Articles: postoperative.
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Review Meta Analysis
Chewing gum and postoperative ileus in adults: a systematic literature review and meta-analysis.
Post-operative ileus (POI) is a major problem following elective abdominal surgery. Several studies have been published investigating the use of chewing gum to reduce POI. These studies however, have produced variable results. Thus, there is currently no consensus on whether chewing gum should be widely instituted as a means to help reduce POI. ⋯ Chewing gum offers only a small benefit in reducing time to flatus and time to passage of bowel motion following abdominal surgery. This benefit is of limited clinical significance. Further studies should be conducted in a modern peri-operative care environment.
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Curr Opin Anaesthesiol · Feb 2015
Review Case ReportsPreoperative evaluation of the patient with lung cancer being considered for lung resection.
This review summarizes the general approach to evaluating the cardiopulmonary fitness of a patient with lung cancer being considered for lung resection. Many patients have a high risk for morbidity and mortality from lung resection owing to severe comorbidities or low cardiopulmonary reserve. A comprehensive and individualized assessment is essential to identify the factors that may impact operative outcome. ⋯ Preoperative assessment requires an understanding of the relative benefits and harms of available treatment options and consideration of patients' values. A balance between the potential to cure one's cancer and the short-term and long-term risks of the selected treatment needs to be reached. All patients should have a baseline FEV(1) and DL(CO) measured, and predicted postoperative FEV(1) and DL(CO) calculated to assist with risk prediction. Measures of exercise performance can help to further risk stratify patients. Means of modifying the risks should be considered for all patients.
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Acta Anaesthesiol Scand · Feb 2015
ReviewEndothelial dysfunction after non-cardiac surgery: a systematic review.
More than 50% of patients with increased troponin levels after non-cardiac surgery have an impaired endothelial function pre-operatively. Non-invasive markers of endothelial function have been developed for the assessment of endothelial dysfunction. The aim of this paper was to systematically review the literature to evaluate the association between non-cardiac surgery and non-invasive markers of endothelial function. ⋯ Endothelial function changes in relation to surgery. Assessment of endothelial function by non-invasive measures has the potential to guide clinicians in the prevention or treatment of post-operative myocardial damage.