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Results for “Preoperative Procedures”

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At least 19 recordsLinked to original sources
PubMed1984

Colonoscopy as a routine preoperative procedure for carcinoma of the colon.

Ninety patients with cancer of the colon who had total colonoscopy in the perioperative period have been reviewed. Almost half of the examinations revealed positive findings, three being unsuspected synchronous carcinomas in an area that would not have been resected with the proposed primary cancer. In addition, 79 polyps in 36 patients, the majority of which were also undetected by barium enema, were found and removed at colonoscopy. Thus, patients with carcinoma of the colon, in view of its tendency to be associated with synchronous polypoid disease, should have colonoscopy in the perioperative period. Whenever possible, this should be carried out preoperatively to confirm the diagnosis, to remove suspected or unsuspected polyps, and to detect unsuspected synchronous carcinoma.

Adenocarcinoma↗
PubMed1978

[End-to-side mesenteric caval in children - significance of blood flow physics in defining the surgical procedure preoperatively (author's transl)].

Elevated blood pressure of the portal circulation in children may be lowered to defined levels by end-to-side shunting of the mesenteric and the portal vein. The question is, whether an optimal geometry of the ellipsoid anastomosis can be calculated preoperatively. A simplified model of the shunt system is presented using electric and hydraulic analogs of the real blood flow physics. It is not taken into account in this model, that there are two capillary beds connected in series in the portal circulation, which both exhibit high blood flow resistance. Shunt resistance as being calculated on the basis of this model in 6 children, and real shunt resistance as being measured in these patients intraoperatively actually turned out to be in the same order of magnitude inspite of the handicaps of the model. Thus to our opinion the calculations presented are suited to determine preoperatively the optimal geometry of an ellipsoid shunt anastomosis intended to lower blood pressure in the portal circulation to levels as desired.

Arteriovenous Shunt, Surgical↗
PubMed1995

[Outpatient preoperative examination by the anesthesiologist. I. Fewer procedures and preoperative hospital days].

OBJECTIVE: To study the effect of the reorganisation of the preoperative screening on the volume of laboratory and function tests, and on preoperative hospital days. SETTING: General Hospital De Weezenlanden, Zwolle, The Netherlands. DESIGN: Retrospective study. METHOD: In The Netherlands the surgeon is responsible for the preoperative screening (anamnesis and general examination). In 1992 the preoperative screening was reorganised and it was carried out in the outpatient department under the responsibility of the anaesthesiologist. Laboratory and function tests were only performed if indicated. Data on 3122 patients, operated in 1991, were compared with the data on 3258 patients from 1992. Multiple regression analysis and chi-square test were used. RESULTS: The proportions of the patients subjected to laboratory tests, ECG or a chest X-ray decreased from 90%, 55%, and 50% respectively in 1991 to 53%, 43% and 10% in 1992 (p < 0.05). Admission on the day of surgery increased from 13% in 1991 to 21% in 1992 (p < 0.01). Clinical preoperative evaluation with admission more than 1 day before surgery, decreased from 5% in 1991 to 4% in 1992 (p = 0.02). The mean duration of the hospital stay before the operation decreased from 0.79 day per patient in 1991 to 0.65 in 1992 (p = 0.02). CONCLUSION: If the preoperative screening is carried out by the anaesthesiologist, all the patients have the opportunity to meet the anaesthesiologist before the operation. The number of preoperative hospital days can be reduced by outpatient preoperative screening. Laboratory and function testing on only if indicated reduces the volume of the laboratory tests, ECGs and chest X-rays.

Adolescent↗
PubMedDate not supplied

Incidence of phlogistic complications in infantile posterior fossa surgery according to the different preoperative diagnostic procedures.

Sixty seven infantile patients developing postoperative phlogistic complications as a consequence of posterior fossa surgery (i.e.: neoplasms, arachnoid cysts, A-V malformations) are herein studied. They have been subdivided in 2 groups in accordance to the different preoperative diagnostic procedures they underwent. In the first series 41 cases of posterior fossa anomalies have been diagnosed by means of air contrast ventriculography with or without cerebral angiography; in the other one the 26 patients were submitted to C.A.T. with or without angiography. In the first group the incidence rate of phlogistic complications was 31.7%, in the second one 3.8%. According to the authors this considerable difference is due to the diagnostic procedures employed. Contraindications to air contrast ventriculography and advantages of CT scan are widely discussed and emphasized.

Arachnoid↗
PubMed1987

Parathyroid imaging: its current status and future role.

The management of autonomous (primary or tertiary) hyperparathyroidism is controversial for two important reasons: (1) Diagnosis of primary or tertiary hyperparathyroidism (as distinct from reactive or secondary hyperparathyroidism) has been revolutionized in the past 20 years as a result of routine inclusion of serum calcium concentration assays in serum multiautomated analysis, now obtained routinely for both hospitalized as well as ambulatory patients. The prevalence of primary hyperparathyroidism in the general population has appeared to rise as a consequence of this assay and the enhanced detection of this disease. This situation has confused the management of hyperparathyroidism since most patients now present with asymptomatic disease, and the need for surgical treatment is controversial in asymptomatic individuals. (2) Primary hyperparathyroidism usually is caused by hypersecretion of parathyroid hormone by an autonomously functioning parathyroid adenoma. In a small percentage of cases, multigland hyperplasia is present. In experienced hands, surgical removal of an adenoma within the thyroid bed cures the hyperparathyroidism 90% to 95% of the time, without performance of a preoperative procedure to localize the adenoma. Approximately 10% of parathyroid tissue is ectopic in location, however. Furthermore, approximately two thirds of "missed" adenomas are within the thyroid bed. Reexploration in the event of a failed operation therefore is not an uncommon occurrence. Parathyroid localization procedures clearly are indicated in patients with primary hyperparathyroidism who have evidence of persistent disease after a failed attempt at surgical cure. In patients first presenting with primary hyperparathyroidism, the need for a localization procedure is less clear, since surgery appears to be successful much of the time without it. Regardless of the nature of the above controversies, surgery for autonomous hyperparathyroidism continues, and localization procedures become more popular. Preoperative localization procedures such as angiography and venography with venous sampling for parathormone are cumbersome and invasive. Noninvasive tests to localize the parathyroid glands have emerged in the past 10 years, including dual tracer radionuclide scintigraphy with 201-thallous chloride and 99m-technetium pertechnetate, high-resolution computer tomography, and fine parts ultrasonography. Dual tracer scintigraphy with thallium and technetium is reported to have a localization sensitivity of 70%-90%. False-negative studies occur primarily in patients with small adenomatous or hyperplastic glands.(ABSTRACT TRUNCATED AT 400 WORDS)

Humans↗
PubMed1979

The value of preoperative screening procedures in stage I and II malignant melanoma.

Fifty patients with melanoma (30 with clinical Stage I disease and 20 with clinical Stage II disease) were analyzed retrospectively along with the screening test done prior to surgery. While the value of the chest X ray is unquestioned in preoperative screening, the same cannot be said of liver, brain, and bone scans. The bone marrow biopsy, however, done with a Janshidi needle was of value in detecting one patient with bone-marrow metastases who on examination had clinical Stage II disease and precluded surgery in this same individual. Therefore, we feel that in the preoperative scanning of patients with Stage I or Stage II human malignant melanoma, and especially in the latter, the bone-marrow biopsy should be done routinely in addition to a hematological profile, liver profile, and chest X ray.

Bone Marrow Examination↗
PubMed1990

[Consensus prevention of hospital infections].

Purpose of this consensus development conference held in Utrecht on 19th May, 1989 was to reach agreement on hygienic hand washing and disinfection procedures, preoperative hand disinfection, isolation procedures, implementation of rules and regulations. A working party had prepared 18 statements on these four subjects, with added explanations. The audience which had received this information in advance, was invited to discuss and possibly modify or reject the statements. Agreement was reached about the following: regular washing of the hands of personnel on the wards is useful to prevent hospital infections; this should be done according to an agreed and feasible protocol defining when and how. Disinfection of the hands of care personnel on the wards should be done with 70-80% alcohol with cetiol; for non-infected patients with normal resistance hand washing and hand disinfection are judged equivalent. Hand disinfection procedures are advocated for personnel caring for immuno-compromised or infected patients. Alcohol (70-80%) with added chlorhexidine (0.5%) and cetiol was chosen for preoperative hand disinfection to be applied after a washing session; brushes should be used sparingly. A category specific isolation system was preferred to a disease specific system. Except for air transmitted infections, barrier nursing is usually adequate. It was deemed important to register practical problems before trying to implement the regulations.

Cross Infection↗
PubMed1995

3-D reconstruction of hepatic neoplasms: a preoperative planning procedure.

Three-dimensional display of intrahepatic vascular structures, tumour(s) and liver surface offers the possibility of perceiving the complex individual anatomy in a coherent fashion. Since this presentation of anatomical structures can be varied at will, the resulting interactive dynamic display of the 3-D data sets can be considered an example of Virtual Reality; the surgeon experiences the interactive 3-D display as a realistic presentation of the patient's surgical anatomy. Three-dimensional display offers the possibility of planning a specific resection in detail, tailored to the individual anatomy. The benefits and problems of various surgical approaches can be worked out in detail, and potential hazardous phases in the operation can be anticipated, thus minimizing unexpected complications. However, because the generation of detailed 3-D renderings takes considerable time investment by an experienced operator it is important to select patients, in whom such an effort is warranted. In our experience, 3-D display of the liver is most likely to be of benefit in the presence of central tumours, or if segmental resections are considered.

Diagnostic Imaging↗