Surgery News - February 2009 - (Page 1) VOL. 5 • NO. 2 • FEBRUARY 2009 DOUG BOYD/EAST CAROLINA UNIVERSITY Data Support Simultaneous Resection Colectomy, hepatectomy safely combined. BY DAMIAN MCNAMARA INSIDE THIS ISSUE 20/20 ICD-10 VISION THE Looms HHS has set a deadline of Oct. 1, 2013, to implement the new code sets. • 5 News From the College Else vier Global Medical Ne ws The perception of a high infection rate prompted the move toward eradication, said Dr. Walter E. Pofahl. MRSA Screening Used To Decrease SSIs BY DAMIAN McNAMARA Else vier Global Medical Ne ws PA L M B E A C H , F L A . — Universal preoperative surveillance for methicillin-resistant Staphylococcus aureus infection coupled with eradication before all elective procedures was not significantly better than screening of high-risk patients and eradication for decreasing the rate of surgical site infections (SSIs) at a large, tertiary care hospital. Clinicians at Pitt County Memorial Hospital in Greenville, N.C., began testing a nasal swab from all elective surgical patients in February 2007 in response to community concerns about the incidence of methicillin-resistant Staphylococcus aureus (MRSA). “There was a perception of a high infection rate at our tertiary care hospital, so our board thought it was important to eradicate and move toward zero infections,” said Dr. Walter E. Pofahl, an ACS Fellow who is chief of the division of advanced laparoscopic, gastrointestinal, and endocrine surgery, East Carolina University, also in Greenville. “MRSA has garnered a tremendous amount of attention in the past few years,” said Dr. Michael F. Rotondo, an ACS Fellow who is chief of trauma See MRSA Screening • page 2 PA L M B E A C H , F L A . — Simultaneous resection performed for primary adenocarcinoma of the large bowel and synchronous liver metastasis yielded complication and mortality rates similar to those seen after a staged approach, according to a review of more than 200 patients. Total operative time, not surprisingly, was shorter with simultaneous resection, and overall hospital length of stay was significantly reduced. Researchers identified 230 patients with colorectal cancer and synchronous liver metastases from 1,344 patients entered into a hepato-pancreatico-biliary database from July 1997 to June 2008. The mean age of the cohort was 61 years, and 130 were men. A total of 70 participants (30%) underwent simultane- ous resection, and the remainder had staged surgery. Patients who had simultaneous colectomy and hepatectomy tended to have liver metastases that were smaller (median 3.1 cm versus 4 cm) and fewer in number (median of two versus three) than those of patients undergoing staged procedures. There was an equal distribution of patients by metastatic risk score (mean score of 3 in each group), but the staged group received more neoadjuvant or preoperative therapy—primarily 5-fluorouracil or irinotecan, Dr. Robert C.G. Martin II said at the annual meeting of the Southern Surgical Association. A total of 39 patients in the simultaneous group (56%) experienced 63 complications, and 88 patients in the staged group (55%) had 162 compliSee Resection • page 2 MedPAC Flak The ACS opposes MedPAC's proposal to adjust pay on the basis of productivity. • 8 Oncology Best for Breast Preop MRI does not reduce reoperation rates. • 1 2 General Surgery Weighty Problem Most bariatric surgery centers lack large scanners. • 1 9 ONLINE EDITION Visit www.facs.org to access articles available only online. Go to Periodicals, then Surgery News to read the latest on topics such as: •SLN mapping for breast cancer •vein graft stenosis •traumatic injury complications UnitedHealth to Close Billing Database B Y M A RY E L L E N SCHNEIDER Else vier Global Medical Ne ws VITAL SIGNS Projected U.S. Health Expenditures (in trillions of dollars) 5 4 3 ELSEVIER GLOBAL MEDICAL NEWS part of York Attorney Aswith New an agreement General Andrew Cuomo, UnitedHealth Group plans to shut down a national billing database used by health plans to determine reimbursements to members who use out-ofnetwork physician services. The billing database, which is operated by the UnitedHealth Group (UHG) subsidiary Ingenix Inc., will be replaced with an independent database run by a qualified nonprofit organization. Under the terms of the agreement, UHG will pay $50 million to help establish the new database. In addition, the nonprofit organization will develop a Total health expenditures Hospital care Physician and clinical services public Web site where consumers can research—before seeking services—how much they may be reimbursed for common out-of-network medical services in their area. Aetna, the nation’s third largest insurer, also has entered into an agreement with the New York attorney general to abandon its use of the Ingenix database in favor of the new one. Aetna also will contribute 60 Columbia Rd., Bldg. B, 2nd flr. Morristown, NJ 07960 CHANGE SERVICE REQUESTED SURGERY NEWS $20 million over 5 years for the creation of the new database. The agreements follow an investigation by Mr. Cuomo’s office into allegations that insurers were systematically underpaying consumers for their out-of-network medical expenses by saying that physician charges were higher than the “usual, customary, and reasonSee Database • page 3 Presorted Standard U.S. Postage PAID Permit No. 384 Lebanon Jct. KY 2 1 0 2007 2009 2011 2013 2015 2017 Note: Based on 2006 National Health Expenditures data. Source: Centers for Medicare and Medicaid Services http://www.facs.org
Table of Contents Feed for the Digital Edition of Surgery News - February 2009 Surgery News - February 2009 Contents The 20/20 Vision ICD-10 Looms News From the College: MedPAC Flak Oncology: Best for Breast General Surgery: Weighty Problem Surgery News - February 2009 Surgery News - February 2009 - Contents (Page 1) Surgery News - February 2009 - Contents (Page 2) Surgery News - February 2009 - Contents (Page 3) Surgery News - February 2009 - Contents (Page 4) Surgery News - February 2009 - The 20/20 Vision ICD-10 Looms (Page 5) Surgery News - February 2009 - The 20/20 Vision ICD-10 Looms (Page 6) Surgery News - February 2009 - The 20/20 Vision ICD-10 Looms (Page 7) Surgery News - February 2009 - News From the College: MedPAC Flak (Page 8) Surgery News - February 2009 - News From the College: MedPAC Flak (Page 9) Surgery News - February 2009 - News From the College: MedPAC Flak (Page 10) Surgery News - February 2009 - News From the College: MedPAC Flak (Page 11) Surgery News - February 2009 - Oncology: Best for Breast (Page 12) Surgery News - February 2009 - Oncology: Best for Breast (Page 13) Surgery News - February 2009 - Oncology: Best for Breast (Page 14) Surgery News - February 2009 - Oncology: Best for Breast (Page 15) Surgery News - February 2009 - Oncology: Best for Breast (Page 16) Surgery News - February 2009 - Oncology: Best for Breast (Page 17) Surgery News - February 2009 - Oncology: Best for Breast (Page 18) Surgery News - February 2009 - General Surgery: Weighty Problem (Page 19) Surgery News - February 2009 - General Surgery: Weighty Problem (Page 20)
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