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Surgery

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156 papers 1000+ followers
https://read.qxmd.com/read/32352895/intra-cavity-lavage-and-wound-irrigation-for-prevention-of-surgical-site-infection-systematic-review-and-network-meta-analysis
#1
Howard Thom, Gill Norman, Nicky J Welton, Emma J Crosbie, Jane Blazeby, Jo C Dumville
Background: Surgical site infections (SSIs) are costly and associated with poorer patient outcomes. Intra-operative surgical site irrigation and intra-cavity lavage may reduce the risk of SSIs through removal of dead or damaged tissue, metabolic waste, and site exudate. Irrigation with antibiotic or antiseptic solutions may further reduce the risk of SSI because of bacteriocidal properties. Randomized controlled trials (RCTs) have been conducted comparing irrigation solutions, but important comparisons (e.g...
April 29, 2020: Surgical Infections
https://read.qxmd.com/read/32285338/what-is-the-appropriate-use-of-laparoscopy-over-open-procedures-in-the-current-covid-19-climate
#2
REVIEW
Yalini Vigneswaran, Vivek N Prachand, Mitchell C Posner, Jeffrey B Matthews, Mustafa Hussain
INTRODUCTION: Among surgeons worldwide, a concern with the use of minimally invasive techniques has been raised due to a proposed risk of viral transmission of the coronavirus disease of 2019 (COVID-19) with the creation of pneumoperitoneum. Due to this proposed concern, we sought to collect the available data and evaluate the use of laparoscopy and the risk of COVID-19 transmission. METHODS: A literature review of viral transmission in surgery and of the available literature regarding the transmission of the COVID-19 virus was performed...
April 13, 2020: Journal of Gastrointestinal Surgery: Official Journal of the Society for Surgery of the Alimentary Tract
https://read.qxmd.com/read/32140477/current-state-of-the-art-imaging-approaches-for-colorectal-liver-metastasis
#3
REVIEW
Bita Hazhirkarzar, Pegah Khoshpouri, Mohammadreza Shaghaghi, Mounes Aliyari Ghasabeh, Timothy M Pawlik, Ihab R Kamel
One of the most common cancers worldwide, colorectal cancer (CRC) has been associated with significant morbidity and mortality and therefore represents an enormous burden to the health care system. Recent advances in CRC treatments have provided patients with primary and metastatic CRC a better long-term prognosis. The presence of synchronous or metachronous metastasis has been associated, however, with worse survival. The most common site of metastatic disease is the liver. A variety of treatment modalities aimed at targeting colorectal liver metastases (CRLM) has been demonstrated to improve the prognosis of these patients...
February 2020: Hepatobiliary Surgery and Nutrition
https://read.qxmd.com/read/24430321/sigmoid-diverticulitis-a-systematic-review
#4
REVIEW
Arden M Morris, Scott E Regenbogen, Karin M Hardiman, Samantha Hendren
IMPORTANCE: Diverticulitis is a common disease. Recent changes in understanding its natural history have substantially modified treatment paradigms. OBJECTIVE: To review the etiology and natural history of diverticulitis and recent changes in treatment guidelines. EVIDENCE REVIEW: We searched the MEDLINE and Cochrane databases for English-language articles pertaining to diagnosis and management of diverticulitis published between January 1, 2000, and March 31, 2013...
January 15, 2014: JAMA: the Journal of the American Medical Association
https://read.qxmd.com/read/31342364/patterns-in-the-use-of-axillary-operations-for-patients-with-node-positive-breast-cancer-after-neoadjuvant-chemotherapy-a-national-cancer-database-ncdb-analysis
#5
Marissa K Srour, Joshua Tseng, Michael Luu, Rodrigo F Alban, Armando E Giuliano, Alice Chung
BACKGROUND: The American College of Surgeons Oncology Group (ACOSOG) Z1071 and Sentinel Neoadjuvant (SENTINA) trials of sentinel node biopsy for node-positive breast cancer treated with neoadjuvant chemotherapy (NAC) demonstrated false-negative rates that varied on the basis of surgical technique. This study evaluated trends in axillary operations before and after publication of these trials. METHODS: This study analyzed patients from National Cancer Database (NCDB) with clinical T0 through T4, N1 and N2, M0 breast cancer who received NAC from 1 January 2012 to 31 December 2015 and sentinel lymph node biopsy (SNB) or axillary lymph node dissection (ALND)...
October 2019: Annals of Surgical Oncology
https://read.qxmd.com/read/30850903/low-risk-of-development-of-a-regional-recurrence-after-an-unsuccessful-repeat-sentinel-lymph-node-biopsy-in-patients-with-ipsilateral-breast-tumor-recurrence
#6
Ingrid G M Poodt, Coco J E F Walstra, Guusje Vugts, Adriana J G Maaskant-Braat, Adri C Voogd, Robert-Jan Schipper, Grard A P Nieuwenhuijzen
BACKGROUND: Unlike sentinel lymph node biopsy (SLNB) in the primary setting, the repeat SLNB (rSLNB) in patients with ipsilateral breast tumor recurrence (IBTR) is challenging, because it is difficult to visualize and/or harvest a sentinel lymph node in every patient. Regional treatments options and safety in terms of regional disease control after such an unsuccessful rSLNB remain unclear. This study assesses factors associated with the performance of axillary lymph node dissection (ALND) after unsuccessful rSLNB and evaluates the occurrence of regional recurrences...
August 2019: Annals of Surgical Oncology
https://read.qxmd.com/read/31492632/2019-international-clinical-practice-guidelines-for-the-treatment-and-prophylaxis-of-venous-thromboembolism-in-patients-with-cancer
#7
REVIEW
Dominique Farge, Corinne Frere, Jean M Connors, Cihan Ay, Alok A Khorana, Andres Munoz, Benjamin Brenner, Ajay Kakkar, Hanadi Rafii, Susan Solymoss, Dialina Brilhante, Manuel Monreal, Henri Bounameaux, Ingrid Pabinger, James Douketis
Venous thromboembolism (VTE) is the second leading cause of death in patients with cancer. These patients are at a high risk of VTE recurrence and bleeding during anticoagulant therapy. The International Initiative on Thrombosis and Cancer is an independent academic working group aimed at establishing a global consensus for the treatment and prophylaxis of VTE in patients with cancer. The International Initiative on Thrombosis and Cancer last updated its evidence-based clinical practice guidelines in 2016 with a free, web-based mobile phone application, which was subsequently endorsed by the International Society on Thrombosis and Haemostasis...
September 3, 2019: Lancet Oncology
https://read.qxmd.com/read/31297674/sentimagic-a-non-inferiority-trial-comparing-superparamagnetic-iron-oxide-versus-technetium-99m-and-blue-dye-in-the-detection-of-axillary-sentinel-nodes-in-patients-with-early-stage-breast-cancer
#8
MULTICENTER STUDY
Michael D Alvarado, Elizabeth A Mittendorf, Mediget Teshome, Alastair M Thompson, Richard J Bold, Mark A Gittleman, Peter D Beitsch, Sarah L Blair, Kaisa Kivilaid, Quentin J Harmer, Kelly K Hunt
BACKGROUND: Sentinel lymph node biopsy (SLNB) is a highly accurate method for staging the axilla in early breast cancer. Superparamagnetic iron oxide mapping agents have been explored to overcome the disadvantages of the standard SLNB technique, which uses a radioisotope tracer with or without blue dye. One such agent, Sienna+, was shown to be non-inferior to the standard technique for SLNB in a number of studies. The SentimagIC trial was designed to establish the non-inferiority of a new formulation of this magnetic tracer, Magtrace (formerly SiennaXP)...
October 2019: Annals of Surgical Oncology
https://read.qxmd.com/read/31668180/management-of-the-patient-with-chronic-intestinal-pseudo-obstruction-and-intestinal-failure
#9
REVIEW
Loris Pironi, Anna Simona Sasdelli
Chronic intestinal pseudo-obstruction (CIPO) is a severe form of intestinal dysmotility disorder, characterized by the impairment of gastrointestinal propulsion of the gut content in the absence of fixed occluding lesions. CIPO is a rare disease that can develop in both children and adults. CIPO is classified as primary/idiopathic, when no underlying disorder is demonstrated, or secondary, when related to systemic diseases. Diagnosis relies on the finding of chronic/recurrent obstructive type symptoms with radiological features of dilated intestine with air/fluid levels without any lumen occluding lesion...
December 2019: Gastroenterology Clinics of North America
https://read.qxmd.com/read/31585125/antiplatelets-anticoagulants-and-colonoscopic-polypectomy
#10
REVIEW
Neena S Abraham
The management of antiplatelet and anticoagulant (ie, antithrombotic) agents is challenging in the periendoscopic setting. In this state-of-the-art update, we review current best practice recommendations focusing on the risk of immediate and delayed postpolypectomy bleeding in the context of drug discontinuation (ie, temporary interruption) and drug continuation. The data regarding polypectomy technique (cold snare vs conventional thermal-based) and prophylactic placement of hemostatic clips are evaluated to assess whether these endoscopic techniques are beneficial in reducing postpolypectomy bleeding...
February 2020: Gastrointestinal Endoscopy
https://read.qxmd.com/read/31415304/gallstone-pancreatitis-admission-versus-normal-cholecystectomy-a-randomized-trial-gallstone-panc-trial
#11
RANDOMIZED CONTROLLED TRIAL
Krislynn M Mueck, Shuyan Wei, Claudia Pedroza, Karla Bernardi, Margaret L Jackson, Mike K Liang, Tien C Ko, Jon E Tyson, Lillian S Kao
INTRODUCTION: Early cholecystectomy shortly after admission for mild gallstone pancreatitis has been proposed based on observational data. We hypothesized that cholecystectomy within 24 hours of admission versus after clinical resolution of gallstone pancreatitis that is predicted to be mild results in decreased length-of-stay (LOS) without an increase in complications. METHODS: Adults with predicted mild gallstone pancreatitis were randomized to cholecystectomy with cholangiogram within 24 hours of presentation (early group) versus after clinical resolution (control) based on abdominal exam and normalized laboratory values...
September 2019: Annals of Surgery
https://read.qxmd.com/read/31210778/2019-wses-guidelines-for-the-management-of-severe-acute-pancreatitis
#12
REVIEW
Ari Leppäniemi, Matti Tolonen, Antonio Tarasconi, Helmut Segovia-Lohse, Emiliano Gamberini, Andrew W Kirkpatrick, Chad G Ball, Neil Parry, Massimo Sartelli, Daan Wolbrink, Harry van Goor, Gianluca Baiocchi, Luca Ansaloni, Walter Biffl, Federico Coccolini, Salomone Di Saverio, Yoram Kluger, Ernest Moore, Fausto Catena
Although most patients with acute pancreatitis have the mild form of the disease, about 20-30% develops a severe form, often associated with single or multiple organ dysfunction requiring intensive care. Identifying the severe form early is one of the major challenges in managing severe acute pancreatitis. Infection of the pancreatic and peripancreatic necrosis occurs in about 20-40% of patients with severe acute pancreatitis, and is associated with worsening organ dysfunctions. While most patients with sterile necrosis can be managed nonoperatively, patients with infected necrosis usually require an intervention that can be percutaneous, endoscopic, or open surgical...
2019: World Journal of Emergency Surgery: WJES
https://read.qxmd.com/read/31071753/the-bubble-sign-a-novel-way-to-detect-a-perforation-after-cold-snare-polypectomy
#13
Joaquín Rodríguez Sánchez, Mónica Sánchez Alonso, María Pellisé Urquiza
No abstract text is available yet for this article.
August 2019: Endoscopy
https://read.qxmd.com/read/30607165/use-of-sentinel-lymph-node-biopsy-after-neoadjuvant-chemotherapy-in-patients-with-axillary-node-positive-breast-cancer-in-diagnosis
#14
Hee Jun Choi, Isaac Kim, Emad Alsharif, Sungmin Park, Jae-Myung Kim, Jai Min Ryu, Seok Jin Nam, Seok Won Kim, Jonghan Yu, Se Kyung Lee, Jeong Eon Lee
Purpose: This study aimed to evaluate the effects of sentinel lymph node biopsy (SLNB) on recurrence and survival after neoadjuvant chemotherapy (NAC) in breast cancer patients with cytology-proven axillary node metastasis. Methods: We selected patients who were diagnosed with invasive breast cancer and axillary lymph node metastasis and were treated with NAC followed by curative surgery between January 2007 and December 2014. We classified patients into three groups: group A, negative sentinel lymph node (SLN) status and no further dissection; group B, negative SLN status with backup axillary lymph node dissection (ALND); and group C, no residual axillary metastasis on pathology with standard ALND...
December 2018: Journal of Breast Cancer
https://read.qxmd.com/read/30720507/open-versus-laparoscopic-versus-robotic-versus-transanal-mesorectal-excision-for-rectal-cancer-a-systematic-review-and-network-meta-analysis
#15
COMPARATIVE STUDY
Constantinos Simillis, Nikhil Lal, Sarah N Thoukididou, Christos Kontovounisios, Jason J Smith, Roel Hompes, Michel Adamina, Paris P Tekkis
OBJECTIVE: To compare techniques for rectal cancer resection. SUMMARY BACKGROUND DATA: Different surgical approaches exist for mesorectal excision. METHODS: Systematic literature review and Bayesian network meta-analysis performed. RESULTS: Twenty-nine randomized controlled trials included, reporting on 6237 participants, comparing: open versus laparoscopic versus robotic versus transanal mesorectal excision. No significant differences identified between treatments in intraoperative morbidity, conversion rate, grade III/IV morbidity, reoperation, anastomotic leak, nodes retrieved, involved distal margin, 5-year overall survival, and locoregional recurrence...
July 2019: Annals of Surgery
https://read.qxmd.com/read/30535100/seven-versus-14-days-of-antibiotic-therapy-for-uncomplicated-gram-negative-bacteremia-a-noninferiority-randomized-controlled-trial
#16
Dafna Yahav, Erica Franceschini, Fidi Koppel, Adi Turjeman, Tanya Babich, Roni Bitterman, Ami Neuberger, Nesrin Ghanem-Zoubi, Antonella Santoro, Noa Eliakim-Raz, Barak Pertzov, Tali Steinmetz, Anat Stern, Yaakov Dickstein, Elias Maroun, Hiba Zayyad, Jihad Bishara, Danny Alon, Yonatan Edel, Elad Goldberg, Claudia Venturelli, Cristina Mussini, Leonard Leibovici, Mical Paul
BACKGROUND: Gram-negative bacteremia is a major cause of morbidity and mortality in hospitalized patients. Data to guide the duration of antibiotic therapy are limited. METHODS: This was a randomized, multicenter, open-label, noninferiority trial. Inpatients with gram-negative bacteremia, who were afebrile and hemodynamically stable for at least 48 hours, were randomized to receive 7 days (intervention) or 14 days (control) of covering antibiotic therapy. Patients with uncontrolled focus of infection were excluded...
September 13, 2019: Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America
https://read.qxmd.com/read/26783860/comparison-between-revised-atlanta-classification-and-determinant-based-classification-for-acute-pancreatitis-in-intensive-care-medicine-why-do-not-use-a-modified-determinant-based-classification
#17
MULTICENTER STUDY
Felix Zubia-Olaskoaga, Enrique Maraví-Poma, Iratxe Urreta-Barallobre, María-Rosario Ramírez-Puerta, Mónica Mourelo-Fariña, María-Pilar Marcos-Neira
OBJECTIVE: To compare the classification performance of the Revised Atlanta Classification, the Determinant-Based Classification, and a new modified Determinant-Based Classification according to observed mortality and morbidity. DESIGN: A prospective multicenter observational study conducted in 1-year period. SETTING: Forty-six international ICUs (Epidemiology of Acute Pancreatitis in Intensive Care Medicine study). PATIENTS: Admitted to an ICU with acute pancreatitis and at least one organ failure...
May 2016: Critical Care Medicine
https://read.qxmd.com/read/29736167/mechanisms-and-management-of-acute-pancreatitis
#18
REVIEW
Ari Garber, Catherine Frakes, Zubin Arora, Prabhleen Chahal
Acute pancreatitis represents a disorder characterized by acute necroinflammatory changes of the pancreas and is histologically characterized by acinar cell destruction. Diagnosed clinically with the Revised Atlanta Criteria, and with alcohol and cholelithiasis/choledocholithiasis as the two most prominent antecedents, acute pancreatitis ranks first amongst gastrointestinal diagnoses requiring admission and 21st amongst all diagnoses requiring hospitalization with estimated costs approximating 2.6 billion dollars annually...
2018: Gastroenterology Research and Practice
https://read.qxmd.com/read/29887421/use-of-a-piece-of-free-omentum-to-prevent-bile-leakage-after-subtotal-cholecystectomy
#19
Yoichi Matsui, Satoshi Hirooka, Masaya Kotsuka, So Yamaki, Tomohisa Yamamoto, Hisashi Kosaka, Sohei Satoi
BACKGROUND: Bile leakage after subtotal cholecystectomy (SC) is clinically serious. To prevent such leakage, we developed a new surgical technique in which a free piece of omentum is plugged into the gallbladder stump (omentum plugging technique). We evaluated whether the omentum plugging technique prevents bile leakage after subtotal cholecystectomy. METHODS: Prospectively collected data of patients who had undergone subtotal cholecystectomy without cystic duct closure in the Department of Surgery of Kansai Medical University during the 12 years from January 2006 to March 2018 were reviewed retrospectively...
September 2018: Surgery
https://read.qxmd.com/read/29946347/bologna-guidelines-for-diagnosis-and-management-of-adhesive-small-bowel-obstruction-asbo-2017-update-of-the-evidence-based-guidelines-from-the-world-society-of-emergency-surgery-asbo-working-group
#20
REVIEW
Richard P G Ten Broek, Pepijn Krielen, Salomone Di Saverio, Federico Coccolini, Walter L Biffl, Luca Ansaloni, George C Velmahos, Massimo Sartelli, Gustavo P Fraga, Michael D Kelly, Frederick A Moore, Andrew B Peitzman, Ari Leppaniemi, Ernest E Moore, Johannes Jeekel, Yoram Kluger, Michael Sugrue, Zsolt J Balogh, Cino Bendinelli, Ian Civil, Raul Coimbra, Mark De Moya, Paula Ferrada, Kenji Inaba, Rao Ivatury, Rifat Latifi, Jeffry L Kashuk, Andrew W Kirkpatrick, Ron Maier, Sandro Rizoli, Boris Sakakushev, Thomas Scalea, Kjetil Søreide, Dieter Weber, Imtiaz Wani, Fikri M Abu-Zidan, Nicola De'Angelis, Frank Piscioneri, Joseph M Galante, Fausto Catena, Harry van Goor
Background: Adhesive small bowel obstruction (ASBO) is a common surgical emergency, causing high morbidity and even some mortality. The adhesions causing such bowel obstructions are typically the footprints of previous abdominal surgical procedures. The present paper presents a revised version of the Bologna guidelines to evidence-based diagnosis and treatment of ASBO. The working group has added paragraphs on prevention of ASBO and special patient groups. Methods: The guideline was written under the auspices of the World Society of Emergency Surgery by the ASBO working group...
2018: World Journal of Emergency Surgery: WJES
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