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Guillermito

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21 papers 0 to 25 followers Artículos claves para un cirujano
By Guillermo Supelano General surgeon, cyclist, runner, alpinist. A guy who found happinnes in his everyday activities!
https://www.readbyqxmd.com/read/29167976/temporary-closure-of-colostomy-with-suture-before-colostomy-takedown-improves-the-postoperative-outcomes
#1
Wan-Hsiang Hu, Ko-Chao Lee, Kai-Lung Tsai, Hong-Hwa Chen
PURPOSE: Temporary loop colostomy is a common surgical procedure used to avoid complications in high-risk distal anastomosis as well as pelvic inflammation. Issues regarding postoperative outcomes of colostomy takedown have been widely discussed in the literature, wound infection especially. Temporary closure of colostomy with suture before takedown was adopted in our study, which provided excellent traction to aid mobilization of stomy and avoided stool spillage to downgrade the wound classification to "clean contamination...
November 22, 2017: International Journal of Colorectal Disease
https://www.readbyqxmd.com/read/25769880/can-general-surgeons-evaluate-visceral-slide-with-transabdominal-ultrasound-to-predict-safe-sites-for-primary-laparoscopic-port-placement-a-prospective-study-of-sonographically-na%C3%A3-ve-operators-at-a-tertiary-center
#2
Samuel Minaker, Cailan MacPherson, Allen Hayashi
BACKGROUND: Port placement injuries are a potentially devastating complication of laparoscopic surgery. Ultrasound assessment for visceral slide has the ability to preoperatively determine adhesion-free areas. The utility of this technique has not been studied when performed by surgeons. METHODS: Surgeons without expertise in ultrasound were taught the visceral slide technique. Patients with a history of abdominal surgery were then assessed for adhesion-free areas on the abdominal wall...
May 2015: American Journal of Surgery
https://www.readbyqxmd.com/read/28597282/the-general-surgeon-s-perspective-of-rectus-diastasis-a-systematic-review-of-treatment-options
#3
Elwin H H Mommers, Jeroen E H Ponten, Aminah K Al Omar, Tammo S de Vries Reilingh, Nicole D Bouvy, Simon W Nienhuijs
BACKGROUND: Diastasis of the rectus abdominis muscles (DRAM) is characterised by thinning and widening of the linea alba, combined with laxity of the ventral abdominal musculature. This causes the midline to "bulge" when intra-abdominal pressure is increased. Plastic surgery treatment for DRAM has been thoroughly evaluated, though general surgical treatments and the efficacy of physiotherapy remain elusive. The aim of this systematic literature review is to evaluate both general surgical and physiotherapeutic treatment options for restoring DRAM in terms of postoperative complications, patient satisfaction, and recurrence rates...
June 8, 2017: Surgical Endoscopy
https://www.readbyqxmd.com/read/29099149/closure-methods-for-laparotomy-incisions-for-preventing-incisional-hernias-and-other-wound-complications
#4
REVIEW
Sunil V Patel, David D Paskar, Richard L Nelson, Satyanarayana S Vedula, Scott R Steele
BACKGROUND: Surgeons who perform laparotomy have a number of decisions to make regarding abdominal closure. Material and size of potential suture types varies widely. In addition, surgeons can choose to close the incision in anatomic layers or mass ('en masse'), as well as using either a continuous or interrupted suturing technique, of which there are different styles of each. There is ongoing debate as to which suturing techniques and suture materials are best for achieving definitive wound closure while minimising the risk of short- and long-term complications...
November 3, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/25138620/an-international-consensus-algorithm-for-management-of-chronic-postoperative-inguinal-pain
#5
J F M Lange, R Kaufmann, A R Wijsmuller, J P E N Pierie, R J Ploeg, D C Chen, P K Amid
PURPOSE: Tension-free mesh repair of inguinal hernia has led to uniformly low recurrence rates. Morbidity associated with this operation is mainly related to chronic pain. No consensus guidelines exist for the management of this condition. The goal of this study is to design an expert-based algorithm for diagnostic and therapeutic management of chronic inguinal postoperative pain (CPIP). METHODS: A group of surgeons considered experts on inguinal hernia surgery was solicited to develop the algorithm...
February 2015: Hernia: the Journal of Hernias and Abdominal Wall Surgery
https://www.readbyqxmd.com/read/29166359/incisional-hernia-after-midline-versus-transverse-specimen-extraction-incision-a-randomized-trial-in-patients-undergoing-laparoscopic-colectomy
#6
Lawrence Lee, Juan Mata, Raoul A Droeser, Pepa Kaneva, Sender Liberman, Patrick Charlebois, Barry Stein, Gerald M Fried, Liane S Feldman
OBJECTIVE: To compare the incidence of incisional hernia (IH) between midline and transverse specimen extraction site in patients undergoing laparoscopic colectomy. BACKGROUND: Midline specimen extraction incision is most commonly used in laparoscopic colectomy, but has high IH risk. IH may be lower for transverse incision. METHODS: A single-center superiority trial was conducted. Eligible patients undergoing laparoscopic colectomy were randomly assigned to midline or transverse specimen extraction...
November 21, 2017: Annals of Surgery
https://www.readbyqxmd.com/read/28838972/acute-pancreatitis-recent-advances-through-randomised-trials
#7
REVIEW
Sven M van Dijk, Nora D L Hallensleben, Hjalmar C van Santvoort, Paul Fockens, Harry van Goor, Marco J Bruno, Marc G Besselink
Acute pancreatitis is one of the most common GI conditions requiring acute hospitalisation and has a rising incidence. In recent years, important insights on the management of acute pancreatitis have been obtained through numerous randomised controlled trials. Based on this evidence, the treatment of acute pancreatitis has gradually developed towards a tailored, multidisciplinary effort, with distinctive roles for gastroenterologists, radiologists and surgeons. This review summarises how to diagnose, classify and manage patients with acute pancreatitis, emphasising the evidence obtained through randomised controlled trials...
November 2017: Gut
https://www.readbyqxmd.com/read/29139566/patient-reported-rates-of-chronic-pain-and-recurrence-after-groin-hernia-repair
#8
K-J Lundström, H Holmberg, A Montgomery, P Nordin
BACKGROUND: The effectiveness of different procedures in routine surgical practice for hernia repair with respect to chronic postoperative pain and reoperation rates is not clear. METHODS: This was prospective cohort study based on a unique combination of patient-reported outcomes and national registry data. Virtually all patients with a groin hernia repair in Sweden between September 2012 and April 2015 were sent a questionnaire 1 year after surgery. Persistent pain, defined as at least 'pain present, cannot be ignored, and interferes with concentration on everyday activities' in the past week was the primary outcome...
November 15, 2017: British Journal of Surgery
https://www.readbyqxmd.com/read/29132517/surgical-critical-care-gastrointestinal-complications
#9
REVIEW
Rowan Sheldon, Matthew Eckert
Critical illness and injury affect the gastrointestinal tract almost uniformly. Complications include the sequelae of direct intestinal injury and repair, impaired motility, intra-abdominal hypertension, and ulceration, among others. Contemporary clinical practice has incorporated many advances in the prevention and treatment of gastrointestinal complications during critical illness. This article discusses the epidemiology, risk factors, means of diagnosis, treatment, and prevention of some of these compilations...
December 2017: Surgical Clinics of North America
https://www.readbyqxmd.com/read/29045062/tokyo-guidelines-2018-flowchart-for-the-management-of-acute-cholecystitis
#10
Kohji Okamoto, Kenji Suzuki, Tadahiro Takada, Steven M Strasberg, Horacio J Asbun, Itaru Endo, Yukio Iwashita, Taizo Hibi, Henry A Pitt, Akiko Umezawa, Koji Asai, Ho-Seong Han, Tsann-Long Hwang, Yasuhisa Mori, Yoo-Seok Yoon, Wayne Shih-Wei Huang, Giulio Belli, Christos Dervenis, Masamichi Yokoe, Seiki Kiriyama, Takao Itoi, Palepu Jagannath, O James Garden, Fumihiko Miura, Masafumi Nakamura, Akihiko Horiguchi, Go Wakabayashi, Daniel Cherqui, Eduardo de Santibañes, Satoru Shikata, Yoshinori Noguchi, Tomohiko Ukai, Ryota Higuchi, Keita Wada, Goro Honda, Avinash Nivritti Supe, Masahiro Yoshida, Toshihiko Mayumi, Dirk J Gouma, Daniel J Deziel, Kui-Hin Liau, Miin-Fu Chen, Kazunori Shibao, Keng-Hao Liu, Cheng-Hsi Su, Angus C W Chan, Dong-Sup Yoon, In-Seok Choi, Eduard Jonas, Xiao-Ping Chen, Sheung Tat Fan, Chen-Guo Ker, Mariano Eduardo Giménez, Seigo Kitano, Masafumi Inomata, Koichi Hirata, Kazuo Inui, Yoshinobu Sumiyama, Masakazu Yamamoto
We propose a new flowchart for the treatment of acute cholecystitis (AC) in TG18. Grade III AC was not indicated for straightforward laparoscopic cholecystectomy (Lap-C). Following analysis of subsequent clinical investigations and drawing on Big Data in particular, TG18 proposes that some Grade III AC can be treated by Lap-C when performed at advanced centers with specialized surgeons experienced in this procedure and for patients that satisfy certain strict criteria. For Grade I, TG18 recommends early Lap-C if the patients meet the criteria of Charlson Comorbidity Index (CCI)≤5 and American Society of Anesthesiologist physical status classification (ASA-PS)≤2...
October 16, 2017: Journal of Hepato-biliary-pancreatic Sciences
https://www.readbyqxmd.com/read/29108644/mesh-sutured-repairs-of-contaminated-incisional-hernias
#11
Gregory A Dumanian, Steven T Lanier, Jason M Souza, Mimi Wu Young, Alexei S Mlodinow, Anne-Marie Boller, Kyle H Mueller, Amy L Halverson, Michael F McGee, Jonah J Stulberg
BACKGROUND: We sought to evaluate the results of a new mesh sutured repair technique for closure of contaminated incisional hernias. METHODS: 48 patients with contaminated hernias 5 cm wide or greater by CT scan were closed with mesh sutures. Surgical site occurrence, infections, and hernia recurrence were compared to similar patient series reported in the literature. RESULTS: Of the 48 patients, 20 had clean-contaminated wounds, 16 had contaminated wounds, and 12 were infected...
October 25, 2017: American Journal of Surgery
https://www.readbyqxmd.com/read/29132510/indications-and-methods-of-anticoagulation-reversal
#12
REVIEW
Jeremy L Holzmacher, Babak Sarani
The use of anticoagulation in the prevention of strokes due to atrial fibrillation or the treatment of venous thromboembolic disease has been on the rise. With the advent and proliferation of direct oral anticoagulation medications, the management of anticoagulation reversal has become increasingly complex, especially when urgent or emergent reversal is required. This review details the commonly used parenteral and oral anticoagulants, the treatment strategies necessary for their reversal, and therapies still in development...
December 2017: Surgical Clinics of North America
https://www.readbyqxmd.com/read/28481858/selected-techniques-of-anal-fistula-surgery-from-antiquity-through-the-early-20th-century-illustrated
#13
Adrian E Ortega, Alan Gesek, Megan Linnebur, Kyle G Cologne
This article highlights surgical approaches to the surgical treatment of anal fistula from antiquity to the early 20th century. Primary translations and other authoritative commentaries on the subject are included. Selected surgical techniques have been reconstructed and illustrated in contemporary interpreted images.
June 2017: Diseases of the Colon and Rectum
https://www.readbyqxmd.com/read/29106826/operating-at-night-does-not-increase-the-risk-of-intraoperative-adverse-events
#14
Trine G Eskesen, Thomas Peponis, Noelle Saillant, David R King, Peter J Fagenholz, George C Velmahos, Haytham M A Kaafarani
BACKGROUND: We sought to investigate the association between nighttime (NT) operating and the occurrence of intraoperative adverse events (iAEs). STUDY DESIGN: Our 2007-2012 institutional ACS-NSQIP and administrative databases were screened for iAEs using the ICD-9-CM-based Patient Safety Indicator "accidental puncture or laceration". Procedures were defined as AM (06.00-14.00 h), PM (14.00-22.00 h), or NT (22.00-06.00 h). Univariate and multivariable analyses were performed to investigate the association between PM and NT operating and the occurrence of iAEs...
October 21, 2017: American Journal of Surgery
https://www.readbyqxmd.com/read/28843832/magnetic-compression-anastomosis-magnamosis-first-in-human-trial
#15
Claire E Graves, Catherine Co, Ryan S Hsi, Dillon Kwiat, Jill Imamura-Ching, Michael R Harrison, Marshall L Stoller
BACKGROUND: Magnetic compression anastomosis (magnamosis) uses a pair of self-centering magnetic Harrison Rings to create an intestinal anastomosis without sutures or staples. We report the first-in-human case series using this unique device. STUDY DESIGN: We conducted a prospective, single-center, first-in-human pilot trial to evaluate the feasibility and safety of creating an intestinal anastomosis using the Magnamosis device. Adult patients requiring any intestinal anastomosis to restore bowel continuity were eligible for inclusion...
November 2017: Journal of the American College of Surgeons
https://www.readbyqxmd.com/read/28943323/hartmann-s-procedure-or-primary-anastomosis-for-generalized-peritonitis-due-to-perforated-diverticulitis-a-prospective-multicenter-randomized-trial-diverti
#16
Valerie Bridoux, Jean Marc Regimbeau, Mehdi Ouaissi, Muriel Mathonnet, Francois Mauvais, Estelle Houivet, Lilian Schwarz, Diane Mege, Igor Sielezneff, Charles Sabbagh, Jean-Jacques Tuech
BACKGROUND: About 25% of patients with acute diverticulitis require emergency intervention. Currently, most patients with diverticular peritonitis undergo a Hartmann's procedure. Our objective was to assess whether primary anastomosis (PA) with a diverting stoma results in lower mortality rates than Hartmann's procedure (HP) in patients with diverticular peritonitis. STUDY DESIGN: We conducted a multicenter randomized controlled trial conducted between June 2008 and May 2012: the DIVERTI (Primary vs Secondary Anastomosis for Hinchey Stage III-IV Diverticulitis) trial...
September 22, 2017: Journal of the American College of Surgeons
https://www.readbyqxmd.com/read/29023332/should-t-tube-drainage-be-performed-for-choledocholithiasis-after-laparoscopic-common-bile-duct-exploration-a-systematic-review-and-meta-analysis-of-randomized-controlled-trials
#17
Woods Zhang, Ge Li, Yan-Ling Chen
BACKGROUND: Laparoscopic common bile duct exploration (LCBDE) has been verified to be a comparatively effective treatment approach for uncomplicated choledocholithiasis, and it has been previously proposed that the primary duct closure (PDC) technique, in which the bile duct can directly be sutured in only 1 step compared with the T-tube drainage (TTD), can be deemed a choice after LCBDE; however, the conventional TTD performance is controversial in the minimally invasive surgery era...
October 11, 2017: Surgical Laparoscopy, Endoscopy & Percutaneous Techniques
https://www.readbyqxmd.com/read/28964507/impact-of-body-mass-index-on-open-ventral-hernia-repair-a-retrospective-review
#18
Lily Owei, Robert A Swendiman, Rachel R Kelz, Daniel T Dempsey, Kristoffel R Dumon
BACKGROUND: A large proportion of patients presenting for ventral hernia repair are obese. It remains unclear, however, whether the degree of obesity is an independent risk factor for adverse outcomes after ventral hernia repair. This study aims to characterize the influence of body mass index class on postoperative complications after open ventral hernia repair. METHODS: A retrospective analysis was conducted using data from the database of the American College of Surgeons National Surgical Quality Improvement Program from 2005 to 2015...
September 27, 2017: Surgery
https://www.readbyqxmd.com/read/28943064/endostapler-versus-hem-o-lok-clip-to-secure-the-appendiceal-stump-and-mesoappendix-during-laparoscopic-appendectomy
#19
Mohammed H Al-Temimi, Mendy A Berglin, Edwin G Kim, Deron J Tessier, Samir D Johna
BACKGROUND: Our study evaluates the safety and cost of using the Hem-O-Lok (HOL) clip in laparoscopic appendectomy (LA). METHOD: We prospectively compared 30-day postoperative outcomes and cost between HOL clip and endoscopic stapler (ES) in LA at a single institution. RESULTS: HOL clip was used in 45 out of 92 LA. Perforated appendicitis (29.8% vs. 11.1%, P = 0.027) and postoperative complications were more common in the ES group (19.2% vs...
September 18, 2017: American Journal of Surgery
https://www.readbyqxmd.com/read/25172046/is-nighttime-the-right-time-risk-of-complications-after-laparoscopic-cholecystectomy-at-night
#20
Uma R Phatak, Winston M Chan, Debbie F Lew, Richard J Escamilla, Tien C Ko, Curtis J Wray, Lillian S Kao
BACKGROUND: Laparoscopic cholecystectomies can be performed at night in high-volume acute care hospitals. We hypothesized that nonelective nighttime laparoscopic cholecystectomies are associated with increased postoperative complications. STUDY DESIGN: We conducted a single-center retrospective review of consecutive laparoscopic cholecystectomy patients between October 2010 and May 2011 at a safety-net hospital in Houston, Texas. Data were collected on demographics, operative time, time of incision, length of stay, 30-day postoperative complications (ie, bile leak/biloma, common bile duct injury, retained stone, superficial surgical site infection, organ space abscess, and bleeding) and death...
October 2014: Journal of the American College of Surgeons
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