Objective:To strengthen preoperative preparation management and reduce preoperative preparation defects.Methods:We set up a special medical care management team to investigate the preoperative preparation in surgical ...Objective:To strengthen preoperative preparation management and reduce preoperative preparation defects.Methods:We set up a special medical care management team to investigate the preoperative preparation in surgical departments,analyze the causes of the shortcomings in preoperative preparation,and propose countermeasures.The medical staff jointly formulated plans related to preoperative preparation management including clear outline of responsibilities,strengthening of training,integrated medical care,timely feedback,and continuous improvement.Besides,the preoperative preparation of patients before and after the improvement measures were compared using statistical analysis.Results:The rate of inadequate preoperative preparation was 11.14 per thousand before the integrated management model was implemented.After the implementation of the integrated management model,the rate of inadequate preoperative preparation decreased to 2.99 per thousand,and the difference was statistically(P<0.05).Conclusion:The integrated management of preoperative preparation can help reduce the rate of preoperative complications and ensure the safety of surgery.展开更多
[Objectives]To explore application effect of healthcare failure mode and effect analysis(HFMEA)in preoperative management of coronary intervention.[Methods]The preoperative management process of 455 patients who under...[Objectives]To explore application effect of healthcare failure mode and effect analysis(HFMEA)in preoperative management of coronary intervention.[Methods]The preoperative management process of 455 patients who underwent coronary intervention surgery from January to March in 2022 was sorted out,and the failure modes and causes in the preoperative management were analyzed.The priority risk value was calculated,and the top 6 failure modes were found out.Improvement measures were formulated according to the causes of failure modes.Two months after the implementation of the procedure,470 patients who underwent coronary intervention surgery from May to July in 2022 were selected as the intervention group,and the optimized preoperative preparation procedure by HFMEA was adopted.The decrease of risk priority number(RPN)and RPN value of two high-risk failure modes,as well as changes in the rate of the time of taking dual-antiplatelet drugs reaching the standard,the rate of passing the dress code,the rate of timely signing of informed consent,and the rate of filling in the handover form of preoperative preparation were analyzed.[Results]The rate of the time of taking dual-antiplatelet drugs reaching the standard,the rate of passing the dress code,the rate of timely signing of informed consent,and the rate of filling in the handover form of preoperative preparation in experimental groups were higher than those of the control group,and the difference was statistically significant(P<0.05).[Conclusions]Applying HFMEA to the management of preoperative preparation process for coronary intervention can effectively improve the timeliness and qualification rate of preoperative preparation for coronary intervention,and provide guarantee for the safe and smooth implementation of coronary intervention.展开更多
Surgical resection remains a mainstay in the treatment of malignant solid tumors.However,the use of neoadjuvant treatments,including chemotherapy,radiotherapy,phototherapy,and immunotherapy,either alone or in combinat...Surgical resection remains a mainstay in the treatment of malignant solid tumors.However,the use of neoadjuvant treatments,including chemotherapy,radiotherapy,phototherapy,and immunotherapy,either alone or in combination,as a preoperative intervention regimen,have attracted increasing attention in the last decade.Early randomized,controlled trials in some tumor settings have not shown a significant difference between the survival rates in long-term neoadjuvant therapy and adjuvant therapy.However,this has not hampered the increasing use of neoadjuvant treatments in clinical practice,due to its evident downstaging of primary tumors to delineate the surgical margin,tailoring systemic therapy response as a clinical tool to optimize subsequent therapeutic regimens,and decreasing the need for surgery,with its potential for increased morbidity.The recent expansion of nanotechnology-based nanomedicine and related medical technologies provides a new approach to address the current challenges of neoadjuvant therapy for preoperative therapeutics.This review not only summarizes how nanomedicine plays an important role in a range of neoadjuvant therapeutic modalities,but also highlights the potential use of nanomedicine as neoadjuvant therapy in preclinical and clinic settings for tumor management.展开更多
Obesity is the abnormal accumulation of fat or adipose tissue in the body.It has become a serious health problem in the world in the last 50 years and is considered a pandemic.Body mass index is a widely used classifi...Obesity is the abnormal accumulation of fat or adipose tissue in the body.It has become a serious health problem in the world in the last 50 years and is considered a pandemic.Body mass index is a widely used classification.Thus,obese individuals can be easily classified and standardized.Obesity is the second cause of preventable deaths after smoking.Obesity significantly increases mortality and morbidity.We thought of preparing a publication about routine procedures for the preoperative evaluation of obesity.The question that we asked as bariatric and metabolic surgeons but which was not exactly answered in the literature was“Is esophagogastroduodenoscopy(EGD)necessary before bariatric surgery?”We found different answers in our literature review.The European Association of Endoscopic Surgery guidelines recommend EGD for all bariatric procedures.They strongly recommend it for Roux-en-Y gastric bypass(RYGB).As a result of a recent study by the members of the British Obesity&Metabolic Surgery Society,preoperative EGD is routinely recommended for patients und-ergoing sleeve gastrectomy,even if they are asymptomatic,but not recommended for RYGB.It is recommended for symptomatic patients scheduled for RYGB.According to the International Sleeve Gastrectomy Expert Panel Consensus Statement,preoperative EGD is definitely recommended for patients scheduled for sleeve gastrectomy,but its routine use for RYGB is controversial.However,a different view is that the American Society for Gastrointestinal Endoscopy recom-mends endoscopy only for symptomatic patients scheduled for bariatric surgery.In the literature,the primary goal of EGD recommended for sleeve gastrectomy has been interpreted as determining esophagitis caused by gastroesophageal reflux.In the light of the literature,it is stated that this procedure is not necessary in America,while it is routinely recommended in the European continent.Considering medicolegal cases that may occur in the future,we are in favor of performing EGD before bariatric surgery.In conclusion,EGD before bariatric surgery is insurance for both patients and physicians.There is a need for larger and prospective studies to reach more precise conclusions on the subject.展开更多
文摘Objective:To strengthen preoperative preparation management and reduce preoperative preparation defects.Methods:We set up a special medical care management team to investigate the preoperative preparation in surgical departments,analyze the causes of the shortcomings in preoperative preparation,and propose countermeasures.The medical staff jointly formulated plans related to preoperative preparation management including clear outline of responsibilities,strengthening of training,integrated medical care,timely feedback,and continuous improvement.Besides,the preoperative preparation of patients before and after the improvement measures were compared using statistical analysis.Results:The rate of inadequate preoperative preparation was 11.14 per thousand before the integrated management model was implemented.After the implementation of the integrated management model,the rate of inadequate preoperative preparation decreased to 2.99 per thousand,and the difference was statistically(P<0.05).Conclusion:The integrated management of preoperative preparation can help reduce the rate of preoperative complications and ensure the safety of surgery.
文摘[Objectives]To explore application effect of healthcare failure mode and effect analysis(HFMEA)in preoperative management of coronary intervention.[Methods]The preoperative management process of 455 patients who underwent coronary intervention surgery from January to March in 2022 was sorted out,and the failure modes and causes in the preoperative management were analyzed.The priority risk value was calculated,and the top 6 failure modes were found out.Improvement measures were formulated according to the causes of failure modes.Two months after the implementation of the procedure,470 patients who underwent coronary intervention surgery from May to July in 2022 were selected as the intervention group,and the optimized preoperative preparation procedure by HFMEA was adopted.The decrease of risk priority number(RPN)and RPN value of two high-risk failure modes,as well as changes in the rate of the time of taking dual-antiplatelet drugs reaching the standard,the rate of passing the dress code,the rate of timely signing of informed consent,and the rate of filling in the handover form of preoperative preparation were analyzed.[Results]The rate of the time of taking dual-antiplatelet drugs reaching the standard,the rate of passing the dress code,the rate of timely signing of informed consent,and the rate of filling in the handover form of preoperative preparation in experimental groups were higher than those of the control group,and the difference was statistically significant(P<0.05).[Conclusions]Applying HFMEA to the management of preoperative preparation process for coronary intervention can effectively improve the timeliness and qualification rate of preoperative preparation for coronary intervention,and provide guarantee for the safe and smooth implementation of coronary intervention.
文摘Surgical resection remains a mainstay in the treatment of malignant solid tumors.However,the use of neoadjuvant treatments,including chemotherapy,radiotherapy,phototherapy,and immunotherapy,either alone or in combination,as a preoperative intervention regimen,have attracted increasing attention in the last decade.Early randomized,controlled trials in some tumor settings have not shown a significant difference between the survival rates in long-term neoadjuvant therapy and adjuvant therapy.However,this has not hampered the increasing use of neoadjuvant treatments in clinical practice,due to its evident downstaging of primary tumors to delineate the surgical margin,tailoring systemic therapy response as a clinical tool to optimize subsequent therapeutic regimens,and decreasing the need for surgery,with its potential for increased morbidity.The recent expansion of nanotechnology-based nanomedicine and related medical technologies provides a new approach to address the current challenges of neoadjuvant therapy for preoperative therapeutics.This review not only summarizes how nanomedicine plays an important role in a range of neoadjuvant therapeutic modalities,but also highlights the potential use of nanomedicine as neoadjuvant therapy in preclinical and clinic settings for tumor management.
文摘Obesity is the abnormal accumulation of fat or adipose tissue in the body.It has become a serious health problem in the world in the last 50 years and is considered a pandemic.Body mass index is a widely used classification.Thus,obese individuals can be easily classified and standardized.Obesity is the second cause of preventable deaths after smoking.Obesity significantly increases mortality and morbidity.We thought of preparing a publication about routine procedures for the preoperative evaluation of obesity.The question that we asked as bariatric and metabolic surgeons but which was not exactly answered in the literature was“Is esophagogastroduodenoscopy(EGD)necessary before bariatric surgery?”We found different answers in our literature review.The European Association of Endoscopic Surgery guidelines recommend EGD for all bariatric procedures.They strongly recommend it for Roux-en-Y gastric bypass(RYGB).As a result of a recent study by the members of the British Obesity&Metabolic Surgery Society,preoperative EGD is routinely recommended for patients und-ergoing sleeve gastrectomy,even if they are asymptomatic,but not recommended for RYGB.It is recommended for symptomatic patients scheduled for RYGB.According to the International Sleeve Gastrectomy Expert Panel Consensus Statement,preoperative EGD is definitely recommended for patients scheduled for sleeve gastrectomy,but its routine use for RYGB is controversial.However,a different view is that the American Society for Gastrointestinal Endoscopy recom-mends endoscopy only for symptomatic patients scheduled for bariatric surgery.In the literature,the primary goal of EGD recommended for sleeve gastrectomy has been interpreted as determining esophagitis caused by gastroesophageal reflux.In the light of the literature,it is stated that this procedure is not necessary in America,while it is routinely recommended in the European continent.Considering medicolegal cases that may occur in the future,we are in favor of performing EGD before bariatric surgery.In conclusion,EGD before bariatric surgery is insurance for both patients and physicians.There is a need for larger and prospective studies to reach more precise conclusions on the subject.
