, risk factors, management, and outcomes...
May 2018: Orthopaedic Journal of Sports Medicine
https://www.readbyqxmd.com/read/29784455/incidence-and-risk-factors-associated-with-30-day-post-operative-venous-thromboembolism-a-nsqip-pediatric-analysis
#2
Jennifer J Ahn, Paul A Merguerian, Margarett Shnorhavorian
INTRO: Venous thromboembolism (VTE) is a rare event in children, but can cause significant morbidity and mortality. The majority of research on pediatric VTE has been in the trauma and critical care populations. The incidence of VTE after surgery in children is not well-established. OBJECTIVE: The objective was to evaluate the incidence of VTE in the 30 days after surgery, as well as associated risk factors. STUDY DESIGN: All cases in the National Surgical Quality Improvement Program Pediatric (NSQIPP) database from 2012 to 2015 were assessed for presence of post-operative VTE...
May 8, 2018: Journal of Pediatric Urology
https://www.readbyqxmd.com/read/29784244/rehabilitation-of-the-laryngectomised-patient-recommendations-of-the-spanish-society-of-otolaryngology-and-head-and-neck-surgery
#3
Pedro Díaz de Cerio Canduela, Ismael Arán González, Rafael Barberá Durban, Alexander Sistiaga Suárez, Marc Tobed Secall, Pablo L Parente Arias
Total laryngectomy remains essential treatment for locally advanced laryngeal carcinoma, related to better survival rates. However, it involves changes for the patient, such as the inability to communicate verbally, breathing or aesthetic changes, which affect their quality of life and require comprehensive rehabilitation. This paper was written by the total laryngectomy rehabilitation workgroup of the National Head and Neck and Skull Base working committee of the Spanish Society of Otolaryngology and Head and Neck Surgery...
May 18, 2018: Acta Otorrinolaringológica Española
https://www.readbyqxmd.com/read/29783911/can-predictive-modeling-identify-head-and-neck-oncology-patients-at-risk-for-readmission
#4
Amy M Manning, Keith A Casper, Kay St Peter, Keith M Wilson, Jonathan R Mark, Ryan M Collar
Objective Unplanned readmission within 30 days is a contributor to health care costs in the United States. The use of predictive modeling during hospitalization to identify patients at risk for readmission offers a novel approach to quality improvement and cost reduction. Study Design Two-phase study including retrospective analysis of prospectively collected data followed by prospective longitudinal study. Setting Tertiary academic medical center. Subjects and Methods Prospectively collected data for patients undergoing surgical treatment for head and neck cancer from January 2013 to January 2015 were used to build predictive models for readmission within 30 days of discharge using logistic regression, classification and regression tree (CART) analysis, and random forests...
May 1, 2018: Otolaryngology—Head and Neck Surgery
https://www.readbyqxmd.com/read/29783235/-statistical-information-about-the-inflammatory-processes-of-the-jaw-facial-part-in-children
#5
Pavlo I Tkachenko, Serhii O Bilokon, Nataliia M Lokhmatova, Vitalina O Dobroskok, Olha B Dolenko, Nataliia M Korotych, Yuliia V Popelo
OBJECTIVE: Introduction: The acute and chronic inflammatory processes prevail in the structure of the dental surgical diseases in children. Notably, various forms of lymphadenitis, adenophlegmon and odontogenous osteomyelitis dominate in the specialized surgical units; however, it is not possible to resolve a number of organizational problems without clear understanding of the statistical situation. The aim: The paper is aimed at the analysis of the incidence rate of major nosological forms of the acute suppurative inflammations of the maxillofacial area in children for the prospective planning of arrangements to provide them with high-quality specialized care...
2018: Wiadomości Lekarskie: Organ Polskiego Towarzystwa Lekarskiego
https://www.readbyqxmd.com/read/29783184/postoperative-outcomes-in-patients-with-a-do-not-resuscitate-dnr-order-undergoing-elective-procedures
#6
Ethan Y Brovman, Elisa C Walsh, Brittany N Burton, Christine E Kuo, Charlotta Lindvall, Rodney A Gabriel, Richard D Urman
STUDY OBJECTIVE: Do-not-resuscitate (DNR) status has been shown to be an independent risk factor for mortality in the post-operative period. Patients with DNR orders often undergo elective surgeries to alleviate symptoms and improve quality of life, but there are limited data on outcomes for informed decision making. DESIGN: Retrospective cohort study. SETTING: A multi-institutional setting including operating room, postoperative recovery area, inpatient wards, and the intensive care unit...
May 18, 2018: Journal of Clinical Anesthesia
https://www.readbyqxmd.com/read/29781362/the-era-of-the-large-databases-outcomes-after-gastroesophageal-surgery-according-to-nsqip-nis-and-ncdb-databases-systematic-literature-review
#7
Gabriela Batista Rodríguez, Andrea Balla, Sonia Fernández-Ananín, Carmen Balagué, Eduard M Targarona
BACKGROUND: The term big data refers to databases that include large amounts of information used in various areas of knowledge. Currently, there are large databases that allow the evaluation of postoperative evolution, such as the American College of Surgeons National Surgical Quality Improvement Program (ACS-NSQIP), the Healthcare Cost and Utilization Project (HCUP) National Inpatient Sample (NIS), and the National Cancer Database (NCDB). The aim of this review was to evaluate the clinical impact of information obtained from these registries regarding gastroesophageal surgery...
May 1, 2018: Surgical Innovation
https://www.readbyqxmd.com/read/29781334/surgical-treatment-of-dystonia
#8
Rubens G Cury, Suneil K Kalia, Binit B Shah, Joohi Jimenez-Shahed, L K Prashanth, Elena Moro
Treatment of dystonia should be individualized and tailored to the specific needs of patients. Surgical treatment is an important option in medically refractory cases. Several issues regarding type of the surgical intervention, targets, and predict factors of benefit are still under debate. Areas covered: To date, several clinical trials have proven the benefit and safety of deep brain stimulation (DBS) for inherited and idiopathic isolated dystonia, whereas there is still insufficient evidence in combined and acquired dystonia...
May 21, 2018: Expert Review of Neurotherapeutics
https://www.readbyqxmd.com/read/29780599/perioperative-blood-transfusion-is-associated-with-post-operative-infectious-complications-in-patients-with-crohn-s-disease
#9
Nan Lan, Luca Stocchi, Yi Li, Bo Shen
Background: We have previously demonstrated that blood transfusion (BT) was associated with post-operative complications in patients undergoing surgery for Crohn's disease (CD), based on our institutional data registry. The aim of this study was to verify the association between perioperative BT and infectious complications in CD patients enrolled in the American College of Surgeons National Surgical Quality Improvement Program (ACS NSQIP) database. Methods: All CD patients undergoing surgery between 2005 and 2013 were identified from NSQIP...
May 2018: Gastroenterology Report
https://www.readbyqxmd.com/read/29776444/mediastinal-staging-of-non-small-cell-lung-cancer-by-endobronchial-and-endoscopic-ultrasonography-with-or-without-additional-surgical-mediastinoscopy-mediastrial-study-protocol-of-a-multicenter-randomised-controlled-trial
#10
Jelle E Bousema, Marcel G W Dijkgraaf, Nicole E Papen-Botterhuis, Hermien W Schreurs, Jos G Maessen, Erik H van der Heijden, Willem H Steup, Jerry Braun, Valentin J J M Noyez, Fieke Hoeijmakers, Naomi Beck, Martijn van Dorp, Niels J M Claessens, Birgitta I Hiddinga, Johannes M A Daniels, David J Heineman, Harmen R Zandbergen, Ad F T M Verhagen, Paul E van Schil, Jouke T Annema, Frank J C van den Broek
BACKGROUND: In case of suspicious lymph nodes on computed tomography (CT) or fluorodeoxyglucose positron emission tomography (FDG-PET), advanced tumour size or central tumour location in patients with suspected non-small cell lung cancer (NSCLC), Dutch and European guidelines recommend mediastinal staging by endosonography (endobronchial ultrasound (EBUS) and endoscopic ultrasound (EUS)) with sampling of mediastinal lymph nodes. If biopsy results from endosonography turn out negative, additional surgical staging of the mediastinum by mediastinoscopy is advised to prevent unnecessary lung resection due to false negative endosonography findings...
May 18, 2018: BMC Surgery
https://www.readbyqxmd.com/read/29775552/right-colon-resection-for-colon-cancer-does-surgical-approach-matter
#11
Ivy N Haskins, Tammy Ju, Matthew Skancke, Xiangyu Kuang, Richard L Amdur, Fred Brody, Vincent Obias, Samir Agarwal
BACKGROUND: Surgical resection with curative intent remains the standard of care for colon cancer. This study aims to compare the 30-day outcomes and oncologic results following open, laparoscopic, and robot-assisted right colon resection for colon cancer using the Targeted Colectomy American College of Surgeons National Surgical Quality Improvement Program (ACS-NSQIP) database. MATERIALS AND METHODS: All patients undergoing elective, right colon resection with primary anastomosis were identified within the targeted colectomy ACS-NSQIP database...
May 18, 2018: Journal of Laparoendoscopic & Advanced Surgical Techniques. Part A
https://www.readbyqxmd.com/read/29774819/midurethral-slings
#12
Joao P Zambon, Catherine Ann Matthews, Gopal H Badlani
Urinary incontinence (UI) is a common symptom affecting almost one-third of adult women. UI can occur because of hypermobility or intrinsic sphincter deficiency of the urethra. Regardless its etiology, it is associated with poor quality of life and most of the incontinent women develop symptoms such as anxiety, depression, and social isolation over time. The synthetic midurethral sling (MUS) was first introduced in 1995 and quickly became the gold standard treatment for women with stress UI because of intrinsic sphincter deficiency and/or urethral hypermobility...
May 2018: Journal of Endourology
https://www.readbyqxmd.com/read/29771399/trends-in-total-hip-arthroplasty-under-the-patient-protection-and-affordable-care-act-a-national-database-analysis-between-2008-and-2015
#13
Jennifer I Etcheson, Nicole E George, Chukwuweike U Gwam, James Nace, Alexander T Caughran, Melbin Thomas, Sana Virani, Ronald E Delanois
The Patient Protection and Affordable Care Act expanded health coverage for low-earning individuals and families. With more Americans having access to care, the use of elective procedures, such as total hip arthroplasty (THA), was expected to increase. Therefore, the aim of this study was to evaluate trends in THA before and after the initiation of the Patient Protection and Affordable Care Act regarding race, age, body mass index, and sex between 2008 and 2015. The National Surgical Quality Improvement Program database was queried for all individuals who had undergone primary THA between 2008 and 2015...
May 16, 2018: Orthopedics
https://www.readbyqxmd.com/read/29770874/electronic-voting-to-improve-morbidity-and-mortality-conferences
#14
Joel Zindel, Reto M Kaderli, Manuel O Jakob, Michel Dosch, Franziska Tschan, Daniel Candinas, Guido Beldi
BACKGROUND: It is of major importance in clinical surgery to identify potential patterns and specific causes of complications. Therefore, morbidity and mortality meetings (M&M) are widely used to discuss and evaluate deviations from expected outcomes in order to improve surgical practice. Moreover, M&M represent an important tool for continuous medical education. In this study, we introduced an electronic voting system to assess whether anonymity during M&M could limit potential biases due to hierarchical structures or opinion leaders...
May 16, 2018: World Journal of Surgery
https://www.readbyqxmd.com/read/29769505/efficacy-of-0-5-hyperbaric-bupivacaine-with-dexamethasone-versus-0-5-hyperbaric-bupivacaine-alone-in-spinal-anaesthesia-for-patient-undergoing-lower-abdominal-urological-and-lower-limb-orthopedic-surgeries
#15
M M Haque, M A Aleem, F H Haque, A B Siddique, R Afrose
Spinal anaesthesia with local anaesthetics has limited duration. Different additives have been used to prolong spinal anaesthesia. The aim of this study was to determine the efficacy of adding dexamethasone to bupivacaine in spinal anaesthesia specially whether it would prolong the duration of sensory block/ surgical analgesia and post-operative analgesia/pain free period or not. This randomized, prospective, double-blind, clinical study was conducted in the Department of Anaesthesia, Analgesia and Critical Care of Combined Military Hospital, Chittagong from October 2016 to August 2017...
April 2018: Mymensingh Medical Journal: MMJ
https://www.readbyqxmd.com/read/29766457/influence-of-age-on-variation-in-patterns-of-care-in-patients-with-rectal-cancer-in-catalonia-spain
#16
R Vernet, J M Borras, L Aliste, M Antonio, A Guarga, P Manchon-Walsh
BACKGROUND: Population ageing is a relevant concern in people diagnosed with rectal cancer. This study evaluates the adherence to clinical practice guidelines (CPGs) and patient outcomes in rectal cancer, with a particular focus on variation according to age. METHODS: This is a multicentre retrospective cohort study of all patients surgically treated for the first time for primary rectal cancer with curative intent in public hospitals in Catalonia during two study periods: first, with data from 2005 to 2007, and then with data from 2011 to 2012...
May 15, 2018: Clinical & Translational Oncology
https://www.readbyqxmd.com/read/29766138/risk-stratification-tools-in-emergency-general-surgery
#17
REVIEW
Joaquim Michael Havens, Alexandra B Columbus, Anupamaa J Seshadri, Carlos V R Brown, Gail T Tominaga, Nathan T Mowery, Marie Crandall
The use of risk stratification tools (RST) aids in clinical triage, decision making and quality assessment in a wide variety of medical fields. Although emergency general surgery (EGS) is characterized by a comorbid, physiologically acute patient population with disparately high rates of perioperative morbidity and mortality, few RST have been explicitly examined in this setting. We examined the available RST with the intent of identifying a tool that comprehensively reflects an EGS patients perioperative risk for death or complication...
2018: Trauma surgery & acute care open
https://www.readbyqxmd.com/read/29765794/femoral-access-for-central-venous-port-system-implantation
#18
Mikhail Cherkashin, Natalia Berezina, Denis Puchkov, Kirill Suprun, Petr Yablonsky
Totally implanted venous access port (TIVAP) systems provide adequate quality of care and life, especially for oncology patients. Long-term vascular access is very important and easy to perform, but in some clinical situations, if patients have a superior caval system occlusion, femoral insertion may be the only option. We present a case of a 70-year-old colorectal adenocarcinoma patient diagnosed with subclavian vein hypoplasia. Her care team decided intraoperatively to implant a port system by the right femoral access...
March 14, 2018: Curēus
https://www.readbyqxmd.com/read/29764908/management-of-endocrine-disease-which-metabolic-procedure-comparing-outcomes-in-sleeve-gastrectomy-and-roux-en-y-gastric-bypass
#19
Adrian T Billeter, Javier de la Garza Herrera, Katharina M Scheurlen, Felix Nickel, Franck Billmann, Beat Müller-Stich
Obesity and its associated comorbidities have become one of the largest challenges for health care in the near future. Conservative therapy for obesity and related comorbidities have a very high failure rate and poor long-term results. Similarly, the conservative and medical management of the majority of metabolic diseases such as type 2 diabetes mellitus are only able to slow down disease progression but have no causal effect on the disease process. Obesity surgery has evolved as a highly effect therapy for severe obesity achieving long-lasting weight loss...
May 15, 2018: European Journal of Endocrinology
https://www.readbyqxmd.com/read/29762383/starch-tolerance-and-the-short-bowel
#20
Jan de Laffolie, Hassan Y Naim, Silvia Rudloff, Klaus-Peter Zimmer
Short bowel syndrome with intestinal failure is a rare disease with a massive impairment in quality of life, requiring a multidisciplinary team approach to medical, surgical, and nutritional therapy. Current pharmacological and surgical therapeutic options are limited; an important cornerstone is enteral and parenteral nutrition. The changed physiology of carbohydrate digestion plays a major role in the adaptation process and can be a target for specific enteral nutrition interventions. An important prognostic factor is the preservation of at least portions of the colon in continuity with small bowel...
June 2018: Journal of Pediatric Gastroenterology and Nutrition
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