Nonintubated Spontaneous Ventilation Offers Better Short-term Outcome for Mediastinal Tumor Surgery

Publication date: October 2019Source: The Annals of Thoracic Surgery, Volume 108, Issue 4Author(s): Hengrui Liang, Jun Liu, Shilong Wu, Yaoliang Zhang, Hui Liu, Hanyu Yang, Yi Zhao, Zhexue Hao, Wenhua Liang, Jianxing HeBackgroundNonintubated spontaneous ventilation video-assisted thoracoscopic surgery (NI-VATS) has been investigated to reduce the adverse effects of tracheal intubation, mechanical ventilation, and general anesthesia in several thoracic diseases. We comparatively assess the comparison between NI-VATS vs intubated anesthesia VATS (I-VATS) on early outcomes of mediastinal lesion resection.MethodsPatients who underwent VATS resection for a mediastinal tumor between December 2015 and September 2018 were retrospectively included for analysis. Patients were divided into two groups according to anesthesia ventilation type: NI-VATS and I-VATS. Propensity score matching was applied to eliminate population bias. Intraoperative and postoperative variables were compared.ResultsA total of 198 patients was included; 75 patients underwent NI-VATS and 123 patients underwent I-VATS. After propensity score matching, both anesthesia time (173.81 vs 227.37 minutes, P
Source: The Annals of Thoracic Surgery - Category: Cardiovascular & Thoracic Surgery Source Type: research

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Publication date: Available online 18 October 2019Source: Anaesthesia Critical Care &Pain MedicineAuthor(s): Jean-Stéphane David, Kenji Inaba
Source: Anaesthesia, Critical Care and Pain Medicine - Category: Anesthesiology Source Type: research
n BA, Shore-Lesserson L, Abernathy J, Schwann N, Lau WT Abstract Bleeding after cardiac surgery is a common and serious complication leading to transfusion of multiple blood products and resulting in increased morbidity and mortality. Despite the publication of numerous guidelines and consensus statements for patient blood management in cardiac surgery, research has revealed that adherence to these guidelines is poor, and as a result, a significant variability in patient transfusion practices among practitioners still remains. In addition, although utilization of point-of-care (POC) coagulation monitors and the us...
Source: Anesthesia and Analgesia - Category: Anesthesiology Authors: Tags: Anesth Analg Source Type: research
ConclusionThere is no need to alter the dosage of oral anticoagulants prior to dental extractions provided the INR is within the therapeutic range of 2.0 –4.0, extractions are done in least traumatic manner and local measures are used to control postoperative hemorrhage, thereby reducing the risk of thromboembolic episodes in these patients.
Source: Journal of Maxillofacial and Oral Surgery - Category: ENT & OMF Source Type: research
ConclusionWe report continuing positive outcomes and satisfaction with our introduction of Minitouch Endometrial Ablation Procedure as our standard clinical practice. It has provided noticeable improvement in our ablation service from safety and efficacy perspectives. The ability to perform more procedures per session, lowered use of analgesics/anesthetics, and quicker recovery are important benefits in our private hospital setting.
Source: Journal of Minimally Invasive Gynecology - Category: OBGYN Source Type: research
ConclusionHysteroscopy as a safe and relatively low pain procedure. Local anesthetic in the form of a paracervical block has been used historically to decrease pain during the procedure. Paracervical block does not significantly decrease pain during procedure, even in menopausal women who were found to have higher pain scales on average. Therefore, future studies should further investigate strategies to decrease pain during office hysteroscopy especially for postmenopausal women.
Source: Journal of Minimally Invasive Gynecology - Category: OBGYN Source Type: research
ConclusionWith its flexibility and smaller size over other devices minimizing the need for cervical dilatation and patient discomfort, the use of Minitouch for outpatient treatment of HMB at our center was shown to be well-tolerated, with high reliability of procedure completion, good safety and efficacy outcomes.
Source: Journal of Minimally Invasive Gynecology - Category: OBGYN Source Type: research
ConclusionsThe overall VTE rate after CABG has been low. However, the condition has been associated with worse 30-day postoperative outcomes and complications. The independent predictors of VTE development included a history of bleeding disorders, congestive heart failure in the 30 days before surgery, and operative time of ≥310 minutes. Understanding these risk factors should aid physicians in the decisions regarding prophylaxis and treatment.
Source: Journal of Vascular Surgery: Venous and Lymphatic Disorders - Category: Surgery Source Type: research
ConclusionsAdverse events in cirrhotic patients undergoing endoscopy appeared to be similar with moderate sedation or MAC, and the frequency was the same for different types of procedures.
Source: Digestive Diseases and Sciences - Category: Gastroenterology Source Type: research
Bleeding after cardiac surgery is a common and serious complication leading to transfusion of multiple blood products and resulting in increased morbidity and mortality. Despite the publication of numerous guidelines and consensus statements for patient blood management in cardiac surgery, research has revealed that adherence to these guidelines is poor, and as a result, a significant variability in patient transfusion practices among practitioners still remains. In addition, although utilization of point of care coagulation monitors and the use of novel therapeutic strategies for perioperative hemostasis, such as the use ...
Source: Journal of Cardiothoracic and Vascular Anesthesia - Category: Anesthesiology Authors: Tags: Special Article Source Type: research
n BA, Shore-Lesserson L, Abernathy J, Schwann N, Lau WT Abstract Bleeding after cardiac surgery is a common and serious complication leading to transfusion of multiple blood products and resulting in increased morbidity and mortality. Despite the publication of numerous guidelines and consensus statements for patient blood management in cardiac surgery, research has revealed that adherence to these guidelines is poor, and as a result, a significant variability in patient transfusion practices among practitioners still remains. In addition, although utilization of point-of-care (POC) coagulation monitors and the us...
Source: Anesthesia and Analgesia - Category: Anesthesiology Authors: Tags: Anesth Analg Source Type: research
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