Preoperative frailty assessment: a review.

Elderly surgical population is growing faster than the rate of population ageing. The risk of postoperative complication is higher in this population, the type of complication and the risk indicators are different from younger patients. There is also a huge heterogeneity in the elderly population.

[Gastric foreign body. Rare complication of nasogastric tube placing].

The use of an uncuffed endotracheal tube for the placement of nasogastric tubes during surgery is not a procedure free of any risk. We report a rare case of gastric foreign body secondary to this procedure. A 67-year-old patient who had underwent a coronary bypass for a three vessels disease two years before complained of postprandial epigastralgia lasting for a few months.

Reporting systems in healthcare from a case-by-case experience to a general framework: an example in anaesthesia.

Reporting systems are becoming more widespread in healthcare. Since they may become mandatory under the pressure of insurance companies and administrative organizations, it is important to begin to go beyond a case-by-case approach and to move to a system where there is a general reflection on the best conditions of development and setting up of such systems in medicine. In this paper, we review existing reporting systems, break down their components, examine how they are constructed and propose some ideas on how to articulate them in a dynamic process in order to improve the validity of the tool as mediator of safety, quality and well-being at work.

Adult liver transplantation at UCL: update 2002.

The authors present the results of a single centre study of 587 liver transplants performed in 522 adults during the period 1984-2002. Results have improved significantly over time due to better pre-, peri- and post-transplant care. One, five, ten and fifteen year actuarial survivals for the whole patient group are 81.

[Peroperative desaturation during gynaecological laparoscopy-hysteroscopy: an unknown aetiology, pleural extravasation].

A 41-year-old patient presented several episodes of desaturation during a gynaecological laparoscopy. The major complication of this procedure is the venous air embolism. Several other side-effects have been reported: heart rate disorders, subcutaneous emphysema or pneumothorax.

Cavocaval adult liver transplantation and retransplantation without venovenous bypass and without portocaval shunting: a prospective feasibility study in adult liver transplantation.

Background: The original method of liver transplantation (LT) included recipient inferior vena cava (IVC) resection and the use of extracorporeal venovenous bypass (VVB). Refinements in technique permit transplantation to be done with IVC preservation and without VVB use.

Material And Methods: Between November 1993 and November 2000, 202 consecutive grafts were performed in 188 adults (>/=16 years of age).

The analgesic efficacy of bilateral combined superficial and deep cervical plexus block administered before thyroid surgery under general anesthesia.

Unlabelled: In this study we evaluated the analgesic efficacy of combined deep and superficial cervical plexus block in patients undergoing thyroidectomy under general anesthesia. For this purpose, 39 patients undergoing elective thyroid surgery were randomized to receive a bilateral combined deep and superficial cervical block (14 mL per side) with saline (Group 1; n = 13), ropivacaine 0.5% (Group 2; n = 13), or ropivacaine 0.

[Postoperative otorrhagia: an unknown complication of Trendelenburg position during laparoscopic surgery?].

Two patients have presented postoperative otorrhagia following gynaecologic laparoscopic procedures. This occurred after uneventful anaesthesia and recovery for surgery performed in forced Trendelenburg position (35 degrees with horizontal position). Different responsible mechanisms are discussed including haemodynamic changes induced by both the Trendelenburg position and the pneumoperitoneum.