Journal of Anesthesia and Surgery最新文献

{"title":"Correlation of Pre-Operative Co-Morbidity Indices with Peri-Operative and Post-Operative Metrics in Urological Patients Undergoing Major Open Procedures","authors":"E. Sarri, I. Sarri, E. Fragkiadis, I. Anastasiou, A. Lampadariou, C. Constantinides, D. Mitropoulos, Ommega Internationals","doi":"10.15436/2377-1364.19.2439","DOIUrl":"https://doi.org/10.15436/2377-1364.19.2439","url":null,"abstract":"Background:Individual surgeon and institutional performance are usually assessed by morbidity and mortality rates, which can be calculated using peri-operative metrics, such as POSSUM (Physiological and Operative Severity Score for the enUmeration of mortality and morbidity). Post-operative risk can be estimated using the surgical Apgar outcome score. However, pre-operative co-morbidity may contribute to case risk diversity and affect immediate peri-operative metrics and short- and long-term morbidity and mortality. We estimated the correlation between pre-operative co-morbidity or risk assessment indices and peri-operative metrics in urological patients.\u0000\u0000Material and Methods:The study included 100 consecutive patients (80.8% males, mean age ± SD 66.3 ± 10.7 years, range 30 - 88 years) undergoing major open urological procedures (39 nephrectomies, 43 radical prostatectomies, 18 radical cystectomies). Pre-operative co-morbidity was assessed using Charlson Comorbidity Index (CCI), age-adjusted CCI (AA-CCI), Cumulative Illness Rating Scale (CIRS), and Index of Co-Existent Diseases (ICED). Pre-operative risk was assessed with the American Society of Anesthesiologists index (ASA). Functional status was quantified based on estimation of the metabolic equivalent (MET). Peri-operative metrics included POSSUM and surgical Apgar scores.\u0000\u0000Results: All pre-operative indices significantly correlated with POSSUM, but none correlated with the surgical Apgar score.\u0000\u0000Conclusions:In patients undergoing major open urological procedures, risk stratification in the post-operative setting using the surgical Apgar score is independent of pre-operative co-morbidity status. In contrast, pre-operative co-morbidity and risk assessment correlated with peri-operative metrics used to calculate morbidity and mortality risk. Reports of death and complication rates do not take into account case diversity and, therefore, should be adjusted for co-morbidity status.","PeriodicalId":280509,"journal":{"name":"Journal of Anesthesia and Surgery","volume":"58 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-04-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"124355328","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Ultrasonography as the First Method of Choice in the Diagnosis of Primary Extrahepatic Echinococcosis: Case Report","authors":"V. Stoyanov, N. Damianov, Ommega Internationals","doi":"10.15436/2377-1364.19.2392","DOIUrl":"https://doi.org/10.15436/2377-1364.19.2392","url":null,"abstract":"The aim of this presentation is to show the high informative value of ultrasonography as the first method of choice in the diagnosis of atypical extra-hepatic forms of echoconcosis. Echinococcosis is zooanthroponosis and is most commonly caused by the larval form of E. granulosus. Echinococcal cysts develop, most commonly in the human liver and second - in the lung. Rare primary localization is echinococcus cysts of greater omentum and spleen. Ultrasonography is first method of ch?ice for diagnostic. The main clinical and laboratory diagnostic methods are immunoelectrophoresis and serological evidence of echinococcosis by ELISA. Timely surgical treatment give it a chance to cure. The use of post-operative antiparasitic chemoprophylaxis and therapy is recommended.","PeriodicalId":280509,"journal":{"name":"Journal of Anesthesia and Surgery","volume":"86 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-01-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"126286988","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prevention and Management of Staple Line Leaks after Laparoscopic Sleeve Gastrectomy","authors":"S. Botaitis, Athanasia Mitsala, Sempachedin Perente, C. Simopoulos, Ommega Internationals","doi":"10.15436/2377-1364.18.1897","DOIUrl":"https://doi.org/10.15436/2377-1364.18.1897","url":null,"abstract":"page no: 95/102 www.ommegaonline.org Vol:5 Issue: 1 Abstract: Laparoscopic Sleeve Gastrectomy (LSG) is gaining ground as a bariatric procedure with proven efficacy on weight loss and obesity-related comorbidities. Compared to other bariatric procedures, its complications can be even more severe. Gastric leak is estimated to be the most serious complication of this procedure due to difficult healing processes not to mention the fact that it may also be responsible for local or general severe septic complications. Staple line dehiscence and subsequent leaks following sleeve gastrectomy are not very frequent but are a difficult complication that can also become chronic. Various options have been suggested but no definitive has been established. The management of patients who develop leakages requires a multidisciplinary team. Choosing the proper approach depends on the clinical condition of the patient and the onset time of leak. Main aim of this paper is to provide an overview of the pathogenic and promoting factors of staple line leak following LSG on the basis of recent literature review and to report the evidence based preventive measures and treatment solutions of this life-threatening complication.","PeriodicalId":280509,"journal":{"name":"Journal of Anesthesia and Surgery","volume":"50 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2018-06-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"132271062","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Mammalian Stress Mechanism (MSM) Explains Radial Artery Spasm (RAS)","authors":"L. Coleman, Ommega Internationals","doi":"10.15436/2377-1364.18.1870","DOIUrl":"https://doi.org/10.15436/2377-1364.18.1870","url":null,"abstract":"page no: 81/94 www.ommegaonline.org Vol:5 Issue: 1 Abstract: Objective: Based on stress theory, this paper proposes a fresh explanation of Radial Artery Spasm (RAS), the nature of which remains unclear.(1) Data Sources: Published research papers accessed via PubMed Study Selection: Abstract review Data Extraction: Computerized Internet Search Data Synthesis: Fresh information relevant to stress theory derived from unrelated research enabled the description of a testable “mammalian stress mechanism” (MSM) that explains the stress theory proposed by Hans Selye. Conclusions: MSM activity explains the nature of RAS.","PeriodicalId":280509,"journal":{"name":"Journal of Anesthesia and Surgery","volume":"26 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2018-06-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"133563908","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Administering of Local Anesthesia with Bupivacaine in the Patients Undergoing Inguinal Hernia Repair","authors":"M. Kolahdouzan, M. Hosseinpour, L. Gafoor, E. Kouchaki, M. Razavizadeh, Ommega Internationals","doi":"10.15436/2377-1364.18.1807","DOIUrl":"https://doi.org/10.15436/2377-1364.18.1807","url":null,"abstract":"Received date: February 27, 2018 Accepted date: May 31, 2018 Published date: June 8, 2018 1Department of General Surgery, Faculty of medicine, Isfahan University of Medical Sciences, Isfahan, Iran 2Department of Surgery, Faculty of medicine, Kashan University of Medical Sciences, Iran 3Department of Neurology, Faculty of medicine, Kashan University of Medical Sciences, Iran 4Department of Anesthesiology, Faculty of medicine, Kashan University of Medical Sciences, Iran 5Department of Surgery, Faculty of medicine, Isfahan University of Medical Sciences, Iran Journal of Anesthesia and Surgery","PeriodicalId":280509,"journal":{"name":"Journal of Anesthesia and Surgery","volume":"30 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2018-06-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"126445862","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}