Medicine – Page 119 – Dr.S.Harsha Vardhan

12th March 202113th June 2021

Does Surgery for Colorectal Liver Metastases Release Tumor Cells ?

For patients with colorectal liver metastasis (CLM), surgical resection is the only hope for cure, but conventional hepatectomy involves mechanical manipulation that could release tumor cells into the bloodstream and result in further spread.

To minimize this risk, an alternative method was introduced in 1992 ― an anterior approach for open right hepatectomies, which involves less manipulation.

However, a trial that compared the two surgical approaches showed no difference between the two in reducing intraoperative tumor cell dissemination.

Circulating tumor cells (CTCs) were detected in 6 of 22 patients (27%) in the anterior hepatectomy group and in 5 of 21 (24%) patients in the conventional hepatectomy group, the study authors report.

11th March 202113th June 2021

Adalimumab Enhances Primary Wound Closure After Hydradenitis Suppurativa Surgery

Delaying surgical reconstruction of fistula structures until after patients with hidradenitis suppurativa (HS) have been on adalimumab for a minimum of 6 months transforms primary wound closure into a highly attractive option, a pilot study suggests.

“Our experience suggests that under the effects of treatment with adalimumab, wound healing disorders with primary wound closure occur less often. And primary wound closure offers advantages over secondary wound healing: shorter length of inpatient stay, lower morbidity, fewer functional problems, and better quality of life,” Gefion Girbig, MD, said at the annual congress of the European Academy of Dermatology and Venereology.

She noted that primary wound closure following surgery for HS is controversial. For example, current German guidelines recommend complete surgical excision of HS lesions, followed by secondary wound healing; the guidelines advise against primary wound closure. But those guidelines were issued back in 2012, years before adalimumab (Humira) achieved regulatory approval as the first and to date only medication indicated for treatment of HS.