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Surgery

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152 papers 1000+ followers
https://read.qxmd.com/read/31342364/patterns-in-the-use-of-axillary-operations-for-patients-with-node-positive-breast-cancer-after-neoadjuvant-chemotherapy-a-national-cancer-database-ncdb-analysis
#1
Marissa K Srour, Joshua Tseng, Michael Luu, Rodrigo F Alban, Armando E Giuliano, Alice Chung
BACKGROUND: The American College of Surgeons Oncology Group (ACOSOG) Z1071 and Sentinel Neoadjuvant (SENTINA) trials of sentinel node biopsy for node-positive breast cancer treated with neoadjuvant chemotherapy (NAC) demonstrated false-negative rates that varied on the basis of surgical technique. This study evaluated trends in axillary operations before and after publication of these trials. METHODS: This study analyzed patients from National Cancer Database (NCDB) with clinical T0 through T4, N1 and N2, M0 breast cancer who received NAC from 1 January 2012 to 31 December 2015 and sentinel lymph node biopsy (SNB) or axillary lymph node dissection (ALND)...
July 24, 2019: Annals of Surgical Oncology
https://read.qxmd.com/read/30850903/low-risk-of-development-of-a-regional-recurrence-after-an-unsuccessful-repeat-sentinel-lymph-node-biopsy-in-patients-with-ipsilateral-breast-tumor-recurrence
#2
Ingrid G M Poodt, Coco J E F Walstra, Guusje Vugts, Adriana J G Maaskant-Braat, Adri C Voogd, Robert-Jan Schipper, Grard A P Nieuwenhuijzen
BACKGROUND: Unlike sentinel lymph node biopsy (SLNB) in the primary setting, the repeat SLNB (rSLNB) in patients with ipsilateral breast tumor recurrence (IBTR) is challenging, because it is difficult to visualize and/or harvest a sentinel lymph node in every patient. Regional treatments options and safety in terms of regional disease control after such an unsuccessful rSLNB remain unclear. This study assesses factors associated with the performance of axillary lymph node dissection (ALND) after unsuccessful rSLNB and evaluates the occurrence of regional recurrences...
August 2019: Annals of Surgical Oncology
https://read.qxmd.com/read/31492632/2019-international-clinical-practice-guidelines-for-the-treatment-and-prophylaxis-of-venous-thromboembolism-in-patients-with-cancer
#3
REVIEW
Dominique Farge, Corinne Frere, Jean M Connors, Cihan Ay, Alok A Khorana, Andres Munoz, Benjamin Brenner, Ajay Kakkar, Hanadi Rafii, Susan Solymoss, Dialina Brilhante, Manuel Monreal, Henri Bounameaux, Ingrid Pabinger, James Douketis
Venous thromboembolism (VTE) is the second leading cause of death in patients with cancer. These patients are at a high risk of VTE recurrence and bleeding during anticoagulant therapy. The International Initiative on Thrombosis and Cancer is an independent academic working group aimed at establishing a global consensus for the treatment and prophylaxis of VTE in patients with cancer. The International Initiative on Thrombosis and Cancer last updated its evidence-based clinical practice guidelines in 2016 with a free, web-based mobile phone application, which was subsequently endorsed by the International Society on Thrombosis and Haemostasis...
September 3, 2019: Lancet Oncology
https://read.qxmd.com/read/31297674/sentimagic-a-non-inferiority-trial-comparing-superparamagnetic-iron-oxide-versus-technetium-99m-and-blue-dye-in-the-detection-of-axillary-sentinel-nodes-in-patients-with-early-stage-breast-cancer
#4
Michael D Alvarado, Elizabeth A Mittendorf, Mediget Teshome, Alastair M Thompson, Richard J Bold, Mark A Gittleman, Peter D Beitsch, Sarah L Blair, Kaisa Kivilaid, Quentin J Harmer, Kelly K Hunt
BACKGROUND: Sentinel lymph node biopsy (SLNB) is a highly accurate method for staging the axilla in early breast cancer. Superparamagnetic iron oxide mapping agents have been explored to overcome the disadvantages of the standard SLNB technique, which uses a radioisotope tracer with or without blue dye. One such agent, Sienna+, was shown to be non-inferior to the standard technique for SLNB in a number of studies. The SentimagIC trial was designed to establish the non-inferiority of a new formulation of this magnetic tracer, Magtrace (formerly SiennaXP)...
October 2019: Annals of Surgical Oncology
https://read.qxmd.com/read/31668180/management-of-the-patient-with-chronic-intestinal-pseudo-obstruction-and-intestinal-failure
#5
REVIEW
Loris Pironi, Anna Simona Sasdelli
Chronic intestinal pseudo-obstruction (CIPO) is a severe form of intestinal dysmotility disorder, characterized by the impairment of gastrointestinal propulsion of the gut content in the absence of fixed occluding lesions. CIPO is a rare disease that can develop in both children and adults. CIPO is classified as primary/idiopathic, when no underlying disorder is demonstrated, or secondary, when related to systemic diseases. Diagnosis relies on the finding of chronic/recurrent obstructive type symptoms with radiological features of dilated intestine with air/fluid levels without any lumen occluding lesion...
December 2019: Gastroenterology Clinics of North America
https://read.qxmd.com/read/31585125/antiplatelets-anticoagulants-and-colonoscopic-polypectomy
#6
REVIEW
Neena S Abraham
The management of antiplatelet and anticoagulant (ie, antithrombotic) agents is challenging in the peri-endoscopic setting. In this state-of-the-art update, we review current best practice recommendations focusing on the risk of immediate and delayed post-polypectomy bleeding (PPB) in the context of drug discontinuation (ie, temporary interruption) and drug continuation. The data regarding polypectomy technique (cold snare versus conventional thermal-based) and prophylactic placement of hemostatic clips are evaluated to assess if these endoscopic techniques are beneficial in reducing PPB...
October 1, 2019: Gastrointestinal Endoscopy
https://read.qxmd.com/read/31415304/gallstone-pancreatitis-admission-versus-normal-cholecystectomy-a-randomized-trial-gallstone-panc-trial
#7
Krislynn M Mueck, Shuyan Wei, Claudia Pedroza, Karla Bernardi, Margaret L Jackson, Mike K Liang, Tien C Ko, Jon E Tyson, Lillian S Kao
INTRODUCTION: Early cholecystectomy shortly after admission for mild gallstone pancreatitis has been proposed based on observational data. We hypothesized that cholecystectomy within 24 hours of admission versus after clinical resolution of gallstone pancreatitis that is predicted to be mild results in decreased length-of-stay (LOS) without an increase in complications. METHODS: Adults with predicted mild gallstone pancreatitis were randomized to cholecystectomy with cholangiogram within 24 hours of presentation (early group) versus after clinical resolution (control) based on abdominal exam and normalized laboratory values...
September 2019: Annals of Surgery
https://read.qxmd.com/read/31210778/2019-wses-guidelines-for-the-management-of-severe-acute-pancreatitis
#8
REVIEW
Ari Leppäniemi, Matti Tolonen, Antonio Tarasconi, Helmut Segovia-Lohse, Emiliano Gamberini, Andrew W Kirkpatrick, Chad G Ball, Neil Parry, Massimo Sartelli, Daan Wolbrink, Harry van Goor, Gianluca Baiocchi, Luca Ansaloni, Walter Biffl, Federico Coccolini, Salomone Di Saverio, Yoram Kluger, Ernest Moore, Fausto Catena
Although most patients with acute pancreatitis have the mild form of the disease, about 20-30% develops a severe form, often associated with single or multiple organ dysfunction requiring intensive care. Identifying the severe form early is one of the major challenges in managing severe acute pancreatitis. Infection of the pancreatic and peripancreatic necrosis occurs in about 20-40% of patients with severe acute pancreatitis, and is associated with worsening organ dysfunctions. While most patients with sterile necrosis can be managed nonoperatively, patients with infected necrosis usually require an intervention that can be percutaneous, endoscopic, or open surgical...
2019: World Journal of Emergency Surgery: WJES
https://read.qxmd.com/read/31071753/the-bubble-sign-a-novel-way-to-detect-a-perforation-after-cold-snare-polypectomy
#9
Joaquín Rodríguez Sánchez, Mónica Sánchez Alonso, María Pellisé Urquiza
No abstract text is available yet for this article.
August 2019: Endoscopy
https://read.qxmd.com/read/30607165/use-of-sentinel-lymph-node-biopsy-after-neoadjuvant-chemotherapy-in-patients-with-axillary-node-positive-breast-cancer-in-diagnosis
#10
Hee Jun Choi, Isaac Kim, Emad Alsharif, Sungmin Park, Jae-Myung Kim, Jai Min Ryu, Seok Jin Nam, Seok Won Kim, Jonghan Yu, Se Kyung Lee, Jeong Eon Lee
Purpose: This study aimed to evaluate the effects of sentinel lymph node biopsy (SLNB) on recurrence and survival after neoadjuvant chemotherapy (NAC) in breast cancer patients with cytology-proven axillary node metastasis. Methods: We selected patients who were diagnosed with invasive breast cancer and axillary lymph node metastasis and were treated with NAC followed by curative surgery between January 2007 and December 2014. We classified patients into three groups: group A, negative sentinel lymph node (SLN) status and no further dissection; group B, negative SLN status with backup axillary lymph node dissection (ALND); and group C, no residual axillary metastasis on pathology with standard ALND...
December 2018: Journal of Breast Cancer
https://read.qxmd.com/read/30720507/open-versus-laparoscopic-versus-robotic-versus-transanal-mesorectal-excision-for-rectal-cancer-a-systematic-review-and-network-meta-analysis
#11
Constantinos Simillis, Nikhil Lal, Sarah N Thoukididou, Christos Kontovounisios, Jason J Smith, Roel Hompes, Michel Adamina, Paris P Tekkis
OBJECTIVE: To compare techniques for rectal cancer resection. SUMMARY BACKGROUND DATA: Different surgical approaches exist for mesorectal excision. METHODS: Systematic literature review and Bayesian network meta-analysis performed. RESULTS: Twenty-nine randomized controlled trials included, reporting on 6237 participants, comparing: open versus laparoscopic versus robotic versus transanal mesorectal excision. No significant differences identified between treatments in intraoperative morbidity, conversion rate, grade III/IV morbidity, reoperation, anastomotic leak, nodes retrieved, involved distal margin, 5-year overall survival, and locoregional recurrence...
July 2019: Annals of Surgery
https://read.qxmd.com/read/30535100/seven-versus-fourteen-days-of-antibiotic-therapy-for-uncomplicated-gram-negative-bacteremia-a-non-inferiority-randomized-controlled-trial
#12
Dafna Yahav, Erica Franceschini, Fidi Koppel, Adi Turjeman, Tanya Babich, Roni Bitterman, Ami Neuberger, Nesrin Ghanem-Zoubi, Antonella Santoro, Noa Eliakim-Raz, Barak Pertzov, Tali Steinmetz, Anat Stern, Yaakov Dickstein, Elias Maroun, Hiba Zayyad, Jihad Bishara, Danny Alon, Yonatan Edel, Elad Goldberg, Claudia Venturelli, Cristina Mussini, Leonard Leibovici, Mical Paul
Background: Gram-negative bacteremia is a major cause of morbidity and mortality in hospitalized patients. Data to guide the duration of antibiotic therapy are limited. Methods: Randomized, multicenter, open-label, non-inferiority trial. Inpatients with Gram-negative bacteremia, afebrile and hemodynamically stable for at least 48 hours, were randomized to receive 7 (intervention) or 14 days (control) of covering antibiotic therapy. Patients with uncontrolled focus of infection were excluded...
December 11, 2018: Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America
https://read.qxmd.com/read/26783860/comparison-between-revised-atlanta-classification-and-determinant-based-classification-for-acute-pancreatitis-in-intensive-care-medicine-why-do-not-use-a-modified-determinant-based-classification
#13
MULTICENTER STUDY
Felix Zubia-Olaskoaga, Enrique Maraví-Poma, Iratxe Urreta-Barallobre, María-Rosario Ramírez-Puerta, Mónica Mourelo-Fariña, María-Pilar Marcos-Neira
OBJECTIVE: To compare the classification performance of the Revised Atlanta Classification, the Determinant-Based Classification, and a new modified Determinant-Based Classification according to observed mortality and morbidity. DESIGN: A prospective multicenter observational study conducted in 1-year period. SETTING: Forty-six international ICUs (Epidemiology of Acute Pancreatitis in Intensive Care Medicine study). PATIENTS: Admitted to an ICU with acute pancreatitis and at least one organ failure...
May 2016: Critical Care Medicine
https://read.qxmd.com/read/29736167/mechanisms-and-management-of-acute-pancreatitis
#14
REVIEW
Ari Garber, Catherine Frakes, Zubin Arora, Prabhleen Chahal
Acute pancreatitis represents a disorder characterized by acute necroinflammatory changes of the pancreas and is histologically characterized by acinar cell destruction. Diagnosed clinically with the Revised Atlanta Criteria, and with alcohol and cholelithiasis/choledocholithiasis as the two most prominent antecedents, acute pancreatitis ranks first amongst gastrointestinal diagnoses requiring admission and 21st amongst all diagnoses requiring hospitalization with estimated costs approximating 2.6 billion dollars annually...
2018: Gastroenterology Research and Practice
https://read.qxmd.com/read/29887421/use-of-a-piece-of-free-omentum-to-prevent-bile-leakage-after-subtotal-cholecystectomy
#15
Yoichi Matsui, Satoshi Hirooka, Masaya Kotsuka, So Yamaki, Tomohisa Yamamoto, Hisashi Kosaka, Sohei Satoi
BACKGROUND: Bile leakage after subtotal cholecystectomy (SC) is clinically serious. To prevent such leakage, we developed a new surgical technique in which a free piece of omentum is plugged into the gallbladder stump (omentum plugging technique). We evaluated whether the omentum plugging technique prevents bile leakage after subtotal cholecystectomy. METHODS: Prospectively collected data of patients who had undergone subtotal cholecystectomy without cystic duct closure in the Department of Surgery of Kansai Medical University during the 12 years from January 2006 to March 2018 were reviewed retrospectively...
September 2018: Surgery
https://read.qxmd.com/read/29946347/bologna-guidelines-for-diagnosis-and-management-of-adhesive-small-bowel-obstruction-asbo-2017-update-of-the-evidence-based-guidelines-from-the-world-society-of-emergency-surgery-asbo-working-group
#16
REVIEW
Richard P G Ten Broek, Pepijn Krielen, Salomone Di Saverio, Federico Coccolini, Walter L Biffl, Luca Ansaloni, George C Velmahos, Massimo Sartelli, Gustavo P Fraga, Michael D Kelly, Frederick A Moore, Andrew B Peitzman, Ari Leppaniemi, Ernest E Moore, Johannes Jeekel, Yoram Kluger, Michael Sugrue, Zsolt J Balogh, Cino Bendinelli, Ian Civil, Raul Coimbra, Mark De Moya, Paula Ferrada, Kenji Inaba, Rao Ivatury, Rifat Latifi, Jeffry L Kashuk, Andrew W Kirkpatrick, Ron Maier, Sandro Rizoli, Boris Sakakushev, Thomas Scalea, Kjetil Søreide, Dieter Weber, Imtiaz Wani, Fikri M Abu-Zidan, Nicola De'Angelis, Frank Piscioneri, Joseph M Galante, Fausto Catena, Harry van Goor
Background: Adhesive small bowel obstruction (ASBO) is a common surgical emergency, causing high morbidity and even some mortality. The adhesions causing such bowel obstructions are typically the footprints of previous abdominal surgical procedures. The present paper presents a revised version of the Bologna guidelines to evidence-based diagnosis and treatment of ASBO. The working group has added paragraphs on prevention of ASBO and special patient groups. Methods: The guideline was written under the auspices of the World Society of Emergency Surgery by the ASBO working group...
2018: World Journal of Emergency Surgery: WJES
https://read.qxmd.com/read/30458567/reprocessing-of-flexible-endoscopes-and-endoscopic-accessories-used-in-gastrointestinal-endoscopy-position-statement-of-the-european-society-of-gastrointestinal-endoscopy-esge-and-european-society-of-gastroenterology-nurses-and-associates-esgena-update-2018
#17
Ulrike Beilenhoff, Holger Biering, Reinhard Blum, Jadranka Brljak, Monica Cimbro, Jean-Marc Dumonceau, Cesare Hassan, Michael Jung, Birgit Kampf, Christiane Neumann, Michael Pietsch, Lionel Pineau, Thierry Ponchon, Stanislav Rejchrt, Jean-François Rey, Verona Schmidt, Jayne Tillett, Jeanin E van Hooft
This Position Statement from the European Society of Gastrointestinal Endoscopy (ESGE) and the European Society of Gastroenterology Nurses and Associates (ESGENA) sets standards for the reprocessing of flexible endoscopes and endoscopic devices used in gastroenterology. An expert working group of gastroenterologists, endoscopy nurses, chemists, microbiologists, and industry representatives provides updated recommendations on all aspects of reprocessing in order to maintain hygiene and infection control.
December 2018: Endoscopy
https://read.qxmd.com/read/30423593/performance-measures-for-endoscopy-services-a-european-society-of-gastrointestinal-endoscopy-esge-quality-improvement-initiative
#18
Roland Valori, George Cortas, Thomas de Lange, Omer Salem Balfaqih, Marjon de Pater, Pierre Eisendrath, Premysl Falt, Irfan Koruk, Akiko Ono, Nadan Rustemović, Erik Schoon, Andrew Veitch, Carlo Senore, Cristina Bellisario, Silvia Minozzi, Cathy Bennett, Michael Bretthauer, Mario Dinis-Ribeiro, Dirk Domagk, Cesare Hassan, Michal F Kaminski, Colin J Rees, Cristiano Spada, Raf Bisschops, Mathew Rutter
The European Society of Gastrointestinal Endoscopy (ESGE) and United European Gastroenterology present a list of key performance measures for endoscopy services. We recommend that these performance measures be adopted by all endoscopy services across Europe. The measures include those related to the leadership, organization, and delivery of the service, as well as those associated with the patient journey. Each measure includes a recommendation for a minimum and target standard for endoscopy services to achieve...
December 2018: Endoscopy
https://read.qxmd.com/read/30465238/current-status-of-immunotherapy-in-metastatic-colorectal-cancer
#19
REVIEW
Pawel Wrobel, Shahid Ahmed
BACKGROUND: Immunotherapy focuses on selectively enhancing the host's immune response against malignant disease. It has been investigated as an important treatment modality against malignant disease for many years, but until recently its use was mostly limited to a few cancers. The advent of new immunemodulating agents in the recent past has changed the landscape for management of many solid tumors. Currently, immunotherapy offers a valuable, and in many cases, a more effective alternate to the conventional cytotoxic therapy...
January 2019: International Journal of Colorectal Disease
https://read.qxmd.com/read/21324384/local-anaesthetic-wound-infiltration-following-paediatric-appendicectomy-a-randomised-controlled-trial-time-to-stop-using-local-anaesthetic-wound-infiltration-following-paediatric-appendicectomy
#20
RANDOMIZED CONTROLLED TRIAL
T J Edwards, S J Carty, A S Carr, A W Lambert
OBJECTIVE: This study sought to determine the efficacy of post-operative wound infiltration with local anaesthetic following paediatric appendicectomy. METHOD: In a randomised, controlled, prospective, clinical trial children aged between five and sixteen years were assigned to one of three treatment arms; infiltration of the surgical wound with bupivicaine, saline, or no infiltration. Anaesthetic and analgesic protocols were employed. Patients and observers were blinded to the treatment group...
2011: International Journal of Surgery
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