Latest & greatest articles for surgery

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Top results for surgery

141. Video‐assisted thoracic surgery is an optimal alternative to conventional thoracotomy for reoperations for ipsilateral pulmonary lesions

Video‐assisted thoracic surgery is an optimal alternative to conventional thoracotomy for reoperations for ipsilateral pulmonary lesions 30152592 2018 12 07 1759-7714 9 11 2018 Nov Thoracic cancer Thorac Cancer Video-assisted thoracic surgery is an optimal alternative to conventional thoracotomy for reoperations for ipsilateral pulmonary lesions. 1421-1428 10.1111/1759-7714.12854 Ipsilateral pulmonary reoperation is empirically considered a contraindication of video-assisted thoracic surgery (...) (VATS) because of intrapleural adhesion and the destruction of anatomical structures caused by previous surgery. The purpose of this study was to present our experience of the use of VATS for ipsilateral reoperations. The medical records of patients who underwent VATS reoperation or re-thoracotomy between January 2006 and March 2017 were retrospectively reviewed. Data were compared to assess the feasibility and safety of VATS for ipsilateral reoperations. The study enrolled 64 patients, including 36

Thoracic cancer2018 Full Text: Link to full Text with Trip Pro

142. Six-Month Outcomes after Restrictive or Liberal Transfusion for Cardiac Surgery.

Six-Month Outcomes after Restrictive or Liberal Transfusion for Cardiac Surgery. Background We reported previously that, in patients undergoing cardiac surgery who were at moderate-to-high risk for death, a restrictive transfusion strategy was noninferior to a liberal strategy with respect to the composite outcome of death from any cause, myocardial infarction, stroke, or new-onset renal failure with dialysis by hospital discharge or 28 days after surgery, whichever came first. We now report (...) the clinical outcomes at 6 months after surgery. Methods We randomly assigned 5243 adults undergoing cardiac surgery to a restrictive red-cell transfusion strategy (transfusion if the hemoglobin concentration was <7.5 g per deciliter intraoperatively or postoperatively) or a liberal red-cell transfusion strategy (transfusion if the hemoglobin concentration was <9.5 g per deciliter intraoperatively or postoperatively when the patient was in the intensive care unit [ICU] or was <8.5 g per deciliter

NEJM2018

143. Perioperative local anaesthesia for reducing pain following septal surgery.

Perioperative local anaesthesia for reducing pain following septal surgery. BACKGROUND: Septal surgery is a well-established procedure used to treat nasal obstruction due to deviation of the nasal septum, which is carried out under local or general anaesthesia. Local anaesthesia is used for postoperative pain control, but its effectiveness and safety are unclear. OBJECTIVES: To assess the effectiveness of perioperative local anaesthesia for reducing pain in septal surgery and to evaluate (...) surgery. We included studies comparing local anaesthesia versus no treatment/placebo. We also included studies comparing different types of local anaesthesia to each other (i.e. local injection, the addition of an anaesthetic agent to nasal packing, where used, and sphenopalatine ganglion block). DATA COLLECTION AND ANALYSIS: We used the standard methodological procedures expected by Cochrane. The primary outcome was postoperative pain intensity at 12, 24 and 48 hours measured by visual analogue scale

Cochrane2018

144. Pancreatic surgery

Pancreatic surgery 30221207 2018 11 14 2415-1289 3 2018 Translational gastroenterology and hepatology Transl Gastroenterol Hepatol Pancreatic surgery. 56 10.21037/tgh.2018.08.01 Fingerhut Abe A Department of Surgery, Medical University of Graz, Graz, Austria. Uranues Selman S Department of Surgery, Medical University of Graz, Graz, Austria. eng Journal Article 2018 08 22 China Transl Gastroenterol Hepatol 101683450 2415-1289 Conflicts of Interest: The authors have no conflicts of interest

Translational gastroenterology and hepatology2018 Full Text: Link to full Text with Trip Pro

145. Intravenous versus inhalational maintenance of anaesthesia for postoperative cognitive outcomes in elderly people undergoing non-cardiac surgery.

Intravenous versus inhalational maintenance of anaesthesia for postoperative cognitive outcomes in elderly people undergoing non-cardiac surgery. BACKGROUND: The use of anaesthetics in the elderly surgical population (more than 60 years of age) is increasing. Postoperative delirium, an acute condition characterized by reduced awareness of the environment and a disturbance in attention, typically occurs between 24 and 72 hours after surgery and can affect up to 60% of elderly surgical patients (...) with a target controlled infusion (TCI) allows plasma and effect-site concentrations to be calculated using an algorithm based on age, gender, weight and height of the patient.TIVA is a viable alternative to inhalational maintenance agents for surgical anaesthesia in elderly people. However, in terms of postoperative cognitive outcomes, the optimal technique is unknown. OBJECTIVES: To compare maintenance of general anaesthesia for elderly people undergoing non-cardiac surgery using propofol-based TIVA

Cochrane2018

146. Surgery versus stereotactic radiotherapy for people with single or solitary brain metastasis.

Surgery versus stereotactic radiotherapy for people with single or solitary brain metastasis. BACKGROUND: Brain metastases occur when cancer cells spread from their original site to the brain and are a frequent cause of morbidity and death in people with cancer. They occur in 20% to 40% of people during the course of their disease. Brain metastases are also the most frequent type of brain malignancy. Single and solitary brain metastasis is infrequent and choosing the most appropriate treatment (...) is a clinical challenge. Surgery and stereotactic radiotherapy are two options. For surgery, tumour resection is performed using microsurgical techniques, while in stereotactic radiotherapy, external ionising radiation beams are precisely focused on the brain metastasis. Stereotactic radiotherapy may be given as a single dose, also known as single dose radiosurgery, or in a number of fractions, also known as fractionated stereotactic radiotherapy. There is uncertainty regarding which treatment (surgery

Cochrane2018

147. Surgery for women with pelvic organ prolapse with or without stress urinary incontinence.

Surgery for women with pelvic organ prolapse with or without stress urinary incontinence. BACKGROUND: Pelvic organ prolapse (POP) is common in women and is frequently associated with stress urinary incontinence (SUI). In many cases however, SUI is present only with the prolapse reduced (occult SUI) or may develop after surgical treatment for prolapse (de novo SUI). OBJECTIVES: To determine the impact on postoperative bladder function of surgery for symptomatic pelvic organ prolapse (...) of the evidence ranged from low to moderate. The main limitations were risk of bias (especially blinding of outcome assessors), indirectness and imprecision associated with low event rates and small samples.POP surgery in women with SUIVaginal repair with vs without concomitant mid-urethral sling (MUS)A concomitant MUS probably improves postoperative rates of subjective SUI, as the evaluated clinical effect appears large (risk ratio (RR) 0.30, 95% confidence interval (CI) 0.19 to 0.48; 319 participants, two

Cochrane2018

148. Perioperative interventions in pelvic organ prolapse surgery.

Perioperative interventions in pelvic organ prolapse surgery. BACKGROUND: Pelvic organ prolapse (POP) affects as many as 50% of parous women, with 14% to 19% of women undergoing a surgical correction. Although surgery for the treatment of POP is common, limited supportive data can be found in the literature regarding the preoperative and postoperative interventions related to these procedures. The main goal of perioperative interventions is to reduce the rate of adverse events while improving (...) women's outcomes following surgical intervention for prolapse. A broad spectrum of perioperative interventions are available, and although the benefits of interventions such as prophylactic antibiotics before abdominal surgery are well established, others are unique to women undergoing POP surgeries and as such need to be investigated separately. OBJECTIVES: The aim of this review is to compare the safety and effectiveness of a range of perioperative interventions versus other interventions

Cochrane2018

149. Geospatial mapping of access to timely essential surgery in sub-Saharan Africa

Geospatial mapping of access to timely essential surgery in sub-Saharan Africa 30147944 2018 11 14 2059-7908 3 4 2018 BMJ global health BMJ Glob Health Geospatial mapping of access to timely essential surgery in sub-Saharan Africa. e000875 10.1136/bmjgh-2018-000875 Despite an estimated one-third of the global burden of disease being surgical, only limited estimates of accessibility to surgical treatment in sub-Saharan Africa exist and these remain spatially undefined. Geographical metrics (...) of access to major hospitals were estimated based on travel time. Estimates were then used to assess need for surgery at country level. Major district and regional hospitals were assumed to have capability to perform bellwether procedures. Geographical locations of hospitals in relation to the population in the 47 sub-Saharan countries were combined with spatial ancillary data on roads, elevation, land use or land cover to estimate travel-time metrics of 30 min, 1 hour and 2 hours. Hospital catchment

BMJ global health2018 Full Text: Link to full Text with Trip Pro

150. 3D HD : Adenosine and Basilar Tip Aneurysm Clipping - OZ Pterional Trans-Sylvian. ( Brain Surgery )

3D HD : Adenosine and Basilar Tip Aneurysm Clipping - OZ Pterional Trans-Sylvian. ( Brain Surgery ) 3D HD : Adenosine and Basilar Tip Aneurysm Clipping - OZ Pterional Trans-Sylvian. ( Brain Surgery ) - YouTube Remind me later Review A privacy reminder from YouTube, a Google company Skip navigation Sign in Search Loading... Choose your language. Close You're viewing YouTube in English (UK) . You can . You're viewing YouTube in English (United Kingdom) . You can . Close Yes, keep it Undo Close (...) This video is unavailable. Watch Queue Queue Watch Queue Queue Remove all Disconnect The next video is starting stop Loading... Watch Queue Queue __count__/__total__ 3D HD : Adenosine and Basilar Tip Aneurysm Clipping - OZ Pterional Trans-Sylvian. ( Brain Surgery ) Loading... Unsubscribe from University of Arkansas (UAMS) - Vascular Neurosurgery Program, Adib Abla, MD? Cancel Unsubscribe Working... Subscribe Subscribed Unsubscribe 102 102 Loading... Loading... Working... Add to Want to watch this again

University of Arkansas (UAMS) - Vascular Neurosurgery Program (Videos)2018

151. Prophylactic anterior vitrectomy during cataract surgery in eyes at increased risk for aqueous misdirection

Prophylactic anterior vitrectomy during cataract surgery in eyes at increased risk for aqueous misdirection 30148233 2018 11 14 2451-9936 12 2018 Dec American journal of ophthalmology case reports Am J Ophthalmol Case Rep Prophylactic anterior vitrectomy during cataract surgery in eyes at increased risk for aqueous misdirection. 24-27 10.1016/j.ajoc.2018.08.002 Patients with chronic narrow angle glaucoma (CNAG) are at increased risk of developing aqueous misdirection (AM) following intraocular (...) surgery. We present a retrospective case series on the use of posterior capsulorrhexis with core vitrectomy by an anterior approach (CAV) at the time of cataract extraction with or without glaucoma surgery as a prophylactic measure for the prevention of AM in CNAG. Retrospective case series of six phakic eyes in four patients with CNAG and other risk factors for AM who underwent posterior capsulorrhexis and CAV at the time of cataract surgery with or without glaucoma surgery. The main outcome measures

American journal of ophthalmology case reports2018 Full Text: Link to full Text with Trip Pro

152. Surgery versus thrombolysis for initial management of acute limb ischaemia.

Surgery versus thrombolysis for initial management of acute limb ischaemia. BACKGROUND: Both peripheral arterial thrombolysis and surgery can be used in the management of peripheral arterial ischaemia. Much is known about the indications, risks, and benefits of thrombolysis. However, whether thrombolysis works better than surgery for initial management of acute limb ischaemia remains unknown. This is the second update of the review first published in 2002. OBJECTIVES: To determine whether (...) thrombolysis or surgery is the more effective technique in the initial management of acute limb ischaemia due to thromboembolism. SEARCH METHODS: For this update, the Cochrane Vascular Information Specialist (CIS) searched the Cochrane Vascular Specialised Register, CENTRAL, MEDLINE Ovid, Embase Ovid, CINAHL, AMED, and clinical trials registries up to 7 May 2018. SELECTION CRITERIA: All randomised controlled studies comparing thrombolysis and surgery for initial treatment of acute limb ischaemia. DATA

Cochrane2018

153. Maxillary distraction osteogenesis versus orthognathic surgery for cleft lip and palate patients.

Maxillary distraction osteogenesis versus orthognathic surgery for cleft lip and palate patients. BACKGROUND: Cleft lip and palate is one of the most common birth defects and can cause difficulties with feeding, speech and hearing, as well as psychosocial problems. Treatment of orofacial clefts is prolonged; it typically commences after birth and lasts until the child reaches adulthood or even into adulthood. Residual deformities, functional disturbances, or both, are frequently seen in adults (...) with a repaired cleft. Conventional orthognathic surgery, such as Le Fort I osteotomy, is often performed for the correction of maxillary hypoplasia. An alternative intervention is distraction osteogenesis, which achieves bone lengthening by gradual mechanical distraction. This review is an update of the original version that was published in 2016. OBJECTIVES: To provide evidence regarding the effects and long-term results of maxillary distraction osteogenesis compared to orthognathic surgery

Cochrane2018

154. In vivo nerve identification in head and neck surgery using diffuse reflectance spectroscopy

In vivo nerve identification in head and neck surgery using diffuse reflectance spectroscopy 30410988 2018 11 14 2378-8038 3 5 2018 Oct Laryngoscope investigative otolaryngology Laryngoscope Investig Otolaryngol In vivo nerve identification in head and neck surgery using diffuse reflectance spectroscopy. 349-355 10.1002/lio2.174 Careful identification of nerves during head and neck surgery is essential to prevent nerve damage. Currently, nerves are identified based on anatomy and appearance (...) /0000-0002-5171-712X Department of Surgery The Netherlands Cancer Institute-Antoni van Leeuwenhoek Amsterdam the Netherlands. Kuhlmann Koert F D KFD Department of Surgery The Netherlands Cancer Institute-Antoni van Leeuwenhoek Amsterdam the Netherlands. Schreuder Pim P Department of Head and Neck Oncology and Surgery The Netherlands Cancer Institute-Antoni van Leeuwenhoek Amsterdam the Netherlands. Bydlon Torre T In-Body Systems Department Philips Research Eindhoven the Netherlands. Smeele Ludi E LE

Laryngoscope investigative otolaryngology2018 Full Text: Link to full Text with Trip Pro

155. Pharmaconutrition administration on outcomes of elective oncological surgery for gastrointestinal malignancies: is timing everything?—a review of published meta-analyses until the end of 2016

Pharmaconutrition administration on outcomes of elective oncological surgery for gastrointestinal malignancies: is timing everything?—a review of published meta-analyses until the end of 2016 30225386 2018 11 14 2415-1289 3 2018 Translational gastroenterology and hepatology Transl Gastroenterol Hepatol Pharmaconutrition administration on outcomes of elective oncological surgery for gastrointestinal malignancies: is timing everything?-a review of published meta-analyses until the end of 2016 (...) . 52 10.21037/tgh.2018.07.12 The last 25 years have seen an increasing number of publications attesting the benefits of pharmaconutrition in the management of patients undergoing elective oncological gastrointestinal surgery. A number of randomized controlled trials and meta-analyses suggest the use of pharmaconutrition in this group of patients produces superior outcomes to standard nutritional formulations in terms of postoperative infective complications, anastomotic breakdown and length

Translational gastroenterology and hepatology2018 Full Text: Link to full Text with Trip Pro

156. Disc replacement is better than fusion in people needing surgery for neck disc disease

Disc replacement is better than fusion in people needing surgery for neck disc disease Signal - Disc replacement is better than fusion in people needing surgery for neck disc disease Dissemination Centre Discover Portal NIHR DC Discover Disc replacement is better than fusion in people needing surgery for neck disc disease Published on 14 September 2015 As in the back, discs in the neck can degenerate and cause pain and nerve damage from pressure by the disc, in this case for cervical nerves (...) . In severe cases, where nerves are affected surgery is performed to relieve pain and numbness. This systematic review of trials found that replacing a damaged disc with an artificial substitute in the neck was better than removing the damaged disc and fusing the vertebrae either side. Compared with fusion, disc replacement improved neck function, reduced pain, and led to fewer further operations for up to five years after surgery. These findings are in line with 2010 NICE guidance on cervical disc

NIHR Dissemination Centre2018

157. Microvascular Outcomes in Patients With Diabetes After Bariatric Surgery Versus Usual Care: A Matched Cohort Study.

Microvascular Outcomes in Patients With Diabetes After Bariatric Surgery Versus Usual Care: A Matched Cohort Study. Background: Bariatric surgery improves glycemic control in patients with type 2 diabetes mellitus (T2DM), but less is known about microvascular outcomes. Objective: To investigate the relationship between bariatric surgery and incident microvascular complications of T2DM. Design: Retrospective matched cohort study from 2005 to 2011 with follow-up through September 2015. Setting: 4 (...) integrated health systems in the United States. Participants: Patients aged 19 to 79 years with T2DM who had bariatric surgery (n = 4024) were matched on age, sex, body mass index, hemoglobin A1c level, insulin use, diabetes duration, and intensity of health care use up to 3 nonsurgical participants (n = 11 059). Intervention: Bariatric procedures (76% gastric bypass, 17% sleeve gastrectomy, and 7% adjustable gastric banding) compared with usual care. Measurements: Adjusted Cox regression analysis

Annals of Internal Medicine2018

158. Safety and efficacy of a novel neurosurgical enhanced recovery after surgery protocol for elective craniotomy: a prospective randomized controlled trial

Safety and efficacy of a novel neurosurgical enhanced recovery after surgery protocol for elective craniotomy: a prospective randomized controlled trial 29932379 2018 06 22 1933-0693 2018 Jun 22 Journal of neurosurgery J. Neurosurg. Safety and efficacy of a novel neurosurgical enhanced recovery after surgery protocol for elective craniotomy: a prospective randomized controlled trial. 1-12 10.3171/2018.1.JNS171552 OBJECTIVE Although enhanced recovery after surgery (ERAS) programs have gained (...) in the ERAS group had a shortened duration of pain (1-2 days; 53% vs. 17%, OR 0.64, 95% CI 0.29-1.37, p = 0.0001). The urinary catheter was removed within 6 hours after surgery in 74% patients in the ERAS group (OR 400.1, 95% CI 23.56-6796, p < 0.0001). The time to first oral liquid intake was a median of 8 hours in the ERAS group compared to 11 hours in the control group (p < 0.0001), and solid food intake occurred at a median of 24 hours in the ERAS group compared to 72 hours in the control group (p

EvidenceUpdates2018

159. Preoperative frailty assessment predicts loss of independence after vascular surgery

Preoperative frailty assessment predicts loss of independence after vascular surgery 29773431 2018 05 18 1097-6809 2018 May 14 Journal of vascular surgery J. Vasc. Surg. Preoperative frailty assessment predicts loss of independence after vascular surgery. S0741-5214(18)30822-X 10.1016/j.jvs.2018.02.044 Frailty, a clinical syndrome associated with loss of metabolic reserves, is prevalent among patients who present to vascular surgery clinics for evaluation. The Clinical Frailty Scale (CFS) is a (...) rapid assessment method shown to be highly specific for identifying frail patients. In this study, we sought to evaluate whether the preoperative CFS score could be used to predict loss of independence after major vascular procedures. We identified all patients living independently at home who were prospectively assessed using the CFS before undergoing an elective major vascular surgery procedure (admitted for >24 hours) at an academic medical center between December 2015 and December 2017. Patient

EvidenceUpdates2018

160. Should thoracic paravertebral blocks be used to prevent chronic postsurgical pain after breast cancer surgery? A systematic analysis of evidence in light of IMMPACT recommendations

Should thoracic paravertebral blocks be used to prevent chronic postsurgical pain after breast cancer surgery? A systematic analysis of evidence in light of IMMPACT recommendations 29794879 2018 06 22 1872-6623 2018 May 23 Pain Pain Should thoracic paravertebral blocks be used to prevent chronic postsurgical pain after breast cancer surgery? A systematic analysis of evidence in light of IMMPACT recommendations. 10.1097/j.pain.0000000000001292 The role of thoracic paravertebral block (PVB (...) ) in preventing chronic postsurgical pain (CPSP) after breast cancer surgery (BCS) has gained interest, but existing evidence is conflicting, and its methodological quality is unclear. This meta-analysis evaluates efficacy of PVB, compared with Control group, in preventing CPSP after BCS, in light of the Initiative on Methods, Measurement, and Pain Assessment in Clinical Trials (IMMPACT) recommendations. Electronic databases were searched for randomized trials comparing PVB with Control group for CPSP

EvidenceUpdates2018