An audit of re-excision for close or involved margins following breast surgery
Aim: UK guidelines suggest a margin of 1mm is acceptable for patients undergoing breast conservation. In the US no ink at the margin is now recommended. We audited re-excision rates to determine how many patients could be spared further surgery using American guidelines. (Source: International Journal of Surgery)
Source: International Journal of Surgery - July 1, 2018 Category: Surgery Authors: B. Tan, P. Carroll, M. Stein, J. Mansell, D. Murphy, K. Fitzgerald, A. Lannigan, J. Murray Source Type: research
Do all node positive breast cancer patients require axillary clearance after neo-adjuvant chemotherapy (NAC)? A 4-year retrospective study
Aim: To determine the proportion of patients who had disease-free lymph nodes on axillary clearance after (NAC) for node positive breast cancer. (Source: International Journal of Surgery)
Source: International Journal of Surgery - July 1, 2018 Category: Surgery Authors: A. Fitchie, G. Shaaban, N. Redmayne, A. Nagarajakumar, M. Patel, A. Kasem, S. Doddi, P. Sinha Source Type: research
The holistic impact of oncotype DX for patients with an intermediate risk breast cancer: A single centre experience
Aim: Oncotype DX is a NICE approved genomic test for patients who have intermediate risk breast cancer. It provides a ten year distant recurrence risk which provides additional information when considering adjuvant chemotherapy benefits. Few studies have looked at the relationship between the Oncotype DX and Nottingham Prognostic Indicator and we note there is less evidence exploring the impact Oncotype DX makes to patients holistically. (Source: International Journal of Surgery)
Source: International Journal of Surgery - July 1, 2018 Category: Surgery Authors: R. Evans, A. Volleamere Source Type: research
Suitability of referrals to the one stop breast clinic
Aim: With increasing awareness of breast cancer, and concern about breast symptoms, there has been a large rise in the number of new patients being referred to One Stop Breast Clinics across the NHS. This audit aimed to compare the suitability of the new referrals to the One Stop Breast Clinics against the Scottish referral guidelines for suspected cancer (HIS 2014). (Source: International Journal of Surgery)
Source: International Journal of Surgery - July 1, 2018 Category: Surgery Authors: S. Nalagatla, C. Musyoka, M. McKirdy Source Type: research
The effect of applying and sustaining trust level antibiotic prophylaxis guidelines on the surgical site infection (SSI) Rate after level 2 therapeutic mammoplasty in a single tertiary institute
Aim: To Evaluate the effect of applying and sustaining trust level antibiotic prophylaxis guidelines on the surgical site infection (SSI) rate after therapeutic mammoplasty in a single tertiary institute. (Source: International Journal of Surgery)
Source: International Journal of Surgery - July 1, 2018 Category: Surgery Authors: S. Al-Zubaidi, M. Kuzman Source Type: research
Giant juvenile fibroadenoma in a 12-year-old girl treated with breast conserving surgery: Largest reported case in the UK
This case report describes the largest juvenile giant fibroadenoma (GJF) reported in the UK to the authors ’ knowledge. Weighing 1600g and measuring 190 x 160 x 65mm. A 12-year-old girl presented with a rapidly enlarging left breast over 2 months in the absence of nipple discharge, pain or skin changes, she did not have a well-defined palpable mass. Ultrasound scan revealed a large lesion (20cm in its largest diameter) with appearance consistent with a GJF. (Source: International Journal of Surgery)
Source: International Journal of Surgery - July 1, 2018 Category: Surgery Authors: T. Stringfellow, M. Douek Source Type: research
Can the radiological response to neo-adjuvant chemotherapy in the breast predict the pathological response in the axilla?
Aim: To investigate whether complete radiological response (rCR) in the breast to neoadjuvant chemotherapy (NACT) could accurately predict response in the axilla. This would identify those patients who could avoid axillary node clearance and undergo sentinel lymph node biopsy instead. (Source: International Journal of Surgery)
Source: International Journal of Surgery - July 1, 2018 Category: Surgery Authors: T. Stringfellow, D. Elfadl, B. Bhaludin, A. Mera, C. Moss, H. Hamed Source Type: research
The effects of intercostal nerve blocks on post-operative pain outcomes following mastectomy and wide local excision
This study aimed to analyse the effects of ICNB on post-operative pain. (Source: International Journal of Surgery)
Source: International Journal of Surgery - July 1, 2018 Category: Surgery Authors: H. Waddington, R. Wilkes Source Type: research
The diagnostic accuracy of ultrasound guided fine needle aspiration and core needle biopsy in diagnosing axillary lymph node metastasis in the post Z011 era: A systematic review and meta-analysis
Aim: We aimed to compare the diagnostic accuracy of Ultrasound guided fine needle aspiration (US-FNA) and US guided core needle biopsy (US-CNB) in axillary staging. (Source: International Journal of Surgery)
Source: International Journal of Surgery - July 1, 2018 Category: Surgery Authors: I. Balasubramanian, C. Fleming, M. Corrigan, H.P. Redmond, M. Kerin, A. Lowery Source Type: research
Comparison of core needle biposy with post operative histopathology to determination of grading of breast cancer
Aims: We evaluated the diagnostic accuracy of core needle biopsy and concordance with histopathology results for the analysis of suspected breast cancer lesions. Furthermore, we sought to determine the efficacy and sensitivity of core biopsy as a basic diagnostic test. (Source: International Journal of Surgery)
Source: International Journal of Surgery - July 1, 2018 Category: Surgery Authors: S. Gupta, C. Cattra, T. Gate, R. Cochrane Source Type: research
Dedicated under 35 breast clinic: Is this the answer?
Aim: The incidence of new breast cancer rises with age with 62 women diagnosed per 100,000 each year under 40. The updated NICE guidelines advice fast-track referral for all patients presenting with a breast or an axillary lump aged over 30 years. We wanted to determine the efficiency of having a dedicated under 35 breast clinic, where all women under the age of 35 and all male breast patients were seen. Within our hospital this clinic is currently undertaken by a fellow doctor and a specialist breast care nurse, with the support of ultrasound imaging only. (Source: International Journal of Surgery)
Source: International Journal of Surgery - July 1, 2018 Category: Surgery Authors: F. Neamonitou, V. Raghavan, M. Green, J. Reid, C. Allen Source Type: research
Mesenteric ischaemia following cardiac surgery – Is hypoperfusion the greatest risk factor?
Aims: To identify risk factors associated with acute mesenteric ischaemia (AMI) following cardiac surgery. To quantify mortality associated with post-operative AMI. (Source: International Journal of Surgery)
Source: International Journal of Surgery - July 1, 2018 Category: Surgery Authors: C. Bisset, G. Beattie, P. Curry Tags: Cardiothoracic Surgery Source Type: research
Extracorporeal membrane oxygenation is a secure and atraumatic alternative to conventional respiratory support during tracheal resection
Aim: Provision of ventilatory support is challenging during tracheal resection. Conventionally, this is achieved by multiple passes of the endotracheal tube, which limits operative intervals to periods of extubation. Tracheal mucosa is sensitive to compression, and even low-pressure cuff expansion can cause tracheal stenosis. However, it is difficult to ascertain the extent to which this ventilatory technique contributes to post-operative anastomotic complications. (Source: International Journal of Surgery)
Source: International Journal of Surgery - July 1, 2018 Category: Surgery Authors: M. Huang, K. Wallwork, G. Martinez, A. Peryt Source Type: research
Surgical aortic valve replacement significantly improves NYHA status in patients with class II and III obesity
Aim: Aortic stenosis is the most common valvular heart disease in the developed world. Its impact on public health is expected to increase due to aging populations. Rising obesity rates are an independent trend, with 27% of UK adults considered obese. Obese patients are at higher risk of cardiorespiratory disease, often with multifactorial causes of breathlessness. When coupled with AS, it may be difficult to unpick the extent to which valvular disease contributes to their symptoms, and whether surgery would improve them. (Source: International Journal of Surgery)
Source: International Journal of Surgery - July 1, 2018 Category: Surgery Authors: M. Huang, K. Wallwork, K. Bhakhri, P. Catarino Source Type: research
A closed loop audit assessing the prescription of cardiovascular secondary prevention medication after coronary artery bypass grafting (CABG)
Aim: To assess the prescription of cardiovascular secondary prevention medication as per ESC, AHA and NICE guidance at time of discharge for patients who had undergone CABG. (Source: International Journal of Surgery)
Source: International Journal of Surgery - July 1, 2018 Category: Surgery Authors: R. Leatherby, M. Koullouros, M. Shah, A. Singh Source Type: research
