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181. Early catheter removal after pelvic floor reconstructive surgery: a randomized trial. Full Text available with Trip Pro

Early catheter removal after pelvic floor reconstructive surgery: a randomized trial. Studies have yet to examine the impact of day-of-surgery voiding trials on post-operative urinary retention in women undergoing obliterative and apical suspension procedures for pelvic organ prolapse. Our objective was to evaluate if time to spontaneous void after these procedures is shorter when a voiding trial is performed on the day of surgery compared with our standard practice of post-operative day 1.We (...) conducted a randomized, parallel-arm trial in patients undergoing major pelvic floor reconstructive surgery. Women were randomized 1:1 to an early (4 h post-operatively on the day of surgery) or a standard (6 am on post-operative day 1) retrograde voiding trial.A total of 57 women consented. Mean age and BMI were 65 ± 11 and 27.9 ± 4.4. Most women had stage III pelvic organ prolapse (77.2%). Groups had similar baseline characteristics. In the intention-to-treat analysis (n = 57), there was no difference

2019 International urogynecology journal Controlled trial quality: uncertain

182. Pre-operative guided imagery in female pelvic medicine and reconstructive surgery: a randomized trial. (Abstract)

Pre-operative guided imagery in female pelvic medicine and reconstructive surgery: a randomized trial. The purpose was to determine if pre-operative guided imagery (GIM) would help women to feel more prepared, less anxious, and have higher satisfaction scores 6 weeks after surgery compared with routine care.Eligible women planning to undergo pelvic floor surgery were enrolled and randomized. The GIM group received an institution-specific CD that uses GIM to detail day of surgery (DOS) events (...) and expectations. Participants were asked to listen to the CD once daily during the week before surgery. At three time points (surgical consent visit, DOS, and 6-weeks post-operatively), we measured anxiety using the State and Trait Anxiety Inventory for Adults (STADI), in addition to preparedness for surgery and overall satisfaction (ten-point Likert scales). Data were analyzed in SPSS 23 using two-tailed t tests.A total of 38 out of 44 (86%) enrolled participants completed the study (GIM: 18, control: 20

2019 International urogynecology journal Controlled trial quality: uncertain

183. Use of an iPadâ„¢ application in preoperative counseling for pelvic reconstructive surgery: a randomized trial. (Abstract)

Use of an iPadâ„¢ application in preoperative counseling for pelvic reconstructive surgery: a randomized trial. The goal of this study was to evaluate whether the addition of an iPad™ application to the informed consent process for pelvic organ prolapse (POP) surgery improves patient understanding and retention of information compared with standard verbal counseling (SVC) alone.Patients scheduled for POP surgery were randomized to SVC alone or SVC augmented with an iPad™ application. Prior (...) to counseling, immediately following counseling, and 6 weeks after surgery, patients completed a written quiz testing their understanding of POP and surgical repair (worst score 0; best score 20). Primary outcome was score change from pre- to immediately postcounseling. Secondary outcomes were patient satisfaction and score change from postcounseling to 6 weeks after surgery. Twenty-six patients per group were needed to detect a 2.8-point difference in score change between groups (80% power; α = 0.05).Sixty

2019 International urogynecology journal Controlled trial quality: uncertain

184. A randomised controlled feasibility trial to evaluate local heat preconditioning on wound healing after reconstructive breast surgery: the preHEAT trial. Full Text available with Trip Pro

A randomised controlled feasibility trial to evaluate local heat preconditioning on wound healing after reconstructive breast surgery: the preHEAT trial. preHEAT was a randomised controlled feasibility trial to determine how best to measure skin necrosis in breast reconstruction to inform the design of a larger multicentre trial.Mastectomy skin flap necrosis (MSFN) is a serious complication resulting in prolonged wound healing. Local heat preconditioning of the MSF before surgery has been shown (...) to reduce skin necrosis in immediate breast reconstruction patients (IBR).preHEAT was a single-centre, randomised control two-arm single-blind parallel arm feasibility trial of local heat preconditioning in breast cancer patients undergoing SSM and NSM at Guy's and St Thomas' Hospital, London, UK. All patients undergoing IBR above the age of 18 were included. Intervention patients heated breast skin to 43 °C in three, 30-min cycles interrupted by spontaneous cooling using hot water bottles. The primary

2019 Pilot and feasibility studies Controlled trial quality: uncertain

185. Successful Use of the Recanalized Remnant Umbilical Vein as a Patch Graft for Venous Reconstruction in Abdominal Surgery. (Abstract)

Successful Use of the Recanalized Remnant Umbilical Vein as a Patch Graft for Venous Reconstruction in Abdominal Surgery. Various approaches have been described for the reconstruction of the portal vein (PV), superior mesenteric vein (SMV), and the inferior vena cava (IVC). We present the use of the recanalized remnant umbilical vein in various settings including transplantation, major liver resection, and pancreatic surgery. We retrospectively analyzed four cases, in which a recanalized (...) remnant umbilical vein was used for vascular reconstruction. The graft harvesting, size of the graft, technique of application, and short-term results of vascular patency were studied. A recanalized umbilical vein was successfully harvested from the ligamentum teres hepatis in all patients with 5 cm (median, range 3-7 cm) in length and 1.3 cm (median, range 1.0-1.8 cm) in width. The preparation of the vein was technically feasible and took no more than 5 min in each patient. All grafts were used

2019 Journal of Gastrointestinal Surgery

186. Young age and high BMI are predictors of early revision surgery after primary anterior cruciate ligament reconstruction: a cohort study from the Swedish and Norwegian knee ligament registries based on 30,747 patients. Full Text available with Trip Pro

Young age and high BMI are predictors of early revision surgery after primary anterior cruciate ligament reconstruction: a cohort study from the Swedish and Norwegian knee ligament registries based on 30,747 patients. To analyse patient-related risk factors for 2-year ACL revision after primary reconstruction. The hypothesis was that younger athletes would have a higher incidence of an early ACL revision.This prospective cohort study was based on data from the Norwegian and Swedish National (...) Knee Ligament Registries and included patients who underwent primary ACL reconstruction from 2004 to 2014. The primary end-point was the 2-year incidence of ACL revision. The impact of activity at the time of injury, patient sex, age, height, weight, BMI, and tobacco usage on the incidence of early ACL revision were described by relative risks (RR) with 95% confidence intervals (CI).A total of 58,692 patients were evaluated for eligibility and 30,591 patients were included in the study. The mean

2019 Knee Surgery, Sports Traumatology, Arthroscopy

187. Canal reconstruction mastoidectomy: Outcomes comparison following primary versus secondary surgery. (Abstract)

Canal reconstruction mastoidectomy: Outcomes comparison following primary versus secondary surgery. Compare surgical and audiometric outcomes following canal wall reconstruction (CWR) tympanomastoidectomy used as a primary versus secondary approach for treating cholesteatoma.Retrospective.Patients treated for primary/secondary cholesteatoma from 2006 to 2017 via CWR were included if they had preoperative/postoperative audiograms, detailed operative note(s), and >12 months' follow-up. Patients (...) into the SG. The groups did not significantly differ in age, sex, or smoking status. Overall, median follow-up was 35 months. SG patients had higher rates of cholesteatoma detected at staged surgery than did PG patients (P = .04). However, these patients exhibited lower rates of open revision surgery (4% vs.13%) and a significant improvement in air-bone gap (P = .004). Three PG patients (7%) required conversion to CWD versus zero SG patients. Secondary outcomes were similar. Patients who underwent delayed

2019 Laryngoscope

188. Reconstructive limb-salvage surgery after lower extremity soft tissue sarcoma resection: A 20-year experience. (Abstract)

Reconstructive limb-salvage surgery after lower extremity soft tissue sarcoma resection: A 20-year experience. Reconstructive surgery is often required following lower extremity soft tissue sarcoma resection. The relationship between the method of plastic surgery reconstruction and postoperative wound healing or functional oncologic outcomes in this patient population is poorly understood.We performed a retrospective review on all adult patients that underwent soft tissue reconstruction (...) survival, local recurrence, or metastatic disease between the different reconstructive methods.In our cohort, the utilization of different reconstructive techniques did not correlate with a difference in postoperative wound complications or oncologic outcomes. Local flaps can effectively reconstruct the majority of lower extremity sarcoma defects that cannot be closed primarily. However, alternative reconstructive techniques may be utilized when indicated without a significant increase in postoperative

2019 Journal of Surgical Oncology

189. Length of Time Between Anterior Cruciate Ligament Reconstruction and Return to Sport Does Not Predict Need for Revision Surgery in National Football League Players. Full Text available with Trip Pro

Length of Time Between Anterior Cruciate Ligament Reconstruction and Return to Sport Does Not Predict Need for Revision Surgery in National Football League Players. To determine whether the length of time between primary anterior cruciate ligament reconstruction (ACLR) and return to sport (RTS) predicted the need for revision ACLR in National Football League (NFL) athletes.All NFL players who underwent ACLR from 2009 to 2015 were identified. The date of index ACLR and date of return to NFL (...) regular-season game play after surgery were recorded. The length of time between ACLR and RTS was compared between players who required revision ACLR and those who did not. Correlation coefficients were used to assess whether players who RTS sooner sustained recurrent anterior cruciate ligament injury at an earlier date.A total of 130 NFL players (average age, 25.3 ± 3.2 years) who underwent ACLR and returned to sport were identified. The average time to RTS after ACLR was 49.7 weeks after surgery

2019 Arthroscopy

190. Anteromedial Portal Drilling Yielded Better Survivorship of Anterior Cruciate Ligament Reconstructions When Comparing Recent Versus Early Surgeries With This Technique. Full Text available with Trip Pro

Anteromedial Portal Drilling Yielded Better Survivorship of Anterior Cruciate Ligament Reconstructions When Comparing Recent Versus Early Surgeries With This Technique. To compare anteromedial (AM) and transtibial (TT) femoral drilling hole techniques in primary anterior cruciate ligament reconstruction, using the Danish Knee Ligament Reconstruction Register, comparing revision rates and clinical outcomes from 2 time periods, 2007 to 2010 and 2012 to 2015.A total of 8,386 primary anterior (...) cruciate ligament reconstructions were registered between January 2007 to December 2010 and 8,818 in the period January 2012 to December 2015. Revision ACL was the primary endpoint. Secondary endpoints were the objective and subjective clinical outcomes. Crude and adjusted relative risks (RRs) with 95% confidence interval (CIs) were calculated.The adjusted RR for revision surgery in the AM (2007-10) group compared with the TT (2007-10) group was 1.45 (95% CI, 1.17-1.78; P < .05), but when comparing

2019 Arthroscopy

191. Association Between Red Blood Cell Distribution Width and Outcomes of Open Airway Reconstruction Surgery in Adults. Full Text available with Trip Pro

Association Between Red Blood Cell Distribution Width and Outcomes of Open Airway Reconstruction Surgery in Adults. Airway reconstruction for adults with laryngotracheal stenosis (LTS) is directed toward improving airway caliber to mitigate the patient's dyspnea and achieve prosthesis-free breathing (ie, without tracheostomy, intraluminal stent, or T-tube). Despite the importance of preoperative risk stratification to minimize postoperative complications, consensus on an objective predictive (...) algorithm for open airway reconstruction is lacking.To determine whether the ability to achieve a prosthesis-free airway in adults after open airway reconstruction is associated with red blood cell distribution width (RDW) at the time of surgery.Case series study investigating 92 consecutive patients 18 years and older with laryngotracheal stenosis who underwent open airway reconstruction at a US tertiary care hospital from January 1, 2006, to January 1, 2017.The main outcome was a prosthesis-free

2019 JAMA otolaryngology-- head & neck surgery

192. Autologous Intestinal Reconstructive Surgery in the Management of Total Intestinal Aganglionosis. (Abstract)

Autologous Intestinal Reconstructive Surgery in the Management of Total Intestinal Aganglionosis. Total/Near Total intestinal aganglionosis (TIA/NTIA) is the most uncommon and life-threatening form of Hirschsprung disease (HD). The management of TIA/NTIA is challenging and the role of autologous intestinal reconstructive (AIR) surgery is controversial. The objective is to evaluate the effectiveness of AIR in patients with TIA/NTIA.Records from children affected by total intestinal aganglionosis (...) transposition of aganglionic ileum with or without myotomy, 2 simple tapering, 1 longitudinal lengthening and tailoring procedure with associated myotomy). AIR significantly reduced median stoma output, from 197 to 31 ml/kg/day (p = 0.0001). The reduction was seen in all patients. In addition, AIR improved enteral tolerance in the long-term in five of eight patients (63%), and temporarily in one, leading to a reduction of PN requirement from 100% to 70% (p = 0.0231).AIR surgery in carefully selected

2019 Journal of Pediatric Gastroenterology and Nutrition

193. Utility of Indocyanine Green Angiography to Identify Clinical Factors Associated With Perfusion of Paramedian Forehead Flaps During Nasal Reconstruction Surgery. Full Text available with Trip Pro

Utility of Indocyanine Green Angiography to Identify Clinical Factors Associated With Perfusion of Paramedian Forehead Flaps During Nasal Reconstruction Surgery. Identifying factors affecting forehead flap neovascularization during nasal reconstruction surgical procedures using quantitative dynamics of fluorescence from indocyanine green angiography may be associated with reduced vascular complications.To identify quantifiable forehead flap perfusion measures using indocyanine green angiography (...) during nasal reconstruction procedures and to evaluate clinical factors associated with neovascularization.Retrospective cohort study of 71 patients at a tertiary referral center of Stanford University, Stanford, California, between January 1, 2010, and March 31, 2018, undergoing forehead flap nasal reconstruction surgery with flap perfusion assessed by indocyanine green angiography.Indocyanine green angiography was performed intraoperatively to record forehead flap neovascularization during

2019 JAMA facial plastic surgery

194. Predictors of perioperative complications in paediatric cranial vault reconstruction surgery: a multicentre observational study from the Pediatric Craniofacial Collaborative Group. Full Text available with Trip Pro

Predictors of perioperative complications in paediatric cranial vault reconstruction surgery: a multicentre observational study from the Pediatric Craniofacial Collaborative Group. The current incidence of major complications in paediatric craniofacial surgery in North America has not been accurately defined. In this report, the Pediatric Craniofacial Collaborative Group evaluates the incidence and determines the independent predictors of major perioperative complications using a multicentre (...) database.The Pediatric Craniofacial Surgery Perioperative Registry was queried for subjects undergoing complex cranial vault reconstruction surgery over a 5-year period. Major perioperative complications were identified through a structured a priori consensus process. Logistic regression was applied to identify predictors of a major perioperative complication with bootstrapping to evaluate discrimination accuracy and provide internal validity of the multivariable model.A total of 1814 patients from 33

2019 British Journal of Anaesthesia

195. Decreasing postoperative narcotics in reconstructive pelvic surgery: a randomized controlled trial (Abstract)

Decreasing postoperative narcotics in reconstructive pelvic surgery: a randomized controlled trial Postoperative pain control is crucial to any successful recovery plan. Many currently used medication regimens are narcotic-focused.The objective of our study was to evaluate the efficacy of a multimodal pain regimen after pelvic reconstructive surgery.The primary outcome measure was narcotic use. Secondary outcomes included pain, nausea, and constipation. Patients were randomized to either usual (...) in pelvic reconstructive surgery was found to decrease postoperative opioid requirements, while providing equivalent pain control.Copyright © 2017 Elsevier Inc. All rights reserved.

2017 EvidenceUpdates

196. The Incidence of Subsequent Meniscal Surgery Is Higher in the Anterior Cruciate Ligament-Reconstructed Knee Than in the Contralateral Knee (Abstract)

The Incidence of Subsequent Meniscal Surgery Is Higher in the Anterior Cruciate Ligament-Reconstructed Knee Than in the Contralateral Knee A goal of anterior cruciate ligament (ACL) reconstruction is to provide a meniscal protective effect for the knee.(1) To evaluate whether there was a different likelihood of subsequent meniscal surgery in the ACL-reconstructed knee or in the normal contralateral knee and (2) to compare the risk factors associated with subsequent meniscal surgery in the ACL (...) -reconstructed knee and contralateral knee.Cohort study; Level of evidence, 3.Using an integrated health care system's ACL reconstruction registry, patients undergoing primary ACL reconstruction, with no meniscal injury at the time of index surgery and a normal contralateral knee, were evaluated. Subsequent meniscal tears associated with ACL graft revision were excluded. Subsequent meniscal surgery in either knee was the outcome of interest. Sex, age, and graft type were assessed as potential risk factors

2017 EvidenceUpdates

197. Activity Restriction Recommendations and Outcomes After Reconstructive Pelvic Surgery: A Randomized Controlled Trial (Abstract)

Activity Restriction Recommendations and Outcomes After Reconstructive Pelvic Surgery: A Randomized Controlled Trial To assess the relationship between prescribed postoperative activity recommendations (liberal compared with restricted) after reconstructive prolapse surgery and patient satisfaction and pelvic floor symptoms.In our multicenter, randomized, double-blind clinical trial, women undergoing reconstructive prolapse surgery were randomized to liberal compared with restricted (...) postoperative activity recommendations. Liberal recommendations instructed women to resume postoperative activity at the woman's own pace with no restrictions on lifting or high-impact activities. Conversely, restricted recommendations instructed women to avoid heavy lifting or strenuous exercise for 3 months. The primary outcome, patient satisfaction, was assessed on a 5-point Likert scale at 3 months postoperatively with the question, "How satisfied are you with the result of your prolapse surgery

2017 EvidenceUpdates

198. Comparison of intra-articular analgesics in arthroscopic anterior cruciate ligament reconstruction surgeries: A randomized controlled trial. Full Text available with Trip Pro

Comparison of intra-articular analgesics in arthroscopic anterior cruciate ligament reconstruction surgeries: A randomized controlled trial. Arthroscopic anterior cruciate ligament reconstruction (ACLR) is one of the most common knee surgeries done worldwide today. It involves immense pain at sites of graft harvest, tibial, and femoral tunnels, thereby delaying recovery and increased patient morbidity, and delayed rehabilitation. Various drugs and combination of drugs administered intra

2019 Journal of anaesthesiology, clinical pharmacology Controlled trial quality: uncertain

199. Evolution of the surgical sealing patch TachoSil<sup>®</sup> in Peyronie's disease reconstructive surgery: technique and contemporary literature review. (Abstract)

Evolution of the surgical sealing patch TachoSil® in Peyronie's disease reconstructive surgery: technique and contemporary literature review. The aim of this study is to review the current literature that reports outcomes of Peyronie's disease (PD) reconstructive surgery using the collagen fleece TachoSil® (Baxter, CA, USA), a novel graft that has self-adhesive properties and gained popularity in recent years.A literature review was performed through PubMed between 2013 and 2018 (...) regarding the use of TachoSil® in PD penile reconstructive surgery. Keywords used for the search were: Peyronie's disease, surgical therapy, surgical outcomes, grafting techniques, graft materials, collagen fleece, surgical patch, and TachoSil.Grafting procedures are indicated for men with PD and preserved erectile function. TachoSil® is a novel graft used for defect closure after tunical incision or partial plaque excision. Long-term results of this technique are encouraging and reliable. One major

2019 World journal of urology

200. Outcomes of the use of different vulvar flaps for reconstruction during surgery for vulvar cancer. (Abstract)

Outcomes of the use of different vulvar flaps for reconstruction during surgery for vulvar cancer. Vulvar carcinoma is a rare cancer, accounting for 3-5% of all gynecological cancers. Surgery is the standard treatment for patients with early stage vulvar cancer and vulvar reconstruction can be performed for these patients. The present study aimed to compare three different flap and to analyze the outcomes of vulvar surgery.We performed a single-center retrospective study between October 2001 (...) and December 2015. We compare patients who underwent radical surgery for vulvar cancer combined with three different vulvar flap reconstructions (GTF, gluteal thigh flap; RF, rhomboid flap; VYF, V-Y flap). We collected data on the operating time, length of hospital stay, reoperation rate, and postoperative complications.We reviewed 179 patients who underwent radical vulvar surgery and 61 (34%) of these underwent additional reconstruction. There were no significant differences in clinical characteristics

2019 European Journal of Surgical Oncology

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