Abstract:
INTRODUCTION:Sentinel lymph node biopsy (SLNB) is the standard of care for staging N0 primary early breast cancers (EBC). Patients in developing countries mostly present with large (LOBC) or locally advanced cancers (LABC) and are treated with neo-adjuvant chemotherapy (NACT). Accuracy of SLNB in staging stage III N0 and post-NACT N0 patients is uncertain. This prospective validation study on LOBC/LABC patients compared the accuracy of SLNB between primary versus post-NACT surgery. MATERIALS AND METHODS:Fifty T3/T4, N0 patients undergoing primary surgery (Group I) and 70 LOBC/LABC (index stage) treated with NACT and N0 at the time of surgery (Group II) were inducted. Validation SLNB was performed using low-cost methylene-blue and (99m)Tc-Antimony colloid. SLN identification (IR) and false-negative (FNR) rates were compared between the groups. Sub-group analysis was done in Group II per index tumor and nodal stage to identify factors predicting SLN IR and FNR in post-NACT patients. SLN IR and FNR in both groups were compared with those in previously published SLN validation study and meta-analysis in EBC. RESULTS:Using combination of blue-dye and radio-colloid, post-NACT SLN IR and FNR (82.9, 13.5 %) were far inferior to T3/T4 primary surgery group (94, 7.7 %; p values 0.034, 0.041) and in EBC. SLN IR using blue-dye alone was dismally low in post-NACT LABCs. Factors predicting unidentified post-NACT SLN and false-negative SLNB included young age, LVI, skin infiltration, extra-nodal spread or N2a stage, and UOQ tumors. CONCLUSIONS:Accuracy of SLNB in T3, N0 tumors undergoing primary surgery is comparable to that of SLNB for N0 EBC. In post-NACT patients, SLNB IR are lower and FNR are higher. Factors predictive of non-identification and false-negative SLNB include pre-NACT skin involvement (T4b), N2a stage or extra-nodal invasion and LVI, and to a lesser extent, young age and UOQ location of the tumor.
journal_name
World J Surgjournal_title
World journal of surgeryauthors
Agarwal G,Rajan S,Gambhir S,Lal P,Krishnani N,Kheruka Sdoi
10.1007/s00268-015-3222-2subject
Has Abstractpub_date
2016-07-01 00:00:00pages
1583-9issue
7eissn
0364-2313issn
1432-2323pii
10.1007/s00268-015-3222-2journal_volume
40pub_type
杂志文章abstract:BACKGROUND:Adhesions due to the reactions caused by the grafts used in primary vascular operations can lead to various problems when a secondary operation is necessary. These problems include bleeding, injuries to neighboring organs, and complications occurring due to a prolonged operation. We investigated the effects ...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/s00268-005-0750-1
更新日期:2006-09-01 00:00:00
abstract:BACKGROUND:This study was designed to establish the current demographic and treatment patterns of mandibular fractures in two urban centers (Lagos University Teaching Hospital, Lagos, and National Hospital, Abuja) in Nigeria. METHODS:All cases of mandibular fractures diagnosed and treated at the Department of Oral and...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/s00268-008-9773-8
更新日期:2008-12-01 00:00:00
abstract:BACKGROUND:Venous thromboembolism (VTE) is a condition that has always been perceived to be rare in Asia. The aim of this systematic review was to gather the current available evidence on the incidence of VTE in this population. A secondary aim was to assess the efficacy of pharmacological prophylaxis, and hence determ...
journal_title:World journal of surgery
pub_type: 杂志文章,评审
doi:10.1007/s00268-014-2763-0
更新日期:2015-01-01 00:00:00
abstract:BACKGROUND:Single-incision laparoscopic colorectal surgery (SILS) suggests a promising alternative to conventional laparoscopic surgery. In this report we describe our initial experience with SILS for both right hemicolectomies and anterior resections. METHODS:Between June 2009 and May 2010, SILS was performed for 32 ...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/s00268-011-0989-7
更新日期:2011-04-01 00:00:00
abstract::Evaluation of prognostic factors of adenocarcinoma of Vater's ampulla is still a matter of debate. The aim of this study was to evaluate retrospectively factors that influence early and long-term outcomes in a 20-year single-institution experience on ampullary carcinoma. A total of 94 consecutive patients with ampulla...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/s00268-004-7498-x
更新日期:2005-04-01 00:00:00
abstract::Organ transplantation continues to be hindered by a limited supply of organs. A significant percentage of potential organ donors are lost to either medical failure or inability to obtain consent for donation. In a surgical intensive care unit (ICU) we have refocused our efforts toward aggressive resuscitation, directe...
journal_title:World journal of surgery
pub_type: 杂志文章,评审
doi:10.1007/pl00012362
更新日期:1999-07-01 00:00:00
abstract::The role of nitric oxide in mediating smooth muscle relaxation is well established. Less is known about the downstream signaling events inside the smooth muscle cell that produce relaxation of the contractile machinery. One possible effector molecule is the small heat shock protein HSP20. Increased phosphorylation of ...
journal_title:World journal of surgery
pub_type: 杂志文章,评审
doi:10.1007/s00268-002-4052-6
更新日期:2002-07-01 00:00:00
abstract::The present prospective clinical study was carried out to investigate the effect of age on mortality, morbidity, and readmission rates after coronary artery bypass grafting (CABG). Data on 1131 consecutive CABG patients were collected in a surgical center and in all 18 secondary referral hospitals up to 3 months after...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/s00268-003-7033-5
更新日期:2003-12-01 00:00:00
abstract::Axillary clearance in node-negative breast cancer patients is performed only for staging and prognostic purposes. The sentinel node concept may provide an alternative conservative approach for these patients. This paper reports on the learning experience with lymphatic mapping involving the use of patent blue dye for ...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/s002689910054
更新日期:2000-03-01 00:00:00
abstract:BACKGROUND:Africa's health workforce crisis has recently been emphasized by major international organizations. As a part of this discussion, it has become apparent that the workforce required to deliver surgical services has been significantly neglected. METHODS:This paper reviews some of the reasons for this relative...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/s00268-008-9473-4
更新日期:2008-06-01 00:00:00
abstract::Angiogenesis is of vital importance during the development and progression of solid tumors. Vascular endothelial growth factor (VEGF) is a major regulator of angiogenesis and could be produced by some cancer cells. To investigate the clinical relevance of VEGF in the tumorigenesis of human thyroid, an immunohistochemi...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/s002680020085
更新日期:2001-03-01 00:00:00
abstract:BACKGROUND:Treatment of peripherally located liver tumors with diaphragmatic invasion is technically demanding but does not preclude resection for cure. The aim of the present study was to compare patients undergoing combined liver and diaphragmatic resection with those submitted to hepatectomy alone so as to evaluate ...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/s00268-013-2083-9
更新日期:2013-09-01 00:00:00
abstract::The current clinical applications of ultrasonography (US) of soft tissue masses are discussed. These include the detection of occult masses, the characterization of palpable masses, tumor surveillance, and US guided percutaneous aspirations/biopsies of soft tissue masses. ...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/s002689910036
更新日期:2000-02-01 00:00:00
abstract::The introduction of laparoscopic techniques for the management of biliary stone disease has expanded the therapeutic choices for surgeons confronted with choledocholithiasis. As new strategies emerge, the treatment of cholelithiasis and choledocholithiasis remains controversial. This paper discusses the options availa...
journal_title:World journal of surgery
pub_type: 杂志文章,评审
doi:10.1007/s002689900531
更新日期:1998-11-01 00:00:00
abstract:BACKGROUND:The aim of this study was to compare the influence of either general (GA) or local (LA) anesthesia on the postoperative neurocognitive outcome in patients undergoing carotid endarterectomy (CEA) in a randomized study. Therefore, we performed a subgroup analysis of the multicenter GALA study. METHODS:A total...
journal_title:World journal of surgery
pub_type: 杂志文章,多中心研究,随机对照试验
doi:10.1007/s00268-009-0047-x
更新日期:2009-07-01 00:00:00
abstract:BACKGROUND:The aim of this study was to assess the efficacy of the Nd:YAG laser for treating stage I squamous cell carcinoma (SCC) of the lip. The retrospective study was performed in a tertiary care referral hospital in northern India. METHODS:In January 2007 the records of patients treated by Nd:YAG laser ablation o...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/s00268-007-9363-1
更新日期:2008-04-01 00:00:00
abstract:INTRODUCTION:Parathyroid cysts are rare but clinically significant lesions. They can be functional, mistaken for a thyroid cyst, and/or managed nonoperatively on occasion. METHODS:We identified seven patients (1 male, 6 females) with the diagnosis of parathyroid cyst from 1998 to 2003. RESULTS:Altogether, 33% of the ...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/s00268-005-0748-8
更新日期:2007-01-01 00:00:00
abstract::Normal cellular survival is dependent on the cooperative expression of genes' signaling through a broad array of DNA patterns. Cancer, however, has an Achilles' heel. Its altered cellular survival is dependent on a limited subset of signals through mutated DNA, possibly as few as three. Identification and control of t...
journal_title:World journal of surgery
pub_type: 杂志文章,评审
doi:10.1007/s00268-011-1100-0
更新日期:2011-08-01 00:00:00
abstract:BACKGROUND:Abdominal packing (AP) in damage-control laparotomy (DCL) is a lifesaving technique that controls coagulopathic hemorrhage in severely injured trauma patients. However, the impact of the duration of AP on the incidence of re-bleeding and on intra-abdominal infections in penetrating abdominal trauma is not cl...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/s00268-012-1745-3
更新日期:2012-12-01 00:00:00
abstract:BACKGROUND:There is increasing interest in provision of essential surgical care as part of public health policy in low- and middle-income countries (LMIC). Relatively simple interventions have been shown to prevent death and disability. We reviewed the published literature to examine the cost-effectiveness of simple su...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/s00268-013-2243-y
更新日期:2014-01-01 00:00:00
abstract:BACKGROUND:Currently, most patients undergoing laparoscopic cholecystectomy (LC) in Switzerland are inpatients for 2-3 days. Due to a lack of available hospital beds, we asked whether day-case surgery would be an option for patients in central Switzerland. The questions of acceptability of outpatient LC and factors con...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/s00268-017-4098-0
更新日期:2017-11-01 00:00:00
abstract:BACKGROUND:A small remnant liver volume is an important risk factor for posthepatectomy liver failure and can be predicted accurately by computed tomography (CT) volumetry using radiologic image analysis software. Unfortunately, this software is expensive and usually requires support by a radiologist. ImageJ is a freel...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/s00268-007-9197-x
更新日期:2007-11-01 00:00:00
abstract::The primal need for nutrients is satisfied by mechanisms for sensing internal stores and detecting food; ATP is the most primitive signal. With increasing density of sensory neurons and glia (the primordial brain) and the emergence of autonomic neural activity throughout the endoderm, transmitters and other signaling ...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/s00268-009-0138-8
更新日期:2009-10-01 00:00:00
abstract::Node dissection for melanoma remains the most important therapeutic decision for the optimal management of the patient with melanoma. In Australia and in some parts of the United States, the majority of patients with intermediate thickness melanoma (1.6-4.00 mm) will undergo elective lymph node dissection. In Europe, ...
journal_title:World journal of surgery
pub_type: 杂志文章,评审
doi:
更新日期:1992-03-01 00:00:00
abstract:BACKGROUND:Our aim was to evaluate the advantages and limitations of delayed laparoscopic cholecystectomy (LC) in a tertiary center. MATERIALS AND METHODS:A retrospective analysis of all patients admitted to our institution with acute calculous cholecystitis (ACC) between January 2003 and December of 2012 was performe...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/s00268-017-3928-4
更新日期:2017-07-01 00:00:00
abstract:: ...
journal_title:World journal of surgery
pub_type: 评论,信件
doi:10.1007/s00268-018-4704-9
更新日期:2019-03-01 00:00:00
abstract:BACKGROUND:Surgery for Graves' disease (GD) is usually performed after adequate control with medical treatment. Occasionally, rapid pre-operative optimization is required. The primary objective was to compare the outcomes of patients undergoing elective surgery for well-controlled GD with those undergoing rapid pre-ope...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/s00268-019-05125-5
更新日期:2019-12-01 00:00:00
abstract::Mansonic schistosomiasis is an endemic disease in Brazil, with an estimated 10-12 million people infested. Among its clinical manifestations, the hepatosplenic form causes portal hypertension which, in turn, brings about severe digestive hemorrhage, the most serious complication of the disease. Normally, the patients ...
journal_title:World journal of surgery
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1007/BF01659051
更新日期:1991-03-01 00:00:00
abstract::Malignant melanoma is notoriously resistant to chemotherapy. Standard single agents include dacarbazine and the nitrosoureas, but most series treating patients with metastatic melanoma report response rates of about 20%. Occasional patients, however, achieve long term remission, amounting to cure, after such treatment...
journal_title:World journal of surgery
pub_type: 杂志文章,评审
doi:10.1007/BF02071532
更新日期:1992-03-01 00:00:00
abstract:INTRODUCTION:Percutaneous needle biopsy (PNB) is the standard of care for diagnosis of breast lesions. Rates of excisional biopsy for breast diagnosis in North America have been reported at approximately 35 %, although significant regional variation exists. A target rate of PNB for diagnosis of breast abnormalities is ...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/s00268-015-3293-0
更新日期:2016-07-01 00:00:00