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This is because it is perceived as a grim clinical situation (more difficult surgical cleaning and/or presence of organ failure) in which the negative consequences of inappropriate antimicrobial therapy are close to inevitable.
Finally, on the venous side of the AVM, the number of draining veins per compartment (the more the better for endovascular treatment if venous migration should occur), possible drainage into the deep venous system (higher risk of haemorrhage, more difficult surgical treatment) and stenosis, which restrict venous outflow, have to be identified to fully determine the risk of a specific AVM.
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The decision may be easy to take when there is only one injured site, as in myomectomy, but may be much more difficult in surgical patients with severe endometriosis.
While tumour recurrence displays similar mammographic features to the primary lesion [ 4], interpretation of the surveillance mammogram is made more difficult by surgical scarring and changes to breast density caused by primary treatment.
Recent legislative changes have made this more difficult and both surgical and pathology support are needed at a senior level.
However, anatomical variations do occur frequently and it is in these situations that surgery might become more difficult and require surgical experience.
Mifepristone-induced abortions are more time-consuming and potentially more difficult than the standard surgical procedure.
It is more difficult to convince the surgical community to undertake this procedure for patients diagnosed with LPR.
SCLC is less common and accounts for 20% of cases, but as this type of lung cancer grows quickly and is likely to spread, it is more difficult to cure by surgical resection.
It is more difficult to achieve successful surgical outcome in older people (adults aged over 60 years), because of a higher prevalence of co-morbidities resulting in lower bone density, frail skin and impaired wound healing.
Local excision or superficial parotidectomy is the surgical procedure of choice in patients with benign lesions; in the case of malignant tumours the patient has to undergo total parotidectomy, a more difficult procedure with the surgical risk of facial nerve palsy.
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Justyna Jupowicz-Kozak
CEO of Professional Science Editing for Scientists @ prosciediting.com