MORNING MUSINGS : MEDICINE AS A PROFESSION

At the Royal Marsden, London

Robotic Esophagectomy at RGCI DELHI

PORT INSERTION RGCI

ANJELINA JOLIE'S PREVENTIVE MASTECTOMY GAINS GLOBAL ATTENTION

http://epaper.telegraphindia.com/paper/7-0-23@05@2013-1001.html

Surgical Clinics of North America Volume 90, Issue 4 , Pages xvii-xviii, August 2010

In this issue of Surgical Clinics of North America, a spectrum of liver surgery topics is summarized bringing the reader up to date with the era of modern hepatic resection surgery. The basics of liver anatomy and history are reviewed, along with the current molecular mechanisms of liver ischemia/reperfusion injury relevant to liver transplantation, hepatic trauma, and elective hepatic resections. Hepatic imaging techniques of ultrasound, CT, and MRI have improved and greatly facilitate our diagnostic capabilities for benign lesions and malignancies; however, the conundrum of the subcentimeter indeterminate liver lesion remains. The often confusing nomenclature of hepatic resection surgery was standardized at the 2000 Brisbane, Australia, International Heptao-Pancreato-Biliary Association meeting and is now known as the Brisbane 2000 terminology. Advances in the past decade include the development of laparoscopic liver resection techniques, which have been reported in more than 3000 cases worldwide. Further, robotic liver resection surgery has been described but remains in its infancy. Repair of laparoscopic cholecystectomy injury remains an uncommon but important task for the hepatobiliary surgeon, as is the potentially life-saving emergency hepatic resection for traumatic liver injury. Resection of hepatic colorectal cancer metastases has seen a paradigm shift from a prior emphasis on number of lesions to the present-day focus on sufficient liver remnant and invokes strategies of portal vein embolization and two-stage hepatectomies to increase resectability rates. Current approaches to management of hepatocellular carcinoma continue to evolve, including live donor liver transplantation, selective hepatic resection, ablative techniques, regional liver therapies, and newer systemic chemotherapy. Intrahepatic cholangiocarcinoma is on the rise, and major hepatic resections have been advocated for metastatic neuroendocrine cancers. Successful liver surgery requires a fundamental understanding of liver anatomy, disease pathophysiology, and modern hepatic resection techniques. Two questions always need to be addressed when contemplating hepatic resection surgery that requires both technical expertise and judgment: (1) Can the lesion technically be resected and (2) Should the lesion be resected? https://rapidshare.com/files/3965833881/91_5.rar

Surgical Clinics of North America Volume 87, Issue 2 , Pages xix-xx, April 2007 This issue of the Surgical Clinics of North America is dedicated to surgical trainees at the level of house officers and fellows. The evaluation and management of both benign and malignant diseases of the breast are likely to demand a substantial fraction of a general surgeon's practice, yet general surgery residents frequently receive their breast pathology education in a fragmented fashion. Exposure to outpatient clinics and office-based management (where much of the decision-making processes in breast cancer take place) is limited, and surgical breast procedures are often assigned to junior trainees, who do not necessarily understand the subtle judgment that is required in planning incisions, skin flaps, and extent of breast resections. The surgical chief resident must finish his/her training program with the requisite number of breast procedures documented in their case log, but the majority of them may have been performed during the first half of the residency, and there may have been very little exposure to considerations regarding neoadjuvant therapy versus postoperative adjuvant therapy, postmastectomy radiation, and breast cancer risk reduction. Our goal was to develop a collection of articles that cover essential areas of surgical as well as nonsurgical breast cancer management. We have therefore compiled 18 articles that focus on several important aspects of breast disease management; most of the articles have been coauthored by surgery trainees so that resident-level perspectives are provided. These articles can be categorized in general as having an emphasis on one of the following areas: (1) contemporary surgical treatment strategies (eg, lymphatic mapping and breast reconstruction); (2) new systemic therapy strategies (adjuvant and neoadjuvant); (3) breast cancer risk reduction (surgical and medical); and (4) novel research directions that trainees should consider (eg, disparity-related research and breast tumor ablation techniques).

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