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Results for “Preoperative Procedures--standards”

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6 recordsLinked to original sources

PubMedDate not supplied

Obstetric infection control in a developing country.

In Ghana, infection has been identified as a major cause of birth-related mortality. Results of a 2-month observation of infection control practices among Ghanaian obstetric nurses and midwives indicated that most personnel did not practice basic rules of asepsis. Problems included frequent breaks in technique, inadequate sterilization and disinfection, and repeated exposure to large amounts of blood and vaginal secretions. Supplies were limited and, even when available, not always used appropriately. The situation in developing countries is different from that in the United States. Therefore, an observational needs assessment is essential to plan relevant and practical measures for change.

Cesarean Section↗

PubMed1993

Extended total gastrectomy for carcinoma of the cardia.

Eighty-five patients with gastric carcinoma developing at or involving the cardia were operated on under a newly established principle to prevent a cancer-positive proximal margin. The choice of operative procedure, standard total gastrectomy or extended total gastrectomy, was determined by the degree of proximal extension of carcinoma as confirmed by preoperative examinations. The cancer-positive rate was decreased in this manner to 1.2% from the 13.8% of the controls operated on before the principle was established. Extended total gastrectomy without sternotomy should be used more frequently than that with sternotomy because of the technical advantages. Survival rates of the 85 patients were 48.3% at three years and 30.4% at five years after the operation, and were not significantly different from the controls. As post-operative survival rate is influenced by factors other than transmural extension of the tumor, this study should prompt us to focus on the problem of the proximal surgical margin in surgery for carcinoma of the gastric cardia.

Cardia↗

PubMed1987

Localization of occult breast lesions: practical solutions to problems of triangulation.

The preoperative triangulation and localization of some occult breast lesions can be complicated if the lesion is located deep in the breast. Based on the authors' experience of 1,400 localization procedures, standard breast positions were modified to help locate lesions that were difficult to see in two projections. Standard compression plates were also modified, allowing placement of fenestrations over deep lesions--especially those in the axillary tail of the breast--to facilitate safe, accurate localization.

Breast Neoplasms↗

PubMed1998

[The sentinel node procedure: standard intervention for surgical treatment of breast cancer].

Axillary lymph node dissection may be avoided in the surgical treatment of breast cancer if the sentinel node appears to be free of metastatic tumour cells. The sentinel node concept has been validated in hundreds of patients, in whom this node has been localized successfully by dye-guided node mapping and (or) gamma-probe localization after injection of a radiopharmaceutical agent. The success rate of sentinel node localization depends on different factors, such as type, volume and injection site of the radiopharmacon, choice of the handheld gamma-probe, timing of the blue dye injection, and clinical stage of the disease. The combination of preoperative lymphoscintigraphy, intraoperative gamma-probe guidance and blue dye administration will increase the success rate of a sentinel node biopsy. Recent reports, from both Europe and the United States, appear to indicate that the sentinel node biopsy will soon be standard procedure in the surgical treatment of (T1-2) breast cancer. In the majority of breast cancer patients axillary lymph node dissection, a cause of much morbidity, may thus be avoided.

Axilla↗

PubMed1996

[Infrarenal abdominal aortic aneurysm: morphological classification as decision aid for therapeutic procedures].

This clinical trial aimed to prospectively investigate the morphological structure of infrarenal abdominal aortic aneurysms (AAA) to establish a valid dataset in the preoperative assessment supporting either the conventional or endovascular (TPEG) surgical approach. Regarding both the general feasibility testing and safe TPEG placing, all the anatomic AAA data must already be measured preprocedurally, due to the necessity for conversion as a frequent consequence of an intraprocedural failure. Between January 1993 and June 1995, all the patients (n = 159) admitted for elective AAA repair, were prospectively analysed. Graded on the basis of these measurements we developed a new AAA classification system supporting the kind of the surgical procedure (standard) approach vs. TPEG). Three different types of AAA were clearly defined. Due to morphological AAA criteria, 86 out of 159 patients (54.1%) might be suitable for TPEG (Type I, IIA and IIB). An infrarenal (proximal) neck < 15 mm, an infrarenal aortic diameter > 24 mm or an extension of the aneurysm to the iliac bifurcation are considered to be exclusion criteria for TPEG placement. In consideration of relevant co-morbidities (e.g. renal artery stenosis, SMA occlusion, iliac occlusive disease, simultaneous operations) only 43 out 159 patients (27.1%) were good candidates for TPEG. In general, smaller AAA are more appropriate for TPEG repair due to better proximal and distal fixation. As a consequence, indication criteria for AAA repair must not be expanded to smaller AAA.

Aged↗

PubMed1988

Pilot study on quality assurance in cardiac surgery.

In 1986 development, testing and improvement of a multi-center based quality assurance procedure has been started by the German Society for Thoracic and Cardiovascular Surgery supplied by a research fund of the Federal Ministry of Research and Technology. Initially five cardiac surgery units took part in defining quality related items, collecting associated data and establishing a common data base. In the first year of its existence this data base received about 3800 records of patients undergoing cardiac surgery procedures using ECC. Preoperative clinical state, intraoperative actions and postoperative results including unexpected events sum up to an average record length of 300 items per procedure. Evaluation and representation of quality related data ist done in two ways: an overall quality profile consisting of 17 so called quality indicators accompanied by six patient-mix indicators enables each cardiac surgeon to get a quick global reference within the multicentrical data context, and several problem oriented profiles assist building and testing of special quality-related hypotheses towards improvement of procedure standards and performance.

Cardiac Surgical Procedures↗