Re: Bilateral dermoids
From: Andrew Folley (agfolley@hotmail.com)
Sat Mar 10 14:28:25 2007
El
I will let the article speak for me. Conservative surgery. Operative word
is conservative
A 10-year retrospective review was conducted of incidental adnexal neoplasms
found at the time of cesarean section. During the 10-year period between
July 1,1976 and June 30, 1986, 17,902 cesarean sections were performed at
Women's Hospital of the Los Angeles County/University of Southern California
Medical Center. Adnexal neoplasms were identified with an incidence of one
neoplasm per 197 cesarean sections. When a neoplasm is discovered during
surgery, conservative surgery is recommended.
(C) 1988 The American College of Obstetricians and Gyn
>From: Dr Eberhard Lisse <el@lisse.NA>
>Reply-To: ob-gyn-l@obgyn.net
>To: Multiple recipients of list OB-GYN-L <ob-gyn-l@dns.obgyn.net>
>Subject: Re: Bilateral dermoids
>Date: Fri, 9 Mar 2007 16:13:52 -0600
>
>Andrew,
>
>with all due respect, you haven't got a silly clue who you are talking
>to or about. I've actually met the man. And I know people having worked
>with him.
>
>Never mind what you are talking about. To misquote Independence Day, I
>can not imagine that they have let you out much :-)-O, but to state that
>the US health system is the best or even among the top is simply
>nonsense, and contrary to all available evidence.
>
>Infant mortality, maternal mortality, teenage pregnancies are neither on
>the top in absolute figures, nor in relative figures, taking expenditure
>into account. Access to health care? Disposable income by Ob&Gyns?
>
>And the list could go on and on.
>
>I would love very much to have access to your resources, or just have
>the same resources I have for a minority of my patients in the one
>hospital available for the majority of my patients in the other (State
>Hospital).
>
>Or even only having more that four Drape Packs available for this
>weekend, and I used one already this afternoon. But as we say here:
>"We'll make a Plan" and try to cross this bridge when we come nearer to
>it :-)-O.
>
>But not only is it my country, I actually like it here, in spite of all
>its issues.
>
>Or maybe because.
>
>So this translates into Me Three :-)-O These things come out. Right now!
>In any case since she is under a spinal you can even get verbal consent.
>
>By the way, this is Lakenheath, and I am quite sure the Air Force has a
>regulation for this particular situation.
>
>el
>
>on 3/9/07 11:23 PM Efrain Ramirez said the following:
> > Me too - leaving bilateral dermoids makes no sense - as I said - another
> > anesthesia, etc... I don't see Andy's point about "keep in mind that
> > you are setting this patient up for a potentially devastating infection
> > with tubo ovarian abcess formation and hysterectomy." ??
> >
> > And I am not sure about USA having the best "medical system" in the
> > world..
> >
> >> Ef
> >
> >> At Fri, 9 Mar 2007, art fougner, md wrote:
> >>
> >> I actually have to side with Steve on this one ... tortuous
> >> interference has not enhanced clinical acumen.
> >>
> >> Art
> >>
> >> At Fri, 9 Mar 2007, Andrew Folley wrote:
> >>> Stephen,
> >>> as you mature you will come to realize that medicine is both art and
>science
> >>> and there are often times several right ways to approach a problem. I
>think
> >>> you misjudge the american system.
> >>> It is still the best medical system in the world. I sense a great
>deal of
> >>> frustration and anger in your thread. Lets use this wonderful internet
> >>> exchange tool to be gentleman and colleagues. andrew
> >>>
> >>>> From: "Raymond Stephen" <stephen.raymond@dhhs.tas.gov.au>
> >>>>
> >>>> There is no doubt from the description that they were dermoids, and
> >>>> washings and other hand-wringing grandma type fussing is just weasel
> >>>> madness from an American system so stuffed up by the fear of
>litigation
> >>>> that the patients suffer. If you had taken washings and aspirated
>and then
> >>>> left them and had to go back afterwards for them the patient would
>have
> >>>> been quite justified if she had sued you for unnecessary surgery!
> >>>>
> >>>> I can't believe the absolute lack of clinical acumen and judgement
>that
> >>>> seems to have come out of this thread.
> >>>>
> >>>> Steve
>
>--
>Dr. Eberhard W. Lisse \ / Obstetrician & Gynaecologist (Saar)
>el@lisse.NA el108-ARIN / * | Telephone: +264 81 124 6733 (cell)
>PO Box 8421 \ / Please do NOT email to this address
>Bachbrecht, Namibia ;____/ if it is DNS related in ANY way
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