Although therapeutic strategies have advanced for many common gastrointestinal cancers, significant progress in the treatment of pancreatic cancer remains elusive. The eagerly anticipated results of randomized trials that evaluated gemcitabine-based combination regimens have proven to be disappointing, researchers report in a review paper that discusses the use of systemic therapy in advanced pancreatic cancer. Whereas 2 recent trials have demonstrated a modest survival benefit with combination therapy, some consider the improvement to be too small to justify the risk of toxicity or added cost.
In patients with acute cholecystitis, performing laparoscopic gallbladder removal within 24 hours of admission, rather than waiting weeks to years after a course of antibiotics has been given, reduces the hospital stay without increasing the risk of complications, new research shows.
Context: Music and surgery. Objective: To determine the effect of live classical piano music on vital signs of patients undergoing ophthalmic surgery. Design: Retrospective case series. Setting and Patients: 203 patients who underwent various ophthalmologic procedures in a period during which a piano was present in the operating room of St. Francis Medical Center. [Note: St. Francis Medical Center has recently been renamed Hawaii Medical Center East.] Intervention: Demographic data, surgical procedures, and the vital signs of 203 patients who underwent ophthalmic procedures were obtained from patient records. Blood pressure, heart rate, and respiratory rate measured in the preoperative holding area were compared with the same parameters taken in the operating room, with and without exposure to live piano music. A paired t-test was used for statistical analysis. Main outcome measure: Mean arterial pressure, heart rate, and respiratory rate. Results: 115 patients who were exposed to live piano music showed a statistically significant decrease in mean arterial blood pressure, heart rate, and respiratory rate in the operating room compared with their vital signs measured in the preoperative holding area (P < .0001). The control group of 88 patients not exposed to live piano music showed a statistically significant increase in mean arterial blood pressure (P < .0002) and heart rate and respiratory rate (P < .0001). Conclusion: Live classical piano music lowered the blood pressure, heart rate, and respiratory rate in patients undergoing ophthalmic surgery.
Intraluminal high-intensity ultrasound appears to be an effective treatment for esophageal tumors, which are usually not amenable to curative resection, and can even achieve complete tumor necrosis, according to French researchers who are the first to use this approach in a small pilot study. Their findings are published online on June 5 by the Journal of Translational Medicine.
A series of four esophageal cancer patients treated with this method recovered uneventfully and received rapid and significant relief from dysphagia.
A new surgical procedure for the treatment of morbid obesity produces better results than sleeve gastrectomy alone, and resolves many comorbidities. The new technique, called sleeve gastrectomy with enteral bypass (SGEBP), was described here at the American Society for Metabolic & Bariatric Surgery 25th Annual Meeting.
Bariatric surgeons might be willing to accept less weight loss and more risk in revisional than in primary endoluminal procedures, according to a survey distributed here at the American Society for Metabolic & Bariatric Surgery (ASMBS) 25th Annual Meeting. The results indicate the levels of weight loss and risk considered acceptable for currently developing bariatric endoluminal procedures.
Patients with morbid obesity who also have chronic renal disease (CRD) may improve or stabilize renal function after gastric bypass, according to a study presented here at the American Society for Metabolic & Bariatric Surgery 25th Annual Meeting.
CRD is common in obese patients, and chronic renal failure is more than 7 times higher in patients with body mass index (BMI) of 40 kg/m2 or higher. However, many centers for bariatric surgery will not perform gastric bypass in CRD patients, particularly those receiving dialysis or awaiting kidney transplant.
In a single-center study, the availability of both open and endovascular repair significantly improved postoperative survival in patients with ruptured abdominal aortic aneurysms (rAAA), according to a report in the Archives of Surgery for June.
Long-term follow-up of chronic pancreatitis patients who underwent the pylorus-preserving variant of the Whipple resection procedure shows that results are ultimately comparable to those achieved using the more recent Frey organ-sparing extended drainage approach, according to German researchers.
To improve surgical safety worldwide, the World Health Organization (WHO) has released a new safety checklist for surgical teams to use in operating rooms, according to a report regarding the Safe Surgery Saves Lives initiative, published online June 25 in The Lancet and also available on the WHO Web site. These WHO guidelines and checklist are the first edition, and they will be finalized for dissemination by late 2008, after completion of evaluation in 8 pilot sites globally.