Latest Updates

Principles in Reconstruction after Resection of Extremity and Truncal Sarcomas

Evan Matros, MD, MPH, Jonas A. Nelson, MD
    • Resection and reconstruction of sarcoma defects require a multidisciplinary effort to achieve the oncologic and reconstructive result with the goal of negative margins and stable bony and soft tissue coverage with appropriate function.
    • Although the reconstructive ladder still applies to postresection defects, advances in microsurgical techniques offer options that, although potentially more complex, provide a more stable long-term solution to complex reconstructive challenges.
    • Advances in perforator techniques for reconstruction have afforded improved donor sites with less donor site morbidity as muscle units are not sacrificed.
    • Limb salvage is now the standard of care following lower extremity sarcoma resection and reconstruction.

Basic Concepts of Anesthesia

Pooja Pandya, MD, George P. Yang, MD, PhD
    • Increasing adoption of risk calculators to assess operative risks
    • Use of regional anesthesia approaches to decrease narcotic usage
    • Impact of ERAS pathways on approaches to perioperative management

Basic Concepts of Anesthesia

Pooja Pandya, MD, George P. Yang, MD, PhD
    • Increasing adoption of risk calculators to assess operative risks
    • Use of regional anesthesia approaches to decrease narcotic usage
    • Impact of ERAS pathways on approaches to perioperative management

Antiepileptic and Antidepressant Drugs Used in the Treatment of Pain

Lucia Daiana Voiculescu, MD
    • Gabapentinoids
    • Antiepileptic and antidepressant drugs used in pain therapy: approved indications and off-label use
    • Antiepileptic drugs used as adjuvant analgesics in the perioperative period

Extent of Gastrectomy and Lymphadenectomy for Gastric Adenocarcinoma

Kevin K. Chang, MD, Sam S. Yoon, MD
    • The eighth edition of the AJCC Cancer Staging Manual now includes prognostic information for clinical TNM staging and post–neoadjuvant therapy staging.
    • A D2 lymphadenectomy is frequently recommended as the nodal dissection of choice for locally advanced gastric adenocarcinoma.
    • Laparoscopy-assisted operations are associated with improved overall morbidity and comparable lymph node yield.

Parenteral Nutrition–Associated Liver Toxicity: Prevention, Diagnosis, and Management

Lorenzo Anez-Bustillos, MD, Meredith A. Baker, MD, Duy T. Dao, MD, Gillian L. Fell, MD, Kathleen M. Gura, PharmD, Mark Puder, MD, PhD
    • Fish oil–based lipid emulsions may be efficacious in the treatment of parenteral nutrition–associated liver disease (PNALD).
    • Lipid reduction (e.g., to 1 g/kg/day) does not decrease the incidence of PNALD but does slow its progression.
    • Patients whose cholestasis reverses with fish oil therapy or achievement of enteral autonomy may have stable rather than progressive cirrhosis and should not be transplanted based on biopsy alone.

Pathologic Evaluation of Soft Tissue Sarcoma

Narasimhan P. Agaram, MBBS
    • Concepts of pathologic examination and grading
    • Important diagnostic criteria for each soft tissue sarcoma
    • Latest molecular diagnostic methods used in the diagnosis of sarcomas

OVERVIEW OF ENTERAL NUTRITION

Rebecca Lynch, MS, RD, LDN, CNSC, Erin Sisk, MS, RD, LDN, CNSC
    • Immunomodulating formulas may not offer additional benefits to critically ill patients.
    • Special pulmonary formulas do not improve outcomes for patients with ARDS.
    • Gastric residuals are not a factor in assessing for enteral tolerance as they do not correlate with risk of aspiration and pneumonia.
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