Surgery in Oncology

Sandostatin for pancreatic fistulas

Among the reffects of Snadostatin is  reduction of blood flow to the Go tract, and inhibition of release of several gastrointestinal hormones, which might decrease leaking from fistulas after surgery and help them heal. Several studies and a meta-analysis looked at this effect.  UNfortunately, the results are mixed and not entirely convincing. A recent Cochrane review of somatostatin analogues (SSAs) for pancreatic surgery concluded that SSAs reduce

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Posttreatment surveillance after hepatic metastases resection for colorectal cancer

Since the appearance of effective new drugs for colorectal cancer and more aggressive surgical approaches to resecting isolated metastases, many patients who had metastatic cancer are now free of disease for an extended period of time. There are few guidelines on how to follow such patients it is fairly new situation and there are no mature studies. For high risk non-metastatic colon cancer, NCCN guidelines recommend annual CT of chest, abdomen

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Taxol carboplatin induction for head and neck cancer

Induction chemotherapy before chemoradiation is becoming standard for many types of head and neck cancer. This is because it allows sparing organs by performing a less extensive surgery on a smaller tumor after it had responded to chemotherapy or no surgery at all and overall effectiveness of treatment remains the same or better. The role of chemotherapy and radiation for advanced head and neck cancer has evolved considerably over the last 20 years.

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Laparascopic liver resection for benign lesions

It is a fairly rare for benign liver lesions to cause pain and there are no specific guidelines for how to treat such situations. However, the literature contains many reports of laparoscopic partial liver resections for non-cancer diagnosis. In experienced hands, laparoscopic liver resection is a favorable alternative to open resection. Surgical morbidity and mortality and long-term survival after laparoscopic resection  appear to be comparable

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Prophylactic Mastectomy in Carriers of BRCA Mutation

Prophylactic total or simple mastectomy for patients at high risk of breast cancer is a difficult issue in that it involves the determination of risk in an individual patient, a separate determination of what level of risk is high enough to justify the extreme choice of prophylactic mastectomy, and assurance from scientific studies in the medical literature that this procedure does result in a reduction of breast cancer occurrence. Mastectomies that

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MRI to screen preoperatively for DCIS

Most guidelines recommend breast MRI for screening in women with genetically high-risk of developing breast cancer and to clarify diagnostic uncertainties after mammography and ultrasound. As use of MRI has increased, many other situations for which, MRI might be helpful came to the fore. Unfortunately, literature support for most of them, is still lacking. One of these new situations is the use of MRI to decide between a mastectomy and the lumpectomy.

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