Surgery and Rehabilitation最新文献_第2页

Accuracy of Sentinel Lymph Node Biopsy in Breast Cancer Using Methylene Blue Dye Technique in a Developing Country 发展中国家使用亚甲基蓝染色技术检测乳腺癌前哨淋巴结活检的准确性

Surgery and Rehabilitation Pub Date : 1900-01-01 DOI: 10.15761/srj.1000153

N. Sookar, Neesha Sookar, Jameel Ali

{"title":"Accuracy of Sentinel Lymph Node Biopsy in Breast Cancer Using Methylene Blue Dye Technique in a Developing Country","authors":"N. Sookar, Neesha Sookar, Jameel Ali","doi":"10.15761/srj.1000153","DOIUrl":"https://doi.org/10.15761/srj.1000153","url":null,"abstract":"Introduction: Accurate assessment of the status of the axillary lymph nodes is crucial in staging, planning treatment and determining prognosis in breast cancer. Traditionally this involved total axillary dissection. Recently, in order to decrease morbidity, the technique of Sentinel Lymph Node Biopsy (SLNB) has virtually replaced standard Axillary Lymph Node Dissection (ALND) in T1 and T2 disease with non-palpable axillary lymph nodes. The two commonly applied techniques for SLNB are radio-colloid and dye injection. In our low resource environment, we planned to use the methylene blue dye injection technique to determine the percentages of false negative as well as true positive and true negatives in order to judge the accuracy and guide applicability of this technique in our setting. Methods: We prospectively analysed data from consecutive proven T1 and T2 female breast cancer patients with non-palpable axillary lymph nodes between January and December 2018 at our institution. Exclusion criteria were patients receiving neo-adjuvant treatment, previous breast or axillary radiation, previous axillary surgery and multi-focality. All patients meeting inclusion criteria were assessed by determining the percentage of true positive and negative as well as false negative (by comparing histology of the excised sentinel lymph node with the histology of at least 10 non-sentinel nodes on permanent sections). Demographics such as age of patient, grade of carcinoma, histological subtype and size of tumours were also analysed. Results: 47 patients were studied. T1 stage accounted for 24% of the patients and T2 for 76%. The incidence of axillary metastases (both sentinel and axillary nodes) was found to be 57% (27 of 47). All patients with positive sentinel nodes had at least 2 positive non-sentinel axillary nodes. True negative was 100% (20 of 20) and true positive was also 100% (27 of 27). There were no false negatives. Conclusion: In comparison with other SLNB validation studies, we report a very accurate technique of SLNB in our setting. Our data suggest SLNB using methylene blue dye can be used as a reliable alternative to the costly technique of radioactive colloid. *Correspondence to: Navin Sookar, Department of Women’s Health, St. James Medical Complex, 112 Western Main Road, St. James, Trinidad and Tobago, Tel: (868)-688-6941; E-mail: navin_shawn@hotmail.com","PeriodicalId":369473,"journal":{"name":"Surgery and Rehabilitation","volume":"33 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"1900-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"128464286","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 1

Effective leadership strategies improve length of stay and patient outcomes in total arthroplasty surgery 有效的领导策略可改善全关节置换术的住院时间和患者预后

Surgery and Rehabilitation Pub Date : 1900-01-01 DOI: 10.15761/srj.1000160

S. Radha, I. Afzal, W. Radford

{"title":"Effective leadership strategies improve length of stay and patient outcomes in total arthroplasty surgery","authors":"S. Radha, I. Afzal, W. Radford","doi":"10.15761/srj.1000160","DOIUrl":"https://doi.org/10.15761/srj.1000160","url":null,"abstract":"Prolonged length of stay (LOS) leads to increased costs and reduced income for the hospital, as well as increased costs to the patient. This, in turn, leads to provision of poor quality of care by healthcare organization due to lack of resources. This research aims to review the causes of longer stay of patients in the hospital post Total Hip Arthroplasty (THA) or TJA (Total Joint Arthroplasty) and the effectiveness of the leadership in reducing the length of stay of patients in the hospital. Mixed Method technique has been adopted to analyse the data. Primary data for the qualitative technique has been obtained using Interviews of the experts in the discharge process of the hospital. Quantitative data was collected from the hospital records for two periods: first for the period 6th October 2016 to 27th March 2017, which is prior to interventions and second period from 27th March 2017 to 6th October 2017, which was the period post intervention. Research findings show that effective leadership encourages effective communication between patients, their families and admitting team that leads to avoid discharge delays. Communication by the team leader with the patients and their families is the most effective strategy in quick discharge. The study shows that one channel of communication prior to surgery from the leader of the team will be most effective strategy. Further, effectiveness of the leader is essential to facilitate effective channels of communication regarding discharge process. Flexible leadership is most suited to the healthcare sector. *Correspondence to: Irrum Afzal, South West London Elective Orthopaedic Centre, London, United Kingdom, E-mail: Irrumaafzal@gmail.com Received: December 09, 2019; Accepted: December 26, 2019; Published: January 03, 2020 Introduction A Total Hip Arthroplasty (THA) is an effective procedure to manage arthritis but also to restore quality of life, which typically involves recreational and physically demanding activities. Most of the cost of THA is involved in the Length of Stay (LOS) in hospital, which healthcare providers naturally seek to shorten. In the past decade, the length of in-patient stay following THA has declined from an average of three weeks to four days [1-3]. Mostly recently, emphasis has been placed on Enhanced Recovery After Surgery (ERAS) aiming to reduce the LOS potentially moving towards day case surgery, discharge within 24 hours, following THA. With the growing emphasis on cost efficiency in the health care system, a measure of success after THA for both patients and hospitals has also shifted towards rapid recovery and shorter LOS. Hospitals and healthcare organisations have therefore been encouraging research efforts on improvements in programmes such as ERAS [4]. In a fluid, complex and dynamic environment where patients discharge from hospital occurs, effective leadership has been seen to be pivotal in attaining successful outcome [5]. Effective strategies to identify and overcome ","PeriodicalId":369473,"journal":{"name":"Surgery and Rehabilitation","volume":"1 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"1900-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"129196031","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

24 hours prehabilitation for thoracoscopic surgery; is it enough to improve outcome? 胸腔镜手术前24小时康复;这是否足以改善结果?

Surgery and Rehabilitation Pub Date : 1900-01-01 DOI: 10.15761/srj.1000159

M. Nafady, H. Elkhayat, A. Sz, Mohammed Ma

引用次数: 0

A rare case of peripheral primitive neuroectodermal tumor in palate 上颚外周原始神经外胚层肿瘤一例

Surgery and Rehabilitation Pub Date : 1900-01-01 DOI: 10.15761/srj.1000154

Rajul Ranka, Anuj Jain, A. Gadbail, M. Chaudhary

引用次数: 0

Images from sentinel lymph node mapping with near-infrared fluorescence during robot-assisted laparoscopic hysterectomy for suspicious of cervical cancer 疑子宫颈癌机器人辅助腹腔镜子宫切除术中前哨淋巴结近红外荧光成像

Surgery and Rehabilitation Pub Date : 1900-01-01 DOI: 10.15761/SRJ.1000151

F. Alessandri, M. Tantari, F. Barra, V. Vellone, C. Gustavino, S. Ferrero, M. Centurioni

引用次数: 0