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Anesthesia in oncological surgery

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https://www.readbyqxmd.com/read/27866303/anesthetic-technique-and-cancer-recurrence-in-oncologic-surgery-unraveling-the-puzzle
#1
Ryungsa Kim
Surgery/anesthetic technique-stimulated immunosuppression in the perioperative period might cause an increase in cancer-related mortality. Whether anesthetic technique can affect the outcomes of cancer patients remains inconclusive. This review discusses data from the available literature on anesthetic techniques applied in oncologic surgery, the long-term outcomes of anesthetic technique, and their relation to survival and cancer recurrence. Searches of the PubMed database up to June 30, 2016, were conducted to identify publications with the terms "anesthetic technique and cancer recurrence," "regional anesthesia and cancer recurrence," "local anesthesia and cancer recurrence," "anesthetic technique and immunosuppression," and "anesthetic technique and oncologic surgery...
November 19, 2016: Cancer Metastasis Reviews
https://www.readbyqxmd.com/read/27833963/anterior-commissure-laryngeal-neoplasm-endoscopic-management
#2
Nicolae Constantin Balica, Mărioara Poenaru, Eugen HoraŢiu Ştefănescu, Eugen Radu Boia, Caius Ion Doroş, Flavia Baderca, Octavian Mazilu
The CO2 laser surgery represents a treatment method of laryngeal bicordal and anterior commissure glottic cancer T1b, T2, N0. In Department of ENT, Timisoara, Romania, during 1.01.2001-31.12.2011 were analyzed 781 files from patients with laryngeal neoplasm. One hundred twenty-seven patients presented the tumor that involved both vocal cords and anterior commissure, stages T1b, T2 and T3. Therapeutic options included CO2 laser microsurgical excision for 55 (43.30%) patients, frontolateral hemilaryngectomy for 16 (12...
2016: Romanian Journal of Morphology and Embryology, Revue Roumaine de Morphologie et Embryologie
https://www.readbyqxmd.com/read/27778491/feasibility-of-robot-assisted-segmental-ureterectomy-and-ureteroureterostomy-in-patient-with-high-medical-comorbidity
#3
Ali Abdel Raheem, Atalla Alatawi, Dae Keun Kim, Abulhasan Sheikh, Koon Ho Rha
INTRODUCTION AND OBJECTIVES: Nephroureterectomy remains the gold standard treatment option for upper tract tumors. However, segmental ureterectomy may be another option in patients with single kidney, borderline renal function or high medical comorbidities. The aim of this video is to assess the feasibility of robotic surgery as a minimally invasive technique in treatment of a high comorbid patient with ureteric tumor. MATERIALS AND METHODS: Eighty-year old male patient, with a medical history of chronic hypertensive and uncontrolled Diabetes Mellitus, was referred to our department for treatment of ureteric tumor...
October 20, 2016: International Braz J Urol: Official Journal of the Brazilian Society of Urology
https://www.readbyqxmd.com/read/27716330/survival-rate-and-perioperative-data-of-patients-who-have-undergone-hemipelvectomy-a-retrospective-case-series
#4
Alfredo Guilherme Haack Couto, Bruno Araújo, Roberto André Torres de Vasconcelos, Marcos José Renni, Clóvis Orlando Da Fonseca, Ismar Lima Cavalcanti
BACKGROUND: Hemipelvectomy is a major orthopedic surgical procedure indicated in specific situations. Although many studies discuss surgical techniques for hemipelvectomy, few studies have presented survival data, especially in underdeveloped countries. Additionally, there is limited information on anesthesia for orthopedic oncologic surgeries. The primary aim of this study was to determine the survival rate after hemipelvectomy, and the secondary aims were to evaluate anesthesia and perioperative care associated with hemipelvectomy and determine the influence of the surgical technique (external hemipelvectomy [amputation] or internal hemipelvectomy [limb sparing surgery]) on anesthesia and perioperative care in Brazil...
October 7, 2016: World Journal of Surgical Oncology
https://www.readbyqxmd.com/read/27638294/rectus-sheath-block-for-postoperative-analgesia-in-gynecological-oncology-surgery-resons-a-randomized-controlled-trial
#5
Sumitra G Bakshi, Amol Mapari, T S Shylasree
BACKGROUND: Opioid-sparing pain management is important for Enhanced Recovery After Surgery. Rectus sheath (RS) blocks are emerging as a promising modality for pain relief following midline laparotomy; however, there are limited prospective clinical trials testing their efficacy. The purpose of this randomized-controlled trial is to assess the morphine-sparing effect of local anesthetic (LA) boluses through RS catheters following elective gynecological oncology surgery. METHOD: After patients' informed consent, bilateral RS catheters were placed intraoperatively in 74 females (American Society of Anesthesiologists physical status I-II) undergoing elective midline laparotomy under general anesthesia...
September 14, 2016: Canadian Journal of Anaesthesia, Journal Canadien D'anesthésie
https://www.readbyqxmd.com/read/27637823/value-based-care-and-bundled-payments-anesthesia-care-costs-for-outpatient-oncology-surgery-using-time-driven-activity-based-costing
#6
Katy E French, Alexis B Guzman, Augustin C Rubio, John C Frenzel, Thomas W Feeley
BACKGROUND: With the movement towards bundled payments, stakeholders should know the true cost of the care they deliver. Time-driven activity-based costing (TDABC) can be used to estimate costs for each episode of care. In this analysis, TDABC is used to both estimate the costs of anesthesia care and identify the primary drivers of those costs of 11 common oncologic outpatient surgical procedures. METHODS: Personnel cost were calculated by determining the hourly cost of each provider and the associated process time of the 11 surgical procedures...
September 2016: Healthcare
https://www.readbyqxmd.com/read/27583025/ultrasound-guided-radiofrequency-ablation-for-ct1a-renal-masses-in-poor-surgical-candidates-mid-term-single-center-outcomes
#7
Ioannis Zachos, Konstantinos Dimitropoulos, Anastasios Karatzas, Michael Samarinas, Argiro Petsiti, Vassilios Tassoudis, Vassilios Tzortzis
OBJECTIVES: Surgical management of small renal masses can be challenging in frail patients and thus modalities such as radiofrequency ablation (RFA) have emerged as valid alternative options. The aim of the current study was to present mid-term oncological and functional results on a series of patients with cT1a renal cell carcinomas (RCCs) who were unfit for surgery and underwent RFA using ultrasound guidance under local anesthesia. METHODS: Data from patients fulfilling the study selection criteria were retrospectively collected...
September 2016: Therapeutic Advances in Medical Oncology
https://www.readbyqxmd.com/read/27468502/-balanced-multimodal-analgesia-in-gynecologic-oncology
#8
A Zh Bayaliieva, I I Khusainova, E A Berdnikova, G H Garipova
UNLABELLED: This article is about the issues of anesthesia during radical surgery in gynecologic oncology. MATERIALS AND METHODS: the study included 336 patients who underwent simple and extended hysterectomy for the period from 2014 to 2015. There were 3 groups where PCA was carried out in groups I and III. RESULTS AND DISCUSSION: found a significant difference between the groups in pain intensity before and after surgery, as well as the need for opioid analgesics in the surgical treatment stages...
March 2016: Anesteziologiia i Reanimatologiia
https://www.readbyqxmd.com/read/27420728/severe-perioperative-bleeding-in-renal-cell-carcinoma-after-elective-pericardiocentesis-associated-left-ventricular-puncture-case-report
#9
Javier Lasala, Miguel Alejandro Patino, Gabriel Mena, Shital Vachhani, Teresa Moon, Thao Bui, January Tsai
In the United States during the year 2015, approximately 61,560 patients are expected to be diagnosed with kidney cancer and 14,080 to die from the disease. We present the case of a patient with renal cell carcinoma who suffered severe perioperative bleeding and coagulopathy after emergency sternotomy. We also engage in relevant aspects of perioperative anesthesia care including the considerations and management of coagulopathy, liver failure and renal failure in the oncologic patient. The case is a 49-year-old man with vena cava tumor thrombus who underwent radiologic tumor embolization, left radical nephrectomy, and inferior vena cava (IVC) thrombectomy...
2016: Medwave
https://www.readbyqxmd.com/read/27370517/perioperative-management-in-children-with-chronic-pain
#10
REVIEW
Meredith R Brooks, Brenda Golianu
Children with chronic pain often undergo surgery and effective perioperative management of their pain can be challenging. Identification of the pediatric chronic pain patient preoperatively and development of a perioperative pain plan may help ensure a safer and more comfortable perioperative course. Successful management usually requires multiple different classes of analgesics, regional anesthesia, and adjunctive nonpharmacological therapies. Neuropathic and oncological pain can be especially difficult to treat and usually requires an individualized approach...
August 2016: Paediatric Anaesthesia
https://www.readbyqxmd.com/read/27232247/considering-value-in-rectal-cancer-surgery-an-analysis-of-costs-and-outcomes-based-on-the-open-laparoscopic-and-robotic-approach-for-proctectomy
#11
Jorge Silva-Velazco, David W Dietz, Luca Stocchi, Meagan Costedio, Emre Gorgun, Matthew F Kalady, Hermann Kessler, Ian C Lavery, Feza H Remzi
OBJECTIVE: The aim of the study was to compare value (outcomes/costs) of proctectomy in patients with rectal cancer by 3 approaches: open, laparoscopic, and robotic. BACKGROUND: The role of minimally invasive proctectomy in rectal cancer is controversial. In the era of value-based medicine, costs must be considered along with outcomes. METHODS: Primary rectal cancer patients undergoing curative intent proctectomy at our institution between 2010 and 2014 were included...
May 26, 2016: Annals of Surgery
https://www.readbyqxmd.com/read/27177906/computerized-analysis-of-the-greater-palatine-foramen-to-gain-the-palatine-neurovascular-bundle-during-palatal-surgery
#12
Pınar Cagimni, Figen Govsa, Mehmet Asim Ozer, Zuhal Kazak
OBJECTIVE: Investigation of the computerized dimensional anatomic location of the greater palatine foramen (GPF) and lesser palatine foramens (LPF) is important indicating site to collect palatal donor tissue, reconstructioning the orofacial area of the oncology patient and applying the greater palatine nerve block anesthesia. The aim of this study is to determine a patient-friendly landmark and to specify the precise location of the GPF in order to standardise certain anatomical marks of safe neurovascular bundle...
May 13, 2016: Surgical and Radiologic Anatomy: SRA
https://www.readbyqxmd.com/read/27160623/-sedated-non-intubated-bilateral-thoracoscopic-sympathectomy-r3-r4
#13
José Manuel Mier-Odriozola
Non-intubated thoracic surgery entails procedures performed through regional anesthesia method in awake or mildly sedated, spontaneously ventilating patients. This method represents advantages for the cardiovascular system, and reduces the orotracheal trauma, postoperative atelectasis, and pneumonia. It also possibly reduces costs. Other theoretical advantages are: easier acceptance of surgery, attenuated stress hormone and immune response, and possibly a better survival in oncological surgery. We show a 34-year-old woman with sever palmar-axillary hyperhidrosis...
March 2016: Gaceta Médica de México
https://www.readbyqxmd.com/read/26850064/perioperative-management-and-oncological-outcomes-following-radical-cystectomy-for-bladder-cancer-a-matched-retrospective-cohort-study
#14
Toby N Weingarten, Ashley M Taccolini, Samuel T Ahle, Kelsey R Dietz, Shaun S Dowd, Igor Frank, Stephen A Boorjian, Prabin Thapa, Andrew C Hanson, Darrell R Schroeder, Juraj Sprung
PURPOSE: The immune system plays an important role in tumour progression. Systemic opioids are immunosuppressive; thus, theoretically they may promote tumour spread. Our primary aim was to test the hypothesis that general anesthesia (GA) with spinal analgesia (SA) in patients with bladder cancer undergoing radical cystectomy (RC) will both reduce systemic opioid use and improve oncological outcomes. Since blood transfusions also induce immunosuppression, a secondary aim was to evaluate the effect of perioperative transfusions on oncological outcomes...
May 2016: Canadian Journal of Anaesthesia, Journal Canadien D'anesthésie
https://www.readbyqxmd.com/read/26844523/a-7-year-retrospective-multisource-analysis-on-the-incidence-of-anesthesia-awareness-with-recall-in-cancer-patients-a-chance-of-collaboration-between-anesthesiologists-and-psycho-oncologists-for-awareness-detection
#15
Marco Cascella, Daniela Viscardi, Vincenzo Schiavone, Farrokh Mehrabmi-Kermani, Maria Rosaria Muzio, Cira Antonietta Forte, Francesco De Falco, Daniela Barberio, Arturo Cuomo
Although randomized controlled studies reported an incidence of anesthesia awareness with recall ∼1 to 2 per 1000 (0.1-0.2%), recent data from the NAP5 study showed an incidence of only 1:19,600. Although in a prospective study many tools for anesthesia awareness detection can be used, a retrospective analysis requires a careful collection of information.The aim of the study was to evaluate the incidence of anesthesia awareness with recall in a cohort of cancer patients through a multisource retrospective analysis, and the clinical description, including the psychological outcome, of the cases detected...
February 2016: Medicine (Baltimore)
https://www.readbyqxmd.com/read/26766966/from-awake-to-monitored-anesthesia-care-thoracic-surgery-a-15-year-evolution
#16
REVIEW
Tommaso C Mineo, Federico Tacconi
Although general anesthesia still represents the standard when performing thoracic surgery, the interest toward alternative methods is increasing. These have evolved from the employ of just local or regional analgesia techniques in completely alert patients (awake thoracic surgery), to more complex protocols entailing conscious sedation and spontaneous ventilation. The main rationale of these methods is to prevent serious complications related to general anesthesia and selective ventilation, such as tracheobronchial injury, acute lung injury, and cardiovascular events...
January 2014: Thoracic Cancer
https://www.readbyqxmd.com/read/26748539/feasibility-for-using-hypofractionated-stereotactic-volumetric-modulated-arc-radiotherapy-vmat-with-adaptive-planning-for-treatment-of-thymoma-in-rabbits-15-cases
#17
Mario Dolera, Luca Malfassi, Giovanni Mazza, Gaetano Urso, Massimo Sala, Silvia Marcarini, Nancy Carrara, Simone Pavesi, Sara Finesso, Michael S Kent
Thymoma is a relatively common tumor in rabbits. Treatment with surgery, radiation therapy, and chemotherapy alone or in combination has been reported with varying outcomes. Stereotactic volumetric modulated arc radiotherapy delivered in a hypofractionated manner allows high doses of radiation to be delivered to the target volume while allowing sparing of adjacent critical structures. This therapy is ideally suited for thymomas in rabbits given their size, the difficulty of multiple anesthesia episodes and the complexity of the radiotherapy plans required due to the tumor's proximity to the heart, lungs, and mediastinal structures...
May 2016: Veterinary Radiology & Ultrasound
https://www.readbyqxmd.com/read/26743391/conservative-treatment-of-serous-borderline-paratesticular-tumor-in-a-pediatric-patient
#18
Simone Caroassai Grisanti, Alberto Martini, Barbara Bigazzi, Maria Rosaria Raspollini, Augusto Delle Rose, Donata Villari, Giulio Nicita
Serous borderline tumors are rare neoplasms. Herein we report our conservative approach, whose rationale is neoplasm low-malignant potential. Tumor was removed under general anesthesia, and frozen section ruled out a germinal malignancy or a stromal tumor such as rhabdomyosarcoma. Ultrasound evaluation was initially performed every 3 months during the first 2 years, every 6 months during the next 3 years, and annually thereafter. After 8 years, the patient has not experienced any relapse, either clinical or ultrasonographical...
March 2016: Urology
https://www.readbyqxmd.com/read/26661949/-complex-pelvic-and-sarcoma-surgery-with-vascular-replacement
#19
S Pistorius, Ch Reeps, J Weitz
Due to optimization of surgical techniques in surgical oncology and vascular surgery, the most modern approaches of anesthesia and intensive care medicine and effective multimodal therapeutic strategies, locally advanced malignant tumors are resected more frequently with a potentially curative intent. In the case of extensive tumors with infiltration of vital vascular structures or of structures which are crucial for extremity preservation, the necessary surgical procedure for complete tumor removal poses a major challenge for the surgeon and incorporates a high risk of perioperative morbidity for the patient...
February 2016: Der Chirurg; Zeitschrift Für Alle Gebiete der Operativen Medizen
https://www.readbyqxmd.com/read/26611799/patient-reported-outcomes-accurately-measure-the-value-of-an-enhanced-recovery-program-in-liver-surgery
#20
Ryan W Day, Charles S Cleeland, Xin S Wang, Sharon Fielder, John Calhoun, Claudius Conrad, Jean-Nicolas Vauthey, Vijaya Gottumukkala, Thomas A Aloia
BACKGROUND: Enhanced recovery (ER) pathways have become increasingly integrated into surgical practice. Studies that compare ER and traditional pathways often focus on outcomes confined to inpatient hospitalization and rarely assess a patient's functional recovery. The aim of this study was to compare functional outcomes for patients treated on an Enhanced Recovery in Liver Surgery (ERLS) pathway vs a traditional pathway. STUDY DESIGN: One hundred and eighteen hepatectomy patients rated symptom severity and life interference using the validated MD Anderson Symptom Inventory preoperatively and postoperatively at every outpatient visit until 31 days after surgery...
December 2015: Journal of the American College of Surgeons
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