0
This Month in Archives of Surgery |

This Month in Archives of Surgery FREE

[+] Author Affiliations

Section Editor: Gerald W. Peskin, MD
Section Editor: Gerald W. Peskin, MD


Arch Surg. 2004;139(3):239. doi:10.1001/archsurg.139.3.239.
Text Size: A A A
Published online

An argument continues to rage regarding the use of octreotide for the prevention of fistulae following pancreatic resection; the Europeans claim that there is value to this therapeutic regimen, whereas in the United States, the studies conducted have shown disappointing results. Dr Suc and colleagues have organized a prospective, multicenter randomized study of this problem, suggesting that octreotide is useful when the main duct is less than 3 mm in diameter and when pancreatoduodenectomy is completed by pancreatojejunostomy. Please see the invited critique by Dr John Windsor of New Zealand.

Dr Spitzer and colleagues, from the Kaiser Permanente Medical Center, Oakland, Calif, have attempted to classify paraspinal tumors according to sacral levels. They have devised a 6-level anatomical classification system based on tumor location, which they feel allows surgeons to anticipate specific problems and evaluate risks of resection and complications.

See Article

PHOTODYNAMIC THERAPY FOR CARCINOMA IN SITU OF THE ANUS

Drs Webber and Fromm of Wayne State University, Detroit, Mich, have come up with a treatment for anal carcinoma in situ in a group of patients who are at high risk for recurrence irrespective of their initial treatment. All were seropositive for the human immunodeficiency virus and were kept free of advancing disease for at least 5 months by the use of photodynamic therapy.

See Article

PANCREATICOGASTROSTOMY DECREASED RELAPAROTOMY CAUSED BY PANCREATIC FISTULA AFTER PANCREATICODUODENECTOMY COMPARED WITH PANCREATICOJEJUNOSTOMY

In this retrospective clinical trial, 250 patients underwent pancreaticoduodenectomy with 83 undergoing pancreaticojejunostomy and 167, pancreaticogastrostomy. Oussoultzoglou et al found that pancreaticogastrostomy is a safe method of reconstruction after pancreaticoduodenectomy, with a significantly lower rate of pancreatic fistula and relaparotomy.

See Article

THE EFFECT OF AN INTERMEDIATE CARE UNIT ON THE DEMOGRAPHICS AND OUTCOMES OF A SURGICAL INTENSIVE CARE UNIT POPULATION

Dr Eachempati and associates point out that opening an intermediate care unit resulted in an increased overall acuity of the surgical intensive care unit population, optimized the use of hospital resources, permitted expansion of emergency or tertiary care services, and improved outcomes for critically ill surgical patients.

See Article

LONG-TERM RESULTS OF HEPATIC RESECTION FOR HEPATOCELLULAR CARCINOMA ORIGINATING FROM THE NONCIRRHOTIC LIVER

The controversy over the appropriate treatment for a small lesion or lesions in patients with noncirrhotic livers harboring hepatocellular carcinoma is resolvable only after appropriate numbers of livers are available for transplantation. Meanwhile, Dr Chang and colleagues suggest that in early disease, patients with noncirrhotic livers had a significantly better survival rate than patients with cirrhotic livers and that hepatic resection is a reasonable first-line treatment, with transplantation reserved as salvage treatment for patients with recurrent disease after resection.

Tables

References

Correspondence

CME
Meets CME requirements for:
Browse CME for all U.S. States
Accreditation Information
The American Medical Association is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians. The AMA designates this journal-based CME activity for a maximum of 1 AMA PRA Category 1 CreditTM per course. Physicians should claim only the credit commensurate with the extent of their participation in the activity. Physicians who complete the CME course and score at least 80% correct on the quiz are eligible for AMA PRA Category 1 CreditTM.
Note: You must get at least of the answers correct to pass this quiz.
You have not filled in all the answers to complete this quiz
The following questions were not answered:
Sorry, you have unsuccessfully completed this CME quiz with a score of
The following questions were not answered correctly:
Commitment to Change (optional):
Indicate what change(s) you will implement in your practice, if any, based on this CME course.
Your quiz results:
The filled radio buttons indicate your responses. The preferred responses are highlighted
For CME Course: A Proposed Model for Initial Assessment and Management of Acute Heart Failure Syndromes
Indicate what changes(s) you will implement in your practice, if any, based on this CME course.
NOTE:
Citing articles are presented as examples only. In non-demo SCM6 implementation, integration with CrossRef’s "Cited By" API will populate this tab (http://www.crossref.org/citedby.html).
Submit a Comment

Multimedia

Some tools below are only available to our subscribers or users with an online account.

Related Content

Customize your page view by dragging & repositioning the boxes below.

See Also...