Collections Rush General Surgery

Rush General Surgery

Collection of articles to supplement our educational curriculum
Marek A Mirski, Abhijit Vijay Lele, Lunei Fitzsimmons, Thomas J K Toung
Vascular air embolism is a potentially life-threatening event that is now encountered routinely in the operating room and other patient care areas. The circumstances under which physicians and nurses may encounter air embolism are no longer limited to neurosurgical procedures conducted in the "sitting position" and occur in such diverse areas as the interventional radiology suite or laparoscopic surgical center. Advances in monitoring devices coupled with an understanding of the pathophysiology of vascular air embolism will enable the physician to successfully manage these potentially challenging clinical scenarios...
January 2007: Anesthesiology
R Cutler Quillin, Gregory C Wilson, Jeffrey M Sutton, Dennis J Hanseman, Flavio Paterno, Madison C Cuffy, Ian M Paquette, Tayyab S Diwan, E Steve Woodle, Daniel E Abbott, Shimul A Shah
BACKGROUND: In Ohio, the obesity rate has increased from 21.5% in 2000 to 30.1% in 2012. Nonalcoholic steatohepatitis is believed to be increasing as an indication for orthotopic liver transplantation. METHODS: We evaluated the diagnosis of nonalcoholic steatohepatitis as an indication for orthotopic liver transplantation and ensuing outcomes relative to other common hepatic diseases requiring orthotopic liver transplantation in Ohio. We queried 2,356 patients with nonalcoholic steatohepatitis, alcoholic cirrhosis (ETOH), and hepatitis C cirrhosis from the Ohio Solid Organ Transplantation Consortium who were listed for and/or received an orthotopic liver transplant from 2000 to 2012...
October 2014: Surgery
Donald E Fry, Michael Pine, Gregory Pine
BACKGROUND: Little information is available about postdischarge adverse events after laparoscopic cholecystectomy. METHODS: Inpatient and 90-day postdischarge adverse events were identified for Medicare patients discharged in 2009-2010 after undergoing elective laparoscopic cholecystectomy on day 0, 1, or 2 of hospitalization at facilities that performed 20 or more laparoscopic cholecystectomies during the study period. A predictive length of stay (LOS) linear regression model was derived and used to identify patients with prolonged LOS (prLOS) whose risk-adjusted LOS exceeded a 3σ upper limit on a moving average control chart...
October 2014: Surgery
Onur Birsen, Muhammet Akyuz, Cem Dural, Erol Aksoy, Shamil Aliyev, Jamie Mitchell, Allan Siperstein, Eren Berber
BACKGROUND: Although adrenal incidentalomas (AI) are detected in ≤5% of patients undergoing chest and abdominal computed tomography (CT), their management is challenging. The current guidelines include recommendations from the National Institutes of Health, the American Association of Endocrine Surgeons (AAES), and the American Association for Cancer Education (AACE). The aim of this study was to develop a new risk stratification model and compare its performance against the existing guidelines for managing AI...
October 2014: Surgery
Jun Lee, Vlad Radulescue, Jahan Porhomayon, Leili Pourafkari, Pradeep Arora, Hasan H Dosluoglu, Nader D Nader
OBJECTIVE: To examine the influence of perioperative blood transfusions on perioperative outcomes and late survival. BACKGROUND: Perioperative blood transfusion has been reported to have a negative impact on perioperative morbidity but its long-term effect on survival is unknown. The purpose of this study was to evaluate the effects of perioperative transfusion on perioperative outcomes and survival. METHODS: We studied 12,345 surgical procedures from Veteran Administration Surgical Quality Improvement Program database from July 1998 through 2010...
January 2015: Annals of Surgery
Å Collin, B Jung, E Nilsson, L Påhlman, J Folkesson
BACKGROUND: A randomized study in 1999-2005 of mechanical bowel preparation (MBP) preceding colonic resection found no decrease in postoperative complications. The aim of the present study was to evaluate the long-term effect of MBP regarding cancer recurrence and survival after colonic resections. METHODS: The cohort of patients with colonic cancer in the MBP study was followed up for 10 years. Data were collected from registers run by the National Board of Health and Welfare...
November 2014: British Journal of Surgery
Daniela Molena, Benedetto Mungo, Miloslawa Stem, Richard L Feinberg, Anne O Lidor
BACKGROUND: The effectiveness of the CMS nonpayment policy for certain hospital-acquired conditions (HAC) is debated, since their preventability is questionable in several groups of patients. This study aimed to determine the rate of the three most common HAC in major surgical resections for cancer: surgical site infection (SSI), urinary tract infection (UTI), and venous thromboembolism (VTE). Additionally, the association of HAC with patients' characteristics and their effect on post-operative outcomes were investigated...
January 2015: Journal of Gastrointestinal Surgery
Minjae Kim, Joanne E Brady, Guohua Li
BACKGROUND: The literature on perioperative acute kidney injury (AKI) focuses mainly on cardiac and major vascular surgery. Among noncardiac general surgery procedures, intraabdominal general surgery has been identified as high risk for developing AKI, but variations in AKI risk and its impact on 30-day mortality among different types of abdominal surgeries are not well characterized. METHODS: We used the American College of Surgeons National Surgical Quality Improvement Program (2005-2010) to identify patients in 15 intraabdominal general surgery procedure categories (n = 457,656)...
November 2014: Anesthesia and Analgesia
Pradeep H Navsaria, Andrew J Nicol, Sorin Edu, Rajiv Gandhi, Chad G Ball
OBJECTIVE: The primary aim of this study was to delineate the role of computed tomography (CT) in patients undergoing NOM for AGSW. BACKGROUND: Nonoperative management (NOM) of abdominal gunshot wounds (AGSWs) remains controversial. METHODS: This prospective study included all patients with abdominal gunshot injuries admitted to our trauma center from April 1, 2004 to September 30, 2009. Exclusion criteria included patients with peritonitis, hemodynamic instability, unreliable physical examination, head and spinal cord injury with an AGSW underwent immediate laparotomy...
April 2015: Annals of Surgery
Katie W Russell, Michael D Rollins, Douglas C Barnhart, Mary C Mone, Rebecka L Meyers, David E Skarda, Elizabeth S Soukup, Richard E Black, Mark S Molitor, Gregory J Stoddard, Eric R Scaife
OBJECTIVE: To determine whether charge awareness affects patient decisions. BACKGROUND: Pediatric uncomplicated appendicitis can be treated with open or laparoscopic techniques. These 2 operations are considered to have clinical equipoise. METHODS: In a prospective, randomized clinical trial, nonobese children admitted to a children's hospital with uncomplicated appendicitis were randomized to view 1 of 2 videos discussing open and laparoscopic appendectomy...
July 2015: Annals of Surgery
Luigina Graziosi, Elisabetta Marino, Verena De Angelis, Alberto Rebonato, Emanuel Cavazzoni, Annibale Donini
BACKGROUND: The neutrophil/lymphocyte ratio (NLR) in the peripheral blood is considered an easily assessable prognostic factor in cancer patients. We evaluated the predictive significance of the NLR in patients affected by gastric cancer that underwent gastric resection. METHODS: From July 2003 to March 2012, 156 patients who had undergone gastrectomy with curative intent for gastric adenocarcinoma were included. Data were retrieved from a prospective collected database...
February 2015: American Journal of Surgery
Uma R Phatak, Winston M Chan, Debbie F Lew, Richard J Escamilla, Tien C Ko, Curtis J Wray, Lillian S Kao
BACKGROUND: Laparoscopic cholecystectomies can be performed at night in high-volume acute care hospitals. We hypothesized that nonelective nighttime laparoscopic cholecystectomies are associated with increased postoperative complications. STUDY DESIGN: We conducted a single-center retrospective review of consecutive laparoscopic cholecystectomy patients between October 2010 and May 2011 at a safety-net hospital in Houston, Texas. Data were collected on demographics, operative time, time of incision, length of stay, 30-day postoperative complications (ie, bile leak/biloma, common bile duct injury, retained stone, superficial surgical site infection, organ space abscess, and bleeding) and death...
October 2014: Journal of the American College of Surgeons
Jeffrey E Keenan, Paul J Speicher, Julie K M Thacker, Monica Walter, Maragatha Kuchibhatla, Christopher R Mantyh
IMPORTANCE: Surgical site infections (SSIs) in colorectal surgery are associated with increased morbidity and health care costs. OBJECTIVE: To determine the effect of a preventive SSI bundle (hereafter bundle) on SSI rates and costs in colorectal surgery. DESIGN: Retrospective study of institutional clinical and cost data. The study period was January 1, 2008, to December 31, 2012, and outcomes were assessed and compared before and after implementation of the bundle on July 1, 2011...
October 2014: JAMA Surgery
Jamie E Anderson, Tazo Inui, Mark A Talamini, David C Chang
BACKGROUND: Acute acalculous cholecystitis is often managed with cholecystectomy or cholecystostomy, but data guiding surgical practice are lacking. MATERIALS AND METHODS: Longitudinal analysis of the California Office of Statewide Health Planning and Development Patient Discharge Data was performed from 1995-2009. Patients with acute acalculous cholecystitis were identified by International Classification of Diseases 9 code. Cox proportional hazard analysis found predictors of time to death, adjusting for patient demographics, sepsis, shock, frailty, Charlson comorbidity index, length of stay, insurance status, teaching hospital status, and year...
August 2014: Journal of Surgical Research
Emily Walker Stockert, Alexander Langerman
BACKGROUND: Efficiency in the operating room has become a topic of great interest. This study aimed to quantify the percent use of instruments among common instrument trays across 4 busy surgical services: Otolaryngology, Plastic Surgery, Bariatric Surgery, and Neurosurgery. We further aimed to calculate the costs associated with tray and instrument sterilization, as well as the implications of missing or damaged instruments. STUDY DESIGN: This was a single-site, observational study conducted on the surgical instrumentation at a large academic medical center in Chicago...
October 2014: Journal of the American College of Surgeons
Joseph Miller, Janice Cho, Meina Joseph Michael, Rola Saouaf, Shirin Towfigh
IMPORTANCE: Occult hernias are symptomatic but not palpable on physical examination. This is more commonly seen with inguinal hernias. Early diagnosis and treatment of occult hernias are essential in relieving symptoms and improving patients' quality of life. OBJECTIVE: To determine the effectiveness of imaging-ultrasonography (US), computed tomography (CT), and magnetic resonance imaging (MRI)--in the diagnosis of occult inguinal hernia. DESIGN, SETTING, AND PARTICIPANTS: A retrospective medical records review of surgical patients with groin and pelvic pain, 2008-2013, was conducted in a single-surgeon hernia specialty practice...
October 2014: JAMA Surgery
Mats Möller, Ulf Gustafsson, Finn Rasmussen, Gunnar Persson, Anders Thorell
IMPORTANCE: The optimal strategy for common bile duct stones (CBDSs) encountered during cholecystectomy is yet to be determined. OBJECTIVE: To evaluate the outcomes after various interventional techniques to clear the bile ducts and the natural course of CBDSs found during intraoperative cholangiography. DESIGN, SETTING, AND PARTICIPANTS: In a large retrospective cohort analysis, we analyzed data from the Swedish Registry for Gallstone Surgery and Endoscopic Retrograde Cholangiopancreatography (GallRiks)...
October 2014: JAMA Surgery
Kristin N Kelly, Fergal J Fleming, Christopher T Aquina, Christian P Probst, Katia Noyes, Walter Pegoli, John R T Monson
OBJECTIVE: This study examines patient and operative factors associated with organ space infection (OSI) in children after appendectomy, specifically focusing on the role of operative approach. BACKGROUND: Although controversy exists regarding the risk of increased postoperative intra-abdominal infections after laparoscopic appendectomy, this approach has been largely adopted in the treatment of pediatric acute appendicitis. METHODS: Children aged 2 to 18 years undergoing open or laparoscopic appendectomy for acute appendicitis were selected from the 2012 American College of Surgeons Pediatric National Surgical Quality Improvement Program database...
September 2014: Annals of Surgery
Brett L Ecker, Edmund K Bartlett, Rebecca L Hoffman, Giorgos C Karakousis, Robert E Roses, Jon B Morris, Rachel R Kelz
BACKGROUND: The model for end-stage liver disease (MELD) has been validated as a prediction tool for postoperative mortality, but its role in predicting morbidity has not been well studied. We sought to determine the role of MELD, among other factors, in predicting morbidity and mortality in patients with nonmalignant ascites undergoing hernia repair. METHODS: All patients undergoing hernia repair in the American College of Surgeons National Surgical Quality Improvement database (2009-11) were identified...
August 2014: Journal of Surgical Research
Erik Schadde, Victoria Ardiles, Ksenija Slankamenac, Christoph Tschuor, Gregory Sergeant, Nadja Amacker, Janine Baumgart, Kris Croome, Roberto Hernandez-Alejandro, Hauke Lang, Eduardo de Santibaňes, Pierre-Alain Clavien
BACKGROUND: Portal vein occlusion to increase the size of the future liver remnant (FLR) is well established, using portal vein ligation (PVL) or embolization (PVE) followed by resection 4-8 weeks later. Associating liver partition with portal vein ligation for staged hepatectomy (ALPPS) combines PVL and complete parenchymal transection, followed by hepatectomy within 1-2 weeks. ALPPS has been recently introduced but remains controversial. We compare the ability of ALPPS versus PVE or PVL for complete tumor resection...
June 2014: World Journal of Surgery
2014-08-06 11:58:03
Fetch more papers »
Fetching more papers... Fetching...
Remove bar
Read by QxMD icon Read

Save your favorite articles in one place with a free QxMD account.


Search Tips

Use Boolean operators: AND/OR

diabetic AND foot
diabetes OR diabetic

Exclude a word using the 'minus' sign

Virchow -triad

Use Parentheses

water AND (cup OR glass)

Add an asterisk (*) at end of a word to include word stems

Neuro* will search for Neurology, Neuroscientist, Neurological, and so on

Use quotes to search for an exact phrase

"primary prevention of cancer"
(heart or cardiac or cardio*) AND arrest -"American Heart Association"

We want to hear from doctors like you!

Take a second to answer a survey question.