Paravertebral catheter versus EPidural analgesia in Minimally invasive Esophageal resectioN: a randomized controlled multicenter trial (PEPMEN trial)

Thoracic epidural analgesia is the standard postoperative pain management strategy in esophageal cancer surgery. However, paravertebral block analgesia may achieve comparable pain control while inducing less s...
Source: BMC Cancer - Category: Cancer & Oncology Authors: Tags: Study protocol Source Type: research

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AbstractEsophageal cancer surgery, comprising esophagectomy with radical lymphadenectomy, is a complex procedure associated with considerable morbidity and mortality. The enhanced recovery after surgery (ERAS) protocol which aims to improve perioperative care, minimize complications, and accelerate recovery is showing promise for achieving better perioperative outcomes. ERAS is a multimodal approach that has been reported to shorten the length of hospital stay, reduce surgical stress response, decrease morbidity, and expedite recovery. While ERAS components straddle preoperative, intraoperative, and postoperative periods...
Source: Surgery Today - Category: Surgery Source Type: research
Conclusions: Following oesophago-gastric cancer surgery, patients experience physical and psychosocial difficulties which can hamper recovery, but many of which are amenable to rehabilitative intervention. Accordingly, rehabilitative measures throughout the early stages of recovery require investigation. Implications for Rehabilitation Curative treatment for oesophageal and gastric cancer is associated with significant risk of post-operative morbidity, resulting in a myriad of physical and nutritional challenges which may impact on post-operative physical recovery. Greater provision of physiotherapy services to counteract ...
Source: Disability and Rehabilitation - Category: Rehabilitation Authors: Tags: Disabil Rehabil Source Type: research
AbstractPurpose of ReviewThe opioid epidemic in the USA has led to a rise in opioid-related gastrointestinal (GI) side effects that are often difficult to diagnose and treat. The aim of this report is to discuss opioid pathophysiology, opioid-related GI side effects, clinical presentation, and diagnostic criteria and to review the current pharmacotherapy available.Recent FindingsOpioid-related GI disorders are increasingly recognized and include, but are not limited to, opioid-induced esophageal dysfunction (OIED), gastroparesis, opioid-induced constipation (OIC), narcotic bowel syndrome (NBS), acute post-operative ileus, ...
Source: Current Gastroenterology Reports - Category: Gastroenterology Source Type: research
Gluten? Lactose? Stomach pain? Digestive troubles? Way too many people suffer from gastrointestinal issues, and much less are aware of the digital technologies that can come to their aid. Did you know that digestibles could successfully replace the dreaded colonoscopy? Or have you heard about microbiome testing? What about the swarm of health apps supporting dietary restrictions? We took a deep breath and jumped into the universe of digital technologies just to bring you as much information about the future of gastroenterology as possible. Will you jump after us? IBS, colorectal cancer, and other animals Referring to...
Source: The Medical Futurist - Category: Information Technology Authors: Tags: Future of Medicine Genomics Health Sensors & Trackers diet dieting digestibles digestion digital health gastro gastroenterologist gastroenterology gastrointestinal gluten gut Innovation lactose microbiome stomach techno Source Type: blogs
Authors: Seesing MFJ, Kingma BF, Weijs TJ, Ruurda JP, van Hillegersberg R Abstract The cornerstone of curative care for esophageal cancer is neoadjuvant chemoradiotherapy followed by esophagectomy with a radical lymphadenectomy. An esophagectomy is a major and complex surgical procedure and is often followed by postoperative morbidity, especially pulmonary complications. These complications may lead to an increase in hospital stay, intensive care unit admission rate and mortality. Therefore, perioperative strategies to reduce these complications have been investigated and implemented in clinical practice. In this r...
Source: Journal of Thoracic Disease - Category: Respiratory Medicine Tags: J Thorac Dis Source Type: research
Conclusions: Magnesium sulfate is an important adjuvant drug in the practice of anesthesia, with several clinical effects and a low incidence of adverse events when used at recommended doses. Introduction Magnesium is the fourth most common ion in the body, and it participates in several cellular processes, including protein synthesis, neuromuscular function and stability of nucleic acid, as well as regulating other electrolytes such as calcium and sodium. Magnesium acts as a cofactor in protein synthesis, neuromuscular function and stability and the function of nucleic acids. It is a component of adenosine 5-triph...
Source: Frontiers in Pharmacology - Category: Drugs & Pharmacology Source Type: research
ConclusionIntraoperative tracheal and bronchial ruptures can be successfully managed with thoracoscopic intracorporeal suture.
Source: International Journal of Surgery Case Reports - Category: Surgery Source Type: research
Background: Appropriate postoperative pain management can improve outcomes in patients with esophageal cancer (EC). Objective: To compare different combinations of anesthesia and analgesia techniques in patients with EC undergoing open thoracotomy. Methods: This randomized, controlled, open-label trial enrolled 100 patients with EC (aged 40–65 years; American Society of Anesthesiologists [ASA] grade I/II) receiving elective surgery at Jiangsu Province Hospital (China) between July 2016 and December 2017. Patients were randomized to 4 groups (nā€Š=ā€Š25 per group): total intravenous general anesthesia plus pat...
Source: Medicine - Category: Internal Medicine Tags: Research Article: Clinical Trial/Experimental Study Source Type: research
We present three cases with pulmonary metastases from BML and discuss the pathogenesis and management of this rare condition. PMID: 30074141 [PubMed - as supplied by publisher]
Source: Clinical Lung Cancer - Category: Cancer & Oncology Authors: Tags: Ir J Med Sci Source Type: research
By SAURABH JHA Of my time arguing with doctors, 30 % is spent convincing British doctors that their American counterparts aren’t idiots, 30 % convincing American doctors that British doctors aren’t idiots, and 40 % convincing both that I’m not an idiot. A British doctor once earnestly asked whether American physicians carry credit card reading machines inside their white coats. Myths about the NHS can be equally comical. British doctors don’t prostate every morning in deference to the NHS, like the citizens of Oceania sang to Big Brother in Orwell’s dystopia. Nor, in their daily rounds, do the...
Source: The Health Care Blog - Category: Consumer Health News Authors: Tags: OP-ED Uncategorized AlfieEvans Source Type: blogs
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