Here are what the editors at HealthDay consider to be the most important developments in Surgery for October 2010. This roundup includes the latest research news from journal articles, as well as the FDA approvals and regulatory changes that are the most likely to affect clinical practice.
Mortality Higher for Primary Spine Surgery Than Revision
FRIDAY, Oct. 29 (HealthDay News) -- Patients undergoing primary posterior spine fusion (PPSF) of the thoracic and lumbar spine have a higher risk of in-hospital death than those undergoing revision posterior spinal fusion (RPSF), according to a study in the October issue of The Spine Journal.
Obesity May Affect Fertility After Vasectomy Reversal
THURSDAY, Oct. 28 (HealthDay News) -- Obese men who have vasectomy reversal have lower serum testosterone levels and more antisperm antibodies than overweight and normal-weight men, but age of their female partners is the only independent predictor of post-surgery pregnancy, according to research published in the October issue of Urology.
Electronic Tracking Ups Capture of Endoscopy Complications
WEDNESDAY, Oct. 27 (HealthDay News) -- An electronic tracking system picks up more outpatient endoscopic-related complications requiring an emergency department visit/hospitalization than does standard physician reporting, according to research published in the Oct. 25 issue of the Archives of Internal Medicine. These visits add substantially to the real cost of endoscopic procedures.
Kidney Stone Risks for Gastric Surgeries Compared
WEDNESDAY, Oct. 27 (HealthDay News) -- Obese patients who undergo gastric banding or sleeve gastrectomy to lose weight are less likely to form kidney stones after the procedure than patients who have the more invasive Roux-en-Y gastric bypass (RYGB) surgery, according to a study in the October issue of Urology.
2 mm Free Margin Minimizes Risk of Residual Disease
WEDNESDAY, Oct. 27 (HealthDay News) -- A free margin of 2 mm from the invasive tumor appears to be associated with a low risk of residual disease in patients undergoing breast-conserving surgery, according to research published in the November issue of the International Journal of Clinical Practice.
Primary Care Trails Other Specialties in Hourly Wages
TUESDAY, Oct. 26 (HealthDay News) -- Primary care physicians have substantially lower hourly wages than other specialists, and although most physicians find Medicare reimbursement inequitable, they show little consensus on how to reform it, according to two studies published in the Oct. 25 issue of the Archives of Internal Medicine.
HealthGrades: Lower Mortality Seen at High-Ranked Hospitals
MONDAY, Oct. 25 (HealthDay News) -- Patients at hospitals performing better than average on a variety of procedures and diagnoses have a lower risk of mortality compared to patients at low-performing hospitals, according to research released Oct. 20 by HealthGrades.
Elective Bilateral Salpingo-Oophorectomy Has Decreased
MONDAY, Oct. 25 (HealthDay News) -- The proportion of women electing to undergo bilateral salpingo-oophorectomy has dropped significantly since 2002 after increasing in prior years, though the risks versus the benefits have not been clearly established, according to a study in the November issue of Obstetrics & Gynecology.
Field of Orthopedic Surgery Found Lacking in Diversity
FRIDAY, Oct. 22 (HealthDay News) -- The field of orthopedic surgery is less diverse than other specialties, employing fewer minorities and the lowest percentage of women, according to research published in the Oct. 6 issue of the Journal of Bone & Joint Surgery.
Sleep Apnea Increases Risk of Post-Surgery Complications
THURSDAY, Oct. 21 (HealthDay News) -- A questionnaire to assess the risk for obstructive sleep apnea syndrome (OSAS) can help identify surgery patients who are at higher risk for postoperative cardiac and pulmonary complications, according to a study in the October issue of the Archives of Otolaryngology -- Head & Neck Surgery.
Infusion Ups Risk of Organ Failure in Trauma Patients
THURSDAY, Oct. 21 (HealthDay News) -- Early transfusion of fresh frozen plasma (FFP) is associated with an increased risk of post-injury multiple organ failure (MOF), according to research published in the October issue of the Archives of Surgery.
Psychiatric Comorbidity Ups 30-Day Surgical Mortality
THURSDAY, Oct. 21 (HealthDay News) -- Surgical patients with a preexisting psychiatric comorbidity have a greater 30-day post-surgical mortality risk, according to research published in the October issue of the Archives of Surgery.
Hospital Compare Web Site May Offer Limited Patient Guidance
WEDNESDAY, Oct. 20 (HealthDay News) -- The use of information available on the Hospital Compare Web site doesn't help patients find hospitals that have better outcomes for high-risk surgeries, according to research published in the October issue of the Archives of Surgery.
VHA Training Program Cuts Surgical Mortality
WEDNESDAY, Oct. 20 (HealthDay News) -- A nationwide Veterans Health Administration (VHA) team training program for operating room personnel cuts surgical mortality by 18 percent, according to research published in the Oct. 20 issue of the Journal of the American Medical Association.
Study Seeks Factors in 'Never-Event' Medical Errors
TUESDAY, Oct. 19 (HealthDay News) -- Wrong-patient and wrong-site procedures -- which are surgical "never events" -- may be continuing at a high frequency, according to research published in the October issue of the Archives of Surgery.
Cervical Spine Procedure Safe on Outpatient Basis
FRIDAY, Oct. 15 (HealthDay News) -- One-level anterior cervical discectomy and fusion (ACDF) may be safely performed on an outpatient basis with a four-hour postoperative observation period, according to a study published in the October issue of the Journal of Spinal Disorders & Techniques.
Stent and CABG Patients Have Similar Mortality Risk
THURSDAY, Oct. 14 (HealthDay News) -- Patients with unprotected left main coronary artery (LMCA) disease who undergo percutaneous coronary intervention (PCI) with stent implantation have similar long-term mortality risk, but a substantially higher revascularization risk, than those who undergo coronary artery bypass grafting (CABG), according to a study published in the Oct. 19 issue of the Journal of the American College of Cardiology.
Percutaneous Ventricular Assist Device Effective
THURSDAY, Oct. 14 (HealthDay News) -- Implantation of a percutaneous ventricular assist device (pVAD) can rapidly improve hemodynamic parameters in patients with severe refractory cardiogenic shock (SRCS) despite intra-aortic balloon pump (IABP) and vasopressor support, according to research published online Oct. 13 in the Journal of the American College of Cardiology.
Evidence Supports Early Spinal Stabilization Surgery
WEDNESDAY, Oct. 13 (HealthDay News) -- In patients with multiple trauma, early surgical stabilization of the spine is associated with a variety of improved outcomes, according to research published in the Oct. 1 issue of Spine.
Transfusion Policies for Cardiac Surgery Vary in U.S.
TUESDAY, Oct. 12 (HealthDay News) -- Transfusion practices vary widely among institutions providing cardiac surgery, but a restrictive perioperative transfusion status does not appear to be inferior to a more liberal transfusion strategy in terms of 30-day morbidity and mortality, according to two studies published in the Oct. 13 issue of The Journal of the American Medical Association.
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Peripheral Artery Disease Procedures Recurrent, Costly
WEDNESDAY, Oct. 13 (HealthDay News) -- Peripheral artery disease (PAD) carries a high economic burden, with many asymptomatic patients going on to experience an ischemic event requiring hospitalization and many symptomatic patients requiring one or more revascularizations and other procedures, according to research published online Oct. 12 in Circulation: Cardiovascular Quality and Outcomes.
Word Choice Influences Patient Perception of Prognosis
MONDAY, Oct. 11 (HealthDay News) -- The way clinicians explain a patient's back pain may influence the patient's perceived prognosis and uptake of therapy; sticking with language used in radiology reports may be more helpful than using degenerative terms, such as "wear and tear," according to research published in the Oct. 1 issue of Spine.
Anti-PE Benefit Seen From Inferior Vena Cava Filters
FRIDAY, Oct. 8 (HealthDay News) -- The prophylactic use of inferior vena cava filters (IVCFs) appears safe and effective in preventing pulmonary embolism (PE) in patients undergoing major spinal surgery who are at high risk, according to research published in the Sept. 15 issue of Spine.
Quality of Life Varies by Prostate Cancer Treatment
FRIDAY, Oct. 8 (HealthDay News) -- Radical prostatectomy, external-beam radiotherapy, and brachytherapy result in several quality-of-life (QoL) issues after prostate cancer treatment in patients not receiving adjuvant hormonal treatment, including either improvement in or worsening of urinary irritative-obstructive symptoms in addition to the more commonly discussed sexual and incontinence issues, according to research published online Oct. 4 in the Journal of Clinical Oncology.
Stress Testing Common in Years After Revascularization
FRIDAY, Oct. 8 (HealthDay News) -- The majority of patients undergoing coronary revascularization are likely to have a stress test in the following two years, with relatively few requiring repeat revascularization, according to research published in the Oct. 12 issue of the Journal of the American College of Cardiology.
Cesarean Rates in England Vary Considerably
THURSDAY, Oct. 7 (HealthDay News) -- An analysis of cesarean deliveries among different National Health Service (NHS) trusts in England found that, while maternal characteristics differ among the trusts, variation remains, even after adjusting for these characteristics. The researchers recommend examining issues linked to emergency procedures; their work was published Oct. 6 in BMJ.
Religiosity May Improve Survival After Liver Transplant
THURSDAY, Oct. 7 (HealthDay News) -- In individuals who undergo a liver transplant, religiosity is associated with prolonged survival after transplantation, according to a study published in the October issue of Liver Transplantation.
Scoliosis Surgery Can Offer Benefits in Middle-Aged
WEDNESDAY, Oct. 6 (HealthDay News) -- Patients with symptomatic scoliosis who are 40 or over are likely to have improvements from surgical treatment, though complications are common, according to research published in the Sept. 15 issue of Spine.
Increasing Catheter Size Tied to Greater Thrombosis Risk
WEDNESDAY, Oct. 6 (HealthDay News) -- Previous deep vein thrombosis (DVT) and increasing catheter size are related to an increased risk for peripherally inserted central catheter (PICC)-associated DVT, according to a study in the October issue of Chest.
AHA Issues Arterial Closure Device Recommendations
TUESDAY, Oct. 5 (HealthDay News) -- The number and quality of clinical studies on arterial closure devices (ACDs) for cardiovascular procedures limits their widespread use, but new recommendations issued by the American Heart Association are intended to aid cardiologists considering use of these technologies. The recommendations were published online Oct. 4 in Circulation.
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