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Clin Breast Cancer 2019 Jan 31. Epub 2019 Jan 31.

Division of Surgical Oncology, Department of Surgery, University of Massachusetts, Worcester, MA. Electronic address:

Introduction: The objective of the study was to evaluate the morbidity, mortality, and postoperative outcomes associated with simple or subcutaneous mastectomy in the management of prophylactic versus therapeutic resection. In this study we aimed to assess if simple or subcutaneous mastectomy for prophylaxis affects perioperative outcomes compared with resection performed for biopsy proven malignancy.

Materials And Methods: The American College of Surgeons National Surgical Quality Improvement Program database was queried for subjects who underwent simple or subcutaneous mastectomy between 2007 and 2012. Read More

J Neurosurg Spine 2019 Mar 1:1-11. Epub 2019 Mar 1.

Departments of1Neurological Surgery and.

OBJECTIVESpinal deformity causing spinal imbalance is directly correlated to pain and disability. Prior studies suggest adult spinal deformity (ASD) patients with rheumatoid arthritis (RA) have more complex deformities and are at higher risk for complications. In this study the authors compared outcomes of ASD patients with RA following thoracolumbar 3-column osteotomies to outcomes of a matched control cohort. Read More

J Orthop Trauma 2019 Jan 22. Epub 2019 Jan 22.

Department of Orthopaedic Surgery, David Geffen School of Medicine at UCLA, Los Angeles, CA, USA.

Objective: To determine relative complication rates and outcome measures in patients treated under a standardized hip fracture program (SHFP).

Methods: The American College of Surgeons National Surgical Quality Improvement Program was queried to identify patients who underwent operative fixation of femoral neck, intertrochanteric, and subtrochanteric hip fractures in 2016. Cohorts of patients who were and were not treated under a documented SHFP were identified. Read More

Medicine (Baltimore) 2018 Dec;97(50):e13643

Honghui Hospital, Xi'an Jiaotong University, No. 76 Nanguo Road, District Beilin, Xi'an, Shaanxi, China.

Study Design: A retrospective study.

Objective: To investigate the effectiveness and safety of intravenous tranexamic acid for reducing perioperative blood loss in patients with multilevel thoracic spinal stenosis (TSS).

Methods: This is a retrospective observational study of 42 patients with multilevel TSS admitted from December 2016 to October 2017 to the spine department of Honghui Hospital who underwent posterolateral bone graft fusion with posterior laminectomy and decompression fixation. Read More

Arab J Urol 2018 Dec 5;16(4):411-416. Epub 2018 Jul 5.

Department of Urology and Men's Health, Al Garhoud Private Hospital, Dubai, United Arab Emirates.

Objectives: To report our experience with the emerging technique of thulium laser enucleation of the prostate (ThuLEP) for the treatment for prostate hyperplasia.

Patients And Methods: Our inclusion criteria were an International Prostate Symptom Score (IPSS) of >15 and a quality-of-life (QoL) score of >3 in patients with confirmed bladder outflow obstruction, no longer responsive to medical therapy, with a significant post-void residual urine volume (PVR; >100 mL), with or without recurrent urinary tract infection and/or acute urinary retention. Patients with neurogenic bladder, urethral strictures, bladder stones, and previously failed transurethral prostate surgery were excluded. Read More

Orthop Nurs 2018 Nov/Dec;37(6):339-345

Kathleen Wilson, MSN, RN, CNL, SCRN, Clinical Nurse Educator Ortho and Neuro, Robert Wood Johnson University Hospital Somerset, Somerville, NJ. Dawnmarie Devito, BSN, RN, CPAN, Clinical Nurse Educator Perioperative Services, Robert Wood Johnson University Hospital New Brunswick, New Brunswick, NJ. Kathleen Evanovich Zavotsky, PhD, RN, CCRN, CEN, ACNS-BC, FAEN, Assistant Vice President, The Center for Professional Development, Innovation and Research, Robert Wood Johnson University Hospital New Brunswick, New Brunswick, NJ. Mitch Rusay, RPh, Performance Improvement Coordinator, Performance Improvement, Robert Wood Johnson University Hospital New Brunswick, New Brunswick, NJ. Megan Allen, MSN, RN, CCM, CCDS, Performance Improvement Coordinator, Performance Improvement, Robert Wood Johnson University Hospital Somerset, Somerville, NJ. Stephanie Huang, BS, RN, CCRN, Staff Nurse, Cardiothoracic Surgical ICU, Robert Wood Johnson University Hospital New Brunswick, New Brunswick, NJ.

The purpose of this article is to describe in detail how an academic hospital system took on the challenge of deep vein thrombosis (DVT) prevention. A VTE Prevention Task Force was formed in response to an increased incidence of hospital acquired DVTs. The interdisciplinary team reviewed the literature and examined the current state of organizational venous thromboembolism (VTE) prevention to identify gaps in process, determine opportunity and approaches for practice and process improvements, and develop standardized VTE prevention protocols. Read More

Spinal Cord 2019 Jan 29;57(1):58-64. Epub 2018 Oct 29.

Department of Orthopaedic Surgery, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Sapporo, Hokkaido, Japan.

Study Design: A prospective observational study.

Objectives: To determine the incidence of deep venous thrombosis (DVT) and to evaluate the risk factors for DVT development associated with degenerative cervical spine disease.

Setting: Hokkaido Spinal Cord Injury Center, Japan. Read More

Eur J Cardiothorac Surg 2018 Oct 4. Epub 2018 Oct 4.

Department of Thoracic Surgery, Beijing Chao-Yang Hospital, Capital Medical University, Beijing, China.

Objectives: Venous thromboembolism (VTE) is a common postoperative complication. Previous studies have shown that the incidence of VTE after major thoracic surgery ranges from 2.3% to 15%. Read More

PM R 2019 Mar 13;11(3):317-321. Epub 2019 Feb 13.

Department of Physical Medicine and Rehabilitation, Penn State Hershey Medicine Center, Penn State College of Medicine, Hummelstown, PA.

Following spinal cord stimulator (SCS) implantation, postoperative pain is commonly incisional or neuropathic from neurological damage. Occasionally, this new pain may mimic symptoms caused by preexisting pathology. This article presents a case of immediate, severe, postoperative leg pain secondary to a lower extremity deep vein thrombosis (DVT) and subsequent pulmonary embolism after percutaneous SCS implantation for failed back syndrome. Read More

J Surg Oncol 2018 Sep 16;118(3):568-573. Epub 2018 Aug 16.

Division of Endocrine and Oncologic Surgery, Hospital of the University of Pennsylvania, Philadelphia, Pennsylvania.

Background And Objectives: Venous thromboembolism (VTE) remains a major cause of perioperative morbidity and mortality despite implementation of prophylaxis guidelines. We sought to identify risk factors for occult deep venous thrombosis (DVT) following abdominal surgery for cancer and measure the clinical impact of a prospectively implemented standardized postoperative DVT screening protocol.

Methods: Patients undergoing abdominal surgery for malignant indication were screened with early postoperative lower extremity duplex to identify DVT. Read More

Cochrane Database Syst Rev 2018 07 11;7:CD009447. Epub 2018 Jul 11.

Department of Internal Medicine, American University of Beirut Medical Center, Riad El Solh, Beirut, Lebanon, 1107 2020.

Background: The choice of the appropriate perioperative thromboprophylaxis for people with cancer depends on the relative benefits and harms of different anticoagulants.

Objectives: To systematically review the evidence for the relative efficacy and safety of anticoagulants for perioperative thromboprophylaxis in people with cancer.

Search Methods: This update of the systematic review was based on the findings of a comprehensive literature search conducted on 14 June 2018 that included a major electronic search of Cochrane Central Register of Controlled Trials (CENTRAL, 2018, Issue 6), MEDLINE (Ovid), and Embase (Ovid); handsearching of conference proceedings; checking of references of included studies; searching for ongoing studies; and using the 'related citation' feature in PubMed. Read More

PLoS One 2018 21;13(6):e0197868. Epub 2018 Jun 21.

Department of Orthopaedics, Guizhou Provincial People's Hospital, Guiyang, Guizhou, China.

Background: Venous thromboembolism (VTE) is considered a potentially serious complication of knee arthroscopy and leads to conditions such as deep venous thrombosis (DVT) and pulmonary embolism (PE). Low-molecular-weight heparin (LMWH) is widely employed in knee arthroscopy to reduce perioperative thromboembolic complications. However, the efficacy and safety of LMWH in knee arthroscopy remains unclear. Read More

Biomed Eng Online 2018 Jun 15;17(1):78. Epub 2018 Jun 15.

Department of Orthopedic Surgery, Shengjing Hospital of China Medical University, Shenyang, 11000, Liaoning, China.

Objective: To investigate the effect of additional semiautomatic intermittent pneumatic compression device (IPCD) in the prevention of deep vein thrombosis (DVT) of lower extremity in these patients undergoing major orthopedic surgery, when compared with the conventional graduated compression stockings alone.

Methods: The data of 112 patients undergoing major orthopedic surgery were retrospectively analyzed. 51 patients who ever received IPCD and graduated compression stockings during major orthopedic surgery were taken as the experimental group, and 61 patients who only received the conventional graduated compression stockings during surgery were taken as the observation group. Read More

J Clin Orthop Trauma 2018 Apr-Jun;9(2):142-145. Epub 2016 Nov 18.

Division of Information Science and Biostatistics, Niigata University Graduate School of Medical and Dental Sciences, 1 Asahimachi Dori Niigata, Niigata 951-8520, Japan.

Background: Venous thromboembolic events (VTE) are a common complication of total knee arthroplasty (TKA). Prior studies have discussed the utility of mechanical VTE prophylaxis as a monotherapy for low-risk TKA patients. We assess the incidence of clinically significant deep venous thrombosis (DVT) or pulmonary embolism (PE) in low-risk TKA patients who receive mechanical VTE prophylaxis and undergo spinal, epidural, or general anesthesia for their surgery. Read More

Sci Rep 2018 Jun 11;8(1):8847. Epub 2018 Jun 11.

Department of Othopedics, West China Hospital, Sichuan University, 37# Wainan Guoxue Road, Chendu, 610041, People's Republic of China.

Our objective was to evaluate the efficacy and safety of natural hirudin and low molecular weight heparin (LMWH) in the prevention of perioperative deep venous thrombosis (DVT) in elderly patients with intertrochanteric fracture. From June 2014 to June 2017, 96 patients with intertrochanteric fractures were treated with proximal femoral nail antirotation (PFNA) were randomly divided into two groups. For DVT prevention, 45 patients were treated with oral natural hirudin and subcutaneous LMWH-calcium (test group) and 51 patients were treated with subcutaneous LMWH-calcium (control group). Read More

World J Urol 2019 Jan 6;37(1):173-179. Epub 2018 Jun 6.

Norris Comprehensive Cancer Center, USC Institute of Urology, Los Angeles, CA, USA.

Purpose: To validate the relationship between ABO blood type and risk of VTE post-RC in a large retrospective database.

Methods: Patients with urothelial bladder cancer (UBC) who underwent RC (intent-to-cure) for whom ABO blood type was available between 2003 and 2015 were identified from our IRB-approved database. VTE was defined as deep vein thrombosis (DVT) or pulmonary embolism (PE) within 90 days of surgery. Read More

J Thorac Dis 2018 Apr;10(4):2223-2230

Department of Thoracic Surgery, Beijing Chao-Yang Hospital, Capital Medical University, Beijing 100020, China.

Background: The high incidence of venous thromboembolism (VTE) has been perceived in post thoracic surgery patients. However, the significance of perioperative coagulation and fibrinolysis related parameters after lung surgery for VTE predicting is not clear. To investigate that, we conducted a prospective single center study. Read More

J Thorac Dis 2018 Apr;10(Suppl 8):S963-S968

Division of Thoracic Surgery, Department of Surgery, Boston University, Boston, MA, USA.

Venous thromboembolism (VTE), composed of deep vein thrombosis (DVT) and PE is a well-recognized cause for significant perioperative morbidity and mortality. While in orthopedic surgery and general oncology surgery there are well established guidelines regarding VTE prophylaxis, based on carefully conducted high level studies, in thoracic surgery the level of evidence and overall knowledge in the field is still lacking, The European Society of Thoracic Surgeons have established an international working group in 2016, whose task was the define contemporary best practice, coordinate research efforts and eventually define best practice guidelines. This collaboration has matured into a multi-organizational effort, with participation of the American Association for Thoracic Surgery, the International Society on Thrombosis and Haemostasis and Chinese and Japanese thoracic societies. Read More

Chin Med J (Engl) 2018 Mar;131(6):638-642

Research Center of Clinical Epidemiology, Peking University Third Hospital, Beijing 100191, China.

Background: Total knee arthroplasty (TKA) is the most frequently performed procedure in treating advanced knee osteoarthritis. Excessive perioperative blood loss can sometimes lead to postoperative anemia. Tranexamic acid (TXA) is a potent fibrinolysis inhibitor which has been extensively used at the surgical incision and closure to lower overall blood loss in adult reconstruction surgery. Read More

Surg Clin North Am 2018 Apr;98(2):293-319

Division of Vascular and Endovascular Surgery, University of Texas Southwestern Medical Center, Professional Office Building 1, Suite 620, 5959 Harry Hines Boulevard, Dallas, TX 75390-9157, USA. Electronic address:

The vena cava filter (VCF) is intended to prevent the progression of deep venous thrombosis to pulmonary embolism. Recently, the indications for VCF placement have expanded, likely due in part to newer retrievable inferior vena caval filters and minimally invasive techniques. This article reviews the available VCFs, the indications for use, the techniques for placement, and possible outcomes and complications. Read More

Otolaryngol Head Neck Surg 2018 Apr 27;158(4):627-636. Epub 2018 Feb 27.

2 Department of Otolaryngology-Head and Neck Surgery, School of Medicine, University of Michigan, Ann Arbor, Michigan, USA.

Objective The aim of this report is to present a cohesive evidence-based approach to reducing venous thromboembolism (VTE) in otolaryngology-head and neck surgery. VTE prevention includes deep venous thrombosis and pulmonary embolism. Despite national efforts in VTE prevention, guidelines do not exist for otolaryngology-head and neck surgery in the United States. Read More

Spine Deform 2018 Mar - Apr;6(2):141-147. Epub 2017 Oct 20.

The Maryland Spine Center, Mercy Medical Center, 301 St Paul Pl, Baltimore, MD 21202, USA.

Study Design: Retrospective review of a prospectively collected database.

Objective: To assess the incidence of deep vein thrombosis (DVT) associated with single- versus multistage posterior-only complex spinal surgeries.

Summary Of Background Data: Dividing the physiologic burden of spinal deformity surgery into multiple stages has been suggested as a potential means of reducing perioperative complications. Read More

Acta Chir Orthop Traumatol Cech 2017 ;84(5):323-329

Klinik für Unfallchirurgie, Orthopädie und Handchirurgie, Klinikum Wolfsburg, Wolfsburg, Germany.

Patients presenting with proximal femur fractures are at high risk of developing DVT and pulmonary embolism. Many of these patients suffer from additional anticoagulant treatment. Patients on anticoagulation treatment are complex to manage, especially regarding timing of surgery due to implemented quality control recommendations. Read More

Knee 2018 Jan 17;25(1):185-191. Epub 2018 Jan 17.

Sunshine Hospitals, Secunderabad, Telangana 500003, India.

Background: Total Knee Arthroplasty (TKA) can be associated with significant perioperative blood loss and blood transfusions. This is a prospective randomised non-inferiority trial comparing intraarticular (IA) and intravenous (IV) routes of administering Tranexamic acid (TXA) with regard to efficacy and safety.

Methods: A total of 113 patients who underwent primary unilateral TKA from January to June 2017 randomly received either 1. Read More

Sci Rep 2018 01 8;8(1):78. Epub 2018 Jan 8.

Orthopaedics Institute, Tianjin Hospital, Tianjin, 300050, People's Republic of China.

Patients who undergo total hip arthroplasty (THA) may experience a large amount of blood loss. The objective of our study is to include randomized controlled trials (RCTs) and compare the clinical outcomes of fibrin sealant (FS) versus placebo after a THA. In October 2015, we searched the following databases: Medline, Embase, PubMed, the Cochrane Controlled Trials Register, Web of Science, the China National Knowledge Infrastructure, the China Wanfang database and Google Scholar. Read More

Surg Today 2018 May 12;48(5):525-533. Epub 2017 Dec 12.

Division of Surgical Oncology, Department of Surgery, School of Medicine, Tottori University Faculty of Medicine, 36-1 Nishi-cho, Yonago, 683-8504, Japan.

Background And Purpose: Venous thromboembolism (VTE) is a potentially fatal perioperative complication. Understanding the risk factors for deep vein thrombosis (DVT) and initiating appropriate prophylaxis is pivotal for reducing the risk of VTE. The purpose of this study was to clarify the perioperative risk factors for DVT in patients undergoing surgery for gastric cancer. Read More

PLoS One 2017 9;12(11):e0187337. Epub 2017 Nov 9.

Department of Orthopaedic Surgery, Dongtan Sacred Heart Hospital, Hwasung, Republic of Korea.

Background: Elderly patients undergoing hip fracture surgery (HFS) are at increased risk of postoperative venous thromboembolism (VTE). To reduce this risk, combined postoperative mechanical and chemical thromboprophylaxis has been routinely performed after HFS in these patients. This retrospective case-control study was conducted to evaluate the additional effectiveness of preoperative mechanical thromboprophylaxis for the prevention of VTE following HFS in elderly patients. Read More

World Neurosurg 2018 Jan 13;109:e510-e516. Epub 2017 Oct 13.

Department of Neurosurgery, Hopital de Hautepierre, Strasbourg, France.

Background: The incidence of venous thromboembolism (VT) in neurosurgical practice is astonishingly high, representing a major cause of morbidity and mortality. Prophylaxis strategies include elastic stockings, low-molecular-weight heparin (LMWH), and intermittent pneumatic compression (IPC) devices.

Objective: To assess the safety and efficacy of 2 different VT prophylaxis protocols implemented in a European neurosurgical center. Read More

Platelets 2017 Sep 31;28(6):614-620. Epub 2017 Aug 31.

b Department of Pathology and Molecular Medicine, and Department of Medicine , Michael G. DeGroote School of Medicine, McMaster University , Hamilton , Ontario , Canada.

Recently published reports have established a heparin-induced thrombocytopenia (HIT)-mimicking thromboembolic disorder without proximate heparin exposure, called spontaneous HIT syndrome. Although the pathophysiology remains unclear, anti-platelet factor 4 (PF4)/heparin antibodies possibly triggered by exposure to knee cartilage glycosaminoglycans or other non-heparin polyanions found on bacterial surfaces and nucleic acids have been postulated. We present a 53-year-old female receiving antithrombotic prophylaxis with aspirin following right total knee replacement surgery (without perioperative or any previous lifetime heparin exposure) who acutely presented with high-risk pulmonary embolism (PE) and right great saphenous vein thrombophlebitis on postoperative day (POD) 14; her platelet count at presentation was 13 × 10/L. Read More

Neurol India 2017 Jul-Aug;65(4):787-793

Department of Neurosurgery, National Institute of Mental Health and Neurosciences (NIMHANS), Bengaluru, Karnataka, India.

Introduction: The exact incidence of deep vein thrombosis (DVT) in the Indian neurosurgical patient population is uncertain. This situation is quite different from its well-documented incidence in the Caucasian population.This study aims to analyze the incidence, etiopathogenesis, and risk factors in the development of DVT in Indians. Read More

Medicine (Baltimore) 2017 Jun;96(24):e7095

aDepartment of Traumatology, Linyi People's Hospital bDepartment of Surgery; Feixian people's Hospital, Linyi, Shandong, China.

Background: We conducted the present meta-analysis to assess the efficacy and safety of tranexamic acid (TXA) plus diluted-epinephrine (DEP) for patients with total joint arthroplasty (TJA, including total knee arthroplasty (TKA) and total hip arthroplasty (THA)).

Methods: Electronic databases (PubMed, EMBASE, the Cochrane Central Register of Controlled Trials (CENTRAL), Chinese Wanfang databases, and Google databases) were systematically searched up to December 2016. Only randomized controlled trials (RCTs) were included. Read More

J Neurosurg Spine 2017 Jun 31;26(6):744-750. Epub 2017 Mar 31.

Group Health Research Institute, Seattle, Washington.

OBJECTIVE Systematic multidisciplinary approaches to improving quality and safety in complex surgical care have shown promise. Complication rates from complex spine surgery range from 10% to 90% for all surgeries, and the overall mortality rate is 1%-4%. These rates suggest the need for improved perioperative complex spine surgery processes designed to minimize risk and improve quality. Read More

Orthop Clin North Am 2017 Apr 27;48(2):127-135. Epub 2017 Jan 27.

Department of Orthopaedics and Sports Medicine, Detroit Medical Center, University Health Center (UHC), 4201 Saint Antoine Street, 9B, Detroit, MI 48201-2153, USA. Electronic address:

Patients undergoing orthopedic surgery have an increased risk for deep venous thrombosis (DVT) and pulmonary embolism (PE). These complications are considered detrimental, as they cause major postoperative morbidity and mortality and lead to a substantial health care burden. Because of the high incidence and serious nature of these complications, it is essential for orthopedic surgeons to have a comprehensive knowledge of the risk factors, diagnosis, and treatment of acute DVT and PE. Read More

J Vasc Surg Venous Lymphat Disord 2017 03 12;5(2):177-184. Epub 2017 Jan 12.

Department of Surgery, Vascular Surgery Division, St. Luke's Memorial Hospital, Ponce Health Sciences University, Ponce, Puerto Rico.

Objective: Hybrid operative thrombectomy (HOT) is a novel technique for the treatment of acute iliofemoral deep venous thrombosis (IFDVT) and is an alternative to percutaneous techniques (PTs) that use thrombolytics. In this study, we compare perioperative and intermediate outcomes of HOT vs PT as interventions for early thrombus removal.

Methods: From July 2008 to May 2015, there were 71 consecutive patients who were treated with either PT (n = 31) or HOT (n = 40) for acute or subacute single-limb IFDVT. Read More

Orthop Surg 2017 May 17;9(2):174-179. Epub 2017 Jan 17.

Department of Orthopaedic Surgery, Sichuan University, Chengdu, China.

Objective: Although there are still some controversies, large previous studies have confirmed that intravenous (i.v.) tranexamic acid (TXA) can effectively reduce blood loss and transfusions in total hip arthroplasty (THA) without increasing the risk of deep venous thrombosis. Read More

Med Klin Intensivmed Notfmed 2017 Mar 10;112(2):117-124. Epub 2017 Jan 10.

Klinik für Kardiologie, Pneumologie und Angiologie, Universitätsklinikum der Heinrich-Heine-Universität Düsseldorf, Moorenstraße 5, 40225, Düsseldorf, Deutschland.

Non-vitamin K antagonist oral anticoagulants (NOACs) are increasingly used in patients with deep vein thrombosis (DVT), pulmonary embolism (PE) and atrial fibrillation (AF). However, there is insufficient data concerning the periinterventional, perioperative, and intensive care management of patients on NOACs. Therefore, the recommendations regarding this management rely on pharmacokinetics of the particular NOAC in combination with the individual patient's characteristics, bleeding risk of the planned intervention/surgery, and urgency of the procedure. Read More

Gastric Cancer 2017 Sep 16;20(5):878-886. Epub 2016 Dec 16.

Division of Gastric Surgery, Shizuoka Cancer Center, 1007 Shimonagakubo, Nagaizumi-cho, Sunto-gun, Shizuoka, 411-8777, Japan.

Background: The prevalence of deep venous thrombosis (DVT) in patients with gastric cancer before surgery is unknown. This study aimed to clarify the risk factors for DVT of the lower extremities in patients with gastric cancer before surgery and to evaluate the usefulness of ultrasonographic screening for prevention of postoperative pulmonary thromboembolism (PTE).

Methods: Patients who had undergone lower-extremity venous ultrasonography before surgery for gastric cancer were retrospectively analyzed. Read More

Medicine (Baltimore) 2016 Dec;95(50):e5573

aDalian Medical University, Dalian, Liaoning bDepartment of Orthopedics, Clinical Medical College of Yangzhou University, Subei People's Hospital, Yangzhou, Jiangsu, China.

Background: As the prevalence of total hip arthroplasty (THA) is increasing, it is usually associated with considerable blood loss. Tranexamic acid (TXA) has been reported to reduce perioperative blood loss in hip joint arthroplasty. But the best route of TXA administration continues to be controversial. Read More

J Reconstr Microsurg 2017 Mar 28;33(3):173-178. Epub 2016 Nov 28.

Division of Plastic Surgery, University of Pennsylvania Health Systems, Philadelphia, Pennsylvania.

 Despite guideline-compliant prophylaxis, an increased rate of deep venous thrombosis (DVT) formation has been reported following autologous versus implant-based breast reconstruction. We hypothesized that tight abdominal fascia closure might decrease lower extremity venous return and promote venous stasis.  An observational crossover study of patients who underwent autologous breast reconstruction using transverse rectus abdominis musculocutaneous/deep inferior epigastric artery perforator flaps was conducted. Read More

Indian J Surg Oncol 2016 Dec 6;7(4):425-429. Epub 2016 Jun 6.

Department of Radiodiagnosis, Dr BRA Institute Rotary Cancer Hospital, All India Institute of Medical Sciences, New Delhi, 110029 India.

The aim of the study was to determine the incidence of postoperative deep vein thrombosis (DVT) in Indian patients undergoing surgery for thoracic and abdomino-pelvic malignancies. A prospective observational study was conducted in a tertiary care cancer centre in North India. Two hundred and fifty consecutive patients who underwent curative surgery for thoracic and abdomino-pelvic malignancies during the period March 2014 to March 2015 were enrolled in the study. Read More

Medicine (Baltimore) 2016 Nov;95(46):e5419

Department of Surgery, University of Ulsan College of Medicine and Asan Medical Center, Seoul, Korea.

Introduction: Antiphospholipid syndrome (APS), autoantibodies directed against phospholipid-binding proteins are associated with cause vascular thrombosis. Patients with APS requiring renal transplantation are at risk of early graft loss due to arterial or venous thrombosis, or thrombotic microangiopathy (TMA). Here, we report 3 cases of successful renal transplantation in patients with APS. Read More

Ann Surg 2017 06;265(6):1087-1093

Department of Vascular Surgery, West China Hospital, Sichuan University, Chengdu , Sichuan Province, China.

Objective: To compare the relative effects between pharmacological thromboprophylaxis and no anticoagulation.

Background: The efficacy and safety of pharmacological thromboprophylaxis in cancer patients undergoing surgery need to be quantified to guide management.

Methods: We searched multiple electronic databases (up to March 31, 2016) for trials of cancer patients undergoing surgery that assessed the relative benefits and harms of perioperative pharmacological thromboprophylaxis. Read More

Acta Med Okayama 2016 Oct;70(5):401-404

Department of Gastroenterological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama 700-8558,

Although intermittent pneumatic compression (IPC) has become common as perioperative prophylaxis for venous thromboembolism (VTE) consisting of pulmonary thromboembolism (PE) and deep vein thrombosis (DVT), the prophylactic effect against VTE, especially lethal PE, is not yet satisfactory. Therefore, pharmacologic prophylaxis, such as with enoxaparin, is desirable. While the efficacy and safety of enoxaparin have been proven in several clinical trials, concern about bleeding with longterm (at least 7 days) use have potentially decreased its widespread adoption. Read More

J Arthroplasty 2016 11 12;31(11):2548-2553. Epub 2016 Apr 12.

Department of Orthopaedic Surgery, West China Hospital, West China Medical School, Sichuan University, Chengdu, Sichuan Province, China.

Background: Revision total hip arthroplasty (THA) is associated with substantial blood loss and a high probability of blood transfusion in the perioperative period. This study aimed to evaluate the efficacy and safety of combination of intravenous (IV) and topical tranexamic acid (TXA) in revision THA.

Methods: Eighty-four consecutive patients undergoing revision THA were randomized into combined group and IV-TXA group. Read More

Infect Control Hosp Epidemiol 2016 12 19;37(12):1453-1457. Epub 2016 Sep 19.

6Division of Critical Care,Department of Anesthesiology,Mayo Clinic,Rochester,Minnesota,United States.

OBJECTIVE Ventilator-associated events (VAEs) are nosocomial events correlated with length of stay, costs, and mortality. Current ventilator bundle practices target the older definition of ventilator-associated pneumonia and have not been systematically evaluated for their impact on VAEs. DESIGN Retrospective cohort study. Read More

Otolaryngol Head Neck Surg 2017 01 3;156(1):118-121. Epub 2016 Oct 3.

1 Department of Otolaryngology, Massachusetts Eye and Ear Infirmary, Boston, Massachusetts, USA.

Patients with head and neck cancer who undergo reconstructive surgery are at risk for deep venous thrombosis (DVT), but the risk profile for patients undergoing major flap reconstruction is highly variable. Herein, we report our findings from a retrospective analysis of head and neck cancer patients (n = 517) who underwent free (n = 384) or pedicled (n = 133) flap reconstructive operations at a major tertiary care center from 2011 to 2014. DVTs developed perioperatively in 9 (1. Read More

Medicine (Baltimore) 2016 Aug;95(33):e4589

Department of Neurosurgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.

Background: The requirement of postoperative bedridden and immobilization renders neurosurgical patients with higher risk of deep vein thrombosis (DVT), then more vulnerable for pulmonary thromboembolism (PTE). But silent pulmonary thromboembolism (SPTE) can be the very early stage of any typical form of PTE, its diagnosis and management is therefore critical in neurosurgical departments. However, to date, perioperative SPTE has not been attached with enough attention. Read More

Ann Surg 2016 Oct;264(4):632-9

*Divisions of Colorectal Surgery, Cedars Sinai Medical Center, Los Angeles, CA †Department of Surgery, Cedars Sinai Medical Center, Los Angeles, CA ‡Division of Vascular Surgery, Cedars Sinai Medical Center, Los Angeles, CA §Biostatistics and Bioinformatics Research Center, Cedars Sinai Medical Center, Los Angeles, CA.

Objective: To identify the optimal timing of perioperative chemical thromboprophylaxis (CTP) and incidence of occult preoperative deep vein thrombosis (OP-DVT) in patients undergoing major colorectal surgery.

Background: There is limited Level 1 data regarding the optimal timing of CTP in major colorectal surgery and the incidence of OP-DVT remains unclear. Both issues influence the occurrence of venous thromboembolism (VTE) and may impact Medicare reimbursement because of penalties for hospital-acquired conditions. Read More

Global Spine J 2016 Aug 26;6(5):465-71. Epub 2015 Nov 26.

Mayo Clinic, Rochester, Minnesota, United States.

Study Design: Retrospective matched cohort analysis.

Objective: The majority of the literature on venous thromboembolism (VTE) after spine surgery is limited to studies of thoracolumbar surgery. Less is known regarding the incidence of VTE and associated risk factors following cervical spine surgery. Read More

Khirurgiia (Mosk) 2016 (5):59-63

The Kazan State Medical University, The Republican Clinical Hospital, the Republic of Tatarstan Ministry of Health Care, Kazan, Russia.

Aim: To evaluate effectiveness of electroneurostimulation of the shin muscles as a constituent part of the prevention of TEC in the hip joint pathology at the hospital stage of treatment.

Material And Methods: With this purpose, there was conducted the extended comparative analysis of the parameters of the blood coagulation system in 27 patients with pathology of the hip joints and the stated concomitant vascular insufficiency. The comparison group comprised 50 patients with uncomplicated pathology of the hip joint who underwent hip joint replacement surgery. Read More