Background: Breast conservation therapy is a widely accepted approach in treating breast cancer, yet the average re-excision rates are approximately 25% despite surgical advancements. The Food and Drug Administration (FDA)-approved MarginProbe device uses radiofrequency spectroscopy for intraoperative margin assessment, potentially reducing re-excision rates. This study evaluated the effectiveness of MarginProbe in reducing re-excisions compared with standard of care (SOC).
View Article and Find Full Text PDFPurpose: Ischemic complications after nipple-sparing mastectomy (NSM) can be ameliorated by 2-stage procedures wherein devascularization of the nipple-areolar complex (NAC) and lumpectomy with or without nodal staging surgery is performed first (1S), weeks prior to a completion NSM (2S). We report the time interval between procedures in relation to the presence of residual carcinoma at 2S NSM.
Methods: Women with breast cancer who received 2S NSM from 2015 to 2022 were identified.
Background: Asian American (AsAm) women have some of the lowest rates of up-to-date breast cancer screening, and lack of disaggregated racial/ethnic data can mask disparities. We evaluated presentation patterns among AsAms at two hospitals with distinct communities: New York Presbyterian-Queens (NYPQ), in Flushing, Queens and Weill Cornell Medical Center (WCM), on the Upper East Side (UES) neighborhood of Manhattan.
Patients And Methods: Patients with newly diagnosed breast cancer between January 2019 and December 2022 were identified using a prospective database and clinical data collected.
The Asian American Pacific Islander (AAPI) population is a heterogeneous group of people from geographically and ethnically distinct regions of the world. Traditionally, these patients have been reported as one large aggregate in the breast cancer literature under the race category of "Asian." A detailed examination of this group shows compelling evidence that breast cancer manifests differently among Asian ethnic subgroups, resulting in overlooked health disparities when these races are grouped together.
View Article and Find Full Text PDFBackground: Devascularization of the nipple-areola complex (NAC) before nipple-sparing mastectomy (NSM) enhances blood flow to the skin. This study analyzed the effect of the interval between stages in two-stage (2S) operations and compared the ischemic events with those of one-stage (1S) NSM.
Methods: Ischemic complications were defined as partial/reversible (PR) or full-thickness/irreversible (FI) skin necrosis of the NAC or flap.
Radiation-induced breast angiosarcoma, or secondary angiosarcoma (SAS), is a rare entity with a high risk of metastatic recurrence. Herein, we describe the use of intraoperative fluorescence-based skin angiography to guide surgical resection following a novel immunotherapy-based regimen for SAS resulting in a complete pathological response.
View Article and Find Full Text PDFIntroduction: Timing to start of chemoprophylaxis for venous thromboembolism (VTE) in patients with traumatic brain injury (TBI) remains controversial. We hypothesize that early administration is not associated with increased intracranial hemorrhage.
Methods: A retrospective study of adult patients with TBI following blunt injury was performed.
The recent use of placing a BioZorb device during breast conservation surgery has been shown to improve targeting of adjuvant radiation therapy by significantly reducing target volume to the breast. However, the risks of surgical and/or infectious complications related to a BioZorb placement are largely unknown. In this case report, we describe a patient who underwent BioZorb placement after breast lumpectomy for ductal carcinoma in situ (DCIS), who presented with repeated infections and eventual erosion of the BioZorb through her nipple-areolar complex (NAC), requiring surgical debridement and excision of her NAC and BioZorb 1 year postoperatively.
View Article and Find Full Text PDFJ Laparoendosc Adv Surg Tech A
December 2020
The rates of incidental appendiceal neoplasms after appendectomy performed for acute appendicitis is <2%. To date, no large studies have investigated the preoperative risk factors or imaging findings associated with incidental appendiceal tumors that present as appendicitis. Our study aims to identify preoperative factors that are associated with an increased risk of appendiceal tumors in patients who present with signs and symptoms of acute appendicitis.
View Article and Find Full Text PDFIntroduction: To date, there are few reports describing the management of traumatic gynecologic injuries leaving physicians with little guidance.
Objective: Describe the injury patterns and the preferred management of these injuries.
Methods: A retrospective cohort study was performed using the National Trauma Data Bank (NTDB) from years 2011 to 2013.
Background: To identify trends in total and subtotal gastrectomy for middle and distal third gastric adenocarcinoma in the U.S.
Methods: NCDB was queried for patients with stage 0-III middle or distal gastric adenocarcinoma treated with total or subtotal gastrectomy.
Background: The incidence and severity of civilian public mass shooting (CPMS) events continue to rise. Understanding the wounding pattern and incidence of potentially preventable death (PPD) after CPMS is key to updating prehospital response strategy.
Methods: A retrospective study of autopsy reports after CPMS events identified via the Federal Bureau of Investigation CPMS database from December 1999 to December 31, 2017 was performed.
Background: Vascular reconstruction during pancreaticoduodenectomy is increasingly utilized to improve pancreatic cancer resectability. However, few multi-institutional studies have evaluated the morbidity and mortality of arterial and venous reconstruction during this procedure.
Methods: A retrospective analysis was performed utilizing the targeted pancreas module of the American College of Surgeons National Surgical Quality Improvement Program (NSQIP) for pancreaticoduodenectomy from 2014 to 2015.
Introduction: A soft pancreas has been associated with an increased risk of post-operative pancreatic fistula formation. Few studies have evaluated the effect of anastomotic technique (duct to mucosa vs invagination) on fistula formation. This study aims to compare the effect of anastomotic technique on fistula formation among patients with a soft pancreas in a large multiinstitutional database.
View Article and Find Full Text PDFBackground: Bariatric surgery is an effective and durable treatment for obesity. However, the number of patients that progress to bariatric surgery after initial evaluation remains low.
Objectives: The purpose of this study was to identify factors influencing a qualified patient's successful progression to surgery in a U.
Background: Venous thromboembolism, including pulmonary embolism (PE) and deep venous thrombosis, is a leading cause of morbidity and mortality after bariatric surgery. Inferior vena cava filters (IVCFs) have been used as a method to reduce the incidence of clinically significant PEs after bariatric surgery.
Objectives: To compare the incidence of postoperative PEs in patients with IVCFs with those in patients without IVCFs at the time of bariatric surgery.
J Laparoendosc Adv Surg Tech A
January 2019
Background: Robotic surgery has increased in recent years for the treatment of colorectal cancer; however, it is not yet the standard of care. This study aims to compare the 30-day outcomes after robotic colectomy for right-sided colon cancer from our institution with those from a national dataset, the targeted colectomy American College of Surgeons National Surgical Quality Improvement Program (ACS-NSQIP) database.
Methods: Patients undergoing elective, robotic, right colon resection for stage I, II, and III colon cancer were identified within the targeted colectomy ACS-NSQIP database from 2012 to 2014.
Background: Screening for blunt cerebrovascular injuries (BCVIs) in asymptomatic high-risk patients has become routine. To date, the length of this asymptomatic period has not been defined. Determining the time to stroke could impact therapy including earlier initiation of antithrombotics in multiply injured patients.
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