surgery

Things aren’t always what they seem.  Why should this colloquialism be any different in the medical realm?

Incidental findings are rather commonplace.  Meaning:  When exploring one diagnostic avenue for a symptom, another existing often more significant issue presents itself unrelated to the initial event.

This is exactly what has been reported by the Japanese Society of Neuropathology.  In a recent published case report, the authors describe an adolescent female who—while undergoing an emergency surgery for appendicitis— was discovered to have large, bilateral, mostly cystic ovarian masses (aka tumors).  

Three months later they were removed.  The mature cystic teratoma of her ovary...

This week a meta-analysis in JAMA Surgery looked at Prevalence and Causes of attrition among surgical residents [1] Here are the highlights:

•    There were nineteen studies of American surgical residencies, involving about 20,00 residents

•    Attrition rate was about 18 percent with a range of 4.4 to 43.6 percent.

•    The primary causes of attrition were ‘uncontrollable lifestyle,' followed by ‘chose another specialty’ – this data did not lend itself to further statistical analysis.

•    The preponderance of attrition was at the end of post-graduate years-one year (PGY-1) (48 percent ) and two (28 percent).

•    Only 20 percent of the residents leaving continued in general surgery residencies; anesthesia, plastic surgery, radiology and...

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Last week in JAMA Surgery, A. Rani Elwy PhD and colleagues presented survey results gathered from Veterans Affairs medical center surgeons at three facilities disclosed to families after both minor events (such as blood loss) and major adverse events needing to be returned to the operating room, or death.

I was interested in their conclusion:

“Surgeons who perceived an adverse event to be extremely or very serious, also reported being...

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Resecting, or surgically removing, a tumor is a delicate and tricky process. Current methods for getting all the cancer, and sparing normal tissue, is imperfect at best. When a surgeon excises cancerous tissue, it is often evaluated by a pathologist to ensure that the margins are cancer free. If not, it could mean that the patient will need more surgery/radiation, or there is a possibility that the cancer could recur.

In a new study published in ...

a-baby-s-coming-1442263-638x345Antibiotics are commonly thought of as a therapeutic treatment. Patients develop strep throat; they get treated with antibiotics. The same goes for pneumonia or a wound infection. But antibiotics can also be used as prophylaxis.

Often patients are put on an antibiotic regimen, before, during or right after a surgical procedure to reduce the chances of an infection at the surgical site.

In the days before antibiotics, these nosocomial infections were a big fear, but these miracle drugs have since made surgery much safer. Unfortunately, the current state of antibiotic efficacy, and the...

161042133Carpal tunnel syndrome, which affects about three percent of women and two percent of men, is caused by excessive pressure on one of the the nerves in the wrist, and is a common cause of pain, numbness, tingling and weakness in the hand. Although initial treatment for CTS involves wrist splinting, followed by steroid injections, many patients eventually require surgery to treat the condition by removing swollen tissues pressing on the median nerve in the wrist. Now, a...