scholarly journals Application of POSSUM and P-POSSUM in Surgical Risk Assessment of Elderly Patients Undergoing Hepatobiliary and Pancreatic Surgery

2020 ◽  
Vol Volume 15 ◽  
pp. 1121-1128
Author(s):  
Zhi-Wei Hu ◽  
Rui-Qiang Xin ◽  
Yi-Jun Xia ◽  
Guang-Peng Jia ◽  
Xiao-Xu Chen ◽  
...  
Keyword(s):  
Risk Assessment ◽  
Elderly Patients ◽  
Pancreatic Surgery ◽  
Surgical Risk ◽  
Hepatobiliary And Pancreatic Surgery ◽  
P Application

Letter to the Editor: Craniopharyngiomas in the elderly: the crucial influence of tumor topography on surgical risk assessment

2021 ◽  
Author(s):  
José M. Pascual ◽  
Ruth Prieto
Keyword(s):  
Risk Assessment ◽  
Elderly Patients ◽  
Tumor Tissue ◽  
Significant Proportion ◽  
Wide Band ◽  
The Elderly ◽  
Surgical Risk ◽  
Definition Of ◽  
Weighted Sequences ◽  
Tumor Topography

Classifying CPs within the overly vague, uninformative category “suprasellar” prevents gaining any true insight regarding the risks associated with the surgical procedure employed. Routine MRI obtained with conventional T1- and T2-weighted sequences along the midsagittal and coronal trans-infundibular planes allow an accurate and reliable preoperative definition of CP topography. CPs developing primarily within the infundibulum and/or tuberal region of the hypothalamus, as well as those wholly located within the 3V, should be distinguished preoperatively from those lesions originally expanding beneath the 3V floor (3VF), the true suprasellar tumors. Among adult patients, about 40% of CPs correspond to infundibulo-tuberal tumors expanding primarily within the 3VF, above an intact pituitary gland and stalk. This subgroup of CPs shows strong adherences to the surrounding hypothalamus, as they are embedded within a wide band of reactive gliotic tissue, usually infiltrated by microscopic finger-like solid cords of tumor tissue. In elderly patients, a significant proportion of CPs correspond to papillary tumors developing above an intact 3VF, usually showing small pedicle-like or sessile-like attachments to the infundibulum. With the current diagnostic MRI workup routinely employed for CPs, it is possible, for the majority of lesions, to preoperatively differentiate these topographical variants and predict the type of CP-hypothalamus relationship that will be found during surgery.

Complications and sequelae of pancreatic surgery. Are scales of surgical risk assessment useful?

2019 ◽  
Vol 30 (2) ◽  
pp. 177-180
Author(s):  
CP Ramírez Plaza
Keyword(s):  
Risk Assessment ◽  
Pancreatic Surgery ◽  
Surgical Risk ◽  
Cirugía Hepática

Resumen Las complicaciones de la cirugía pancreática es Uno de los principales motivos de preocupación del cirujano que realiza cirugía hepática Video pancreática. Siendo las fístulas pancreáticas las que más incidencia tienen en el posoperatorio. Analizamos en este artículo la posibilidad de evitar este tipo de complicaciones aplicando escalas de valoración del riesgo tanto por Paciente como por patología como por tipo de intervención. Uno de los factores más limitantes a la hora de la recuperación posoperatoria son este tipo de complicaciones, si consiguiéramos controlarla mediante uso de escalas de valoración de riesgo y tratamientos más individualizados claramente la disminución de estas complicaciones tendría un gran impacto en esta cirugía tan compleja.

The Use of Frailty as a Surgical Risk Assessment Tool in Elderly Patients

2014 ◽  
Vol 3 (1) ◽  
pp. 1-7 ◽  
Author(s):  
Louis M. Revenig ◽  
Kenneth Ogan ◽  
Thomas J. Guzzo ◽  
Daniel J. Canter
Keyword(s):  
Risk Assessment ◽  
Elderly Patients ◽  
Assessment Tool ◽  
Risk Assessment Tool ◽  
Surgical Risk

Robotic hepatobiliary and pancreatic surgery: a cohort study

2011 ◽  
Vol 18 (4) ◽  
pp. 471-480 ◽  
Author(s):  
Oliver C. Y. Chan ◽  
Chung Ngai Tang ◽  
Eric C. H. Lai ◽  
George P. C. Yang ◽  
Michael K. W. Li
Keyword(s):  
Cohort Study ◽  
Pancreatic Surgery ◽  
Hepatobiliary And Pancreatic Surgery

scholarly journals P16 An audit of elderly patients with a femoral fracture: is the quality of care received by patients affected by where in the femur the fracture occurs?

BJS Open ◽  
2021 ◽  
Vol 5 (Supplement_1) ◽  
Author(s):  
O A Javed ◽  
M J Khan ◽  
Y Abbas ◽  
S Pillai ◽  
K Hristova ◽  
...  
Keyword(s):  
Risk Assessment ◽  
Elderly Patients ◽  
Bone Health ◽  
Nutritional Assessment ◽  
Femur Fracture ◽  
Femoral Fractures ◽  
Neck Of Femur ◽  
Femur Fractures ◽  
Neck Of Femur Fracture ◽  
Health Review

Abstract Introduction Elderly patients with femoral fractures are often frail and require a multidisciplinary approach to optimise medical care, rehabilitation and prevention of further injury. Previously, neck of femur fracture patients were the focus of such an approach, but NICE and BOAST guidelines emphasise extending this care to other elderly trauma patients. Methods A retrospective analysis of 43 patients over 60 years old at Gloucestershire Hospitals NHS Foundation Trust in 2019 with a femoral fracture other than a neck of femur fracture. BOAST guideline standards were surgery within 36 hours, orthogeriatric assessment within 72 hours, a documented ceiling of treatment, falls risk assessment, bone health review, nutritional assessment and physiotherapy review. Results Our study showed worse outcomes in all standards for patients with femoral shaft, distal femur and periprosthetic femur fractures compared to neck of femur fractures: surgery within 36 hours (63.9% vs. 66%); orthogeriatric assessment within 72 hours (32.6% vs. 91.9%); falls risk assessment (76.7% vs. 99.6%); bone health review (41.9% vs. 99.7%); nutritional assessment (55.8% vs. 99.6%); physiotherapy review (97.7% vs. 98.9%). The group also had worse outcomes for average length of stay (19 days vs. 14 days) and 30 day mortality (9.3% vs. 8.6%). Discussion Our study showed a discrepancy in care received by elderly patients with femoral fractures other than neck of femur. We will introduce a proforma for all femoral fractures, present our findings to orthogeriatric, bone health and physiotherapy teams to involve them in the care of such patients and re-audit following these recommendations.

The trans-sphenoidal resection of pituitary adenomas in elderly patients and surgical risk

Pituitary ◽  
2012 ◽  
Vol 16 (2) ◽  
pp. 146-151 ◽  
Author(s):  
M. Locatelli ◽  
G. Bertani ◽  
G. Carrabba ◽  
P. Rampini ◽  
M. Zavanone ◽  
...  
Keyword(s):  
Elderly Patients ◽  
Pituitary Adenomas ◽  
Surgical Risk
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