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https://www.readbyqxmd.com/read/28333309/positive-margin-re-excision-following-immediate-autologous-breast-reconstruction-morbidity-cosmetic-outcome-and-oncologic-significance
#1
Oscar Ochoa, Constantine Theoharis, Steven Pisano, Minas Chrysopoulo, Peter Ledoux, Gary Arishita, Chet Nastala
Background: Acquisition of negative resection margins is paramount in the surgical management of operable breast cancer. Management of positive margins following mastectomy and immediate breast reconstruction is presently poorly defined. Objectives: The present study aims at defining morbidity and cosmetic sequela of re-excision procedures aimed at clearing involved mastectomy margins in the setting of immediate autologous breast reconstruction. Oncologic outcomes are recorded...
March 17, 2017: Aesthetic Surgery Journal
https://www.readbyqxmd.com/read/28331744/factors-that-affect-drain-indwelling-time-after-breast-cancer-surgery
#2
Ömer Uslukaya, Ahmet Türkoğlu, Metehan Gümüş, Zübeyir Bozdağ, Ahmet Yılmaz, Hatice Gümüş, Şeyhmus Kaya, Mesut Gül
OBJECTIVE: The most common procedure to prevent seroma formation, a common complication after breast and axillary surgery, is to use prophylactic surgical drains. Ongoing discussions continue regarding the ideal time for removing drains after surgical procedures. In this study, we aimed to investigate factors that affect drain indwelling time (DIT). MATERIALS AND METHODS: From 2014 to 2015, a total of 91 consecutive patients with breast cancer were included in the study...
July 2016: J Breast Health (2013)
https://www.readbyqxmd.com/read/28327108/impact-of-the-ultrasonic-scalpel-on-the-amount-of-drained-lymph-after-axillary-or-inguinal-lymphadenectomy
#3
Olivier Gié, Marie-Laure Matthey-Gié, Pedro-Manuel Marques-Vidal, Nicolas Demartines, Maurice Matter
BACKGROUND: Seroma formation and lymphoedema are frequently encountered complications after radical lymph node dissection (RLND). Attempts to reduce the lymphatic morbidity include the use of Ultrasonic Scalpel. The aim of the present analysis was to assess the impact of the ultrasonic scalpel on the amount of drained lymph after lymph node dissection. METHODS: Patients listed for a RLND or completion lymph node dissection (CLND) were enrolled in a prospective randomized trial to compare the impact of two surgical dissection techniques (USS versus control) on the amount of drained lymph...
March 21, 2017: BMC Surgery
https://www.readbyqxmd.com/read/28322104/feasibility-of-laparoscopic-abdominal-wall-reconstruction-in-an-outpatient-community-hospital-setting-using-cptfe-prosthetic-mesh-a-prospective-multicenter-case-series
#4
Terry Unruh, Joseph Adjei Boachie, Eduardo Smith-Singares
Objective This study investigated the use of prosthetic condensed polytetrafluoroethylene (cPTFE) for laparoscopic ventral hernia repair (LVHR) in an outpatient community-hospital setting. Methods Patients underwent LVHR with cPTFE at one of three community hospitals. Primary endpoint was hernia recurrence at 1-year postoperatively. Secondary endpoints included pain, surgical site infection, medical/surgical complications, and patient-reported outcomes. Results This study included 65 females and 52 males, aged 46...
December 2016: Journal of International Medical Research
https://www.readbyqxmd.com/read/28320428/a-topology-based-method-to-mitigate-the-dosimetric-uncertainty-caused-by-the-positional-variation-of-the-boost-volume-in-breast-conservative-radiotherapy
#5
Peng-Yi Lee, Chih-Yuan Lin, Shang-Wen Chen, Chun-Ru Chien, Chun-Nan Chu, Hsiu-Ting Hsu, Ji-An Liang, Ying-Jun Lin, An-Cheng Shiau
BACKGROUND: To improve local control rate in patients with breast cancer receiving adjuvant radiotherapy after breast conservative surgery, additional boost dose to the tumor bed could be delivered simultaneously via the simultaneous integrated boost (SIB) modulated technique. However, the position of tumor bed kept changing during the treatment course as the treatment position was aligned to bony anatomy. This study aimed to analyze the positional uncertainties between bony anatomy and tumor bed, and a topology-based approach was derived to stratify patients with high variation in tumor bed localization...
March 20, 2017: Radiation Oncology
https://www.readbyqxmd.com/read/28318112/diagnostic-dilemmas-and-pitfalls-in-thinprep-%C3%A2-cytology-of-breast-fine-needle-aspiration-biopsy-report-of-six-cases-with-histological-correlates
#6
Jose Victor Scarpa Carniello, Fresia Pareja, Maria Laureana Santos-Zabala, Marcia Edelweiss
Fine needle aspirations (FNA) of the breast for primary diagnoses have become less popular in the USA and are usually performed for lesions with low or extremely high clinical suspicion. They are also performed for lesions in close proximity to a breast implant. Liquid-based cytological preparations, such as ThinPrep(®) (TP), provide a practical alternative to clinicians who are performing FNA. Using a selection of cases that represent challenging diagnoses, we describe common diagnostic pitfalls of breast FNA that are specifically associated with this preparation...
March 20, 2017: Diagnostic Cytopathology
https://www.readbyqxmd.com/read/28315496/remeex-device-external-mechanical-regulator-for-female-stress-urinary-incontinence-a-critical-review-of-a-single-operator-long-term-experience-on-implants-and-readjustments
#7
Franco Mantovani
OBJECTIVE: A single-operator, long-term (15 years) experience on a sling technique that allows a postoperative adjustment of its tension is presented to retrospectively report the objective and subjective outcomes in the treatment of female stress urinary incontinence (SUI). The readjustment option prevents the need of a reoperation in case of relapse with great compliance of the patients. MATERIALS AND METHODS: Indications for surgical tratment of SUI by ReMeEx included patients affected with not only true intrinsic sphyncteric deficency (ISD) and fixed urethra but also mild urethral hypermobility, previous incontinence surgery and relapsing conditions such as diabetes and obesity...
March 18, 2017: Urologia
https://www.readbyqxmd.com/read/28302520/complex-hernias-with-loss-of-domain-in-morbidly-obese-patients-role-of-laparoscopic-sleeve-gastrectomy-in-a-multi-step-approach
#8
Yves Borbély, Jens Zerkowski, Julia Altmeier, Anna Eschenburg, Dino Kröll, Philipp Nett
BACKGROUND: Morbid obesity and its associated co-morbidities are risk factors for the development of abdominal hernias, add complexity to their repair, and increase perioperative risk. Repair of hernias with loss of domain (LoD) is further complicated by risk of abdominal compartment syndrome. A staged concept with an initial weight loss procedure might enable a reposition of the herniated viscera, improve co-morbidities for, and prohibit abdominal compartment syndrome in the subsequent repair...
January 27, 2017: Surgery for Obesity and related Diseases: Official Journal of the American Society for Bariatric Surgery
https://www.readbyqxmd.com/read/28301361/modified-fleur-de-lis-abdominoplasty-for-massive-weight-loss-patients
#9
Ulrich Eugen Ziegler, Selina Nora Ziegler, Philip Helge Zeplin
INTRODUCTION: Fleur-de-lis abdominoplasty is an effective procedure for correcting abdominal contour abnormalities in both the vertical and horizontal orientation. Tension on the approximated tissue edges and reduced microvascular perfusion is mainly responsible for wound dehiscence and delayed wound healing in the T-point area and seroma formation. To reduce these complications, we developed a modification of the fleur-de-lis abdominoplasty technique forming upper abdominal skin flaps with deepithelialized mediocaudal edges...
March 16, 2017: Annals of Plastic Surgery
https://www.readbyqxmd.com/read/28295813/organized-breast-seroma-mimicking-local-tumor-recurrence
#10
Natalia Rotaru, Janna Punga, Maxim Crivceanschii, Ion Codreanu
No abstract text is available yet for this article.
March 13, 2017: Breast Journal
https://www.readbyqxmd.com/read/28291215/-complications-of-intrathecal-baclofen-therapy
#11
D L Paskhin, A V Dekopov, A A Tomsky, E D Isagulyan, E M Salova
AIM: To analyze complications of intrathecal baclofen therapy and identify high-risk groups. MATERIAL AND METHODS: We implanted 52 pumps to spastic patients for chronic intrathecal baclofen infusion. Two groups of patients were distinguished: 23 patients with spinal spasticity (group 1) and 29 patients with cerebral spasticity (group 2). The mean patient age was 37.2±14.6 years in group 1 and 17.3±10.3 years in group 2. Surgery was performed according to a standard procedure...
2017: Zhurnal Voprosy Neĭrokhirurgii Imeni N. N. Burdenko
https://www.readbyqxmd.com/read/28290970/severe-systemic-lead-toxicity-resulting-from-extra-articular-retained-shrapnel-presenting-as-jaundice-and-hepatitis-a-case-report-and-review-of-the-literature
#12
Ian A Grasso, Matthew R Blattner, Tyler Short, John W Downs
INTRODUCTION: Despite greater than 60,000 nonfatal firearm injuries per year in the United States, retained shrapnel is a relatively rare cause of systemic lead toxicity with less than 100 cases reported in the medical literature since 1867. While intra-articular retained shrapnel as a cause of lead toxicity is well-described, extra-articular fragments are less well known to cause symptomatic disease. CASE REPORT: A 31-year-old man initially presented with abdominal pain, constipation, jaundice, and elevated liver transaminases approximately 3 weeks after suffering a left lower extremity injury during athletic activity...
March 2017: Military Medicine
https://www.readbyqxmd.com/read/28284510/breast-implant-texturing-associated-with-delamination-of-capsular-layers-a-histological-analysis-of-the-double-capsule-phenomenon
#13
J I Efanov, J P Giot, J Fernandez, M A Danino
BACKGROUND: Macro-texturing of breast implants was developed with the double goal of improving implant stabilization within the breast cavity and decreasing the rate of capsular contractures. However, recent evidence suggests that double capsular formation, a potentially worrisome phenomenon associated with late seromas and biofilms, occurs with preponderance in macro-textured implants. Our objective was to analyze histologically different regions of double capsules to determine if they are more prone to mechanical movements...
March 8, 2017: Annales de Chirurgie Plastique et Esthétique
https://www.readbyqxmd.com/read/28281003/bone-morphogenetic-protein-in-adult-spinal-deformity-surgery-a-meta-analysis
#14
Gregory W Poorman, Cyrus M Jalai, Anthony Boniello, Nancy Worley, Shearwood McClelland, Peter G Passias
INTRODUCTION: Since its introduction BMP has been utilized in populations with higher rates of malunion, such as adult spinal deformity (ASD) patients. Contradictory conclusions exist in spinal literature regarding the safety and efficacy of the use of BMP in this setting. Previous studies, however, did not distinguish deformity cases from spondylolisthesis or stenosis. The purpose of this study is to evaluate the safety and efficacy of BMP use in spinal fusion surgery for ASD. METHODS: 166 papers were screened after database search...
March 9, 2017: European Spine Journal
https://www.readbyqxmd.com/read/28280672/obesity-related-risk-factors-in-implant-based-breast-reconstruction-using-alloderm
#15
James C Yuen, Cathryn A Coleman, Stephen W Erickson
With a population in which 70% of the patients were overweight or obese, we reviewed retrospectively 135 breasts of 70 consecutive patients who underwent implant-based immediate breast reconstruction using freeze-dried AlloDerm as the acellular dermal matrix. Several obesity-related parameters were evaluated to determine their possible correlation to early postoperative complications. We found that breast width and surface area of AlloDerm usage correlated with the development of infection and mastectomy skin flap necrosis...
February 2017: Plastic and Reconstructive Surgery. Global Open
https://www.readbyqxmd.com/read/28274179/quantity-guided-drain-management-reduces-seroma-formation-and-wound-infections-after-radical-lymph-node-dissection-results-of-a-comparative-observational-study-of-374-melanoma-patients
#16
Gerold Koplin, Julian W Mall, Wieland Raue, Stefanie Böhm, Ulrike Hoeller, Oliver Haase
BACKGROUND: Lymphatic fistulas are common complications after lymph node dissections in melanoma patients. We investigated whether drain management could improve the patient's outcome. METHODS: Patients who underwent axillary or inguinal lymph node dissection (RALND or RILND) for malignant melanoma were recorded in a prospective database. Two different methods of drain management were compared. Either the drain was removed no later than the eighth postoperative day (period I, 2003-2007) or it was left in place until fluid flow was below 50 ml in 24 h for two consecutive days (period II, 2008-2011)...
March 8, 2017: Acta Chirurgica Belgica
https://www.readbyqxmd.com/read/28272855/a-fifteen-year-experience-of-total-thyroidectomy-for-the-management-of-simple-multinodular-goitres-in-a-low-medium-income-country
#17
A O Afolabi, O O Ayandipo, O O Afuwape, O A Ogundoyin
INTRODUCTION: Total thyroidectomy as a treatment for simple multinodular goitre is not well recognised in most centres in low middle income countries. METHOD: This paper is a retrospective review of outcomes of total thyroidectomy for simple multinodular goitres in the last fifteen years in a tertiary hospital in Nigeria. RESULTS: A total of 652 thyroidectomies were done from January 2001 to December 2015. Simple multinodular goitres were indication for a total thyroidectomy in 447 patients (68...
November 2016: South African Journal of Surgery. Suid-Afrikaanse Tydskrif Vir Chirurgie
https://www.readbyqxmd.com/read/28266958/vancomycin-powder-regimen-for-prevention-of-surgical-site-infection-in-complex-spine-surgeries
#18
Michael Van Hal, Joon Lee, Dann Laudermilch, Chinedu Nwasike, James Kang
STUDY DESIGN: In total, 496 patients of a single surgeon cohort examining the surgical-site infection (SSI) rates with the addition of vancomycin powder in both diabetic and revision spine surgery cases. A historical control group of 652 patients were compared from the same surgeon over an earlier time period before the inception of using vancomycin powder prophylaxis. OBJECTIVE: The objective of this study was to describe and compare the rates of infection in high-risk patient populations while using vancomycin powder...
March 6, 2017: Clinical Spine Surgery
https://www.readbyqxmd.com/read/28263432/the-effect-of-cell-debris-within-biologic-scaffolds-upon-the-macrophage-response
#19
Ricardo Londono, Jenna L Dziki, Eric Haljasmaa, Neill Turner, Cynthia Leifer, Stephen F Badylak
All biomaterials, including biologic scaffolds composed of extracellular matrix (ECM), elicit a host immune response when implanted. The type and intensity of this response depends in part upon the thoroughness of decellularization and removal of cell debris from the source tissue. Pro-inflammatory responses have been associated with negative downstream remodeling events including scar tissue formation, encapsulation, and seroma formation. The relative effects of specific cellular components upon the inflammatory response are not known...
March 6, 2017: Journal of Biomedical Materials Research. Part A
https://www.readbyqxmd.com/read/28261372/alternatives-to-acellular-dermal-matrix-utilization-of-a-gore-dualmesh-sling-as-a-cost-conscious-adjunct-for-breast-reconstruction
#20
Jacob N Grow, James Butterworth, Paul Petty
Objective: This study seeks an alternative to acellular dermal matrix in 2-staged breast reconstruction while minimizing cost. It was hypothesized that use of a Gore DualMesh would allow for similar intraoperative tissue expander fill volumes, time to second-stage reconstruction, and number of postoperative fills compared with acellular dermal matrix at only a fraction of the expense. Methods: Retrospective analysis comparing Gore DualMesh (59 breasts, 34 patients), acellular dermal matrix (13 breasts, 8 patients), and total muscle coverage (25 breasts, 14 patients) for postmastectomy breast reconstruction was performed...
2017: Eplasty
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