Search results for "Perioperative"
showing 10 items of 332 documents
Frailty and emergency surgery in the elderly: protocol of a prospective, multicenter study in Italy for evaluating perioperative outcome (The FRAILES…
2018
Improvements in living conditions and progress in medical management have resulted in better quality of life and longer life expectancy. Therefore, the number of older people undergoing surgery is increasing. Frailty is often described as a syndrome in aged patients where there is augmented vulnerability due to progressive loss of functional reserves. Studies suggest that frailty predisposes elderly to worsening outcome after surgery. Since emergency surgery is associated with higher mortality rates, it is paramount to have an accurate stratification of surgical risk in such patients. The aim of our study is to characterize the clinicopathological findings, management, and short-term outcom…
Follow-up of patients after revascularisation for peripheral arterial diseases: a consensus document from the European Society of Cardiology Working …
2019
International audience; Peripheral arterial diseases comprise different clinical presentations, from cerebrovascular disease down to lower extremity artery disease, from subclinical to disabling symptoms and events. According to clinical presentation, the patient's general condition, anatomical location and extension of lesions, revascularisation may be needed in addition to best medical treatment. The 2017 European Society of Cardiology guidelines in collaboration with the European Society for Vascular Surgery have addressed the indications for revascularisation. While most cases are amenable to either endovascular or surgical revascularisation, maintaining long-term patency is often chall…
Perioperative and anesthetic deaths: toxicological and medico legal aspects
2019
Abstract Background Anesthesia has become safer during decades, though there is still a preventable mortality; the complexity of medical and surgical interventions, increasingly older and sicker patients, has created a host of new hazards in anesthesiology. In this paper, some of these perioperative (PO) fatal adverse events are investigated in terms of health responsibility. Selective literature research in several data bases, concerning perioperative and anesthetic deaths and medical responsibility, was performed. Main text A generally accepted definition of the anesthesia and perioperatory-related death still remains one of the major concerns in forensic pathology, and the terms “operati…
1599 Peri- and Postoperative Complications of 215 Cases of Inguinal Hernia in Children
2012
Background The cure of inguinal hernia in children consists of high ligation of hernial sac, generally evolving with few complications. Aim The evaluation of casuistry structure and evaluation of peri- and postoperative complications in children. Method Retrospective analytical study for a period of three years includes case studies which required high ligation of the hernia sac (procesus vaginalis). Results The 214 cases were stratified according to: Location: left side 29 hernias (13.5%); bilateral 4 (1.8%); right side 181 (84.5%) cases; Age: 1–3 years, 70 (32.7%); 4–6 years, 71 (33.1%); 7–12 years, 62 (28.9%); 13–18 years, 11 cases (5.1%); During hospitalization: ≤ 3 days, 65 (30.3%); 4–…
Sicher zwischen Leitlinie und Leitplanke: Umfrage zur Praxis des perioperativen Managements der radikalen Zystektomie in Deutschland
2020
Zusammenfassung Hintergrund und Zielsetzung Die radikale Zystektomie (RCX) ist die kurative Standardbehandlung für muskelinvasive Harnblasenkarzinome. Aufgrund des operativen Ausmaßes und der damit verbundenen komplexen stationären Betreuung ist die RCX mit hoher Morbidität und Mortalität verbunden. Ziel war es, Daten aus dem klinischen Alltag zur gegenwärtigen Praxis des perioperativen Managements zu erfassen. Methoden Mitglieder der DGU und der German Society of Residents in Urology beantworteten anonym einen 24 Fragen umfassenden Online-Fragebogen. Gegenstand waren sowohl klinisch relevante Aspekte der gegenwärtigen EAU/DGU-Leitlinien als auch kontrovers diskutierte klinische Fragen. Erg…
The heart in the elderly critically ill patient
2002
Cardiac complications such as myocardial infarction and congestive heart failure are the primary source of perioperative morbidity and mortality in elderly surgical patients. This is the result of structural and functional age-related changes in the heart and the vasculature and an increasing incidence of cardiovascular disorders. Appropriate perioperative management of the elderly patient should be based on the extent of functional compromise, the type and severity of pre-existing disease, and the invasiveness of the surgical procedure. Current studies suggest that appropriately administered medical therapy, particularly beta-adrenergic blockade, may reduce perioperative cardiovascular mor…
Early cardiac unloading with ImpellaCP™ in acute myocardial infarction with ventricular septal defect
2020
Abstract Despite a relative contraindication, mechanical support with Impella™ left ventricular assist device has already been described for ischaemic ventricular septal defect treatment, either as a bridge to surgery, as intraoperative mechanical haemodynamic support, or to ensure intraprocedural haemodynamic stability during device closure. We describe two cases of ventricular septal defect complicating acute myocardial infarction, where the percutaneous ImpellaCP was implanted early (differently than previously described) with the aim of preventing haemodynamic instability, while deferring surgical repair. We present a report of haemodynamic, echocardiographic, biochemical, and clinical …
EP756 Laterally extended endopelvic resection: a comparative analysis between laparotomic and laparoscopically modified approach
2019
Introduction/Background Laterally Extended Endopelvic Resection (LEER) has been identified as a valid therapeutic option for women with gynecological malignancies involving the pelvic side wall. The historical approach to LEER is laparotomic, recently we have proposed the so called Laparoscopically Modified Laterally Extended Endopelvic Resection (LM-LEER).The objective of this study is to compare surgical and oncological outcomes between LEER and LM-LEER in a consecutive series of patients with gynecological malignancies infiltrating the pelvic side wall. Methodology We retrospectively evaluated women submitted to LEER between October 2012 and January 2019. Inclusion criteria for LM-LEER w…
Microwave-induced thermoablation with Amica-probe is a safe and reproducible method to treat solid renal masses: results from a phase I study.
2012
Microwave thermal ablation (MWTA) could be considered in the future for treating small solid renal masses. The aim of the present study was to determine both the tolerability of the new Amica-probe applicator-induced MWTA used in vivo on patients with solid renal masses and the effects of heating on renal tumors and normal renal parenchyma. Fourteen patients with renal masses eligible for open radical nephrectomy were enrolled in this phase I study. All patients underwent MWTA of renal masses during the open surgery procedure before clamping of renal vascular pedicle. The effects of MWTA on patients' coagulation and tumor/renal vasculature were investigated. The histological effects of MWTA…
First clinical uterus transplantation trial: a six-month report.
2014
Objective To report the 6-month results of the first clinical uterus transplantation (UTx) trial. This type of transplantation may become a treatment of absolute uterine-factor infertility (AUFI). Design Prospective observational study. Setting University hospital. Patient(s) Nine AUFI women and their live uterine donors, the majority being mothers. Intervention(s) Live-donor UTx and low-dose induction immunosuppression. Main Outcome Measure(s) Data from preoperative investigations, surgery and follow-up for 6 months. Result(s) Durations of donor and recipient surgery ranged from 10 to 13 hours and from 4 to 6 hours, respectively. No immediate perioperative complications occurred in any of …