Data on the functional status of the cardiorespiratory system are required to identify patients at risk for postoperative complication in the presence of lung diseases. Very many factors influence the course of an operation and the postoperative period so there is no golden standard or the only parameter for predicting how the postoperative period runs. Patients with normal spirographic values (FEV1, more than 80%??) and without cardiovascular comorbidity are at a slight risk for postoperative complications. These patients do not need to be additionally examined. A less than one-month history of myocardial infarction, instable angina pectoris, decompensated heart failure, severe valvular disease are contraindications to planned surgery. The risk of cardiovascular events is high when the signs of myocardial ischemia occur with low exercise (less than 4 MET). Stress echocardiography, loading tests, and radioisotopic study are used as auxiliary techniques, FEV1, under 60%; ppo-FEV1, and ppo-DC, under 40%; VO2max, under 15 ml/kg/min are the values of a high risk for respiratory complications.
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J Neurosurg Case Lessons
January 2025
Department of Neurosurgery, Kanto Rosai Hospital, Kanagawa, Japan.
Background: The presence of significant tortuosity in access routes to aneurysms can interfere with catheter guidance and manipulation and significantly impact treatment strategies.
Observations: In this report, the authors combined intentional staged aneurysm embolization with the construction of a new direct access route, which they call a "highway bypass," for a symptomatic posterior circulation cerebral aneurysm that was difficult to access with a catheter. Notably, the highway bypass is used for catheter passage, and technical tips should be considered.
Acta Orthop
January 2025
Department of Surgical Sciences, Section for Orthopaedics, Uppsala University, Uppsala, Sweden.
Background And Purpose: Evidence for long-term outcomes following acetabular fractures in older adults is limited. We aimed to evaluate mortality, complications, and need for subsequent surgical procedures in operatively and nonoperatively treated older patients with acetabular fractures.
Methods: Patients aged ≥ 70 years with acetabular fractures treated at Uppsala University Hospital between 2010 and 2020 were included.
Anesth Analg
January 2025
School of Medicine, University of Santiago de Compostela, Santiago de Compostela, Spain.
Background: Some studies suggest that balanced solutions may improve outcomes in critical care patients. However, in patients with traumatic brain injury (TBI) existing data indicate that normal saline may be preferred. We hypothesized that mortality in critically ill patients with and without TBI would differ with the use of balanced salt solutions versus normal saline.
View Article and Find Full Text PDFSpine Deform
January 2025
Orthopedic Unit, Department of Surgery, Bambino Gesù Children's Hospital, Rome, Italy.
Purpose: Adolescent idiopathic scoliosis surgery (AIS) is often associated with high costs and significant recovery challenges. Enhanced recovery after surgery (ERAS) protocols aim to improve outcomes, reducing hospital stays and complications compared to traditional (TD) pathways. This study evaluates the impact of ERAS protocols on AIS treatment.
View Article and Find Full Text PDFTech Coloproctol
January 2025
Department of Colorectal Surgery, Peace Hospital Affiliated to Changzhi Medical College, 110 Yan'an South Road, Luzhou District, Changzhi City, 046000, Shanxi Province, China.
Objective: To investigate the efficacy of laparoscopic sigmoid extraperitoneal colostomy combined with pelvic peritoneal closure in abdominoperineal resection for low rectal cancer.
Methods: We retrospectively analyzed the clinical data of 162 patients with low rectal cancer, who underwent laparoscopic abdominoperineal resection from January 2015 to January 2019 at the Affiliated Peace Hospital of Changzhi Medical College. Extraperitoneal stoma construction was performed in 98 patients (study group), while 64 patients (control group) underwent the procedure without suturing the pelvic peritoneum.
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