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https://www.readbyqxmd.com/read/29793212/should-we-excise-are-there-any-clinical-or-histologic-features-that-predict-upgrade-in-papillomas-incidental-or-non-incidental
#1
Michael Zaleski, Yun An Chen, Alison L Chetlen, Julie Mack, Liyan Xu, Daleela G Dodge, Dipti M Karamchandani
The clinical decision to excise intraductal papilloma (IDP) without atypia diagnosed on biopsy remains controversial. We sought to establish clinical and histologic predictors (if any) which may predict upgrade in IDP. 296 biopsies (in 278 women) with histologic diagnosis of IDP without atypia were retrospectively identified and placed into Incidental (no corresponding imaging correlate), or Non-incidental (positive imaging correlate) groups. 253/296 (85.5%) cases were non-incidental, and 43/296 (14.5%) were incidental...
May 11, 2018: Annals of Diagnostic Pathology
https://www.readbyqxmd.com/read/29793113/assessment-of-the-risk-of-antiangiogenic-agents-before-and-after-surgery
#2
REVIEW
Christina E Bailey, Alexander A Parikh
Angiogenesis plays a critical role in the growth, progression, and metastasis of numerous solid tumor types, and thus, antiangiogenic agents have been studied for many years as potential therapeutic agents. Many different antiangiogenic agents, including monoclonal antibodies and multi-targeted tyrosine kinase inhibitors (TKIs), have been approved for various oncology indications, and promising clinical activity has been demonstrated. However, some of these agents have also been associated with serious safety concerns...
May 8, 2018: Cancer Treatment Reviews
https://www.readbyqxmd.com/read/29792999/does-solid-fusion-eliminate-rod-fracture-after-pedicle-subtraction-osteotomy-in-ankylosing-spondylitis-related-thoracolumbar-kyphosis
#3
Shi-Zhou Zhao, Bang-Ping Qian, Mu Qiao, Jun Jiang, Yong Qiu
BACKGROUND CONTEXT: Rod fracture (RF) has a negative impact on the surgical outcome of ankylosing spondylitis (AS) patients following lumbar pedicle subtraction osteotomy (PSO). However, there is a paucity of published studies analyzing the risk factors for RF in PSO-treated AS patients with thoracolumbar kyphosis. PURPOSE: To investigate the risk factors for RF after PSO for thoracolumbar kyphosis secondary to AS. STUDY DESIGN/SETTING: Retrospective single-center study...
May 21, 2018: Spine Journal: Official Journal of the North American Spine Society
https://www.readbyqxmd.com/read/29792995/lumbar-discectomy-is-associated-with-higher-rates-of-lumbar-fusion
#4
Hector Castillo, Ravi Chintapalli, Harout Boyajian, Sebastian A Cruz, Vince K Morgan, Lewis L Shi, Michael J Lee
BACKGROUND CONTEXT: Lumbar disc herniation affects over three million people in the United States every year, and the rate of operation continually increases, particularly in patients 60 years or older.1,2 Surgical discectomy is a common treatment for lumbar disc herniation.1,3 One concern for this method is the risk of undergoing additional surgeries. 2,5,7 There are very limited population-level studies that examine the rate of lumbar fusion following lumbar discectomy. Additionally, there is no study that examines the risk of undergoing lumbar fusion in patients who have undergone lumbar discectomies compared to the risk of lumbar fusion in the general population with no previous lumbar discectomy...
May 21, 2018: Spine Journal: Official Journal of the North American Spine Society
https://www.readbyqxmd.com/read/29792881/the-temporal-association-of-robotic-surgical-diffusion-with-overtreatment-of-the-small-renal-mass
#5
Paras H Shah, Manaf A Alom, Bradley C Leibovich, R Houston Thompson, Robert G Uzzo, Louis R Kavoussi, Lee Richstone, Bimal Bhindi, Elizabeth B Habermann, Vidhu Joshi, Stephen A Boorjian
PURPOSE: To evaluate contemporary practice patterns in the management of small renal masses. METHODS: We identified 52,804 patients within the National Cancer Database diagnosed with a small renal mass (≤4cm) between 2010-2014. Utilization trends for active surveillance, ablation, and robotic, laparoscopic, and open surgical techniques were compared among all-comers, elderly patients (≥75 years) and individuals with competing health risks (Charlson index ≥2)...
May 21, 2018: Journal of Urology
https://www.readbyqxmd.com/read/29792853/preoperative-obstructive-sleep-apnea-screening-in-gynecologic-oncology-patients
#6
Ross F Harrison, Erin E Medlin, Chase B Petersen, Stephen L Rose, Ellen M Hartenbach, David M Kushner, Ryan J Spencer, Laurel W Rice, Ahmed N Al-Niaimi
BACKGROUND: Women with a gynecologic cancer tend to be older, obese, and postmenopausal, characteristics that are associated with an increased risk for obstructive sleep apnea. However, there is limited investigation regarding the condition's prevalence in this population or its impact on postoperative outcomes. In other surgical populations, patients with obstructive sleep apnea have been observed to be at increased risk for adverse postoperative events. OBJECTIVES: To estimate the prevalence of obstructive sleep apnea among gynecologic oncology patients undergoing elective surgery and to investigate for a relationship between obstructive sleep apnea and postoperative outcomes...
May 21, 2018: American Journal of Obstetrics and Gynecology
https://www.readbyqxmd.com/read/29792835/safety-and-efficacy-of-outpatient-parotidectomy
#7
Andrea Ziegler, Gina Lazzara, Eric Thorpe
PURPOSE: Given the increasing costs of medical care, there has been a shift to outpatient elective surgeries in certain patient populations among all surgical specialties. The goal of this study was to compare the safety and efficacy of outpatient parotidectomy with traditional inpatient parotidectomy. MATERIALS AND METHODS: This is a retrospective chart review of all patients who underwent a parotidectomy at a single tertiary academic center from 2007 through 2017...
May 7, 2018: Journal of Oral and Maxillofacial Surgery
https://www.readbyqxmd.com/read/29792735/hip-fracture-in-the-setting-of-limited-life-expectancy-the-importance-of-considering-goals-of-care-and-prognosis
#8
C Bree Johnston, Amanda Holleran, Thuan Ong, Ursula McVeigh, Elizabeth Ames
IMPORTANCE: Many older patients with a limited life expectancy experience fragility fracture of the hip, and this event is associated with increased risk of premature mortality, functional decline, and institutionalization. The treating team, in collaboration with patients and their families, must determine whether a surgical or conservative approach is in the patient's best interest when a patient has limited life expectancy. OBSERVATION: Goals of care discussions appear to be rare in the setting of fragility fracture...
May 24, 2018: Journal of Palliative Medicine
https://www.readbyqxmd.com/read/29792734/clinical-updates-on-perianal-fistulas-in-crohn-s-disease
#9
Ori Rackovsky, Robert Hirten, Ryan Ungaro, Jean-Frederic Colombel
Perianal fistulizing disease is an aggressive and debilitating phenotype of Crohn's disease (CD), representing a significant therapeutic challenge. New work has led to advancement in epidemiology and long term outcomes of perianal disease. The range of therapeutic options continues to expand, including new biologic agents, biosimilars, and stem cell therapy. Areas covered: We discuss updates to all aspects of management of perianal disease, with a focus on the last three years of published data. Areas considered include new data on epidemiology and prognostication, medical and surgical therapy, and stem cell therapy...
May 24, 2018: Expert Review of Gastroenterology & Hepatology
https://www.readbyqxmd.com/read/29792721/-use-of-viscoelastic-methods-in-surgery
#10
D Šmíd, J Zatloukal, T Kural, J Fichtl, V Opatrný, J Moláček
INTRODUCTION: Major liver resections are associated with high morbidity and mortality. The main causes of this fact include a significant blood loss which may be associated with this surgical procedure. Hemocoagulation disorder, diagnosed by standard laboratory tests, is very frequent in the postoperative period and often requires the administration of blood derivatives. Several recent studies, however, have questioned the presence of such coagulopathy when viscoelastic methods are used to assess the coagulation process...
2018: Rozhledy V Chirurgii: Měsíčník Československé Chirurgické Společnosti
https://www.readbyqxmd.com/read/29792520/changes-in-the-neurovascular-anatomy-of-the-shoulder-after-an-open-latarjet-procedure-defining-a-surgical-safe-zone
#11
Christopher M LaPrade, Andrew S Bernhardson, Zachary S Aman, Gilbert Moatshe, Jorge Chahla, Grant J Dornan, Robert F LaPrade, Matthew T Provencher
BACKGROUND: Although previous literature has described the relevant anatomy for an open anterior Bankart approach of the shoulder, there is little known regarding the anatomic relationship changes in the neurovascular structures after an open Latarjet procedure. PURPOSE: To define the neurovascular anatomy of the native shoulder in relation to the coracoid and to define the anatomy after the Latarjet procedure in relation to the glenoid to determine distances to these neurovascular structures with and without neurolysis of the musculocutaneous nerve (MCN) from the conjoint tendon...
May 1, 2018: American Journal of Sports Medicine
https://www.readbyqxmd.com/read/29792393/outcomes-of-transcatheter-aortic-valve-implantation-compared-with-surgical-aortic-valve-replacement-in-geriatric-patients-with-chronic-kidney-disease
#12
Linda Shavit, Shuli Silberman, Rachel Tauber, Ofer Merin, Daniel Bitran, Daniel Fink
BACKGROUND: Transcatheter aortic valve implantation (TAVI) is a less invasive treatment modality for patients with severe aortic valve stenosis (AS) who are at a higher risk if they have surgery. Preoperative chronic kidney disease (CKD) influences outcomes of cardiac surgery and is associated with a higher mortality and more complicated hospital course. The aims of our study were to evaluate the comparative outcomes of TAVI versus surgical aortic valve replacement (SAVR) in geriatric patients with preoperative CKD...
May 24, 2018: Clinical Nephrology
https://www.readbyqxmd.com/read/29792183/estimated-intraoperative-blood-loss-correlates-with-postoperative-cardiopulmonary-complications-and-length-of-stay-in-patients-undergoing-video-assisted-thoracoscopic-lung-cancer-lobectomy-a-retrospective-cohort-study
#13
Shuangjiang Li, Kun Zhou, Yutian Lai, Cheng Shen, Yanming Wu, Guowei Che
BACKGROUND: The purpose of our study was to estimate the influence of estimated intraoperative blood loss (EIBL) on postoperative cardiopulmonary complications (PCCs) in patients undergoing video-assisted thoracoscopic surgery (VATS) lobectomy for non-small-cell lung cancer (NSCLC). METHODS: We conducted a single-center retrospective analysis on the clinical data of consecutive patients in our institution between April 2015 and February 2016. Demographic differences between PCC group and non-PCC group were initially assessed...
May 23, 2018: BMC Surgery
https://www.readbyqxmd.com/read/29792180/screening-for-congenital-fetal-anomalies-in-low-risk-pregnancy-the-kenyatta-national-hospital-experience
#14
Callen Kwamboka Onyambu, Norah Mukiri Tharamba
BACKGROUND: Congenital malformations contribute significantly to the disease burden among children globally. A study conducted in Kenya on understanding the burden of surgical congenital anomalies, highlights the need for Kenyan health systems to go beyond the medical dimensions of illness. This could be achieved by linking knowledge of the severe congenital anomalies (CAs) and their impact of varying disability to the delivery of local health services and public health program planning...
May 23, 2018: BMC Pregnancy and Childbirth
https://www.readbyqxmd.com/read/29792086/risk-of-further-surgery-on-the-same-or-opposite-side-and-mortality-after-primary-total-hip-arthroplasty-a-multi-state-analysis-of-133-654-patients-from-the-swedish-hip-arthroplasty-register
#15
Peter H J Cnudde, Szilard Nemes, Erik Bülow, A John Timperley, Sarah L Whitehouse, Johan Kärrholm, Ola Rolfson
Background and purpose - The hip-related timeline of patients following a total hip arthroplasty (THA) can vary. Ideally patients will live their life without need for further surgery; however, some will undergo replacement on the contralateral hip and/or reoperations. We analyzed the probability of mortality and further hip-related surgery on the same or contralateral hip. Patients and methods - We performed a multi-state survival analysis on a prospectively followed cohort of 133,654 Swedish patients undergoing an elective THA between 1999 and 2012...
May 23, 2018: Acta Orthopaedica
https://www.readbyqxmd.com/read/29792045/annals-express-renal-stones
#16
Adie Viljoen, Rabia Chaudhry, John Bycroft
Renal stone disease is a worldwide problem which carries significant morbidity. It frequently requires specialist urology intervention. Patients with recurrent disease and those at high risk require specialist investigations and review. Certain cases benefit from medical and surgical intervention. In this review we discuss the pathophysiology, risk assessment, specialist investigations and various interventions, their rationale and evidence-base. This review aims to provide an update of the previous publication in 2001 in this journal on this topic...
January 1, 2018: Annals of Clinical Biochemistry
https://www.readbyqxmd.com/read/29791982/-management-of-intrahepatic-duct-stone
#17
REVIEW
Sang Woo Cha
Intrahepatic duct (IHD) stone is the presence of calculi within the intrahepatic bile duct specifically located proximal to the confluence of the left and right hepatic ducts. This stone is characterized by its intractable nature and frequent recurrence, requiring multiple therapeutic interventions. Without proper treatment, biliary strictures and retained stones can lead to repeated episodes of cholangitis, liver abscesses, secondary biliary cirrhosis, portal hypertension, and death from sepsis or hepatic failure...
May 25, 2018: Korean Journal of Gastroenterology, Taehan Sohwagi Hakhoe Chi
https://www.readbyqxmd.com/read/29791711/percutaneous-edge-to-edge-transcatheter-mitral-valve-repair-current-indications-and-future-perspectives
#18
Martino Pepe, Emanuela De Cillis, Tommaso Acquaviva, Annagrazia Cecere, Pasquale D'Alessandro, Arturo Giordano, Marco Matteo Ciccone, Alessandro Santo Bortone
Mitral regurgitation (MR) is the most prevalent valvular heart disease (VHD) and represents an important cause of heart failure. Medical therapy has a limited role in improving symptoms and does not hinder the progression of valvular disease. Surgery is the treatment of choice for severe symptomatic MR; valve repair is currently the preferred surgical approach because it reduces peri-operative mortality and ensures a good medium- to long-term survival outcome. Nevertheless, a non-negligible proportion of patients with indications for surgical correction are considered to be at prohibitive perioperative risk, mainly because of old age and multiple comorbidities...
June 1, 2018: Surgical Technology International
https://www.readbyqxmd.com/read/29791695/current-strategies-to-prevent-iatrogenic-ureteral-injury-during-colorectal-surgery
#19
Jonathan Douissard, Frederic Ris, Philippe Morel, Nicolas Christian Buchs
Iatrogenic ureteral injuries are a source of major concern among surgeons performing colorectal procedures. Although they are uncommon, these lesions lead to severe morbidity and long-term functional disabilities, as well as an increase in mortality, hospital stay, and cost. The laparoscopic approach has gained popularity in the field of colorectal surgery and is associated with improved global postoperative outcomes. However, it is also considered to increase the risk of ureteral injury when compared to open surgery, especially during left colonic and rectal resections...
June 1, 2018: Surgical Technology International
https://www.readbyqxmd.com/read/29791009/withdrawn-interventions-for-replacing-missing-teeth-1-versus-2-stage-implant-placement
#20
REVIEW
Marco Esposito, Maria Gabriella Grusovin, Yun Shane Chew, Paul Coulthard, Helen V Worthington
BACKGROUND: Implants may be placed penetrating the oral mucosa (1-stage procedure) or can be completely buried under the oral mucosa (2-stage procedure) during the healing phase of the bone at the implant surface. With a 2-stage procedure the risk of having unwanted loading onto the implants is minimized, but a second minor surgical intervention is needed to connect the healing abutments and more time is needed prior to start the prosthetic phase because of the wound-healing period required in relation to the second surgical intervention...
May 23, 2018: Cochrane Database of Systematic Reviews
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