International Journal of Surgery-Oncology最新文献

Obesity is likely to supersede tobacco as the biggest cause of premature death. England has some of the worst figures and trends in obesity compared with the rest of the Europe. Rising obesity prevalence is an international crisis that has the potential to overwhelm health care resources as well as creating enormous human suffering and social cost. This article outlines potential public health policy solutions to this crisis.

Little data exist on effect of undergoing laparoscopic prostatectomy(LP) versus open prostatectomy(OP) upon 30-day mortality rates among low-risk prostate cancer patients.

Materials and methods: Using the National Cancer Database, we identified men (2004 to 2013) with biopsy-proven, low-risk prostate cancer who met the eligibility criteria: N0, M0, T-stage≤2A, PSA≤10 ng/mL, and Gleason score=6. We utilized a 1:N matched case-control study, with cases and controls matched by race, insurance status, Charlson-Deyo comorbidity score, surgical margin status, and facility type to investigate the short-term comparative effectiveness of LP versus OP.

Results: Among the 448,773 patients in the National Cancer Database with low-risk prostate cancer, 116,359 patients met the above inclusion criteria. The target group was restricted to patients who received LP or OP, thus, leaving 44,720 patients for the study. The use of LP (compared with OP) was associated with patients with privately insured patients, treatment at an academic/research centers, high-volume hospitals, and white race (all P<0.01). LP was less frequently utilized for black patients, those who received treatment at community centers, and for those with Medicaid insurance(all P<0.01). The odds ratio of death for surgery type (laparoscopy vs. open) was estimated at 0.31 (95% confidence interval, 0.135-0.701; P<0.05). Thus, the risk of death within 30 days was 69% lower with LP compared with OP.

Conclusions: We found that the 30-day mortality rate among low-risk prostate cancer patients is significantly lower among patients who received LP when compared with OP, with various clinicopathologic parameters associated with its preferential use.

Excessive fat accumulation in the body may impair health leading to a significant long-term health consequences including the development of diabetes, coronary heart disease, and osteoarthritis as well as increasing the risk of developing certain cancers and influencing their outcomes. England has some of the worst figures and trends in obesity compared with the rest of the Europe. In the majority of European countries the trend has increased from 10% to 40% in the last 10 years, whereas in England prevalence has more than doubled. This article outlines the public health impact of rising obesity levels.

Despite increasing popularity of minimal-invasive techniques in the pediatric population, their use in diagnosis and management of pediatric malignancy is still debated. Moreover, there is limited evidence to clarify this controversy due to low incidence of each individual type of pediatric tumor, huge diversity of the disease entity, heterogeneity of surgical technique, and lack of well-designed studies on pediatric oncologic minimal-invasive surgery. However, a rapid development of medical instruments and technologies accelerated the current trend toward less invasive surgery, including oncologic endosurgery. The aim of this article is to review current literatures about the application of the minimal-invasive approach for pediatric tumors and to give an overview of the current status, indications, individual techniques, and future perspectives.

Surgery is the only curative therapy for gastric cancer but most operable gastric cancer presents in a locally advanced stage characterized by tumor infiltration of the serosa or the presence of regional lymph node metastases. Surgery alone is no longer the standard treatment for locally advanced gastric cancer as the prognosis is markedly improved by perioperative chemotherapy. The decisive factor for optimum treatment is the multidisciplinary team specialized in gastric cancer. However, despite multimodal therapy and adequate surgery only 30% of gastric cancer patients are alive at 3 years. This article reviewed the principles of the surgical management of gastric cancer (minimally invasive or open) and how this may optimize multimodal treatment.

Ward rounds permeate health care delivery worldwide and form an important daily activity within all hospitals. In this study, the daily morning ward round in plastic surgery was examined from a teleological and systems point of view.

Methods: Data were gathered from the following sources to inform the systems analysis: patient interviews, staff interviews, direct observations of the ward round on multiple occasions, and through process mapping.

Results: To better understand the ward and its layout, a schematic of it was developed. Following observations of the ward round and the way in which decisions are made on it, an IDEF0 map was developed. Three patients were invited to take part in the study. Three members of staff were interviewed. The overarching themes from the interviews related to aspects of communication which this paper details.

Conclusions: This small-scale study demonstrates how the ward round as a process can be assessed, including product quality, process quality, the measurement and management of capacity, the role of standardization, the role and significance of bottlenecks, the key information flows, including the role of feedback, and the motivation and incentives of system participants and ideas for improvement generated.

Few people truly relish being interviewed. But as a professional, you will go through a number of interviews in your life that will affect your career progression. In this article, we provide some tips on how best to prepare for a medical interview, both in terms of your portfolio and interview practice. Advice is also given on how to maximize performance during the interview and gain the most from reflection afterwards.

Delivering an oral presentation in conferences and meetings can seem daunting. However, if delivered effectively, it can be an invaluable opportunity to showcase your work in front of peers as well as receive feedback on your project. In this "How to" article, we demonstrate how one can plan and successfully deliver an engaging oral presentation.

Reflective practice is a paper requirement of your career progression in health care. However, if done properly, it can greatly improve your skills as a health care provider. This article provides some structure to reflective practice to allow a health care provider to engage more with reflective practice and get more out of the experience.