Home Surgery June 2016 Briefing – Surgery

June 2016 Briefing – Surgery

Here are what the editors at HealthDay consider to be the most important developments in Surgery for June 2016. This roundup includes the latest research news from journal articles, as well as the FDA approvals and regulatory changes that are the most likely to affect clinical practice.

BRCA1 Mutations May Raise Risk of Serous/Serous-Like Uterine CA

THURSDAY, June 30, 2016 (HealthDay News) — Women with BRCA mutations undergoing risk-reducing salpingo-oophorectomy (RRSO) do not have increased risk for uterine cancer, but the risk of serous/serous-like endometrial carcinoma is increased for BRCA1+ women, according to a study published online June 30 in JAMA Oncology.

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Benefits for Robotic-Assisted Laparoscopic Prostatectomy

WEDNESDAY, June 29, 2016 (HealthDay News) — Robotic-assisted laparoscopic prostatectomy is associated with reductions in positive surgical margins, postoperative radiation therapy, and 30-day mortality, according to a study published in the July issue of The Journal of Urology.

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Electronic Record Demands Are Overwhelming Many Physicians

WEDNESDAY, June 29, 2016 (HealthDay News) — Physicians using electronic practice tools report higher rates of burnout and increased frustration with the amount of computerized paperwork, according to research published online June 27 in the Mayo Clinic Proceedings.

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Gastric Bypass Helps Achieve Diabetes Treatment Goals

WEDNESDAY, June 29, 2016 (HealthDay News) — The addition of Roux-en-Y gastric bypass to lifestyle-medical management is associated with improved achievement of treatment goals in type 2 diabetes, according to a study published online June 16 in Diabetes Care.

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Too Many Elderly, Terminal Patients Getting Unnecessary Tx

TUESDAY, June 28, 2016 (HealthDay News) — Patients dying in old age often receive unnecessary end-of-life medical treatments in hospitals, according to research published online June 27 in the International Journal for Quality in Health Care.

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Ultrasound Findings Can Predict Pancreas Transplant Failure

TUESDAY, June 28, 2016 (HealthDay News) — For pancreas transplant recipients, absent or reversed arterial Doppler flow is associated with subsequent transplant failure, according to a study published in the July issue of Radiology.

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Guidance Updated for Sedation of Pediatric Patients

TUESDAY, June 28, 2016 (HealthDay News) — Guidelines have been updated for monitoring and management of pediatric patients before, during, and after sedation, according to a clinical report published online June 27 in Pediatrics.

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Gastric Bypass Cuts Hormonal Responses to Hypoglycemia

TUESDAY, June 28, 2016 (HealthDay News) — Gastric bypass (GBP) surgery is associated with reduced symptoms and neurohormonal responses to hypoglycemia, according to a study published online June 16 in Diabetes.

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Patients Face High Hospital Bills Despite Having Insurance

MONDAY, June 27, 2016 (HealthDay News) — Costs of hospitalization for privately insured adults rose more than 37 percent over five years, with patients paying more than $1,000 on average by 2013, according to research published online June 27 in JAMA Internal Medicine.

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2017 Will Bring Premium Rate Increases Under ACA

FRIDAY, June 24, 2016 (HealthDay News) — Health insurance premiums under the Affordable Care Act will rise in 2017, analysts and insurance brokers say.

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Nerve Transposition Technique Successful in Facial Paralysis

FRIDAY, June 24, 2016 (HealthDay News) — After facial paralysis, mobilization and transposition of the intratemporal segment of the facial nerve for end-to-side coaptation to the hypoglossal nerve can restore facial tone and symmetry, according to research published online June 23 in JAMA Facial Plastic Surgery.

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Adverse Outcomes Up With Kidney Retransplant in HIV+

THURSDAY, June 23, 2016 (HealthDay News) — Primary HIV+ kidney transplant recipients who lose their graft and seek retransplantation (re-KT) have an increased risk of death and graft loss, according to a study published online June 15 in the American Journal of Transplantation.

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Superior Hypogastric Plexus Block Beneficial After Hysterectomy

THURSDAY, June 23, 2016 (HealthDay News) — For women undergoing abdominal hysterectomy, superior hypogastric plexus block with ropivacaine is associated with reduced opioid consumption, according to a study published online June 12 in BJOG: An International Journal of Obstetrics and Gynaecology.

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Materials in Vitreous Seen in About Half of Phaco Cases

WEDNESDAY, June 22, 2016 (HealthDay News) — Materials in the vitreous (MIV) are identified in approximately half of phacoemulsification cataract surgery (phaco) cases, in Berger’s space or the anterior vitreous (AV), according to a study published online June 17 in Clinical & Experimental Ophthalmology.

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Dropping Troponin Test May Up Number of Donor Hearts Available

WEDNESDAY, June 22, 2016 (HealthDay News) — The troponin I blood test that’s used to check the health of a donor heart may not accurately predict if a heart transplant will be successful, according to a study published online June 21 in Circulation: Heart Failure.

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APCs, Doctors Order Low-Value Services With Similar Frequency

WEDNESDAY, June 22, 2016 (HealthDay News) — Advanced practice clinicians (APCs) and physicians order low-value health services with similar frequency, according to a study published online June 20 in the Annals of Internal Medicine.

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25(OH)D Levels Linked to Survival in Pancreatic Cancer

WEDNESDAY, June 22, 2016 (HealthDay News) — Prediagnostic 25-hydroxyvitamin D (25[OH]D) levels are associated with survival in pancreatic cancer, according to a study published online June 20 in the Journal of Clinical Oncology.

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Surgery Tied to Longer Survival for Lung Cancer Patients

TUESDAY, June 21, 2016 (HealthDay News) — Many patients with advanced stage non-small-cell lung cancer (NSCLC) might live longer if treated surgically, but few patients are actually undergoing surgery, according to a study published online June 9 in the Annals of Thoracic Surgery.

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Tips Provided for Leveraging Social Media

TUESDAY, June 21, 2016 (HealthDay News) — During a presentation at the 2016 American Medical Association Annual Meeting, Kevin Pho, M.D., founder and editor of the popular physician blog KevinMD, shared insights into making a difference in health care through use of social media.

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Persistent High Spending Common in Year Before Death

TUESDAY, June 21, 2016 (HealthDay News) — Almost half of older Medicare beneficiaries have high persistent spending throughout the full year before death, according to a study published in the June issue of Health Affairs.

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Study Looks at Recurrence After Laparoscopic Radical Cystectomy

TUESDAY, June 21, 2016 (HealthDay News) — Early unexpected recurrences after laparoscopic radical cystectomy occur in 8.7 percent of patients with favorable pathological characteristics, according to a study published in the June issue of The Journal of Urology.

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TAVI Can Be Performed Without ICU Admission

MONDAY, June 20, 2016 (HealthDay News) — Transcatheter aortic valve implantation (TAVI) can be performed in low-risk patients without admission to the intensive care unit (ICU), according to a study published in the July 1 issue of The American Journal of Cardiology.

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Reset Room Can Help Address Physician Burnout

MONDAY, June 20, 2016 (HealthDay News) — The creation of a reset room is one of several solutions that can help physicians and medical providers address burnout, according to a report published by the American Medical Association.

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Bariatric Surgery Improves Adipose Tissue Function

MONDAY, June 20, 2016 (HealthDay News) — Bariatric surgery is associated with improvements in adipose tissue function, some of which are independent of weight loss, according to research published online June 8 in Obesity Reviews.

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Strategy Needed to Address Impending Physician Shortage

FRIDAY, June 17, 2016 (HealthDay News) — Steps should be taken to combat the impending physician shortage of between 61,700 and 94,700 doctors that the United States is expected to face over the next decade, according to an article published in Medical Economics.

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Number of Circulating Tumor Cells Up After Surgery in SCCHN

FRIDAY, June 17, 2016 (HealthDay News) — Most patients with squamous cell carcinoma of the head and neck (SCCHN) have an increase in the number of circulating tumor cells (CTCs) after surgical resection, according to a study published online June 5 in Head & Neck.

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Race, Procedure Type Impact Morbidity in Pediatric Urologic Sx

FRIDAY, June 17, 2016 (HealthDay News) — Race and procedure type impact 30-day morbidity in pediatric patients undergoing urologic procedures, according to a study published online June 17 in Pediatrics.

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Gross Total Resection for the Best Results in Glioblastoma

FRIDAY, June 17, 2016 (HealthDay News) — More extensive surgeries may best optimize patient survival in glioblastoma multiforme, according to research published online June 16 in JAMA Oncology.

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Enhanced Recovery Pathway Helpful in Gyn-Onc Surgery

FRIDAY, June 17, 2016 (HealthDay News) — An enhanced recovery pathway is beneficial for gynecologic oncology patients undergoing minimally invasive surgery, according to a study published in the July issue of Obstetrics & Gynecology.

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Laparoscopic Nephrectomy Feasible As Outpatient Surgery

FRIDAY, June 17, 2016 (HealthDay News) — Laparoscopic nephrectomy can be safely performed as outpatient surgery in select patients, according to a study published in the June issue of The Journal of Urology.

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Potential Impact of Single-Payer Health Care Discussed

THURSDAY, June 16, 2016 (HealthDay News) — Democratic presidential candidate Bernie Sanders is promoting his version of single-payer health care, although the actual impact of such a system is unclear, according to a report published in Medical Economics.

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Unplanned Readmission for ~8 Percent of Surgical Discharges

THURSDAY, June 16, 2016 (HealthDay News) — Unplanned readmissions occur in about 8 percent of patients discharged from the general surgical service, according to a study published online June 15 in JAMA Surgery.

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Prices for Care Rise Significantly As Multi-Hospital Systems Emerge

THURSDAY, June 16, 2016 (HealthDay News) — Hospital prices in California increased substantially from 2004 to 2013, with a larger increase in hospitals that are members of multi-hospital systems, according to a study published online June 9 in Inquiry.

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Economic Impact of Recurrent Laryngeal Nerve Injury Measured

WEDNESDAY, June 15, 2016 (HealthDay News) — The management of recurrent laryngeal nerve (RLN) injury has a considerable economic impact, according to a study published online June 5 in Head & Neck.

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Reoperation Rate 4 Percent for Mesh-Based Prolapse Surgery

WEDNESDAY, June 15, 2016 (HealthDay News) — For women undergoing mesh-based prolapse surgery, the reoperation rate is 4.0 percent at a median of 1.17 years, with reduced risk for patients of surgeons with very high volume, according to a study published in the July issue of Obstetrics and Gynecology.

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ERs Seeing More Severe Wounds From Gun Violence

WEDNESDAY, June 15, 2016 (HealthDay News) — Injuries from gun violence may be increasing in severity in emergency departments across the United States, according to a research letter published in the June 14 issue of the Journal of the American Medical Association.

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Four-Step Strategy Suggested for Boosting Practice Quality of Care

WEDNESDAY, June 15, 2016 (HealthDay News) — Four steps can help doctors improve patient care and office efficiency, according to a report published by the American Medical Association (AMA).

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Even Short-Term T2DM Remission Reduces Risk of Microvascular Dz

TUESDAY, June 14, 2016 (HealthDay News) — For patients with type 2 diabetes, remission after bariatric surgery is associated with a reduced risk of microvascular disease, even after subsequent relapse, according to a study published online June 6 in Diabetes Care.

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Many Patients Prescribed Opioids Sharing Leftover Pills

MONDAY, June 13, 2016 (HealthDay News) — More than half of patients prescribed opioids receive more than they need, and many share the drugs or fail to store them securely, according to research published online June 13 in JAMA Internal Medicine.

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Type of Shaving Impacts Body Image in Elective Cranial Sx

MONDAY, June 13, 2016 (HealthDay News) — For patients undergoing elective cranial surgery, the rate of surgical site infections is similar for regional and strip hair shaving, but regional shaving negatively affects patient body image, according to a study published in the July issue of the Journal of Clinical Nursing.

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Ultrasound Beats Palpation for Femoral Artery Catheterization

MONDAY, June 13, 2016 (HealthDay News) — For children undergoing heart surgery, real-time ultrasound guidance is superior to a palpation technique for femoral artery catheterization, according to a study published online June 1 in Pediatric Anesthesia.

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Pediatric Unanticipated Admission Incidence 0.97 Percent

FRIDAY, June 10, 2016 (HealthDay News) — The incidence of pediatric unanticipated admissions is 0.97 percent, with about half of admissions related to anesthesia, according to a study published online June 1 in Pediatric Anesthesia.

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Oral Contraceptive Use Ups Surgery Risk in Crohn’s

FRIDAY, June 10, 2016 (HealthDay News) — For females with Crohn’s disease (CD), long-term use of oral contraceptives (OCs) is associated with increased risk of surgery, according to a study published in the June issue of Gastroenterology.

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Patient Experience Linked to Urologic CA Surgical Outcomes

THURSDAY, June 9, 2016 (HealthDay News) — Patient experience is associated with urologic cancer surgical outcomes, according to a study published online June 2 in Cancer.

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Postural Instability Predicts Off-Loading Nonadherence in T2DM

THURSDAY, June 9, 2016 (HealthDay News) — For patients with diabetic foot ulcers (DFUs), off-loading adherence is associated with healing, but postural instability is a powerful predictor of nonadherence, according to a study published online June 6 in Diabetes.

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Early Use of Anesthesia Does Not Lead to Cognitive Deficits in Kids

WEDNESDAY, June 8, 2016 (HealthDay News) — General anesthesia doesn’t seem to harm young children’s mental development, according to research published in the June 7 issue of the Journal of the American Medical Association.

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Review: Similar/Improved Outcomes for TAVI Versus SAVR

TUESDAY, June 7, 2016 (HealthDay News) — Transcatheter aortic valve implantation (TAVI) may be associated with improved clinical outcomes versus surgical aortic valve replacement (SAVR) in adults with severe aortic stenosis, according to a review and meta-analysis published online June 7 in the Annals of Internal Medicine.

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Review Links Tonsillectomy to Risk of Crohn’s Disease

TUESDAY, June 7, 2016 (HealthDay News) — Tonsillectomy is associated with increased risk of developing Crohn’s disease (CD), but not ulcerative colitis (UC), according to a review and meta-analysis published in the June issue of the Journal of Gastroenterology and Hepatology.

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Hip Arthroscopy Often Not the Best Option for Older Patients

MONDAY, June 6, 2016 (HealthDay News) — Many patients in their 60s who have hip arthroscopy need total hip arthroplasty (THA) within two years, according to research published in the April issue of Arthroscopy: The Journal of Arthroscopic and Related Surgery.

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125I Brachytherapy Ups Anastomotic Leakage in Rectal CA

MONDAY, June 6, 2016 (HealthDay News) — For patients with rectal carcinoma, intraoperative iodine-125 seed implantation brachytherapy is associated with increased risk of anastomotic leakage (AL) and pelvic autonomic nerve dysfunction, according to a study published in the June issue of the Journal of Gastroenterology and Hepatology.

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Many Still on Opioids Six Months After Total Joint Arthroplasty

FRIDAY, June 3, 2016 (HealthDay News) — A significant number of patients continue to take prescription opioids many months after joint replacement surgery, according to a study published in the June issue of Pain.

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Too Few Patients Receive Surgical Treatment for Ovarian Cancer

FRIDAY, June 3, 2016 (HealthDay News) — Surgery may significantly extend ovarian cancer patients’ lives, but one in five women do not have the procedure, according to a study published online May 5 in Gynecologic Oncology.

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Post-CABG Infection Risk Up Significantly for Severely Obese

FRIDAY, June 3, 2016 (HealthDay News) — Severely obese patients may have a higher risk of certain complications after coronary artery bypass grafting (CABG) surgery than normal-weight patients, according to a study published online June 1 in the Journal of the American Heart Association.

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Stem Cells Can Restore Motor Function in Stroke Patients

FRIDAY, June 3, 2016 (HealthDay News) — Injecting modified, human, adult stem cells directly into the brain is a safe and effective way to restore motor function in stroke patients long after their stroke occurred, according to a study published online June 2 in Stroke.

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15.5 Million Americans Now Surviving Cancer

FRIDAY, June 3, 2016 (HealthDay News) — Cancer survivors in the United States reached record numbers this year — 15.5 million — and the American Cancer Society predicts they’ll total more than 20 million in another decade. The report, prepared by the American Cancer Society in collaboration with the U.S. National Cancer Institute, was published online June 2 in CA: A Cancer Journal for Clinicians.

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Breast Cancer Survivors Benefit From Mindfulness Meditation

THURSDAY, June 2, 2016 (HealthDay News) — Mindfulness meditation seems to help breast cancer patients better manage symptoms of fatigue, anxiety, and fear of recurrence, according to a study published online May 31 in the Journal of Clinical Oncology.

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New Program May Help Cut UTIs Associated With Catheter Use

THURSDAY, June 2, 2016 (HealthDay News) — A new program may help reduce both urinary catheter use and its associated infections, according to research findings published in the June 2 issue of the New England Journal of Medicine.

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Patients Like to See Physicians Wearing White Coats

THURSDAY, June 2, 2016 (HealthDay News) — Most patients prefer that physicians wear white coats, according to research published online June 1 in JAMA Dermatology.

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Vigilance Urged for Heparin-Induced Thrombocytopenia

WEDNESDAY, June 1, 2016 (HealthDay News) — Diagnosis and management of heparin-induced thrombocytopenia (HIT) are discussed in a review published in the May 31 issue of the Journal of the American College of Cardiology.

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Parathyroidectomy Ups QOL in Primary Hyperparathyroidism

WEDNESDAY, June 1, 2016 (HealthDay News) — Patients undergoing parathyroidectomy for primary hyperparathyroidism (PHPT) have lower quality-of-life (QOL) than controls undergoing thyroid surgery, but QOL improves after surgery, according to a study published in the June issue of Head & Neck.

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