The impact of a surgical assessment unit on numbers of general surgery outliers.

Aims: Patient care and efficiency outcomes are improved if acute patients admitted to non-specialty (outlier) wards are minimised.1 Assessment units may help to reduce numbers of outlier patients.2 A surgical assessment unit (SAU) was recently established at Middlemore Hospital.

Columnar cell change with atypia (flat epithelial atypia) on breast core biopsy-outcomes following open excision.

Columnar cell change with atypia (CCCA) is a relatively recently recognized pathologic breast entity considered to be a risk factor for subsequent development of breast carcinoma. The aim of this study was to investigate the significance of finding CCCA on breast core biopsy, by establishing the frequency of other breast pathology on subsequently performed surgical excision specimens. All cases with CCCA as the most advanced lesion on core biopsy were reviewed.

Gastric cancer location and histological subtype in Pacific people and Māori defies international trends.

Aims: Gastric cancer location and histopathology in Pacific people (mostly of Samoan, Tongan, Niuean, or Cook Islands origin) and Māori in New Zealand has not been specifically examined.

Methods: A retrospective review of all histologically-proven new cases of gastric adenocarcinoma and gastro-oesophageal adenocarcinoma at Middlemore Hospital (Auckland, New Zealand) from June 2003-June 2009 was conducted. Demographic data, clinical presentation, diagnostic/ staging investigations and surgical outcomes were recorded.

The role of ultrasound in the management of breast disease.

Surgeon-performed ultrasound has also been increasingly utilised by breast surgeons in particular, who find ultrasound an invaluable tool in the office to assist in the management of breast patients, and also in the operating room where it can be used to directly guide excision of impalpable breast lesions without the use of hookwires. In the future, the role of ultrasound will continue to grow, particularly with the advent of 3-D ultrasound, and in the evolving area of breast lesion ablation techniques using modalities such as radiofrequency ablation or laser therapy. Ultrasound is a very important tool in the assessment and management of breast disease and it has dramatically changed the way breast cancer patients are managed.

Intraoperative ultrasonography-guided excision of nonpalpable breast lesions.

Background: The use of intraoperative ultrasonography (US) to localize and guide excision of nonpalpable breast lesions has advantages over other techniques. It avoids the need for additional resources and minimizes patient morbidity.

Methods And Results: The technique of surgeon-performed US-guided excision as described in this report is straightforward and safe, easily reproducible, and suitable for teaching.

Accuracy of sentinel node biopsy for breast cancer using blue dye alone.

Blue dye alone (BDA), lymphoscintigraphy alone, or, a combination of the two techniques are used for sentinel node biopsy (SNB) in breast cancer. This study reviews the effectiveness of the SNB technique using BDA by measuring the node identification rate and comparing the cohort node positivity with expected rates from established nomograms. A consecutive case series was examined from the database.