Wide Resection of Extremity/Truncal Soft Tissue Sarcomas
The potentially curative treatment of sarcoma is negative margin wide resection, the clinical tumor with an en bloc margin of surrounding tissue potentially contains microscopic tumor. Planned margins should be 1 to 2 cm but can be less for oncologically equivalent barrier tissues or to preserve an adjacent critical structure. Tumor spillage should be avoided. The role of radiation and/or chemotherapy should be discussed before surgery, as there are potential benefits to preoperative administration. An isolated local recurrence is potentially curable. Amputation is rarely necessary and should only be pursued after other ...
Source: Surgical Clinics of North America - June 23, 2022 Category: Surgery Authors: Ankit Patel, John M. Kane Source Type: research
The Suspicious Soft Tissue Mass
Surgeons are frequently referred patients for the evaluation of a soft tissue mass. Given that “common things occur commonly,” the majority will be benign entities such as a lipoma, epidermal inclusion cyst, hematoma, abscess, ganglion cyst, and such. Surgical excision is often the definitive treatment. However, when the mass is a sarcoma or some other soft tissue neoplasm, surgery as the initial treatment can be suboptimal. Consequently, when the clinical history or physical examination does not fit with a more common benign process, one should pause to consider further workup of the mass prior to surgery. (Source: Su...
Source: Surgical Clinics of North America - June 13, 2022 Category: Surgery Authors: John M. Kane Tags: Preface Source Type: research
Evaluation and Treatment of Massive Hemoptysis
Massive hemoptysis is appropriately defined as life-threatening hemoptysis that causes airway obstruction, respiratory failure, and/or hypotension. Patients with this condition die from asphyxiation, not hemorrhagic shock. Any patient who presents with life-threatening hemoptysis requires immediate treatment to secure the airway and stabilize hemodynamics. Early activation and coordinated response from a multidisciplinary team is critical. Once the airway is secure and appropriate resuscitation is initiated, priorities are to localize the source of the bleeding and gain hemorrhage control. Nonsurgical control of hemorrhage...
Source: Surgical Clinics of North America - June 1, 2022 Category: Surgery Authors: Beau Prey, Andrew Francis, James Williams, Bahirathan Krishnadasan Source Type: research
Minimally Invasive and Sublobar Resections for Lung Cancer
Current guidelines for non –small cell lung cancer (NSCLC) recommend segmentectomy over lobectomy for patients with poor pulmonary reserve or for peripheral nodules less than or equal to 2 cm with adenocarcinoma in situ histology, greater than 50% ground-glass opacity on computed tomography, or radiologic doubling time gr eater than or equal to 400 days. However, emerging data suggest oncologic equivalence of segmentectomy to lobectomy for less than or equal to 2 cm, peripheral stage IA NSCLC regardless of histologic type or radiographic findings. (Source: Surgical Clinics of North America)
Source: Surgical Clinics of North America - June 1, 2022 Category: Surgery Authors: Caroline M. Godfrey, Hannah N. Marmor, Eric S. Lambright, Eric L. Grogan Source Type: research
Epidemiology of Coronary Artery Disease
Although the mortality of coronary artery disease (CAD) has declined over recent decades, CAD remains the leading cause of death in the United States (US) and presents a significant economic burden. Epidemiologic studies have identified numerous risk factors for CAD. Some risk factors –including smoking, hypertension, dyslipidemia, and physical inactivity–are decreasing within the US population while Others, including advanced age, diabetes, and obesity are increasing. The most significant historic advances in CAD therapy were the development of coronary artery bypass graftin g (CABG), percutaneous coronary interventio...
Source: Surgical Clinics of North America - June 1, 2022 Category: Surgery Authors: John P. Duggan, Alex S. Peters, Gregory D. Trachiotis, Jared L. Antevil Source Type: research
