Journal of surgical oncology
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Comparative Study
Utilization of and charges for robotic versus laparoscopic versus open surgery for endometrial cancer.
To analyze the utilization and hospital charges associated with robotic (RS) versus laparoscopic (LS) versus open surgery (OS) in endometrial cancer patients. ⋯ In this statewide analysis of endometrial cancer patients, the utilization of robotic surgery increased and is associated with higher hospital charges compared to laparoscopic and open procedures.
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Cytoreductive surgery (CRS) and hyperthermic intraperitoneal chemotherapy (HIPEC) provide a promising therapeutic option for selected patients with peritoneal carcinomatosis. The use of intraperitoneal oxaliplatin seems to further improve the efficacy of the combined treatment concept. Nevertheless, additional toxicity might be expected. ⋯ Our data suggest that the use of IP oxaliplatin in the context of CRS and HIPEC does not significantly increase perioperative morbidity and/or mortality rates. Nevertheless, randomized controlled trials are required to determine the optimal intraperitoneal chemotherapeutic regimen regarding toxicity, postoperative complications, and oncological outcome.
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Irreversible electroporation (IRE) has shown promise for ablation of lesions in proximity to vital structures in the preclinical setting. This study aims to evaluate the safety and efficacy of IRE for hepatic tumors in the clinical setting. ⋯ IRE appears to be a safe treatment for hepatic tumors in proximity to vital structures. Further prospective evaluation is needed to determine the optimal effectiveness of IRE in relation to size and technique for IRE of the liver.
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A new classification of pulmonary adenocarcinoma has been recently proposed by the International Association for the Study of Lung Cancer, American Thoracic Society and European Respiratory Society (IASLC/ATS/ERS). This study was undertaken in an attempt to explore the clinical implication of this new classification in Chinese patients. ⋯ We have demonstrated a valuable prognostic role of the new classification in Chinese patients. This new classification is valuable of screening out patients with high risk of recurrence to receive postoperative adjuvant therapy.
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Considerable debate exists as to appropriate perioperative fluid management. Data from several studies suggest that the amount of fluid administered perioperatively influences surgical outcome. Pancreatic resection is a major procedure in which complications are common. We examined 1,030 sequential patients who had undergone pancreatic resection at Memorial Sloan-Kettering Cancer Center. We documented the prevalence and nature of their complications, and then correlated complications to intraoperative fluid administration. ⋯ In this retrospective review of intraoperative fluid administration we were not able to demonstrate a clinically significant association between postoperative complications and intraoperative crystalloid and colloid fluid administration. A randomized controlled trial has been initiated to address this question.