Current Management of Splenic Injuries: Who Needs a Splenectomy?
AbstractPurpose of ReviewThis is a review of the current indications for splenectomy for trauma.Recent FindingsAs the role of interventional radiology and the acceptance of non-operative strategies gain wider acceptance, the role of splenectomy is decreasing. There continues to be questions on how far the role of non-operative management can be pushed and at what cost. Alternatively, that risk must be weighed against the long and short term consequences of a splenectomy.SummaryEmergent surgical exploration of the abdomen is indicated for hemodynamically unstable trauma patients and patients with peritonitis from an associa...
Source: Current Surgery Reports - June 29, 2018 Category: Surgery Source Type: research
Surgical Management of Hilar Cholangiocarcinoma
AbstractPurpose of ReviewTo provide a comprehensive review of the preoperative and operative considerations for the surgical management of hilar cholangiocarcinoma.Recent FindingsThe management of hilar cholangiocarcinoma has evolved over the past 20 years, with data from large institutional series emerging, which has influenced decisions regarding the need for preoperative biliary drainage, portal-vein embolization, extent of surgical resection, role of transplantation, and efficacy of adjuvant and palliative therapies.SummaryHepatectomy has become the standard of care for resectable hilar cholangiocarcinoma, while tran...
Source: Current Surgery Reports - June 18, 2018 Category: Surgery Source Type: research
Fasting and its Therapeutic Impact in Brain Tumors
This article is an attempt to review a controversial strategy of modulating tumor biology by understanding their metabolic characteristics, how they differ from normal healthy cells, and implementing therapies that include nutritional interventions.SummaryAlthough fasting as part of the management of brain malignancies is controversial and may be contrary to popular opinion, developing supportive evidence in targeting their special metabolic profile is promising and fascinating. (Source: Current Surgery Reports)
Source: Current Surgery Reports - May 31, 2018 Category: Surgery Source Type: research
Curing Diabetes Through Bariatric Surgery: Evolution of Our Understanding
AbstractPurpose of ReviewThe goal of this review is to summarize available data on the impact of bariatric surgery on diabetes and to explore the mechanisms responsible for these outcomes.Recent FindingsIn randomized controlled trials and when compared to standard medical management, bariatric surgery is consistently superior with regards to weight loss and remission of type 2 diabetes. Remission rates are proportional to weight loss. The likelihood of remission from type 2 diabetes after bariatric surgery can be estimated from several available clinical parameters.SummaryBariatric surgery is superior in improving glycemic...
Source: Current Surgery Reports - May 29, 2018 Category: Surgery Source Type: research
The Criteria for Treating Appendicitis Non-operatively
AbstractPurpose of reviewThere has been growing interest in the role of non-operative management of appendicitis. There have been multiple trials in adults, and there is a growing body of research in pediatric patients. This manuscript reviews the most recent trials and meta-analyses of non-operative management of acute, uncomplicated appendicitis in pediatric patients.Recent findingsAntibiotics alone are a safe treatment alternative for uncomplicated acute appendicitis without an appendicolith. There are no increased risks of complications or progression to complicated appendicitis with non-operative management with antib...
Source: Current Surgery Reports - May 8, 2018 Category: Surgery Source Type: research
Parenteral Nutrition for Management of Malignant Bowel Obstruction
AbstractPurpose of ReviewThis review article focuses on the practice of providing parenteral nutrition in cases of malignant bowel obstruction (MBO) where the enteral route of feeding is unavailable.Recent FindingsParenteral nutrition is an option in patients with MBO in whom enteral nutrition cannot be provided. However, its use is associated with complications that should lead to careful patient selection in determining who will benefit from its use. MBO often represents the end stage of the disease process, and not all patient presentations will benefit from parental nutrition (PN). Recent research does indicate that ce...
Source: Current Surgery Reports - May 2, 2018 Category: Surgery Source Type: research
Repair of Sternal Cleft in Children
AbstractPurpose of ReviewThe goal of this paper is to review the surgical techniques for the correction of sternal cleft in children.Recent FindingsVarious surgical techniques have been developed for the correction of sternal cleft since 1949, when the first successful repair was reported.SummarySternal cleft is an uncommon congenital chest wall deformity. The optimal correction can be achieved by primary repair of the defect in patients younger than 1 year of age, especially during the neonatal period, mostly with an easy technique. In older children, more extensive techniques are applied, using either autologous tissue...
Source: Current Surgery Reports - April 7, 2018 Category: Surgery Source Type: research
Obesity, Metabolic Syndrome, and Breast Cancer: From Prevention to Intervention
AbstractPurpose of reviewObesity contributes to an estimated forty-percent, or 630,000 cases, of malignant neoplasms diagnosed in the United States, and higher body mass index (BMI) has been associated with at least seventeen types of solid tumors, including 9% of all breast cancer cases. In this review, we discuss the impact of obesity and consequences of obesity, including the metabolic syndrome and type 2 diabetes mellitus, on breast cancer risk and recurrence.Recent findingsRecent work has identified multiple molecular mechanisms that may underlie the association between obesity and breast cancer. In particular, insuli...
Source: Current Surgery Reports - February 24, 2018 Category: Surgery Source Type: research
