Abstract:
BACKGROUND:The aim of this study was to compare the influence of either general (GA) or local (LA) anesthesia on the postoperative neurocognitive outcome in patients undergoing carotid endarterectomy (CEA) in a randomized study. Therefore, we performed a subgroup analysis of the multicenter GALA study. METHODS:A total of 40 patients were enrolled and randomized to receive either LA (n = 17) or GA (n = 23) anesthesia. The indication for intraoperative shunting was based on the intraoperative cognitive performance in the LA group and on the clinical experience of the surgeon in the GA group. Outcome measurements included patient performance on a neuropsychological Trail Making Test, evaluation of patients mood using the self-report inventory BSKE, and serum levels of the neurobiochemical marker S100beta. The data were analyzed for each variable using a t-test and were presented as the mean (SD). Differences in shunt frequency were analyzed performing a chi-squared test. Group differences in the Trail Making Test, BSKE evaluation, and S100beta concentrations were derived from the analyses of covariances with repeated measurements using preoperative values as covariates. RESULTS:Compared to baseline, the S100beta concentrations increased significantly in the GA group [0.086 (0.038) vs. 0.061 (0.024) microg/l; p < 0.001] before unclamping of the carotid artery, whereas there were no changes in the LA group [0.068 (0.024) microg/l, p = 0.09 vs. 0.061 (0.021) microg/l, p = 0.09). Furthermore, we detected significant group differences after surgical intervention (GA 0.087 (0.031) microg/l; LA 0.06 (0.021) microg/l; p = 0.006). The postoperative neurocognitive performance in the Trail Making Test decreased significantly in the GA group, whereas there were no significant changes in the LA group. The self-report inventory BSKE evaluation revealed no significant group differences. CONCLUSIONS:We concluded that performing local anesthesia in patients undergoing CEA positively influenced early postoperative neurocognitive outcomes. Significant group differences in postoperative S100beta concentrations confirmed the beneficial effect of local anesthesia.
journal_name
World J Surgjournal_title
World journal of surgeryauthors
Weber CF,Friedl H,Hueppe M,Hintereder G,Schmitz-Rixen T,Zwissler B,Meininger Ddoi
10.1007/s00268-009-0047-xsubject
Has Abstractpub_date
2009-07-01 00:00:00pages
1526-32issue
7eissn
0364-2313issn
1432-2323journal_volume
33pub_type
杂志文章,多中心研究,随机对照试验abstract:BACKGROUND:The importance of safe anesthesia for the best possible surgical outcomes in every patient is not disputed in high resource settings. Low-income countries lag far behind in the provision of, and training for, safe anesthesia practice. Too little is known about numbers and types of providers in a majority of ...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/s00268-014-2775-9
更新日期:2015-04-01 00:00:00
abstract::The limited number of publications on repair of the foramen of Morgagni hernia concentrates mainly on the laparotomy approach. We present our experience with the transthoracic approach. Patients who were diagnosed as having a foramen of Morgagni hernia and were operated on via the transthoracic approach between Decemb...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/s00268-005-0055-4
更新日期:2005-11-01 00:00:00
abstract:BACKGROUND:The goal of the present study was to evaluate the effects of preoperative oral carbohydrate supplementation (OCH) on the postoperative metabolic stress response of patients undergoing elective abdominal surgery. METHODS:The study was designed as a controlled, prospective, cohort study including 38 patients ...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/s00268-012-1590-4
更新日期:2012-08-01 00:00:00
abstract:BACKGROUND:We sought to identify affordable and sustainable methods to strengthen trauma care capabilities globally, especially in developing countries, using the Guidelines for Essential Trauma Care. These guidelines were created by the World Health Organization (WHO) and the International Society of Surgery and provi...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/s00268-005-0768-4
更新日期:2006-06-01 00:00:00
abstract::The pathogenesis of pain in chronic pancreatitis remains an enigma. The cause of pain is almost certainly multifactorial and may vary at different stages of the disease process. These factors may include the release of excessive oxygen-derived free radicals, tissue hypoxia and acidosis, inflammatory infiltration with ...
journal_title:World journal of surgery
pub_type: 杂志文章,评审
doi:10.1007/s00268-003-7235-x
更新日期:2003-11-01 00:00:00
abstract:BACKGROUND:The goal of the present study was to critically review and identify the strength of available evidence in the literature on the use of laparoscopic appendectomy (LA) in complicated appendicitis (CA). METHODS:The Cochrane Library and Controlled Trials Registry, MEDLINE (Ovid), PubMed, Web of knowledge, and S...
journal_title:World journal of surgery
pub_type: 杂志文章,meta分析,评审
doi:10.1007/s00268-010-0669-z
更新日期:2010-09-01 00:00:00
abstract:BACKGROUND:Primary hyperparathyroidism (PHPT) is a common endocrine disorder that predominantly affects patients >60 and is increasing in prevalence. Identifying risk factors for poor outcomes after parathyroidectomy in older adults will help tailor operative decision making. The impact of frailty on surgical outcomes ...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/s00268-018-4629-3
更新日期:2018-10-01 00:00:00
abstract:OBJECTIVE:To evaluate comparative outcomes of laparoscopic transcystic (TC) and transductal (TD) common bile duct (CBD) exploration. METHODS:We systematically searched MEDLINE, EMBASE, CINAHL, CENTRAL, the World Health Organization International Clinical Trials Registry, ClinicalTrials.gov, ISRCTN Register, and biblio...
journal_title:World journal of surgery
pub_type: 杂志文章,meta分析
doi:10.1007/s00268-019-05005-y
更新日期:2019-08-01 00:00:00
abstract:BACKGROUND:Patients with renal hyperparathyroidism (RHPT) are susceptible to major electrolyte fluctuations following parathyroidectomy, which may predispose them to early readmission. The purpose of this study is to evaluate risk factors for readmission in patients undergoing parathyroidectomy for RHPT. METHODS:Patie...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/s00268-018-4823-3
更新日期:2019-02-01 00:00:00
abstract:BACKGROUND:It has been suggested that gender and age could be factors that influence the likelihood of success following antireflux surgery, and our anecdotal impression has been that the outcome following Nissen fundoplication in older women is often disappointing. If correct, characterization of the extent of any dif...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/s00268-009-0216-y
更新日期:2009-12-01 00:00:00
abstract:BACKGROUND:When needle core biopsies (NCBs) of the breast reveal fibroepithelial lesions (FELs), excision is often performed to rule out a phyllodes tumor (PT), despite low malignancy rates. Consequently, the natural history of observed FELs is not well described. We analyzed the malignancy risk in excised FELs and the...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/s00268-020-05385-6
更新日期:2020-05-01 00:00:00
abstract:BACKGROUND:The albumin-bilirubin (ALBI) score was initially developed for assessing liver dysfunction severity and was suggested to have prognostic value in patients with hepatocellular carcinoma. We aimed to evaluate the prognostic impact of ALBI grade in patients with advanced gastric cancer (GC) after radical gastre...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/s00268-017-4234-x
更新日期:2018-03-01 00:00:00
abstract:BACKGROUND:The management of positive ductal margins with carcinoma in situ (R1-CIS) after resection is controversial. The aim of this study was to evaluate the impact of R1-CIS on survival in patients who underwent resection for distal cholangiocarcinoma. METHODS:We enrolled 121 consecutive patients with distal chola...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/s00268-020-05799-2
更新日期:2021-01-01 00:00:00
abstract:BACKGROUND:Resection of hepatocellular carcinoma (HCC) located in the right liver often requires hepatic mobilization. However, exposure of the HCC may be restricted when using the conventional abdominal approach (AA). In such cases, a thoracoabdominal approach (TA) can provide a good operating field. Although several ...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/s00268-011-1023-9
更新日期:2011-05-01 00:00:00
abstract:BACKGROUND:In primary hyperparathyroidism (PHPT) the predictive value of technetium 99m sestamibi single emission computed tomography (Tc99m-MIBI-SPECT) for localizing pathological parathyroid glands before a first parathyroidectomy (PTx) is 83-100%. Data are scarce in patients undergoing reoperative parathyroidectomy ...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/s00268-010-0818-4
更新日期:2011-01-01 00:00:00
abstract:BACKGROUND:Enhanced recovery (ERAS) guidelines do not differentiate between left- and right-sided colectomies, but differences in recovery have been reported for the two procedure types. We aimed to compare compliance with the ERAS protocol and outcomes after right versus left colectomy. METHODS:Between June 2011 and ...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/s00268-016-3563-5
更新日期:2016-10-01 00:00:00
abstract::The primal need for nutrients is satisfied by mechanisms for sensing internal stores and detecting food; ATP is the most primitive signal. With increasing density of sensory neurons and glia (the primordial brain) and the emergence of autonomic neural activity throughout the endoderm, transmitters and other signaling ...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/s00268-009-0138-8
更新日期:2009-10-01 00:00:00
abstract:BACKGROUND:Although ultrasonographic (US) evaluation is currently recommended for the workup of all palpable thyroid nodules, little guidance exists regarding the manner in which US data are to be used. Herein, we examine the available evidence and recommend how US can be used most effectively to predict malignancy. We...
journal_title:World journal of surgery
pub_type: 杂志文章,评审
doi:10.1007/s00268-008-9494-z
更新日期:2008-07-01 00:00:00
abstract:INTRODUCTION:The decision to perform a relaparotomy in patients with secondary peritonitis is based on "clinical judgment" with inherent variability among surgeons. Our objective was to review the literature on prognostic variables for ongoing abdominal infection. Predictive variables for positive findings at relaparot...
journal_title:World journal of surgery
pub_type: 杂志文章,评审
doi:10.1007/s00268-005-0333-1
更新日期:2006-12-01 00:00:00
abstract:BACKGROUND:Chronic pilonidal disease is a debilitating condition that typically affects young adults. There is a wide variety of available therapeutic strategies reflecting the inconsistent outcomes attributed to the various operative approaches. The majority involve excision of the sinus tract followed by either prima...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/s00268-011-1138-z
更新日期:2011-08-01 00:00:00
abstract::From January, 1972 to June, 1989, 51 patients with liver hemangiomas (32 females and 19 males, mean age 35 years) were evaluated for surgical treatment. Diameters of the masses were 5 cm to 20 cm (median 8.5 cm). Nine of the patients had already been treated for cancer. Twenty-two (43.1%) of the 51 patients were sympt...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/BF02104457
更新日期:1992-05-01 00:00:00
abstract::Precise localization of cervical node metastasis of papillary thyroid carcinoma is rarely described. The aim of this retrospective study was to map their cervical involvement. Between 1974 and 1996 a series of 119 patients had total thyroidectomy with bilateral cervical lymph node dissection. Patients who had secondar...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/s002689900609
更新日期:1999-09-01 00:00:00
abstract:BACKGROUND:Surgical 'never events' have serious adverse outcomes for patients. A never event can be defined as a serious, avoidable patient safety incident that would not occur if necessary preventative measures are implemented. The literature from South Africa on this topic is limited. This study aims to understand th...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/s00268-019-05008-9
更新日期:2019-09-01 00:00:00
abstract:BACKGROUND:We have developed a new technique for treatment of intramucosal carcinoma which exceeds the standard indication for endoscopic mucosal resection and carcinoma invading the submucosa without lymph node metastasis that are located in the posterior wall of the stomach, which we refer to as laparoscopic intragas...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/s00268-007-9115-2
更新日期:2007-08-01 00:00:00
abstract::Cyclophilins are originally identified as cellular binding proteins for the immunosuppressive drug cyclosporin A. Many cyclophilins, including CypA, CypB, CypC, CypD, and Cyp40, have been discovered and shown to be ubiquitously distributed in many types of cells and organ systems. Recent investigations have uncovered ...
journal_title:World journal of surgery
pub_type: 杂志文章,评审
doi:10.1007/s00268-004-7812-7
更新日期:2005-03-01 00:00:00
abstract::The success of parathyroid surgery is determined by the identification and removal of all parathyroid tumors. Parathyroid tumors accumulate and retain 2-methoxyisobutylisonitrile (MIBI) labeled with technetium-99m. Intravenous injection of this radiopharmacon prior to parathyroid surgery allows identification of parat...
journal_title:World journal of surgery
pub_type: 临床试验,杂志文章
doi:10.1007/s002689900427
更新日期:1998-06-01 00:00:00
abstract::We sought to determine whether early eschar excision en masse (EEE) at one operation would be effective in the prevention and treatment of postburn organ dysfunction (OD) and multiple organ dysfunction syndrome (MODS). A total of 60 patients, with total body surface burned area over 35% and a third degree burn area ov...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/s002689900661
更新日期:1999-12-01 00:00:00
abstract::In the original article, Mehreen K. Bhettani's last name and Mubarik Rehman's first name are misspelled. ...
journal_title:World journal of surgery
pub_type: 杂志文章,已发布勘误
doi:10.1007/s00268-019-05334-y
更新日期:2020-06-01 00:00:00
abstract:BACKGROUND:The aim of this study was to assess the efficacy of the Nd:YAG laser for treating stage I squamous cell carcinoma (SCC) of the lip. The retrospective study was performed in a tertiary care referral hospital in northern India. METHODS:In January 2007 the records of patients treated by Nd:YAG laser ablation o...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/s00268-007-9363-1
更新日期:2008-04-01 00:00:00
abstract:BACKGROUND:There are few established metrics to define surgical capacity in resource-limited settings. Previous work hypothesizes that the relative frequency of cesarean sections (CS) at a hospital, expressed as a proportion of total operative procedures (%CS), may serve as a proxy measure of surgical capacity. We atte...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/s00268-012-1629-6
更新日期:2012-09-01 00:00:00