Có 20+ tài liệu thuộc chủ đề "các thực hành tốt nhất cho an toàn bệnh nhân"
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pneumoperitoneum 100–1 sigmoid volvulus 109 small bowel obstruction. cramping 367 Crohn’s disease. surgical intervention bypass surgery 343 resection 342–3 stricture biopsy 342 strictureplasty 341–2 surgical treatment. perianal crohn’s disease 340–1 toxic megacolon 341. operative therapy complications of 257 Hartmann reversal 256–8 postoperative resection 258–9 procedures of 258–9. fecal contamination 282–3 fecal continence 87. postoperative bleeding 173–4 postoperative 281–2 hemorrhoid. small...
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Colon and. Rectal Surgery. Improved Outcomes in Colon and Rectal Surgery Whitlow • Beck • MargolinHicks • Timmcke. Improved Outcomes in Colon and Rectal Surgery. Improved Outcomes in Colon and Rectal Surgery is an essential reference for all colorectal surgeons, fellows and residents, as well as those working in gastroenterology and the medico-legal profession.. Charles B Whitlow MD, Program Director,...
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This volume is the third in a series dealing with improving outcomes, avoid- ing complications, and in general improving the lot of patients who require surgery for conditions of the large bowel, rectum, and anus.. It should be in the library of all neophyte surgeons and deserves to be read even by experienced practitioners.. With con- stantly improving laparoscopic techniques,...
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almost 25% of patients aged more than 60 had an abnormal value in one report.(66) The diabetic patient who is recognized and well managed perioperatively can achieve a surgi- cal mortality which is equal to the nondiabetic patient. The decision-making must be tailored to the stroke risk of the individual patient based on their history and the magnitude and bleeding...
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During the procedure the patient complains of light- headedness and numbness of the tongue. In this chapter, we will be discussing the various kinds of anesthesia used in the operating room for colorec- tal surgery, including their relative benefits and risks. Additionally, we will be discussing new treatments for postoperative pain relief, as well as one of the more visible...
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They found no benefit to the oral antibiotics and indeed found that patients randomized to three doses of oral medications had lower tolerance of the prep. They concluded that mechanical bowel preparation might be omitted, but that further studies should be performed.. All in all, the authors felt that routine mechanical bowel preparation should be reconsidered.. Some clinicians have advocated...
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The relative high incidence of these problems reflects the early learning curve with stapling instruments and the early developmental nature of the instru- ments used. A prospective randomized multicenter study by Dochetry and colleagues described 652 patients who were randomized to a sutured (n = 321) or stapled large bowel anastomosis (n = 331) between 1985 and 1989.(32) During the...
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Placing one’s fingers on either side of the adhesion and palpating can be of assistance to feel the plane and also sometimes stretch out the adhesion for easier division. Of course, one of the biggest keys to success is proper traction and counter-traction. If the traction is too forceful though, tearing of the bowel may occur.. Adhesion formation is a...
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Empiric-based practice relies on mechanical bowel preparation together with oral antibiotics to reduce the bacterial load of the bowel and, in theory, to decrease the risks of anas- tomotic leak and surgical site infection. A Cochrane review evaluating the efficacy of bowel prepara- tion in its ability to reduce postoperative complications included 1,592 patients from nine randomized, controlled trials stratified...
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In a study of over 1,000 patients, the addi- tion of ketorolac to standard intravenous morphine significantly reduced the overall postoperative morphine requirements, and low- ered side effects both directly attributable to the narcotic (mental status, pulmonary) as well as gastrointestinal function (ileus, nau- sea, vomiting).(4) The anti-inflammatory action of these agents, especially when used on a set schedule, may...
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Viscusi ER, Goldstein S, Witkowski T et al. Bonacini M, Quiason S, Reynolds M et al. Roberts JP, Benson MJ, Rogers J et al. Tollesson PO, Cassuto J, Rimbäck G et al. Randomized clinical trial of the impact of early enteral feeding on postoperative ileus and recovery. Welsch T, Muller SA, Ulrich A et al. Care paths and optimal postop...
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One critical obser- vation of the water perfused systems is that the patient may react to the sensation of water dripping from the anus with increased tone. Simpson et al. Although written consent is not required as the patient is fully awake, at our institution we obtain full informed consent and con- firmation of patient identity, condition being evaluated, and...
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Figure 11.3 Small Bowel Obstruction. There is air in the right inguinal canal. Figure 11.4 Large Bowel Obstruction. Supine radiograph demonstrates dilated colon as well as dilated small bowel in the right lower quadrant, indicating a large bowel obstruction with incompetent ileocecal valve.. Most stran- gulating obstructions are closed-loop obstructions (blocked at both ends), and this occurs typically with incarcerated...
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CTV is performed by scanning of the pelvis from the iliac crest to the popliteal fossa approximately 120 s after completion of the CTA.. focal thickening of the base of the cecum. or obstructing calci- fied appendicolith (Figures 11.30A and 11.30B). Appendicitis may cause reactive dilatation of the small bowel and mimic a small-bowel obstruction, resulting in a missed diagnosis...
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Transabdominal US is typically limited in its evalu- ation of the gastrointestinal tract. Due to the superior sensitivity and specificity of other imaging modalities, US evaluation of the bowel is typically reserved for situations where limitation of radiation exposure is desired (i.e., pediatric and pregnant patients).. US of the liver demonstrates an isoechoic mass with a hypoechoic peripheral halo. Transrectal...
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Maglinte DD, Kelvin FM, Sandrasegaran K et al. Furukawa A, Yamasaki M, Takahashi M et al. Suri S, Gupta S, Sudhakar PJ et al. Boudiaf M, Soyer P, Terem C et al. Maglinte DD, Gage SN, Harmon BH et al. Obstruction of the small intestine: accuracy and role of CT in diagnosis.. Maglinte DD, Reyes BL, Harmon BH et al....
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Cohen SM, Wexner SD, Binder SR et al. Kolts BE, Lyles, WE, Achem SR et al. Rejchrt S, Burues J, Siroky M et al. Zwas FR, Cirillo NW et al. Sorbi D, Norton I, Conio et al. Gossum AV, Cozzsoli A, Adler M et al: Colonoscopic snare polypectomy: analysis of 1,485 resection comparing two types occurring. Gibbs DH, Opelka FG,...
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Five days after the proce- dure, she presents to the emergency room with a lower GI bleed. During this office visit, you had discussed with the patient, her risk fac- tors, indications for the procedure, details of the procedure, and potential risks. The procedure was performed in the usual fashion. This chapter will briefly review important aspects of the United...
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Ulcerative disease of the anorectum in the HIV positive patient. Emergency abdominal operations in the patient with AIDS. Surgery in the AIDS patient. Gastrointestinal surgery in the AIDS patient.. 9 (1,3-dihydroxy- 2-propoxymethyl) quanine (gancylovir) in the treatment of cytomegalovirus gastrointestinal disease in AIDS. Pneumatic compression stockings are ordered for placement in the holding area. Unfractionated heparin (5,000 units subcutaneously) is...
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Few diseases are more chronicled in human history than sympto- matic hemorrhoidal disease.(1, 2) Citations of hemorrhoidal dis- ease have been noted in historic texts dating back to Babylonian, Egyptian, Greek, and Hebrew cultures.(1, 2) A multitude of treat- ment regimens have been offered including anal dilation, vari- ous topical liniments, and the often feared red hot poker.(3, 4) Although...