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February 2019 Briefing – Surgery

Here are what the editors at HealthDay consider to be the most important developments in Surgery for February 2019. 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.

Robotically Assisted Devices Not Approved for Cancer Surgery

THURSDAY, Feb. 28, 2019 (HealthDay News) — The use of robotically assisted surgical devices for breast removal and other cancer-related surgeries is not approved by the U.S. Food and Drug Administration because there is no proof of its safety or effectiveness in such cases, the agency says in a warning to doctors and patients.

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Risk Factors ID’d for Site Infection After Orthopedic Surgery in Seniors

THURSDAY, Feb. 28, 2019 (HealthDay News) — Five risk factors are independently associated with surgical site infection among geriatric patients undergoing elective orthopedic surgery, according to a study published online Feb. 20 in the International Wound Journal.

Abstract/Full Text (subscription or payment may be required)

Intervention Can Reduce Racial Differences in Lung Cancer Care

THURSDAY, Feb. 28, 2019 (HealthDay News) — An intervention that includes race-specific feedback and real-time electronic warnings can reduce racial differences in care for early-stage lung cancer, according to a study published online Feb. 4 in Cancer Medicine.

Abstract/Full Text

Lymphadenectomy Does Not Up Survival in Advanced Ovarian Cancer

WEDNESDAY, Feb. 27, 2019 (HealthDay News) — For patients with advanced ovarian cancer who have undergone intra-abdominal macroscopically complete resection and have clinically negative lymph nodes, lymphadenectomy is not associated with longer overall or progression-free survival, according to a study published in the Feb. 28 issue of the New England Journal of Medicine.

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Editorial (subscription or payment may be required)

Rate of Opioid Rx Stable After Pediatric Outpatient Surgery

WEDNESDAY, Feb. 27, 2019 (HealthDay News) — From 2013 to 2017, the rate of receiving a take-home opioid prescription remained stable after pediatric outpatient surgery as did the dose prescribed, but the maximum take-home dose declined, according to a study recently published in Pain Medicine.

Abstract/Full Text

Kidney Disease Affects Revascularization Outcomes

WEDNESDAY, Feb. 27, 2019 (HealthDay News) — The presence of comorbid chronic kidney disease (CKD) negatively impacts myocardial revascularization outcomes in patients with type 2 diabetes mellitus (T2DM), according to a study published in the Feb. 5 issue of the Journal of the American College of Cardiology.

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Editorial (subscription or payment may be required)

Overlapping Surgery Appears Safe for Common Procedures

TUESDAY, Feb. 26, 2019 (HealthDay News) — Overlapping surgery is not associated with differences in in-hospital mortality or complication rates but is linked to increased surgery length, according to a study published in the Feb. 26 issue of the Journal of the American Medical Association.

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Editor’s Note

FDA: Thermography No Substitute for Mammograms

MONDAY, Feb. 25, 2019 (HealthDay News) — Despite claims to the contrary, thermography should not be used in place of mammography for breast cancer screening, detection, or diagnosis, according to the U.S. Food and Drug Administration.

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2014 to 2017 Saw Improvement in Burnout for U.S. Physicians

MONDAY, Feb. 25, 2019 (HealthDay News) — From 2014 to 2017, there was an improvement in burnout and satisfaction with work-life integration among U.S. physicians, according to a study published online Feb. 22 in the Mayo Clinic Proceedings.

Abstract/Full Text

Preoperative Phone Visits for Cataract Patients Safe, Efficient

MONDAY, Feb. 25, 2019 (HealthDay News) — Phone visits can safely substitute for a standard, in-person history and physical (H&P) in patients undergoing cataract surgery, according to a study published online Feb. 7 in the Journal of General Internal Medicine.

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National Health Spending Set to Increase 5.5 Percent Annually

FRIDAY, Feb. 22, 2019 (HealthDay News) — National health spending is projected to increase at an annual rate of 5.5. percent from 2018 to 2027, with fundamental economic and demographic factors the main drivers, according to a report published online Feb. 20 in Health Affairs.

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Most Patients Do Not Disclose Complementary Medicine Use

FRIDAY, Feb. 22, 2019 (HealthDay News) — Just one-third of users of biologically based complementary medicine (CM) disclose their use to traditional health care providers, according to a review published online Feb. 7 in Scientific Reports.

Abstract/Full Text

One-Third of PCPs Discuss Breast Cancer Treatments With Patients

FRIDAY, Feb. 22, 2019 (HealthDay News) — One-third of primary care providers (PCPs) report participating in breast cancer treatment decisions, according to a study published online Feb. 1 in Cancer.

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Cholecystectomy in Pregnancy Tied to Worse Outcomes

FRIDAY, Feb. 22, 2019 (HealthDay News) — Women who undergo cholecystectomy during the third trimester of pregnancy experience worse outcomes than women who wait until after delivery, according to a study published online Feb. 12 in the Journal of the American College of Surgeons.

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Operative Treatment Seems Most Effective for Adult Lumbar Scoliosis

FRIDAY, Feb. 22, 2019 (HealthDay News) — In as-treated analyses, surgery is superior to nonoperative care at two years among patients with adult symptomatic lumbar scoliosis, according to a study published in the Feb. 20 issue of The Journal of Bone & Joint Surgery.

Abstract/Full Text (subscription or payment may be required)

Editorial

Vertical Integration Has Little Impact on Quality Measures

THURSDAY, Feb. 21, 2019 (HealthDay News) — Vertical integration between hospitals and physicians has little impact on quality measures, while increased hospital market concentration is strongly associated with reduced quality in measures of patient satisfaction, according to a study published online Feb. 9 in Medical Care Research and Review.

Abstract/Full Text

Many Experience Improvement in Sex Life After Bariatric Surgery

THURSDAY, Feb. 21, 2019 (HealthDay News) — About half of women and men who report some level of dissatisfaction with their sexual life prior to bariatric surgery experience clinically meaningful improvement during five years of follow-up, according to a study published online Feb. 20 in JAMA Surgery.

Abstract/Full Text

Editorial (subscription or payment may be required)

Risk for Revision Surgery After Shoulder Replacement Varies

THURSDAY, Feb. 21, 2019 (HealthDay News) — The lifetime risk for revision surgery after elective shoulder replacement surgery varies from 2.7 to 23.6 percent, according to a study published online Feb. 20 in The BMJ.

Abstract/Full Text

Leg Amputation in ESRD Patients Should Prompt Palliative Care Discussion

THURSDAY, Feb. 21, 2019 (HealthDay News) — Nearly one in 10 patients with end-stage renal disease (ESRD) undergoes lower-extremity amputation in their last year of life, according to a study published online Feb. 19 in the Journal of the American Society of Nephrology.

Abstract/Full Text (subscription or payment may be required)

Editorial

New Kaiser Permanente Medical School Plans to Waive Tuition

WEDNESDAY, Feb. 20, 2019 (HealthDay News) — A new medical school to be opened by California-based health system Kaiser Permanente will waive tuition for all students in its first five graduating classes.

The New York Times Article

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Experimental Test May Quickly Diagnose Sepsis

WEDNESDAY, Feb. 20, 2019 (HealthDay News) — A blood test that can quickly diagnose dangerous sepsis infections has been developed, according to research published in the Feb. 1 issue of Biosensors and Bioelectronics.

CNN Article

Abstract/Full Text

Hospital Prices Growing Faster Than Physician Prices

FRIDAY, Feb. 15, 2019 (HealthDay News) — Growth in hospital prices and payments outpaced growth in physician prices and payments from 2007 through 2014, according to a report published in the February issue of Health Affairs.

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Over Half of Hip Replacements Expected to Last 25 Years

FRIDAY, Feb. 15, 2019 (HealthDay News) — In more than half of patients, hip replacements may be expected to last 25 years, while most knee replacements will last 25 years, according to two reviews published in the Feb. 16 issue of The Lancet.

Abstract/Full Text – Hip (subscription or payment may be required)

Abstract/Full Text – Knee (subscription or payment may be required)

Editorial (subscription or payment may be required)

Brief Anesthesia in Infancy Does Not Mar Neurodevelopment

FRIDAY, Feb. 15, 2019 (HealthDay News) — Neurodevelopmental outcomes at 5 years of age are equivalent after brief general anesthesia or awake-regional anesthesia in infancy, according to a study published in the Feb. 16 issue of The Lancet.

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Editorial (subscription or payment may be required)

Cancer Death Risk Up for Kidney Transplant, Dialysis Patients

THURSDAY, Feb. 14, 2019 (HealthDay News) — Dialysis and kidney transplant patients have more than a 2.5-fold increased risk for cancer death, according to a study published online Feb. 14 in the Journal of the American Society of Nephrology.

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Hip Preservation Appropriateness Guidelines May Be Limited

THURSDAY, Feb. 14, 2019 (HealthDay News) — The American Academy of Orthopaedic Surgeons (AAOS) hip preservation surgery appropriateness classification system is driven almost entirely by age and radiographic hip osteoarthritis (OA) evaluation, according to a study published online Jan. 24 in Arthritis Care & Research.

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Improved Outcomes Seen With Liver Grafts From Older Donors

WEDNESDAY, Feb. 13, 2019 (HealthDay News) — From 2003 to 2016, liver graft loss and mortality improved among recipients of liver grafts from older donors, according to a study published online Feb. 13 in JAMA Surgery.

Abstract/Full Text (subscription or payment may be required)

Editorial (subscription or payment may be required)

Health Care Spending Per Person Increased to $5,641 in 2017

TUESDAY, Feb. 12, 2019 (HealthDay News) — In 2017, health care spending per person reached $5,641, according to the Health Care Cost Institute (HCCI) annual Health Care Cost and Utilization Report.

Health Care Cost and Utilization Report

Many Systematic Reviews Do Not Fully Report Adverse Events

TUESDAY, Feb. 12, 2019 (HealthDay News) — Many systematic review protocols in the International Prospective Register of Systematic Reviews (PROSPERO) do not include adverse event reporting, according to a study published in the April issue of the Journal of Clinical Epidemiology.

Abstract/Full Text

Use of Watchful Waiting Up for Low-Risk Localized Prostate Cancer

TUESDAY, Feb. 12, 2019 (HealthDay News) — From 2010 to 2015, there was an increase in use of active surveillance or watchful waiting (AS/WW) rates in men with low-risk and intermediate-risk localized prostate cancer, according to a research letter published online Feb. 11 in the Journal of the American Medical Association.

Abstract/Full Text

Racial/Ethnic, Income Variation ID’d in the Opioid Epidemic

MONDAY, Feb. 11, 2019 (HealthDay News) — There is considerable race/ethnicity and income-level variation in the opioid epidemic, according to research published online Feb. 11 in JAMA Internal Medicine.

Abstract/Full Text – Friedman Study

Abstract/Full Text – Research Letter 1 (subscription or payment may be required)

Abstract/Full Text – Research Letter 2 (subscription or payment may be required)

Editorial (subscription or payment may be required)

Functional Decline Seen for Many Frail Patients After TAVR, SAVR

MONDAY, Feb. 11, 2019 (HealthDay News) — Older patients with severe frailty undergoing transcatheter aortic valve replacement (TAVR) and surgical aortic valve replacement (SAVR) frequently experience subsequent functional decline or lack of improvement, according to a study published online Feb. 4 in JAMA Internal Medicine.

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Editorial (subscription or payment may be required)

Smaller Germinal Centers Identified in Recurrent Tonsillitis

MONDAY, Feb. 11, 2019 (HealthDay News) — Children with recurrent tonsillitis (RT) have smaller germinal centers, according to a study published in the Feb. 6 issue of Science Translational Medicine.

Abstract/Full Text

Women Less Likely to Get Periop Care Before Hip Fracture Surgery

MONDAY, Feb. 11, 2019 (HealthDay News) — Although more women have hip fracture surgery, they are less likely to receive perioperative geriatric care and anesthesia consultations, according to a study published online Feb. 11 in CMAJ, the journal of the Canadian Medical Association.

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Simulation Captures Performance With Multifocal Intraocular Lens

MONDAY, Feb. 11, 2019 (HealthDay News) — Visual simulation in an adaptive optics (AO) environment can capture optical and visual performance with real multifocal intraocular lenses (M-IOLs), according to a study published online Feb. 7 in Scientific Reports.

Abstract/Full Text

Vaccine-Preventable Infections Common After Peds Transplant

FRIDAY, Feb. 8, 2019 (HealthDay News) — Hospitalization for vaccine-preventable infections occurs in more than 15 percent of pediatric solid organ transplant recipients in the first five years after surgery, according to a study recently published in JAMA Pediatrics.

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Certain Opioids Less Effective With SSRI Antidepressants

FRIDAY, Feb. 8, 2019 (HealthDay News) — Certain opioids are less effective for postoperative pain in patients taking selective serotonin reuptake inhibitor (SSRI) antidepressants, according to a study published online Feb. 6 in PLOS ONE.

Abstract/Full Text

Delayed EMS Response Time Tied to Mortality After Car Accident

FRIDAY, Feb. 8, 2019 (HealthDay News) — Longer emergency medical service (EMS) response times are associated with higher rates of motor vehicle crash (MVC) mortality, according to a study published online Feb. 6 in JAMA Surgery.

Abstract/Full Text (subscription or payment may be required)

Editorial (subscription or payment may be required)

FDA: Number of U.S. Women With Breast Implant-Caused Cancer Has Increased

THURSDAY, Feb. 7, 2019 (HealthDay News) — There has been an increase in the number of U.S. women diagnosed with a cancer caused by breast implants, the U.S. Food and Drug Administration said Wednesday.

NBC News Article

More Information: FDA

Letter to Health Care Providers

Shoulder Decompression Surgery Not Recommended

THURSDAY, Feb. 7, 2019 (HealthDay News) — For adults with atraumatic shoulder pain for more than three months diagnosed as subacromial pain syndrome (SAPS), subacromial decompression surgery is not recommended, according to a clinical practice guideline published online Feb. 6 in The BMJ.

Abstract/Full Text

Donor Heart Recovery From Drug-Intoxicated Deaths Has Increased

THURSDAY, Feb. 7, 2019 (HealthDay News) — The percentage of donors from whom hearts were recovered for transplantation who died from drug intoxication increased from 1999 to 2016, according to a study published in the Feb. 7 issue of the New England Journal of Medicine.

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Conservative Management Feasible for Adnexal Masses

THURSDAY, Feb. 7, 2019 (HealthDay News) — The risk for malignancy and acute complications is low for patients with an adnexal mass with benign ultrasound morphology who are managed conservatively, according to a study published online Feb. 5 in the The Lancet Oncology.

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Editorial (subscription or payment may be required)

T2DM Initially Remits in Majority Who Undergo Gastric Bypass

THURSDAY, Feb. 7, 2019 (HealthDay News) — Roux-en-Y gastric bypass (RYGB) is associated with high levels of type 2 diabetes remission at one year, although 27 percent relapse after five years, according to a study published online Feb. 6 in Diabetologia.

Abstract/Full Text

EEG-Guided Anesthesia Does Not Cut Postop Delirium in Seniors

WEDNESDAY, Feb. 6, 2019 (HealthDay News) — For older adults undergoing surgery, electroencephalogram (EEG)-guided anesthetic administration is not associated with a reduction in postoperative delirium, according to a study published in the Feb. 5 issue of the Journal of the American Medical Association.

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Editorial (subscription or payment may be required)

Recommendations Updated for Tonsillectomy in Children

WEDNESDAY, Feb. 6, 2019 (HealthDay News) — Recommendations have been updated for tonsillectomy in children; the revised clinical practice guideline was published in a supplement to the February issue of Otolaryngology-Head and Neck Surgery.

Abstract/Full Text

ERAS Protocol Can Cut Opioid Use After Spine Surgery

WEDNESDAY, Feb. 6, 2019 (HealthDay News) — Implementation of a novel enhanced recovery after surgery (ERAS) protocol can reduce patients’ postoperative opioid requirements after elective spinal or peripheral nerve surgery, according to a study recently published in the Journal of Neurosurgery.

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Blood Type A2 to B Kidney Transplant Feasible

WEDNESDAY, Feb. 6, 2019 (HealthDay News) — Outcomes are similar for blood type A2 to blood type B and B to B deceased donor kidney transplantation (DDKTx), according to a study published online Jan. 30 in the Journal of the American College of Surgeons.

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Gastric Bypass May Aid Muscle Strength, Physical Performance

WEDNESDAY, Feb. 6, 2019 (HealthDay News) — Relative muscle strength and physical function improve meaningfully after gastric bypass, according to a study recently published in the Journal of Clinical Endocrinology & Metabolism.

Abstract/Full Text

California Bill Would Tighten Controls on Children’s Genitalia Surgery

TUESDAY, Feb. 5, 2019 (HealthDay News) — A bill that would place more restrictions on children’s genitalia surgery in California raises serious concerns among doctors in the state. Under the bill, doctors would not be able to treat or perform surgery on children born with genitals that do not match a single gender or are otherwise atypical unless such surgery is medically necessary or the child consents, the Associated Press reported.

AP News Article

Frailty Tied to Liver Transplant Wait-List Mortality in Cirrhosis

MONDAY, Feb. 4, 2019 (HealthDay News) — In patients with cirrhosis, frailty is more frequently observed in those with ascites or hepatic encephalopathy (HE) and is independently associated with liver transplant wait-list mortality, according to a study published online Jan. 19 in Gastroenterology.

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After Elbow Surgery, Children May Be Overprescribed Opioids

MONDAY, Feb. 4, 2019 (HealthDay News) — Opioids may be overprescribed to children after orthopedic surgery for supracondylar humerus fractures, according to a study published in the Jan. 16 issue of The Journal of Bone & Joint Surgery.

Abstract/Full Text (subscription or payment may be required)

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