Page 426 – Renal and Urology News

Splenectomy – procedures

What the Anesthesiologist Should Know before the Operative Procedure There are several indications for splenectomy – traumatic injury, idiopathic thrombocytopenia purpura (ITP), hereditary spherocytosis, staging surgery, splenic infarction, and splenomegaly. Each has different associated comorbidities and risks involved. Depending on the indication, splenectomies can be performed either laparoscopically or in open fashion. Traumatic injury was…

Parathyroidectomy

What the Anesthesiologist Should Know before the Operative Procedure Parathyroidectomy is the definitive surgical treatment for elevated levels of parathyroid hormone (PTH). PTH is the principal hormone regulating calcium hemostasis. PTH maintains serum calcium by stimulating bone resorption, thus releasing calcium, and by enhancing gastrointestinal absorption and inhibiting renal excretion of calcium. In primary hyperparathyroidism…

Cystectomy and Urinary Division – Procedures

What the Anesthesiologist Should Know before the Operative Procedure Many patients with bladder tumor choose radical cystectomy (RCX) as the treatment. RCX remains the most effective treatment for muscle invasive bladder cancer and for recurrent high-grade nonmuscle invasive bladder cancer (NMIBC) tumors. Different organs are moved for males and females. Because cystectomy interrupts the normal…

Myelodysplasia

What the Anesthesiologist Should Know before the Operative Procedure Myelodysplasia includes all the following conditions with varying degrees of spinal dysraphism (i.e., abnormal fusion of the posterior neuropore or failure of the neural tube to fuse): Encephalocoele – a relatively rare defect involving the cranium Meningocoele – contains CSF and no neural tissueContinue Reading Myelomeningocoele…

Excision of the radial head

What the Anesthesiologist Should Know before the Operative Procedure Radial head excision is performed only in stable elbow with laterally based elbow pain as a result of forearm rotation and/or axial loading. Radial head excision is not performed in elbows with pre-existing instability, especially in fracture dislocation, because of poor outcome result. The anesthesiologist should…

Lysis of Adhesions

What the Anesthesiologist Should Know before the Operative Procedure Intra-abdominal adhesions develop as a result of abdominal surgery (laparotomy or laparoscopic) or less commonly from inflammatory conditions. In fact, adhesions are the most common etiology for small bowel obstruction. While many patients who develop adhesions can be managed conservatively, some will require surgery for lysis…

HIV patients

What should the Anesthesiologist Should Know Prior to the Operative Procedure Background Human immunodeficiency virus (HIV), the causative viral organism of acquired immunodeficiency syndrome (AIDS), was first recognized over 20 years ago, and has since infected approximately 50 million people worldwide. In the United States, there are between 850,000 to 1 million cases of HIV/AIDS,…

Surgical treatment of pericardial disease

What the Anesthesiologist Should Know before the Operative Procedure The pericardium has two layers, the visceral layer, which covers the heart and the origin of the great vessels. The parietal layer is reflected off the visceral layer and is a thin layer of fibro-elastic tissue that forms a sac around the heart and separates the…

The Thrombophilic Parturient (e.g., LMWH)

What the Anesthesiologist Should Know before the Operative Procedure Pregnancy induces a hypercoagulable state. While the incidence of thromboembolic complications in the peripartum period is low, they remain a major cause of maternal morbidity and mortality. In most cases, the risks associated with administering anticoagulation therapy are greater than those of the hypercoagulable state associated…

Pelvic laparoscopy

What the Anesthesiologist Should Know before the Operative Procedure Pelvic laparoscopy may be done by gynecologists, obstetricians, urologists or colon and rectal surgeons. Sometimes it may also be performed by transplant surgeons working on the urinary bladder after kidney or pancreas transplants draining into the bladder. It will be important to know if the patient…

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