Current surgery
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Sentinel lymph node biopsy (SLNB) is a minimally invasive, accurate method of evaluating axillary lymph nodes in patients with invasive cancer. The technique has also been applied successfully in patients with ductal carcinoma in situ (DCIS). The purpose of this study was to review our experience performing SLNB in patients with a biopsy diagnosis of DCIS. ⋯ Sentinel lymph node biopsy can be performed accurately in patients with a biopsy diagnosis of DCIS. The rate of axillary disease in patients with pure, completely resected DCIS is low; therefore, SLNB is not indicated in all patients with this biopsy diagnosis. Because of a high rate of invasive disease on the final pathology of patients with DCIS diagnosed by core biopsy, these patients should be offered SLNB.
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In most reports, dialysis-dependent patients are known to be at increased risk for perioperative morbidity and mortality after cardiac surgical procedures.(1-7) However, the preoperative factors important for risk stratification of patients who have renal insufficiency but are not dialysis dependent are unclear. We set forth to ascertain preoperative risk factors important for predicting 2 endpoints: (1) dialysis at discharge and (2) hospital death. ⋯ These data allow for a more accurate assessment of risk stratification in this group of patients with renal insufficiency but who are not dependent on dialysis. Given the data presented here and other studies that report good outcomes for patients with renal disease after cardiac surgical procedures,(8-10) earlier operative intervention for coronary disease in this subset of patients might be warranted.