Latest & greatest articles for surgery

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Top results for surgery

181. Effects of a Patient Activation Tool on Decision Making Between Surgery and Nonoperative Management for Pediatric Appendicitis: A Randomized Clinical Trial Full Text available with Trip Pro

Effects of a Patient Activation Tool on Decision Making Between Surgery and Nonoperative Management for Pediatric Appendicitis: A Randomized Clinical Trial Strategies to activate and engage patients and caregivers in shared decision making in the acute care setting may result in improved outcomes.To determine whether a patient activation tool (PAT) can improve decision-making and patient-centered outcomes among pediatric patients and their caregivers who choose between surgery and nonoperative (...) management for their child's appendicitis.This single-blind, randomized clinical trial collected data from a single tertiary children's hospital from March 1, 2014, through April 30, 2016, with 1-year follow-up completed on May 1, 2017. Two hundred of 236 eligible children and adolescents aged 7 to 17 years with uncomplicated appendicitis enrolled with their caregivers. After receiving the randomized clinical intervention, caregivers chose surgery or nonoperative management. Data were analyzed from March

2019 EvidenceUpdates

182. The Arthroplasty Candidacy Help Engine tool to select candidates for hip and knee replacement surgery: development and economic modelling Full Text available with Trip Pro

The Arthroplasty Candidacy Help Engine tool to select candidates for hip and knee replacement surgery: development and economic modelling The Arthroplasty Candidacy Help Engine tool to select candidates for hip and knee replacement surgery: development and economic modelling Journals Library An error occurred retrieving content to display, please try again. >> >> >> Page Not Found Page not found (404) Sorry - the page you requested could not be found. Please choose a page from the navigation (...) or try a website search above to find the information you need. >> >> >> >> Issue {{metadata .Issue }} Toolkit 1)"> 0)"> 1)"> {{metadata.Title}} {{metadata.Headline}} The Oxford hip and knee scores can be used to assess individuals' suitability for surgery, and this study showed that surgery nearly always costs less than £20,000 per QALY. {{author}} {{($index , , , , , , , , , , , , , , , , , , , , , , , , & . Andrew Price 1, * , James Smith 1 , Helen Dakin 2 , Sujin Kang 1 , Peter Eibich 2

2019 NIHR HTA programme

183. Septoplasty with or without concurrent turbinate surgery versus non-surgical management for nasal obstruction in adults with a deviated septum: a pragmatic, randomised controlled trial. (Abstract)

Septoplasty with or without concurrent turbinate surgery versus non-surgical management for nasal obstruction in adults with a deviated septum: a pragmatic, randomised controlled trial. Septoplasty (surgical correction of the deviated nasal septum) is the most frequently performed ear, nose, and throat operation in adults, but no randomised controlled trials or non-randomised comparative studies on the effectiveness of septoplasty have been published. Consequently, health-care providers, health (...) septoplasty with or without concurrent turbinate surgery or non-surgical management. Patients were stratified by sex, age (<35 years or ≥35 years), and deviation severity (mild, moderate, or severe). The primary outcome was health-related quality of life, measured with the validated Glasgow Health Status Inventory at 12 months. Analyses were done on an intention-to-treat basis. The trial is registered with the Netherlands Trial Register, number NTR3868.Between Sept 2, 2013, and Dec 12, 2016, we randomly

2019 Lancet Controlled trial quality: predicted high

184. Association between urinary dickkopf-3, acute kidney injury, and subsequent loss of kidney function in patients undergoing cardiac surgery: an observational cohort study. (Abstract)

Association between urinary dickkopf-3, acute kidney injury, and subsequent loss of kidney function in patients undergoing cardiac surgery: an observational cohort study. Cardiac surgery is associated with a high risk of postoperative acute kidney injury (AKI) and subsequent loss of kidney function. We explored the clinical utility of urinary dickkopf-3 (DKK3), a renal tubular stress marker, for preoperative identification of patients at risk for AKI and subsequent kidney function loss.This (...) observational cohort study included patients who had cardiac surgery in a derivation cohort and those who had cardiac surgery in a validation cohort (RenalRIP trial). The study comprised consecutive patients who had elective cardiac surgery at the Saarland University Medical Centre (Homburg, Germany; derivation cohort) and those undergoing elective cardiac surgery (selected on the basis of a Cleveland Clinical Foundation score of 6 or higher) who were enrolled in the prospective RenalRIP multicentre trial

2019 Lancet

185. Optimizing cerebral oxygenation in cardiac surgery: A randomized controlled trial examining neurocognitive and perioperative outcomes (Abstract)

Optimizing cerebral oxygenation in cardiac surgery: A randomized controlled trial examining neurocognitive and perioperative outcomes The study objective was to determine whether targeted therapy to optimize cerebral oxygenation is associated with improved neurocognitive and perioperative outcomes.In a prospective trial, intraoperative cerebral oximetry monitoring using bilateral forehead probes was performed in cardiac surgical patients who were randomly assigned to an intervention group (...) with cognitive change scores. Perioperative outcomes did not differ between the intervention and control groups.Targeted therapy to optimize cerebral oxygenation was associated with better memory outcome in a group of cardiac surgical patients. Some aspects of the protocol other than desaturation duration and severity contributed to the observed neuroprotective effect.Copyright © 2019 The American Association for Thoracic Surgery. Published by Elsevier Inc. All rights reserved.

2019 EvidenceUpdates

186. Comprehensive functional exercises with patient education for the prevention of venous thrombosis after major gynecologic surgery: A randomized controlled study (Abstract)

Comprehensive functional exercises with patient education for the prevention of venous thrombosis after major gynecologic surgery: A randomized controlled study To explore the functional exercises of deep breathing and lower limb motions for the prevention of venous thrombosis in patients undergoing major surgery for gynecologic malignancy.All eligible patients admitted to the gynecologic oncology unit were randomized into the study and control groups. A comprehensive set of functional (...) interval 0.035-0.815, p = 0.032) adjusted with diagnosis and surgical parameters. The detailed educational material had improved the perception and satisfaction of patients about the prevention of VTE.In a phase 3, single-center randomized controlled study, a comprehensive set of functional exercises combining deep breathing and lower limb motions would significantly decrease the risk of venous thrombosis in patients undergoing major surgery for gynecologic malignancy, especially the risk

2019 EvidenceUpdates

187. Bariatric surgery: an HTA report on the efficacy, safety and cost-effectiveness

Bariatric surgery: an HTA report on the efficacy, safety and cost-effectiveness 2019 www.kce.fgov.be KCE REPORT 316 BARIATRIC SURGERY: AN HTA REPORT ON THE EFFICACY, SAFETY AND COST-EFFECTIVENESS 2019 www.kce.fgov.be KCE REPORT 316 HEALTH TECHNOLOGY ASSESSMENT BARIATRIC SURGERY: AN HTA REPORT ON THE EFFICACY, SAFETY AND COST-EFFECTIVENESS PETER LOUWAGIE, MATTIAS NEYT, DORIEN DOSSCHE, CÉCILE CAMBERLIN, BELINDA TEN GEUZENDAM, KOEN VAN DEN HEEDE, HANS VAN BRABANDT COLOPHON Title: Bariatric surgery (...) Médical Pédiatrique Clairs Vallons and Dr. Leen Verleye (KCE) for the methodological support. Reported interests: ‘All experts and stakeholders consulted within this report were selected because of their involvement in the topic of Bariatric Surgery. Therefore, by definition, each of them might have a certain degree of conflict of interest to the main topic of this report’ Membership of a stakeholder group on which the results of this report could have an impact: Thierry Lafullarde (President

2019 Belgian Health Care Knowledge Centre

188. Refractive surgery. (Abstract)

Refractive surgery. Refractive surgery has evolved beyond laser refractive techniques over the past decade. Laser refractive surgery procedures (such as laser in-situ keratomileusis), surface ablation techniques (such as laser epithelial keratomileusis), and photorefractive keratectomy have now been established as fairly safe procedures that produce excellent visual outcomes for patients with low-to-moderate amounts of ametropia. Additionally, a broader selection of options are now available

2019 Lancet

189. Association of Unrecognized Obstructive Sleep Apnea With Postoperative Cardiovascular Events in Patients Undergoing Major Noncardiac Surgery. Full Text available with Trip Pro

Association of Unrecognized Obstructive Sleep Apnea With Postoperative Cardiovascular Events in Patients Undergoing Major Noncardiac Surgery. Unrecognized obstructive sleep apnea increases cardiovascular risks in the general population, but whether obstructive sleep apnea poses a similar risk in the perioperative period remains uncertain.To determine the association between obstructive sleep apnea and 30-day risk of cardiovascular complications after major noncardiac surgery.Prospective cohort (...) study involving adult at-risk patients without prior diagnosis of sleep apnea and undergoing major noncardiac surgery from 8 hospitals in 5 countries between January 2012 and July 2017, with follow-up until August 2017. Postoperative monitoring included nocturnal pulse oximetry and measurement of cardiac troponin concentrations.Obstructive sleep apnea was classified as mild (respiratory event index [REI] 5-14.9 events/h), moderate (REI 15-30), and severe (REI >30), based on preoperative portable

2019 JAMA

190. STA to MCA Bypass. 3D HD. Brain bypass surgery.

STA to MCA Bypass. 3D HD. Brain bypass surgery. YouTube © 2019 YouTube, LLC [[unseenCount_]] [[placeholder_]] [[countryCode]] [[menuStrings_.BACK_ALT_LABEL]] [[menuStrings_.SEARCH_ALT_LABEL]] [[message]] [[data.tooltip]] [[text]] [[getSimpleString(data.text)]] [[getSimpleString(data.text)]] [[computeTooltip_(data.untoggledTooltip, data.toggledTooltip, data.isToggled)]] [[computeTooltip_(data.untoggledTooltip, data.toggledTooltip, data.isToggled)]] [[label]] [[getSimpleString(data.title

2019 University of Arkansas (UAMS) - Vascular Neurosurgery Program (Videos)

191. Guidelines for Perioperative Care in Cardiac Surgery: Enhanced Recovery After Surgery Society Recommendations Full Text available with Trip Pro

Guidelines for Perioperative Care in Cardiac Surgery: Enhanced Recovery After Surgery Society Recommendations Enhanced Recovery After Surgery (ERAS) evidence-based protocols for perioperative care can lead to improvements in clinical outcomes and cost savings. This article aims to present consensus recommendations for the optimal perioperative management of patients undergoing cardiac surgery. A review of meta-analyses, randomized clinical trials, large nonrandomized studies, and reviews (...) was conducted for each protocol element. The quality of the evidence was graded and used to form consensus recommendations for each topic. Development of these recommendations was endorsed by the Enhanced Recovery After Surgery Society.

2019 EvidenceUpdates

192. A Perioperative Small Dose of Dexamethasone Enhances Postoperative Recovery by Reducing Volume and Inflammatory Contents in Wound Drainage After Thyroid Surgery: A Double-Blinded, Randomized, Prospective Study (Abstract)

A Perioperative Small Dose of Dexamethasone Enhances Postoperative Recovery by Reducing Volume and Inflammatory Contents in Wound Drainage After Thyroid Surgery: A Double-Blinded, Randomized, Prospective Study The aims of this study were to assess the effect of perioperative dexamethasone on postoperative thyroid surgery recovery using measures of wound drainage volume and C-reactive protein (CRP) levels and leukocyte counts.From January to September 2014, healthy patients, aged between 18 (...) and 65 years, had elective thyroid surgery in the tertiary hospital. Eligible patients were randomized into either group D (dexamethasone 0.1 mg/kg IV) or group S (saline IV) after anesthesia induction. At the end of surgery, a drainage tube was placed at the thyroid bed with a negative pressure ball connected outside the wound. Drainage fluids were collected after thyroid surgery. The fluid volume and the levels of C-reactive protein and leukocyte counts inside were analyzed. All patients were

2019 EvidenceUpdates

193. Effect of Calcium-Channel Blocker Therapy on Radial Artery Grafts After Coronary Bypass Surgery (Abstract)

Effect of Calcium-Channel Blocker Therapy on Radial Artery Grafts After Coronary Bypass Surgery Few studies have evaluated the effect of chronic calcium-channel blocker therapy (CCB) on the angiographic and clinical outcome of radial artery (RA) grafts used for coronary bypass surgery.The purpose of this study was to evaluate if CCB influences midterm clinical and angiographic outcomes of RA grafts.Patient-level data of 6 angiographic randomized trials evaluating RA graft status at midterm

2019 EvidenceUpdates

194. Robot-assisted surgery in thoracic and visceral indications

Robot-assisted surgery in thoracic and visceral indications Dec2015 © EUnetHTA, 2015. Reproduction is authorised provided EUnetHTA is explicitly acknowledged 1 EUnetHTA Joint Action 3 WP4 Version 1.4, 06.05.2019 This report is part of the project/joint action ‘724130/EUnetHTA JA3’ which has received funding from the European Union’s Health Programme (2014-2020) Rapid assessment of other technologies using the HTA Core Model ® for Rapid Relative Effectiveness Assessment ROBOT-ASSISTED SURGERY (...) IN THORACIC AND VISCERAL INDICATIONS Project ID: OTCA14 Robot-assisted surgery for thoracic and visceral surgery Version 1.4, 06.05.2019 EUnetHTA Joint Action 3 WP4 2 DOCUMENT HISTORY AND CONTRIBUTORS Version Date Description V1.0 31.01.19 First draft. V1.1 27.02.19 Input from co-author has been processed. V1.2 29.03.19 Input from dedicated reviewers has been processed. V1.3 30.04.19 Input from external experts and manufacturer(s) has been processed. V1.4 06.05.19 Input from medical editing has been

2019 EUnetHTA

195. Randomized clinical trial of liposomal bupivacaine transverse abdominis plane block versus intrathecal analgesia in colorectal surgery (Abstract)

Randomized clinical trial of liposomal bupivacaine transverse abdominis plane block versus intrathecal analgesia in colorectal surgery Transverse abdominis plane (TAP) block is considered an effective alternative to neuraxial analgesia for abdominal surgery. However, limited evidence supports its use over traditional analgesic modalities in colorectal surgery. This study compared the analgesic efficacy of liposomal bupivacaine TAP block with intrathecal (IT) opioid administration (...) in a multicentre RCT.Patients undergoing elective small bowel or colorectal resection were randomized to receive TAP block or a single injection of IT analgesia with hydromorphone. Patients were assessed at 4, 8, 16, 24 and 48 h after surgery. Primary outcomes were mean pain scores and morphine milligram equivalents (MMEs) administered within 48 h after surgery. Secondary outcomes included duration of hospital stay, incidence of postoperative ileus and use of intravenous patient-controlled analgesia.In total

2019 EvidenceUpdates

196. Bypass Surgery or Stenting for Left Main Coronary Artery Disease in Patients With Diabetes (Abstract)

Bypass Surgery or Stenting for Left Main Coronary Artery Disease in Patients With Diabetes The randomized EXCEL (Evaluation of XIENCE versus Coronary Artery Bypass Surgery for Effectiveness of Left Main Revascularization) trial reported a similar rate of the 3-year composite primary endpoint of death, myocardial infarction (MI), or stroke in patients with left main coronary artery disease (LMCAD) and site-assessed low or intermediate SYNTAX scores treated with percutaneous coronary intervention (...) ) or the major secondary endpoints of death, MI, or stroke at 30 days (p = 0.61) or death, MI, stroke, or ischemia-driven revascularization at 3 years (p = 0.65).In the EXCEL trial, the relative 30-day and 3-year outcomes of PCI with everolimus-eluting stents versus CABG were consistent in diabetic and nondiabetic patients with LMCAD and site-assessed low or intermediate SYNTAX scores.(Evaluation of XIENCE versus Coronary Artery Bypass Surgery for Effectiveness of Left Main Revascularization [EXCEL

2019 EvidenceUpdates

197. Ultrasound-guided serratus anterior plane block for analgesia after thoracic surgery Full Text available with Trip Pro

Ultrasound-guided serratus anterior plane block for analgesia after thoracic surgery Patients who undergo surgical procedures that impair the integrity of the chest wall frequently experience extremely severe postoperative pain. Opiates and weaker analgesics, such as nonsteroidal anti-inflammatory drugs (NSAIDs), are not sufficiently effective in achieving control of severe pain and might cause respiratory and gastrointestinal complications. In the past decade, there has been an increased (...) interest in the use of regional nerve blocks for post-thoracoscopy and post-thoracotomy analgesia.This is a prospective, randomized, double-blind and single-center study. We recruited 104 patients who underwent elective thoracoscopy. Prior to surgery, the participating patients were randomized into one of two study groups: Group 1- the "standard control group" that received standard postoperative pain control with intravenous opioids, NSAIDs and acetaminophen (paracetamol) and Group 2- the "block group

2019 EvidenceUpdates

198. Validation of a Model Predicting De Novo Stress Urinary Incontinence in Women Undergoing Pelvic Organ Prolapse Surgery (Abstract)

Validation of a Model Predicting De Novo Stress Urinary Incontinence in Women Undergoing Pelvic Organ Prolapse Surgery To validate a previously developed prediction model for de novo stress urinary incontinence (SUI) after undergoing vaginal surgery for pelvic organ prolapse (POP).Model performance was determined using a cohort of women who participated in two, 14-center randomized trials in the Netherlands that evaluated whether postoperative SUI 1 year after surgery was reduced (...) with or without concomitant midurethral sling at the time of surgery for symptomatic women who had at least stage 2 POP. Age, number of previous vaginal births, urine leakage associated with urgency, history of diabetes, body mass index, preoperative stress test result, and placement of a midurethral sling were used to calculate the predicted probability of an individual developing de novo SUI. Predicted probabilities were compared with outcomes and quantitated using the concordance index and calibration

2019 EvidenceUpdates

199. Custom-made or customisable 3D printed implants and cutting guides versus non-3D printed standard implants and cutting guides for improving outcome in patients undergoing knee, maxillofacial, or cranial surgery

Custom-made or customisable 3D printed implants and cutting guides versus non-3D printed standard implants and cutting guides for improving outcome in patients undergoing knee, maxillofacial, or cranial surgery Dec2015 © EUnetHTA, 2015. Reproduction is authorised provided EUnetHTA is explicitly acknowledged 1 EUnetHTA Joint Action 3 WP4 Version 1.4, 17 th April 2019 This report is part of the project / joint action ‘724130 / EUnetHTA JA3’ which has received funding from the European Union’s (...) Health Programme (2014-2020) Rapid assessment of other technologies using the HTA Core Model ® for Rapid Relative Effectiveness Assessment Custom-made or customisable 3D printed implants and cutting guides versus non- 3D printed standard implants and cutting guides for improving outcome in patients undergoing knee, maxillofacial, or cranial surgery PROJECT ID: OTCA11 Custom-made 3D printed implants and cutting guides in knee, maxillofacial, or cranial surgery EUnetHTA Joint Action 3 WP4 2 DOCUMENT

2019 EUnetHTA

200. Effect of ultra-short-term treatment of patients with iron deficiency or anaemia undergoing cardiac surgery: a prospective randomised trial. (Abstract)

Effect of ultra-short-term treatment of patients with iron deficiency or anaemia undergoing cardiac surgery: a prospective randomised trial. Anaemia and iron deficiency are frequent in patients scheduled for cardiac surgery. This study assessed whether immediate preoperative treatment could result in reduced perioperative red blood cell (RBC) transfusions and improved outcome.In this single-centre, randomised, double-blind, parallel-group controlled study, patients undergoing elective cardiac (...) surgery with anaemia (n=253; haemoglobin concentration (Hb) <120 g/L in women and Hb <130 g/L in men) or isolated iron deficiency (n=252; ferritin <100 mcg/L, no anaemia) were enrolled. Participants were randomly assigned (1:1) with the use of a computer-generated range minimisation (allocation probability 0·8) to receive either placebo or combination treatment consisting of a slow infusion of 20 mg/kg ferric carboxymaltose, 40 000 U subcutaneous erythropoietin alpha, 1 mg subcutaneous vitamin B12

2019 Lancet Controlled trial quality: predicted high