Objective: The experience of the Sydney Melanoma Unit (SMU) is documented to offer quality assurance (QA) standards and an acceptable range for lymph node yield for regional lymph node dissection (RLND) in melanoma patients.
Summary Background Data: Surgery is the most effective treatment for melanoma involving lymph nodes (LN). QA for RLND procedures, including adequacy of surgery and histopathology, is not well developed. The number of LN removed is one auditable measurement, known as a reliable predictor of surgical quality in other tumors.
Methods: Data were retrieved from the SMU prospective database for patients treated from 1993 to 2006. There were 2039 RLND by SMU surgeons and 324 by non-SMU surgeons. The axilla, groin, cervical dissections of < or = 3 levels (CD < or = 3) and cervical dissections > or = 4 levels (CD > or = 4) were assessed.
Results: At axillary dissection the mean number of LN resected by SMU surgeons was 21.9 (median 21; range 1-83; 90% of cases > or = 10 LN), groin dissection mean 14.5 LN (median 13; range 1-54; 90% of cases > or = 7 LN), CD < or = 3 dissection mean 19.5 LN (median 18.5; range 1-52; 90% of cases > or = 6 LN) and CD > or = 4 dissection mean 38.9 LN (median 36; range 5-103; 90% of cases > or = 20 LN). SMU surgeons retrieved significantly more LN than non-SMU surgeons for axillary and groin dissections (P < 0.0005).
Conclusions: These data benchmark performance for melanoma RLND. Cases with a low node count (below the 90 percentile) should be assessed critically. Standard RLND operations should have a reproducible mean and predictable distribution of LN retrieved.
Background/aims: Alzheimer's Disease (AD) is a progressive neurodegenerative disorder that severely affects cognitive functions and memory. Early detection is crucial for timely intervention and improved patient outcomes. However, traditional diagnostic tools, such as MRI and PET scans, are costly and less accessible.
Introduction: Proactive esophageal cooling reduces injury during radiofrequency (RF) ablation of the left atrium (LA) for the treatment of atrial fibrillation (AF). New catheters are capable of higher wattage settings up to 90 W (very high-power short duration, vHPSD) for 4s. Varying power and duration however does not eliminate the risk of thermal injury.
Background And Purpose: Segmentation imperfections (noise) in radiotherapy organ-at-risk segmentation naturally arise from specialist experience and image quality. Using clinical contours can result in sub-optimal convolutional neural network (CNN) training and performance, but manual curation is costly. We address the impact of simulated and clinical segmentation noise on CNN parotid gland (PG) segmentation performance and provide proof-of-concept for an easily implemented auto-curation countermeasure.
Background: Venous thromboembolism (VTE) is a significant complication following total knee arthroplasty (TKA) and total hip arthroplasty (THA). Aspirin has gained attention as a cost-effective, safe alternative to traditional anticoagulants like enoxaparin, but comparative data on efficacy and safety remain limited.
Methods: This randomized controlled trial compared the efficacy of aspirin and enoxaparin in preventing VTE following TKA and THA.
Introduction: medial patellofemoral ligament reconstruction (MPFLr) is a common surgical procedure for treating patellar instability. Grafts can be fixed to the femur using a bone-tunnel technique with an interference screw. However, this may lead to femoral tunnel enlargement (FTE) post-operatively.
