“Stroke is the third leading cause of death and the most common cause of long‐term disability. Severe narrowing (stenosis) of the carotid artery is an important cause of stroke. Surgical treatment (carotid endarterectomy) may reduce the risk of stroke, but carries a risk of operative complications. This is an update of a Cochrane Review, originally published in 1999, and most recently updated in 2017.” (Rerkasem)
“Recurrent laryngeal nerve (RLN) paralysis is the most common and significant complication of thyroid or parathyroid cancer surgery. Unilateral RLN paralysis is often due to the adhesions that accompany thyroid cancer. Even with no signs of paralysis preoperatively, a cancerous thyroid gland may be found firmly adherent to RLN intraoperatively, in which case a segment of RLN must be sacrificed for the sake of cancer eradication.””Recurrent laryngeal nerve (RLN) paralysis is the most common and significant complication of thyroid or parathyroid cancer surgery. Unilateral RLN paralysis is often due to the adhesions that accompany thyroid cancer. Even with no signs of paralysis preoperatively, a cancerous thyroid gland may be found firmly adherent to RLN intraoperatively, in which case a segment of RLN must be sacrificed for the sake of cancer eradication.”
Acute variceal bleeding is the major cause of mortality in patients with cirrhosis. The standard medical and endo-scopic treatment has reduced the mortality of variceal bleeding from 50% to 10–20%. The refractory variceal bleedis either because of failure to control the bleed or failure of secondary prophylaxis. The patients refractory to standardmedical therapy need further interventions. The rescue therapies include balloon tamponade, self-expanding metalstents (SEMS) placement, shunt procedures, including transjugular intrahepatic portosystemic shunt (TIPS),balloon-occluded retrograde transvenous obliteration (BRTO), and endoscopic ultrasound (EUS) guided coiling.
“Study results indicate that the modified Sugiura procedure is an effective rescue therapy in patients who are not candidates for selective shunts, transhepatic porto-systemic shunt, or transplantation. Emergency settings and decreased liver function are associated with an increased morbidity.”
“Management of interventional radiology catheters has received much less attention in the literature than the techniques of catheter placement. However, this aspect of patient care by interventional radiologists is vitally important in avoiding catheter-related problems.”
Lak KL, Goldblatt MI. Mesh Selection in Abdominal Wall Reconstruction. Plast Reconstr Surg. 2018 Sep;142(3 Suppl):99S-106S. Full-text for Emory users.
Abdominal wall reconstruction is a relevant and important topic not only in plastic and reconstructive surgery, but in the practice of general surgeons. The ideal anatomic location for mesh placement during the repair of ventral hernias has been debated; however, the most common anatomic locations include onlay, inlay, sublay-retromuscular, sublaypreperitoneal, and sublay-intraperitoneal techniques (Alimi)
Surgical Focus 