The history of pancreatic cancer surgery, though fraught with failure and setbacks, is punctuated by periods of incremental progress dependent upon the state of the art and the mettle of the surgeons daring enough to ...The history of pancreatic cancer surgery, though fraught with failure and setbacks, is punctuated by periods of incremental progress dependent upon the state of the art and the mettle of the surgeons daring enough to attempt it. Surgical anesthesia and the aseptic techniques developed during the latter half of the 19 th century were instrumental in establishing a viable setting for pancreatic surgery to develop. Together, they allowed for bolder interventions and improved survival through the postoperative period. Surgical management began with palliative procedures to address biliary obstruction in advanced disease. By the turn of the century, surgical pioneers such as Alessandro Codivilla and Walther Kausch were demonstrating the technical feasibility of pancreatic head resections and applying principles learned from palliation to perform complicated anatomical reconstructions. Allen O. Whipple, the namesake of the pancreaticoduodenectomy（PD）, was the first to take a systematic approach to refining the procedure. Perhaps his greatest contribution was sparking a renewed interest in the surgical management of periampullary cancers and engendering a community of surgeons who advanced the field through their collective efforts. Though the work of Whipple and his contemporaries legitimized PD as an accepted surgical option, it was the establishment of high-volume centers of excellence and a multidisciplinary approach in the later decades of the 20^th century that made it a viable surgical option. Today, pancreatic surgeons are experimenting with minimally invasive surgical techniques, expanding indications for resection, and investigating new methods for screening and early detection. In the future, the effective management of pancreatic cancer will depend upon our ability to reliably detect the earliest cancers and precursor lesions to allow for truly curative resections.展开更多
History of breast cancer dates back to at least 1600 B.C. and treatment methods have undergone significant progress over the last hundred years. We are moving away from frighteningly radical, and towards increasingly ...History of breast cancer dates back to at least 1600 B.C. and treatment methods have undergone significant progress over the last hundred years. We are moving away from frighteningly radical, and towards increasingly more conservational breast cancer surgery. And while mastectomy is no longer a first-line choice for all breast cancers, it is still an important and, really, an essential procedure to discuss and research about. Different types and techniques exist and evidence regarding each is vast-with novel techniques appearing even nowadays. For example, robotic surgery is increasingly more common in many surgical specialties and procedures, and mastectomy is no exception. With several high-profile celebrities recently discussing their experiences of breast cancer and mastectomies, this article covers a multitude of essential aspects relevant to this topic, in turn, hopefully, helping patients and doctors deal with the diagnosis and plan the treatment accordingly. Current breast cancer care and mastectomy trends are also discussed here, giving the readers an up-to-date overview of how breast cancer can and should be managed.展开更多
文摘The history of pancreatic cancer surgery, though fraught with failure and setbacks, is punctuated by periods of incremental progress dependent upon the state of the art and the mettle of the surgeons daring enough to attempt it. Surgical anesthesia and the aseptic techniques developed during the latter half of the 19 th century were instrumental in establishing a viable setting for pancreatic surgery to develop. Together, they allowed for bolder interventions and improved survival through the postoperative period. Surgical management began with palliative procedures to address biliary obstruction in advanced disease. By the turn of the century, surgical pioneers such as Alessandro Codivilla and Walther Kausch were demonstrating the technical feasibility of pancreatic head resections and applying principles learned from palliation to perform complicated anatomical reconstructions. Allen O. Whipple, the namesake of the pancreaticoduodenectomy（PD）, was the first to take a systematic approach to refining the procedure. Perhaps his greatest contribution was sparking a renewed interest in the surgical management of periampullary cancers and engendering a community of surgeons who advanced the field through their collective efforts. Though the work of Whipple and his contemporaries legitimized PD as an accepted surgical option, it was the establishment of high-volume centers of excellence and a multidisciplinary approach in the later decades of the 20^th century that made it a viable surgical option. Today, pancreatic surgeons are experimenting with minimally invasive surgical techniques, expanding indications for resection, and investigating new methods for screening and early detection. In the future, the effective management of pancreatic cancer will depend upon our ability to reliably detect the earliest cancers and precursor lesions to allow for truly curative resections.
文摘History of breast cancer dates back to at least 1600 B.C. and treatment methods have undergone significant progress over the last hundred years. We are moving away from frighteningly radical, and towards increasingly more conservational breast cancer surgery. And while mastectomy is no longer a first-line choice for all breast cancers, it is still an important and, really, an essential procedure to discuss and research about. Different types and techniques exist and evidence regarding each is vast-with novel techniques appearing even nowadays. For example, robotic surgery is increasingly more common in many surgical specialties and procedures, and mastectomy is no exception. With several high-profile celebrities recently discussing their experiences of breast cancer and mastectomies, this article covers a multitude of essential aspects relevant to this topic, in turn, hopefully, helping patients and doctors deal with the diagnosis and plan the treatment accordingly. Current breast cancer care and mastectomy trends are also discussed here, giving the readers an up-to-date overview of how breast cancer can and should be managed.
