Chronic intestinal failure and short bowel syndrome in Crohn’s disease

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“Chronic intestinal failure (CIF) is a rare but feared severe complication of
Crohn’s disease, with 60% of patients permanently dependent on parenteral nutrition.
This review aims to summarize the knowledge available in the current literature
describing recent advances in the management and treatment of adult patients with
CIF, with emphasis on patients with Crohn’s disease. Moreover, it aims to further
understanding of modern approaches to CIF complications such as catheter-related
bloodstream infections and intestinal failure-associated liver disease.”

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Management of antithrombotic therapy in patients undergoing invasive procedures

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“The question of whether antithrombotic therapy should be suspended in a patient who
will be undergoing an invasive procedure involves balancing the risk of postproce-
dural bleeding with continued treatment against the thrombotic risk with suspension
of treatment and use of bridging anticoagulation therapy. In general, a patient under-
going a procedure that is associated with a low risk of bleeding (low-risk procedure)
can safely continue antithrombotic therapy and should do so, particularly if the pa-
tient is at high risk for a thromboembolic event (high-risk patient). Conversely, a pa-
tient undergoing a high-risk procedure can temporarily discontinue antithrombotic
agents safely if the patient is at low risk for a thromboembolic event (low-risk patient).”

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Preoperative inspiratory muscle training for postoperative pulmonary complications in adults undergoing cardiac and major abdominal surgery

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“Despite advances in perioperative care in the last few decades, postoperative pulmonary complications (PPCs) are probably the leading cause of morbidity and mortality in adults undergoing chest and abdominal surgery. PPCs and cardiac complications are commonly regarded as the two major causes of perioperative problems in selected groups of patients undergoing these high-risk surgical procedures. However, PPCs are more common than postoperative cardiac complications and play a bigger role in mortality and healthcare costs. Despite these factors, the natural history of PPCs and the necessity of preventive strategies have not been well recognized in studies to date.”

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Evaluation of Surgical Site Infections by Wound ClassificationSystem Using the ACS-NSQIP

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“The wound classification system is an important predictor of postoperative outcomes. Recent studies have focused on elements such as preoperative risk factors and co-morbidities, operative time, prophylactic antibiotic use, and the American Society of Anesthesiology (ASA) physical status score, along with wound classification to predict postoperative surgical outcomes”

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Risk Factors for Chronic Pain after Open Ventral Hernia Repair by Underlay Mesh Placement

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“Incisional hernia is one of the most frequent long-term complications after abdominal surgery (11%–20%). After primary repair, rates of recurrence range from 24% to 54%. It has been clearly demonstrated that the use of prostheses for a tension-free repair allows for a
significant reduction in recurrence rate, and even for the treatment of small defects. However, the type and position of the mesh and the mesh fixation technique used are still a matter of debate. The underlay position of the mesh allows for easy treatment of major parietal defects with limited dissection and potentially lower rates of mesh infection, but this position exposes the patient to the risk of small bowel occlusion and enterocutaneous fistula.”

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Risk factors for postoperative cervical haematoma in patients undergoing thyroidectomy (REDHOT)

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“In endocrine surgery, thyroidectomy is the most frequently performed surgical procedure.
Morbidity related to thyroidectomy is mainly represented by hypoparathyroidism, recurrent laryngeal nerve injury, and cervical haematoma. These complications can occur at a
considerable rate even if thyroid surgery is performed by highly experienced surgeons.
Obtaining accurate haemostasis during thyroidectomy is crucial to prevent the occurrence of postoperative bleeding and, allowing adequate vision of the anatomical structures, is also important to avert the onset of the other complications.”

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