Complication management with minimally invasive spine procedures.

Spine surgery as we know it has changed dramatically over the past 2 decades. More patients are undergoing minimally invasive procedures. Surgeons are becoming more comfortable with these procedures, and changes in technology have led to several new approaches and products to make surgery safer for patients and improve patient outcomes.

Axillary lymph node failure in patients treated with accelerated partial breast irradiation.

Background: Data on the risk of axillary failure (AF) after accelerated partial breast irradiation (APBI) are limited. In this study, the authors determined the rate of AF and regional lymph node failure (RNF) in patients who received various forms of APBI and identified factors that were associated with its occurrence.

Methods: In total, 534 patients with early stage breast cancer were treated at William Beaumont Hospital with APBI, including 466 patients (87%) with invasive breast cancer and 68 patients (13%) with ductal carcinoma in situ.

Fluoro-2-deoxy-D-glucose positron emission tomography/computed tomography predicts extrahepatic metastatic potential of colorectal metastasis: a practical guide for yttrium-90 microsphere liver-directed therapy.

The objective of this retrospective study was to assess the likelihood of extrahepatic metastases based on tumor metabolic load index (TMLI) for patients with colorectal liver metastases to determine the potential intermediate endpoint of yttrium-90 (Y-90) microsphere liver-directed therapy. Forty-eight (48) patients with colorectal metastatic cancer of the liver who were referred for Y-90 microsphere therapy and F-18 fluoro-2-deoxy-D-glucose positron emission tomography (PET) imaging were included. All patients had baseline computed tomography, hepatic angiography, and planning intra-arterial technetium-99m macro-aggregated albumin scans.

Massive blood transfusion therapy.

Surgical patients requiring massive blood transfusion therapy present many challenges for the anesthetist. The decision to transfuse homologous banked blood and its components must be weighed against the potential complications that may occur in this form of therapy. A review of metabolic changes that occur in banked blood, the risk of infection, and physiologic derangements that may develop during massive blood transfusion are presented.