International journal of surgery
-
Unilateral and bilateral antegrade cerebral perfusions (ACP) are recognized methods of cerebral protection in aortic arch surgery. However, the adequacy of cerebral protection in aortic arch surgery with deep hypothermic circulatory arrest is controversial. In this study, we compared unilateral and bilateral ACP of cerebral protection in aortic arch surgery by assessing the patient's intraoperative and postoperative brain function. ⋯ When the duration of DHCA was 25 min or less, no significant differences were observed between unilateral and bilateral ACP. However, when DHCA exceeded 25 min, bilateral ACP was more effective compared to unilateral ACP. Due to the high variations in circle of Willis as well as increased safety, simplicity, and efficiency, the bilateral ACP approach is preferred over the unilateral technique.
-
Review Meta Analysis
Goal-directed fluid therapy for reducing risk of surgical site infections following abdominal surgery - A systematic review and meta-analysis of randomized controlled trials.
Surgical site infections (SSIs) become a key indicator of quality of care. This meta-analysis aimed to determine the effect of goal-directed fluid therapy (GDFT) on the risk of SSIs after abdominal surgery. ⋯ This systematic review suggests that perioperative GDFT is associated with a reduction in the incidence of SSIs after abdominal surgery.
-
Prehabilitation programs aim to optimise patients in order to enhance post-operative recovery. This study aims to review the composition of prehabilitation programs for patients undergoing major abdominal cancer surgery and define the outcome measures that are used to evaluate this intervention. ⋯ Prehabilitation programs in patients undergoing abdominal cancer surgery remain heterogeneous in their composition, mode of administration, outcome measures of functional capacity that are used to evaluate their impact. All these aspects require standardisation prior to the evaluation of prehabilitation on a larger scale.
-
The dysphagia and recurrent laryngeal nerve (RLN) palsy are the most common complications of the patients who underwent anterior cervical surgery in the current literature. These morbidities have led to the study of the impact of sidedness in anterior cervical spine surgery. However, many reports documented the left-side was more effective and safe than right-side based on the anatomy. ⋯ The most common complication which observed in 2.80% of our cases was dysphagia. Postoperatively, there was only one patient with hematoma and died (0.19%) and symptomatic recurrent laryngeal nerve palsy occurred in 0.39% of the cases. The anterolateral right-side anterior approach didn't increase the incidence of the dysphagia and recurrent laryngeal nerve (RLN) palsy.
-
Acute kidney injury (AKI) has been increasingly recognized as a common and serious postoperative complication. Although many studies have been conducted to investigate postoperative AKI after thoracic surgery, little is known about AKI after esophageal surgery. Thus, we conducted this study to determine the incidence and identify risk factors of postoperative AKI after esophageal cancer surgery. ⋯ Postoperative AKI occurred in 2.4% of patients after esophageal surgery for cancer. Preoperative serum creatinine level, duration of surgery, smoking history and hypertension were independent risk factors for postoperative AKI.