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As 2014 comes to a close, AASPA would like to wish its members, partners and other industry professionals a safe and happy holiday season. As we reflect on the past year for the industry, we would like to provide the readers of the AASPA Newsline a look at the most accessed articles from the year. Our regular publication will resume Jan. 6, 2015.
1. New guideline provides recommendations for breast cancer surgeons
From March 11: Over the past 20 years, rigorous clinical trials have demonstrated that lumpectomy followed by radiation therapy is as effective as mastectomy for the treatment of breast cancer, providing female patients with a breast-conserving treatment option. During lumpectomy, surgeons remove both the primary tumor and a rim of normal tissue surrounding the tumor, referred to as the "surgical margin."
2. App's map of the human body also charts next generation of surgical training
New York Daily News
From Jan. 14: Thanks to 3-D mapping technology you can peek at Central Park, walk the Great Wall of China or even zoom in on the Big Dipper without leaving your sofa. Now a new map lets you explore locations much, much closer to home — like your bones, muscles, brain and heart.
3. Researchers find knee surgeries unnecessary
From Jan. 7: Researchers found that repairing meniscal cartilage in the knee is not effective anymore than a placebo. They suspected that about 500,000 U.S. surgeries might be proved useless. Researchers believe that the most common diagnosis of the knee that requires treatment is a tear in the meniscus.
4. Surgeons perform first aortic valve surgery without opening the chest
From March 18: Surgeons in France report that they have performed the first total endoscopic aortic valve replacement (TEAVR) in 2 human patients. Their paper has been published in the the Journal of Thoracic and Cardiovascular Surgery. In recent years the development of TAVR (transcatheter aortic valve replacement) has attracted enormous attention. But TAVR, which is performed by an interventional cardiologist, is generally restricted to patients who are either not suitable for surgery or at very high risk for surgery. The new paper is the latest indication that surgeons too are now working to limit as much as possible the trauma of aortic valve surgery.
5. Antibiotics instead of surgery for appendicitis in children
The Washington Post
From April 29: Children rushed to hospitals with appendicitis are routinely treated surgically. But a new study indicates that many of them may be able to avoid going under the knife — or more accurately, the laparoscope — and be treated with antibiotics instead. Researchers from Nationwide Children’s Hospital in Columbus, Ohio, offered a choice of surgery or antibiotics to 77 patients with uncomplicated cases of appendicitis over the course of a year. Thirty chose to address the infection with the medication, rather than the traditional surgical procedure. Physicians were able to eliminate the problem in 27 of them, with no recurrence after 30 days.
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6. Potentially fatal complication found in heart valve put in children
From Jan. 28: Pediatric cardiac surgeons at Boston Children’s Hospital are warning the medical community about a potentially fatal problem in children and young adults who received a bioprosthetic valve manufactured by Sorin. The surgeons initially became concerned when a young asymptomatic patient died suddenly after her valve underwent rapid calcification, only 7 months after a routine followup echocardiogram found no signs of blockage.
7. Are a third of knee replacements 'inappropriate?'
Medscape (free login required)
From July 8: One third of total knee replacement surgeries in the United States may be "inappropriate," according to an article published online June 30 in Arthritis & Rheumatism. The findings point to the need for the development of consensus patient selection criteria for the surgery, the authors write.
8. Botulinum toxin for postop afib?
From May 13: Injecting botulinum toxin into the fat pads around the heart after bypass surgery might stave off postoperative atrial fibrillation, a pilot study showed. Patients who received injections of botulinum toxin instead of a normal saline placebo had a significantly lower rate of atrial tachyarrhythmias — including atrial fibrillation and atrial flutter/tachycardia — in the first 30 days, according to Evgeny Pokushalov, M.D., Ph.D., of the State Research Institute of Circulation Pathology in Novosibirsk, Russia.
9. New knee implant saves the ligaments
From July 29: A new total knee replacement that saves all of the ligaments can make a person's knee feel and move just like the original. During a traditional total knee replacement, the surgeon must remove the "island" of bone to which the anterior cruciate ligament (ACL) and the posterior cruciate ligament (PCL) are attached. The new knee features a shape that protects that island of bone and saves the ligaments.
10. Which hysterectomy method is best?
U-T San Diego
From March 25: The belly button is a new entry point for one of the most common surgeries among women. A Scripps Health surgeon recently performed the region’s first two robot-assisted hysterectomy surgeries that use a single incision in a patient’s belly button for access. The procedure is gaining traction nationwide because it creates fewer scars than other techniques, though debate continues about whether it yields meaningful health gains over other minimally invasive surgical techniques. Health providers also note that not every patient is a good fit for the belly-button surgery.
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