Surgery in Oncology

Octreotide for pancreatic fistula – pro

The principal effects of octreotide include inhibition of growth hormone (GH), glucagon, and insulin. However, there are other effects that have been attemtped to be exploited to therapeutic ends, including to help heal pancreatic and gastreointeistinal fistulas.  Among themare reduction of splanchnic blood flow, and inhibition of release of several gastrointestinal hormones, including serotonin, gastrin, vasoactive intestinal peptide, secretin,

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Electrical stimulation for bone fusion – pro

Data from uncontrolled studies of patients with failed spinal fusion suggests that noninvasive electrical stimulation results in a significantly higher fusion rate. The lack of controlled clinical trials is balanced by the fact that these patients served as their own control. The most common bone stimulators include low-intensity pulsed ultrasound (LIPUS) and pulsed electromagnetic field therapy. Data from a randomized controlled clinical trial of

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Autologous hematopoietic tissue graft – pro

Autologous hematopoietic tissue graft is a collection of stem cells, paltelets and tissue factors that are placed into an operative site to promote healing and prevent infections. Much of the aplication has been in plastic and cardiac surgery as well as in wound healing. There are no guideliens that I could locate, cosnesnsus statemetns or large prospective studies and there are studies that show that this treatment is not effective as well as many

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Bilateral breast cancer – pro

Lay Summary: Bilateral mastectomies followed by standard adjuvant chemotherapy is the prevailing approach for bilateral breast cancer. About 3% or breast cancers present with synchronous bilateral disease IBBC) and 11% are bilateral over the course of a patient's lifetiime.Unlike unilateral breast cancer there are no clear treatment guidelines for BBC.In a recent retrospective review, thirty out of 1100 (2.7%) patients with breast cancer treated

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Prophylactic and reconstructive bilateral mastectomy – pro

Prophylactic mastectomy is the surgical removal of both breasts to help prevent breast cancer. Prophylactic mastectomy is a controversial procedure among members of the medical community. Based on recent scientific findings that show prophylactic mastectomy to be effective at preventing breast cancer, some physicians think that it is sometimes defensible. According to the American Cancer Society Board of Directors, "only very strong clinical and/or

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Treatment of brain metastases – pro

Lay Summary: We overview treatment options for brain metastases. Surgical resection should be considered in patients with single brain metastasis in an accessible location, especially when the size is large, the mass effect is considerable and an obstructive hydrocephalus is present. Surgery is recommended when the systemic disease is absent/controlled and the Karnofsky Performance score is 70 or more (level A recommendation). When the combined resection

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Gastric bypass – pro

As weight loss begins to slow down after gastric bypass, the risk of nutritional problems increases. This is due to dysfunctional or bypassed small bowel. B12 and iron deficiency are two of the most common problems and often do not respond to typical multivitamin supplementation. Iron deficiency after gastric bypass is usually only seen in menstruating women or in patients who are actively and chronically bleeding. Ferritin or iron levels and erythrocyte

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Posttreatment surveillance after hepatic metastases resection for colorectal cancer – pro

There are few guidelines on how to follow metastatic colon cancer patients with no evidence of disease because it is fairly new situation, with wider use of metasatectomy and after new effective drugs came on the scene and there are no mature studies. For high risk non-metastatic colon cancer,  NCCN guidelines for high risk colon cancers recommend annual CT of chest, abdomen and pelvis. Post-surgery surveillance is also warranted following resection

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Taxol carboplatin induction for head and neck cancer – pro

Induction chemotherapy before chemoradiation is becoming standard for many types of head and neck cancer. The role of chemotherapy and radiation for advanced head and neck cancer has evolved considerably over the last 20 years. Several studies, most prominently the Radiation Therapy Oncology Group (RTOG) study 91-11, which was undertaken in collaboration with the Head and Neck Intergroup and published in 2003, established the use of concurrent chemotherapy

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Laparascopic liver resection for benign lesions – pro

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. Perioperative morbidity and mortality and long-term survival after laparoscopic resection  appear to be comparable

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