Abstract:
BACKGROUND:The purpose of this study was to evaluate postoperative pain and postoperative nausea and vomiting (PONV) in patients with paravertebral blocks (PVB) undergoing breast cancer surgery with or without axillary staging. METHODS:An Institutional Review Board approved, retrospective chart review from January 2007 to December 2009 was performed at a single institution. Charts were reviewed for type of breast cancer surgery, axillary staging, PVB, PONV, postoperative pain score, dosages of pain medication and antiemetic medication given in the Post Anesthesia Care Unit (PACU), and during the postoperative days (POD). The study population consisted of females with a diagnosis of breast cancer undergoing breast cancer surgery, with or without axillary staging. Patients were excluded if they: had simultaneous myocutaneous tissue flap breast reconstruction, had additional surgical procedures, used continuous delivery postoperative pain medications, had a history of chronic pain, or had a history of chronic antiemetics prior to surgery. All patients received standard perioperative medications per the anesthesia department. RESULTS:A total of 419 patients underwent breast cancer surgery during the given time period of which 337 patients were able to be included in the study. Of these patients, 241 of the 337 patients had PVB and 96 patients did not have PVB. The mean age was 59.5 years. The mean BMI was 28.7 kg/m(2). Also, 45.5% of the patients who had PVB (110) had a mastectomy, while 41.1% of patients in the non-PVB cohort (39) had a mastectomy. In addition, 45 patients with PVB had immediate tissue expander reconstruction and only 14 patients in the non-PVB group. Of patients with PVB, 53.3% (129) had a sentinel lymph node biopsy (SLN) and 33.5% (81) had full axillary dissections. Of patients in the non-PVB, 35.8% (34) had no axillary staging and 44.2% (42) underwent SLN. Also, 229 patients with PVB and 78 patients without PVB had a general anesthetic. Only 3.3% of patients with PVB and 4.2% of patients without PVB had postoperative nausea (P = 0.746). One patient with PVB and no patients without PVB reported emesis in the PACU (P = 1). There was no difference in morphine equivalents (P = 0.234) or in pain scores (P = 0.521) between the 2 groups in the PACU. There was no difference in amount of morphine equivalents given on POD0 (P = 0.8) or POD1 (P = 0.079). The reconstruction patients with PVB used less opioid analgesic on POD1 compared with the non-PVB reconstruction group (P = 0.02). CONCLUSIONS:Patients undergoing breast cancer surgery who have paravertebral blocks have similar postoperative nausea and vomiting and similar postoperative pain scores compared with patients without paravertebral blocks. PVB may have an important role in decreasing postoperative pain and opioid analgesic usage in patients electing to have immediate breast reconstruction with tissue expanders.
journal_name
Ann Surg Oncoljournal_title
Annals of surgical oncologyauthors
Aufforth R,Jain J,Morreale J,Baumgarten R,Falk J,Wesen Cdoi
10.1245/s10434-011-1899-5subject
Has Abstractpub_date
2012-02-01 00:00:00pages
548-52issue
2eissn
1068-9265issn
1534-4681journal_volume
19pub_type
临床试验,杂志文章abstract:BACKGROUND:Incidence rates of hypoparathyroidism and vocal cord paralysis are high following central compartment reoperation, but few prospective studies have assessed morbidities and factors predictive of hypocalcemia after reoperation. We investigated recurrence patterns, morbidity, and factors predictive of postoper...
journal_title:Annals of surgical oncology
pub_type: 杂志文章
doi:10.1245/s10434-010-1470-9
更新日期:2011-05-01 00:00:00
abstract:BACKGROUND:This study aimed to determine the relationship between mammographic calcifications and magnetic resonance imaging (MRI) tumoral enhancement before and after neoadjuvant chemotherapy (NAC) and to assess the impact of these findings on surgical management. METHODS:This Institutional Review Board-approved, Hea...
journal_title:Annals of surgical oncology
pub_type: 杂志文章
doi:10.1245/s10434-016-5741-y
更新日期:2017-06-01 00:00:00
abstract:BACKGROUND:Preoperative cutaneous lymphoscintigraphy (LS) to identify sentinel (first-tier) lymph nodes was performed in 250 consecutive melanoma patients before wide local excision only or wide local excision with sentinel node biopsy. METHODS:The location of the sentinel nodes was marked on the overlying skin in all...
journal_title:Annals of surgical oncology
pub_type: 杂志文章
doi:10.1007/BF02303644
更新日期:1998-09-01 00:00:00
abstract:OBJECTIVES:The purpose of this study was to assess the quality of care in patients who underwent sentinel lymph node (SLN) mapping for endometrial and cervical cancer staging, and evaluate the impact of different techniques on patient satisfaction, i.e. radiotracer Tc99m versus indocyanine green (ICG) or methylene blue...
journal_title:Annals of surgical oncology
pub_type: 杂志文章
doi:10.1245/s10434-016-5233-0
更新日期:2016-09-01 00:00:00
abstract:BACKGROUND:Glioma recurrence usually occurs close to the tumor resection margins as a result of residual infiltrating glioma cells. 5-aminolevulinic acid (ALA) fluorescence-guided resection of gliomas has been demonstrated to enhance discrimination of tumor tissue and to improve survival. ALA-based photodynamic therapy...
journal_title:Annals of surgical oncology
pub_type: 杂志文章
doi:10.1245/s10434-011-2201-6
更新日期:2013-12-01 00:00:00
abstract:BACKGROUND:The appropriate management of breast cancer risk in BRCA mutation carriers following ovarian cancer diagnosis remains unclear. We sought to determine the survival benefit and cost effectiveness of risk-reducing mastectomy (RRM) among women with BRCA1/2 mutations following stage II-IV ovarian cancer. DESIGN:...
journal_title:Annals of surgical oncology
pub_type: 杂志文章
doi:10.1245/s10434-017-5995-z
更新日期:2017-10-01 00:00:00
abstract:BACKGROUND:The purpose of this study was to investigate the diagnostic and prognostic value of circulating endothelial cell (CEC), a potential surrogate of tumor angiogenesis, in malignant pleural mesothelioma (MPM). METHODS:We prospectively evaluated CEC count in 4.0 mL of peripheral blood sampled from patients with ...
journal_title:Annals of surgical oncology
pub_type: 杂志文章
doi:10.1245/s10434-012-2506-0
更新日期:2012-12-01 00:00:00
abstract:BACKGROUND:Diffuse malignant peritoneal mesothelioma (DMPM) is an aggressive disease for which cytoreductive surgery (CRS) and hyperthermic intraperitoneal chemotherapy (HIPEC) have been used with remarkable survival benefits. Our aim was to analyze the clinicopathologic characteristics and prognosis of recurrent DMPM ...
journal_title:Annals of surgical oncology
pub_type: 杂志文章
doi:10.1245/s10434-014-3977-y
更新日期:2015-05-01 00:00:00
abstract:BACKGROUND:Given the emerging evidence supporting the lack of prognostic significance of gross extrathyroidal extension invading only strap muscles (strap-gETE), this study investigated whether lobectomy is feasible for patients with strap-gETE. METHODS:A retrospective cohort study was conducted with 636 patients who ...
journal_title:Annals of surgical oncology
pub_type: 杂志文章
doi:10.1245/s10434-019-07778-x
更新日期:2019-12-01 00:00:00
abstract:BACKGROUND:Pleomorphic carcinomas of the lung are uncommon malignant tumors composed of carcinomatous and sarcomatous components and are distinguished from other non-small-cell lung carcinomas by a more aggressive clinical course with early distant metastases and far worse survival. Epidermal growth factor receptor (EG...
journal_title:Annals of surgical oncology
pub_type: 杂志文章
doi:10.1245/s10434-011-1621-7
更新日期:2011-10-01 00:00:00
abstract:BACKGROUND:Lymphadenectomy is important in the surgical treatment of apparent early epithelial ovarian cancers (eEOC); however, its extent is not well defined. We evaluated the role of systematic lymphadenectomy, the risk factors related with lymph node metastases, the implications, and the morbidity of comprehensive s...
journal_title:Annals of surgical oncology
pub_type: 杂志文章
doi:10.1245/s10434-012-2439-7
更新日期:2012-11-01 00:00:00
abstract:BACKGROUND:Primary breast cancers that overexpress human epidermal growth factor receptor 2 have variable biological features and clinical outcomes. A subgroup of HER2-overexpressing tumors that express basal-like immunohistochemical markers-the so-called basal-HER2+ subtype--is associated with poor prognosis. We inves...
journal_title:Annals of surgical oncology
pub_type: 杂志文章
doi:10.1245/s10434-011-2032-5
更新日期:2012-03-01 00:00:00
abstract:BACKGROUND:Complete ablation rates after a single session of radiofrequency ablation (RFA) of hepatocellular carcinoma (HCC) vary from 48% to 97%. Limited data are available regarding risk factors and prognostic significance of incomplete ablation. METHODS:Between April 2001 and March 2006, 298 patients underwent RFA ...
journal_title:Annals of surgical oncology
pub_type: 杂志文章
doi:10.1245/s10434-007-9733-9
更新日期:2008-03-01 00:00:00
abstract:PURPOSE:Rates of both unilateral (UM) and contralateral prophylactic mastectomy (CPM) for unilateral early-stage breast cancer (ESBC) have been increasing since 2003. Recent studies suggest that this increase may be due to women choosing UM and CPM because of fear. We conducted an in-depth qualitative study to identify...
journal_title:Annals of surgical oncology
pub_type: 杂志文章
doi:10.1245/s10434-014-4033-7
更新日期:2015-02-01 00:00:00
abstract:BACKGROUND:Excess visceral adipose tissue may promote cancer development and progression via an obesity-related metabolic derangements, including adipocytokine-related inflammation, insulin resistance, and hypoxia. The relationship between visceral fat content and patient prognosis has been reported in some types of ca...
journal_title:Annals of surgical oncology
pub_type: 杂志文章
doi:10.1245/s10434-015-4432-4
更新日期:2015-11-01 00:00:00
abstract:BACKGROUND:Pseudoangiomatous stromal hyperplasia (PASH) is a benign localized fibrotic lesion in which clusters of spindle cells form cleftlike spaces, resembling ectatic vessels. Its relationship to breast cancer risk has not been characterized. MATERIALS AND METHODS:Histological presence of PASH was evaluated by rev...
journal_title:Annals of surgical oncology
pub_type: 杂志文章
doi:10.1245/s10434-010-1170-5
更新日期:2010-12-01 00:00:00
abstract::Preoperative needle diagnosis (PND) is being considered as a quality measure in breast cancer surgery. This criterion has not been thoroughly evaluated in the literature. The purpose of this study is to assess ease of access to these data and rate of compliance in a tertiary care center. We retrospectively reviewed al...
journal_title:Annals of surgical oncology
pub_type: 杂志文章
doi:10.1245/s10434-008-0188-4
更新日期:2009-05-01 00:00:00
abstract:BACKGROUND:The heterogeneous nuclear ribonucleoprotein (hnRNP) K is an essential RNA and DNA binding protein involved in gene expression and signal transduction. The role of hnRNP K in cancer is relatively understudied. However, several cellular functions strongly indicate that hnRNP K is involved in tumorigenesis. Onc...
journal_title:Annals of surgical oncology
pub_type: 杂志文章
doi:10.1245/s10434-010-1121-1
更新日期:2010-10-01 00:00:00
abstract:BACKGROUND:Malignant obstruction of the proximal colon (MOPC) traditionally has been treated with acute resection. However, morbidity and mortality rates following these emergency surgeries are high. Initial bowel decompression by stent placement or stoma construction has been used for distal obstructions as an alterna...
journal_title:Annals of surgical oncology
pub_type: 杂志文章
doi:10.1245/s10434-016-5247-7
更新日期:2016-10-01 00:00:00
abstract:BACKGROUND:The biopsy method of choice for soft tissue sarcomas (STS) of the limb and limb girdle is controversial. There have been no randomized controlled trials that compare incision biopsy with Tru-cut biopsy. We present a large series, which includes an analysis of the effectiveness of Tru-cut core biopsy both in ...
journal_title:Annals of surgical oncology
pub_type: 杂志文章
doi:10.1007/s10434-001-0080-y
更新日期:2001-01-01 00:00:00
abstract:BACKGROUND:Melphalan (L-PAM) hyperthermic isolated limb perfusion (HILP) is currently considered the standard treatment for patients with in-transit metastases from cutaneous melanoma. We here report on the results of L-PAM and low-dose tumor necrosis factor (TNF)alpha HILP in patients with bulky disease. METHODS:Twen...
journal_title:Annals of surgical oncology
pub_type: 临床试验,杂志文章
doi:10.1245/aso.2004.03.019
更新日期:2004-02-01 00:00:00
abstract:BACKGROUND:Postmastectomy radiation (PMRT) and regional nodal irradiation (RNI) improve outcomes for patients at high risk of locoregional recurrence (LRR). Node-negative patients with the triple-negative (TN) subtype and those who do not have a pCR with neoadjuvant chemotherapy (NAC) are at increased risk for LRR, but...
journal_title:Annals of surgical oncology
pub_type: 杂志文章
doi:10.1245/s10434-020-09136-8
更新日期:2020-09-21 00:00:00
abstract::Isolated hepatic perfusion (IHP) is a proven approach for regional delivery of chemotherapy in patients with unresectable primary and metastatic tumors of the liver. Most trials of IHP have utilized melphalan as the active drug in the perfusate. We performed a phase I trial to evaluate the efficacy, safety, and maximu...
journal_title:Annals of surgical oncology
pub_type: 杂志文章
doi:10.1245/s10434-008-0179-5
更新日期:2009-02-01 00:00:00
abstract:BACKGROUND:Touch imprint cytology (TIC) is a fast, cheap and specific intraoperative examination of the sentinel lymph nodes (SLNs) in early breast cancer patients. The results of TIC in patients with ultrasonically (US) uninvolved axillary lymph nodes are not known. The objective of our study was to compare the result...
journal_title:Annals of surgical oncology
pub_type: 杂志文章
doi:10.1245/s10434-008-9957-3
更新日期:2008-08-01 00:00:00
abstract:BACKGROUND:Dermatofibrosarcoma protuberans (DFSP) is a dermal sarcoma often diagnosed by excision biopsy, and is often incompletely excised, with high recurrence rates. Traditional wide excision involves resection margins of 2-4 cm, often resulting in morbid procedures requiring surgical reconstruction. An alternative ...
journal_title:Annals of surgical oncology
pub_type: 杂志文章
doi:10.1245/s10434-019-08011-5
更新日期:2020-03-01 00:00:00
abstract:: ...
journal_title:Annals of surgical oncology
pub_type: 评论,杂志文章
doi:10.1245/s10434-018-6891-x
更新日期:2018-12-01 00:00:00
abstract:BACKGROUND:Women considering risk reduction surgery after a diagnosis of breast/ovarian cancer and/or inherited cancer gene mutation face difficult decisions. The safety of combined breast and gynecologic surgery has not been well studied; therefore, we evaluated the outcomes for patients who have undergone coordinated...
journal_title:Annals of surgical oncology
pub_type: 杂志文章
doi:10.1245/s10434-016-5479-6
更新日期:2017-01-01 00:00:00
abstract:: ...
journal_title:Annals of surgical oncology
pub_type: 评论,杂志文章
doi:10.1245/s10434-018-6969-5
更新日期:2018-12-01 00:00:00
abstract:BACKGROUND:Breast surgeons have a wide variety of intraoperative techniques available to help achieve low rates for positive margins of excision, with variable levels of evidence. METHODS:A systematic review of the medical literature from 1995 to July 2016 was conducted, with 434 abstracts identified and evaluated. Th...
journal_title:Annals of surgical oncology
pub_type: 杂志文章,meta分析
doi:10.1245/s10434-016-5756-4
更新日期:2018-01-01 00:00:00
abstract:PURPOSE:To identify the prognostic factors and evaluate the impact of chemotherapy regimens on the outcomes of pediatric osteosarcoma of the extremities. METHODS:Patients younger than 18 years and diagnosed with high-grade osteosarcoma of the extremities during the period between January 2004 and December 2011 were in...
journal_title:Annals of surgical oncology
pub_type: 临床试验,杂志文章
doi:10.1245/s10434-014-4154-z
更新日期:2015-04-01 00:00:00