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Perioperative management

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59 papers 25 to 100 followers
By Giovanni Gambino M.D. Ph.D.
Alice Charlotte Adelaide Murray, Ravi P Kiran
No abstract text is available yet for this article.
September 2016: Advances in Surgery
Kristina L Guyton, Neil H Hyman, John C Alverdy
No abstract text is available yet for this article.
September 2016: Advances in Surgery
John E Scarborough, Christopher R Mantyh, Zhifei Sun, John Migaly
OBJECTIVE: To determine the association between preoperative bowel preparation and 30-day outcomes after elective colorectal resection. METHODS: Patients from the 2012 Colectomy-Targeted American College of Surgeons National Surgical Quality Improvement Program (ACS NSQIP) database who underwent elective colorectal resection were included for analysis and assigned to 1 of 4 groups based on the type of preoperative preparation they received [combined mechanical and oral antibiotic preparation (OAP), mechanical preparation only, OAP only, or no preoperative bowel preparation]...
August 2015: Annals of Surgery
Ahmad Elnahas, David Urbach, Gerald Lebovic, Muhammad Mamdani, Allan Okrainec, Fayez A Quereshy, Timothy D Jackson
BACKGROUND: Routine preoperative mechanical bowel preparation (MBP) for left-sided colorectal resections remains controversial. This study aims to evaluate the association between MBP and 30-day anastomotic leaks. METHODS: A retrospective cohort study was conducted using data from the National Surgical Quality Improvement Program from 2011 to 2012. Multiple imputation was used for missing data, and a multivariable logistic regression was performed to adjust for clinically relevant variables...
November 2015: American Journal of Surgery
S T K Yauw, K E Wever, A Hoesseini, M Ritskes-Hoitinga, H van Goor
BACKGROUND: The contribution of animal research to a reduction in clinical intestinal anastomotic leakage is unknown, despite numerous experimental studies. In view of the current societal call to replace, reduce and refine animal experiments, this study examined the quality of animal research related to anastomotic healing and leakage. METHODS: Animal studies on intestinal anastomotic healing were retrieved systematically from PubMed and Embase. Study objective, conclusion and animal model were recorded...
June 2015: British Journal of Surgery
Chang Woo Kim, Se Jin Baek, Hyuk Hur, Byung Soh Min, Seung Hyuk Baik, Nam Kyu Kim
OBJECTIVE: To review and compare clinical manifestations of and risk factors for anastomotic leakage (AL) after low anterior resection for rectal cancer between minimally invasive surgery (MIS) and open surgery (OS). BACKGROUND: MIS for rectal cancer has become popular, and its clinical course is different from OS. Many studies have reported on the risk factors and oncologic influence of AL. However, few have directly compared clinical manifestations and risk factors for AL between MIS and OS...
January 2016: Annals of Surgery
Christian S Meyhoff, Lars N Jorgensen, Lars S Rasmussen, Jørn Wetterslev
No abstract text is available yet for this article.
April 2015: American Journal of Surgery
M L Krajewski, K Raghunathan, S M Paluszkiewicz, C R Schermer, A D Shaw
BACKGROUND: The objective of this systematic review and meta-analysis was to assess the relationship between the chloride content of intravenous resuscitation fluids and patient outcomes in the perioperative or intensive care setting. METHODS: Systematic searches were performed of PubMed/MEDLINE, Embase and Cochrane Library (CENTRAL) databases in accordance with PRISMA guidelines. Randomized clinical trials, controlled clinical trials and observational studies were included if they compared outcomes in acutely ill or surgical patients receiving either high-chloride (ion concentration greater than 111 mmol/l up to and including 154 mmol/l) or lower-chloride (concentration 111 mmol/l or less) crystalloids for resuscitation...
January 2015: British Journal of Surgery
André L Mihaljevic, Rebekka Schirren, Mine Özer, Stephanie Ottl, Sybille Grün, Christoph W Michalski, Mert Erkan, Carsten Jäger, Carolin Reiser-Erkan, Victoria Kehl, Tibor Schuster, Jürgen Roder, Ulf Clauer, Carolin Orlitsch, Tomas F Hoffmann, Reinhard Lange, Thomas Harzenetter, Phillip Steiner, Milena Michalski, Karl Henkel, Josef Stadler, Georg A Pistorius, Anja Jahn, Robert Obermaier, Robert Unger, Roland Strunk, Frank Willeke, Holger Vogelsang, Bert Halve, Karl-Heinz Dietl, Hendrik Hilgenstock, Alexander Meyer, Hans-Jörg Krämling, Markus Wagner, Michael H Schoenberg, Florian Zeller, Johannes Schmidt, Helmut Friess, Jörg Kleeff
OBJECTIVE: To determine whether circular plastic wound edge protectors (CWEPs) significantly reduce the rate of surgical site infections (SSIs) in comparison to standard surgical towels in patients undergoing laparotomy. BACKGROUND: SSIs cause substantial morbidity, prolonged hospitalization, and costs and remain one of the most frequent surgical complications. CWEPs have been proposed as a measure to reduce the incidence of SSIs. METHODS: In this randomized controlled, multicenter, 2-arm, parallel-group design, patient- and observer-blinded trial patients undergoing open elective abdominal surgery were assigned to either intraoperative wound coverage with a CWEP or standard coverage with surgical towels...
November 2014: Annals of Surgery
Kostan W Reisinger, Martijn Poeze, Karel W E Hulsewé, Bernadette A van Acker, Annemarie A van Bijnen, Anton G M Hoofwijk, Jan H M B Stoot, Joep P M Derikx
BACKGROUND: Anastomotic leakage is a frequent and life-threatening complication after colorectal surgery. Early recognition of anastomotic leakage is critical to reduce mortality. Because early clinical and radiologic signs of anastomotic leakage are often nonspecific, there is an urgent need for accurate biomarkers. Markers of inflammation and gut damage might be suitable, as these are hallmarks of anastomotic leakage. STUDY DESIGN: In 84 patients undergoing scheduled colorectal surgery with primary anastomosis, plasma samples were collected preoperatively and daily after surgery...
October 2014: Journal of the American College of Surgeons
Jeffrey E Keenan, Paul J Speicher, Julie K M Thacker, Monica Walter, Maragatha Kuchibhatla, Christopher R Mantyh
IMPORTANCE: Surgical site infections (SSIs) in colorectal surgery are associated with increased morbidity and health care costs. OBJECTIVE: To determine the effect of a preventive SSI bundle (hereafter bundle) on SSI rates and costs in colorectal surgery. DESIGN: Retrospective study of institutional clinical and cost data. The study period was January 1, 2008, to December 31, 2012, and outcomes were assessed and compared before and after implementation of the bundle on July 1, 2011...
October 2014: JAMA Surgery
A G Renehan
No abstract text is available yet for this article.
November 2014: British Journal of Surgery
Gregory S Peirce, Jonathan P Swisher, Josiah D Freemyer, Joanna R Crossett, Thomas M Wertin, Kanayochukwu J Aluka, Steven Tobias, Llewellyn V Lee, Stephen P Hetz, Kurt G Davis
BACKGROUND: Postoperative radiographs demonstrating pneumoperitoneum are a vexing problem for surgeons. This dilemma stems from uncertainty regarding the length of time for resolution of gas introduced operatively via either an open or a laparoscopic approach. We attempted to quantify the duration of pneumoperitoneum after both laparoscopic and open surgery in an animal model. METHODS: A prospective study using 2 groups of 10 pigs (Sus scrofa) was performed. The animals were assigned to undergo either an exploratory laparoscopy or an open abdominal exploration...
December 2014: American Journal of Surgery
Ira L Leeds, Elizabeth C Wick, Genevieve B Melton
The argument for close temperature control, to which regulatory bodies have held health systems in an effort to reduce the burden of hospital-acquired infections, is not fully supported by current evidence. The literature is complex on the topic, and overinterpretation of historical data supporting close temperature regulation does not preclude an important recognition of these early works' contribution to high-quality surgical care. Avoidance of hypothermia through the regular use of active rewarming should be a routine part of safe surgical care...
2014: Advances in Surgery
Donald J Lucas, Timothy M Pawlik
Readmission is a large problem after both medical and surgical admissions. Recent policy changes that include substantial financial penalties have made readmission an important, if not the most important, pay-for-performance program for health care in the United States. The CMS Hospital Readmissions Reduction Program currently applies only to patients with certain medical diagnoses, but it is expanding into orthopedic surgery in 2014, and will likely involve more surgical procedures in the future. Accordingly, hospitals and researchers will increasingly be focused on understanding and preventing readmission...
2014: Advances in Surgery
Prakash A Patel, Lee A Fleisher
The rising use of antiplatelet therapy for primary prevention and secondary prevention of cardiovascular and cerebrovascular events poses a dilemma for physicians in the perioperative period. The proven benefits of aspirin in preventing further thrombotic events in patients with prior ACS or stroke make it difficult to withdraw this therapy. The risk of hypercoagulability associated with surgery is also independent of antiplatelet withdrawal, but adds to the rebound effect of platelet responsiveness. Therefore, aspirin should be continued whenever feasible...
2014: Advances in Surgery
Matteo Ravaioli, Antonio Daniele Pinna, Gianfranco Francioni, Marco Montorsi, Luigi Veneroni, Gian Luca Grazi, Gian Marco Palini, Francesca Gavazzi, Giacomo Stacchini, Cristina Ridolfi, Matteo Serenari, Alessandro Zerbi
OBJECTIVE: To optimize the results of low-volume (LV) centers for hepatopancreaticobiliary (HPB) surgery. BACKGROUND: High-volume (HV) centers for HPB surgery have lower mortality than LV. Strategies for collaboration between HV and LV centers are not well investigated. METHODS: Postoperative outcomes of patients undergoing curative HPB resection were evaluated at an LV hospital before (2006-2008) and during the collaboration (2009-2012) and at 2 hospitals with HV for either liver or pancreatic resection (2009-2012)...
November 2014: Annals of Surgery
Usama Ahmed Ali, Tony Dunne, Brooke Gurland, Jon D Vogel, Ravi P Kiran
BACKGROUND: The aim of this study was to determine factors associated with deviation in length of hospital stay (LOS) from that determined by diagnosis-related groups. METHODS: A cohort study from a prospectively collected database was conducted, including consecutive patients undergoing surgery in a high-volume colorectal surgery department in 2009. RESULTS: For 1,461 included patients, average expected and actual LOS were 8.17 days (interquartile range, 4...
October 2014: American Journal of Surgery
Ajit Pai, Michael G Hurtuk, John J Park, Slawomir J Marecik, Leela M Prasad
No abstract text is available yet for this article.
April 2016: Annals of Surgery
Jonathan Hewitt, Susan J Moug, Maeve Middleton, Mohua Chakrabarti, Micheal J Stechman, Kathryn McCarthy
BACKGROUND: We assessed the prevalence of frailty in an older acute general surgical population and its correlation with length of hospital stay, readmission to hospital, and 30- and 90-day mortality. METHODS: In 3 acute surgical admission units, we assessed consecutive participants aged over 65 years with general surgical conditions. We measured the prevalence of frailty using a 7-point frailty score. We measured length of hospital stay, readmission to hospital, and mortality at both 30 and 90 days...
February 2015: American Journal of Surgery
2014-09-06 20:12:14
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