Articles: postoperative-complications.
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Randomized Controlled Trial Multicenter Study
The role of goal-directed therapy in the prevention of acute kidney injury after major gastrointestinal surgery: Substudy of the OPTIMISE trial.
Acute kidney injury (AKI) is an important adverse outcome after major surgery. Peri-operative goal-directed haemodynamic therapy (GDT) may improve outcomes by reducing complications such as AKI. ⋯ In this trial, GDT did not reduce the incidence of AKI amongst high-risk patients undergoing major gastrointestinal surgery. This may reflect improving standards in usual patient care.
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Total pancreatectomy is required to treat diseases involving the entire pancreas, and is characterized by high morbidity rates and impaired long-term quality of life (QoL). To date, risk factors associated with perioperative and long-term outcomes have not been determined fully. ⋯ Total pancreatectomy can be performed with acceptable morbidity and mortality rates. Older patients had a higher risk of postoperative complications but reported better QoL than younger patients.
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J. Neurol. Neurosurg. Psychiatr. · Dec 2019
Multicenter StudyPredicting symptomatic intracranial haemorrhage after mechanical thrombectomy: the TAG score.
There is limited data on predictors of symptomatic intracranial haemorrhage (sICH) in patients who underwent mechanical thrombectomy. In this study, we aim to determine those predictors with external validation. ⋯ High TAG scores are associated with sICH in patients receiving mechanical thrombectomy. Larger studies are needed to validate this scoring system and test strategies to reduce sICH risk and make thrombectomy safer in patients with elevated TAG scores.
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Spinal epidural lipomatosis (SEL) results from excess lumbar epidural fat (EF) accumulation that compresses the cauda equina or nerve roots. Guidelines for the therapeutic management of SEL are not currently available. ⋯ Patients with SEL exhibited significant improvements in surgical outcomes at 1 and 2 years postoperatively. However, compared with the non-SEL group, the efficacy of posterior lumbar spinous-splitting decompression surgery was worse in the SEL group, especially for walking ability. These results indicate that EF accumulation should be considered when planning treatment for patients with lumbar spinal canal stenosis and estimating the efficacy of lumbar decompression surgery.
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Multicenter Study
Outcome and long-term quality of life after total pancreatectomy (PANORAMA): a nationwide cohort study.
The threshold to perform total pancreatectomy is rather high, predominantly because of concerns for long-term consequences of brittle diabetes on patients' quality of life. Contemporary data on postoperative outcomes, diabetes management, and long-term quality of life after total pancreatectomy from large nationwide series are, however, lacking. ⋯ This nationwide study found increased use of total pancreatectomy with a relatively high 90-day mortality. Long-term quality of life was lower compared to the general population, although differences were small. Diabetes-related distress and treatment satisfaction were similar to patients with type 1 diabetes.