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laparoscopic appendectomy

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https://www.readbyqxmd.com/read/28729189/the-quality-in-training-initiative-giving-residents-data-to-learn-clinical-effectiveness
#1
Morgan M Sellers, Matt Fordham, Craig W Miller, Clifford Y Ko, Rachel R Kelz
BACKGROUND: Training programs are expected to provide clinical outcomes data to residents. Few systems have the necessary infrastructure. We evaluated initial adoption and use of the Quality In-Training Initiative (QITI) platform linking National Surgical Quality Improvement Program (NSQIP) data to trainees. STUDY DESIGN: Proportions of Accreditation Council for Graduate Medical Education general surgery residency programs with differing levels of NSQIP and QITI affiliation were calculated and program characteristics were compared...
July 17, 2017: Journal of Surgical Education
https://www.readbyqxmd.com/read/28718262/laparoscopic-approach-to-a-rare-interstitial-incisional-hernia-following-appendectomy
#2
Kerim Erdem Ulucay, Muhammad Umar Younis
Among the complications of an open appendectomy is the presentation of an incisional hernia. An interstitial or interparietal hernia is the one in which the hernia sac is present between the muscle layers of the abdominal wall which makes the presentation of a post-operative incisional interstitial hernia quite a rarity. A 52-year-old female was admitted through the outpatient clinic presenting with the complaints of discomfort and a bulge felt in the right hypochondrium for the last 3 years. Radiological investigations were able to delineate an interstitial incisional hernia through the previous open appendectomy scar...
April 2017: Journal of Ayub Medical College, Abbottabad: JAMC
https://www.readbyqxmd.com/read/28710611/bad-bacteria-in-acute-appendicitis-rare-but-relevant
#3
Alexander Reinisch, Patrizia Malkomes, Nils Habbe, Wolf Otto Bechstein, Juliane Liese
PURPOSE: Bacterial infections are a factor for morbidity in patients with acute appendicitis (AA). The spreading of multidrug-resistant (MDR) bacteria is a significant problem in surgery, and the most relevant MDR pathogens are summarized as Enterobacteriaceae, Staphylococcus aureus, Klebsiella pneumoniae, Acinetobacter baumannii, Pseudomonas aeruginosa, and Enterococci (ESKAPE) bacteria. Data regarding the species and distribution of bacteria in AA are available, but information about the resistances and their relevance is deficient...
July 15, 2017: International Journal of Colorectal Disease
https://www.readbyqxmd.com/read/28708770/laparoscopic-appendectomy-for-complicated-acute-appendicitis-in-the-elderly-a-single-center-experience
#4
Jiahua Yang, Kun Yu, Wei Li, Xianke Si, Jixun Zhang, Wentao Wu, Yijun Cao
BACKGROUND: The use of laparoscopic appendectomy for complicated acute appendicitis remains controversial in the elderly. This study aimed to compare the postoperative outcomes of elderly patients who received either laparoscopic appendectomy or open appendectomy. PATIENTS AND METHODS: A single-centre retrospective analysis of the clinical records of elderly patients (age, above 65 y) who underwent operations from January 2012 to November 2015 was performed. Demographic data, intraoperative variables, length of stay, and surgical complications were retrieved...
July 13, 2017: Surgical Laparoscopy, Endoscopy & Percutaneous Techniques
https://www.readbyqxmd.com/read/28707383/two-cases-of-early-recurrence-after-transabdominal-preperitoneal-inguinal-hernia-repair
#5
Yoshihisa Yaguchi, Tsuyoshi Inaba, Yoshimasa Kumata, Masahiro Horikawa, Takashi Kiyokawa, Ryoji Fukushima
We performed transabdominal preperitoneal inguinal hernia repair in 46 patients (58 diseases), two of whom experienced early recurrence after mesh repair. Case 1 was a 76-year-old man with a bilateral inguinal hernia (recurrence site, left indirect hernia) after appendectomy. The recurrence occurred 1 month after transabdominal preperitoneal inguinal hernia repair. The mesh was dislocated to the lateral side, and we repaired it using the direct Kugel® patch with an anterior technique. Case 2 was a 79-year-old man with a bilateral inguinal hernia (recurrence site, right direct hernia with an orifice >3 cm) after appendectomy...
July 13, 2017: Asian Journal of Endoscopic Surgery
https://www.readbyqxmd.com/read/28706890/clinical-implication-of-discrepancies-between-surgical-and-pathologic-diagnoses-of-acute-appendicitis
#6
Jinbeom Cho, Dosang Lee, Kiyoung Sung, Jongmin Baek, Junhyun Lee
PURPOSE: The postoperative treatment after appendectomy is usually decided on the basis of the surgeons' intraoperative findings. Comparatively, the pathologic diagnosis of appendicitis is confirmed several days after the surgery; therefore, it usually does not affect the postoperative treatment strategy. The aim of this study was to investigate the discrepancies between the surgical and pathologic diagnoses of appendicitis and to identify their clinical implication. METHODS: A retrospective observational study was performed in 1,817 patients who underwent 3-port laparoscopic appendectomy for the final diagnosis of appendicitis...
July 2017: Annals of Surgical Treatment and Research
https://www.readbyqxmd.com/read/28698745/new-surgical-technologies-could-facilitate-surgical-hemostasis-in-hemophilic-patients
#7
Milcho J Panovski, Igor V Fildishevski, Ljubomir Lj Ognjenovic, Violeta I Dejanova-Ilijevska
BACKGROUND: It's assumed that surgery in haemophilia can be accomplished these days safely. AIM: The aim of this study was to investigate the influence of new surgical technologies in the perioperative management and outcome of surgical procedures in haemophiliacs. METHODS: Two patients with mild haemophilia A underwent surgery (laparoscopic appendectomy and inguinal hernia repair). In both patients, the replacement therapy, with factor VIII, started 30 min before surgery...
June 15, 2017: Open Access Macedonian Journal of Medical Sciences
https://www.readbyqxmd.com/read/28693476/intended-cost-reduction-in-laparoscopic-appendectomy-by-introducing-the-endoloop-a-single-center-experience
#8
Matthias Mehdorn, Olaf Schürmann, H Maximilian Mehdorn, Ines Gockel
BACKGROUND: Cost reduction measures in medicine are gaining greater importance nowadays, especially in high-volume procedures such as laparoscopic appendectomy (LAE). Currently there are two common methods of dissecting the appendix from the caecal pole: linear stapler and endoloops. The endoloop is the cheaper device but can only be used in uncomplicated cases of appendicitis. Therefore both methods are used in LAE depending on intraoperative findings. The goal of this study was to retrospectively evaluate possible cost reduction due to increased use of endoloop in LAE in our general surgery department of a tertiary referral university hospital...
July 11, 2017: BMC Surgery
https://www.readbyqxmd.com/read/28688655/pediatric-laparoscopic-appendectomy-risk-factors-and-costs-associated-with-nationwide-readmissions
#9
Jessica L Buicko, Joshua Parreco, Samantha N Abel, Michael A Lopez, Juan E Sola, Eduardo A Perez
BACKGROUND: Previous studies of readmission after pediatric laparoscopic appendectomy have been limited to individual hospitals or noncompeting public pediatric hospitals. The purpose of this study was to evaluate the risk factors and costs associated with nonelective, 30-d readmissions in pediatric patients nationwide across public and private hospitals. MATERIALS AND METHODS: The Nationwide Readmission Database for 2013 was queried for all patients under the age of 18 y with a diagnosis of acute appendicitis undergoing laparoscopic appendectomy...
July 2017: Journal of Surgical Research
https://www.readbyqxmd.com/read/28661313/acute-appendicitis-after-kidney-transplantation-experience-at-a-tertiary-care-hospital-in-mexico-city
#10
Edgar Ortiz-Brizuela, Alejandro Quiroz-Compeán, Mario Vilatobá-Chapa, Josefina Alberú-Gómez
OBJECTIVES: Here, we describe the presentation, treatment, and outcomes of acute appendicitis in kidney transplant recipients at a tertiary care hospital in Mexico City. MATERIALS AND METHODS: We conducted a retrospective case series study at a tertiary care hospital in Mexico City from January 2000 to January 2015. RESULTS: During our study period, 1186 patients received a kidney transplant; among these patients, we identified 10 cases of acute appendicitis (0...
June 28, 2017: Experimental and Clinical Transplantation
https://www.readbyqxmd.com/read/28650684/intentional-ingestion-of-elemental-mercury-requiring-multi-step-decontamination-and-prophylactic-appendectomy-a-case-report-and-treatment-proposal
#11
Andrea Michielan, Azzurra Schicchi, Roberto Cappuccio, Davide Lonati, Francesca Lamboglia, Alessandra Vitalba, Alessandro Caroli, Marta Crevani, Carlo A Locatelli, Giorgio Betetto
BACKGROUND: Ingestion of elemental mercury (Hg0) is considered non-toxic. After massive ingestion, local intestinal complications may develop: retention within appendix is quite frequent but treatment is debated. We describe a case of intentional ingestion of Hg0 requiring multi-step decontamination and prophylactic appendectomy. Case detail: A 19-year-old woman was admitted to ED for abdominal pain. History revealed ingestion of large amount of Hg0 as suicide attempt. To prevent absorption, facilitate elimination, and avoid complications a conservative approach was started...
June 26, 2017: Clinical Toxicology
https://www.readbyqxmd.com/read/28647737/trends-in-the-management-of-acute-appendicitis-in-a-single-center-quality-register-cohort-of-5-614-patients
#12
Martin J A Dahlberg, Emil H A Pieniowski, Lennart Å S Boström
Acute appendicitis is one of the most common reasons for emergency surgery. At Stockholm South General Hospital, information on all patients - 15 years or older - undergoing surgery for acute appendicitis is included in a quality register. Data on surgical method, preoperative imaging, hospital stay, intraoperative findings, and 30-day complications were recorded for each patient. From January 2004 to December 2014, 5,614 consecutive patients were registered. The percentage of patients examined with preoperative imaging increased from 30% in 2004 to 93% in 2014...
June 24, 2017: Digestive Surgery
https://www.readbyqxmd.com/read/28637573/laparoscopic-appendectomy-protocol-expedites-management-of-uncomplicated-acute-appendicitis
#13
Alvaro M Bada, Joseph A Ibrahim, Karen Safcsak, Andrew C Gratzon, Chadwick P Smith, Michael L Cheatham
Bed availability remains a constant struggle for tertiary care centers resulting in the use of management protocols to streamline patient care and reduce length of stay (LOS). A standardized perioperative management protocol for uncomplicated acute appendicitis (UA) was implemented in April 2014 to decrease both CT scan usage and LOS. Patients who underwent laparoscopic appendectomy for UA from April 2012 to May 2013 (PRE group) and April 2014 to May 2015 (POST group) were compared retrospectively. There were no differences in patient demographics or clinical findings between the groups...
June 1, 2017: American Surgeon
https://www.readbyqxmd.com/read/28635516/concentration-of-uhcl1-in-the-serum-of-children-with-acute-appendicitis-before-and-after-surgery-and-its-correlation-with-crp-and-prealbumin
#14
Ewa Matuszczak, Marzena Tylicka, Wojciech Dębek, Anna Tokarzewicz, Ewa Gorodkiewicz, Adam Hermanowicz
Ubiquitin-mediated protein degradation plays a crucial role in various cellular processes, including signal transduction, cell differentiation, and stress response. Ubiquitin C-terminal hydrolase 1 (UCHL1) is a unique deubiquitinating enzyme that has both hydrolase and ligase activities. The aim of this study was the determination of UCHL1 concentration in serum of children with appendicitis, before and after the surgery. MATERIAL AND METHODS: 42 children with acute appendicitis, who were managed at the Pediatric Surgery Department, between 2013 and 2014, were randomly included into the study (age 9 months up to 14 years, mean age 2...
February 27, 2017: Journal of Investigative Surgery: the Official Journal of the Academy of Surgical Research
https://www.readbyqxmd.com/read/28623596/impact-of-residency-training-level-on-the-surgical-quality-following-general-surgery-procedures
#15
Dominik Loiero, Maja Slankamenac, Pierre-Alain Clavien, Ksenija Slankamenac
OBJECTIVE: To investigate the safety of surgical performance by residents of different training level performing common general surgical procedures. METHODS: Data were consecutively collected from all patients undergoing general surgical procedures such as laparoscopic cholecystectomy, laparoscopic appendectomy, inguinal, femoral and umbilical hernia repair from 2005 to 2011 at the Department of Surgery of the University Hospital of Zurich, Switzerland. The operating surgeons were grouped into junior residents, senior residents and consultants...
June 16, 2017: World Journal of Surgery
https://www.readbyqxmd.com/read/28618350/minimally-invasive-appendectomy-for-resection-of-appendiceal-mucocele-case-series-and-review-of-the-literature
#16
Sonia T Orcutt, Daniel A Anaya, Mokenge Malafa
INTRODUCTION: Appendiceal mucoceles encompass neoplastic and non-neoplastic causes of a distended Appendix filled with mucus. Appendectomy is recommended when an appendiceal mucocele is identified, incidentally or otherwise, in the event it is secondary to a malignancy. For an intact mucocele, it is critically important to avoid rupturing the mucocele during resection, as rupture of a neoplastic mucocele can result in pseudomyxoma peritonei, or mucin deposits in the peritoneum, which is associated with long-term morbidity and mortality...
May 29, 2017: International Journal of Surgery Case Reports
https://www.readbyqxmd.com/read/28614043/antibiotics-vs-appendectomy-for-acute-uncomplicated-appendicitis-in-adults-review-of-the-evidence-and-future-directions
#17
Jared M Huston, Lillian S Kao, Phillip K Chang, James M Sanders, Sara Buckman, Charles A Adams, Christine S Cocanour, Sarah E Parli, Julia Grabowski, Jose Diaz, Jeffrey M Tessier, Therese M Duane
BACKGROUND: Acute appendicitis is the most common abdominal surgical emergency in the United States, with a lifetime risk of 7%-8%. The treatment paradigm for complicated appendicitis has evolved over the past decade, and many cases now are managed by broad-spectrum antibiotics. We determined the role of non-operative and operative management in adult patients with uncomplicated appendicitis. METHODS: Several meta-analyses have attempted to clarify the debate. Arguably the most influential is the Appendicitis Acuta (APPAC) Trial...
July 2017: Surgical Infections
https://www.readbyqxmd.com/read/28610706/ultrasound-guided-bilateral-rectus-sheath-block-vs-conventional-local-analgesia-in-single-port-laparoscopic-appendectomy-for-children-with-nonperforated-appendicitis
#18
Caroline Maloney, Michelle Kallis, Ibrahim Abd El-Shafy, Aaron M Lipskar, John Hagen, Michelle Kars
INTRODUCTION: Despite its minimally invasive approach, laparoscopic surgery can cause considerable pain. Regional analgesic techniques such as the rectus sheath block (RSB) offer improved pain management following elective umbilical hernia repair in the pediatric population. This effect has not been examined in laparoscopic single-incision surgery in children. We sought to compare the efficacy of bilateral ultrasound-guided RSB versus local anesthetic infiltration (LAI) in providing postoperative pain relief in pediatric single-incision transumbilical laparoscopic assisted appendectomy (TULA) with same-day discharge...
June 2, 2017: Journal of Pediatric Surgery
https://www.readbyqxmd.com/read/28602526/resident-operative-experience-at-independent-academic-medical-centers-a-comparison-to-the-national-cohort
#19
Amit R T Joshi, Amber W Trickey, Benjamin T Jarman, Kara J Kallies, Robert Josloff, Jonathan M Dort, Ravi Kothuru
PURPOSE: Independent Academic Medical Centers (IAMCs) comprise one-third of U.S. general surgery training programs. It is unclear whether IAMCs offer qualitatively or quantitatively different operative experiences than the national cohort. We analyzed a large representative sample of IAMCs to compare operative volume and variety, with a focus on low-volume procedures. METHODS: Accreditation Council for Graduate Medical Education Program Case Reports from 27 IAMCs were collected and analyzed for 3 academic years (2012-2015)...
June 8, 2017: Journal of Surgical Education
https://www.readbyqxmd.com/read/28597283/transumbilical-laparoscopic-assisted-appendectomy-in-children-is-it-worth-it
#20
Sara Hernandez-Martin, Lidia Ayuso, Ada Yessenia Molina, Javier Pison, Miguel Angel Martinez-Bermejo, Alberto Perez-Martinez
INTRODUCTION: Transumbilical laparoscopic-assisted appendectomy (TULAA) is the technique of choice for all types of appendicitis in our Department. It combines the advantages of laparoscopy (global vision and minimally invasion) and open surgery (lower cost). The objective was to assess the results of our TULAA series and compare them to the results of standard laparoscopic appendectomies (SLA) performed during the same period. METHODS: Retrospective review of total appendectomies performed since TULAA introduction (September 2003 to December 2015) with statistic analysis of the results...
June 8, 2017: Surgical Endoscopy
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