1,188 results match your criteria yale preoperative


Predictors and Sequelae of Postoperative Delirium in a Geriatric Patient Population With Hip Fracture.

J Am Acad Orthop Surg Glob Res Rev 2021 May 14;5(5). Epub 2021 May 14.

From the Department of Orthopaedics and Rehabilitation, Yale School of Medicine, New Haven, CT (Ms. Haynes, Mr. Alder, Dr. Toombs, Dr. Rubin, and Dr. Grauer), and the Department of Orthopaedics, Geisel School of Medicine at Dartmouth, Hanover, New Hampshire (Mr. Amakiri).

Introduction: Postoperative delirium is common for patients with hip fracture. Predictors of postoperative delirium and its association with preexisting dementia and adverse postoperative outcomes in a geriatric hip fracture population were assessed.

Methods: Patients with hip fracture aged 60 years and older were identified in the 2016 and 2017 National Surgical Quality Improvement Program Procedure Targeted Databases. Read More

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Resection of pancreatic cystic neoplasms in recurrent acute pancreatitis prevents recurrent pancreatitis but does not identify more malignancies.

World J Gastroenterol 2021 Apr;27(15):1630-1642

Department of Surgery, Yale University School of Medicine, New Haven, CT 06510, United States.

Background: Recurrent acute pancreatitis (RAP) may be a presenting feature of and an indication for resection of pancreatic cysts, including intra-ductal papillary mucinous neoplasm (IPMN). Few data are available regarding the prevalence of malignancy and post-operative RAP in this population.

Aim: To study the role of resection to help prevent RAP and analyze if presentation as RAP would be a predictor for malignancy. Read More

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Perioperative thrombocytopenia.

Curr Opin Anaesthesiol 2021 Jun;34(3):335-344

Vanderbilt University Medical Center, Department of Anesthesiology, Nashville, Tennessee.

Purpose Of Review: In this review, we discuss recent developments and trends in the perioperative management of thrombocytopenia.

Recent Findings: Large contemporary data base studies show that preoperative thrombocytopenia is present in about 8% of asymptomatic patients, and is associated with increased risks for bleeding and 30-day mortality. Traditionally specific threshold platelet counts were recommended for specific procedures. Read More

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The Incidence of New Persistent Opioid Use Following Cardiac Surgery via Sternotomy.

Ann Thorac Surg 2021 Apr 27. Epub 2021 Apr 27.

Faculty of Medicine, University of Iceland, Reykjavik, Iceland,; Department of Anesthesiology and Critical Care Medicine, Landspitali University Hospital, Reykjavik, Iceland. Electronic address:

Background: In recent years, increased attention has turned towards the risk of chronic opioid usage following surgery. In this nationwide cohort study, we examined the rate of new persistent opioid use following cardiac surgery via sternotomy.

Methods: All opioid-naïve patients undergoing heart surgery via sternotomy from 2005 to 2018 in Iceland, were included in the study. Read More

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Sistrunk vs modified Sistrunk procedures: Does procedure type matter?

J Pediatr Surg 2021 Mar 26. Epub 2021 Mar 26.

Division of Pediatric Surgery, Department of Surgery, Children's Medical Center, University of Texas Southwestern, Dallas TX USA. Electronic address:

Background: Thyroglossal Duct Cyst (TDC) is the most common congenital neck mass in children and is surgically managed with a Sistrunk procedure. Some surgeons perform a modified Sistrunk (mSis), involving the dissection of the fistula beyond the hyoid bone without coring out the foramen cecum at the base of the tongue. We aim to evaluate surgical outcomes of children undergoing Sistrunk (Sis) or modified Sistrunk (mSis) procedures for TDC at an academic pediatric institution. Read More

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Depth Electrode Guided Anterior Insulectomy: 2-Dimensional Operative Video.

Oper Neurosurg (Hagerstown) 2021 Apr 22. Epub 2021 Apr 22.

Department of Neurosurgery, Yale New Haven Hospital, New Haven, Connecticut, USA.

The insula is well established as an epileptogenic area.1 Insular epilepsy surgery demands precise anatomic knowledge2-4 and tailored removal of the epileptic zone with careful neuromonitoring.5 We present an operative video illustrating an intracranial electroencephalogram (EEG) depth electrode guided anterior insulectomy. Read More

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Effect of music on pediatric endoscopic examinations: a randomized controlled trial.

Endosc Int Open 2021 Apr 13;9(4):E599-E605. Epub 2021 Apr 13.

Department of Gastroenterology and Nutrition, Division of Pediatrics, Escuela de Medicina, Pontificia Universidad Católica de Chile, Chile.

 The primary objective was to measure the effect of music as an adjunct to sedation in patient anxiety levels during pediatric endoscopic examinations.  We performed a single-blind randomized controlled trial comparing music with no music in children aged 2 to 18 years. Anxiety was measured using the Modified Yale Preoperative Anxiety Scale (m-YPAS) and the Visual Analog Anxiety Scale (VAS-anxiety). Read More

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Nasopharyngeal airway and subcranial space analysis in Pfeiffer syndrome.

Br J Oral Maxillofac Surg 2020 Dec 15. Epub 2020 Dec 15.

Division of Plastic and Reconstructive Surgery, Yale School of Medicine, New Haven, CT, USA. Electronic address:

Tracheotomy in infancy helps patients with Pfeiffer syndrome to survive by preventing respiratory crisis, but difficulty in decannulation may consequently be a challenge. This study has investigated the regional abnormalities of the nasopharyngeal airway in children with Pfeiffer syndrome to provide an anatomical basis for the surgical treatment and decannulation of the upper airway. Seventy-two preoperative computed tomograms (CT) (Pfeiffer syndrome n=30; control n=42) were included. Read More

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December 2020

IMAGING OF VASCULAR MALFORMATIONS WITH A HIGH-INTENSITY FOCUSED ULTRASOUND PROBE FOR TREATMENT PLANNING.

J Vasc Surg Venous Lymphat Disord 2021 Apr 7. Epub 2021 Apr 7.

Division of Vascular and Endovascular Surgery, Department of Surgery, Yale University School of Medicine, New Haven, CT; Vascular Malformations Program, Yale New Haven Hospital, New Haven, CT. Electronic address:

Objective: We aimed to investigate whether a current commercially available High-Intensity Focused Ultrasound (HIFU) probe can adequately image targeted vascular malformations in anticipation of HIFU treatment planning and delivery.

Methods: We enrolled 10 consecutive patients scheduled to undergo treatment of their symptomatic peripheral vascular malformations (VM) confirmed on routine preoperative contrast enhanced magnetic resonance imaging (MRI) and soft tissue duplex ultrasound (DUS). Lesions were situated no more than 6 cm from the skin. Read More

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The Utility of the Subalar Graft in Nostril Symmetry in Rhinoplasty.

Plast Reconstr Surg 2021 May;147(5):1063-1069

From the Department of Surgery, Divisions of Otolaryngology and Surgical Outcomes and Epidemiology, Yale School of Medicine; the Department of Surgery, Division of Plastic and Reconstructive Surgery, University of Massachusetts Medical School-Baystate; and the Department of Otolaryngology Head and Neck Surgery, Icahn School of Medicine at Mount Sinai.

Background: A deviated nose can be attributable to multiple anatomical factors, including asymmetric maxilla. A subalar graft helps to correct maxillary hypoplasia and may be a useful tool for correcting a deviated nose. The authors' objective is to show the effects of the subalar graft in improving nostril symmetry and to propose an algorithm for using this graft in open and endonasal rhinoplasty. Read More

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Self-produced audio-visual animation introduction alleviates preoperative anxiety in pediatric strabismus surgery: a randomized controlled study.

BMC Ophthalmol 2021 Apr 7;21(1):163. Epub 2021 Apr 7.

Department of Anesthesiology, The First Affiliated Hospital of Wenzhou Medical University, South Baixiang Town, Wenzhou, Zhejiang, China.

Background: Hospital anxiety caused by strabismus surgery has an unpleasant and disturbing feeling for both children and their parents. This study aimed to determine the effect of viewing a self-produced audio-visual animation introduction on preoperative anxiety and emergence agitation of pediatric patients undergoing strabismus surgery.

Methods: In this prospective randomized study, 1 hundred children scheduled for strabismus surgery with aged 3 ~ 6 years. Read More

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Can a deep learning model based on intraoperative time-series monitoring data predict post-hysterectomy quality of recovery?

Perioper Med (Lond) 2021 Apr 6;10(1). Epub 2021 Apr 6.

Department of Anesthesiology, Yale University School of Medicine, 333 Cedar St, New Haven, CT, 06520, USA.

Background: Intraoperative physiological monitoring generates a large quantity of time-series data that might be associated with postoperative outcomes. Using a deep learning model based on intraoperative time-series monitoring data to predict postoperative quality of recovery has not been previously reported.

Methods: Perioperative data from female patients having laparoscopic hysterectomy were prospectively collected. Read More

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Clinical Outcomes of a Combined Robotic Transabdominal and Open Transperineal Approach for Anastomotic Posterior Urethroplasty.

J Endourol 2021 Apr 5. Epub 2021 Apr 5.

New York University Medical Center, 12297, Urology, New York, New York, United States;

Background Robotic pelvic surgery is increasingly utilized for reconstruction proximal to the genitourinary diaphragm. We describe a combined robotic transabdominal and open transperineal approach for complex anastomotic posterior urethroplasty. Methods We performed a multi-institutional retrospective study of patients who underwent anastomotic posterior urethroplasty by a combined robotic transabdominal and open transperineal approach between 1/2012 and 12/2018. Read More

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Impact of Neoadjuvant Chemotherapy and Pretreatment Biliary Drainage for Pancreatic Head Ductal Adenocarcinoma.

Dig Dis Sci 2021 Apr 3. Epub 2021 Apr 3.

Section of Digestive Diseases, Yale University School of Medicine, 333 Cedar Street, 1080 LMP, New Haven, CT, 06520-8019, USA.

Background: Pancreatic ductal adenocarcinoma (PDAC) is one of the leading causes of cancer-related deaths in the USA. Although management strategies have evolved, there are continued controversies about the use of neoadjuvant chemotherapy (NAC) and pretreatment biliary drainage (PBD) in patients with resectable and potentially resectable disease.

Aims: We aimed to characterize the practice trends and outcomes for NAC and PBD. Read More

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Tumor location and reduction in functional MRI estimates of language laterality.

J Neurosurg 2021 Apr 2:1-11. Epub 2021 Apr 2.

1Department of Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine at UCLA, University of California, Los Angeles, California; and.

Objective: Brain tumors located close to the language cortex may distort functional MRI (fMRI)-based estimates of language dominance. The nature of this distortion, and whether this is an artifact of numerous confounders, remains unknown. The authors hypothesized tumor bias based on laterality estimates independent of confounders and that the effects are the greatest for tumors proximal to Broca's area. Read More

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Aesthetic Rhinoplasty: Technique, 3-Dimensional Simulation, and Outcome Assessment.

Aesthet Surg J Open Forum 2021 Jan 4;3(1):ojaa054. Epub 2020 Dec 4.

Yale Plastic Surgery, New Haven, CT, USA.

Communication of goals and realistic expectations between the surgeon and patient is a crucial step of aesthetic rhinoplasty. Three-dimensional (3D) imaging technology allows for sharing of simulated outcomes in the office setting, thereby facilitating this process. This article highlights the use of 3D rhinoplasty simulation in preoperative assessment and the senior author's preferred surgical technique in open rhinoplasty. Read More

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January 2021

Orthognathic Surgery to Improve Facial Profile: Assessment, 3-Dimensional Planning, and Technique.

Aesthet Surg J Open Forum 2021 Jan 19;3(1):ojaa051. Epub 2020 Nov 19.

Plastic and Reconstructive Surgery, Yale School of Medicine, New Haven, CT, USA.

A concave profile with class III malocclusion is most often due to a combination of maxillary hypoplasia and mandibular hyperplasia. Surgical correction entails normalization of jaw positions and is more challenging in the setting of concurrent asymmetry and open bite. Treatment should optimize both facial harmony and occlusion. Read More

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January 2021

The Value of Total Knee Replacement in Patients With Knee Osteoarthritis and a Body Mass Index of 40 kg/m or Greater : A Cost-Effectiveness Analysis.

Ann Intern Med 2021 Mar 23. Epub 2021 Mar 23.

Orthopaedic and Arthritis Center for Outcomes Research (OrACORe) and Policy and Innovation eValuation in Orthopaedic Treatments (PIVOT) Center, Brigham and Women's Hospital, Harvard Medical School, and Boston University School of Public Health, Boston, Massachusetts (E.L.).

Background: Total knee replacement (TKR) is an effective and cost-effective strategy for treating end-stage knee osteoarthritis. Greater risk for complications among TKR recipients with a body mass index (BMI) of 40 kg/m or greater has raised concerns about the value of TKR in this population.

Objective: To assess the value of TKR in recipients with a BMI of 40 kg/m or greater using a cost-effectiveness analysis. Read More

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Morbidity and Outcomes After Distal Pancreatectomy for Primary Retroperitoneal Sarcoma: An Analysis by the Trans-Atlantic Australasian Retroperitoneal Sarcoma Working Group.

Ann Surg Oncol 2021 Mar 19. Epub 2021 Mar 19.

Department of Surgical Oncology, Netherlands Cancer Institute, Amsterdam, Netherlands.

Background: Multi-visceral resection often is used in the treatment of retroperitoneal sarcoma (RPS). The morbidity after distal pancreatectomy for primary pancreatic cancer is well-documented, but the outcomes after distal pancreatectomy for primary RPS are not. This study aimed to evaluate morbidity and oncologic outcomes after distal pancreatectomy for primary RPS. Read More

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Application of a non-pharmacological technique in addition to the pharmacological protocol for the management of children's preoperative anxiety: A 10 years' experience.

Pediatr Med Chir 2021 Mar 19;43(1). Epub 2021 Mar 19.

Pediatric Surgery Department, Ca' Foncello Hospital, Treviso.

The aim of the study was to investigate how Non- Pharmacological Techniques (NPT), in addition to standard pharmacological techniques, can help to manage and reduce the preoperative anxiety of children waiting for Day Surgery procedures (DS). Isola Serena activity started in 2008 to manage the preoperative time of children waiting for surgery in the playing room. The latter is run by a pedagogist. Read More

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Abdominal subcutaneous fat thickness as a substitute for BMI in predicting complications in abdominally-based autologous breast reconstruction.

Microsurgery 2021 May 15;41(4):341-347. Epub 2021 Mar 15.

Section of Plastic and Reconstructive Surgery, Department of Surgery, Yale University School of Medicine, New Haven, Connecticut, USA.

Introduction: Patient selection for autologous tissue transfer for postmastectomy breast reconstruction often utilizes body mass index (BMI) to risk stratify patients, though it only estimates fat content and does not address fat distribution. This study aims to identify a measurement of abdominal subcutaneous fat thickness (ASFT) from preoperative computed tomography (CT) angiography imaging to better predict complications.

Methods: A retrospective review of patients who underwent an abdominal microvascular free flap breast reconstruction was performed. Read More

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Use of magnetic resonance imaging lymphangiography for preoperative planning in lymphedema surgery: A systematic review.

Microsurgery 2021 May 12;41(4):384-390. Epub 2021 Mar 12.

Section of Plastic and Reconstructive Surgery, University of Michigan, Ann Arbor, Michigan, USA.

Background: In recent years, magnetic resonance imaging lymphangiography (MRL) has emerged as a way to predict if patients are candidates for lymphedema surgery, particularly lymphovenous anastomosis (LVA). Our goal was to conduct a systematic review of the literature on the use of MRL for preoperative planning in lymphedema surgery. We hypothesized that MRL could add valuable information to the standard preoperative evaluation of lymphedema patients. Read More

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Cephalocranial Disproportionate Fossa Volume and Normal Skull Base Angle in Pfeiffer Syndrome.

J Craniofac Surg 2021 Mar-Apr 01;32(2):581-586

Division of Plastic and Reconstructive Surgery, Yale School of Medicine, New Haven, CT.

Background: Pfeiffer syndrome is a rare syndromic craniosynostosis disorder, with a wide range of clinical manifestations. This study aims to investigate the structural abnormalities of cranial fossa and skull base development in Pfeiffer patients, to provide an anatomic basis for surgical interventions.

Method: Thirty preoperative CT scans of Pfeiffer syndrome patients were compared to 35 normal controls. Read More

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Cavitron ultrasonic surgical aspirator for mitral annular decalcification.

Multimed Man Cardiothorac Surg 2021 03 2;2021. Epub 2021 Mar 2.

Section of Cardiac Surgery, Yale University School of Medicine.

Mitral valve surgery can be especially difficult in patients with mitral annular calcification. Not only is it associated with higher morbidity and mortality, but there is no consensus strategy for the treatment of mitral annular calcification, which may render some patients inoperable. We describe a case of severe mitral annular calcification successfully treated with the cavitron ultrasonic surgical aspirator. Read More

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Association of Acute Care Surgeon Experience With Emergency Surgery Patient Outcomes and Mortality.

JAMA Surg 2021 May;156(5):472-478

Department of Surgery, Yale School of Medicine, New Haven, Connecticut.

Importance: Previous studies comparing emergency surgery outcomes with surgeon experience have been small or used administrative databases without controlling for patient physiology or operative complexity.

Objective: To evaluate the association of acute care surgeon experience with patient morbidity and mortality after emergency surgical procedures.

Design, Setting, And Participants: This cohort study evaluated the association of surgeon experience with emergency surgery outcomes at 5 US academic level 1 trauma centers where the same surgeons provided emergency general surgical care. Read More

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Combination uterine artery embolization and hysteroscopic resection for a symptomatic uterine leiomyoma: A collaborative single-session approach for better patient care.

Clin Imaging 2021 Jan 30;77:111-116. Epub 2021 Jan 30.

The Department of Radiology, Division of Interventional Radiology, NewYork-Presbyterian Hospital/Weill Cornell Medical Center, New York, NY, USA.

Uterine artery embolization (UAE) for symptomatic uterine fibroids is accompanied by transcervical fibroid expulsion in 3-15% of cases. It can be a source of significant patient distress, may require reintervention for removal, and is the most common reason for hospital readmission following UAE. Conversely, the success of hysteroscopic resection decreases with increasing fibroid size while the risk of complications increases. Read More

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January 2021

The Utility of Imaging Parameters in Predicting Long-Term Clinical Improvement After Shunt Surgery in Patients with Idiopathic Normal Pressure Hydrocephalus.

World Neurosurg 2021 May 1;149:e1-e10. Epub 2021 Mar 1.

Department of Radiology and Biomedical Imaging, Yale School of Medicine, New Haven, Connecticut, USA. Electronic address:

Objective: It is difficult to predict which patients with idiopathic normal pressure hydrocephalus (iNPH) will improve after shunt surgery. This study investigated the association between preoperative imaging parameters in patients with iNPH and long-term outcome after shunt placement.

Methods: Patients with iNPH who showed a response to large-volume cerebrospinal fluid drainage and subsequently underwent ventriculoperitoneal shunt surgery were reviewed. Read More

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Impact of Music Therapy on Preoperative Anxiety and Degree of Cooperation With Anesthesia Induction in Children With Simple Congenital Heart Disease.

J Perianesth Nurs 2021 Feb 27. Epub 2021 Feb 27.

Department of Cardiac Surgery, Fujian Maternity and Child Health Hospital, Affiliated Hospital of Fujian Medical University, Fuzhou, China; Fujian Key Laboratory of Women and Children's Critical Diseases Research, Fujian Maternity and Child Health Hospital, Fuzhou, China; Department of Cardiovascular Surgery, Union Hospital, Fujian Medical University, Fuzhou, China. Electronic address:

Purpose: To evaluate the impact of music therapy (MT) on preoperative anxiety and degree of cooperation with anesthesia induction in children with simple congenital heart disease (CHD).

Design: A randomized controlled clinical study.

Methods: Ninety children were randomly assigned to the MT and control groups. Read More

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February 2021

The Use of Tablet Computers to Reduce Preoperative Anxiety in Children Before Anesthesia: A Randomized Controlled Study.

J Perianesth Nurs 2021 Feb 23. Epub 2021 Feb 23.

Department of Anaesthesiology and Intensive Care, University Hospital Odense, Odense, Denmark; Department of Clinical Research - Anaesthesiology, University of Southern Denmark, Odense, Denmark.

Purpose: Children undergoing surgery and general anesthesia often experience preoperative anxiety (POA) with related negative short-, medium- and long-term consequences. Anxiolytic premedication has negative side effects, and nonpharmacologic interventions are often resource demanding and not always readily available in a busy clinical setting. The use of an age-appropriate game on a tablet computer may reduce POA, postoperative pain, and occurrence of emergence delirium (ED). Read More

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February 2021

[Factors affecting intraoperative changes in regional cerebral tissue oxygen saturation in elderly patients undergoing laparoscopic hysterectomy].

Zhonghua Yi Xue Za Zhi 2021 Feb;101(7):492-497

Department of Anesthesiology, Peking University Third Hospital, Beijing 100191, China.

To explore the factors that affect the fluctuation of intraoperative regional cerebral oxygen saturation (rSctO) in elderly patients undergoing laparoscopic hysterectomy. A retrospective analysis of 39 elderly patients undergoing elective laparoscopic hysterectomy in Yale New Haven Hospital from October 2016 to February 2017 was performed. Factors including patients' demographic data, past medical history, intraoperative monitoring index and rSctO index (baseline, maximum, minimum, maximum-baseline, baseline-minimum) were recorded. Read More

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February 2021