Search results for "Perioperative care"

Perioperative and periprocedural airway management and respiratory safety for the obese patient: 2016 SIAARTI Consensus.

2016

Proper management of obese patients requires a team vision and appropriate behaviors by all health care providers in hospital. Specialist competencies are fundamental, as are specific clinical pathways and good clinical practices designed to deal with patients whose Body Mass Index (BMI) is ≥30 kg/m2. Standards of care for bariatric and non-bariatric surgery and for the critical care management of this population exist but are not well defined nor clearly followed in every hospital. Thus every anesthesiologist is likely to deal with this challenging population. Obesity is a multisystem, chronic, proinflammatory disorder. Unfortunately many countries are facing a marked increase in the obese…

An international assessment of the adoption of enhanced recovery after surgery (ERAS®) principles across colorectal units in 2019–2020

2021

Aim The Enhanced Recovery After Surgery (ERAS® ) Society guidelines aim to standardise perioperative care in colorectal surgery via 25 principles. We aimed to assess the variation in uptake of these principles across an international network of colorectal units. Method An online survey was circulated amongst European Society of Coloproctology members in 2019/20. For each ERAS® principle, respondents were asked to score how frequently the principle was implemented in their hospital, from 1 ('rarely') to 4 ('always'). Respondents were also asked to recall whether practice had changed since 2017. Subgroup analyses based on hospital characteristics were conducted. Results Of hospitals approache…

Perioperative management of obstructive sleep apnea: A systematic review

2018

Introduction Obstructive sleep apnea (OSA) is the leading sleep disordered breathing condition, with a prevalence rate of moderate to severe OSA of approximately 10-17% in the general population. Evidence acquisition We performed an Ovid-Medline search of all articles published up to August 2016. We included all articles providing updated evidence on epidemiology, pathophysiologic mechanisms and perioperative interventions. Evidence synthesis OSA is associated with a number of comorbidities and increased perioperative risks. Although in-laboratory polysomnography represents the gold-standard for diagnosis of OSA, it is costly and time-consuming. Anesthesiologists may screen patients for OSA…

European guidelines on perioperative venous thromboembolism prophylaxis:Day surgery and fast-track surgery

2017

: In recent years, day surgery and fast-track surgery have experienced a continuous increase in volume. Many procedures are now performed on an outpatient protocol, including general, orthopaedic, oncological, reconstructive or vascular surgery. The management of these patients is safe, but the incidence of venous thromboembolism in this population remains unknown. Several risk factors can be identified and stratified derived from studies of inpatient surgical management (e.g. Caprini score). Recommendations for thromboprophylaxis should be tailored from the assessment of both personal and procedure-related risk factors, although with a lack of evidence for application in outpatient managem…

Progress in the multidisciplinary treatment of gastrointestinal cancer and the impact on clinical practice: perioperative management of rectal cancer

2008

Incidence and predictors of portal and splenic vein thrombosis after pure laparoscopic splenectomy.

2017

Background. Optimal modalities for diagnosis, treatment, and surveillance of portal or splenic vein thrombosis have not yet been defined. The present retrospective study aimed to investigate the role of computed tomography performed systematically before and after laparoscopic splenectomy to assess the incidence of portal or splenic vein thrombosis, predictors, and outcomes. Methods. Computed tomography scans were obtained from 170 patients undergoing elective laparoscopic splenectomy between 2005 and 2015. Pre- and postoperative splenic vein diameter was measured at the splenoportal junction and at a distance of 2, 4, 6 cm from it. Univariate and multivariate analyses were used to identify…

Anaesthetic techniques to prevent perioperative stroke.

2013

Different techniques and interventions that can be used by an anaesthesiologist to minimize the perioperative stroke risk are summarized.The most important risk factors for perioperative stoke are not modifiable, for example previous stroke or renal failure, but they can be used to identify patients with a high risk for perioperative stroke. The antiplatelet therapy should be continued in patients with a high risk for cardiovascular thrombosis. This might be true even for operations in which bleeding should be strictly avoided such as eye surgery. One of the most recent neuroprotective approaches is the remote ischaemic preconditioning.Perioperative stroke increases morbidity and mortality …

Pathology Reporting of Resected Pancreatic/Periampullary Cancer Specimen

2018

Pancreatic specimens have always been a great challenge for surgical pathologists due to their anatomic complexity and the difficulty of becoming familiar with these specimens. However, pancreatic specimens are becoming more and more common in many hospitals because of the improvements in surgical techniques and perioperative care that have dramatically reduced the postoperative mortality rate.

Significance of preoperative C-reactive protein as a parameter of the perioperative course and long-term prognosis in squamous cell carcinoma and ade…

2006

AIM: C-reactive protein (CRP) is an acute-phase reactant and a known indicator of the malignant potential of the tumour. The aim of this study was to investigate the significance of preoperative CRP as a parameter of the perioperative course and long-term prognosis in patients with squamous cell carcinoma and adenocarcinoma of the oesophagus. METHODS: Serum CRP was determined preoperatively in 291 of 371 patients undergoing oesophagectomy for cancer from December 1989 to March 2004. Median patient age was 59 (28-79) year, 82.5% of patients were males. Squamous cell carcinoma was diagnosed in 151 (51.9%) and adenocarcinoma in 122 patients. Transhiatal oesophagectomy was done in 151 (51.9%) p…

The dawning of perioperative care in esophageal cancer

2017

The currently published paper “ Reduced fitness and physical functioning are long-term sequelae after curative treatment for esophageal cancer: a matched control study ” by Gannon et al . (1) focuses on a highly relevant topic of esophageal surgery, which has been greatly under-addressed in the past. Objective data on physical performance outcomes and health-related quality of life (HRQOL) of disease-free survivors after esophagectomy for cancer compared with a noncancer control group are rare (1). Data by Gannon et al . clearly show that disease-free survivors of curative esophageal cancer treatment display a significant compromise in physical functioning as compared to the control group, …