An assessment of different scoring systems in cirrhotic patients undergoing nontransplant surgery.

Background: Determining surgical risk in cirrhotic patients is difficult and multiple scoring systems have sought to quantify this risk. The purpose of our study was to assess the impact of Childs-Turcotte-Pugh (CTP), Model of End-Stage Liver Disease (MELD), and MELD-Sodium (MELD-Na) scores on postoperative morbidity and mortality for cirrhotic patients undergoing nontransplant surgery.

Methods: We performed a single-center retrospective review of all cirrhotic patients who underwent nontransplant surgery under general anesthesia over a 6-year period of time to analyze outcomes using the 3 scoring systems.

Emergency canine surgery in a deployed forward surgical team: a case report.

Introduction: Forward surgical teams (FSTs) perform a variety of non-doctrinal functions. During their deployment to Afghanistan, the 541st FST (Airborne) performed emergency surgery on a German shepherd military working dog (MWD).

Methods: Retrospective examination of a case of veterinary surgery in a deployed FST.

Patient surveillance after treatment for soft-tissue sarcoma.

About 1% of all cancers are soft tissue sarcomas (STS); about 60% of these occur in the extremities. Post-treatment surveillance programs are designed to identify recurrence, new primary cancers, and complications of therapy early enough to increase survival duration and quality of life. The intensity of surveillance varies among surgeons.

Humanitarian assistance in Afghanistan: a prospective evaluation of clinical effectiveness.

Objective: To examine the clinical effectiveness of patient encounters during humanitarian assistance (HA) missions performed by the 48th Combat Support Hospital in Afghanistan.

Methods: Data were prospectively gathered from missions in the villages of Aroki (January 21, 2003), Tangee (March 25, 2003), and Turkman (April 22, 2003). Health care providers evaluated the effectiveness of each patient encounter using a data-gathering instrument with clearly defined outcome measures.

Endoscopy in a deployed combat support hospital: maintaining military end-strength.

Objective: The objective was to examine the safety and efficacy of the 48th Combat Support Hospital's use of diagnostic endoscopy in Afghanistan.

Methods: A retrospective review was performed on the medical records of all endoscopy patients treated at the 48th Combat Support Hospital in Bagram, Afghanistan, from December 6, 2002 through June 7, 2003.

Results: Twenty-four patients (male, 21; female, 3; mean age, 35 years) underwent 28 endoscopic procedures as follows: colonoscopy, 14; esophagogastroduodenoscopy (EGD), 13; and flexible sigmoidoscopy, 1.

Operation Enduring Freedom: the 48th Combat Support Hospital in Afghanistan.

Objective: To examine the experience of the 48th Combat Support Hospital (CSH) while deployed to Afghanistan, with an emphasis on trauma care.

Materials And Methods: Before redeployment, a retrospective review was performed on the medical records of all patients treated at the 48th CSH from December 6, 2002 through June 7, 2003.

Results: During the 6-month period, 10,679 patients were evaluated and/or treated.

Surgical caseload in army general surgery programs: a 10-year retrospective.

Purpose: Over the past decade, the Army Medical Department (AMEDD) has been affected by a military-wide drawdown. The volume and acuity of patients appears to be declining, raising questions regarding quantity and quality in Army surgical training programs. The purpose of this study is to examine the caseloads of Army general surgery programs compared with national averages, and to compare the board examination performance of Army residents with national pass rates.

Long-term management of patients after potentially curative treatment of extremity soft tissue sarcoma: practice patterns of members of the Society of Surgical Oncology.

The optimal strategy for follow-up of extremity soft tissue sarcoma patients after primary treatment with curative intent is not known. The 1592 members of the Society of Surgical Oncology (SSO) were sent a survey to determine their practices. Office visits and chest X-rays were the most frequently performed items for all years.

Secondary operations are frequently required to complete the surgical phase of therapy in the era of breast conservation and sentinel lymph node biopsy.

Background: Breast conservation therapy (BCT) is an oncologically equivalent and cosmetically preferable alternative to mastectomy for most early-stage breast cancers. The number of operations required to complete the surgical phase of therapy with BCT has not been widely reported.

Methods: From our institutional tumor registry, we reviewed the records of all patients receiving primary surgical therapy for breast cancer from January 1, 1998, to June 30, 2002.

Extremity soft tissue sarcoma patient follow-up: tumor grade and size affect surveillance strategies after potentially curative surgery.

A large recent survey disclosed considerable variation in the intensity of follow-up after potentially curative surgery for extremity soft tissue sarcoma among highly credentialed clinicians. The source of the variation is not known. The survey was reanalyzed to investigate whether tumor grade and size account for the variation.

Predictive value of intraoperative touch preparation analysis of sentinel lymph nodes for axillary metastasis in breast cancer.

Background: Accurate intraoperative diagnosis of axillary malignancy facilitates completion axillary lymph node dissection (ALND) at the time of initial surgery. The capability to address both the primary tumor and axillary disease in a single procedure offers several advantages. This study was designed to define the predictive value of intraoperative touch preparation analysis of sentinel lymph nodes for axillary metastasis in breast cancer and to evaluate the ability of the technique to facilitate accurate synchronous ALND.

How surgeon age affects surveillance strategies for extremity soft tissue sarcoma patients after potentially curative treatment.

Background: The optimal strategy for follow-up of extremity soft tissue sarcoma patients after potentially curative treatment remains unknown. We investigated whether the date of completion of formal surgical training affects choice of surveillance strategy.

Materials And Methods: The 1,592 members of the Society of Surgical Oncology were asked how often they use 12 separate surveillance modalities during years 1-5 and 10 postsurgery.