Advances in Intraoperative Margin Assessment for Breast Cancer
Abstract
Breast-conserving therapy including partial mastectomy and radiation is commonly performed for patients who are surgical candidates for breast cancer. Although it is as effective as mastectomy for the treatment of early breast cancer, re-excision for positive or close margins is common. This is costly, inconvenient for patients and delays initiation of adjuvant therapies. Commonly used methods for breast tumor localization and optimization of margin assessment include preoperative wire or seed localization, precise specimen orientation, specimen radiography, and cavity shaving. Unfortunately, t...
Source: Current Surgery Reports - March 25, 2016 Category: Surgery Source Type: research
Obesity and Breast Cancer: A Complex Relationship
Abstract
As prevalence of obesity continues to rise in the United States, we are beginning to elucidate the complex role of obesity-associated chronic inflammation, endocrine dysfunction, and hormone production as a driver for increased breast cancer risk. Epidemiological data suggest that obesity (BMI > 30) is associated with increased breast cancer incidence, worse prognosis, and higher mortality rates. Mechanistically, obesity and excess fat mass represent a state of chronic inflammation, insulin resistance, adipokine imbalance, and increased estrogen signaling. This pro-tumorigenic environment ...
Source: Current Surgery Reports - March 20, 2016 Category: Surgery Source Type: research
Post Mastectomy Pain Syndrome Management
Abstract
Post mastectomy pain syndrome is a chronic pain condition that occurs after surgical intervention. This problem has long been underrecognized, however it affects a large percentage of women following treatment of breast cancer. We will discuss risk factors, potential methods for prevention, and current treatment options, as well as potential lessons from other surgical disciplines that can inform management. Further research is needed to define better treatment algorithms and additional options from women who suffer from this condition. (Source: Current Surgery Reports)
Source: Current Surgery Reports - March 18, 2016 Category: Surgery Source Type: research
Fluid Management, Volume Overload, and Gastrointestinal Tolerance in the Perioperative Period
Abstract
This following is an extensive review of the practice of fluid administration in various medical and surgical disease states and the resilience of the intestinal track compared with other organ systems in maintaining preserved function in a fluid-overloaded state. Recent evidence supports a more conservative and even goal-directed fluid treatment strategy in cardiac, pulmonary, and septic medical conditions. However, the evidence is not as strong in favoring a restrictive versus a more liberal fluid strategy in several surgical specialties including general surgery and colorectal surgery. Despi...
Source: Current Surgery Reports - March 18, 2016 Category: Surgery Source Type: research
Redefining Quality of Surgical Care for the Frail Elderly
Abstract
Frailty is a critical factor influencing the health and outcomes of older surgical patients. Current surgical care for these patients is plagued by high morbidity and mortality rates. There is a growing interest in improving the quality of surgical care for older adults which has resulted in several recent advancements. Unique quality indicators for the older surgical population, multidisciplinary consensus on best practices, and an emerging focus on process and outcome measures that matter to older patients are recent contributions to a movement that will redefine the quality of surgical care ...
Source: Current Surgery Reports - March 9, 2016 Category: Surgery Source Type: research
