Adolescent Bariatric Surgery: Quality, Outcomes, and Debates
AbstractPurpose of ReviewTo provide an updated evaluation of the literature regarding safety and outcomes in pediatric bariatric surgery and to explore associated controversies related to surgical timing and age concerns, as well as other ethical issues.Recent FindingsNonsurgical management of pediatric patients with obesity becomes less effective with increasing age and severity of disease. For carefully selected adolescent patients, bariatric surgery has been shown to provide sustained weight loss, reduction in comorbidities, and improved quality of life; however, high-level evidence is limited. Current data support surg...
Source: Current Surgery Reports - January 16, 2017 Category: Surgery Source Type: research
Chronic Type B Aortic Dissection: Endovascular and Hybrid Aortic Management
AbstractPurpose of ReviewChronic and subacute type B aortic dissection (TBAD) management has advanced drastically over the past decade. We review the major progress reported in the scientific literature.Recent FindingsSince early twenty first century, endovascular aortic repair has been on the rise for management of chronic and subacute TBAD. The technique has shown a mortality benefit in comparison to the open approach. High-risk patients who cannot tolerate open procedure and had challenging aortic anatomy benefit from hybrid approaches. More recently, total endovascular approaches are being investigated to treat these h...
Source: Current Surgery Reports - January 12, 2017 Category: Surgery Source Type: research
Nutrition Therapy in Shock
AbstractPurpose of ReviewThe dictum of surgical metabolism describing the ebb and flow of nutrients after injury can be seen as an alteration of the hormonal milieu. Shock, therefore, is a state by which nutrients are delivered only by diffusion, while shock resolution is marked by a transition to nutrient diversion into essential and salvage pathways. The gut requires significant cardiac output at rest, and this demand increases during enteral feeding. The mismatch between supply and demand can be exacerbated during the shock state, or, paradoxically, improved.Recent FindingsEnteral nutrition (EN) should be initiated with...
Source: Current Surgery Reports - October 26, 2016 Category: Surgery Source Type: research
Overcoming Immunologic Barriers to Kidney Transplantation: Desensitization and Paired Donation
AbstractPurpose of ReviewRenal transplantation offers a significant survival benefit over dialysis for patients with end-stage renal disease. Furthermore, transplantation with a living donor kidney offers superior survival when compared to a deceased donor. However, supply of transplantable kidneys continues to fall short of demand; living donation offers a solution to help decrease this disparity. For those patients who have willing donors, many will be incompatible secondary to blood group or tissue mismatches. In this setting, a crucial decision must be made —pursue living donor transplantation by overcoming the incom...
Source: Current Surgery Reports - October 25, 2016 Category: Surgery Source Type: research
Surgery Versus Stereotactic Body Radiotherapy for Resectable Lung Cancer
AbstractPurpose of ReviewRadiotherapy has been considered in the past an option for local control of resectable lung cancer only in cases of patients considered unfit or declining surgical treatment.Recent FindingsRecent technological improvements allow radiation oncologists to deliver precisely targeted radiation at much higher doses compared to traditional radiation therapy, in one single or few sessions, minimizing damage to the surrounding healthy tissue. In this review, we discuss the advantages and inconveniences of surgery and stereotactic body radiotherapy (SBRT) for the treatment of resectable non-small cell lung ...
Source: Current Surgery Reports - October 12, 2016 Category: Surgery Source Type: research
Fenestrated Aortic Endografts in the Last 3 Years: An Update
AbstractPurpose of ReviewFenestrated endovascular aortic aneurysm repair (FEVAR) is an accepted treatment option for patients who are not suitable for conventional endovascular aortic aneurysm repair or open surgical repair (OSR). Five years ago, the FDA approved the use of FEVAR in patients with inadequate infrarenal aortic seal zones (short necks). This procedural paradigm continues to gain in popularity compared to OSR for complex aortic disease. We seek to define the current state of fenestrated endovascular repair by reviewing relevant literature over the past 3 years.Recent FindingsFEVAR continues to prove to be effi...
Source: Current Surgery Reports - September 30, 2016 Category: Surgery Source Type: research
Enhanced Recovery Pathways in Bariatric Surgery: A Contemporary Review
This article presents a review of the practice of bariatric and metabolic surgeries in regard to enhanced recovery pathways (ERP) and its expansion in the field.Recent FindingsGeneral surgery perioperative care evolved in recent years with upcoming data mainly from colorectal surgery. Recent evidence showed a reduction in the length of stay and cost, without a raise in morbidity in the fragile obese population. Some groups even present how they achieve ambulatory bariatric surgery with careful patient selection. With research data coming from different fields and more recent studies in bariatric surgery specifically, exper...
Source: Current Surgery Reports - September 26, 2016 Category: Surgery Source Type: research
Risk Stratification in Lung Resection
We present a simplified functional algorithm for the surgical risk stratification in lung resection candidates. (Source: Current Surgery Reports)
Source: Current Surgery Reports - September 19, 2016 Category: Surgery Source Type: research
The Utility of Preoperative Frailty Assessment
AbstractPurpose of reviewThe geriatric patient population represents an ever increasing proportion of a surgeon ’s practice spectrum. With this comes the need to understand the factors largely impacting the geriatric surgical population. One of these factors is frailty. At first glance frailty appears as a simple concept. However, a review of the literature reveals a plethora of definitions, quantification endeavors, and theories attempting to delineate its principle attributes.Recent findingsDespite the variety of theories, the literature supports a strong link between frailty and poor surgical outcomes. While this link...
Source: Current Surgery Reports - September 14, 2016 Category: Surgery Source Type: research
Stomach Intestinal Pyloric Sparing Surgery or SIPS
AbstractPurpose of ReviewAs the field of bariatric surgery expands, the demand for a procedure that optimizes weight loss while minimizing complications grows ever higher. This paper proposes to give a rationale for this procedure as a salvage option for vertical sleeve gastrectomies (VSG) or as an initial bariatric procedure for patients requiring more weight loss and reduction in comorbidities than a VSG can offer. Stomach intestinal pyloric sparing surgery (SIPS) is a form of modified duodenal switch which is comprised a slightly larger than average vertical sleeve gastrectomy with a single postpyloric duodenal-enteral ...
Source: Current Surgery Reports - September 12, 2016 Category: Surgery Source Type: research
Review of Complex Iliocaval Reconstructions
AbstractPurpose of ReviewReconstruction of the iliocaval system is primarily performed in symptomatic patients with obstructive chronic venous disease (CVD). Such pathology can be primary/nonthrombotic or secondary/postthrombotic. The former encompasses pathology including May –Thurner syndrome, the most common etiology of primary CVD responsible for up to a third of the disease burden. Secondary CVD is usually due to postthrombotic syndrome. Other indications for iliocaval reconstructions include malignancy involving the iliocaval territory, trauma, or radiation injury . In this review, we evaluate complex iliocaval ven...
Source: Current Surgery Reports - August 25, 2016 Category: Surgery Source Type: research
Robotic Versus Video-Assisted Thoracoscopic Lobectomy (VATS) for Lung Cancer
This article discusses the concerns of both techniques and the future expectations. (Source: Current Surgery Reports)
Source: Current Surgery Reports - August 19, 2016 Category: Surgery Source Type: research
Nutritional Support in the Setting of Persistent Inflammation, Immunosuppression, and Catabolism Syndrome (PICS)
AbstractPurpose of ReviewThe Persistent Inflammation, Immunosuppression, and Catabolism syndrome (PICS) is a new phenotype of survivors of critical illness that occurs after major inflammatory insults such as sepsis, severe postoperative complication, and trauma.Recent FindingsThese chronically, critically ill patients suffer from dismal outcomes but little is known about how to prevent or treat this syndrome. Through a recently awarded P50 grant the University of Florida aims to produce translational research to understand the etiology and therapeutic intervention for PICS.SummaryIn creating awareness of nutritional suppl...
Source: Current Surgery Reports - August 7, 2016 Category: Surgery Source Type: research
Nutritional Support in the Settingd of Persistent Inflammation, Immunosuppression, and Catabolism Syndrome (PICS)
AbstractPurpose of ReviewThe Persistent Inflammation, Immunosuppression, and Catabolism syndrome (PICS) is a new phenotype of survivors of critical illness that occurs after major inflammatory insults such as sepsis, severe postoperative complication, and trauma.Recent FindingsThese chronically, critically ill patients suffer from dismal outcomes but little is known about how to prevent or treat this syndrome. Through a recently awarded P50 grant the University of Florida aims to produce translational research to understand the etiology and therapeutic intervention for PICS.SummaryIn creating awareness of nutritional suppl...
Source: Current Surgery Reports - August 7, 2016 Category: Surgery Source Type: research
Advances in Immediate Breast Reconstruction and Reconstruction after Breast Conservation
AbstractPurpose of ReviewThe number of breast reconstruction cases performed in the United States continues to rise every year. The aim of this paper is to give an overview of trends in breast reconstruction after both mastectomy and breast conservation, including highlights of recent advances and new issues.Recent FindingsThe two main types of breast reconstruction are implant-based and autologous approaches. In the United States, implant-based reconstruction is performed more commonly than autologous reconstruction. Historically, implant-based reconstruction has been performed in two stages, but now increasingly is compl...
Source: Current Surgery Reports - August 5, 2016 Category: Surgery Source Type: research
