Summary and conclusionsNeedle aspiration with immediate cytological reporting has been practised in a breast clinic for one year. Patients benefit by receiving immediately the provisional diagnosis and, when indicated, appointments for metastatic surveys. Close co-operation between surgeon and cytologist has resulted in increased skill in aspiration, better preparation of samples, and greater accuracy in interpretation of reports.Since 5% of clinically benign lesions have proved malignant, even on immediate reporting, we would recommend cytological examination of all breast lumps. IntroductionIn a newly established breast clinic preliminary use of aspiration cytologyl-3 gave an unacceptably high incidence of false-negative reports and unsatisfactory preparations. These were apparently due to poor aspiration technique and faulty preparation of slides.4 Accordingly it was arranged that a cytologist should prepare slides at the clinic. Now, using the Diff Quik rapid staining method, a provisional report is given within five minutes of aspiration. If the preparation is found to be unsatisfactory aspiration is immediately repeated.Results obtained during the first year of this procedure have been analysed, with particular emphasis on finding reasons for false-negative and unsatisfactory reports. The value of aspiration cytology in patient management, the usefulness of which was recently questioned,5 has been assessed prospectively.
Laparoscopic cholecystectomy is gaining increasing acceptance as a mode of minimally invasive surgery. We describe a peculiar gynecologic complication following uncomplicated laparoscopic cholecystectomy. Our patient presented with a four-month history of subacute pelvic pain, primarily located in the right lower quadrant, two years after laparoscopic cholecystectomy. Diagnostic laparoscopy revealed a hemaclip embedded in the right ovarian capsule of an otherwise normal pelvis. The hemaclip had probably dislodged from its original site of placement in the upper abdomen, and migrated to the dependent portions of the pelvis, where it implanted in a follicular stigma and became affixed to the ovarian capsule. The hemaclip was removed without complications, and the patient's symptoms improved.
Corresponding author's email: juan.wisnivesky@mssm.edu: Lobectomy is the standard of care for stage IA lung cancer. Several prospective studies have shown similar results after limited Objective resection for tumors ≤2 cm in size. The objective of the study was to compare survival after lobectomy and limited resection among screen-detected non-small cell lung cancer (NSCLC) ≤2 cm in size.: Using data from the International Early Lung Cancer Action Methods Program we identified 249 patients with solid tumors ≤2 cm in size classified as stage IA NSCLC that underwent lobectomy or limited resection (segmentectomy or wedge resection). The Kaplan-Meier method was used to estimate unadjusted survival of patients treated with lobectomy vs. limited resection. We used logistic regression to determine propensity scores for undergoing limited resection based on the patients' preoperative characteristics (age, sex, race/ethnicity, education, smoking history, tumor size and histology, and comorbidities). Overall survival of patients treated with lobectomy or limited resection was compared after adjusting for their propensity score and the number of lymph nodes sampled during surgery.: Mean age was 63.7 (7.2) and 52% were males. Overall, 47 (19%) Results patients underwent limited resection (72% wedge resection and 28% segmentectomy). Unadjusted survival was equivalent among patients undergoing limited resection and lobectomy (p=0.88). For the entire sample, the adjusted hazard ratio (HR) for all cause mortality (0.92; 95% confidence interval [CI]: 0.23-3.91) for patients undergoing limited resection were not significantly different from those having lobectomy. Similarly, we found no significant differences in overall survival for patients treated with limited resection compared to lobectomy when data was analyzed stratifying (HR: 0.86; 95% CI: 0.23-3.30) and matching (HR: 0.82; 95% CI: 0.34-1.96) patients by their propensity scores.: These results suggest that survival of patients with screen-detected NSCLC ≤2 cm in size undergoing Conclusions limited resection or lobectomy appears to be similar. Although these findings should be confirmed in prospective trials, our results suggest that limited resection may be an effective therapeutic alternative for these patients. This abstract is funded by: None Am J Respir Crit Care Med 183;2011:A5394 Internet address: www.atsjournals.org Online Abstracts Issue
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