Database : MEDLINE
Search on : Postoperative and Hemorrhage [Words]
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[PMID]: 29520186
[Au] Autor:Han GJ; Kim S; Lee NK; Kim CW; Seo HI; Kim HS; Kim TU
[Ad] Address:Department of Radiology, Biomedical Research Institute, Pusan National University Hospital, Pusan National University School of Medicine, Busan 49241, Korea.
[Ti] Title:Prediction of Late Postoperative Hemorrhage after Whipple Procedure Using Computed Tomography Performed During Early Postoperative Period.
[So] Source:Korean J Radiol;19(2):284-291, 2018 Mar-Apr.
[Is] ISSN:2005-8330
[Cp] Country of publication:Korea (South)
[La] Language:eng
[Ab] Abstract:Objective: Postpancreatectomy hemorrhage (PPH) is an uncommon but serious complication of Whipple surgery. To evaluate the radiologic features associated with late PPH at the first postoperative follow up CT, before bleeding. Materials and Methods: To evaluate the radiological features associated with late PPH at the first follow-up CT, two radiologists retrospectively reviewed the initial postoperative follow-up CT images of 151 patients, who had undergone Whipple surgery. Twenty patients showed PPH due to vascular problem or anastomotic ulcer. The research compared CT and clinical findings of 20 patients with late PPH and 131 patients without late PPH, including presence of suggestive feature of pancreatic fistula (presence of air at fluid along pancreaticojejunostomy [PJ]), abscess (fluid collection with an enhancing rim or gas), fluid along hepaticojejunostomy or PJ, the density of ascites, and the size of visible gastroduodenal artery (GDA) stump. Results: CT findings including pancreatic fistula, abscess, and large GDA stump were associated with PPH on univariate analysis ( ≤ 0.009). On multivariate analysis, radiological features suggestive of a pancreatic fistula, abscess, and a GDA stump > 4.45 mm were associated with PPH ( ≤ 0.031). Conclusion: Early postoperative CT findings including GDA stump size larger than 4.45 mm, fluid collection with an enhancing rim or gas, and air at fluid along PJ, could predict late PPH.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1803
[Cu] Class update date: 180311
[Lr] Last revision date:180311
[St] Status:In-Data-Review
[do] DOI:10.3348/kjr.2018.19.2.284

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[PMID]: 29515720
[Au] Autor:El Bakkaly A; Ettayebi F; Oubeja H; Erraji M; Zerhouni H
[Ad] Address:Service des Urgences Chirurgicales Pédiatriques, CHU Ibn Sina, Faculté de Médecine Mohammed V, Rabat, Maroc.
[Ti] Title:Syndrome de Bean chez l'enfant: à propos de deux cas. [Bean's syndrome in children: about two cases].
[So] Source:Pan Afr Med J;28:102, 2017.
[Is] ISSN:1937-8688
[Cp] Country of publication:Uganda
[La] Language:fre
[Ab] Abstract:Diffuse angiomatosis or Bean's syndrome is a rare disease characterized by venous malformations mainly involving the skin and the digestive tract which can result in hemorrhage of variable severity. This study reports the case of two children aged 5 and 9 and a half years respectively with diffuse angiomatosis who had been treated in the Department of Emergency Paediatric Surgery over the years. The diagnosis was based on rectal bleeding and/or melenas causing severe anemia requiring regular transfusions in both patients as well as skin angiomas occurrence at the level of the limbs. Radiological evaluation showed the presence of multiple lesions at the level of the jejunum and ileum consistent with small intestinal angiomatosis in the child aged 9 and a half years. It didn't show abdominal lesions in the child aged 5 years. The two patients were admitted to the operating block. Angiomas were surgically individualized. Some of them were actively bleeding. Enterotomy was performed. Postoperative sequelae was marked by the stop of the bleedings. This study aims to update the current understanding of this rare pathology as well as the benefit of surgical treatment in controlling the complications caused by this pathology and in reducing the frequency of transfusions.
[Pt] Publication type:ENGLISH ABSTRACT; JOURNAL ARTICLE
[Em] Entry month:1803
[Cu] Class update date: 180311
[Lr] Last revision date:180311
[St] Status:In-Process
[do] DOI:10.11604/pamj.2017.28.102.11109

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[PMID]: 29505518
[Au] Autor:Zhang S; Huang Q; Xu B; Ma J; Cao G; Pei F
[Ad] Address:Department of Orthopaedics, West China Hospital, Sichuan University, Chengdu, Sichuan, China.
[Ti] Title:Effectiveness and safety of an optimized blood management program in total hip and knee arthroplasty: A large, single-center, retrospective study.
[So] Source:Medicine (Baltimore);97(1):e9429, 2018 Jan.
[Is] ISSN:1536-5964
[Cp] Country of publication:United States
[La] Language:eng
[Ab] Abstract:Little has been published on blood management in total hip and knee arthroplasty (THA and TKA, respectively) patients focusing on both hematopoiesis and hemostasis. Our aim was to explore the effectiveness and safety of an optimized blood management program in THA and TKA patients in a large, single-center, retrospective study.We retrospectively reviewed consecutive primary unilateral THA and TKA patients' data at our institution through the National Health Database. They were divided into 3 groups according to an optimized blood management program: group A-combined use of intravenous and topical tranexamic acid (TXA); group B-use of recombinant human erythropoietin (rHuEPO) and iron supplements in addition to treatments in group A; group C-use of additional multiple boluses of TXA in addition to treatments in group B. The primary outcomes were hemoglobin (Hb) drop and calculated total blood loss (TBL). Other outcome measurements such as transfusion rate, postoperative length of stay (PLOS), venous thromboembolism (VTE), and mortality were also compared.From 2014 to 2016, a total of 1907 unilateral THA (986 in group A, 745 in group B, and 176 in group C) and 1505 unilateral TKA (795 in group A, 556 in group B, and 154 in group C) procedures were conducted at our institution. The Hb drop, calculated TBL, and PLOS in group C were significantly lower than those in groups A and B for THA and TKA patients. The transfusion rate in group C was also significantly less than in groups A and B for THA patients, while it was similar in groups A and B for TKA patients. No patients in group C received a transfusion. A significant difference was not detected in the incidence of deep vein thrombosis. No episode of symptomatic pulmonary embolism or all-cause mortality occurred within 30 days postoperatively.The current retrospective study suggests that for patients receiving primary unilateral THA or TKA, multiple boluses of intravenous TXA combined with topical TXA, rHuEPO, and iron supplements can reduce the calculated TBL, Hb drop, transfusion rate, and PLOS without increasing the incidence of VTE or mortality.
[Mh] MeSH terms primary: Anemia/drug therapy
Antifibrinolytic Agents/administration & dosage
Blood Loss, Surgical/prevention & control
Erythropoietin/therapeutic use
Iron/therapeutic use
Trace Elements/therapeutic use
Tranexamic Acid/administration & dosage
[Mh] MeSH terms secundary: Administration, Intravenous
Administration, Topical
Adult
Aged
Anemia/etiology
Arthroplasty, Replacement, Hip/adverse effects
Arthroplasty, Replacement, Knee/adverse effects
Female
Humans
Male
Middle Aged
Recombinant Proteins/therapeutic use
Retrospective Studies
[Pt] Publication type:JOURNAL ARTICLE
[Nm] Name of substance:0 (Antifibrinolytic Agents); 0 (Recombinant Proteins); 0 (Trace Elements); 11096-26-7 (Erythropoietin); 6T84R30KC1 (Tranexamic Acid); E1UOL152H7 (Iron)
[Em] Entry month:1803
[Cu] Class update date: 180309
[Lr] Last revision date:180309
[Js] Journal subset:AIM; IM
[Da] Date of entry for processing:180306
[St] Status:MEDLINE
[do] DOI:10.1097/MD.0000000000009429

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[PMID]: 28749044
[Au] Autor:Li X; Fu Y; Miao J; Li H; Hu B
[Ad] Address:Department of Thoracic Surgery, Beijing Chaoyang Hospital, Capital Medical University, Beijing, China.
[Ti] Title:Video-assisted thoracoscopic lobectomy after percutaneous coronary intervention in lung cancer patients with concomitant coronary heart disease.
[So] Source:Thorac Cancer;8(5):477-481, 2017 Sep.
[Is] ISSN:1759-7714
[Cp] Country of publication:Singapore
[La] Language:eng
[Ab] Abstract:BACKGROUND: In recent years, based on clinical observations, the number of lung cancer patients with concomitant coronary heart disease (CHD) has gradually increased. However, because of the requirement of long-term anticoagulant therapy after percutaneous coronary intervention (PCI), some of these patients lose the opportunity for surgical treatment, resulting in tumor progression. The objective of this study was to determine the appropriate timing of video-assisted thoracic surgery (VATS) lobectomy after PCI without increasing perioperative cardiovascular risk. METHODS: This study retrospectively analyzed clinical data of patients with a combination of NSCLC and CHD who underwent selective pulmonary lobectomy by VATS in the early postoperative PCI period between 2010 and 2015 at Beijing Chaoyang Hospital, China. RESULTS: Fourteen patients received VATS lobectomy after PCI. The disease had progressed to T stage in two patients after PCI. No perioperative death occurred. Two patients suffered postoperative atrial fibrillation: one had a pulmonary infection, and the other had acute coronary syndrome. All patients recovered and were discharged. CONCLUSION: For NSCLC patients with severe CHD, the use of VATS lobectomy in the early postoperative PCI period could not only advance the timing of surgery, but may also control perioperative hemorrhage and CHD event risks within acceptable ranges, which could provide more patients with an opportunity to undergo surgical treatment.
[Mh] MeSH terms primary: Carcinoma, Non-Small-Cell Lung/surgery
Coronary Disease/surgery
Lung Neoplasms/surgery
[Mh] MeSH terms secundary: Aged
Comorbidity
Female
Humans
Male
Middle Aged
Percutaneous Coronary Intervention
Pneumonectomy/methods
Retrospective Studies
Thoracic Surgery, Video-Assisted/methods
Treatment Outcome
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1803
[Cu] Class update date: 180309
[Lr] Last revision date:180309
[Js] Journal subset:IM
[Da] Date of entry for processing:170728
[St] Status:MEDLINE
[do] DOI:10.1111/1759-7714.12471

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[PMID]: 29462365
[Au] Autor:Skrap M; Vescovi MC; Pauletto G; Maieron M; Tomasino B; Bagatto D; Tuniz F
[Ad] Address:Department of Neurosurgery, Azienda Ospedaliero Universitaria S. Maria della Misericordia, Udine, Italy.
[Ti] Title:Supratentorial Cavernous Malformations Involving the Cortico Spinal Tract and Sensory Motor Cortex: Treatment Strategies, Surgical Considerations, and Outcomes.
[So] Source:Oper Neurosurg (Hagerstown);, 2018 02 16.
[Is] ISSN:2332-4260
[Cp] Country of publication:United States
[La] Language:eng
[Ab] Abstract:BACKGROUND: Cavernous malformations (CMs) are congenital malformations and may be located anywhere in the brain. We present a series of CMs located close to or inside of the motor-sensory cortex or corticospinal tract (CST) with clinical onset due to hemorrhage or mass effect. In such cases, surgery becomes an acceptable option. OBJECTIVE: To evaluate the role of diffusion tensor imaging (DTI), functional-magnetic-resonance imaging (fMRI), intraoperative neurophysiological monitoring, neuronavigation, and brain-mapping and the clinical results of surgical treatment of CMs in this critical location. METHODS: The study included 54 patients harboring 22 cortical and 32 deep locations. This series was distinct because in group I, where the DTI was not obtained, and in the group II, where this evaluation was performed. RESULTS: The postoperative permanent morbidity rate was 4% in the historical group for the deeper CMs, and there was no morbidity in the second group. DTI and fMRI permitted us to estimate the distance between the CMs and both the cortical activation cluster and the pyramidal tract. These data, in addition to intraoperative mapping and monitoring, made it necessary for us to perform a partial resection in 2 cases in the second series. CONCLUSION: CMs are congenital lesions and CST fibers can run directly on their surface. Integration of fMRI and DTI data with intraoperative functional monitoring and direct cortical and subcortical mapping are mandatory to accomplish an optimal resection, tailoring the best surgical approach to the acceptable morbidity. A subtotal resection could be considered an option for deep locations.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1802
[Cu] Class update date: 180309
[Lr] Last revision date:180309
[St] Status:Publisher
[do] DOI:10.1093/ons/opx281

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[PMID]: 29361459
[Au] Autor:Muñoz-Atienza V; Gil-Rendo A; Amo-Salas M; Núñez-Guerrero P; Martín-Fernández J
[Ad] Address:Department of Surgery, Universitary General Hospital of Ciudad Real, Ciudad Real, Spain. Electronic address: virgimua@hotmail.com.
[Ti] Title:Extended use of bemiparin as thromboprophylaxis during bariatric surgery: results of anti-factor Xa activity measurements.
[So] Source:Surg Obes Relat Dis;14(3):354-360, 2018 Mar.
[Is] ISSN:1878-7533
[Cp] Country of publication:United States
[La] Language:eng
[Ab] Abstract:BACKGROUND: The incidence of venous thromboembolism (VTE) in morbidly obese patients after obesity surgery is between .2% and 3.5%. Because there are a lack of prospective studies on the type of drug, the correct dosage, and the optimal duration, there are no specific recommendations found in the guidelines on thrombophylaxis. OBJECTIVES: To compare the incidence of VTE and hemorrhagic events in bariatric surgical patients receiving bemiparin thromboprophylaxis who have prophylactic and nonprophylactic Anti-factor Xa (AFXa) levels. SETTING: University General Hospital of Ciudad Real, Spain, public practice. METHODS: A cohort study of 122 morbidly obese patients who underwent bariatric surgery. The thromboprophylactic regimen consisted of bemiparin 5000 IU/24 hr for 30 days. AFXa levels were measured on the second and third day postoperation (prophylactic range: .3-.5 IU/mL). Body mass index, co-morbidities, prothrombotic risk factors, and thrombotic and hemorrhagic events were noted. RESULTS: The mean body mass index was 48.4 kg/m . In 50 samples, the level of AFXa was within the prophylactic range; in 71, they were in the subprophylactic range. No VTEs were observed. Major hemorrhagic events were observed in 2.4%. We did not find a significant association between AFXa and thromboembolic and hemorrhagic events. There is a significant negative correlation between the level of AFXa and body mass index. CONCLUSION: A regimen of 5000 IU/24 hr of bemiparin for 30 days after obesity surgery appears to prevent VTE without increasing the risk of a major hemorrhage. The level of AFXa is not associated with postoperative thrombotic or hemorrhagic events occurring after bariatric surgery.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1801
[Cu] Class update date: 180309
[Lr] Last revision date:180309
[St] Status:In-Data-Review

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[PMID]: 29352439
[Au] Autor:Tan CHN; Kim G; So J; Shabbir A
[Ad] Address:Division of Upper Gastrointestinal Surgery, Department of Surgery, National University Health System Singapore, National University of Singapore, 1E, Kent Ridge Road, NUHS Tower Block, Level 8, Singapore, Singapore.
[Ti] Title:Single-Incision Laparoscopic Transgastric Underrunning and Closure of Cameron Ulcers in Acute Gastrointestinal Bleeding.
[So] Source:J Gastrointest Surg;22(3):553-556, 2018 Mar.
[Is] ISSN:1873-4626
[Cp] Country of publication:United States
[La] Language:eng
[Ab] Abstract:INTRODUCTION: Endoscopic therapy remains the cornerstone of hemostasis for gastrointestinal bleeding. In situations where hemostasis cannot be achieved via endoscopic or radiological methods, surgery is necessary. Traditional open surgery for bleeding gastric ulcers can be very morbid and unsuitable especially in hemodynamically unstable patients in extremis. We describe a minimally invasive, transgastric approach for underrunning and closure of Cameron ulcers. METHODS: Our patient is a 75-year-old Chinese lady, who presented to the emergency department with fresh melena. She was hemodynamically unstable with severe metabolic acidosis. CT angiography revealed blood clots within the stomach, with no active blush. On urgent gastroscopy, large blood clots obscured the site of hemorrhage. A Mallory-Weiss tear was noted. Our patient subsequently underwent a successful single-incision laparoscopic transgastric (SLT) underrunning and closure of two Cameron ulcers. RESULTS: Our patient had an uneventful recovery and subsequently underwent a successful laparoscopic para-esophageal hernia repair on postoperative day 9. CONCLUSION: A SLT approach is a suitable minimally invasive option for the surgical management of hemostasis and closure of bleeding gastric ulcers not amenable to endoscopic or radiological interventions.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1801
[Cu] Class update date: 180309
[Lr] Last revision date:180309
[St] Status:In-Data-Review
[do] DOI:10.1007/s11605-018-3667-3

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[PMID]: 29298439
[Au] Autor:Anastasilakis K; Mourgela A; Kaniouras D; Moschou K
[Ti] Title:Tips, Tricks, and Advantages of 27-G Vitrectomy.
[So] Source:Ophthalmologica;239(2-3):176-177, 2018.
[Is] ISSN:1423-0267
[Cp] Country of publication:Switzerland
[La] Language:eng
[Ab] Abstract:PURPOSE: We present the advantages and technique variations of 27-G vitrectomy in a variety of surgical retina cases. METHODS: Patients with epiretinal membrane, retinal detachment, and proliferative diabetic retinopathy with vitreous hemorrhage and tractional detachments underwent 27-G vitrectomy. We present technique tricks, solutions to various problems and pitfalls, and the advantages of 27-G vitrectomy. RESULTS: Postoperative visual acuity improved significantly in all patients. Anatomical restoration was achieved in all cases. CONCLUSIONS: 27-G vitrectomy offers satisfactory outcomes in a wide variety of surgical retina cases and shows significant advantages in the postoperative course.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1801
[Cu] Class update date: 180308
[Lr] Last revision date:180308
[St] Status:In-Process
[do] DOI:10.1159/000485519

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[PMID]: 29268649
[Au] Autor:Yurttas T; Filipovic M
[Ad] Address:1 Klinik für Anästhesie, Intensiv-, Rettungs- und Schmerzmedizin des Kantonsspitals St. Gallen.
[Ti] Title:Strategien zum Umgang mit antithrombotischen Medikamenten im perioperativen Umfeld.
[So] Source:Ther Umsch;74(7):361-367, 2017.
[Is] ISSN:0040-5930
[Cp] Country of publication:Switzerland
[La] Language:ger
[Mh] MeSH terms primary: Blood Loss, Surgical/prevention & control
Fibrinolytic Agents/administration & dosage
Fibrinolytic Agents/adverse effects
Postoperative Complications/chemically induced
Postoperative Complications/prevention & control
Postoperative Hemorrhage/chemically induced
Postoperative Hemorrhage/prevention & control
[Mh] MeSH terms secundary: Drug Administration Schedule
Evidence-Based Medicine
Humans
Monitoring, Intraoperative/methods
Postoperative Hemorrhage/diagnosis
Postoperative Hemorrhage/etiology
Treatment Outcome
[Pt] Publication type:JOURNAL ARTICLE; REVIEW
[Nm] Name of substance:0 (Fibrinolytic Agents)
[Em] Entry month:1803
[Cu] Class update date: 180308
[Lr] Last revision date:180308
[Js] Journal subset:IM
[Da] Date of entry for processing:171223
[St] Status:MEDLINE
[do] DOI:10.1024/0040-5930/a000927

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[PMID]: 28455779
[Au] Autor:Nam K; Oh HM; Koo CH; Kim TK; Cho YJ; Hong DM; Jeon Y
[Ad] Address:Department of Anesthesiology and Pain Medicine, Seoul National University Hospital, 101 Daehak-ro, Jongno, Seoul, 03080, Republic of Korea.
[Ti] Title:Microvascular reactivity measured by vascular occlusion test is an independent predictor for postoperative bleeding in patients undergoing cardiac surgery.
[So] Source:J Clin Monit Comput;32(2):295-301, 2018 Apr.
[Is] ISSN:1573-2614
[Cp] Country of publication:Netherlands
[La] Language:eng
[Ab] Abstract:The purpose of the study is to investigate the relationship between microvascular reactivity and postoperative bleeding in cardiac surgery. The authors retrospectively analyzed a prospectively collected registry of cardiac surgery patients. Data from 154 patients enrolled in the registry were analyzed. A linear mixed model was performed to evaluate the association between the amount of postoperative chest tube output (CTO, milliliter, repeatedly measured at 0-8, 8-24, and 24-48 h) and tissue oxygen saturation (StO recovery slope (%/s) measured by vascular occlusion test (VOT) at skin closure. A logistic regression was carried out to see the relationship between StO recovery slope and packed red blood cell (PRBC) transfusion during the 48-h postoperative period. In the multivariable adjusted model, the effect of StO recovery slope on postoperative CTO (log-transformed) was statistically significant, and the degree of StO recovery slope was inversely related to the amount of CTO (exp(estimate) = 0.935; exp(95% CI) 0.881-0.992; p = 0.027). StO recovery slope was also inversely associated with postoperative PRBC transfusion possibility (OR = 0.795; 95% CI 0.633-0.998; p = 0.048). Microvascular reactivity measured by VOT is independently and inversely associated with postoperative bleeding in patients undergoing cardiac surgery.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1704
[Cu] Class update date: 180309
[Lr] Last revision date:180309
[St] Status:In-Data-Review
[do] DOI:10.1007/s10877-017-0020-4


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