Radical cystectomy is a morbid procedure performed on an aging and often frail population. Nonetheless, advances in preoperative and intraoperative management have significantly improved patient outcomes. Preoperative optimization includes a focus on patient education, risk factor reduction, risk stratification, nutritional optimization, and bowel motility enhancement. Intraoperative optimization focuses on maintaining normothermia, restrictive fluid administration, minimization of blood transfusions, and nonopioid pain management.
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Pediatric patients undergoing cardiothoracic surgery are at increased risk for health care-associated infections, especially surgical site infections (SSIs). Delayed sternal closures are associated with prolonged lengths of stay and contribute to infection risks and morbidities. At a single-site academic pediatric center, we created an SSI-prevention bundle targeting the preoperative, intraoperative, and postoperative care periods.
View Article and Find Full Text PDFGlycemic control to improve post-operative outcomes in patients with type 2 diabetes mellitus: Results of the SUGAR (Surgical Universal euGlycemic Attainment during Recovery) initiative.
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The University of Texas MD Anderson Cancer Center, Department of Gynecologic Oncology and Reproductive Medicine, Houston, TX, USA.
Objective: Hyperglycemia, or glucose values >180 mg/dL, is associated with adverse post-operative outcomes. Our objective was to determine the impact of improving peri-operative glycemic control and evaluate infectious complications among patients with type 2 diabetes mellitus undergoing open gynecologic surgery.
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Intramural pregnancy after intrauterine insemination in a nulligravid patient without previous uterine trauma, complicated by idiopathic thrombocytopenic purpura: A case report.
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Sakai City Medical Center, 1-1-1, Ebaraji-cho, Nishi-ku, Sakai, Osaka 593-8304, Japan.
Intramural pregnancy (IMP) is an extremely rare form of ectopic pregnancy (EP), typically associated with previous uterine trauma, adenomyosis, or assisted reproductive technology (ART), such as embryo transfer (ET). Despite its potentially life-threatening nature, the absence of definitive preoperative diagnostic criteria for IMP complicates its early detection and management, especially in patients without known risk factors. Additionally, management becomes more challenging when there is an elevated risk of hemorrhage.
View Article and Find Full Text PDFThe role of intraoperative monitoring in target selection in deep brain stimulation: A single centre study.
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January 2025
Department of Neurology, University Medical Centre Ljubljana, 1000 Ljubljana, Slovenia.
Introduction: Intraoperative microelectrode recording (MER) and intraoperative test stimulation may provide vital information for optimal electrode placement and clinical outcome in movement disorders patients treated with deep brain stimulation (DBS). The aims of this retrospective study were to determine (i) how often the planned (imaging based) placements of electrodes were changed due to MER and intraoperative test stimulation in Parkinson's disease (PD), dystonia and essential tremor (ET) patients; (ii) whether the frequency of repositioning changed over time; (iii) whether patients' age or disease duration (in PD) influenced the frequency of repositioning.
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A quantitative amplitude of vagus nerve obtained by intraoperative neuromonitoring predicts postoperative vocal cord paralysis among patients in thyroid/parathyroid surgery as a second option.
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Department of Breast and Thyroid Surgery, Kitasato University Hospital/Kitasato University School of Medicine, Kanagawa, Japan.
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