Latest & greatest articles for surgery

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Top results for surgery

21. Dexamethasone before bowel surgery reduces postoperative nausea and vomiting

Dexamethasone before bowel surgery reduces postoperative nausea and vomiting Signal - Dexamethasone before bowel surgery reduces postoperative nausea and vomiting Dissemination Centre Discover Portal NIHR DC Discover Dexamethasone before bowel surgery reduces postoperative nausea and vomiting Published on 8 August 2017 A single dose of dexamethasone given at the time of anaesthesia for bowel surgery reduced vomiting in the next 24 hours, with no increase in complications. Thirteen people need (...) to be treated to prevent one extra episode of vomiting. Dexamethasone (a steroid) is one of several drugs recommended for patients at moderate and high risk of postoperative nausea and vomiting. It isn’t widely used in bowel surgery. In this large UK-based trial, treating eight people also prevented one person requesting additional anti-sickness drugs. There was no increase in adverse events, and patients given dexamethasone returned to eating quicker. Postoperative nausea and vomiting can delay recovery

NIHR Dissemination Centre2018

22. Using mesh does not improve results in vaginal prolapse surgery

Using mesh does not improve results in vaginal prolapse surgery Signal - Using mesh does not improve results in vaginal prolapse surgery Dissemination Centre Discover Portal NIHR DC Discover Using mesh does not improve results in vaginal prolapse surgery Published on 15 August 2017 Using a synthetic mesh or biological tissue graft is no better than standard surgical repair, without the use of these materials, in women with vaginal wall prolapse. Some women had problems from the mesh. This large (...) pragmatic study looked at over 3000 women with vaginal prolapse. Half of these were randomised; the rest contributed data but were not part of the main evaluation. The study separately compared mesh and biological grafts to a repair without these additions. It also took account of whether it was women’s first or subsequent repair operation. There was no difference in prolapse symptoms or quality of life at two years in women who had surgery that used mesh or biological graft and those who had standard

NIHR Dissemination Centre2018

23. Laminar airflow in surgery might not reduce surgical site infections

Laminar airflow in surgery might not reduce surgical site infections Signal - Laminar airflow in surgery might not reduce surgical site infections Dissemination Centre Discover Portal NIHR DC Discover Laminar airflow in surgery might not reduce surgical site infections Published on 11 July 2017 The type of theatre ventilation system used during hip and knee replacement, abdominal or vascular surgery has no effect on the rate of surgical site infections. Prevention of surgical site infection (...) is a complex area with many potential targets for action. So decisions relating to commissioning or decommissioning these systems will need to consider the totality of the evidence alongside the costs. This systematic review included 12 observational studies comparing wound infection rates following surgery performed in theatres using laminar airflow or conventional ventilation. Laminar ventilation distributes air in parallel layers, forming a “curtain” which has been thought to limit contamination

NIHR Dissemination Centre2018

24. Men feel physically and psychologically ill-prepared for prostate cancer surgery

Men feel physically and psychologically ill-prepared for prostate cancer surgery Signal - Men feel physically and psychologically ill-prepared for prostate cancer surgery Dissemination Centre Discover Portal NIHR DC Discover Men feel physically and psychologically ill-prepared for prostate cancer surgery Published on 28 November 2017 Following prostate cancer surgery men often experience physical changes, such as urinary incontinence and erectile dysfunction, causing negative emotions (...) and distress. This review found that men felt poorly prepared – psychologically and physically – for the changes they might experience after surgery. Surgery was often described as "life-changing", and men described worrying about their future. NICE recommend that men and their partners/carers are fully informed about prostate cancer treatment options and their possible complications, and are supported in decision-making. This includes having access to psychosexual support at any time. This global review

NIHR Dissemination Centre2018

25. Weight loss surgery is value for money in selected people with severe obesity

Weight loss surgery is value for money in selected people with severe obesity Signal - Weight loss surgery is value for money in selected people with severe obesity Dissemination Centre Discover Portal NIHR DC Discover Weight loss surgery is value for money in selected people with severe obesity Published on 23 August 2016 Surgery is a cost-effective method of weight loss for severely and morbidly obese people. This study of general practice data compared health costs and outcomes for people (...) with severe or morbid obesity who underwent surgery and those who did not. Surgery was associated with a reduced chance of developing diabetes and an increased chance of remission in people with diabetes. It was more cost-effective – using NHS thresholds – for morbidly obese people who had diabetes, than for those without diabetes. Weight loss surgery either reduces the amount of food people can consume or the amount of energy they can absorb from food. A quarter of UK adults are obese, with 3.6% of women

NIHR Dissemination Centre2018

26. One-stage, instead of two-stage, surgery may be almost as safe for infected knee replacements

One-stage, instead of two-stage, surgery may be almost as safe for infected knee replacements Signal - One-stage, instead of two-stage, surgery may be almost as safe for infected knee replacements Dissemination Centre Discover Portal NIHR DC Discover One-stage, instead of two-stage, surgery may be almost as safe for infected knee replacements Published on 30 August 2016 A one-stage knee replacement procedure to treat an infected prosthetic knee may offer similar outcomes for most people (...) as the more commonly used two-stage procedure. Re-infection was seen in 7.6% of people after one-stage revision surgery, compared to 8.8% after a two-stage procedure. Other outcomes, such as range of motion, were also similar. This review of observational studies described different techniques and approaches and because of the way this information was gathered there are some uncertainties as to whether these are now used or if other factors were important too. An infection is one of the most serious

NIHR Dissemination Centre2018

27. Epidural anaesthesia helps return of bowel function after abdominal surgery

Epidural anaesthesia helps return of bowel function after abdominal surgery Signal - Epidural anaesthesia helps return of bowel function after abdominal surgery Dissemination Centre Discover Portal NIHR DC Discover Epidural anaesthesia helps return of bowel function after abdominal surgery Published on 27 September 2016 High quality evidence suggests that an epidural anaesthetic (with or without an opioid) promotes the return of gut function after abdominal surgery. This is when compared (...) to an opioid based regimen, given either through an epidural or into the bloodstream. Epidural anaesthetic also gave a clinically meaningful reduction in pain. Evidence for other outcomes, including reduction in vomiting, was less reliable. Poor gut function and pain in the period following abdominal surgery are common. Opioid pain-relief also carries additional risks. Improving these factors could theoretically have benefits in terms of reducing hospital stays and costs. Ultimately, decisions to use

NIHR Dissemination Centre2018

28. Surgery to remove the thymus gland improves weakness for people with myasthenia gravis

Surgery to remove the thymus gland improves weakness for people with myasthenia gravis Signal - Surgery to remove the thymus gland improves weakness for people with myasthenia gravis Dissemination Centre Discover Portal NIHR DC Discover Surgery to remove the thymus gland improves weakness for people with myasthenia gravis Published on 3 October 2016 Having a thymectomy (surgery to remove the thymus gland) improves various measures of weakness and reduces the need for other treatment in people (...) with myasthenia gravis. When combined with standard steroid treatment, surgery gives a meaningful, but small, improvement compared with steroids alone. Importantly it also reduced the requirement for steroids or immune suppressing drugs and their side effects. Myasthenia gravis is a rare condition where the body’s own immune system attacks the nerves carrying signals to the muscles. This causes the muscles to become tired and weak. The thymus gland in the chest is part of the immune system. Although

NIHR Dissemination Centre2018

29. Uncertainty over the use of stents after telescopic surgery for kidney stones

Uncertainty over the use of stents after telescopic surgery for kidney stones Signal - Uncertainty over the use of stents after telescopic surgery for kidney stones Dissemination Centre Discover Portal NIHR DC Discover Uncertainty over the use of stents after telescopic surgery for kidney stones Published on 8 November 2016 Inserting a stent, a narrow tube, after ureteroscopic surgery for removal of kidney stones reduces unplanned hospital readmissions but causes more pain upon urination (...) . This review compared outcomes for patients having ureteroscopic surgery for stones who had a stent placed in the ureter (the tube connecting the kidney with the bladder) with patients who had the stent left out. There was significant variability in the results of the individual studies, and it is possible that clinical judgment was influencing the decision of whether or not to place a stent. The review shows there is a balance between the pros and cons of using a stent, and therefore a need for clinical

NIHR Dissemination Centre2018

30. Aortic valve implantation without open surgery has short term benefits

Aortic valve implantation without open surgery has short term benefits Signal - Aortic valve implantation without open surgery has short term benefits Dissemination Centre Discover Portal NIHR DC Discover Aortic valve implantation without open surgery has short term benefits Published on 22 November 2016 For people with severe symptomatic aortic stenosis, implanting an aortic valve by guiding it into place through the blood vessels rather than by open heart surgery improves survival at two (...) years. This review pooled data from four major trials of different catheter-based devices in people who were eligible for either treatment. It found the less invasive approach improved survival compared to open heart surgery at two years, when the results for all surgical risk categories were combined. The less invasive approach is already an option for people who are at high surgical risk or cannot have open heart surgery because of the risk. The less invasive technique caused fewer initial

NIHR Dissemination Centre2018

31. A statin drug during admission for heart surgery did not prevent an irregular heart beat

A statin drug during admission for heart surgery did not prevent an irregular heart beat Signal - A statin drug during admission for heart surgery did not prevent an irregular heart beat Dissemination Centre Discover Portal NIHR DC Discover A statin drug during admission for heart surgery did not prevent an irregular heart beat Published on 14 July 2016 The statin, rosuvastatin, taken by adults before and after heart surgery, did not prevent atrial fibrillation or heart muscle injury compared (...) to placebo. Acute kidney injury was more common for adults who received rosuvastatin. Atrial fibrillation (AF) is a type of irregular heart rhythm which is relatively common after heart surgery. A previous review of published research suggested that atrial fibrillation might be half as common with perioperative atorvastatin therapy, but the evidence was not reliable. This large trial included 1,922 adults from a hospital in Hong Kong mostly awaiting coronary-artery bypass graft. Rosuvastatin 20mg daily

NIHR Dissemination Centre2018

32. Early oral feeding after stomach surgery is safe and reduces time spent in hospital

Early oral feeding after stomach surgery is safe and reduces time spent in hospital Signal - Early oral feeding after stomach surgery is safe and reduces time spent in hospital Dissemination Centre Discover Portal NIHR DC Discover Early oral feeding after stomach surgery is safe and reduces time spent in hospital Published on 24 March 2016 After upper gastrointestinal surgery, returning a patient to oral feeding on the day of the surgery, or the day after, is as safe as waiting for a few days (...) . It also reduces the time the patient spends in hospital by about two days, potentially saving money. This systematic review and meta-analysis found no difference in adverse outcomes – such as leakage at the surgical site, need for re-insertion of a feeding tube, reoperations, readmissions or mortality – when adults were fed early compared with later after upper gastrointestinal surgery. Future research is needed on patient satisfaction and to see if patients undergoing surgery at different sites

NIHR Dissemination Centre2018

33. No clear difference between open and keyhole surgery for the repair of ruptured abdominal aortic aneurysms

No clear difference between open and keyhole surgery for the repair of ruptured abdominal aortic aneurysms Signal - No clear difference between open and keyhole surgery for the repair of ruptured abdominal aortic aneurysms Dissemination Centre Discover Portal NIHR DC Discover No clear difference between open and keyhole surgery for the repair of ruptured abdominal aortic aneurysms Published on 3 May 2016 Open and keyhole surgery for repairing a ruptured abdominal aortic aneurysm show similar (...) rates of death at three months, though keyhole surgery leads to slightly shorter hospital stays. Women were found to benefit slightly more from the keyhole technique than men, according to this review and meta-analysis. An abdominal aortic aneurysm is a swelling of the aorta – the body’s main artery. Large aneurysms are rare but if they burst there is catastrophic bleeding. The traditional treatment for abdominal aortic aneurysm is open repair: keyhole repair (also known as endovascular repair

NIHR Dissemination Centre2018

34. Physiotherapy education before major abdominal surgery reduces lung complications

Physiotherapy education before major abdominal surgery reduces lung complications Physiotherapy education before major abdominal surgery reduces lung complications Dissemination Centre Discover Portal NIHR DC Discover Physiotherapy education before major abdominal surgery reduces lung complications Published on 3 April 2018 A physiotherapy session before planned abdominal surgery, explaining the importance of breathing exercises and sitting out of bed as soon after surgery as possible, halves (...) the risk of pneumonia. This trial compared the physiotherapy session with usual care which was provided to all 432 participants. This consisted of a leaflet given in the pre-operative outpatient clinic outlining the exercises, and physiotherapy input in the days after surgery. Just seven people would need to receive the additional 30-minute pre-operative physiotherapy session to prevent one lung complication. The study was carried out in Australia and New Zealand, where usual care may differ from

NIHR Dissemination Centre2018

35. Alternative sedative reduces the risk of acute kidney injury following cardiac surgery

Alternative sedative reduces the risk of acute kidney injury following cardiac surgery Alternative sedative reduces the risk of acute kidney injury following cardiac surgery Dissemination Centre Discover Portal NIHR DC Discover Alternative sedative reduces the risk of acute kidney injury following cardiac surgery Published on 10 July 2018 doi: The sedative drug dexmedetomidine can reduce the risk of acute kidney injury when given during non-emergency cardiac surgery. Trial participants who (...) received dexmedetomidine were a third less likely to develop acute kidney injury than those receiving placebo or other treatments. There was no difference in mortality or length of hospital stay. This systematic review identified 10 studies of 1,575 participants. Surgical procedures included coronary artery bypass grafting with or without valve surgery and aortic vascular surgery. Dexmedetomidine was given before or shortly after surgery. Most participants were followed up for the duration

NIHR Dissemination Centre2018

36. Enhanced recovery programmes after stomach cancer surgery reduce hospital stay without increasing complications

Enhanced recovery programmes after stomach cancer surgery reduce hospital stay without increasing complications Stomach cancer surgery and enhanced recovery programmes (ERAS) Dissemination Centre Discover Portal NIHR DC Discover Enhanced recovery programmes after stomach cancer surgery reduce hospital stay without increasing complications Published on 18 July 2018 doi: Enhanced recovery programmes reduce length of hospital stay and associated healthcare costs after stomach cancer surgery (...) , with no impact on short-term mortality or post-operative complications. They also improved post-operative quality of life. The enhanced recovery approach includes a range of components designed to help people to recover more quickly and have better outcomes after surgery. These include optimising people's health preoperatively, attention to detail during anaesthesia and surgery, early return to feeding and encouraging people onto their feet as soon as possible afterwards. Enhanced recovery is already

NIHR Dissemination Centre2018

37. Gallbladder surgery through a single-incision is more risky than a multiple incision technique

Gallbladder surgery through a single-incision is more risky than a multiple incision technique Gallbladder surgery through a single-incision is more risky than a multiple incision technique Dissemination Centre Discover Portal NIHR DC Discover Gallbladder surgery through a single-incision is more risky than a multiple incision technique Published on 17 July 2018 doi: Single-incision keyhole gallbladder removal surgery carries increased risk of adverse events, such as puncturing the gallbladder (...) appropriate option. Share your views on the research. Why was this study needed? About 10 to 15% of adults are thought to have gallstones, but not everyone has symptoms. The gallbladder may be removed if gallstones are painful or cause complications. Most operations to remove the gallbladder are carried out by keyhole surgery. Access via multiple incisions is standard practice, although single incision access is an option. Adverse events include complications such as puncturing the gallbladder, excessive

NIHR Dissemination Centre2018

38. Music can reduce pain and anxiety following surgery

Music can reduce pain and anxiety following surgery Music can reduce anxiety and pain following surgery Dissemination Centre Discover Portal NIHR DC Discover Music can reduce pain and anxiety following surgery Published on 7 August 2018 doi: Recorded music played before, during or after surgery in adults reduces self-reported post-operative pain and anxiety, compared with usual care. The average effect is equivalent to a reduction in anxiety of 21 percentage points and a 10 percentage point (...) reduction in pain within a few days of surgery. It is thought that placebo and distraction effects probably play a role, but in this review music still improved pain when used for patients under a general anaesthetic. Nearly two-thirds of patients experience severe pain after surgery. Anxiety can amplify perceptions of pain and lead to slower recovery. This systematic review included over 90 small-scale trials with a small effect, and it was not possible to blind conscious patients to which intervention

NIHR Dissemination Centre2018

39. Fewer wound hernias occur if mesh is used to reinforce abdominal aortic aneurysm surgery

Fewer wound hernias occur if mesh is used to reinforce abdominal aortic aneurysm surgery Fewer wound hernias occur if mesh is used to reinforce abdominal aortic aneurysm surgery Dissemination Centre Discover Portal NIHR DC Discover Fewer wound hernias occur if mesh is used to reinforce abdominal aortic aneurysm surgery Published on 18 September 2018 doi: Mesh reinforcement may result in patients developing fewer hernias at the incision site after aortic aneurysm surgery. This type of hernia (...) is a common complication of midline (vertical) incisions and can cause pain and restrict everyday activities. Although using mesh was linked with fewer incisional hernias, this systematic review could not determine with any certainty whether this led to fewer later operations on the hernia. Reoperation carries extra risk, especially in people who have had an aortic aneurysm. Therefore, the presence of hernias may not necessarily lead to more surgery. While preventing hernias is beneficial, mesh may only

NIHR Dissemination Centre2018

40. Keyhole surgery is more effective than physiotherapy for hip impingement

Keyhole surgery is more effective than physiotherapy for hip impingement Keyhole surgery is more effective than physiotherapy for hip impingement Dissemination Centre Discover Portal NIHR DC Discover Keyhole surgery is more effective than physiotherapy for hip impingement Published on 2 October 2018 doi: Keyhole surgery to reshape the joint surfaces in people with hip impingement improves hip-related quality of life more than physiotherapy. In hip impingement, there is a painful restriction (...) of the smooth movement of the ball of the femur inside the cup (acetabulum) of the pelvis. It mainly affects younger, active people. Observational studies have supported the use of keyhole surgery (arthroscopy), but there was a lack of high-quality evidence. This NIHR-funded study is the first trial to compare arthroscopy with optimal conservative care. Both arthroscopy and physiotherapy led to improvements on a 100-point hip score by 12 months. However, arthroscopy caused an additional 6.8 points

NIHR Dissemination Centre2018