The Role of Axillary Ultrasound in Determining Nodal Status in Patients with Early Breast Cancer Undergoing Sentinel Node Biopsy: Are there Other Factors Which Should be Considered?

Abstract

s / International Journal of Surgery 8 (2010) 501–578 516 temperature only. Temperature and water vapour pressure demonstrated a statistically significant association with epistaxis admission rates (pearson correlation coefficients for mean temperature and mean water vapour pressure 0.06 and 0.05 respectively, p 40 mm, while all those with true negative scans had tumours 40mm) should be considered for additional staging or clearance despite a radiologically negative axilla. SURGICAL RECONSTRUCTION FOR SEVERE AORTO-ILIAC OCCLUSIVE DISEASE: A 9-YEAR EXPERIENCE WITH MEDIUM-TERM OUTCOME Alexander Rolls, Robert S.M. Davies, AndrewW. Bradbury, Donald J. Adam. University Department of Vascular Surgery, Heart of England NHS Foundation Trust, Birmingham, UK Aims: To assess the outcome of bypass grafting for aorto-iliac occlusive disease (AIOD). Methods: A retrospective review of 114 patients who underwent 122 surgical reconstructions for AIOD in a single institution between 2000 and 2008 was performed. Early( 30 days) outcomes(patient survival, amputation-free survival and re-interventionfree survival) were assessed. Results: 53 patients [median (range) age: 59(35–81)] underwent 53 anatomical bypasses (AB) [aorto-femoral (AFB) (n 1⁄4 45), ilio-femoral (IFB) (n 1⁄4 6), aorto-popliteal (APB) (n 1⁄4 1), aorto-iliac (AIB) (n 1⁄4 1)] for intermittent claudication (IC) (n 1⁄4 27) or severe limb ischaemia (SLI) (n 1⁄4 26). 61 patients [median (range) age: 67(47-90)] underwent 69 extraanatomical bypasses (EAB) [femoral-femoral crossover (FFB) (n 1⁄4 61), axillo-(bi)femoral (AxFB) (n 1⁄4 5), ilio-femoral crossover (n 1⁄4 3)] for IC (n 1⁄4 28) or SLI (n 1⁄4 41). Amputation-free survival at 1-, 6-, 12and 24-months after AB was 92%, 85%, 83% and 81%, respectively, and after EAB was 89%, 82%, 74% and 63%, respectively (p 1⁄4 0.0029). Re-intervention-free survival at 1-, 6-, 12and 24-months after AB was 92%, 81%, 81% and 73%, respectively, and after EAB was 90%, 77%, 66% and 54%, respectively (p 1⁄4 0.0085). Conclusion: Anatomical bypass grafting for severe symptomatic AIOD is associated with superior outcomes compared with extra-anatomical bypass. These contemporary data provide a benchmark with which to compare the outcomes of established and evolving endovascular therapies. PRE-OPERATIVE SERUM PH PREDICTS MORTALITY IN EMERGENCY CARDIOPULMONARY BYPASS SURGERY (CPB) Abdul Nasir , Sarah Smyth , Michael Parker , Alastair N.J. Graham, O.C. Nzewi , J. Mark Jones . 1 Dept. of Cardiothoracic Surgery Royal Victoria Hospital, Belfast, UK; 2 Clinical Research Support Centre Royal Victoria Hospital, Belfast, UK Objective: Hypoperfusion with end-organ ischaemia causing acidosis poses a risk to life. Our aim was to assess if pre-operative serum pH was associated with outcome after emergency CPB surgery. Methods: Data was collected for all emergency patients (excluding pulmonary embolectomy) between January2004 and February2009. Means based on continuous measurements were compared using a permutation test, and percentages based on counts were compared using Fisher's Exact Test. A binary logistic model was used to relate mortality to pH and logistic Euroscore. Results: A total of 103 patients were identified and analysed according to those with pH 7.35 (n1⁄4 58). Mean age was similar in both groups (56v62years respectively; P 1⁄4 0.09). Mean logistic Euroscore (44.6v33.8; P1⁄4 0.04), observedmortality (28.9v10.3 %; P 1⁄4 0.02), incidence of stroke (2.17v0 %) and renal failure (19.56v6.89 %; P 1⁄4 0.07) were higher in those with pH 7.35, indicating that this effect is additional to the logistic Euroscore. (0.67v0.3). Conclusions: Pre-operative acidosis was associated with increased mortality following emergency CPB surgery. This effect is in addition to parameters assessed in the Euroscore. This may be useful in predicting outcome after emergency surgery. MUSCLE MASS IN ELDERLY COLORECTAL CANCER IS UNRELATED TO PLASMA MYOGLOBIN CONCENTRATION S.M. Nyasavajjala, A. Selby, W. Hildebrandt, J.P. Williams, R. Singh, K. Smith, S. Liptrot, J.N. Lund, M.J. Rennie. School of Graduate Entry Medicine and Health, Derby, University of Nottingham Background and Aims: Progressive muscle wasting is a characteristic feature of cancer cachexia and increases the risk of a poor prognosis. Weber et.al. suggested that in patients with pancreatic and gastric cancers plasma myoglobin concentration is a good index of muscle mass, enabling wasting to be assessed conveniently. Therefore, we wished to test its reliability for this purpose in patients with early colorectal cancer.