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    Management of endometriosis CNGOF/HAS clinical practice guidelines short version.
    J Gynecol Obstet Hum Reprod 2018 Jun 16. Epub 2018 Jun 16.
    Service de Gynécologie-Obstétrique et Reproduction Humaine, CHU Estaing, 1 place Lucie Aubrac, 63003 Clermont-Ferrand, France.
    First-line diagnostic investigations for endometriosis are physical examination and pelvic ultrasound. The second-line investigations are: targeted pelvic examination performed by an expert clinician, transvaginal ultrasound performed by an expert physician sonographer (radiologist or gynaecologist), and pelvic MRI. Management of endometriosis is recommended when the disease has a functional impact. Read More

    Surgical Treatment of Diplopia in Graves Orbitopathy Patients.
    Ophthalmic Plast Reconstr Surg 2018 Jun 13. Epub 2018 Jun 13.
    Department of Ophthalmology, Orbital Center, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands.
    Purpose: To review the authors' current understanding of motility dysfunction in patients with thyroid eye disease and to summarize appropriate evaluation and available management options.

    Methods: Data were retrieved from a systematic search of the literature.

    Results: Diplopia is one of the most disabling symptoms for Graves orbitopathy patients. Read More

    Flexible bronchoscopy in pulmonary diseases in children with congenital cardiovascular abnormalities.
    Exp Ther Med 2018 Jun 2;15(6):5481-5486. Epub 2018 May 2.
    Department of Pediatrics, West China Second University Hospital, Sichuan University, Chengdu, Sichuan 610041, P.R. China.
    There is a lack of data describing the role of flexible bronchoscopy (FB) in evaluating pulmonary diseases in children with congenital cardiovascular abnormalities in China. Determining whether those children suffer from respiratory complications may be useful for future preoperative planning and family counseling. The present study aimed to investigate the features and FB-associated findings with respect to pulmonary diseases in children with congenital cardiovascular abnormalities. Read More

    Granular cell tumor of the breast: Molecular pathology and clinical management.
    Breast J 2018 Jun 13. Epub 2018 Jun 13.
    Division of Breast Surgery, European Institute of Oncology, Milano, Italy.
    Granular cell tumor is a rare condition that occasionally affects breast parenchyma: approximately, 5%-15% of all granular cell tumors represent 1:1000 of breast tumors. In this study, we reported a consecutive series of 12 patients with primary granular cell tumor of the breast observed at our institute, focusing attention on preoperative management, surgical approach, and long-term follow-up. Eight cases (8/12; 66. Read More

    Twin penile skin flap, is it the answer for repair of long anterior urethral strictures?
    Arab J Urol 2018 Jun 28;16(2):224-231. Epub 2018 Mar 28.
    Department of Urology, Ain Shams University, Cairo, Egypt.
    Objective: To present our twin ventral penile skin flap technique for the management of complex long anterior urethral strictures not caused by lichen sclerosis (LS), with evaluation of surgical outcome and complications.

    Patients And Methods: We retrospectively reviewed patients diagnosed with long complex anterior urethral strictures who were all referred to Ain Shams University hospital and operated on by three reconstructive surgeons. The surgical procedure was carried out as follows: exposure of the urethra through a ventral longitudinal penile skin incision and another perineal incision; two ventral longitudinal dartos-based penile skin flaps are used for urethral augmentation as onlay flaps. Read More

    Reporting and evaluating wait times for urgent hip fracture surgery in Ontario, Canada.
    CMAJ 2018 Jun;190(23):E702-E709
    Department of Surgery (Pincus, Wasserstein, Ravi, Byrne, Nathens, Kreder, Jenkinson), University of Toronto; Institute for Clinical Evaluative Sciences (Pincus, Ravi, Paterson, Nathens, Kreder, Wodchis); Institute of Health Policy, Management and Evaluation (Pincus, Byrne, Huang, Paterson, Nathens, Kreder, Jenkinson, Wodchis), University of Toronto; Department of Surgery (Wasserstein, Ravi, Byrne, Nathens, Kreder, Jenkinson), Sunnybrook Health Sciences Centre; Toronto Rehabilitation Institute-University Health Network (Wodchis), Toronto, Ont.
    Background: Although a delay of 24 hours for hip fracture repair is associated with medical complications and costs, it is unknown how long patients wait for surgery for hip fracture. We describe novel methods for measuring exact urgent and emergent surgical wait times (in hours) and the factors that influence them.

    Methods: Adults aged 45 years and older who underwent surgery for hip fracture (the most common urgently performed procedure) in Ontario, Canada, between 2009 and 2014 were eligible. Read More

    Gastric cancer: French intergroup clinical practice guidelines for diagnosis, treatments and follow-up (SNFGE, FFCD, GERCOR, UNICANCER, SFCD, SFED, SFRO).
    Dig Liver Dis 2018 Jun 6. Epub 2018 Jun 6.
    Department of Hepato-gastroenterology and Digestive Oncology, CHU Rouen, Rouen, France.
    Introduction: This document is a summary of the French Intergroup guidelines regarding the management of gastric cancer published in October 2016, available on the website of the French Society of Gastroenterology (SNFGE) (, updated in October 2017. Read More

    CT Lymphangiography (CTL) in Primary Intestinal Lymphangiectasia (PIL): A Comparative Study with Intraoperative Enteroscopy (IOE).
    Acad Radiol 2018 Jun 6. Epub 2018 Jun 6.
    Department of Radiology, Beijing Shijitan Hospital, Capital Medical University, No. 10 Tieyi St, Haidian District, Beijing 100038, China. Electronic address:
    Rationale And Objectives: To investigate the clinical feasibility of CT lymphangiography (CTL) in primary intestinal lymphangiectasia (PIL) by comparison with intraoperative enteroscopy (IOE) during exploratory laparotomy.

    Materials And Methods: Eleven PIL patients (F/M, two/nine, age range 10-37 years) were recruited in this study, and they were performed IOE during exploratory laparotomy for suspected serious lymphatic-intestinal leakages. All the patients were performed CTL before surgery, and the imaging data were reviewed by two radiologists separately. Read More

    Clinical application of Lin's biopsy grasper for intrauterine targeted biopsy and polypectomy during office hysteroscopy.
    Taiwan J Obstet Gynecol 2018 Jun;57(3):379-382
    Department of Obstetrics and Gynecology, Kawasaki Municipal Hospital, Kawasaki, Japan.
    Objective: Hysteroscopy has widely been used for diagnosis of the uterine cavity; however, target biopsy has often been difficult in part to the inherent limitations of ancillary instruments. Lin's biopsy grasper was specifically designed to work in conjunction with a flexible hysteroscope to obtain intrauterine biopsy under transabdominal sonography. Herein, we share our clinical experience in the management of endometrial abnormalities with the use of Lin's biopsy grasper during office-based hysteroscopy. Read More

    Etiology, Evaluation, and Treatment of Failed Back Surgery Syndrome.
    Asian Spine J 2018 Jun 4;12(3):574-585. Epub 2018 Jun 4.
    Department of Orthopedic Surgery, Hôtel Dieu de France Hospital, Saint Joseph University, Beirut, Lebanon.
    The study aimed to review the etiology of failed back surgery syndrome (FBSS) and to propose a treatment algorithm based on a systematic review of the current literature and individual experience. FBSS is a term that groups the conditions with recurring low back pain after spine surgery with or without a radicular component. Since the information on FBSS incidence is limited, data needs to be retrieved from old studies. Read More

    Session 1: The evolution and development of the multidisciplinary team approach: USA, European and UK experiences - what can we do better?
    Colorectal Dis 2018 May;20 Suppl 1:17-27
    Royal Marsden NHS Foundation Trust, London, UK.
    The process of determining the best treatments that should be offered to patients with newly diagnosed colon and rectal cancer remains highly variable around the world. The aim of this expert review was to agree the key elements of good quality preoperative treatment decision making. Read More

    Association of Plane of Total Mesorectal Excision With Prognosis of Rectal Cancer: Secondary Analysis of the CAO/ARO/AIO-04 Phase 3 Randomized Clinical Trial.
    JAMA Surg 2018 Jun 6:e181607. Epub 2018 Jun 6.
    Department of General and Visceral Surgery, University of Erlangen, Erlangen, Germany.
    Importance: Previous retrospective studies have shown that surgical quality affects local control in rectal cancer..

    Objective: In this secondary end point analysis, we evaluated the prognostic effect of the total mesorectal excision (TME) plane in the CAO/ARO/AIO-04 phase 3 randomized clinical trial. Read More

    Short-term evaluation of the adjustable bulbourethral male sling for post-prostatectomy urinary incontinence.
    Low Urin Tract Symptoms 2018 Jun 4. Epub 2018 Jun 4.
    Division of Urology, Department of Surgery, Jewish General Hospital, McGill University, Montreal, Canada.
    Objective: The Argus perineal sling is a minimally invasive surgical option to treat post-prostatectomy stress urinary incontinence (PPSUI). This study retrospectively evaluated the short-term clinical outcomes with the Argus sling for PPSUI management and determined the effects of potential preoperative parameters on intraoperative retrograde leak point pressure (RLPP).

    Methods: In this retrospective review of 16 men with various degrees of stress incontinence after prostatic surgery who underwent Argus sling, PPSUI was evaluated by pad usage, urodynamics, 24-hour pad weight, and validated questionnaires. Read More

    Perioperative and Modifiable Risk Factors for Periprosthetic Joint Infections (PJI) and Recommended Guidelines.
    Curr Rev Musculoskelet Med 2018 Jun 4. Epub 2018 Jun 4.
    Department of Orthopaedic Surgery, Carolinas Medical Center, 1000 Blythe Blvd, Charlotte, NC, 28203, USA.
    Purpose Of Review: Periprosthetic joint infection (PJI) remains a complication that is associated with high morbidity as well as high healthcare expenses. The purpose of this review is to examine patient and perioperative modifiable risk factors that can be altered to help improve rates of PJI.

    Recent Findings: Evidence-based review of literature shows that improved control of post-operative glycemia, appropriate management of obesity, malnutrition, metabolic syndrome, preoperative anemia, and smoking cessation can help minimize risk of PJI. Read More

    Residents' Learning Curve for Manual Small-Incision Cataract Surgery at Aravind Eye Hospital, India.
    Ophthalmology 2018 May 31. Epub 2018 May 31.
    Chairman, Aravind Eye Hospital, Madurai, India. Electronic address:
    Purpose: The goal of this study was to document the resident learning curve for manual small-incision cataract surgery (MSICS) and to identify implications for the design of ophthalmology residency programs aimed to train surgeons for developing countries.

    Design: Hospital-based retrospective cohort study.

    Participants: All 38 residents entering 2 postgraduate residency programs at Aravind Eye Hospital, Madurai, in 2012 and 2013. Read More

    A behavioral rating system predicts weight loss and quality of life after bariatric surgery.
    Surg Obes Relat Dis 2018 Apr 22. Epub 2018 Apr 22.
    Indiana University Health North Hospital, Carmel, Indiana; Indiana University School of Medicine, Indianapolis, Indiana.
    Background: Bariatric surgery represents the most effective intervention for severe obesity available today; however, significant variability in postoperative outcomes exists. Effective tools that predict postoperative outcomes are needed for decision-making and patient counseling.

    Objectives: We hypothesized that a validated behavioral assessment tool, the Cleveland Clinic Behavioral Rating Scale (CCBRS), would predict excess weight loss, health-related quality of life, depression, anxiety, and alcohol use after bariatric surgery. Read More

    Incidence and predictive factors for additional opioid prescription after endoscopic sinus surgery.
    Int Forum Allergy Rhinol 2018 May 31. Epub 2018 May 31.
    Department of Surgery, Division of Otolaryngology-Head & Neck Surgery, University of California San Diego, San Diego, CA.
    Background: Excessive postoperative opioid prescription is a source of prescription diversion in the United States opioid crisis and may contribute to chronic opioid use. Efficient prescription by the surgeon can mitigate opioid abuse and improve postoperative pain control. In this study we sought to better characterize the incidence and predictive baseline characteristics associated with the need for additional opioid prescription after endoscopic sinus surgery (ESS) for chronic rhinosinusitis. Read More

    Evaluation of anesthesia in endoscopic strip craniectomy: A review of 121 patients.
    Paediatr Anaesth 2018 May 30. Epub 2018 May 30.
    Department of Anaesthesiology, Radboud University Medical Center, Nijmegen, The Netherlands.
    Objective: The aim of this study was to evaluate pre-, intra-, and postoperative anesthetic parameters in endoscopic strip craniectomy in order to improve anesthesiological care.

    Materials And Methods: This is a retrospective patient cohort study of our first 121 patients treated by endoscopic strip craniectomy. Preoperative as well as intra- and postoperative anesthesiological and neurological parameters were analyzed. Read More

    Opioid Use Disorders: Perioperative Management of a Special Population.
    Anesth Analg 2018 May 25. Epub 2018 May 25.
    From the Departments o Psychiatry and.
    Opioid-related overdose deaths have reached epidemic levels within the last decade. The efforts to prevent, identify, and treat opioid use disorders (OUDs) mostly focus on the outpatient setting. Despite their frequent overrepresentation, less is known about the inpatient management of patients with OUDs. Read More

    New cross-sectional imaging in IBD.
    Curr Opin Gastroenterol 2018 Jul;34(4):194-207
    Department of Gastroenterology, Faculty of Medicine, Centro Hospitalar São João.
    Purpose Of Review: Cross-sectional imaging, namely ultrasound, CT and MR enterography, complements clinical and endoscopic monitoring of activity and complications in IBD, and emerging new radiological technologies may have clinical applications in the near future. This review offers an update on the potential role of these new imaging methods in the management of IBD.

    Recent Findings: Specific MR techniques [diffusion-weighted imaging (DWI), diffusion kurtosis imaging (DKI) and magnetization transfer] allow accurate detection of inflammation (DWI and maybe DKI) and fibrosis (magnetization transfer) in Crohn's disease, without the need of intravenous gadolinium administration. Read More

    Soft Palate Pleomorphic Adenoma of a Minor Salivary Gland: An Unusual Presentation.
    Case Rep Otolaryngol 2018 31;2018:3986098. Epub 2018 Mar 31.
    Department of Otolaryngology, The Royal London Hospital, Whitechapel Road, Whitechapel, London E1 1BB, UK.
    Approximately 10% of pleomorphic adenomas occur in the minor salivary glands with the palate being the most common site. Pleomorphic adenomas account for the majority of palatal tumours; however, minor salivary gland tumours have a higher risk of malignancy compared to tumours of the major salivary glands, so appropriate diagnostic evaluation should be prompt. We present a case of a 52-year-old man with a longstanding history of a soft palate pleomorphic adenoma which required excision under general anaesthetic via a mandibular swing approach. Read More

    Surgical and functional outcome of olfactory groove meningiomas: Lessons from the past experience and strategy development.
    Clin Neurol Neurosurg 2018 May 18;171:46-52. Epub 2018 May 18.
    Department of Neurosurgery, Sanador Medical Center Hospital, Bucharest, Romania.
    Object: Olfactory groove meningiomas (OGMs) constitute a unique subset of intracranial meningiomas, since they usually remain clinically silent for a long period of time, and they may be of large size upon their diagnosis. Their surgical management remains quite challenging. The surgical and the neuropsychological outcome of patients with OGM are presented in our current study, in order to establish a basis for developing efficacious surgical strategies for the management of this clinico-pathological entity. Read More

    [Safety and efficacy of total hip arthroplasty in patients with end stage renal disease].
    Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi 2017 Dec;31(12):1418-1422
    Department of Orthopedics, West China Hospital, Sichuan University, Chengdu Sichuan, 610041, P.R.China.
    Objective: To evaluate the safety and efficacy of total hip arthroplasty (THA) in patients with end stage renal disease (ESRD).

    Methods: Between December 2009 and May 2016, 30 THAs were performed in 28 patients with dialysis-dependent renal failure (18 patients) or renal transplantation (10 patients). A retrospective case control study was carried out to compare these 28 ESRD patients (ESRD group) with a matched cohort of 28 nonrenal patients (control group). Read More

    [Application of interrupted suture at exercise position in total knee arthroplasty].
    Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi 2018 Apr;32(4):400-405
    Department of Orthopedics, the Fourth Affiliated Hospital of Harbin Medical University, Harbin Heilongjiang, 150000, P.R.China.
    Objective: To investigate the effectiveness of interrupted suture under exercise position in total knee arthroplasty (TKA).

    Methods: Eighty-four patients with osteoarthritis who were treated with TKA between July 2015 and July 2016 were enrolled in the study. All patients were randomly divided into control group and observation group with 42 cases in each group. Read More

    Cardiac diseases among liver transplant candidates.
    Clin Transplant 2018 May 27:e13296. Epub 2018 May 27.
    Department of Anesthesiology and Perioperative Medicine, Mayo Clinic, Jacksonville, FL, USA.
    Improvements in early survival after liver transplant (LT) have allowed for the selection of LT candidates with multiple comorbidities. Cardiovascular disease is a major contributor to post-LT complications. We performed a literature search to identify the causes of cardiac disease in the LT population and to describe techniques for diagnosis and perioperative management. Read More

    Plasmapheresis for Management of Antiphospholipid Syndrome in the Neurosurgical Patient.
    Oper Neurosurg (Hagerstown) 2018 May 24. Epub 2018 May 24.
    Department of Neurological Surgery, Washington University School of Medicine, St. Louis, Missouri.
    Background And Importance: Antiphospholipid syndrome (APS) is an autoimmune disorder associated with a hypercoagulable state and increased risk of intraoperative and postoperative thrombosis. Few neurosurgical studies have examined the management of these patients, though the standard of care in most other disciplines involves the use of anticoagulation therapy. However, this is associated with risks such as hemorrhage, thrombosis due to warfarin withdrawal, and is not compatible with operative intervention. Read More

    An Innovative Perioperative Pain Program for Chronic Opioid Users: An Academic Medical Center's Response to the Opioid Crisis.
    Am J Med Qual 2018 May 1:1062860618777298. Epub 2018 May 1.
    1 Johns Hopkins Medicine, Baltimore, MD.
    Increased utilization of prescription opioids for pain management has led to a nationwide public health crisis with alarming rates of addiction and opioid-related deaths. In the surgical setting, opioid prescriptions have been implicated as a contributing factor to the opioid epidemic. The authors developed an innovative model to address aspects of pain management and opioid utilization during preoperative evaluation, acute surgical hospitalization, and postoperative follow-up for chronic opioid users. Read More

    Lateral Patellar Instability in the Skeletally Mature Patient: Evaluation and Surgical Management.
    J Am Acad Orthop Surg 2018 Jun;26(12):429-439
    From the Department of Orthopaedic Surgery, University of Virginia Health System, Charlottesville, VA (Dr. Diduch), StoneSprings Orthopedics, Dulles, VA (Dr. Kandil), and Orthopaedic Associates of Central Texas, Austin, TX (Dr. Burrus).
    Lateral patellar instability is a common disease process that affects all types of patients. Depending on the patient's anatomy and the results of preoperative imaging, surgical management options include medial patellofemoral ligament reconstruction, tibial tubercle osteotomy, and sulcus-deepening trochleoplasty. Medial patellofemoral ligament reconstruction or repair is useful for almost all patients, whereas tibial tubercle osteotomy is helpful to correct a lateralized tibial tubercle and the associated elevated lateral pull of the extensor mechanism. Read More

    Prophylactic Central Compartment Neck Dissection in Papillary Thyroid Cancer and Effect on Locoregional Recurrence.
    Ann Surg Oncol 2018 May 21. Epub 2018 May 21.
    Division of Surgical Oncology and Endocrine Surgery, Vanderbilt University, Nashville, TN, USA.
    Background: Prophylactic central compartment neck dissection (pCCND) in addition to total thyroidectomy (TT) includes removal of central compartment lymph nodes in the absence of clinical involvement on preoperative and intraoperative evaluation. The data regarding the influence of pCCND on oncologic outcomes and surgical complication rates is mixed and, therefore, is the focus of this analysis.

    Methods: A systematic review of the literature on total thyroidectomy with prophylactic central compartment neck dissection (TT + pCCND) from January 1990 to October 2017 identified 221 abstracts of which 17 met inclusion criteria and were reviewed (1 randomized-control trial, 13 retrospective cohort studies, and 3 meta-analyses). Read More

    [Application of perihilar surgical techniques in perihilar biliary tract tumours].
    Zhonghua Wai Ke Za Zhi 2018 May;56(5):332-337
    Department of Biliary-Pancreatic Surgery, Ren Ji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai 200127, China.
    Perihilar biliary tract tumours include hilar cholangiocarcinoma, gallbladder cancer invading the hepatic hilum and intrahepatic cholangiocarcioma invading the hepatic hilum.The tumours have the special characteristics such as strong invasion capability, the anatomic variant, the pathophysiological complexity, the biological behavior diversity and the difficulty of preoperative evaluation which result in low R0 resection rate, more postoperative complications, more mortality and poor prognosis.The perihilar surgical techniques system aims to set a reasonable and individual operation procedure on the principle of precision surgery by taking the key technique of hilar dissection and exposing, evaluting the hilar anatomy by the means of three-dimensional digital medical image evaluation system, evaluting the relationship between the tumour and hepatic artery and portal vein under the condition of hepatic hilum complete exposure by combining anterograde and retrograde route from intra and extra-hepatic direction to hepatic hilum. Read More

    [Expert consensus on standardized processes of ambulatory biliary surgery (2018 edition)].
    • Authors:
    • ,
    Zhonghua Wai Ke Za Zhi 2018 May;56(5):321-327
    The definition of ambulatory surgery is that the patient is admitted, operated and discharged within a day (24 hours) , but does not include outpatient surgery. It can shorten the average hospital stay, reduce medical expenses, accelerate the recovery of patients, and has been approved to have great social and economic benefits.The main contents of this consensus include: (1)the establishment of ambulatory biliary surgery system, which involves the facilities building, team building, the construction of management systems, operation management, operation state analysis and benefit evaluation; (2)Patient selection criteria, pre-hospital assessment, surgical scheduling, preoperative education, anesthesia and management of adverse reactions after anesthesia, intraoperative application of general surgical principles and postoperative emergency plans, perioperative nursing; (3)Discharge criteria and pre-discharge assessment, post-discharge follow-up and rehabilitation guidance; (4) quality and safety control index system of ambulatory biliary surgery. Read More

    [Oligometastases in gastric and esophageal cancer : Current clinical trials and surgical concepts].
    Chirurg 2018 May 17. Epub 2018 May 17.
    Klinik für Allgemeine, Viszeral- und Transplantationschirurgie, Hoppe-Seyler-Straße 3, 72076, Tübingen, Deutschland.
    There is an increasing role of surgery even in metastatic tumor stages. In colorectal cancer patients with limited metastases, complete cytoreduction is able to offer long-term survival in synchronic as well as metachronic situations. In tumors of the upper gastrointestinal tract (UGIT), however, the impact of surgery in metastatic disease remains to be clarified. Read More

    J Minim Invasive Gynecol 2018 May 14. Epub 2018 May 14.
    Gynecologic surgery unit, Hautepierre Universitary Hospital, Strasbourg, France.
    Study Objective: Demonstrate a laparoscopic management of an arteriovenous malformation in a patient with deep pelvic endometriosis DESIGN: A step-by-step explanation of the surgery using video (instructive video).

    Setting: Hautepierre Universitary Hospital of Strasbourg in France INTERVENTION: We describe the case of a 37 years old patient presenting deep pelvic endometriosis and an uterine arteriovenous malformation. It was during a tubal ligation in 2015, that the deep pelvic endometriosis was diagnosed. Read More

    Pain management after bone reconstruction surgery using an analgesic bone cement: a functional non-invasive in vivo study using gait analysis.
    J Pain 2018 May 14. Epub 2018 May 14.
    CEISAM, CNRS UMR 6230, University of Nantes, Nantes, France. Electronic address:
    Postoperative pain following bone reconstruction is a serious complication that could jeopardize the global success of a surgery. This pain must be controlled and minimized during the first 3-4 postoperative days to prevent it from becoming chronic. In this study, a critical-size bone defect was created at the femoral distal end of rats and filled by an injectable calcium phosphate cement (CPC) loaded or not with local anesthetics (bupivacaine or ropivacaine). Read More

    Preoperative thyroid function and weight loss after bariatric surgery.
    Int J Obes (Lond) 2018 May 16. Epub 2018 May 16.
    Department of Endocrinology, Diabetes and Metabolism, Centro Hospitalar São João, Porto, Portugal.
    Thyroid function has an important role on body weight regulation. However, the impact of thyroid function on weight loss after bariatric surgery is still largely unknown. We evaluated the association between preoperative thyroid function and the excess weight loss 1 year after surgery, in 641 patients with morbid obesity who underwent bariatric surgery. Read More

    Misconceptions Surrounding Penicillin Allergy: Implications for Anesthesiologists.
    Anesth Analg 2018 May 10. Epub 2018 May 10.
    From the Department of Anesthesia.
    Administration of preoperative antimicrobial prophylaxis, often with a cephalosporin, is the mainstay of surgical site infection prevention guidelines. Unfortunately, due to prevalent misconceptions, patients labeled as having a penicillin allergy often receive alternate and less-effective antibiotics, placing them at risk of a variety of adverse effects including increased morbidity and higher risk of surgical site infection. The perioperative physician should ascertain the nature of previous reactions to aid in determining the probability of the prevalence of a true allergy. Read More

    Dialysis Patients Undergoing Total Knee Arthroplasty Have Significantly Increased Odds of Perioperative Adverse Events Independent of Demographic and Comorbidity Factors.
    J Arthroplasty 2018 Apr 19. Epub 2018 Apr 19.
    Department of Orthopaedics and Rehabilitation, Yale School of Medicine, New Haven, Connecticut.
    Background: The prevalence of dialysis-dependent patients is growing, and an increasing number of these patients are being considered for total knee arthroplasty (TKA). Studies assessing the preoperative risk associated with TKA in this population are limited to institutional cohorts with small sample sizes or national inpatient databases that lack follow-up data.

    Methods: The 2006-2015 National Surgical Quality Improvement Program databases were queried for adult patients undergoing elective TKA. Read More

    Onyx Embolization Before the Surgical Treatment of Grade III Spetzler-Martin Brain Arteriovenous Malformations: Single-Center Experience and Technical Nuances.
    World Neurosurg 2018 May 9. Epub 2018 May 9.
    Neurosurgery Unit, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy; Department of Clinical-Surgical, Diagnostic and Pediatric Sciences, University of Pavia, Pavia, Italy.
    Background: Grade III Spetzler-Martin brain arteriovenous malformations (AVMs) are a specific set of AVMs with high variability in terms of site, size, angioarchitecture, flow dynamics, and involvement of eloquent areas. Surgery preceded by preoperative embolization has been reported as a useful treatment option for these lesions. The aim of this study is to report outcomes and personal experience of combined preoperative Onyx embolization and surgical resection on a consecutive series of grade III brain AVMs. Read More

    [A preliminary observation of implanting a double-eyelet capsular tension ring in eyes with serious lens subluxation].
    Zhonghua Yan Ke Za Zhi 2018 May;54(5):343-348
    Zhongshan Ophthalmic Center, Sun Yat-Sen University, State Key Laboratory of Ophthalmology, Guangzhou 510060, China.
    To evaluate the clinical efficiency of an iris hook combined with a modified double-eyelet capsular tension ring (MCTR) in the treatment of serious lens subluxation. Retrospective case series. A total of 16 patients (20 eyes) with serious lens subluxation were enrolled in Zhongshan Ophthalmic Center from March 2016 to December 2016. Read More

    Treatment of hematomas after anterior cervical spine surgery: A retrospective study of 15 cases.
    Neurochirurgie 2018 May 4. Epub 2018 May 4.
    Department of Orthopedics, The First Affiliated Hospital of China Medical University,Shenyang,Republic of China.
    Objective: Postoperative hematoma is a rare and dangerous complication of cervical spine surgery. The aim of this study was to investigate the incidence and related factors of postoperative hematoma, and to report on 15 cases at our institution over a 6-year period.

    Methods: Fifteen cases of postoperative hematoma were retrospectively identified. Read More

    Assessing the costs and benefits of perioperative iron deficiency anemia management with ferric carboxymaltose in Germany.
    Risk Manag Healthc Policy 2018 24;11:77-82. Epub 2018 Apr 24.
    Unit of PharmacoEpidemiology and PharmacoEconomics, Department of Pharmacy, University of Groningen, Groningen, the Netherlands.
    Background: Perioperative administration of ferric carboxymaltose (FCM) was previously shown to reduce both the need for transfusions and the hospital length of stay in patients with preoperative iron deficiency anemia (IDA). In this study, we estimated the economic consequences of perioperative administration using FCM vs usual care in patients with IDA from the perspective of a German hospital using decision-analytic modeling.

    Materials And Methods: The model was populated with clinical inputs (transfusion rates, blood units transfused, hospital length of stay) from a previously reported randomized trial comparing FCM vs usual care for managing IDA patients undergoing elective abdominal surgery. Read More

    Predictive value of SNOT-22 on additional opiate prescriptions after endoscopic sinus surgery.
    Int Forum Allergy Rhinol 2018 May 3. Epub 2018 May 3.
    Department of Surgery, Division of Otolaryngology-Head and Neck Surgery, University of California San Diego, San Diego, CA.
    Background: Endoscopic sinus surgery (ESS) is generally well tolerated, yet a subset of patients require an additional opiate prescription in the postoperative period. The purpose of this study was to quantify differences in both preoperative and immediate postoperative 22-item Sino-Nasal Outcome Test (SNOT-22) scores between patients with a single prescription and those requiring additional opiate prescriptions (AOPs).

    Methods: Patients undergoing ESS between November 2016 and August 2017 were reviewed retrospectively. Read More

    Evaluation of the pharyngeal airway using computational fluid dynamics in patients with acromegaly.
    Laryngoscope Investig Otolaryngol 2018 Apr 25;3(2):133-138. Epub 2018 Mar 25.
    Department of Anesthesiology and Critical Care Medicine Graduate School of Medical and Dental Sciences, Kagoshima University Kagoshima Japan.
    Objectives: Perioperative airway management may be particularly challenging in patients with acromegaly undergoing trans-sphenoidal pituitary surgery (TSS). Management for airway obstruction is required prior to pituitary surgery to minimize perioperative hypoxia. The purpose of this retrospective study was to evaluate airway obstruction by simulation of computational fluid dynamics (CFD) using computed tomography (CT) images in patients who had undergone TSS. Read More

    Simulation as a preoperative planning approach in advanced heart failure patients. A retrospective clinical analysis.
    Biomed Eng Online 2018 May 2;17(1):52. Epub 2018 May 2.
    National Research Council, Institute of Clinical Physiology, Rome, Italy.
    Background: Modelling and simulation may become clinically applicable tools for detailed evaluation of the cardiovascular system and clinical decision-making to guide therapeutic intervention. Models based on pressure-volume relationship and zero-dimensional representation of the cardiovascular system may be a suitable choice given their simplicity and versatility. This approach has great potential for application in heart failure where the impact of left ventricular assist devices has played a significant role as a bridge to transplant and more recently as a long-term solution for non eligible candidates. Read More

    A data-driven patient blood management strategy in liver transplantation.
    Vox Sang 2018 May 1. Epub 2018 May 1.
    Division of Transplantation, Department of Surgery, University of Washington, Seattle, WA, USA.
    Background And Objectives: Blood utilization during liver transplant has decreased, but remains highly variable due to many complex surgical and physiologic factors. Previous models attempted to predict utilization using preoperative variables to stratify cases into two usage groups, usually using entire blood units for measurement. We sought to develop a practical predictive model using specific transfusion volumes (in ml) to develop a data-driven patient blood management strategy. Read More

    Prevention and management of complications following tracheal resections-lessons learned at the Massachusetts General Hospital.
    Ann Cardiothorac Surg 2018 Mar;7(2):237-243
    Division of Thoracic Surgery, Massachusetts General Hospital, Boston, MA, USA.
    Tracheal surgery has developed and evolved over the last 50 years, becoming an integral part of the clinical practice of modern thoracic surgeons. Today, surgeons can safely and effectively operate on most patients suffering from post-intubation tracheal stenosis, tracheal tumors and other pathologies that result in an abnormal shape and function of the central airways. The Massachusetts General Hospital (MGH) in Boston witnessed first-hand the birth and growth of tracheal surgery under Dr. Read More

    Transaxillary decompression of thoracic outlet syndrome patients presenting with cervical ribs.
    J Vasc Surg 2018 Apr 25. Epub 2018 Apr 25.
    Division of Vascular Surgery, Gonda (Goldschmied) Vascular Center, David Geffen School of Medicine at UCLA, Los Angeles, Calif.
    Objective: The transaxillary approach to thoracic outlet decompression in the presence of cervical ribs offers the advantage of less manipulation of the brachial plexus and associated nerves. This may result in reduced incidence of perioperative complications, such as nerve injuries. Our objective was to report contemporary data for a series of patients with thoracic outlet syndrome (TOS) and cervical ribs managed through a transaxillary approach. Read More

    A Comparative Report on Intracranial Tumor-to-Tumor Metastasis and Collision Tumors.
    World Neurosurg 2018 Apr 26. Epub 2018 Apr 26.
    Department of Neurosurgery, Brown University, Providence, Rhode Island, USA; Normal Prince Neurosciences Institute, Brown University, Providence, Rhode Island, USA; Warren Alpert Medical School of Brown University, Brown University, Providence, Rhode Island, USA. Electronic address:
    Background: The incidence of 2 distinct tumor types occupying the same anatomic location is rarely observed and may be accounted for by 2 separate mechanisms: tumor-to-tumor metastasis and collision tumors, where 2 adjacent tumors invade one another. These rare phenomena arise from distinct mechanisms, which may affect their preoperative recognition, surgical approach, and postoperative care. We review 2 cases, highlighting their identification and perioperative management. Read More

    Obstructive Sleep Apnea and the Impact on Surgical Outcomes in Gynecology.
    Obstet Gynecol Surv 2018 Apr;73(4):242-250
    Associate Professor, Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, University of Wisconsin School of Medicine and Public Health, Madison, WI.
    Importance: Obstructive sleep apnea syndrome (OSAS) is a common medical condition in the United States and affects gynecologic surgical outcomes.

    Objective: The aim of this review was to improve perioperative diagnosis and management of OSAS in patients presenting for gynecologic surgery and ultimately improve perioperative outcomes. The role of preoperative evaluation and screening is also addressed. Read More

    The Role of 3D Reconstruction True-Volume Analysis in Osteochondral Lesions of the Talus: A Case Series.
    Foot Ankle Int 2018 Apr 1:1071100718771834. Epub 2018 Apr 1.
    1 Department of Orthopaedic Surgery, Penn State Hershey Bone and Joint Institute, Penn State Milton S. Hershey Medical Center, Hershey, PA, USA.
    Background: Evaluation and management of osteochondral lesions of the talus (OLTs) often warrant advanced imaging studies, especially in revision or cases with cystic defects. It is possible that orthopedic surgeons may overestimate the size and misinterpret the morphology of OLT from conventional computed tomography (CT), thereby influencing treatment strategies. The purpose of this study was to determine the utility of a novel means to estimate the true-volume of OLTs using 3D reconstructed images and volume analysis. Read More

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