Biomedical subjects

Omer Aziz

Publications and source records attributed to Omer Aziz.

21 records · Page 2Linked to original sources

PubMed2003

Expanded use of suction and stabilization devices in cardiothoracic surgery.

BACKGROUND: Recent developments in beating heart instrumentation have allowed surgeons to perform multivessel off-pump coronary artery bypass surgery by overcoming the factors that impair surgical performance (limited visualization, continuous movement of the target area, and hemodynamic instability during exposure of the inferior and posterior parts of the heart). We have explored the possibility of further expanding apical and epicardial suction devices beyond their ordinary use in coronary artery surgery. METHODS: A retrospective review of our cardiac surgery database was undertaken to identify the incidences in which these devices have been used in a somewhat novel manner in the field of cardiac surgery. RESULTS: During this time period we identified 20 instances in which either apical or epicardial suction devices were used alone or together. The nature of the procedures included dividing pericardial adhesions (pericardiectomy, n = 2; dividing adhesions in redo-coronary surgery, n = 4), securing epicardial hemostasis (penetrating cardiac trauma, n = 2; securing hemostasis during reexploration after cardiac surgery, n = 10), and facilitating epicardial microwave ablation (n = 2). On all 20 occasions the intended procedures were undertaken uneventfully. Furthermore, the use of apical and epicardial devices greatly facilitated the operative procedures and avoided the use of cardiopulmonary bypass on all occasions. CONCLUSIONS: In summary, we would like to highlight the expanding role for apical and epicardial suction devices to an area beyond coronary artery surgery in which we have found their use invaluable.

Atrial Fibrillation↗

PubMed2003

Leg wound infection after coronary artery bypass grafting: a meta-analysis comparing minimally invasive versus conventional vein harvesting.

The great saphenous vein remains the most commonly harvested conduit for revascularization in coronary artery bypass grafting (CABG). Our aim is to compare minimally invasive vein harvest techniques to conventional vein harvest with regards to leg wound infection rates. A meta-analysis of identified randomized controlled trials, reporting a comparison between the two techniques published between 1965 and 2002, was undertaken. The outcome of interest was leg wound infection. Fourteen randomized studies were identified and included in the meta-analysis. Our study revealed that wound infection was significantly lower in the minimally invasive vein harvest group (odds ratio 0.22 with 95% confidence intervals of 0.14 to 0.34). Our study suggests that using minimally invasive techniques might reduce leg wound infection rate following great saphenous vein harvesting for CABG. Further research is required to evaluate the potential benefits of minimally invasive vein harvesting techniques on the cost of postoperative care and quality of the harvested vein.

Coronary Artery Bypass↗

PubMedDate not supplied

Evaluating operative risk in colorectal cancer surgery: ASA and POSSUM-based predictive models.

OBJECTIVE: To review two predictive models, based on the American Society of Anaesthesiologists (ASA) and the Physiological and Operative Severity Score for the enumeration of Mortality and morbidity (POSSUM)-used for estimating postoperative mortality in patients, undergoing surgery for colorectal disease, in the UK. METHODS: Data was derived from three multicentre, UK-based studies involving a total of 16,006 patients with malignant or non-malignant bowel pathologies. Data sources were: The Colorectal-POSSUM (CR-POSSUM) Study population, comprising 6883 patients undergoing colorectal surgery in 15 UK hospitals between 1993 and 2001; The Association of Coloproctology of Great Britain and Ireland (ACPGBI) Colorectal Cancer (CRC) Database, encompassing 8077 newly diagnosed CRC patients, undergoing surgical resections in 79 hospitals, between April 2000 and March 2002; The ACPGBI Malignant Bowel Obstruction (MBO) Study, encompassing 1046 patients with MBO in 148 hospitals, treated between April 1998 and March 1999. Multifactorial logistic regression analyses were used to adjust for case-mix, identify risk factors for in-hospital/30-day operative mortality and to accommodate the variability of outcomes between hospitals. RESULTS: In the ACPGBI CRC study, 7374 patients had surgery, 6622(89.8%) a major bowel resection and 1465(19.9%) emergency surgery. Nine hundred and eighty-nine (94.6%) patients with MBO had surgery and 854(86.3%) underwent bowel resection. In the CR-POSSUM study, of the 6790(98.6%) patients undergoing surgery, 3451(50.8%) had a major colorectal resection, including 2107(31.0%) as an emergency. The operative mortality was 7.5% for the ACPGBI CRC study, 15.7% for patients with MBO and 5.7% for patients in the CR-POSSUM study. When tested, the predictive models showed good discrimination, with an area under the receiver-operator characteristic curve of 77.5% for the ACPGBI CRC, 80.1% for the MBO and 89.8% for the CR-POSSUM. CONCLUSIONS: Prediction of postoperative death can be made by the clinician using simple, numerical, tables derived from the ACPGBI CRC, MBO and CR-POSSUM models. The models can be used in everyday practice for pre-operative counselling of patients and their carers, as a part of the process of informed consent. They may also be used to compare the outcomes between multidisciplinary CRC teams.

Adult↗