Decompressive Craniotomy and Craniectomy for Brain Trauma
Abstract
Purpose of Review
There is still substantial controversy surrounding the utility of decompressive craniectomy (DC) in patients with traumatic brain injury (TBI). Some surgeons readily perform these operations, while others are more hesitant due to concerns about patient outcomes in severe TBI.
Recent Findings
In this paper, the authors outline recent literature regarding the use of DC in TBI patients, starting with a brief background on surgical methods then examini...
Source: Current Surgery Reports - July 10, 2016 Category: Surgery Source Type: research
Incorporating Shared Decision Making into Perioperative Care of Older Adults
Abstract
Purpose of review
Older patients represent a growing and significant portion of the surgical population. Due to age-related changes in physiology and the presence of multiple comorbidities, older patients are more likely to experience complications, functional decline, increased care needs, and decreased independence following surgery. Identification of risk factors preoperatively permits early use of prevention strategies to mitigate risk, which translates into optimal postoperative outcomes.
...
Source: Current Surgery Reports - July 6, 2016 Category: Surgery Source Type: research
Organ-Specific Nutrition: One for the History Books or Still an Active Player?
Abstract
Purpose of Review
Critical illness frequently involves multi-organ failure and it can be difficult to treat nutritional derangements in these patients. Organ-specific formulas were initially created to meet the specific nutritional needs of critically ill patients. Formulas have been developed to augment pulmonary, pancreas, liver, and renal failure. There is overall minimal evidence evaluating these formulas and many of the studies are small.
Recent Findings
A few ...
Source: Current Surgery Reports - June 29, 2016 Category: Surgery Source Type: research
Surgical Updates on Thoracic Outlet Syndrome
Abstract
Purpose of Review
Thoracic outlet syndrome is a widely recognized, yet highly disputed, syndrome mostly affecting structures of the thoracic outlet, including the brachial plexus, subclavian artery, and subclavian vein. Surgical decompression in the form of first rib resection with scalenectomy remains the mainstay of treatment particularly for venous and arterial thoracic outlet syndrome. This review serves as an update of recent publications/updates in the literature.
Recent Findings
...
Source: Current Surgery Reports - June 29, 2016 Category: Surgery Source Type: research
Update on the Management of Pancreatic Cancer: Determinants for Surgery and Widening the Therapeutic Window of Surgical Resection
Abstract
Purpose of Review
Pancreatic cancer continues to be a disease associated with poor long-term survival. Surgical resection is associated with high morbidity and delays in systemic therapy.
Recent Findings
Recognition of pancreatic cancer as a systemic disease has led to the increased utilization of multimodality therapy and shifting paradigms in the sequence of care. Identification of biomarkers and improved understanding of tumor biology have allowed for improved pa...
Source: Current Surgery Reports - June 7, 2016 Category: Surgery Source Type: research
Management Scheme for Adrenal Incidentalomas: Who Gets What?
Abstract
Purpose of Review
To address the common questions in the evaluation and management of the patient with an adrenal incidentaloma.
Recent Findings
Four sets of guidelines for the management of adrenal incidentalomas have been developed in recent years.
Summary
Adrenal incidentalomas are common and can be discovered via a wide variety of imaging studies performed for myriad reasons; t...
Source: Current Surgery Reports - May 29, 2016 Category: Surgery Source Type: research
Management of the Central and Lateral Neck in Patients with Differentiated Thyroid Cancer
Abstract
Purpose of Review
The incidence of differentiated thyroid cancer, including papillary, follicular, and Hürthle cell histologies, is increasing rapidly in the United States. It is associated with significant risk of locoregional lymph node metastasis; this is especially true for papillary thyroid cancer (PTC), which now accounts for approximately 90 % of all new thyroid cancer diagnoses. Overall, differentiated thyroid cancer is associated with a good prognosis and excellent long-term survival.
...
Source: Current Surgery Reports - May 25, 2016 Category: Surgery Source Type: research
Renal Trauma: When to Embolize?
Abstract
Purpose of Review
The management of solid organ injury continues to evolve from operative therapy to non-operative therapy with the highest success rates seen in the management of blunt renal trauma. Angio-embolization has emerged as an important modality to increase the success rate of non-operative management of kidney injuries.
Recent Findings
There is a paucity of literature defining the optimal indications for renal embolization, but several retrospective revie...
Source: Current Surgery Reports - May 23, 2016 Category: Surgery Source Type: research
Robotic Single-Site Surgery: A Summary of the Current Clinical Experience
Abstract
The robotic single-site platform was released in late 2011 and since then it has been applied in the fields of gynecologic surgery and general surgery. In this review, we include the reported robotic experience in the above-described fields using this platform to perform surgery as well as its advantages and limitations. (Source: Current Surgery Reports)
Source: Current Surgery Reports - May 12, 2016 Category: Surgery Source Type: research
Postoperative Functional Outcomes in Older Adults
Abstract
As the world’s aging population grows, the surgical population is increasingly made up of older adults. Due to changes in physiologic function and increasing comorbidity burden, older adults are at increased risk of morbidity, mortality, and functional decline after surgery. In addition, decision to undergo surgery for the older adult may be based on the postoperative functional outcome rather than survival. Although few studies have evaluated an older adult’s function as a postoperative outcome, surgeons are becoming increasingly aware of the importance of maintaining or regaining function...
Source: Current Surgery Reports - May 3, 2016 Category: Surgery Source Type: research
Management of Hepatocellular Carcinoma (HCC)
Abstract
Hepatocellular carcinoma (HCC) is the fifth most common malignancy worldwide and the third leading cause of cancer-related death. Historically, HCC has been a problem mostly faced by patients from Asian countries due to the high prevalence of hepatitis B (HBV). Increasing global rates of HBV, hepatitis C, and obesity-related non-alcoholic steatohepatitis has caused a global increased incidence in HCC. Potentially curative therapies for HCC include liver resection, liver transplant, and radiofrequency ablation. More advanced HCC may be palliated with transarterial chemoembolization, transcathete...
Source: Current Surgery Reports - May 2, 2016 Category: Surgery Source Type: research
Robotic Colorectal Surgery
Abstract
Surgical innovation is constant, most recently is the introduction of robotic surgery. While the incorporation of minimally invasive surgery in the field of colorectal surgery is generally rapid, robotic surgery is yet to gain momentum in the field. Laparoscopic colorectal surgery is now widely practiced, yet it has its own limitations, specifically in rectal surgery and operating in the pelvis. The advent of robotic surgery comes with hopes to address these limitations at no cost of compromising oncological outcomes. There are abundant reports in the literature on early experiences with the ...
Source: Current Surgery Reports - April 28, 2016 Category: Surgery Source Type: research
Blunt Pediatric Pancreatic Trauma: An Update
Abstract
Blunt pediatric pancreatic trauma is a relatively uncommon problem, and historically has been difficult to manage in a protocolized fashion due to low patient volumes and a heterogeneity of injury severity. Symptoms can be subtle and insidious, and laboratory investigations and imaging studies can be misleading and even normal initially, often leading to a delay in diagnosis. More recently, the American Association for the Surgery of Trauma has standardized injury severity into formal grades, which has made treating and studying pancreatic trauma more manageable. In this review, we discuss the ...
Source: Current Surgery Reports - April 14, 2016 Category: Surgery Source Type: research
Nipple-Sparing Mastectomy: To Spare Or Not To Spare?
This article aims to critically review indications, oncologic safety, and recent advances in operative techniques. Current strategies for minimizing complications of nipple-sparing mastectomy are discussed including incision choices, adjunct tactics, and our experience. (Source: Current Surgery Reports)
Source: Current Surgery Reports - April 10, 2016 Category: Surgery Source Type: research
Update on the Massive Transfusion Guidelines on Hemorrhagic Shock: After the Wars
Abstract
Over the past decade, crystalloid- and red blood cell-dominated massive resuscitation practices have largely been replaced with high-ratio transfusion of plasma, platelets, and red blood cells (RBCs) in massively bleeding trauma patients. Literature from military and civilian experiences with massive transfusion (MT) was reviewed, beginning with military transfusion practices at the onset of the wars in Afghanistan and Iraq and continuing through to present day. Early and balanced resuscitation (1:1:1 ratio of plasma, platelets, and RBCs) is superior to crystalloid- or red blood cell-driven res...
Source: Current Surgery Reports - April 5, 2016 Category: Surgery Source Type: research
