Seminars in Colon and Rectal Surgery, Journal Year: 2023, Volume and Issue: 34(4), P. 100986 - 100986
Published: Oct. 17, 2023
Language: Английский
Revista de Gastroenterología de México (English Edition), Journal Year: 2024, Volume and Issue: 89(3), P. 418 - 441
Published: July 1, 2024
Management of the patient with cirrhosis liver that requires surgical treatment has been relatively unexplored. In Mexico, there is currently no formal stance or expert recommendations to guide clinical decision-making in this context. The present position paper reviews existing evidence on risks, prognoses, precautions, special care, and specific management procedures for patients require interventions invasive procedures. Our aim provide by an panel, based best published evidence, consequently ensure timely, quality, efficient, low-risk care group patients. Twenty-seven were developed address preoperative considerations, intraoperative settings, postoperative follow-up care. assessment major should be overseen a multidisciplinary team includes anesthesiologist, hepatologist, gastroenterologist, nutritionist. With respect decompensated patients, nephrology specialist may required, given kidney function also parameter involved prognosis these El terreno del paciente con cirrosis que requiere de una intervención quirúrgica ha sido poco explorado. En México, la fecha contamos un posicionamiento o recomendaciones expertos ayuden toma decisiones clínicas en este contexto. Revisar evidencia existente sobre el riesgo, pronóstico, precauciones, cuidados especiales y manejo proceder específico para los pacientes requieren ser intervenidos quirúrgicamente mediante procedimientos invasivos, emitir por panel experto, basadas mejor publicada atención oportuna, calidad, eficiente menor riesgo posible grupo pacientes. Se obtuvieron 27 recomendaciones, donde se abordan preoperatorio, escenario transoperatorio seguimiento postoperatorios. La valoración cuidado procedimiento quirúrgico invasivo mayor, debe estar cargo equipo multidisciplinario brinde soporte al cirujano, durante todo perioperatorio, incluir anestesiólogo, hepatólogo, gastroenterólogo, nutriólogo clínico. descompensado, puede necesario involucrar especialistas nefrología ya función renal es parámetro implicado también pronóstico estos
Citations
5
Journal of Clinical Medicine, Journal Year: 2025, Volume and Issue: 14(4), P. 1077 - 1077
Published: Feb. 8, 2025
Background: Liver function and the presence of portal hypertension, as well urgency type surgery, are prognostic factors in advanced chronic liver disease (ACLD) patients undergoing extrahepatic major surgeries. Emergent surgery ACLD has 4–10 times higher mortality rates than elective surgery. However, perioperative management improvements have been made recent years. Methods: This is a retrospective, observational, unicentric study 482 with who underwent from 2010 to 2019. We compared baseline characteristics postoperative according ascites, emergency, period. Results: In total, 140 (29%) had 191 (39.6%) urgent The 90-day was 2.8-fold ascites [HR (95%CI) 2.8 (1.6–5.0); p = 0.001] 3-fold surgeries [3.0 (1.6 − 5.5); < 0.001)]. Urgent revealed highest risk [6.3 (2.7–14.8); 0.001)], which persisted current (2015–2019) [12.8 (2.9–56.5); Portal hypertension meaningful abdominal Conclusions: emergent increase despite improvements.
Language: Английский
Citations
0
Epilepsia, Journal Year: 2025, Volume and Issue: unknown
Published: May 2, 2025
Abstract Objective Readiness Brain Operation Optimization Training (ReBOOT) is a manualized cognitive prehabilitation program for patients considering epilepsy surgery designed to improve presurgical preparedness through education and reduce the impact of postsurgical changes with preemptive compensatory training. The purpose this study was understand feasibility prehabilitation, examine patient satisfaction ReBOOT, assess in strategy use following ReBOOT. Methods Seventeen participants (65% female, mean age = 41 years) were enrolled which includes two one‐on‐one psychoeducation sessions, four group sessions on strategies, weekly goal setting facilitate implementation strategies. Patient retention, attendance, completion tracked. Participants also completed Everyday Compensation Questionnaire pre‐ postintervention along survey postintervention. Aggregate ratings examined, paired samples t ‐test used change Results Five withdrew shortly after consent, prior starting because surgical status/date or lack desire complete relevant activities. Of 12 remaining participants, only missed one session. indicated that they found ReBOOT be quite beneficial, reported information support provided by felt effective at preparing them potential changes. Most made some (i.e., little moderate) progress their goals each week demonstrated increased end Significance Findings indicate feasible. high reporting multiple benefits, completion. These results highlight as worthwhile pursuit demonstrate may serve useful clinical resource future further validation its efficacy.
Language: Английский
Citations
0
Current anesthesiology reports, Journal Year: 2024, Volume and Issue: 14(2), P. 172 - 179
Published: Feb. 6, 2024
Language: Английский
Citations
2
Hepatology International, Journal Year: 2024, Volume and Issue: 18(3), P. 876 - 891
Published: March 12, 2024
Language: Английский
Citations
2
Clinics in Liver Disease, Journal Year: 2024, Volume and Issue: 28(3), P. 555 - 576
Published: May 8, 2024
Language: Английский
Citations
2
International Journal of Surgery, Journal Year: 2024, Volume and Issue: unknown
Published: March 18, 2024
Background: The obesity epidemic has led to an increase in the proportion of patients with chronic liver disease due metabolic associated steatosic and prevalence cirrhosis. Metabolic bariatric surgery been proven determine weight loss, obesity-related medical problems remission, steatosis, inflammation, fibrosis improvement. However, cirrhosis portal hypertension are well-known risk factors for increased morbidity mortality after surgery. aim this study is evaluate safety compensated advanced clinically significant hypertension. Material Methods: This international, multicentric, retrospective on 63 individuals affected by who underwent tertiary referral centers experts hepatobiliary surgeons between January 2010 October 2022. primary endpoint was post-operative at 90 days. secondary endpoints included postoperative loss last follow-up complication rate. In addition, we performed subgroup analyses Child-Pugh (A vs. B) score, MELD (≤9 >9) score type Results: One patient (1.6%) experienced gastric leakage mortality. There were 3 (5%) reported cases vein thrombosis, 2 (3%) acute renal failure, 1 encephalopathy. A resulted be a protective factor intraoperative bleeding requiring transfusion univariate analysis ((OR: 0.73, 95% CI: 0.55 – 0.97, P =0.046) but not multivariate analysis. MELD>9 did result any complication. Conclusion: safe expert surgeons. Larger, prospective studies longer periods needed confirm these results.
Language: Английский
Citations
2
Journal of Gastrointestinal Surgery, Journal Year: 2024, Volume and Issue: unknown, P. 101881 - 101881
Published: Nov. 1, 2024
Language: Английский
Citations
1
Clinics and Research in Hepatology and Gastroenterology, Journal Year: 2023, Volume and Issue: 47(8), P. 102205 - 102205
Published: Sept. 5, 2023
Language: Английский
Citations
3
Journal of Clinical Medicine, Journal Year: 2023, Volume and Issue: 12(18), P. 6100 - 6100
Published: Sept. 21, 2023
Patients with advanced chronic liver disease (ACLD) or cirrhosis undergoing surgery have an increased risk of morbidity and mortality in contrast to the general population. This is a retrospective, observational study evaluate predictive capacity surgical scores European patients ACLD. Cirrhosis was defined by presence thrombocytopenia <150,000/uL splenomegaly, AST-to-Platelet Ratio Index >2, nodular edge seen via ultrasound, transient elastography >15 kPa, and/or signs portal hypertension. We assessed variables related 90-day discrimination calibration current (Child-Pugh, MELD-Na, MRS, NSQIP, VOCAL-Penn). Only ACLD major surgeries included VOCAL-Penn were considered (n = 512). The rate at 90 days after 9.8%. Baseline disparities between H. Mar cohorts identified. Etiology, obesity, platelet count not associated mortality. showed best (C-statistic90D 0.876) overall (Brier90D 0.054), but excellent our cohort. suboptimal diabetes (C-statistic30D 0.770), without hypertension 0.555), abdominal wall 0.608) urgent (C-statistic180D 0.692) surgeries. Our cohort has shown similar those described American studies. However, some score mortality, VOCAL-Penn's discriminative ability decreases diabetes, hypertension, These results should be validated larger multicenter prospective
Language: Английский
Citations
2