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Perioperative management of malnutrition in the elderly 认领 引用
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作者 Yin-Bo Kang Wei-Bing Shuang 《Frontiers of Nursing》 2025年第2期155-161,共7页
The nutritional situation of the elderly is closely related to the occurrence and development of many diseases.How to reduce the damage of surgery,and improve the postoperative survival rate and quality of life in mal... The nutritional situation of the elderly is closely related to the occurrence and development of many diseases.How to reduce the damage of surgery,and improve the postoperative survival rate and quality of life in malnourished elderly patients is very important.Through the elderly malnutrition perioperative risk factors analysis,we make strategies for risk factors of perioperative-related prevention,from preoperative,intraoperative,and postoperative management of patients,to improve the patient’s life. 展开更多
关键词 elderly patients malnutrition method perioperative management recover
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Pathophysiological consequences of obstructive jaundice and perioperative management 认领 引用 被引量：98
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作者 Efstathios T Pavlidis Theodoros E Pavlidis 《Hepatobiliary & Pancreatic Diseases International》 SCIE CAS CSCD 2018年第1期17-21,共5页
Background:Obstructive jaundice is a common problem in daily clinical practice.Understanding completely the pathophysiological changes in obstructive jaundice remains a challenge for planning current and future manage... Background:Obstructive jaundice is a common problem in daily clinical practice.Understanding completely the pathophysiological changes in obstructive jaundice remains a challenge for planning current and future management.Data sources:A Pub Med was searched for relevant articles published up to August 2016.The effect of obstructive jaundice on proinflammatory cytokines,coagulation status,hemodynamics and organ functions were evaluated.Results:The effects of obstructive jaundice included biliary tree,the hepatic cell and liver function as well as systemic complications.The lack of bile in the gut,the disruption of the intestinal mucosal barrier,the increased absorption of endotoxin and the subsequent endotoxemia cause proinflammatory cytokine production(TNF-α,IL-6).Bilirubin induces systemic inflammatory response syndrome which may lead to multiple organ dysfunction syndrome.The principal clinical manifestations include hemodynamic instability and acute renal failure,cardiovascular suppression,immune compromise,coagulation disorders,nutritional impairment,and wound healing defect.The proper management includes full replacement of water and electrolyte deficiency,prophylactic antibiotics,lactulose,vitamin K and fresh frozen plasma,albumin and dopamine.The preoperative biliary drainage has not been indicated in overall,but only in a few selected cases.Conclusion:The perioperative management is an essential measure in improving the outcome after the appropriate surgical operation in jaundiced patients especially those with malignancy. 展开更多
关键词 Obstructive jaundice Perioperative management Preoperative biliary drainage Lactulose Endotoxin Biliary obstruction
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Expert consensus on the perioperative management of patients with sepsis 认领 引用 被引量：12
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作者 Jun-ping Chen Xiang-ming Fang +19 位作者 Xiao-ju Jin Rong-tian Kang Ke-xuan Liu Jin-bao Li Yan Luo Zhi-jie Lu Chang-hong Miao Han-xiang Ma Wei Mei Yang-wen Ou Si-hua Qi Zai-sheng Qin Guo-gang Tian An-shi Wu Dong-xin Wang Tian Yu Yong-hao Yu Jing Zhao Ming-zhang Zuo Shi-hai Zhang 《World Journal of Emergency Medicine》 CAS 2015年第4期245-260,共16页
INTRODUCTION Sepsis is defined as an infection associated with systemic manifestations of inflammation, which has become the most common complication in the perioperative period caused by severe burnrauma and major su... INTRODUCTION Sepsis is defined as an infection associated with systemic manifestations of inflammation, which has become the most common complication in the perioperative period caused by severe burnrauma and major surgical operation.[1,2] The incidence of sepsis in adults is estimated to be 149–240/100 000 per year, and that of severe sepsis and septic shock is 56–91/100 000 per year. In the last decade, the short-term mortality of sepsis has declined to around 20% in developed countries partly due to the international Surviving Sepsis Campaign （SSC）, while the mortality remains very high （50%–80%） in 1–5 years after discharge from hospitals.[3–7] Thus, sepsis and its subsequent severe sepsis and septic shock are currently major issues in the field of medical and health care. 展开更多
关键词 Expert consensus perioperative management patients with sepsis
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Effectiveness of enhanced recovery after surgery in the perioperative management of patients with bone surgery in China 认领 引用 被引量：4
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作者 Li-Yan Zhao Xiong-Tao Liu +6 位作者 Zhi-Li Zhao Ru Gu Xiu-Mei Ni Rui Deng Xiao-Ying Li Ming-Ji Gao Wei-Na Zhu 《World Journal of Clinical Cases》 SCIE 2021年第33期10151-10160,共10页
BACKGROUND Enhanced recovery after surgery(ERAS)was introduced in China in 2007.Over time,the scope of ERAS has expanded from abdominal surgery to orthopedics,urology and other fields.Continuous development and resear... BACKGROUND Enhanced recovery after surgery(ERAS)was introduced in China in 2007.Over time,the scope of ERAS has expanded from abdominal surgery to orthopedics,urology and other fields.Continuous development and research has contributed to progress of ERAS in China.In 2019,to promote the application of ERAS in bone tumor surgery,we formed the“Consensus of Experts on Perioperative Management of Accelerated Rehabilitation in Major Surgery of Bone Tumors in China”.AIM To evaluate the effect of enhanced recovery after bone tumor surgery in perioperative management in China.METHODS One hundred and seven patients who underwent bone tumor surgery at the Second Affiliated Hospital of Xi’an Jiaotong University between May 2019 and April 2021 were randomized into a study group(53 cases)and a control group(54 cases).The study group adopted the ERAS protocol and the control group adopted conventional care.Main outcome measures included postoperative length of stay(LOS),postoperative complications,mortality,and 30-d readmission rates.Secondary outcomes included postoperative visual analog scale(VAS)score of pain,number of blood transfusions,drainage volume in 24 h after operation,patient satisfaction 30 d after discharge,VAS score at 30 d after discharge,and daily standing walking time.RESULTS There were no significant differences in the baseline data,clinical features and surgical site between the two groups.The LOS in the study group with the ERAS protocol was 7.72±3.34 d compared with 10.28±4.27 d in the control group who followed conventional care.The incidence of postoperative nausea and vomiting(PONV)in the study group was 19%and 37%in the control group.The VAS scores of pain on postoperative day 1(POD1)and POD3 in the study group were 4.79±2.34 and 2.79±1.53 compared with 5.28±3.27 and 3.98±2.27 in the control group.The drainage volume in 24 h after the operation was 124.36±23.43 mL in the study group and 167.43±30.87 mL in the control group.The number of blood transfusions in the study group was also lower.The patient satisfaction rate was higher in the study group than in the control group.CONCLUSION The ERAS protocol in the perioperative period of bone tumor surgery can decrease LOS,PONV,and postoperative pain,blood transfusion and 24-h drainage,improve patient satisfaction and accelerate recovery. 展开更多
关键词 Enhanced recovery after surgery Bone tumor surgery Perioperative management Effect evaluation Clinical application
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Effects of perioperative managements on ocular surface microbiota in intravitreal injection patients 认领 引用 被引量：2
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作者 Ya-Guang Hu Qiong Wu +7 位作者 Tian-Hui Li Fang Sui Ming Zhang Zhen Zhang Rui Shi Na Hui Li Qin Li Li 《International Journal of Ophthalmology(English edition)》 SCIE CAS 2022年第2期248-254,共7页
AIM:To investigate the effects of on ocular surface microbiota in patients who received intravitreal injections.METHODS:Samples of ocular surface microbiota were obtained from 41 eyes of 41 patients who visited the De... AIM:To investigate the effects of on ocular surface microbiota in patients who received intravitreal injections.METHODS:Samples of ocular surface microbiota were obtained from 41 eyes of 41 patients who visited the Department of Ophthalmology.Patients were separated for three groups.Group A did not receive perioperative managements or intravitreal injection.Group B1 received only once and B2 received more than twice.In operating room,the samples were collected on the ocular surface.Operating taxonomic units(OTUs) clustering and alpha/beta diversity analysis was performed.The microbial 16S rRNA from samples were analyzed using the Hi Seq 2500 platform.RESULTS:Alpha diversity did not differ in each group,and beta diversity differed in the B2 group.Beta diversity showed a significant difference between Group A and B2(P=0.048).With the perioperative managements before intravitreal injection,the composition and relative abundance were altered.Top 10 microbiota on phylum and genus level,and then microbiota notably changed at genus level were listed.Gram-negative bacteria were varied more.Furthermore,Proteus was not found in Groups A and B1,but it was appeared after the patients received perioperative management and intravitreal injections in Group B2.CONCLUSION:With the perioperative managements,the balance of microbiota on the ocular surface is destroyed,and relative composition and abundance of microbiota on the ocular surface is obviously altered.The clinical doctors should pay more attention on the consequence of perioperative managements before intravitreal injection. 展开更多
关键词 microbiota perioperative managements ocular surface intravitreal injection high-throughput sequencing
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Perioperative management of primary liver cancer 认领 引用 被引量：7
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作者 Hui-Hua Yiao 《World Journal of Gastroenterology》 SCIE CAS 2007年第13期1970-1974,共5页
AIM:To minimize the complications and mortality and improve the survival in primary liver cancer (PLC) patients undergoing hepatic resection. METHODS: We conducted a retrospective analysis of 2143 PLC patients treated... AIM:To minimize the complications and mortality and improve the survival in primary liver cancer (PLC) patients undergoing hepatic resection. METHODS: We conducted a retrospective analysis of 2143 PLC patients treated from January 1990 to January 2004. The patients were divided into two groups using January 1997 as a cut-off. Small tumor size (< 5 cm), preoperative redox tolerance index (RTI), vascular control method, and postoperative arterial ketone body ratio (AKBR) were used as indicators of surgical outcome. RESULTS: Small tumors had less complications and lower mortality and higher overall survival rate. Use of RTI for selecting patients and types of hepatectomy, reduced complications (21.1% vs 11.0%) and mortality (1.6% vs 0.3%). The half liver vascular occlusion protocol (n = 523) versus the Pringle method (n = 476) showed that the former significantly reduced the postoperative complications (25.8% vs 11.9%) and mortality (2.3% vs 0.6%) respectively, and cut mean hospital stay was 3.5 d. Postoperative AKBR was a reliable indicator of the energy status in survivors. CONCLUSION: RTI is of value in predicting hepatic functional reserve, half liver occlusion could protect the residual liver function, and AKBR measurement is a simple and accurate means of assessing the state of postoperative metabolism. Optimal perioperative management is an important factor for minimizing complications and mortality in patients undergoing hepatic resection. 展开更多
关键词 Liver cancer Hepatectomy Optimal perioperative management Arterial ketone body ratio Redox tolerance index
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Anaesthetic perioperative management of patients with pancreatic cancer 认领 引用 被引量：2
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作者 Lesley De Pietri Roberto Montalti Bruno Begliomini 《World Journal of Gastroenterology》 SCIE CAS 2014年第9期2304-2320,共17页
Pancreatic cancer remains a significant and unresolved therapeutic challenge.Currently,the only curative treatment for pancreatic cancer is surgical resection.Pancreatic surgery represents a technically demanding majo... Pancreatic cancer remains a significant and unresolved therapeutic challenge.Currently,the only curative treatment for pancreatic cancer is surgical resection.Pancreatic surgery represents a technically demanding major abdominal procedure that can occasionally lead to a number of pathophysiological alterations resulting in increased morbidity and mortality.Systemic,rather than surgical complications,cause the majority of deaths.Because patients are increasingly referred to surgery with at advanced ages and because pancreatic surgery is extremely complex,anaesthesiologists and surgeons play a crucial role in preoperative evaluations and diagnoses for surgical intervention.The anaesthetist plays a key role in perioperative management and can significantly influence patient outcome.To optimise overall care,patients should be appropriately referred to tertiary centres,where multidisciplinary teams(surgical,medical,radiation oncologists,gastroenterologists,interventional radiologists and anaesthetists)work together and where close cooperation between surgeons and anaesthesiologists promotes the safe performance of major gastrointestinal surgeries with acceptable morbidity and mortality rates.In this review,we sought to provide simple daily recommendations to the clinicians who manage pancreatic surgery patients to make their work easier and suggest a joint approach between surgeons and anaesthesiologists in daily decision making. 展开更多
关键词 Pancreatic cancer Pancreatic surgery Perioperative anaesthesia management
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Perioperative management of patients with traumatic intracranial hemorrhage and pretraumatic oral warfarin 认领 引用
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作者 陈开来 《外科研究与新技术（中英文）》 2011年第3期201-202,共2页
Objective To study perioperative management in treatment of traumatic intracranial hemorrhage in patients with pretraumatic anticoagulation therapy of oral warfarin.Methods 10 patients of traumatic intracranial hemorr... Objective To study perioperative management in treatment of traumatic intracranial hemorrhage in patients with pretraumatic anticoagulation therapy of oral warfarin.Methods 10 patients of traumatic intracranial hemorrhage with pretraumatic anticoagulation therapy of oral warfarin received vitamin K,FFP and PCC 展开更多
关键词 oral Perioperative management of patients with traumatic intracranial hemorrhage and pretraumatic oral warfarin
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Discussion on the Implementation Effect of the Accelerated Rehabilitation Surgery Concept in the Perioperative Management of Hepatectomy 认领 引用
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作者 JIANXuezhong 《外文科技期刊数据库（文摘版）医药卫生》 2022年第3期091-095,共5页
Objective: to explore the effect of nursing concept in the perioperative management of hepctomy. Method: time choice between April and June 2019, a total of 116 patients receiving liver resection, according to the ope... Objective: to explore the effect of nursing concept in the perioperative management of hepctomy. Method: time choice between April and June 2019, a total of 116 patients receiving liver resection, according to the operation time, the first 58 patients during the routine care mode, it into the control group, after 58 patients accelerated rehabilitation surgery care mode, into the research group, respectively than different care mode after the index, pain score data, postoperative complication data. Results: the study group was not only lower than the control group (P ＜0.05), but also the surgical index data (P ＜0.05), and the pain score data (P ＜0.05), and significantly better than the ALT, ALT, T and TBIL indicators (P ＜0.05).Conclusion: the perioperative management of resection and the concept of accelerated rehabilitation surgery can accelerate the rehabilitation of patients. 展开更多
关键词 the concept of accelerated rehabilitation surgery hepatectomy perioperative management effect
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Perioperative outcomes and phase-specific intraoperative glycemic management in simultaneous pancreas-kidney transplantation:A single-center case series 认领 引用 被引量：1
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作者 Felix R Montes Juan Diego Gutierrez-Navarro +9 位作者 Natalia Restrepo-Patiño Laura Gutiérrez-Soriano Eduardo Becerra-Zapata Juan Carlos Kling Laura Peña-Blanco Rodrigo Martinez-Ardila Nicolas Diaz-Riaño Laura Gonzalez-Vasquez Nathaly Ramirez-Sanchez Luis Manuel Barrera-Lozano 《World Journal of Transplantation》 2026年第2期201-209,共9页
BACKGROUND Simultaneous pancreas-kidney transplantation(SPKT),an established treatment for patients with type 1 diabetes mellitus(T1DM)or type 2 diabetes mellitus(T2DM)and end-stage renal disease(ESRD),provides metabo... BACKGROUND Simultaneous pancreas-kidney transplantation(SPKT),an established treatment for patients with type 1 diabetes mellitus(T1DM)or type 2 diabetes mellitus(T2DM)and end-stage renal disease(ESRD),provides metabolic stabilization and improved survival.Although perioperative glycemic control is crucial for graft viability;intraoperative management remains understudied,and standardized phase-specific protocols are lacking.AIM To explore the feasibility,safety,and immediate outcomes of a six-phase intraoperative glycemic control algorithm for SPKT.METHODS This retrospective case series included 11 patients with T1DM or T2DM and ESRD who underwent SPKT at a quaternary care center between January 2024 and May 2025.All patients were managed using a six-phase institutional glycemic control algorithm that maintains intraoperative blood glucose levels within predefined targets.Data on clinical,metabolic,surgical variables;complications;and early outcomes were collected.RESULTS In most cases,intraoperative blood glucose levels were maintained within target ranges;however variations were observed[range:63-453 mg/dL(3.5-25.2 mmol/L)].No severe hypoglycemia or ketoacidosis occurred.During the first 24 postoperative hours,seven patients(63.6%)achieved euglycemia without exogenous insulin,whereas two required transient insulin therapy.Six patients(54.5%)had postoperative complications,including thrombotic(n=4),infectious(n=2),and reperfusion syndrome(n=1).One patient experienced more than one event.All events were successfully managed,without graft loss,acute rejection,or in-hospital mortality.CONCLUSION The phase-specific intraoperative glycemic protocol for SPKT is feasible and safe.However,prospective studies with larger cohorts are warranted to assess its long-term impact on graft survival and patient outcomes. 展开更多
关键词 Simultaneous pancreas-kidney transplantation Intraoperative glycemic control Perioperative management Pancreatic graft function Metabolic stability
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Effect of whole-process management protocol in preventing devicerelated intraoperative pressure injuries in patients undergoing gastrointestinal surgery 认领 引用
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作者 Juan Ge Zhen-Lin Wang 《World Journal of Gastrointestinal Surgery》 SCIE 2026年第7期255-264,共10页
BACKGROUND Intraoperative device-related pressure injuries are common in gastrointestinal surgery,and conventional nursing has limited preventive efficacy.A comprehensive perioperative strategy is urgently needed.AIM ... BACKGROUND Intraoperative device-related pressure injuries are common in gastrointestinal surgery,and conventional nursing has limited preventive efficacy.A comprehensive perioperative strategy is urgently needed.AIM To evaluate the efficacy of a whole-process management protocol in preventing device-related pressure injuries during gastrointestinal surgery.METHODS This retrospective cohort study included 104 patients undergoing gastrointestinal surgery.The observation group(n=53)received a whole-process management protocol,while the control group(n=51)received standard care.The primary outcome was incidence of intraoperative pressure injuries.Secondary outcomes included postoperative complications,recovery indices,inflammatory markers,anxiety,sleep quality,and quality of life.Between-group comparisons were performed using theχ2 test,independent t-test,or Mann-Whitney U test,as appropriate.Repeated measures were analyzed using mixed-effects models.RESULTS The observation group had significantly lower pressure injury incidence at 1 day postoperatively(5.66%vs 27.45%,P=0.003)and fewer total complications(50.94%vs 80.39%,P=0.002).Times to flatus,regular diet,and wound healing were shorter in the observation group(all P<0.05).Mixed-effects models revealed significant group-by-time interactions favoring the observation group for highsensitivity C-reactive protein(P=0.004),anxiety scores(P=0.008),and all domains of quality of life(P<0.01).CONCLUSION The whole-process management protocol significantly reduces device-related pressure injuries and improves postoperative recovery,inflammation,anxiety,sleep,and quality of life in patients undergoing gastrointestinal surgery. 展开更多
关键词 Whole-process management protocol Gastrointestinal surgery Device-related pressure injury Perioperative management Postoperative complications Quality of life
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Perioperative challenges in management of diabetic patients undergoing non-cardiac surgery 认领 引用 被引量：9
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作者 Ursula Galway Praveen Chahar +4 位作者 Marc T Schmidt Jorge A Araujo-Duran Jeevan Shivakumar Alparslan Turan Kurt Ruetzler 《World Journal of Diabetes》 SCIE 2021年第8期1255-1266,共12页
Prediabetes and diabetes are important disease processes which have several perioperative implications.About one third of the United States population is considered to have prediabetes.The prevalence in surgical patie... Prediabetes and diabetes are important disease processes which have several perioperative implications.About one third of the United States population is considered to have prediabetes.The prevalence in surgical patients is even higher.This is due to the associated micro and macrovascular complications of diabetes that result in the need for subsequent surgical procedures.A careful preoperative evaluation of diabetic patients and patients at risk for prediabetes is essential to reduce perioperative mortality and morbidity.This preoperative evaluation involves an optimization of preoperative comorbidities.It also includes optimization of antidiabetic medication regimens,as the avoidance of unintentional hypoglycemic and hyperglycemic episodes during the perioperative period is crucial.The focus of the perioperative management is to ensure euglycemia and thus improve postoperative outcomes.Therefore,prolonged preoperative fasting should be avoided and close monitoring of blood glucose should be initiated and continued throughout surgery.This can be accomplished with either analysis in blood gas samples,venous phlebotomy or point-of-care testing.Although capillary and arterial whole blood glucose do not meet standard guidelines for glucose testing,they can still be used to guide insulin dosing in the operating room.Intraoperative glycemic control goals may vary slightly in different protocols but overall the guidelines suggest a glucose range in the operating room should be between 140 mg/dL to 180 mg/dL.When hyperglycemia is detected in the operating room,blood glucose management may be initiated with subcutaneous rapid-acting insulin,with intravenous infusion or boluses of regular insulin.Fluid and electrolyte management are other perioperative challenges.Notably diabetic ketoacidosis and hyperglycemic hyperosmolar nonketotic state are the two most serious acute metabolic complications of diabetes that must be recognized early and treated. 展开更多
关键词 Diabetes mellitus Perioperative management Insulin Hyperglycaemia Anaesthesia Surgery
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Perioperative Nursing Management of a Lateral Ventricle Trigone Meningioma Resected via a Contralateral Approach:A Case Report 认领 引用
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作者 Li Hu Xuelian Yang +3 位作者 Xi Peng Zhou Zheng Dong Li Hua Yu 《Journal of Clinical and Nursing Research》 2025年第12期370-379,共10页
This article summarizes the nursing experience with a patient who underwent resection of a lateral ventricle trigone meningioma via a contralateral interhemispheric approach.Key nursing measures included preoperative ... This article summarizes the nursing experience with a patient who underwent resection of a lateral ventricle trigone meningioma via a contralateral interhemispheric approach.Key nursing measures included preoperative health education and psychological care,baseline neurological assessment,and comprehensive physiological preparation.Postoperative care focused on intensive vital sign monitoring and support,comprehensive neurological evaluation and early rehabilitation,as well as a proactive strategy for preventing secondary epilepsy and controlling intracranial infection.Through active treatment and systematic nursing care,the patient achieved an uncomplicated recovery and was discharged on postoperative day 9.The successful implementation of these structured nursing interventions contributed to favorable postoperative outcomes,offering a valuable reference for the perioperative management of similar complex neurosurgical cases. 展开更多
关键词 The lateral ventricle trigone Meningioma Perioperative nursing management
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Endoscopic management of infected necrotizing pancreatitis:Advancing through standardization 认领 引用 被引量：2
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作者 Yan Zeng Jun-Wen Zhang Jian Yang 《World Journal of Gastroenterology》 SCIE CAS 2025年第20期18-31,共14页
Infected necrotizing pancreatitis(INP)remains a life-threatening complication of acute pancreatitis.Despite advancements such as endoscopic ultrasound(EUS)-guided drainage,lumen-apposing metal stents,and protocolized ... Infected necrotizing pancreatitis(INP)remains a life-threatening complication of acute pancreatitis.Despite advancements such as endoscopic ultrasound(EUS)-guided drainage,lumen-apposing metal stents,and protocolized step-up strate-gies,the clinical practice remains heterogeneous,with variability in endoscopic strategies,procedural timing,device selection,and adjunctive techniques contri-buting to inconsistent outcomes.This review synthesizes current evidence to contribute to a structured framework integrating multidisciplinary team decision-making,advanced imaging(three-dimensional reconstruction,contrast-enhanced computed tomography/magnetic resonance imaging),EUS assessment,and biomarker-driven risk stratification(C-reactive protein,procalcitonin)to optimize patient selection,intervention timing,and complication management.Key stan-dardization components include endoscopic assessment and procedural strate-gies,optimal timing of intervention,personalized approaches for complex pan-creatic collections,and techniques to reduce the number of endoscopic debride-ments and mitigate complications.This work aims to enhance clinical outcomes,minimize practice heterogeneity,and establish a foundation for future research and guideline development in endoscopic management of INP. 展开更多
关键词 Infected necrotizing pancreatitis Endoscopic management Perioperative management Standardized management Multidisciplinary collaboration
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Perioperative risk factors for prognosis in patients undergoing radical esophagectomy:A retrospective study 认领 引用
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作者 Shu-Gang Liu Xin-Jian Xu +2 位作者 Ming He Ji-Dong Zhao Lin Pei 《World Journal of Gastrointestinal Surgery》 SCIE 2025年第4期174-186,共13页
BACKGROUND Esophageal cancer constitutes one of the most aggressive malignant neoplasms associated with poor clinical outcomes.While surgical resection remains the cornerstone of curative intervention,optimization of ... BACKGROUND Esophageal cancer constitutes one of the most aggressive malignant neoplasms associated with poor clinical outcomes.While surgical resection remains the cornerstone of curative intervention,optimization of perioperative care protocols has emerged as an essential strategy to reduce postoperative complications and potentially improve long-term survival rates in patients undergoing esophagectomy.However,substantial debate persists regarding the relative importance of various perioperative risk factors and their impact on post-resection outcomes.AIM To identify perioperative factors affecting prognosis after radical esophagectomy,aiming to improve patient outcomes through targeted interventions.METHODS A retrospective study analyzed 378 patients with esophageal cancer who underwent radical esophagectomy(McKeown,Sweet,or Ivor-Lewis procedures)from January 2022 through December 2023.All operations were performed by experienced surgeons following standardized perioperative protocols.The investigation gathered data on patient demographics,surgical parameters,tumor pathology(using the 8th edition American Joint Committee on Cancer staging system),and survival outcomes.Statistical analyses utilized Kaplan-Meier estimates and Cox proportional hazards modeling,with adjustment for confounding variables.RESULTS Multivariate Cox proportional hazards analysis identified three independent predictors of survival:Tumor-nodemetastasis staging[Hazard ratio(HR)=2.31,95%confidence interval(CI):1.72-3.10,P5 days)(HR=1.43,95%CI:1.08-1.89,P=0.012).Kaplan-Meier analysis demonstrated significantly lower overall survival rates in patients requiring analgesics for>5 days compared to≤5 days(P=0.003),with consistent patterns observed for both opioid(P=0.019)and nonsteroidal anti-inflammatory drug use(P=0.028).The extended analgesic group exhibited a higher proportion of elderly patients(48.47%vs 35.57%,P=0.015),while other baseline characteristics and tumor features remained comparable between groups.CONCLUSION Tumor-node-metastasis staging,tumor differentiation,and duration of postoperative analgesic use independently predict survival following radical esophagectomy,underscoring the significance of optimal pain management protocols. 展开更多
关键词 Radical esophagectomy Perioperative management Prognostic factors Postoperative analgesic use Survival analysis
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Perioperative management of endoscopic transsphenoidal pituitary surgery 认领 引用 被引量：4
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作者 Martin Hanson Hao Li +3 位作者 Eliza Geer Sasan Karimi Viviane Tabar Marc A.Cohen 《World Journal of Otorhinolaryngology-Head and Neck Surgery》 CAS 2020年第2期84-93,共10页
The contemporary embrace of endoscopic technology in the approach to the anterior skull base has altered the perioperative landscape for patients requiring pituitary surgery.Utility of a multi-disciplinary unit in man... The contemporary embrace of endoscopic technology in the approach to the anterior skull base has altered the perioperative landscape for patients requiring pituitary surgery.Utility of a multi-disciplinary unit in management decisions facilitates the delivery of optimal care.Evolution of technology and surgical expertise in pituitary surgery mandates ongoing review of all components of the care central to these patients.The many areas of potential variability in the pre,intra and post-operative timeline of pituitary surgery are readily identifiable.Core undertakings and contemporary controversies in the peri-operative management of patients undergoing endoscopic transsphenoidal pituitary surgery are assessed against the available literature with a view to providing guidance for the best evidence-based practice. 展开更多
关键词 Pituitary Pituitary surgery Endoscopic skull base surgery Perioperative management
Advances in the prevention and management of postoperative bleeding complications in pancreaticoduodenectomy:Current strategies and future directions precise 认领 引用
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作者 Qian Wang Geng-Geng Liu +4 位作者 Feng Pan Jia-Yi Xu Yan Jiao Qing Liu Ya-Hui Liu 《World Journal of Clinical Oncology》 2025年第8期123-127,共5页
Postoperative bleeding(POB)is a major complication following pancreaticoduodenectomy(PD),leading to significant morbidity and potential mortality.This minireview focuses on the prevention and management strategies for... Postoperative bleeding(POB)is a major complication following pancreaticoduodenectomy(PD),leading to significant morbidity and potential mortality.This minireview focuses on the prevention and management strategies for POB,synthesizing current evidence on surgical techniques,perioperative management,and postoperative interventions.Effective prevention strategies include the use of regional vessel wrapping,optimal pancreatic anastomosis,and meticulous intraoperative hemostasis.Postoperative management strategies,such as early detection using predictive models and advanced imaging,along with endovascular interventions like angiographic embolization and stent graft placement,are essential for timely intervention.Risk factors,including pancreatic texture,anticoagulation therapy,and patient comorbidities,further influence bleeding outcomes.The minireview also identifies gaps in current research and emphasizes the need for prospective randomized controlled trials to establish standardized protocols.Overall,a multidisciplinary approach combining surgical expertise,predictive analytics,and personalized care is essential to improving patient out comes and minimizing the risk of POB following PD. 展开更多
关键词 Postoperative bleeding Pancreaticoduodenectomy Prevention strategies Surgical techniques Angiographic embolization Predictive models Risk factors Perioperative management Endovascular interventions
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Perioperative approach to nephrotoxicity in cytoreductive surgery and hyperthermic intraperitoneal chemotherapy 认领 引用
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作者 Şenay Göksu Özgül Düzgün 《World Journal of Gastrointestinal Surgery》 SCIE 2025年第10期117-124,共8页
BACKGROUND Combining cytoreductive surgery(CRS)and hyperthermic intraperitoneal chemotherapy(HIPEC)is a promising treatment approach for peritoneal carcinomatosis(PC).However,intraperitoneal chemotherapeutic agents si... BACKGROUND Combining cytoreductive surgery(CRS)and hyperthermic intraperitoneal chemotherapy(HIPEC)is a promising treatment approach for peritoneal carcinomatosis(PC).However,intraperitoneal chemotherapeutic agents significantly increase the risk of acute kidney injury(AKI).Identifying perioperative risk factors plays a critical role in preserving renal function.AIM To evaluate postoperative renal outcomes in patients with PC who underwent CRS+HIPEC.METHODS Patients who underwent CRS+HIPEC for PC between 2017 and 2024 were included in this retrospective cohort study.Demographic data,preoperative estimated glomerular filtration rate,HIPEC agents used(cisplatin,mitomycin C,oxaliplatin),intraoperative fluid management,vasopressor use,and postoperative creatinine levels were recorded.AKI was defined according to the 2012 Kidney Disease:Improving Global Outcomes criteria.Independent predictors were identified through multivariate logistic regression analysis.RESULTS AKI developed in 61 of 445 patients(13.7%).Among them,62.0%were stage I,24.6%were stage II,and 13.1%were stage III.The highest AKI rate was observed in the cisplatin group(21.4%),with lower rates in the oxaliplatin group(9.6%)and the mitomycin C group(6.5%).Independent risk factors included cisplatin use[odds ratio(OR)=2.8;95%confidence interval:1.6-4.9;P<0.001),intraoperative fluid administration<6000 mL(OR=2.1;P=0.02),vasopressor requirement(OR=1.9;P=0.03),and preoperative estimated glomerular filtration rate<75 mL/minute/1.73 m2(OR=2.3;P=0.01).AKI was associated with a prolonged hospital stay.Three patients(0.7%)progressed to chronic kidney disease.CONCLUSION Independent risk factors such as cisplatin use,inadequate fluid replacement,vasopressor requirement,and preoperative renal function should be considered during perioperative planning to reduce AKI risk following CRS+HIPEC. 展开更多
关键词 Cytoreductive surgery Hyperthermic intraperitoneal chemotherapy Acute kidney injury Cisplatin Estimated glomerular filtration rate Perioperative management
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Supervised anesthesiology residents do not adversely affect perioperative outcomes in elderly patient:A single-center experience from China 认领 引用
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作者 Dehua Wu Weixing Wang +3 位作者 Yanxuan Shi Jiawen Tang Guoqing Ding Tao Zhu 《Progress in Medical Education》 2025年第2期96-106,共11页
Objective:The anesthesia residency training system is designed to provide supervised practice,enabling residents to progress from simple to complex procedures and higher-risk patients.However,it remains unclear whethe... Objective:The anesthesia residency training system is designed to provide supervised practice,enabling residents to progress from simple to complex procedures and higher-risk patients.However,it remains unclear whether residents acquire sufficient competence to be considered qualified anesthesiologists by the end of their training.This study aimed to evaluate whether anesthesia care provided by supervised CA-5 residents affects postoperative outcomes in elderly patients undergoing non-cardiac surgery.Methods:A retrospective analysis was conducted on clinical data from elderly patients who underwent non-cardiac surgery between January 2020 and December 2021 at Songjiang Hospital Affiliated to Shanghai Jiao Tong University School of Medicine.Patients were categorized into two groups:those managed by CA-5 residents(Resident group,n=294)and those managed by attending anesthesiologists(Attending group,n=521).Propensity score matching(PSM;1:1)was used to ensure comparability between the groups.The primary outcome was a composite of in-hospital postoperative complications.Secondary outcomes included intraoperative hemodynamic changes,the need for intensive care unit(ICU)admission,length of ICU and hospital stays,and in-hospital mortality.Multivariable logistic regression assessed the adjusted association between anesthesia provider type and postoperative morbidity and mortality.Results:Among the 815 elderly patients included,105(12.9%)experienced postoperative complications and 22(2.7%)died during hospitalization.No significant differences were observed in postoperative complications or mortality between the two groups,either before PSM(morbidity:11.9%vs.13.4%,p=0.531;mortality:3.7%vs.2.1%,p=0.168)or after PSM(morbidity:12.0%vs.14.4%,p=0.392;mortality:3.8%vs.1.4%,p=0.067).Multivariate analysis confirmed that postoperative morbidity and mortality were not significantly associated with resident involvement,either before PSM(morbidity:OR=0.882,95%CI:0.552-1.410,p=0.600;mortality:OR=1.293,95%CI:0.479-3.492,p=0.612)or after PSM(morbidity:OR=0.881,95%CI:0.523-1.486,p=0.636;mortality:OR=3.122,95%CI:0.805-12.106,p=0.100).Conclusions:Postoperative morbidity and mortality rates in elderly patients undergoing non-cardiac surgery are comparable between those anesthetized by supervised CA-5 residents and those managed by attending anesthesiologists.These results suggest that supervised CA-5 residents do not adversely affect patient safety. 展开更多
关键词 Outcomes residency training anesthesia education perioperative management
Integrating Biomarker-Based Fatty Liver Indices Into Multidisciplinary Treatment Pathways for Digestive Tumors 认领 引用
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作者 Xudong Song Jingjing Dai Guoquan Tao 《iLABMED》 CSCD 2026年第2期130-131,共2页
Dear Editor,We read the recent study by Ding et al.[1],which was published by iLABMED in 2025 with great interest in which the laboratory-based fatty liver index(FLI-L)and the physical examination-combined laboratory-... Dear Editor,We read the recent study by Ding et al.[1],which was published by iLABMED in 2025 with great interest in which the laboratory-based fatty liver index(FLI-L)and the physical examination-combined laboratory-based fatty liver index(FLI-PL)were developed and validated. 展开更多
关键词 digestive tumor fatty liver index metabolic-associated fatty liver disease multidisciplinary treatment perioperative management
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