Articles: surgery.
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General surgeons' attitudes toward breast reconstruction may affect referrals to plastic surgeons. The propensity to refer to plastic surgeons prior to surgical treatment decisions for breast cancer varies markedly across general surgeons and is associated with receipt of reconstruction. In this study, the authors used data from a large physician survey to examine factors associated with general surgeons' propensity to refer breast cancer patients to plastic surgeons prior to mastectomy. ⋯ A large proportion of surgeons do not refer breast cancer patients to plastic surgery at the time of surgical decision-making. Surgeons who have a high referral propensity are more likely to be women, to have a high clinical breast volume, and to work in cancer centers. These data support the importance of comanagement through multidisciplinary care models. Women need more opportunities to discuss reconstructive options to make informed surgical treatment decisions about their breast cancer.
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Journal of neurosurgery · May 2007
Case ReportsDetection of unanticipated intracranial hemorrhage during intraoperative magnetic resonance image-guided neurosurgery. Report of two cases.
The authors report unanticipated intraoperative intracranial hemorrhaging in two pediatric neurosurgical patients. Both children were undergoing elective craniotomies with the aid of intraoperative magnetic resonance (iMR) imaging. In both cases, the ability of iMR imaging to aid in diagnosis allowed prompt and definitive treatment of potentially life-threatening complications. These cases illustrate the ability of iMR imaging to aid in differentiating unexpected and/or unexplained intraoperative events in pediatric neurosurgery.
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Current guidelines for surgeons' decisions about whether to offer cosmetic surgery are ineffective. Therefore, surgeons have to make difficult decisions on a case-by-case basis. The authors sought to identify the patient variables that influence surgeons' decisions in practice. ⋯ Surgeons' decisions about whether to offer elective cosmetic surgery follow systematic rules. By incorporating the factors that surgeons use in their decision making, more effective guidelines about elective cosmetic surgery provision than are presently available could be developed.
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Clinical Trial
[Percutaneous, 2D-fluoroscopic navigated iliosacral screw placement in the supine position: technique, possibilities, and limits].
In pelvic surgery, computer-assisted procedures are currently used predominantly for percutaneous iliosacral screw placement. The aim of this study was to evaluate the possibilities and limits of a 2D-fluoroscopic navigated procedure used for this indication. ⋯ The 2D-fluoroscopic navigated procedure used in this study can be recommended for percutaneous stabilisation of non or minor displaced injuries of the posterior pelvis. This procedure reduces intraoperative radiation exposure and improves intraoperative orientation but does not crucially enhance the precision of screw placement compared to the non-navigated technique. Finally, it is limited by its poor image resolution and lack of three-dimensionality.