Neurological conditions in the perioperative period
Publication date: Available online 14 November 2019Source: Surgery (Oxford)Author(s): Robert Crooks, Christopher JohnsonAbstractThe wide spectrum of neurological disorders and their effects on the function of the central and peripheral nervous system can cause an extensive array of symptoms and significant morbidity and mortality. This morbidity and mortality is often amplified in the perioperative period with an elevated risk of anaesthetic complications and adverse events. However, the number of patients with neurological disease requiring surgery is unlikely to diminish, and therefore this anaesthetic risk needs to be m...
Source: Surgery (Oxford) - November 14, 2019 Category: Surgery Source Type: research
Preoperative cardiopulmonary exercise testing: physiological basis and investigation
Publication date: Available online 14 November 2019Source: Surgery (Oxford)Author(s): Anurag VatsAbstractThe number of cardiopulmonary exercise testing (CPET) centres has doubled in the UK since 2011. Approximately 30,000 tests are performed every year in the UK now. It is a useful tool helping preoperative risk stratification. Patients with poor exercise tolerance are more likely to suffer perioperative complications and death. Interpretation of a large amount of data generated during the test requires a good understanding of basic exercise physiology and its clinical application. Incorporation of CPET data in a global pr...
Source: Surgery (Oxford) - November 14, 2019 Category: Surgery Source Type: research
Management of patients with musculoskeletal disease and burns
This article highlights the important considerations for perioperative management of these conditions. (Source: Surgery (Oxford))
Source: Surgery (Oxford) - November 9, 2019 Category: Surgery Source Type: research
Safe sedation practice for surgeons
This article uses this publication as a framework to discuss the generic principles and practice of sedation and should not be seen as a substitute for more formal training. (Source: Surgery (Oxford))
Source: Surgery (Oxford) - November 9, 2019 Category: Surgery Source Type: research
The patient with endocrine disease
This article will cover the management of diabetes, thyroid and adrenal disease in the perioperative period. (Source: Surgery (Oxford))
Source: Surgery (Oxford) - November 9, 2019 Category: Surgery Source Type: research
Preoperative optimization and enhanced recovery after surgery
Publication date: Available online 9 November 2019Source: Surgery (Oxford)Author(s): Sarah L. Cooper, Paul PanesarAbstractEnhanced recovery pathways have been repeatedly shown to reduce length of stay and complication rates for patients undergoing elective major surgery across multiple surgical specialties. The success of the enhanced recovery approach relies on excellent patient preparation and reliable implementation of evidence based, standardized care components at each stage of the surgical journey. Multidisciplinary team engagement and continuous audit of outcomes are crucial in sustaining a successful enhanced recov...
Source: Surgery (Oxford) - November 9, 2019 Category: Surgery Source Type: research
Day surgery guidelines
Publication date: Available online 9 November 2019Source: Surgery (Oxford)Author(s): Monalisa J. MarbaniangAbstractDay surgery has made major strides in keeping with advances in surgical and anaesthetic techniques. Patient and financial benefits of early ambulation and enhanced recovery programmes are well recognized. The NHS Modernisation Agency recommends that 75% of all surgical procedures performed in a Trust should be done as day case procedures. National and international interest in day case surgery guidelines and pathways on: patient care, facilitating admission and discharge, and logistical aspects of running a da...
Source: Surgery (Oxford) - November 9, 2019 Category: Surgery Source Type: research
Challenging patient groups
This article focuses on those patients that do not necessarily fit a systems-based approach of classification. Many of these patients present challenges to the clinicians involved with perioperative care and so it is important to have a good understanding of how they should be managed. This article will focus on elderly patients, pregnant patients presenting for non-obstetric surgery, obese patients and immunocompromised patients. We have chosen to focus on key aspects of preoperative, intraoperative and postoperative care for each patient group, highlighting the physiological basis of such recommendations. (Source: Surgery (Oxford))
Source: Surgery (Oxford) - November 9, 2019 Category: Surgery Source Type: research
Disorders of sex development
Publication date: Available online 28 October 2019Source: Surgery (Oxford)Author(s): Mark Woodward, Kate BurnsAbstractDisorders of sex development (DSD) occur in 1–2/10,000 live births, with a specific molecular diagnosis only possible in 20% of cases. Presentation is usually at birth, and gender assignment must be avoided before review by an expert multidisciplinary team. Initial investigations allow a working diagnosis to be made within 48 hours. In 46,XY DSD, surgery may be necessary to correct hypospadias, reposition or remove undescended testes, and remove symptomatic Mullerian remnants. In 46,XX DSD, feminizing sur...
Source: Surgery (Oxford) - October 29, 2019 Category: Surgery Source Type: research
Test yourself: MCQ and Single Best Answer
Publication date: Available online 28 October 2019Source: Surgery (Oxford)Author(s): Adrian Ben Cresswell (Source: Surgery (Oxford))
Source: Surgery (Oxford) - October 29, 2019 Category: Surgery Source Type: research
Transition from fetus to neonate
This article provides an overview of the key physiological changes that take place as the fetus transtitions to neonatal life. It provides and an overview of fetal transition with a focus on respiratory and cardiovascular changes. (Source: Surgery (Oxford))
Source: Surgery (Oxford) - October 23, 2019 Category: Surgery Source Type: research
Congenital anterior abdominal wall defects
This article provides an overview of the key aspects of antenatal, perinatal and postnatal management, highlighting areas of controversy where further study is required. (Source: Surgery (Oxford))
Source: Surgery (Oxford) - October 23, 2019 Category: Surgery Source Type: research
Bilious vomiting in the newborn
Publication date: Available online 22 October 2019Source: Surgery (Oxford)Author(s): Lucinda G.C. Tullie, Michael P. StantonAbstractBilious (dark green) vomiting in the newborn is a surgical emergency as the underlying diagnosis may be volvulus of the entire midgut secondary to malrotation. This diagnosis is time critical as, untreated, volvulus will lead to midgut necrosis, resulting in short gut syndrome or death. While a range of other diagnoses are possible, transfer to a paediatric surgical centre should be undertaken urgently so that malrotation/volvulus can be excluded or treated. This review focuses on the causes, ...
Source: Surgery (Oxford) - October 23, 2019 Category: Surgery Source Type: research
Antenatal screening and fetal intervention
This article focuses on congenital anomalies relevant to surgeons, initially looking at screening and diagnosis and how this may affect treatment and surgery following delivery. The second part will look at some of the interventions that have been tried to treat ‘surgical’ congenital anomalies in utero. (Source: Surgery (Oxford))
Source: Surgery (Oxford) - October 23, 2019 Category: Surgery Source Type: research
Hirschsprung's disease
This article aims to provide an overview of Hirschsprung's disease, outlining the aetiology of HSCR and management of children with HSCR. (Source: Surgery (Oxford))
Source: Surgery (Oxford) - October 23, 2019 Category: Surgery Source Type: research
