Articles: surgery.
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Nearly one-third of individuals with epilepsy have drug-resistant epilepsy, treated most effectively with surgery. This study aims to discuss the demographic profile, surgical access, and strategies used in drug-resistant epilepsy in Africa. ⋯ These findings demonstrate the efficacy and long-term benefits of epilepsy surgery in Africa, where epilepsy is a significant public health challenge. The high rates of seizure freedom and reduced seizure frequency from surgery highlight its potential to improve the quality of life for individuals with drug-resistant epilepsy in Africa.
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Whether surgical axillary staging as part of breast-conserving therapy can be omitted without compromising survival has remained unclear. ⋯ In this trial involving patients with clinically node-negative, T1 or T2 invasive breast cancer (90% with clinical T1 cancer and 79% with pathological T1 cancer), omission of surgical axillary staging was noninferior to sentinel-lymph-node biopsy after a median follow-up of 6 years. (Funded by the German Cancer Aid; INSEMA ClinicalTrials.gov number, NCT02466737.).
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Hemipelvectomy is a complex surgery that is usually performed with curative intent. It is rarely performed for palliation in patients with advanced cancer, and its efficacy in achieving palliation is unknown. ⋯ Palliative-intent hemipelvectomy provided palliation in a minority of patients, did not improve function, and had high morbidity and mortality. Patients with small anterior pelvic tumors may benefit from palliative hemipelvectomy; for others, less invasive approaches should be considered whenever feasible.