Pre-operative Assessment of Spinal Patients

2017 ◽  
Author(s):  
José Aguirre
Keyword(s):  
Operative Assessment

scholarly journals P89 Patient reported comorbidity is not a reliable data source: a systematic review of the literature

BJS Open ◽  
2021 ◽  
Vol 5 (Supplement_1) ◽  
Author(s):  
Chung Mun Alice Lin ◽  
Alexander Orman ◽  
Nicholas D Clement ◽  
David J Deehan ◽  
Chung M A Lin
Keyword(s):  
Medical Record ◽  
Meta Analysis ◽  
Analysis Data ◽  
Fundamental Factor ◽  
Resource Limitations ◽  
Patient Reported ◽  
Data Source ◽  
Reported Data ◽  
Operative Assessment ◽  
Source Of Information

Abstract Introduction There is currently an increased demand for elective orthopaedic surgery. However, due to the ever-growing financial, time and resource limitations, there is a pressing need to identify those who would benefit most from surgery but with the lowest risk of complications. Comorbidities are a fundamental factor in this decision and the traditional way to ascertain this is through medical record data abstraction during pre-operative assessment. However, this can be time consuming and expensive. We therefore set out to establish whether patient reported comorbidities are reliable as a principal source of information. Method Searches were performed on PubMed and Medline, and citations independently screened. Included studies were published between 2010 to 2020 assessing the reliability of at least one patient reported comorbidity against their medical record or clinical assessment as gold standard. Cohen’s kappa coefficient values were grouped into systems and a meta-analysis performed comparing the reliability between studies. Results Meta-analysis data showed poor-to-moderate reliability for diseases in cardiovascular, musculoskeletal, neurological and respiratory systems as well as for malignancy and depression. Endocrine diseases showed good-to-excellent reliability. Factors found to affect the concordance included sex, age, ethnicity, education, living alone, marital status, number or severity of comorbidities, mental health and disability. Conclusion Our study showed poor-to-moderate reliability for all systems except endocrine, consisting of thyroid disease and diabetes mellitus, which demonstrated good-to-excellent reliability. Although patient reported data is useful and can facilitate a complete pre-operative overview of the patient, it is not reliable enough to be used as a standalone measure.

scholarly journals Diagnostic performance of high-resolution ultrasound in pre- and postoperative evaluation of the hand tendons injuries

2021 ◽  
Vol 52 (1) ◽  
Author(s):  
Ahmed Abdelrahman Mohamed Baz ◽  
Aya Bahaa Hussien ◽  
Hesham Mostafa Abdel Samad ◽  
Hatem Mohamed Said El-Azizi
Keyword(s):  
High Resolution ◽  
Preoperative Evaluation ◽  
Tendon Injuries ◽  
Diagnostic Modality ◽  
Complete Tear ◽  
Observational Cohort ◽  
Male Patients ◽  
Mri Study ◽  
Operative Assessment ◽  
Gold Standards

Abstract Background Hand tendon injuries are recognized clinical entities that are frequently seen. Clinical examinations usually warrant radiological correlative studies for confirmation and as a postoperative screening test. Here is a prospective observational cohort study enrolling 30 patients who were diagnosed clinically to have hand tendon injuries either pre- or postoperative; their ages were ranging from 5 to 64 years with a mean ± SD of 31.43 ± 12.19 years; 23 male patients (76.7%) and 7 female patients (23.3%) were evaluated by high-resolution ultrasound examination and a correlative evaluation was done by either intra-operative assessment or MRI study as gold standards. Results High-resolution ultrasound (HRUS) findings were binned into seventeen cases (56%) that had tendon tears, of which 10 cases (33.3%) had a complete tear and 7 cases (23.3%) had a partial tear. Postoperative tendon integrity was present in 13 cases (43.3%), a tendon callus was found in 2 cases (6.66%), and a postoperative abnormal motion on the dynamic study was present in 15 cases (50%). Intra-tendinous foreign bodies were detected in two cases (6.66%), a gap between the torn ends was found in 10 cases (33.3%), and re-tear (rupture) of the repaired tendons was present in four cases (13.3%). Coexistent nerve injuries were seen in two cases (6.66%); for the forementioned findings, HRUS had gained high accuracy measures as correlated to the gold standards (100% sensitivity and 100% specificity). Conclusion High-resolution ultrasound serves as a highly accurate potential diagnostic modality for preoperative evaluation of hand tendon injuries and the postoperative follow-up.

scholarly journals Laparoscopic spleen preserving distal pancreatectomy with intra-operative assessment and frozen section may prevent unnecessary splenectomy

HPB ◽  
2019 ◽  
Vol 21 ◽  
pp. S933-S934
Author(s):  
L. Tanno ◽  
N. Siddiqi ◽  
S. Barbaro ◽  
M. Fontana ◽  
A. Jayyusi ◽  
...  
Keyword(s):  
Distal Pancreatectomy ◽  
Frozen Section ◽  
Spleen Preserving ◽  
Operative Assessment

Quantitative intra-operative assessment of peritoneal carcinomatosis – A comparison of three prognostic tools

2009 ◽  
Vol 35 (10) ◽  
pp. 1078-1084 ◽  
Author(s):  
H.A.M. Swellengrebel ◽  
F.A.N. Zoetmulder ◽  
R.M. Smeenk ◽  
N. Antonini ◽  
V.J. Verwaal
Keyword(s):  
Peritoneal Carcinomatosis ◽  
Operative Assessment

Development of a Model for the Acquisition and Assessment of Advanced Laparoscopic Suturing Skills Using an Automated Device

2018 ◽  
Vol 25 (3) ◽  
pp. 286-290 ◽  
Author(s):  
Elif Bilgic ◽  
Madoka Takao ◽  
Pepa Kaneva ◽  
Satoshi Endo ◽  
Toshitatsu Takao ◽  
...  
Keyword(s):  
Laparoscopic Surgery ◽  
Interrater Reliability ◽  
Intraclass Correlation ◽  
Correlation Coefficients ◽  
Instructional Video ◽  
Validity Evidence ◽  
Laparoscopic Suturing ◽  
Intraclass Correlation Coefficients ◽  
Operative Assessment ◽  
Suturing Skills

Background. Needs assessment identified a gap regarding laparoscopic suturing skills targeted in simulation. This study collected validity evidence for an advanced laparoscopic suturing task using an Endo StitchTM device. Methods. Experienced (ES) and novice surgeons (NS) performed continuous suturing after watching an instructional video. Scores were based on time and accuracy, and Global Operative Assessment of Laparoscopic Surgery. Data are shown as medians [25th-75th percentiles] (ES vs NS). Interrater reliability was calculated using intraclass correlation coefficients (confidence interval). Results. Seventeen participants were enrolled. Experienced surgeons had significantly greater task (980 [964-999] vs 666 [391-711], P = .0035) and Global Operative Assessment of Laparoscopic Surgery scores (25 [24-25] vs 14 [12-17], P = .0029). Interrater reliability for time and accuracy were 1.0 and 0.9 (0.74-0.96), respectively. All experienced surgeons agreed that the task was relevant to practice. Conclusion. This study provides validity evidence for the task as a measure of laparoscopic suturing skill using an automated suturing device. It could help trainees acquire the skills they need to better prepare for clinical learning.

Excision of nasopharyngeal angiofibroma facilitated by intra-operative 3D-image guidance

2000 ◽  
Vol 114 (4) ◽  
pp. 311-313 ◽  
Author(s):  
A. Murray ◽  
M. Falconer ◽  
G. W. McGarry
Keyword(s):  
Image Guidance ◽  
Juvenile Nasopharyngeal Angiofibroma ◽  
3D Image ◽  
Nasopharyngeal Angiofibroma ◽  
Infra Red ◽  
Operative Evaluation ◽  
Guidance Systems ◽  
Operative Assessment

The latest 3D-image guidance systems to assist surgeons have greatly improved over earlier models. We describe the use of an optical infra-red system to assist in the removal of a juvenile nasopharyngeal angiofibroma. The specific advantages of this system in pre-operative assessment, intra-operative evaluation and excision of the angiofibroma are discussed.

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