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Surgical oncology

Fawz Kazzazi, Rosanna C Ching, Charles M Malata
Introduction: Thin women have fewer autologous tissue breast reconstructive options than their higher body mass index counterparts-due to a lack of adequate donor sites. They are therefore usually offered expander/implant techniques. The total autologous latissimus dorsi flap is generally used in "well-padded" individuals, as they have enough fat on their back on which a completely autologous reconstruction could be based. When implant-based reconstruction is contraindicated (for instance due to planned adjuvant radiotherapy) or unacceptable to the patient, the total autologous latissimus dorsi flap can provide adequate tissue volume by utilizing the additional back fat deposits even in the thin, small-breasted patient...
2018: Eplasty
Jennifer J Mueller, Henrik Lajer, Berit Jul Mosgaard, Slim Bach Hamba, Philippe Morice, Sebastien Gouy, Yaser Hussein, Robert A Soslow, Brooke A Schlappe, Qin C Zhou, Alexia Iasonos, Claus Høgdall, Alexandra Leary, Roisin E OʼCearbhaill, Nadeem R Abu-Rustum
OBJECTIVE: We sought to describe a large, international cohort of patients diagnosed with primary mucinous ovarian carcinoma (PMOC) across 3 tertiary medical centers to evaluate differences in patient characteristics, surgical/adjuvant treatment strategies, and oncologic outcomes. METHODS: This was a retrospective review spanning 1976-2014. All tumors were centrally reviewed by an expert gynecologic pathologist. Each center used a combination of clinical and histologic criteria to confirm a PMOC diagnosis...
March 21, 2018: International Journal of Gynecological Cancer
Michael Galgano, Jared Fridley, Adetokunbo Oyelese, Albert Telfian, Thomas Kosztowski, David Choi, Ziya L Gokaslan
Metastatic spinal disease is a source of significant morbidity in patients with cancer. Recent advancements in adjuvant oncologic therapy has led to increased survival for many patients who harbor neoplastic disease. As a result of this, the chance of developing metastatic spinal disease over the course of a cancer patient's lifespan has increased. Symptomatic metastatic spinal disease can cause significant morbidity including severe pain, neurologic deficit, and loss of ambulation. Current treatment of these patients typically involves the use of multiple modalities, including surgery, radiation, and chemotherapy...
March 21, 2018: Expert Review of Anticancer Therapy
Humaid Ahmad, Jahanzaib Haider, Sheeraz S Siddiqui, Sumbul Naz, Faizan Nihal, Shams Nadeem Alam
Necrotizing fasciitis (NF) is a rare entity with its subacute form being even rarer. The condition has also been described to occur in the peristomal area in relation to different clinical scenarios. However, it has not been described in the setting of adjuvant chemotherapy where these medications have already been given. While the diagnosis may be delayed or missed due to the subtle symptomatology of the indolent subacute form of NF, another reason for a delayed or missed diagnosis may be the excessive use of tape and the stoma belt around the stomal appliance to prolong the life of the appliance beyond its recommended days of usage due to economic constraints...
January 16, 2018: Curēus
Salvina Barra, Liliana Belgioia, Michela Marcenaro, Serena Callegari, Alice Pastorino, Luca Trapani, Francesca Cavagnetto, Stefania Garelli, Renzo Corvò
Background: After radical prostatectomy (RP) radiotherapy (RT) plays a role, both as adjuvant or salvage treatment. If negative features are present such as extracapsular extension, seminal vesicle invasion, lymph invasion, and positive surgical margins, RT after RP reduces the risk of recurrence, although it is associated with an increased risk of acute and late toxicities. An intensified RT delivered in a shortened time could improve clinical outcome and be safely combined with hormonal therapy (HT)...
2018: Cancer Management and Research
Dugald Seely, Julie K Ennis, Ellen McDonell, Linlu Zhao
BACKGROUND AND OBJECTIVES: There is a lack of information on therapies recommended by naturopathic doctors (NDs) for lung and gastroesophageal cancer care. Study objectives were to: (1) identify the most common interventions considered for use by NDs; (2) identify interventions NDs recommend to support key therapeutic goals; and (3) identify potential contraindications between integrative and conventional therapies. METHODS: Oncology Association of Naturopathic Physicians (OncANP) members (n = 351) were invited to complete an electronic survey...
March 1, 2018: Integrative Cancer Therapies
Lieve G J Leijssen, Anne M Dinaux, Ramzi Amri, Hiroko Kunitake, Liliana G Bordeianou, David L Berger
BACKGROUND: Although extended colectomy is often chosen for patients with transverse colon cancer, the optimal surgical approach for mid-transverse colon cancer has not been established. METHODS: We identified patients who underwent a transverse (TC) or an extended colectomy (EC) for mid-transverse colon cancer between 2004 and 2014. To adjust for potential selection bias between the groups, a propensity score matching analysis was performed. RESULTS: A total of 103 patients were included, of whom 63% underwent EC (right 47%, left 17%) and 37% TC...
March 19, 2018: World Journal of Surgery
Marcel A Kamp, Maxine Dibué-Adjei, Jan F Cornelius, Philipp J Slotty, Hans-Jakob Steiger, Sebastian A Ahmadi, Marion Rapp, Michael Sabel
The oncological impact of cytoreductive surgery for malignant glioma has been analyzed in a few prospective, randomized studies; however, the impact of different cytoreductive surgical techniques of cerebral tumors remains controversial. Despite retrospective analyses revealing an oncological impact of complete surgical resection in cerebral metastases and low-grade glioma, the oncological impact of further extension of resection to a supramarginal resection remains disputable lacking high-grade evidence: supramarginal resections have yet to be analyzed in malignant glioma...
March 20, 2018: Neurosurgical Review
Oscar D Martín, Heilen Bravo, Marcos Arias, Diego Dallos, Yesica Quiroz, Luis G Medina, Giovanni E Cacciamani, Raul G Carlini
The objective of this review is to evaluate the factors that determine the development or deterioration of Chronic Kidney Disease (CKD) after partial nephrectomy (PN). When current literature is reviewed, it is found that factors that influence renal function after partial nephrectomy, are multifactorial. Those are divided into pre-surgical factors, such as hypertension, diabetes mellitus, urolithiasis, obesity, metabolic syndrome among others; intra-surgical factors, like the surgical technique used, the remaining healthy tissue, the experience of the surgeon, the time and type of ischemia among others...
January 2018: Oncoscience
Chenzhou Wu, John Gleysteen, Nutte Tarn Teraphongphom, Yi Li, Eben Rosenthal
Head and neck cancers become a severe threat to human's health nowadays and represent the sixth most common cancer worldwide. Surgery remains the first-line choice for head and neck cancer patients. Limited resectable tissue mass and complicated anatomy structures in the head and neck region put the surgeons in a dilemma between the extensive resection and a better quality of life for the patients. Early diagnosis and treatment of the pre-malignancies, as well as real-time in vivo detection of surgical margins during en bloc resection, could be leveraged to minimize the resection of normal tissues...
March 18, 2018: International Journal of Oral Science
Federico Davini, Sara Ricciardi, Carmelina Cristina Zirafa, Ilenia Cavaliere, Gaetano Romano, Franca Melfi
Background: The incidental detection of solitary pulmonary nodule (SPN) is currently increasing due to the widespread use of computed tomography (CT) during the follow up in oncological patients or in screening trials. A quick and definitive histological diagnosis of these nodes is mandatory as, in case of primitive lung cancer, an early detection could improve both surgical results and prognosis. The minimally invasive pulmonary resection (MIPR) is the gold standard procedure for diagnosis and treatment of small lung nodules, but it can be difficult to localize deep nonpalpable nodes that lie in the lung parenchyma...
2018: Journal of Visualized Surgery
C M Chingkoe, A Brook, A J Moser, K J Mortele
PURPOSE: At our tertiary medical center, multidisciplinary subspecialists meet twice a week during a CME-accredited conference to discuss oncologic and non-oncologic patients with pancreatic diseases at which time a subspecialized abdominal staff radiologist reinterprets the patient's relevant imaging studies. This study assesses the changes in patient management due to imaging reinterpretation during multidisciplinary pancreas conference (MPC). MATERIALS AND METHODS: In this retrospective, IRB-approved, HIPAA-compliant study, imaging studies of all patients discussed at MPC between July 1 and December 31, 2015 were assessed for technical adequacy, and original reports analyzed for congruency with reinterpretation...
March 17, 2018: Abdominal Radiology
Nabeel Alshafai, Rodolfo Maduri, Mrigank Shail, Domenico Chirchiglia, David Meyronet, Francesco Signorelli
Hemangioblastomas (HBLs) are challenging vascular tumours with rare suprasellar location Surgery is recommended in patients with visual impairment, endocrine disorders or hydrocephalus. Surgical removal of pituitary stalk HBLs is challenging due to their location and high vascularity. Our narrative review was guided by the question: "what is the more suitable surgical approach to excise a suprasellar HBL?". Pertinent English literature was scrutinized from database inception to October 2016. Eighteen articles matched our selection criteria...
March 10, 2018: Clinical Neurology and Neurosurgery
Ramez N Eskander, James Kauderer, Krishnansu S Tewari, Robert S Mannel, Robert E Bristow, David M O'Malley, Stephen C Rubin, Gretchen E Glaser, Chad A Hamilton, Keiichi Fujiwara, Warner K Huh, Frederick Ueland, Jean-Marie Stephan, Robert A Burger
PURPOSE: We sought to determine the level of concordance among surgeons' assessment of residual disease (RD) and pre-treatment computed tomography (CT) findings among women who underwent optimal surgical cytoreduction for advanced stage ovarian cancer. METHODS: This is a post-trial ad hoc analysis of a phase 3 randomized clinical trial evaluating the impact of bevacizumab in primary and maintenance therapy for patients with advanced stage ovarian cancer following surgical cytoreduction...
March 14, 2018: Gynecologic Oncology
Hanisah Guro, Jai Young Cho, Ho-Seong Han, Yoo-Seok Yoon, YoungRok Choi, Sungho Kim, Kilhwan Kim, In Gun Hyun
BACKGROUND: To compare the surgical outcomes of major laparoscopic liver resection (LLR) and open liver resection (OLR) for hepatocellular carcinoma (HCC). METHODS: We retrospectively reviewed the medical records of 177 patients who underwent major liver resection for HCC between January 2004 and June 2015. We divided the 177 patients into two groups according to the type of procedure: major LLR (LLR group; n = 67) and major OLR (OLR group; n = 110). RESULTS: Procedures in the LLR group were right hepatectomy (30 patients), right posterior sectionectomy (28), left hepatectomy (11), right anterior sectionectomy (6), extended right hepatectomy (6), and central bisectionectomy (2)...
March 2018: Surgical Oncology
Mariana Andozia Morini, Roberto Lodeiro Muller, Paulo César Barbosa de Castro Junior, Rafael José de Souza, Eliney Ferreira Faria
INTRODUCTION: Prostate cancer (PC) most of the time presents with an indolent course. Thus, delays in treatment due to any causes might not affect long-term survival and may not affect cancer cure rates. PURPOSE: In this study, we evaluated the effect of delay-time between PC diagnosis and radical prostatectomy regarding oncological outcomes: Gleason score upgrade on surgical specimen, pathologic extracapsular extension (ECE) on surgical specimen, and postoperative biochemical recurrence (BCR) on follow-up...
March 16, 2018: World Journal of Urology
Alessandro Frati, Alessandro Pesce, Mauro Palmieri, Megi Celniku, Antonino Raco, Maurizio Salvati
BACKGROUND: The benefits associated to the surgical treatment of brain metastases (BM) in elderly patients has been extensively debated due to their higher biological fragility, but we still miss a "threshold". The aim of this work is to critically evaluate their outcomes by a systematic comparison to the cohort of the youngest patients of our series of BM. METHODS: The surgical, radiological and oncologic outcomes of patients suffering from BM have been retrospectively reviewed for the present study...
March 13, 2018: World Neurosurgery
Shaina F Bruce, Danielle N Carr, Elizabeth R Burton, Joel I Sorosky, Mark S Shahin, Mary C Naglak, Mitchell I Edelson
OBJECTIVE: Surgical site infections (SSI) are associated with increased morbidity, mortality, and healthcare costs. This study investigated whether implementation of an abdominal closure bundle reduces surgical site infection rates. We aimed to identify sub-populations that would benefit the most from this intervention. METHODS: We conducted a retrospective cohort study of all patients that underwent exploratory laparotomy by a Gynecologic Oncologist from January 1, 2011 to April 1, 2017...
March 14, 2018: Gynecologic Oncology
Angelena Crown, Nicketti Handy, Flavio G Rocha, Janie W Grumley
INTRODUCTION: Oncoplastic breast conserving surgery (BCS) can enhance both cosmetic and oncologic breast cancer outcomes. This study evaluates the outcomes and complications associated with oncoplastic reduction mammaplasty performed by surgical breast oncologists. METHODS: A single institution retrospective chart review of patients undergoing oncoplastic reduction mammaplasty by a surgical breast oncologist for the treatment of breast cancer. RESULTS: Seventy-one patients were identified...
February 28, 2018: American Journal of Surgery
Giuseppe Marulli, Giovanni Maria Comacchio, Marco Schiavon, Alessandro Rebusso, Marco Mammana, Davide Zampieri, Egle Perissinotto, Federico Rea
OBJECTIVES: Minimally invasive techniques seem to be promising alternatives to open approaches in the surgical treatment of early-stage thymoma, although there are controversies because of lack of data on long-term results. The aim of the study was to evaluate the surgical and oncological results after robotic thymectomy for early-stage thymoma compared to median sternotomy. METHODS: Between 1982 and 2017, 164 patients with early-stage thymoma (Masaoka I and II) were operated on by median sternotomy (108 patients) or the robotic approach (56 patients)...
March 13, 2018: European Journal of Cardio-thoracic Surgery
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