The overall bowel obstruction rate was unchanged; however, adhesive small-bowel obstruction requiring reoperation was significantly reduced by the use of Seprafilm, which was the only factor that predicted this outcome.

Laparoscopy has allowed surgeons the ability to perform procedures which result in less postoperative discomfort, earlier return to daily activities, and better cosmesis. For example, laparoscopic cholecystectomy has virtually replaced open cholecystectomy, and many of these operations are performed in the outpatient setting. The role of laparoscopic appendectomy is yet to be defined, however. Over an 18-month period from February 1992 to July 1993, 75 laparoscopic appendectomies were performed at Kaiser Permanente Medical Center in Los Angeles. Thirty-five of the patients undergoing this procedure were outpatients. While there were a total of three complications, including two intraabdominal abscesses, there were no complications in the outpatient appendectomy group. Laparoscopic appendectomy may be safely performed in the outpatient setting in patients with acute nonperforated appendicitis.

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One hundred and eighty-five breast cancers were demonstrated by xeroradiography in 6,238 patients. Sixty-two cancers were occult, and constituted one-third of the demonstrable breast cancers. Some of the patients with clinically nonpalpable carcinomas had high risk factors known to be associated with the development of breast cancer. The diagnosis was usually established and confirmed by wide excisional biopsy of the area containing the suspicious lesion. In some instances the lesion was localized preoperatively by xeroradiography using a technique of skin markings. Specimen xeroradiography was utilized if there were calcifications seen on the preoperative xeroradiograph. There was a significantly decreased incidence of axillary node metastases in the occult cases when compared to the dominant mass cases.