New prostate surgery not necessarily better: study

Men who have less invasive prostate cancer surgery — often done robotically — are more likely to be incontinent and have erectile dysfunction than men who have conventional open surgery, U.S. researchers said on Tuesday.

Many men, especially those who are wealthy and highly educated, favor minimally invasive surgery because they assume the high-tech approach will yield better results, but the evidence on that is mixed, the team reported in the Journal of the American Medical Association.

“We found men undergoing minimally invasive versus open surgery were more likely to have a diagnosis of incontinence and erectile dysfunction,” Dr. Jim Hu of Brigham and Women’s Hospital in Boston said in a telephone briefing.

Hu said use of minimally invasive surgery has taken off since the introduction and heavy marketing of robot-assisted surgery, such as the da Vinci system made by Intuitive Surgical Inc.

The system consists of robotic arms, controlled from a console, that allow surgeons to perform less invasive surgeries. Hospitals advertise the systems as being able to reduce trauma, blood loss, risk of infection, scarring and often pain.

Hu said so far, there have been few studies that compare minimally invasive surgery with open surgery.

To do that, he and colleagues used billing data from the Medicare insurance program for the elderly on procedures done from 2003 to 2007. During that time, use of minimally invasive surgery for prostate cancer increased fivefold.

While both approaches fared equally well as a cancer treatment, they found that men who got the minimally invasive approach had shorter hospital stays, were less likely to need blood transfusions, and had fewer breathing problems after surgery than those who got conventional surgery.

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Healthier U.S. school meals boost costs: study

Improving nutritional value of U.S. school food programs by increasing servings of fruits, vegetables and whole grains could increase the cost of breakfast by as much as 25 percent and lunch by 9 percent, according to a report released on Tuesday.

A report from the Institute of Medicine, an arm of the National Academies, proposed updating school meal programs to meet nutritional needs and foster better eating habits, but recognized healthier, fresher ingredients would boost costs, especially at breakfast where fruit servings would increase.

“It will cost a little more,” Virginia Stallings, a professor at The Children’s Hospital of Philadelphia and chair of the group that conducted the study, said in an interview.

“But this will be a very wise investment in children’s health,” she added.

Most school food providers would need more government money to help pay for food, training and equipment, the report said.

The Institute of Medicine conducted the review of the country’s school breakfast and lunch programs at the request of the U.S. Agriculture Department, which oversees them. School meal programs provide 40 million meals daily and more than half of students’ food and nutrient intake during the school day.

Child nutrition programs, which cost about $21 billion a year, are due for reauthorization this year but Congress is not expected to approve an overhaul for some time.

Officials at the USDA are updating the nutrition and meal requirements used for school breakfast and lunch programs, and looked for recommendations from the Institute of Medicine. The framework, last updated in 1995, sets food and nutrient standards that must be met by school programs to qualify for cash reimbursements and food from the government.

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New prostate surgery not necessarily better: study

New prostate surgery not necessarily better: study

Healthier U.S. school meals boost costs: study

Healthier U.S. school meals boost costs: study