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https://www.readbyqxmd.com/read/28643007/the-role-of-lipofilling-after-breast-reconstruction-evaluation-of-outcomes-and-patient-satisfaction-with-breast-q
#1
Annalisa Cogliandro, Mauro Barone, Stefania Tenna, Marco Morelli Coppola, Paolo Persichetti
INTRODUCTION: The aim of this study was to measure patient satisfaction using the BREAST-Q reconstruction module in patients selected for lipofilling procedures after implant breast reconstructions. MATERIALS AND METHODS: Seventy patients who underwent breast reconstruction with or without delayed lipofilling were enrolled between 2011 and 2015, and they completed BREAST-Q surveys. We administered the questionnaire electronically 6 months and 1 year after surgery...
June 22, 2017: Aesthetic Plastic Surgery
https://www.readbyqxmd.com/read/28637424/gabapentin-in-procedure-specific-postoperative-pain-management-preplanned-subgroup-analyses-from-a-systematic-review-with-meta-analyses-and-trial-sequential-analyses
#2
Maria Louise Fabritius, Anja Geisler, Pernille Lykke Petersen, Jørn Wetterslev, Ole Mathiesen, Jørgen Berg Dahl
BACKGROUND: It has been argued that postoperative pain treatment should be "procedure-specific", since different analgesics may have specific effects dependent on the surgical procedure. The aim of the present subgroup analysis was to compare the beneficial and harmful effects of perioperative gabapentin treatment in different surgical procedures. METHODS: Relevant databases were searched for randomized clinical trials (RCTs) comparing gabapentin versus placebo...
June 21, 2017: BMC Anesthesiology
https://www.readbyqxmd.com/read/28625445/prospective-double-blind-randomized-placebo-controlled-clinical-trial-of-the-pectoral-nerves-pecs-block-type-ii
#3
Barbara Versyck, Geert-Jan van Geffen, Patrick Van Houwe
STUDY OBJECTIVE: The aim of this clinical trial was to test the hypothesis whether adding the pectoral nerves (Pecs) block type II to the anesthetic procedure reduces opioid consumption during and after breast surgery. DESIGN: A prospective randomized double blind placebo-controlled study. SETTING: A secondary hospital. PATIENTS: 140 breast cancer stage 1-3 patients undergoing mastectomy or tumorectomy with sentinel node or axillary node dissection...
August 2017: Journal of Clinical Anesthesia
https://www.readbyqxmd.com/read/28605205/analysis-of-factors-influencing-drain-amount-time-to-drain-removal-and-seroma-formation-in-patients-undergoing-immediate-expander-implant-breast-reconstruction
#4
Kyong-Je Woo, Joo Myong Paik, Goo-Hyun Mun, Jai-Kyong Pyon, Byung-Joon Jeon, Sa Ik Bang
BACKGROUND: Placement of a closed suction drain is a common cause of patient complaints, such as postoperative pain or discomfort following immediate expander-implant breast reconstruction. This study aims to identify factors that affect drainage volume, time to drain removal, and seroma formation. METHODS: A retrospective chart review of prospectively collected data was conducted on patients who underwent immediate expander-implant breast reconstructions following nipple-sparing or skin-sparing mastectomy without skin excision (nipple areolar complex excision only) between February 2010 and April 2015...
June 12, 2017: Journal of Plastic Surgery and Hand Surgery
https://www.readbyqxmd.com/read/28601480/the-trajectory-of-postoperative-pain-following-mastectomy-with-and-without-paravertebral-block
#5
Rochelle Wynne, Natalie Lui, Kristen Tytler, Carol Koffsovitz, Victor Kirwa, Bernhard Riedel, Shane Ryan
Evidence to support the argument that general anesthesia (GA) with paravertebral block (PVB) provides better pain relief for mastectomy patients than GA alone is contradictory. The aim of this study was to explore pain and analgesia after mastectomy with or without PVB during acute inpatient recovery. A retrospective study was conducted in a single hospital providing specialist cancer services in metropolitan Melbourne, Australia. We explored pain and concomitant analgesic administration in 80 consecutive women recovering from mastectomy who underwent GA with (n = 40) or without (n = 40) PVB...
June 7, 2017: Pain Management Nursing: Official Journal of the American Society of Pain Management Nurses
https://www.readbyqxmd.com/read/28584507/a-comparative-study-of-the-use-of-harmonic-scalpel-versus-unipolar-cautery-in-modified-radical-mastectomy
#6
Pallavi Mittal, Ashwani Kumar, Sunmeet Kaur, Paras Kumar Pandove, Rachan Lal Singla, Jagpal Singh
CONTEXT: Oncosurgery is an emerging branch with the set goals of prolonging the life and ensuring the best possible quality of life to the surviving patient. The use of harmonic scalpel has proved to be beneficial in a variety of surgeries but its role in breast surgery is still controversial. AIMS: We conducted this study to compare the intraoperative and postoperative outcomes in modified radical mastectomy using harmonic scalpel versus electrocautery. SUBJECTS AND METHODS: Fifty female patients with confirmed diagnosis of breast carcinoma and planned for modified radical mastectomy were taken up for surgery...
January 2017: Nigerian Journal of Surgery: Official Publication of the Nigerian Surgical Research Society
https://www.readbyqxmd.com/read/28584346/analgesic-efficacy-of-ultrasound-guided-paravertebral-block-versus-serratus-plane-block-for-modified-radical-mastectomy-a-randomised-controlled-trial
#7
Kapil Gupta, Kadapa Srikanth, Kiran Kumar Girdhar, Vincent Chan
BACKGROUND AND AIMS: Modified radical mastectomy (MRM) may be associated with severe post-operative pain, leading to chronic pain syndrome. We compared the post-operative analgesic profile of two ultrasound-guided nerve blocks: Paravertebral block (PVB) and serratus plane block (SPB). METHODS: This double-blind, randomised study was conducted on fifty adult females, scheduled for MRM with axillary dissection. After inducing general anaesthesia with intravenous midazolam 1 mg, fentanyl 1...
May 2017: Indian Journal of Anaesthesia
https://www.readbyqxmd.com/read/28574950/prepectoral-breast-reconstruction-a-safe-alternative-to-submuscular-prosthetic-reconstruction-following-nipple-sparing-mastectomy
#8
Hani Sbitany, Merisa Piper, Rachel Lentz
BACKGROUND: Nipple sparing mastectomy (NSM) with immediate prosthetic reconstruction is routinely performed due to excellent aesthetic results, and safe oncologic outcomes. Typically, subpectoral expanders are placed, but in select patients, this can lead to significant postoperative pain and animation deformity, due to pectoralis major muscle disinsertion and stretch. Prepectoral reconstruction is a technique that eliminates dissection of the pectoralis major, by placing the prosthesis completely above the muscle with complete acellular dermal matrix (ADM) coverage...
May 31, 2017: Plastic and Reconstructive Surgery
https://www.readbyqxmd.com/read/28560595/trends-in-sexual-function-after-breast-cancer-surgery
#9
Lauren F Cornell, Dawn M Mussallem, Tammeza C Gibson, Nancy N Diehl, Sanjay P Bagaria, Sarah A McLaughlin
PURPOSE: Sexual dysfunction is assumed to be common, but understudied, in breast cancer patients. Herein, we use the validated female sexual functioning index (FSFI) to evaluate changes in female sexual function after breast cancer surgery. METHODS: The FSFI assesses sexual function in six domains (desire, arousal, lubrication, orgasm, satisfaction, pain) on a 36-point scale, with scores >26.6 indicating better sexual function. We identified 226 women with unilateral breast cancer undergoing surgery at our institution from June 2010-January 2015...
May 30, 2017: Annals of Surgical Oncology
https://www.readbyqxmd.com/read/28558811/focal-necrosis-mimicking-breast-cancer-following-coronary-bypass-grafting
#10
Oldřich Coufal, Tomáš Ostřížek, Petr Krsička, Eva Lžičařová, Rudolf Nenutil, Monika Procházková, Beatrix Bencsiková, Peter Grell, Roman Šefr
BACKGROUND: Breast cancer can be diagnosed easily in most cases. However, occasionally, we are faced with some conditions that can mimic it. These may include inflammations, benign tumors, cysts, hematomas, or, more rarely, focal necrosis. CASE PRESENTATION: This report presents a case of focal breast necrosis following myocardial revascularization with the left internal mammary artery, which is a very rare condition, with only few cases described in the literature...
May 30, 2017: World Journal of Surgical Oncology
https://www.readbyqxmd.com/read/28536526/dexmedetomidine-improves-postoperative-patient-controlled-analgesia-following-radical-mastectomy
#11
Wei Fan, Hong Xue, Yong Sun, HaiKou Yang, Jun Zhang, Guangming Li, Ying Zheng, Yi Liu
Acute postoperative pain following radical mastectomy is a high risk for prolonged convalescence and potential persistent pain in patients with breast cancer. The present study was designed to observe the effect of intraoperative use of dexmedetomidine on acute postoperative pain following radical mastectomy under general anesthesia. Forty-five patients were enrolled into the study and divided into two groups that were maintained with propofol/remifentanil/Ringer's solution or propofol/remifentanil/Dexmedetomidine followed by morphine-based patient-controlled analgesia...
2017: Frontiers in Pharmacology
https://www.readbyqxmd.com/read/28529229/frances-burney-s-mastectomy-narrative-and-discourses-of-breast-cancer-in-the-long-eighteenth-century
#12
Heather Meek
This paper examines Frances Burney's 1812 mastectomy letter alongside contemporaneous medical treatises on the subject of breast cancer. Burney's letter offers a critique of a medical community that misconstrues her experience and can be viewed as pathography, or disability memoir. Examining the letter and the treatises in this way illuminates the brutality of some medical practices and the frequent incongruity between the patients' and the physicians' understandings of pain. However, the letter and the treatises also share much in common; both at times emphasize the patient's words and experiences, and both reveal the impressive and contradictory range of ideas surrounding breast cancer in the long eighteenth century...
2017: Literature and Medicine
https://www.readbyqxmd.com/read/28528191/subcutaneous-implant-breast-reconstruction-time-to-reconsider
#13
REVIEW
M-K Tasoulis, F M Iqbal, S Cawthorn, F MacNeill, R Vidya
Improvements in breast surgery techniques such as skin and nipple preserving mastectomy and innovative prosthetics (implants, acellular dermal matrices and meshes) is renewing interest in subcutaneous (pre-pectoral) implant reconstruction. The aim of this paper is to review the current literature in an attempt to provide a rationale that may support a return to subcutaneous implant placement, so minimising the pain and functional problems resulting from submuscular breast reconstruction.
May 4, 2017: European Journal of Surgical Oncology
https://www.readbyqxmd.com/read/28514220/case-242-radiation-induced-angiosarcoma
#14
Meredith Disharoon, Kamilia F Kozlowski, Jessica M Kaniowski
History In 2004, this woman received a diagnosis of invasive mammillary carcinoma, tubular variant, strongly positive for estrogen and progesterone receptors. Her lesion was found at screening mammography performed at an outside institution when she was 59 years old. She underwent partial mastectomy, with partial axillary node dissection and sentinel node mapping. A 0.6 × 0.5 cm Nottingham grade 1 infiltrating ductal carcinoma was removed from the right upper outer quadrant, margins were free of tumor, and there was no angiolymphatic invasion...
June 2017: Radiology
https://www.readbyqxmd.com/read/28439445/ultrasound-guided-continuous-interpectoral-block-for-patient-undergoing-mastectomy-and-axillary-clearance
#15
Mario Fajardo-Pérez, Ece Yamak Altınpulluk, Javier García-Miguel, Borja Quintana-Gordon
Using a single dose of local anaesthetics has some disadvantages and provides limited analgesia depending on the pharmacokinetic characteristics of the local anaesthetic used. Nevertheless, the use of continuous perineural infusions allows sustained pain control. Ultrasound-guided interpectoral block followed by the placement of catheters in patients undergoing mastectomies with or without lymph node axillary dissections can result in sufficient pain control. We present a case of a 58-year-old woman undergoing mastectomy and axillary clearance who received ultrasound-guided continuous interpectoral block for postoperative analgesia...
April 2017: Turkish Journal of Anaesthesiology and Reanimation
https://www.readbyqxmd.com/read/28428928/origin-branching-and-communications-of-the-intercostobrachial-nerve-a-meta-analysis-with-implications-for-mastectomy-and-axillary-lymph-node-dissection-in-breast-cancer
#16
REVIEW
Brandon Michael Henry, Matthew J Graves, Jakub R Pękala, Beatrice Sanna, Wan Chin Hsieh, R Shane Tubbs, Jerzy A Walocha, Krzysztof A Tomaszewski
The intercostobrachial nerve (ICBN), which usually originates from the lateral cutaneous branch of the second intercostal nerve, innervates areas of the axilla, lateral chest, and medial arm. It is at risk for injury during operative procedures that are often used in the management of breast cancer and such injury has been associated with postoperative sensory loss and neuropathic pain, decreasing the quality of life. PubMed, Excerpta Medica Database (EMBASE), ScienceDirect, Google Scholar, China National Knowledge Infrastructure (CNKI), Scientific Electronic Library Online (SciELO), Biosciences Information Service (BIOSIS), and Web of Science were searched comprehensively...
March 17, 2017: Curēus
https://www.readbyqxmd.com/read/28387892/anesthesia-and-analgesia-in-breast-surgery-the-benefits-of-peripheral-nerve-block
#17
L Calì Cassi, F Biffoli, D Francesconi, G Petrella, O Buonomo
Breast surgery is frequently associated with postoperative pain, nausea and vomiting, that result in increased patient's suffering, prolongation of hospital stays and related costs. Thoracic paravertebral nerve block (TPVB) is a viable option to the classic multimodal analgesia in breast surgery as it enhances surgical anesthesia and postoperative analgesia. In this review, we report the results of a number of studies on the role of TPVB in breast surgery. This technique is associated with a superior control of the pain, a reduction in opioids consumption after surgery, a decrease in postoperative nausea and vomiting, and an overall decrease in length of hospital stay...
March 2017: European Review for Medical and Pharmacological Sciences
https://www.readbyqxmd.com/read/28350973/is-it-really-useful-the-harmonic-scalpel-in-axillary-dissection-for-locally-advanced-breast-cancer-a-case-series
#18
G Militello, P De Marco, N Falco, K Kabhuli, A Mascolino, L Licari, R Tutino, G Cocorullo, G Gulotta
BACKGROUND: The seroma is one of the most common complications in the axillary lymph nodal dissection (different surgical approaches have been tried to reduce the seroma incidence). In our study we evaluate the outcome of patients using or not the ultrasonic scalpel (Harmonic scalpel) according to a standardized surgical technique. PATIENTS AND METHODS: From January 2011 to December 2015 120 patients underwent axillary dissection for breast cancer. Patients were divided in two groups: patients belonging to the first group underwent Harmonic scalpel dissection and patients belonging to the second group underwent classical dissection...
November 2016: Il Giornale di Chirurgia
https://www.readbyqxmd.com/read/28346808/patient-reported-outcomes-1-year-after-immediate-breast-reconstruction-results-of-the-mastectomy-reconstruction-outcomes-consortium-study
#19
Andrea L Pusic, Evan Matros, Neil Fine, Edward Buchel, Gayle M Gordillo, Jennifer B Hamill, Hyungjin M Kim, Ji Qi, Claudia Albornoz, Anne F Klassen, Edwin G Wilkins
Purpose The goals of immediate postmastectomy breast reconstruction are to minimize deformity and optimize quality of life as perceived by patients. We prospectively evaluated patient-reported outcomes (PROs) in women undergoing immediate implant-based or autologous reconstruction. Methods Women undergoing immediate postmastectomy reconstruction for invasive cancer and/or carcinoma in situ were enrolled at 11 sites. Women underwent implant-based or autologous tissue reconstruction. Patients completed the BREAST-Q, a condition-specific PRO measure for breast surgery patients, and Patient-Reported Outcomes Measurement Information System-29, a generic PRO measure, before and 1 year after surgery...
March 27, 2017: Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology
https://www.readbyqxmd.com/read/28333359/cryolipolysis-for-nonsurgical-reduction-of-fat-in-the-lateral-chest-wall-post-mastectomy
#20
Jennifer L Harrington, Peter J Capizzi
Background: Many patients that have undergone mastectomy surgery are left with residual lateral fat under the arm. While the fat may be associated with pain and cause undesirable bulges in clothing and skin irritation, most post-mastectomy patients are not interested in additional surgery. Objectives: Cryolipolysis is a nonsurgical procedure for fat reduction. The procedure is typically performed for aesthetic improvement in the abdomen, thighs, and flanks, but cryolipolysis was explored in this study for reconstructive purposes...
June 1, 2017: Aesthetic Surgery Journal
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