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Latest & greatest articles for surgery
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Comparison of Anterior Suprascapular, Supraclavicular, and Interscalene Nerve Block Approaches for Major Outpatient Arthroscopic Shoulder Surgery: A Randomized, Double-blind, Noninferiority Trial 29634491 2018 06 19 1528-1175 129 1 2018 Jul Anesthesiology Anesthesiology Comparison of Anterior Suprascapular, Supraclavicular, and Interscalene Nerve Block Approaches for Major Outpatient Arthroscopic Shoulder Surgery: A Randomized, Double-blind, Noninferiority Trial. 47-57 10.1097/ALN (...) .0000000000002208 The interscalene nerve block provides analgesia for shoulder surgery, but is associated with diaphragm paralysis. One solution may be performing brachial plexus blocks more distally. This noninferiority study evaluated analgesia for blocks at the supraclavicular and anterior suprascapular levels, comparing them individually to the interscalene approach. One hundred-eighty-nine subjects undergoing arthroscopic shoulder surgery were recruited to this double-blind trial and randomized
Multicentre randomized clinical trial of inspiratory muscle training versus usual care before surgery for oesophageal cancer 29603130 2018 03 31 1365-2168 105 5 2018 Apr The British journal of surgery Br J Surg Multicentre randomized clinical trial of inspiratory muscle training versus usual care before surgery for oesophageal cancer. 502-511 10.1002/bjs.10803 Up to 40 per cent of patients undergoing oesophagectomy develop pneumonia. The aim of this study was to assess whether preoperative (...) inspiratory muscle training (IMT) reduces the rate of pneumonia after oesophagectomy. Patients with oesophageal cancer were randomized to a home-based IMT programme before surgery or usual care. IMT included the use of a flow-resistive inspiratory loading device, and patients were instructed to train twice a day at high intensity (more than 60 per cent of maximum inspiratory muscle strength) for 2 weeks or longer until surgery. The primary outcome was postoperative pneumonia; secondary outcomes were
Enhanced Recovery After Surgery Programs for Laparoscopic Abdominal Surgery: A Systematic Review and Meta-analysis 29750324 2018 05 11 1432-2323 2018 May 10 World journal of surgery World J Surg Enhanced Recovery After Surgery Programs for Laparoscopic Abdominal Surgery: A Systematic Review and Meta-analysis. 10.1007/s00268-018-4656-0 Enhanced recovery after surgery (ERAS) protocols or laparoscopic technique has been applied in various surgical procedures. However, the clinical efficacy (...) of combination of the two methods still remains unclear. Thus, our aim was to assess the role of ERAS protocols in laparoscopic abdominal surgery. We performed a systematic literature search in various databases from January 1990 to October 2017. The results were analyzed according to predefined criteria. In the present meta-analysis, the outcomes of 34 comparative studies (15 randomized controlled studies and 19 non-randomized controlled studies) enrolling 3615 patients (1749 in the ERAS group and 1866
Preperitoneal or Subcutaneous Wound Catheters as Alternative for Epidural Analgesia in Abdominal Surgery: A Systematic Review and Meta-analysis 29781846 2018 05 21 1528-1140 2018 May 17 Annals of surgery Ann. Surg. Preperitoneal or Subcutaneous Wound Catheters as Alternative for Epidural Analgesia in Abdominal Surgery: A Systematic Review and Meta-analysis. 10.1097/SLA.0000000000002817 To assess whether the location of wound catheters (ie, preperitoneal vs. subcutaneous) impacts outcomes, when (...) compared with alternatives such as epidural analgesia. Continuous wound infiltration is an alternative for epidural analgesia in abdominal surgery but studies have shown conflicting results. This difference could be explained by different efficacy of preperitoneal versus subcutaneous placement of the infiltrative catheters. A systematic review and meta-analysis was performed according to the Preferred Reporting Items for Systematic Reviews and Meta-analyses guidelines until April 3, 2017. Primary
Supervised Physical Training Improves Weight Loss After Roux-en-Y Gastric Bypass Surgery: A Randomized Controlled Trial 29566463 2018 04 24 1930-739X 26 5 2018 May Obesity (Silver Spring, Md.) Obesity (Silver Spring) Supervised Physical Training Improves Weight Loss After Roux-en-Y Gastric Bypass Surgery: A Randomized Controlled Trial. 828-837 10.1002/oby.22143 Bariatric surgery results in significant weight loss and reduces cardiovascular morbidity. However, a large variation in postsurgery (...) weight loss is seen. Physical activity promotes weight loss in nonsurgically treated subjects with obesity. The aim of this study was to investigate the effects of 6 months of supervised physical training following Roux-en-Y gastric bypass surgery (RYGB) on body weight and cardiovascular risk markers. Sixty participants eligible for RYGB were included. Six months post surgery, the participants were randomly assigned to either twice-weekly supervised physical training sessions in a fitness center (INT
Systematic review and network meta-analysis of resective surgery for mesial temporal lobe epilepsy 29769251 2018 05 17 1468-330X 2018 May 16 Journal of neurology, neurosurgery, and psychiatry J. Neurol. Neurosurg. Psychiatry Systematic review and network meta-analysis of resective surgery for mesial temporal lobe epilepsy. jnnp-2017-317783 10.1136/jnnp-2017-317783 To evaluate the effectiveness of anterior temporal lobectomy (ATL) versus selective amygdalohippocampectomy (SAH) on seizure-free
The impact of hyperoxia on outcomes after cardiac surgery: a systematic review and narrative synthesis 29721817 2018 07 11 1496-8975 65 8 2018 Aug Canadian journal of anaesthesia = Journal canadien d'anesthesie Can J Anaesth The impact of hyperoxia on outcomes after cardiac surgery: a systematic review and narrative synthesis. 923-935 10.1007/s12630-018-1143-x Historically, cardiac surgery patients have often been managed with supraphysiologic intraoperative oxygen levels to protect against (...) the risks of cellular hypoxia inherent in the un-physiologic nature of surgery and cardiopulmonary bypass. This may result in excessive reactive oxygen species generation and exacerbation of ischemia-reperfusion injury. In this review, we synthesize all available data from randomized controlled trials (RCTs) to investigate the impact that hyperoxia has on postoperative organ dysfunction, length of stay, and mortality during adult cardiac surgery. We searched Medline, Embase, Scopus, and Cochrane Central
Bowel Obstruction and Ventral Hernia After Laparoscopic Versus Open Surgery for Rectal Cancer in A Randomized Trial (COLOR II) 29746337 2018 05 10 1528-1140 2018 May 09 Annals of surgery Ann. Surg. Bowel Obstruction and Ventral Hernia After Laparoscopic Versus Open Surgery for Rectal Cancer in A Randomized Trial (COLOR II). 10.1097/SLA.0000000000002790 The aim of this study was to evaluate the risk of bowel obstruction, incisional, and parastomal hernia following laparoscopic versus open (...) surgery for rectal cancer. Laparoscopic surgery for rectal cancer has been adopted worldwide, after trials reported similar oncological outcomes compared with open surgery. Little is known about long-term morbidity, including bowel obstruction, incisional, and parastomal hernia following surgery. Patients included in the international, multicenter, noninferior, open-label, randomized COLOR II trial were followed for five years. Primary endpoint was local recurrence at 3-year follow-up. Secondary
Chemotherapy versus chemoradiotherapy after surgery and preoperative chemotherapy for resectable gastric cancer (CRITICS): an international, open-label, randomised phase 3 trial 29650363 2018 05 04 1474-5488 19 5 2018 May The Lancet. Oncology Lancet Oncol. Chemotherapy versus chemoradiotherapy after surgery and preoperative chemotherapy for resectable gastric cancer (CRITICS): an international, open-label, randomised phase 3 trial. 616-628 S1470-2045(18)30132-3 10.1016/S1470-2045(18)30132-3 (...) chemotherapy (chemotherapy group) or preoperative chemotherapy with postoperative chemoradiotherapy (chemoradiotherapy group). Randomisation was done before patients were given any preoperative chemotherapy treatment and was stratified by histological subtype, tumour localisation, and hospital. Patients and investigators were not masked to treatment allocation. Surgery consisted of a radical resection of the primary tumour and at least a D1+ lymph node dissection. Postoperative treatment started within 4
Effect of Remote Ischemic Preconditioning on Outcomes in Adult Cardiac Surgery: A Systematic Review and Meta-analysis of Randomized Controlled Studies 29210794 2018 06 18 1526-7598 127 1 2018 Jul Anesthesia and analgesia Anesth. Analg. Effect of Remote Ischemic Preconditioning on Outcomes in Adult Cardiac Surgery: A Systematic Review and Meta-analysis of Randomized Controlled Studies. 30-38 10.1213/ANE.0000000000002674 Remote ischemic preconditioning (RIPC) has been demonstrated to prevent (...) organ dysfunction in cardiac surgery patients. However, recent large, prospective, multicenter, randomized controlled trials (RCTs) had controversial results. Thus, a meta-analysis of RCTs was performed to investigate whether RIPC can reduce the incidence of acute myocardial infarction (AMI), acute kidney injury (AKI), and mortality in adult cardiac surgery patients. Study data were collected from Medline, Elsevier, Cochrane Central Register of Controlled Trials and Web of Science databases. RCTs
Meta-analysis evaluating music interventions for anxiety and pain in surgery 29665028 2018 05 14 1365-2168 105 7 2018 Jun The British journal of surgery Br J Surg Meta-analysis evaluating music interventions for anxiety and pain in surgery. 773-783 10.1002/bjs.10853 This study aimed to evaluate anxiety and pain following perioperative music interventions compared with control conditions in adult patients. Eleven electronic databases were searched for full-text publications of RCTs investigating (...) the effect of music interventions on anxiety and pain during invasive surgery published between 1 January 1980 and 20 October 2016. Results and data were double-screened and extracted independently. Random-effects meta-analysis was used to calculate effect sizes as standardized mean differences (MDs). Heterogeneity was investigated in subgroup analyses and metaregression analyses. The review was registered in the PROSPERO database as CRD42016024921. Ninety-two RCTs (7385 patients) were included
Hybrid Surgery to Treat Multiple Visceral Aneurysms Secondary to Polyarteritis Nodosa 29984216 2018 11 14 2288-7970 34 2 2018 Jun Vascular specialist international Vasc Specialist Int Hybrid Surgery to Treat Multiple Visceral Aneurysms Secondary to Polyarteritis Nodosa. 35-38 10.5758/vsi.2018.34.2.35 A 57-year-old woman presented to vascular surgery clinic with visceral artery aneurysms that were incidentally detected during regular check-up. Imaging studies revealed occlusion of the celiac (...) Division of Vascular Surgery, Department of Surgery, Seoul National University Hospital, Seoul, Korea. Cho Sungsin S Division of Vascular Surgery, Department of Surgery, Seoul National University Hospital, Seoul, Korea. Jae Hwan Jun HJ Department of Radiology, Seoul National University Hospital, Seoul, Korea. Min Seung-Kee SK Division of Vascular Surgery, Department of Surgery, Seoul National University Hospital, Seoul, Korea. eng Journal Article 2018 06 30 Korea (South) Vasc Specialist Int 101633116
Assessment of functional capacity before major non-cardiac surgery: an international, prospective cohort study. BACKGROUND: Functional capacity is an important component of risk assessment for major surgery. Doctors' clinical subjective assessment of patients' functional capacity has uncertain accuracy. We did a study to compare preoperative subjective assessment with alternative markers of fitness (cardiopulmonary exercise testing [CPET], scores on the Duke Activity Status Index [DASI (...) ] questionnaire, and serum N-terminal pro-B-type natriuretic peptide [NT pro-BNP] concentrations) for predicting death or complications after major elective non-cardiac surgery. METHODS: We did a multicentre, international, prospective cohort study at 25 hospitals: five in Canada, seven in the UK, ten in Australia, and three in New Zealand. We recruited adults aged at least 40 years who were scheduled for major non-cardiac surgery and deemed to have one or more risk factors for cardiac complications (eg
Chronic rhinosinusitis and endoscopic sinus surgery 30035258 2018 11 14 2589-1081 4 1 2018 Mar World journal of otorhinolaryngology - head and neck surgery World J Otorhinolaryngol Head Neck Surg Chronic rhinosinusitis and endoscopic sinus surgery. 29-32 10.1016/j.wjorl.2018.03.005 Olfactory dysfunction is a major symptom reported by patients with chronic rhinosinusitis (CRS). Surgical treatment of this disease requires close surveillance of such dysfunction because of wide ranging implications (...) for safety, quality of life, and impact on the flavor of foods and beverages. This review highlights key findings regarding the influences of endoscopic sinus surgery (ESS) on olfactory function across the unique presentations of CRS. Such findings provide information useful for informing patients of potential complications and for obtaining informed consent prior to surgical intervention. ESS has been shown to improve olfaction across all types of CRS as assessed through quantitative testing
Surgery for Triple Pathology of Giant Vestibular Schwannoma Associated with Carotid Artery Stenosis and Intracranial Aneurysm: Case Report 29977731 2018 11 14 2193-6358 79 2 2018 Apr Journal of neurological surgery reports J Neurol Surg Rep Surgery for Triple Pathology of Giant Vestibular Schwannoma Associated with Carotid Artery Stenosis and Intracranial Aneurysm: Case Report. e65-e69 10.1055/s-0038-1666806 Here we report the case of a 56-year-old woman who presented with a highly unusual
Ex vivo ovine model for teaching open laryngotracheal surgery 30101225 2018 11 14 2589-1081 4 2 2018 Jun World journal of otorhinolaryngology - head and neck surgery World J Otorhinolaryngol Head Neck Surg Ex vivo ovine model for teaching open laryngotracheal surgery. 140-144 10.1016/j.wjorl.2018.04.002 To develop an animal model for teaching open laryngotracheal surgical procedures. The heads and necks from 5 pre-pubescent sheep were harvested after humane anesthesia. After 2-5 days to allow (...) graft alignment. The sheep head and neck provides an inexpensive, realistic, and safe model for surgical training for a variety of open laryngotracheal procedures. This is particularly relevant given the recent emphasis on surgical simulation and the relative rarity of some of these procedures in residency training. Soliman Ahmed M S AMS Department of Otolaryngology - Head & Neck Surgery, Lewis Katz School of Medicine Temple University, Philadelphia, PA, 19140, USA. Ianacone David C DC Department
Restricting blood transfusion may not be effective after cardiac surgery Signal - Restricting blood transfusion may not be effective after cardiac surgery Dissemination Centre Discover Portal NIHR DC Discover Restricting blood transfusion may not be effective after cardiac surgery Published on 12 March 2015 This large NIHR-funded randomised trial found that using a lower haemoglobin threshold was no better or cheaper than using a higher one when deciding to transfuse blood after non-emergency (...) cardiac surgery. People with milder anaemia, receiving blood transfusion at a haemoglobin level less than 90g/L (the liberal transfusion group) had similar health outcomes and health costs in the three months after surgery, compared with those only given a transfusion when they developed more severe anaemia at a threshold less than 75g/L (the restricted transfusion group). However, more deaths were recorded in the restricted group. Doctors may need to review recommended transfusion practice after
Fibrin sealants for the prevention of postoperative pancreatic fistula following pancreatic surgery. BACKGROUND: Postoperative pancreatic fistula is one of the most frequent and potentially life-threatening complications following pancreatic resections. Fibrin sealants are introduced to reduce postoperative pancreatic fistula by some surgeons. However, the use of fibrin sealants during pancreatic surgery is controversial. This is an update of a Cochrane Review last published in 2016. OBJECTIVES (...) : To assess the safety, effectiveness, and potential adverse effects of fibrin sealants for the prevention of postoperative pancreatic fistula following pancreatic surgery. SEARCH METHODS: We searched trial registers and the following biomedical databases: the Cochrane Library (2018, Issue 4), MEDLINE (1946 to 12 April 2018), Embase (1980 to 12 April 2018), Science Citation Index Expanded (1900 to 12 April 2018), and Chinese Biomedical Literature Database (CBM) (1978 to 12 April 2018). SELECTION CRITERIA