Feature Channels: Surgery

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A new technique that brings CT imaging into the operating room will allow surgeons to precisely demarcate and remove small sub-centimeter lung nodules, leaving as much healthy tissue as possible, according to Raphael Bueno, MD, of Brigham and Women’s Hospital in Boston. His team is presenting the results of this late-breaking research at the 94th AATS Annual Meeting in Toronto, ON, Canada on April 30, 2014.

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A new study presenting data from 17 cardiac surgical centers in Virginia, representing 100 surgeons and 99% of cardiac operations performed in the state, demonstrates that, even today, significant variations – among surgeons and hospitals - still exist in the performance of mitral valve repair vs replacement for moderate to severe mitral regurgitation. Significant associations were observed between the propensity for MV repair and both institutional and surgeon annual volume, although increasing surgeon volume appears to be the much stronger predictor.

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Children with a heart defect called transposition of great arteries (TGA) are born with the two major blood vessels (aorta and the main lung artery) arising from the wrong sides of the heart. Consequently, blood is pumping inappropriately between the lungs and the rest of the body, a fatal condition unless surgically treated. The surgery of choice, the arterial switch operation (ASO), is usually performed within the first few weeks of life. In a retrospective analysis of 30 years of experience performing ASOs, Hanna A. Jensen, MD, PhD, and the rest of the team led by Victor Tsang, MD, FRCS, from the Great Ormond Street Hospital for Children NHS Foundation Trust in London, suggest that 90-day outcomes may give a more revealing picture than the traditional reliance on 30-day data. She is presenting the results of this research at the 94th AATS Annual Meeting in Toronto.

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High-risk operable lung cancer patients have poorer quality of life scores than the normal U.S. population. However surgery can still be undertaken safely: Low global quality of life scores were not associated with lower survival, recurrence-free rate, or for higher risk for adverse events following sublobar resection, a major surgical procedure.

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A Loyola University Medical Center patient has received one of the world’s quickest lung transplants. Kenneth Baumgardner received the transplant just six days after going on the waiting list. And he went home after spending only five days in the hospital.

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Plastic and reconstructive surgeons leading the first retrospective study of all known facial transplants worldwide conclude that the procedure is relatively safe, increasingly feasible, and a clear life-changer that can and should be offered to far more carefully selected patients.

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The use of transplant organs from animals (xenotransplantation) could help to compensate for the shortage of human organs available for transplant. NIH researchers have demonstrated that by using hearts from genetically engineered pigs in combination with target-specific immunosuppression of recipient baboons, organ survival can be significantly prolonged. This has potential for paving the way for the use of animal organs for transplantation into humans.

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Investigators propose that NASA’s “threat and error model” – derived from analyzing >30,000 commercial flights and which explains >90% of crashes – is directly applicable to pediatric cardiac surgery.

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Despite their overall low risk, procedures to treat kidney stones lead to complications that require hospitalization or emergency care for one in seven patients, according to researchers at Duke Medicine.

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Thirty years after a surgeon successfully reattached his severed arm, Bob Seeman returned to honor the surgeon, Dr. Michael Pinzur. Seeman said Pinzur has a "we-can-do-it mentality for which I will be forever thankful."

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The development of graphene—a highly advanced metamaterial with many unique and varied properties—may lead to exciting new applications in the diagnosis and treatment of neurological diseases, according to a report in the May issue of Neurosurgery, official journal of the Congress of Neurological Surgeons. The journal is published by Lippincott Williams & Wilkins, a part of Wolters Kluwer Health.

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Changes in managing patients before, during and after colorectal surgery cut hospital stays by two days and reduced readmission rates, according to researchers who led a study of the approach at Duke University Hospital.

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A new prediction tool can help doctors better identify patients who are at highest risk for respiratory failure after surgery and therefore prevent the often deadly condition, suggest data from a large multi-center study published in the May issue of Anesthesiology.

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Acute respiratory distress syndrome is a leading cause of respiratory failure after surgery. Patients who develop the lung disorder postoperatively are at higher risk of dying in the hospital, and those who survive the syndrome may still bear its physical effects years later. A Mayo Clinic-led study is helping physicians better identify patients most at risk, the first step toward preventing this dangerous and costly surgical complication. They found nine independent risk factors, including sepsis, high-risk aortic vascular surgery, high-risk cardiac surgery, emergency surgery, cirrhosis of the liver, and admission to the hospital from a location other than home, such as a nursing home.

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Despite decades of common use for surgeries of all kinds, the precise mechanism through which general anesthesia works on the body remains a mystery. New research led by the Perelman School of Medicine at the University of Pennsylvania investigated the common anesthetic sevoflurane and found that it binds at multiple key cell membrane protein locations that may contribute to the induction of the anesthetic response. Their findings will appear online in PNAS (Proceedings of the National Academy of Science).

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Being tired and run-down during her second trimester of pregnancy was something that 25-year-old Sharon Savino had felt before being pregnant with her son and daughter. But after developing a bad cough around Christmas, she started coughing up blood, and knew something was completely wrong.

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Using antibiotics alone to treat children with uncomplicated acute appendicitis is a reasonable alternative to surgery that leads to less pain and fewer missed school days, according to a pilot study. The research is the first prospective study on nonoperative management of acute appendicitis in pediatric patients in the United States.

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Newswise hosts the first live, interactive virtual event for major research finding for journalists. Newswise and Wake Forest Baptist Medical Center are collaborating to offer direct access to the investigator via Newswise Live, an interactive virtual event.

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A technique using anesthesia-containing nanoparticles—drawn to the targeted area of the body by magnets—could one day provide a useful alternative to nerve block for local anesthesia in patients, suggests an experimental study in the April issue of Anesthesia & Analgesia, official journal of the International Anesthesia Research Society (IARS).

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Hospitalized patients account for at least half of cancelled operating room time, suggests a study published in Anesthesia & Analgesia, official journal of the International Anesthesia Research Society (IARS).

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For patients undergoing surgery, adding a sedative drug called dexmedetomidine can reduce the necessary doses of other anesthetic drugs, reports a study in the April issue of Anesthesia & Analgesia, official journal of the International Anesthesia Research Society (IARS).

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Researchers will present findings at the AANS Annual Scientific Meeting on the study that sheds light on the basis of neuropathic pain that persists after apparently successful surgery.

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Surgery for frail, senior citizen patients can be risky. A new patient-centered, team-based approach to deciding whether these high-risk patients will benefit from surgery is championed in an April 10 Perspective of the New England Journal of Medicine. The Perspective suggests that the decision to have surgery must balance the advantages and disadvantages of surgical and non-surgical treatment as well as the patient’s values and goals in a team-based setting that includes the patient, his or her family, the surgeon, the primary care physician and the physician anesthesiologist.

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Researchers will present findings of a study testing a double-blind, placebo-controlled trial of IV acetaminophen in post-craniotomy patients at the AANS Annual Scientific Meeting.

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Researchers who reviewed the outcomes of more than 470 aneurysm patients, nearly evenly divided between those whose procedure involved coiling or clipping, will present findings of their study during the AANS Annual Scientific Meeting.

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A team of researchers has reviewed a nationwide, prospective, longitudinal outcomes database that measures the safety and effectiveness of everyday neurosurgical spine care and will present the findings at the AANS Annual Scientific Meeting.

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Analyzing a national database of hospital inpatient records, a team of researchers reports an expected spike in mortality six days after cardiac surgery, but also a more surprising and potentially troubling jump in deaths at the 30-day mark.

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A research team will present the findings at the 82nd AANS Annual Scientific Meeting, reporting significant discrepancies between discharge codes and surgeons’ own diagnoses.

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A team of researchers will present their finding that proprioception significantly improved prosthetic control in the absence of vision at the AANS Annual Scientific Meeting.

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A team of researchers announced interesting results at the 2014 AANS Annual Scientific Meeting from their investigation on the influence of Aquaporin 4 on intracranial hemorrhage.

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Results of a study that revealed significant differences in the tumors by subgroup will be presented at the AANS Annual Scientific Meeting.

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At the AANS Annual Scientific Meeting, researchers will present the results of a study to determine the cumulative effects of head impacts as they relate to changes in the brain absent of concussion.

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Researchers will present findings at the AANS Annual Scientific meeting of their studying testing if Intralaminar thalamic deep brain stimulation (ILN-DBS) could have an effect on dementia and other neurodegenerative diseases that cause severe cognitive dysfunction.

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A biomedical engineering breakthrough could speed soft tissue injury recovery and limit disfigurement from radical cancer surgeries. It could circumvent the need to harvest and transfer large amounts of tissue, avoiding many current complications.

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Researchers who conducted intraparenchymal transplantation of bone marrow-derived cell therapy in chronic stroke patients will present their findings at the AANS Annual Scientific Meeting.

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During a presentation during the 82nd AANS Annual Scientific Meeting, researchers highlighted the results of research that explores whether 5 aminolevulinic-acid fluorescence (5-ALA) offers additional detection benefits compared to intraoperative MRI (iMRI) when dealing with invasive tumors.

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Unique laboratory testing during breast cancer lumpectomies to make sure surgeons remove all cancerous tissue spares patients the need for a repeat lumpectomy in roughly 96 percent of cases at Mayo Clinic in Rochester, a success rate much higher than the rate nationally, a Mayo study shows. During the years reviewed, 13.2 percent of breast cancer lumpectomy patients nationally had to return to the operating room within a month of their initial surgery, compared to 3.6 percent at Mayo in Rochester, which uses a technique called frozen section analysis to test excised tissue for cancer while patient are still on the operating table.

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In a series of research studies, Cedars-Sinai spinal surgeons show that a new method of computer-guided spine surgery is beneficial for spinal reconstruction and for treating complex tumors and degenerative spine problems, resulting in fewer complications and better outcomes for patients.

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Much has been reported about the potential for increased risk of alcohol misuse after weight loss surgery (WLS), with most theories pointing to lower alcohol tolerance and a longer time to return to a sober state after surgery, but a new study from Beth Israel Deaconess Medical Center suggests that upwards of half of high-risk drinkers are actually less likely to report high-risk drinking behavior after weight loss surgery.

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An orphan drug renders destructive antibodies harmless, allowing physicians at UI Health to perform a successful kidney transplant in a highly positive crossmatch patient.

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Stephen Wiley, a lifelong cowboy from Terrell, has helped UT Southwestern Medical Center pioneer a new treatment for vocal cord cancer.

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The fewer the red blood cell transfusions, the less likely patients were to develop infections like pneumonia.

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In a report published in the April edition of the Journal of Spinal Disorders and Techniques, a Johns Hopkins team says that only 10 percent of orthopaedic surgeons and neurosurgeons follow professional guidelines recommending routine psychological screenings of patients prior to major surgery for severe back and leg pain.

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Hospital readmission rates are not a reliable measure of hospital quality in cardiac surgical care because they are driven by chance rather than statistically significant measurements

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Researchers at the University of Adelaide have discovered that a commonly used anesthetic technique to reduce the blood pressure of patients undergoing surgery could increase the risk of starving the brain of oxygen.

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A team of scientists from the Cancer Science Institute of Singapore (CSI Singapore) at the National University of Singapore and National University Cancer Institute Singapore (NCIS), and their collaborators from the Cedars-Sinai Medical Centre, UCLA School of Medicine, demonstrated that a number of novel genetic defects are able to induce oesophageal cancer.

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Narine Sarvazyan, Ph.D., professor of pharmacology and physiology at the George Washington University School of Medicine and Health Sciences, has invented a new organ to help return blood flow from veins lacking functional valves.

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Johns Hopkins researchers have devised a computerized process that could make minimally invasive surgery more accurate and streamlined using equipment already common in the operating room.

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Surgical aortic valve replacement generally improves patients’ symptoms and prolongs survival. However, the perceived risk of surgical aortic valve replacement in patients over 80 may result in surgery being denied or a recommendation for alternative therapy. Investigators at the Mayo Clinic challenge the way these patients have been managed. They report that repeat sternotomy in patients over 80 who have previously had coronary bypass graft surgery can be done with low risk. Their findings are published in The Journal of Thoracic and Cardiovascular Surgery, an official publication of the American Association for Thoracic Surgery.

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Veterans with liver disease who live more than 100 miles from a Veterans Administration hospital that offers liver transplants are only half as likely to be placed on the liver transplant waitlist to receive a new organ compared to veterans who live closer to transplant centers, according to a new study from the Perelman School of Medicine of the University of Pennsylvania. The findings, which are published in the March 26 issue of JAMA, also reveal that the further liver disease patients live from these five transplant centers, the more likely they are to die.