American journal of surgery
-
Although 90% of patients with neurogenic thoracic outlet syndrome (NTOS) experience "excellent" or "good" results after thoracic outlet decompression, recurrent symptoms may develop in certain patients. ⋯ Complete excision of cervical or first ribs and subtotal excision (instead of simple division) of the scalene muscles will decrease the incidence of recurrent NTOS. Pectoralis minor tenotomy should be considered part of complete thoracic outlet decompression. Anterior scalene muscle block accurately predicts outcome of reoperation for certain types of recurrent NTOS.
-
Randomized Controlled Trial Clinical Trial
The effectiveness of video feedback in the acquisition of orthopedic technical skills.
The addition of video feedback to bench model training offers residents the opportunity to see themselves perform a surgical task. Videotaped feedback therefore promotes self-evaluation, a critical learning skill, and also has the potential to influence how a resident executes a skill once they have had the opportunity to see themselves perform the task. ⋯ This study failed to demonstrate an improvement in technical skills based on utilization of video feedback.
-
Comparative Study
The role of central venous pressure and type of vascular control in blood loss during major liver resections.
Blood loss during liver resection constitutes the primary determinant of the postoperative outcome. Various techniques of vascular control and maintenance of a low central vein pressure (CVP) have been used in order to prevent intraoperative blood loss and postoperative complications. Our study aims at assessing the effects of different levels of CVP in relation to type of vascular control on perioperative blood loss and patient outcome. ⋯ Elevated CVP during major liver resections results in greater blood loss and a longer hospital stay. The Pringle maneuver with CVP 5 mm Hg or less is associated with blood loss not significantly different from that with SHVE. The latter, though, has been shown not to be affected by CVP levels and should be used whenever CVP remains high despite adequate anesthetic management.
-
Review Comparative Study
Pathophysiologic changes and effects of hypothermia on outcome in elective surgery and trauma patients.
Generally, hypothermia is defined as a core temperature <35 degrees C. In elective surgery, induced hypothermia has beneficial effects. It is recommended to diminish complications attributable to ischemia reperfusion injury. ⋯ This might have a beneficial effect on outcome. Nevertheless, posttraumatic infectious complications may be higher because of an immunosuppressive profile. Further studies are needed to investigate the impact of induced hypothermia on outcome in trauma patients.