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8 records – page 1 of 1.

[Actual problems of the surgical treatment of chest gunshot wounds].

https://arctichealth.org/en/permalink/ahliterature176321
Source
Voen Med Zh. 2004 Dec;325(12):22-6, 96
Publication Type
Article
Date
Dec-2004
Author
O V Kochergaev
S F Usik
M M Mutalibov
Kh I Muradov
G S Shastun
Source
Voen Med Zh. 2004 Dec;325(12):22-6, 96
Date
Dec-2004
Language
Russian
Publication Type
Article
Keywords
Adolescent
Adult
Humans
Male
Middle Aged
Military Personnel
Russia
Thoracic Injuries - surgery
Thoracic Surgical Procedures - methods
Treatment Outcome
Wounds, Gunshot - surgery
Abstract
The experience obtained during the treatment of 86 casualties with chest injuries was generalized. The authors present the scheme of diagnosis and treatment for the given patient category. To diagnose the cardiac injuries the operation (pericardium fenestration) was proposed. Application of the proposed scheme for diagnosing and treating the casualties with chest injuries allowed to reduce the number of early pleural complications from 55.1 to 22.1% and diagnostic mistakes--from 34.2 to 11.2%.
PubMed ID
15690852 View in PubMed
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[Aortopexy in the surgical treatment of tracheomalacia in children]

https://arctichealth.org/en/permalink/ahliterature29229
Source
Klin Khir. 2005 Sep;(9):18-22
Publication Type
Article
Date
Sep-2005
Author
D Iu Kryvchenia
Ie O Rudenko
O K Sliepov
L F Chumakova
Source
Klin Khir. 2005 Sep;(9):18-22
Date
Sep-2005
Language
Ukrainian
Publication Type
Article
Keywords
Adolescent
Aorta - surgery
Child
Child, Preschool
English Abstract
Esophageal Atresia - complications
Follow-Up Studies
Humans
Infant
Thoracic Surgical Procedures - methods
Tracheal Diseases - etiology - surgery
Tracheoesophageal Fistula - etiology - surgery
Treatment Outcome
Abstract
Aortopexy was performed in 55 patients for respiratory ways obstruction of various origin. There were estimated immediate and late follow-up results of aortopexy application, solely or in conjunction with tracheoplasty in 11 patients, ageing from 1 mo to 5 years, performed for tracheomalacia, which included idiopathic, associated with esophageal atresia and tracheoesophageal fistula forms. Local tracheomalacia was revealed in 8 patients, diffuse--in 3. In 6 observations aortopexy was conducted only, in 5 - aortopexy in conjunction with tracheoplasty using pericardial or fasciopleural flaps. In presence of esophageal disease concominantly its segmental resection of cicatricially changed portion was performed, as well as the recurrent tracheoesophageal fistula division and suturing. Generally, positive result in immediate and late follow-up period was noted in all the patients. In 3 patients there was revealed incomplete stabilization of trachea with the membranous portion of the wall expulsion up to 1/2 of lumen and persistence of nonsignificant respiratory symptoms, caused by presence of gastro-esophageal reflux. The results obtained witness, that aortopexy constitutes an effective method of surgical treatment of respiratory ways obstruction, caused by tracheomalacia. The presence of diffuse tracheomalacia needs additional tracheoplasty to the aortopexy performance.
PubMed ID
16445038 View in PubMed
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Drug, devices, technologies, and techniques for blood management in minimally invasive and conventional cardiothoracic surgery: a consensus statement from the International Society for Minimally Invasive Cardiothoracic Surgery (ISMICS) 2011.

https://arctichealth.org/en/permalink/ahliterature119221
Source
Innovations (Phila). 2012 Jul-Aug;7(4):229-41
Publication Type
Conference/Meeting Material
Article
Author
Alan H Menkis
Janet Martin
Davy C H Cheng
David C Fitzgerald
John J Freedman
Changqing Gao
Andreas Koster
G Scott Mackenzie
Gavin J Murphy
Bruce Spiess
Niv Ad
Author Affiliation
WRHA Cardiac Sciences Program, Department of Surgery, University of Manitoba, Winnipeg, MB Canada.
Source
Innovations (Phila). 2012 Jul-Aug;7(4):229-41
Language
English
Publication Type
Conference/Meeting Material
Article
Keywords
Antifibrinolytic Agents - therapeutic use
Blood Loss, Surgical - prevention & control
Blood Transfusion - adverse effects - methods
Canada
Cardiac Surgical Procedures - instrumentation - methods
Cardiology
Coronary Artery Bypass, Off-Pump - methods
Erythropoietin - therapeutic use
Factor VIIa - therapeutic use
Humans
International Cooperation
Iron - therapeutic use
Meta-Analysis as Topic
Perioperative Period
Platelet Aggregation Inhibitors - therapeutic use
Practice Guidelines as Topic
Randomized Controlled Trials as Topic
Societies, Medical
Surgical Procedures, Minimally Invasive - methods
Thoracic Surgical Procedures - methods
Treatment Outcome
Abstract
The objectives of this consensus conference were to evaluate the evidence for the efficacy and safety of perioperative drugs, technologies, and techniques in reducing allogeneic blood transfusion for adults undergoing cardiac surgery and to develop evidence-based recommendations for comprehensive perioperative blood management in cardiac surgery, with emphasis on minimally invasive cardiac surgery.
The consensus panel short-listed the potential topics for review from a comprehensive list of potential drugs, devices, technologies, and techniques. The process of short-listing was based on the need to prioritize and focus on the areas of highest importance to surgeons, anesthesiologists, perfusionists, hematologists, and allied health care involved in the management of patients who undergo cardiac surgery whether through the conventional or minimally invasive approach. MEDLINE, Cochrane Library, and Embase databases were searched from their date of inception to May 2011, and supplemental hand searches were also performed. Detailed methodology and search strategies are outlined in each of the subsequently published systematic reviews. In general, all relevant synonyms for drugs (antifibrinolytic, aprotinin, [Latin Small Letter Open E]-aminocaproic acid, tranexamic acid [TA], desmopressin, anticoagulants, heparin, antiplatelets, anti-Xa agents, adenosine diphosphate inhibitors, acetylsalicylic acid [ASA], factor VIIa [FVIIa]), technologies (cell salvage, miniaturized cardiopulmonary bypass (CPB) circuits, biocompatible circuits, ultrafiltration), and techniques (transfusion thresholds, minimally invasive cardiac or aortic surgery) were searched and combined with terms for blood, red blood cells, fresh-frozen plasma, platelets, transfusion, and allogeneic exposure. The American Heart Association/American College of Cardiology system was used to label the level of evidence and class of each recommendation.
Database search identified more than 6900 articles, with 4423 full-text randomized controlled trials assessed for eligibility, and the final 125 systematic reviews and meta-analyses were used in the consensus conference. The results of the consensus conference, including the evidence-based statements and the recommendations, are outlined in the text, with references given for the relevant evidence that formed the basis for the statements and recommendations. RECOMMENDATIONS FOR ANTIFIBRINOLYTICS: The lysine analogs ?-aminocaproic acid (Amicar) and tranexamic acid (TA) reduce exposure to allogeneic blood inpatients undergoing on-pump cardiac surgery. These agents are recommended to be used routinely as part of a blood conservation strategy especially in patients at risk of undergoing onpump cardiac surgery (Class I, Level A). It is important not to exceed maximum TA total dosages (50Y100mg/kg) because of potential neurotoxicity in the elderly and open-heart procedures (Class IIb, Level C). Aprotinin is not recommended in adult cardiac surgery until further studies on its safety profile have been performed (Class III, Level A). RECOMMENDATIONS FOR TA IN OFF-PUMP CORONARY ARTERY BYPASS: Tranexamic acid may be recommended as part of a blood conservation strategy in high risk patients undergoing off-pump coronary artery bypass (OPCAB) surgery (Class I, Level A).Tranexamic acid dosing in OPCAB surgery needs further study particularly with regard to possible neurotoxicity such as seizures.In addition, the benefit-risk ratio in OPCAB needs further eludication because of the lower inherent risk for bleeding in this group (Class IIb, Level C). RECOMMENDATIONS FOR DDAVP: DDAVP can be considered for prophylaxis in coronary artery bypass grafting (CABG) surgery, in particular, for patients onASA within 7 days or prolonged CPB more than 140 minutes (Class IIa, Level A). Caution should be used with the DDAVP infusion rate to avoid significant systemic hypotension (Class I, Level A). RECOMMENDATIONS FOR TOPICAL HEMOSTATICS: The routine use of topical antifibrinolytics in cardiac surgery isnot recommended (Class IIa, Level A). Topical fibrin sealants may be considered in clinical situations where conventional approaches of surgical and medical improvement of hemostasis are not effective, that is, with bleeding problems more local than generalized, bearing in mind the blackbox warning of bovine thrombin by the US Food and Drug Administration (Class IIb, Level C).Recommendations for FVIIa:Prophylactic use of FVIIa cannot be recommended because of a significant increase in the risk of thromboembolic events and stroke (Class IIa, Level A).Factor VIIa may be considered in clinical situations where conventional approaches of surgical and pharmacologic hemostasis have failed and uncontrollable hemorrhage poses a high risk of severe and life-threatening outcomes (Class IIb, Level B). RECOMMENDATIONS FOR ERYTHROPOIETIN PLUS IRON: It is reasonable to administer erythropoietin preoperatively to increase red blood cell mass in patients who are anemic or refuse blood products (such as for Jehovah?s Witness faith) or who are likely to have postoperative anemia (Class IIa, Level A). RECOMMENDATIONS FOR ANTIPLATELETS BEFORE CARDIAC SURGERY: Acetylsalicylic acid may be continued until surgery (Class IIa,Level B) For stable elective CABG procedures with no drug-elutingstent, stop clopidogrel 5 days before surgery (Class I, Level A).h For stable elective CABG procedures with drug-eluting stents less than 1 year old, consider continuing clopidogrel or heparin as abridge to surgery (Class IIb, Level C).h Direct-acting P2Y12 receptor antagonists may be a better alternative than clopidogrel in acute coronary syndrome patients undergoing CABG surgery (Class IIa, Level B). RECOMMENDATIONS FOR ANTIPLATELETS AFTER CARDIAC SURGERY: In stable CABG surgery (nonYacute coronary syndrome patients), the routine use of postoperative clopidogrel with ASAis not warranted (Class IIb, Level B). RECOMMENDATIONS FOR ACUTE NORMOVOLEMIC HEMODILUTION: Acute normovolemic hemodilution can be considered in selected patients with adequate preoperative hemoglobin to reduce post-CPB bleeding (Class IIa, Level A).The routine use of acute normovolemic hemodilution is not recommended (Class IIb, Level B). RECOMMENDATIONS FOR RETROGRADE AUTOLOGOUS PRIMING: Retrograde autologous priming is recommended as a blood conservation modality to reduce allogeneic blood transfusion for onpump cardiac surgery (Class I, Level A). RECOMMENDATIONS FOR CELL SALVAGE: Routine use of cell salvage is recommended in operations where an increased blood loss is expected (Class 1, Level A). Cell salvage should be used throughout the entire operation and not merely as a replacement for CPB cardiotomy suction (Class IIa, Level A).
BIOCOMPATIBLE CPB CIRCUITS: The routine use of biocompatible coated CPB circuitry may be considered as part of a multimodal blood conservation program. However, the heterogeneity of surface-modified products, anticoagulation management, and CPB technique does not significantly impact surgical blood loss and transfusion needs (Class IIb,Level A). RECOMMENDATIONS FOR MINIATURIZED EXTRACORPOREAL CARDIOPULMONARY CIRCUIT VERSUS CONVENTIONAL EXTRACORPOREAL CARDIOPULMONARY CIRCUIT: Miniaturized extracorporeal cardiopulmonary circuit can be considered as a blood conservation technique to reduce allogeneic blood exposure (Class IIa, Level A); however, issues related to heparinization management and biocompatible coatings remain to be clarified. RECOMMENDATIONS FOR ULTRAFILTRATION (CONTINUOUS OR MODIFIED):h Ultrafiltration may be considered for blood conservation (Class IIb, Level A); however, the impact on clinically relevant outcomes remains unknown. RECOMMENDATIONS FOR PLATELET PLASMAPHERESIS:It is reasonable to recommend platelet plasmapheresis for blood management in cardiac surgery (Class IIa, Level A), although the impact on clinically relevant outcomes remains unknown. RECOMMENDATIONS FOR POINT-OF-CARE MONITORING:The evidence is too premature to recommend point-of-caretechnology for routine use because its use has not been shown to impact clinical outcome (Class IIb, Level A). RECOMMENDATIONS FOR SURGICAL TECHNIQUES FOR OPCAB, MINIMALLY INVASIVE STERNOTOMY FOR AORTIC VALVE SURGERY, MINIMALLY INVASIVE STERNOTOMY FOR MITRAL VALVE SURGERY, AND TRANSCATHETHER AORTIC VALVE IMPLANTATION: Although these minimally invasive procedures are not primarily selected for the purpose of blood management, the reduced allogeneic blood exposure should be considered in the balance of benefits and risks when selecting the appropriate surgery for patients.
PubMed ID
23123988 View in PubMed
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[Report "Endosurgery for thoracic organs defects in children" Protocol No295 of Moscow Thoracic surgeons Society session from March 24.2015].

https://arctichealth.org/en/permalink/ahliterature270151
Source
Khirurgiia (Mosk). 2015;(8 Pt 2):52-5
Publication Type
Article
Date
2015

Self-Reported Physical Quality of Life Before Thoracic Operations Is Associated With Long-Term Survival.

https://arctichealth.org/en/permalink/ahliterature281882
Source
Ann Thorac Surg. 2017 Feb;103(2):484-490
Publication Type
Article
Date
Feb-2017
Author
Mamdoh Al-Ameri
Per Bergman
Anders Franco-Cereceda
Ulrik Sartipy
Source
Ann Thorac Surg. 2017 Feb;103(2):484-490
Date
Feb-2017
Language
English
Publication Type
Article
Keywords
Aged
Cohort Studies
Confidence Intervals
Female
Health status
Humans
Male
Mental health
Middle Aged
Preoperative Care - methods
Preoperative Period
Proportional Hazards Models
Prospective Studies
Quality of Life
Self Report
Survival Rate
Sweden
Thoracic Surgical Procedures - methods - mortality
Treatment Outcome
Abstract
The aim was to analyze the association between baseline self-reported health-related quality of life and long-term survival after thoracic operations.
In a prospective population-based cohort study, we included patients scheduled for thoracic operations and obtained information about preoperative health-related quality of life using the validated quality-of-life instrument Short Form-36. Patients were categorized according to higher or lower physical and mental component scores, compared with an age- and sex-matched reference population. The primary outcome measure was all-cause mortality and was ascertained from Swedish national registers. We used Cox regression for estimation of hazard ratios (HRs) and 95% confidence intervals (CIs) for the association between preoperative physical/mental quality of life and long-term survival while adjusting for differences in baseline characteristics, cancer stage, histopathologic process, and other factors.
We included 249 patients between 2006 and 2008. During a median follow-up time of 8.0 years, 119 patients (48%) died. Having a physical component summary score less than reference was significantly associated with mortality (multivariable adjusted HR 2.02, 95% CI: 1.34 to 3.06, p = 0.001). A mental component summary score less than reference was not associated with mortality (adjusted HR 1.32, 95% CI: 0.84 to 3.06, p = 0.233).
In patients who underwent thoracic operations, a self-reported physical quality of life lower than reference value was associated with significantly worse survival independent of histopathologic process, cancer stage, extent of operations, and other patient-related factors. The preoperative mental component of quality of life was not associated with long-term survival.
PubMed ID
27666786 View in PubMed
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[Surgery of modern combat damage of breast].

https://arctichealth.org/en/permalink/ahliterature142978
Source
Voen Med Zh. 2010 Jan;331(1):20-8
Publication Type
Article
Date
Jan-2010
Author
P G Briusov
Source
Voen Med Zh. 2010 Jan;331(1):20-8
Date
Jan-2010
Language
Russian
Publication Type
Article
Keywords
Female
Hospitals, Military
Humans
Male
Russia
Thoracic Injuries - classification - surgery
Thoracic Surgical Procedures - methods
War
Wounds, Gunshot - classification - surgery
Abstract
The article presents an overall estimate of experience of surgical treatment of ballistic penetrating wounds of bosom of 1920 wounded in Afgan war (1979-1989) and 367 wounded during the armed conflict on Northern Caucasus (1994-1996). Ballistic penetrating wounds of bosom in modern military conflicts are characterized by high mortality on battle field, achieving 30%. In conditions of heavy wound the choice of optimum surgery tactics poses several difficulties, and due to it indications urgent thoracotomy are often increased. Multistage system of delivery of health care, used in Afgan war, during battle actions on the Northern Caucasus was changed to 2-stage system, where wounded persons during 1-2 hours were delivered to a specialist in multiprofile base hospital, placed in a combat zone. Effectuating of thoracocentesis with a closed drainage of pleural space stays the most popular and extended method of treatment ballistic penetrating wounds of bosom, used by 85% of wounded persons. Using of operative videothoracoscopia in 1995 during delivery of emergency specialized surgical medical care to wounded persons in forward base hospital leaded to decreasing of frequency of using of large thoracotomy to 2,4%. There was overviewed the modern conception of surgical treatment of patients, having bosom wounds.
PubMed ID
20536034 View in PubMed
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Source
Ugeskr Laeger. 1999 Apr 12;161(15):2211-3
Publication Type
Article
Date
Apr-12-1999
Author
A P Ainsworth
K B Andersen
Author Affiliation
Odense Universitetshospital, thorax-karkirurgisk afdeling T.
Source
Ugeskr Laeger. 1999 Apr 12;161(15):2211-3
Date
Apr-12-1999
Language
Danish
Publication Type
Article
Keywords
Adolescent
Age Factors
Child
Child, Preschool
Denmark
English Abstract
Female
Humans
Infant
Infant, Newborn
Male
Retrospective Studies
Thoracic Surgical Procedures - methods - mortality - statistics & numerical data
Abstract
In order to study non-cardiac thoracic surgery in children we reviewed the files of all children under 16 years, who had surgery at the Department of Thoracic and Cardiovascular Surgery, Odense University Hospital from 1987 to 1996. Thirty-three children had chest tube insertion because of neonatal pneumothorax. Twelve of these died within five days after birth. Fifty-five children had surgery for primary intrathoracic diseases. Congenital pulmonary malformations were most common in the youngest children. Traumatic diseases were most common in the oldest. No immediate postoperative deaths occurred, but seven children were dead at the follow-up. Thirty-eight had surgery for involvement of the thoracic organs secondary to other often malignant diseases. Eleven of these were dead at the follow-up. It is concluded, that thoracic surgery is required for a number of diseases in children and is well tolerated. However, severe primary diseases lead to an increased mortality.
PubMed ID
10222817 View in PubMed
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Venovenous extracorporeal membrane oxygenation treatment in a low-volume and geographically isolated cardiothoracic centre.

https://arctichealth.org/en/permalink/ahliterature310622
Source
Acta Anaesthesiol Scand. 2019 08; 63(7):879-884
Publication Type
Journal Article
Research Support, Non-U.S. Gov't
Date
08-2019
Author
Inga L Ingvarsdottir
Halla Vidarsdottir
Felix Valsson
Liney Simonardottir
Martin I Sigurdsson
Gunnar Myrdal
Arnar Geirsson
Tomas Gudbjartsson
Author Affiliation
Department of Anaesthesiology and Intensive Care, Landspitali University Hospital, Reykjavik, Iceland.
Source
Acta Anaesthesiol Scand. 2019 08; 63(7):879-884
Date
08-2019
Language
English
Publication Type
Journal Article
Research Support, Non-U.S. Gov't
Keywords
APACHE
Adolescent
Adult
Aged
Cardiac Surgical Procedures - methods - statistics & numerical data
Drowning
Extracorporeal Membrane Oxygenation - statistics & numerical data
Female
Follow-Up Studies
Hospital Mortality
Humans
Iceland
Male
Middle Aged
Pneumonia - complications
Registries
Respiratory Distress Syndrome - therapy
Retrospective Studies
Survival Analysis
Thoracic Surgical Procedures - methods - statistics & numerical data
Young Adult
Abstract
Extracorporeal membrane oxygenation (ECMO) treatment is generally offered in large tertiary cardiothoracic referral centres. Here we present the indications and outcome of venovenous-ECMO (VV-ECMO) treatment in a low-volume, geographically isolated single-centre in Iceland, a country of 350 000 inhabitants. Our hypothesis was that patient survival in such a centre can be similar to that at high-volume centres.
A retrospective study that included all patients treated with VV-ECMO in Iceland from 1991-2016 (n = 17). Information on demographics, indications and in-hospital survival was collected from patient charts and APACHE II and Murray scores were calculated. Information on long-term survival was collected from a centralized registry.
Seventeen patients were treated with VV-ECMO (nine males, median age 33 years, range 14-74), the indication for 16 patients was severe acute respiratory distress syndrome, most often following pneumonia (n = 6), H1N1-infection (n = 3) or drowning (n = 2). Median APACHE-II and Murray-scores were 20 and 3.5, respectively, and median duration of VV-ECMO treatment was 9 days (range 2-40 days). In total 11 patients (64,7%) survived the treatment, with 10 patients (58,8%) surviving hospital discharge, all of who were still alive at long-term follow-up, with a median follow-up time of 9 years (August 15th, 2017).
Venovenous-ECMO service can be provided in a low-volume and geographically isolated centre, like Iceland, with short- and long-term outcomes comparable to larger centres.
PubMed ID
30937908 View in PubMed
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8 records – page 1 of 1.