Early detection of recurrence of malignant melanoma gives a survival advantage, so patients who have had “thick” melanomas removed from their skin are followed up closely. A study in Bristol of 244 patients (British Journal of Plastic Surgery 1997;50:349-53) found that two fifths of the treatable recurrences were diagnosed in the first year after surgery. The report suggests that patients should be seen every two months for the first year, every three months in the second, and gradually less often, until after 10 years the follow up can be done in general practice.

The gall bladder is perforated and stones are spilled into the peritoneal cavity more frequently during laparoscopic cholecystectomy than during open surgery, says a report in the Canadian Journal of Surgery (1997;40:300-4). Stones left behind in the abdomen usually cause no problems, but they may lead to serious complications requiring open surgery. Furthermore, a stone left behind is a potential nidus for a legal action at a later date.

Treatment of acute myocardial infarction with glucose, insulin, and potassium …