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Breast Cancer and Implants: Surgery Options

There's reassuring news for women with breast implants who develop breast cancer.

Despite earlier concerns, many can be effectively treated with breast-conserving treatment rather than a more disfiguring mastectomy to remove the entire affected breast, researchers say.

Read more: Breast Cancer and Implants: Surgery Options

Perspective: Carotid Stenting and the History of Disruptive Technology in Vascular Surgery

  • Written by Frank J. Veith, MD
  • Category: Adult Surgery
Introduction
A disruptive technology can be defined as one that displaces a standard old method for performing certain functions because the new one is so clearly better. Examples of disruptive technologies would be the electric light displacing candle light, steam power displacing sail power for ships, jet engines displacing piston engines for long distance aircraft, and computer word processing displacing the typewriter. Disruptive technologies change the way things are done, put companies out of business, and lead to increased productivity and progress.

Read more: Perspective: Carotid Stenting and the History of Disruptive Technology in Vascular Surgery

Announcing the Otolaryngology-Head and Neck Surgery Section of The Medscape Journal of Medicine

  • Written by David Goldenberg, MD
  • Category: Adult Surgery
I am proud to introduce the Otolaryngology-Head and Neck Surgery (OTO-HNS) section of The Medscape Journal of Medicine. This is the first exclusively online, open access, MEDLINE-indexed journal dedicated to otolaryngology-head and neck surgery. Not to be mislabeled as "just another Web site" or an "online textbook," the OTO-HNS section of The Medscape Journal of Medicine is a fully peer-reviewed, MEDLINE-indexed journal.

Read more: Announcing the Otolaryngology-Head and Neck Surgery Section of The Medscape Journal of Medicine

Researchers Point to Flaws in Recent Cancer Studies

  • Written by Allison Gandey
  • Category: Adult Surgery
Observational studies of treatment outcomes must be viewed with caution, investigators urge. In a report published online April 21 in Cancer, researchers showed that selection bias continues to be a major problem in observational data.

Read more: Researchers Point to Flaws in Recent Cancer Studies

Immunotherapeutic Reduces Risk for Relapse After Lung Cancer Surgery

  • Written by Zosia Chustecka
  • Category: Adult Surgery
In a phase 2 trial of patients with non-small-cell lung cancer, an immunotherapeutic reduced the risk for relapse after lung cancer surgery to the same extent as has been seen with chemotherapy, but with far fewer adverse events. The product, known as MAGE-A3 antigen-specific cancer immunotherapeutic (ASCI), is being developed by GlaxoSmithKline in Belgium.

Read more: Immunotherapeutic Reduces Risk for Relapse After Lung Cancer Surgery

Wound Infection After Breast Surgery: Higher Than We Thought?

  • Written by Albert Lowenfels, MD
  • Category: Adult Surgery
Hospital-Associated Costs Due to Surgical Site Infection After Breast Surgery
Olsen MA, Chu-Ongsakul S, Brandt KE, Dietz JR, Mayfield J, Fraser VJ
Arch Surg. 2008;143:53-60

Summary
The aim of this study, which was conducted in a single hospital, was to determine the frequency and associated costs arising from a surgical wound infection after breast surgery. During the study period, 50 of the 949 women undergoing breast surgery (5.3%) developed a wound infection in the year immediately after the operation. Median time interval from surgery to diagnosis of wound infection was 25 days, and in only 2 patients was the wound infection diagnosed during the initial hospitalization. Infection rates were higher if the patient underwent an implant. The estimated cost for a wound infection after adjusting for type of surgery, disease stage, and other variables was about $4000 (95% confidence interval $2800-$5500).

Read more: Wound Infection After Breast Surgery: Higher Than We Thought?

Endovascular vs Open Repair of Abdominal Aortic Aneurysms: Any Long-term Difference?

  • Written by Albert B. Lowenfels, MD
  • Category: Adult Surgery
Endovascular vs Open Repair of Abdominal Aortic Aneurysms in the Medicare Population

Schermerhorn ML, O'Malley J, Jhaveri A, Cotterill P; Pomposelli F; Landon BE
N Engl J Med. 2008;358:464-474

Summary
How does endovascular repair (EVAR) of abdominal aneurysms compare with conventional open repair? The authors reviewed results from 22,830 Medicare patients (average age, 74 years) followed for up to 4 years after they had received either endovascular or open procedures. Early mortality was much lower after endovascular repair: 1.2% vs 4.8%, P < .001). During the follow-up period, the EVAR group had a higher frequency of rupture (1.8% vs 0.5%) and more patients required additional surgery for the graft than those who had the open procedure. However, patients treated with an open repair had more complications related to the abdominal surgery, such as bowel obstruction or abdominal wall hernia, than those who had EVAR. By 4 years, the overall survival in the 2 groups, which initially favored the endovascular group, was identical.

Read more: Endovascular vs Open Repair of Abdominal Aortic Aneurysms: Any Long-term Difference?

Vaginal Hysterectomy Feasible in Nulliparous Women

  • Written by Will Boggs, MD
  • Category: Adult Surgery
Vaginal hysterectomy is preferable for benign uterine pathology even in women without previous vaginal delivery, according to a report in the April Obstetrics & Gynecology.

"The advantages of the vaginal route (with or without laparoscopy) are numerous for patients and for society," Dr. Arnaud Le Tohic from Bichat-Claude Bernard University Hospital in Paris told Reuters Health. "Hospital stay is shorter, there is no (or really short) scar which is cosmetically better for patients, pain is lower, analgesic use is lower, recovery is faster, and finally cost is lower for everyone."

Read more: Vaginal Hysterectomy Feasible in Nulliparous Women

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