Abstract:
BACKGROUND:Breast surgery has evolved with more focus on improving cosmetic outcomes, which requires increased operative time and technical complexity. Implications of these technical advances in surgery for the surgeon are unclear, but they may increase intraoperative demands, both mentally and physically. We prospectively evaluated mental and physical demand across breast surgery procedures, and compared surgeon ergonomic risk between nipple-sparing (NSM) and skin-sparing mastectomy (SSM) using subjective and objective measures. METHODS:From May 2017 to July 2017, breast surgeons completed modified NASA-Task Load Index (TLX) workload surveys after cases. From January 2018 to July 2018, surgeons completed workload surveys and wore inertial measurement units to evaluate their postures during NSM and SSM cases. Mean angles of surgical postures, ergonomic risk, survey items, and patient factors were analyzed. RESULTS:Procedural duration was moderately related to surgeon frustration, mental and physical demand, and fatigue (p < 0.001). NSMs were rated 23% more physically demanding (M = 13.3, SD = 4.3) and demanded 28% more effort (M = 14.4, SD = 4.6) than SSMs (M = 10.8, SD = 4.7; M = 11.8, SD = 5.0). Incision type was a contributing factor in workload and procedural difficulty. Left arm mean angle was significantly greater for NSM (M = 30.1 degrees, SD = 6.6) than SSMs (M = 18.2 degrees, SD = 4.3). A higher musculoskeletal disorder risk score for the trunk was significantly associated with higher surgeon physical workload (p = 0.02). CONCLUSION:Nipple-sparing mastectomy required the highest surgeon-reported workload of all breast procedures, including physical demand and effort. Objective measures identified the surgeons' left upper arm as being at the greatest risk for a work-related musculoskeletal disorder, specifically from performing NSMs.
journal_name
Ann Surg Oncoljournal_title
Annals of surgical oncologyauthors
Hallbeck MS,Law KE,Lowndes BR,Linden AR,Morrow M,Blocker RC,Cain SM,Degnim AC,Hieken TJ,Jakub JW,Racz JM,Farley DR,Nelson H,Boughey JCdoi
10.1245/s10434-019-08159-0subject
Has Abstractpub_date
2020-05-01 00:00:00pages
1318-1326issue
5eissn
1068-9265issn
1534-4681pii
10.1245/s10434-019-08159-0journal_volume
27pub_type
杂志文章abstract:BACKGROUND:Identification of melanoma patients who need completion lymphadenectomy and adjuvant treatment after positive sentinel lymph node (SLN) biopsy would be a fundamental step forward toward personalized medicine. This study tested the hypothesis that the microscopic features of metastatic SLNs might predict not ...
journal_title:Annals of surgical oncology
pub_type: 杂志文章
doi:10.1245/s10434-007-9734-8
更新日期:2008-04-01 00:00:00
abstract:BACKGROUND:More information is needed for selection of patients with peritoneal metastases from endometrial cancer (EC) to undergo cytoreductive surgery (CRS) plus hyperthermic intraperitoneal chemotherapy (HIPEC). METHODS:This study analyzed clinical, pathologic, and treatment data for patients with peritoneal metast...
journal_title:Annals of surgical oncology
pub_type: 杂志文章,多中心研究
doi:10.1245/s10434-017-6307-3
更新日期:2018-03-01 00:00:00
abstract:BACKGROUND:There is increasing evidence that tumor hypoxia plays a significant role in the chemoresistance of melanoma, but to our knowledge, real-time tumor oxygenation during isolated limb infusion (ILI) has not been studied. We sought to demonstrate the feasibility of measuring real-time alterations in tissue oxygen...
journal_title:Annals of surgical oncology
pub_type: 杂志文章
doi:10.1245/s10434-013-3222-0
更新日期:2014-05-01 00:00:00
abstract:BACKGROUND:Neoadjuvant chemoradiotherapy (CRT) followed by radical surgery including total mesorectal excision (TME) is standard treatment in patients with locally advanced rectal cancer. Emerging data indicate that patients with complete pathologic response (ypCR) after CRT have favorable outcome, suggesting the possi...
journal_title:Annals of surgical oncology
pub_type: 杂志文章
doi:10.1245/s10434-011-1822-0
更新日期:2011-12-01 00:00:00
abstract:BACKGROUND:An expert consensus meeting had defined the standard lymphadenectomy during pancreatoduodenectomy for an adenocarcinoma of the head of the pancreas. There is a controversy regarding the possibility to perform this optimal lymphadenectomy by minimally invasive approach. PATIENTS:The patient was a 68-year-old...
journal_title:Annals of surgical oncology
pub_type: 杂志文章
doi:10.1245/s10434-016-5421-y
更新日期:2016-12-01 00:00:00
abstract:PURPOSE:To assess patterns of uptake and outcomes of laparoscopic colon and rectal cancer surgery in Ontario, and the potential influence of surgical fee incentives instituted on October 1, 2005. METHODS:We used Ontario administrative databases from fiscal years 2002 to 2009. Study outcomes were uptake rates of laparo...
journal_title:Annals of surgical oncology
pub_type: 杂志文章
doi:10.1245/s10434-013-3123-2
更新日期:2013-11-01 00:00:00
abstract:BACKGROUND:Adjuvant chemotherapy with 5-fluorouracil modulated by folinic acid, combined with oxaliplatin, has now become an accepted standard of care for patients with stage III colon cancer. In contrast, the use of adjuvant therapy for stage II patients remains controversial, and the identification of reliable progno...
journal_title:Annals of surgical oncology
pub_type: 杂志文章,评审
doi:10.1245/ASO.2006.07.003
更新日期:2006-06-01 00:00:00
abstract::Preoperative, operative, and postoperative factors may all contribute to high rates of anemia in patients undergoing surgery for cancer. Allogeneic blood transfusion is associated with both infectious risks and noninfectious risks such as human errors, hemolytic reactions, transfusion-related acute lung injury, transf...
journal_title:Annals of surgical oncology
pub_type: 杂志文章,评审
doi:10.1245/s10434-007-9502-9
更新日期:2008-01-01 00:00:00
abstract:BACKGROUND:Patients with palpable melanoma groin metastases have a poor prognosis. There is debate whether a combined superficial and deep groin dissection (CGD) is necessary or if superficial groin dissection (SGD) alone is sufficient. AIM:The aim of this study was to analyze risk factors for deep pelvic nodal involv...
journal_title:Annals of surgical oncology
pub_type: 杂志文章,多中心研究
doi:10.1245/s10434-015-4602-4
更新日期:2015-12-01 00:00:00
abstract:BACKGROUND:The prognosis of patients with peritoneally metastasized colorectal cancer has improved significantly with the introduction of cytoreductive surgery followed by hyperthermic intraperitoneal chemotherapy (CRS + HIPEC). Although a macroscopically complete resection is achieved in nearly every patient, recurren...
journal_title:Annals of surgical oncology
pub_type: 杂志文章
doi:10.1245/s10434-014-4297-y
更新日期:2015-08-01 00:00:00
abstract:BACKGROUND:Although advocated by some, minimally invasive adrenalectomy (MIA) for adrenocortical carcinoma (ACC) is controversial. Moreover, the oncologic implications for patients requiring conversion to an open procedure during attempted MIA for ACC are not extensively reported. PATIENTS AND METHODS:The National Can...
journal_title:Annals of surgical oncology
pub_type: 杂志文章
doi:10.1245/s10434-020-08824-9
更新日期:2021-01-01 00:00:00
abstract:BACKGROUND:Isolated hepatic perfusion (IHP) of chemotherapy has been proposed to deliver high doses of drug while avoiding systemic toxicity. Hypotonic cisplatin has a high in vitro activity on human colon cancer cells. We studied the safety of a 30-min hypoxic single-pass IHP with hypotonic cisplatin. METHODS:A preli...
journal_title:Annals of surgical oncology
pub_type: 杂志文章
doi:10.1245/s10434-009-0775-z
更新日期:2010-03-01 00:00:00
abstract:BACKGROUND:There is no consensus as to the impact of lymph node micrometastasis on survival of patients with gastric cancer. The aim of this study was to clarify the prognostic significance of lymph node micrometastasis in patients with histologically node-negative gastric cancer. METHODS:Lymph nodes (n = 2039) from 6...
journal_title:Annals of surgical oncology
pub_type: 杂志文章
doi:10.1007/BF02574499
更新日期:2002-10-01 00:00:00
abstract:BACKGROUND:Integration of palliative care services into the surgical treatment plan is important for holistic patient care. We sought to examine the association between patient race/ethnicity and county-level vulnerability relative to patterns of hospice utilization. PATIENTS AND METHODS:Medicare Standard Analytic Fil...
journal_title:Annals of surgical oncology
pub_type: 杂志文章
doi:10.1245/s10434-020-09227-6
更新日期:2020-10-14 00:00:00
abstract:BACKGROUND:Cancer registries have been set up worldwide to provide information for cancer health planning. There are known variations in breast cancer incidence and mortality worldwide. However, breast cancer incidence, pathological characteristics, and survival data is still under-reported in Asian countries. This is ...
journal_title:Annals of surgical oncology
pub_type: 杂志文章
doi:10.1245/s10434-011-1960-4
更新日期:2011-10-01 00:00:00
abstract:PURPOSE:To investigate the influence of the introduction of total mesorectal excision (TME) on local recurrence rate and survival in patients with rectal cancer. METHODS:A total of 171 consecutive patients underwent anterior or abdominoperineal resection for primary rectal cancer. When the TME technique was introduced...
journal_title:Annals of surgical oncology
pub_type: 杂志文章
doi:10.1245/s10434-011-1571-0
更新日期:2011-07-01 00:00:00
abstract:BACKGROUND:Appendiceal goblet cell adenocarcinoma (GCA) is often misclassified and mistreated due to mixed histologic features. In general, cytoreductive surgery plus hyperthermic intraperitoneal chemotherapy (CRS/HIPEC) is standard of care for peritoneal carcinomatosis (PC) from mucinous appendiceal tumors; however, i...
journal_title:Annals of surgical oncology
pub_type: 杂志文章
doi:10.1245/s10434-019-07932-5
更新日期:2020-01-01 00:00:00
abstract:BACKGROUND:Radioactive seed localization (RSL) and the Savi Scout® radar (SSR) are newer alternatives to wire-guided localization (WL) for nonpalpable breast lesions. OBJECTIVE:The aim of this study was to compare three localization devices when multiple devices were used for preoperative localization for breast surge...
journal_title:Annals of surgical oncology
pub_type: 杂志文章
doi:10.1245/s10434-020-09159-1
更新日期:2020-09-28 00:00:00
abstract:BACKGROUND:The relative effects of growth hormone on tumor versus host growth and protein metabolism are not known. This study examines the influence of recombinant rat growth hormone (r-rGH) on host and tumor growth, host body composition, and protein synthesis of tumor and host in tumor-bearing rats. METHODS:After l...
journal_title:Annals of surgical oncology
pub_type: 杂志文章
doi:10.1007/BF02303570
更新日期:1994-07-01 00:00:00
abstract:BACKGROUND:Hereditary diffuse gastric cancer (HDGC) is an autosomal dominant cancer syndrome. Up to 30% of families with HDGC have mutations in the E-cadherin gene, CDH1. The role of prophylactic versus therapeutic gastrectomy for HDGC was studied prospectively. METHODS:Eighteen consecutive patients with CDH1 mutation...
journal_title:Annals of surgical oncology
pub_type: 杂志文章
doi:10.1245/s10434-011-1648-9
更新日期:2011-09-01 00:00:00
abstract:BACKGROUND:Pseudomyxoma peritonei syndrome is a rare disease arising from perforation of an adenoma of the appendix. The syndrome is characterized by progressive accumulation of mucinous fluid and tumor within the abdomen and pelvis. Although this tumor is only superficially invasive and does not metastasize, it is a f...
journal_title:Annals of surgical oncology
pub_type: 杂志文章
doi:10.1007/BF02523654
更新日期:2000-04-01 00:00:00
abstract:BACKGROUND:Tumor size can be measured easily before or during operation with no special tools, but its prognostic use in patients with gastric carcinoma is still unclear. METHODS:Clinicopathologic data of 479 patients who underwent curative operation for gastric carcinoma were studies. The relationship between tumor s...
journal_title:Annals of surgical oncology
pub_type: 杂志文章
doi:10.1007/BF02303796
更新日期:1997-03-01 00:00:00
abstract:PURPOSE:Retroperitoneal sarcomas (RPS) are rare malignancies, comprising just 10-15 % of all soft-tissue sarcomas. These are challenging tumors to treat, with surgical resection being the only modality capable of providing a cure. This study analyzed the management and survival of patients resected at a large academic ...
journal_title:Annals of surgical oncology
pub_type: 临床试验,杂志文章
doi:10.1245/s10434-014-3616-7
更新日期:2014-07-01 00:00:00
abstract:BACKGROUND:Antiangiogenic therapies have been developed recently in combination with traditional chemotherapy for patients with metastatic colorectal cancer. The aim of this study was to clarify the association between messenger RNA (mRNA) levels of vascular endothelial growth factor (VEGF) and its receptors (VEGFR) in...
journal_title:Annals of surgical oncology
pub_type: 杂志文章
doi:10.1245/s10434-008-9811-7
更新日期:2008-04-01 00:00:00
abstract:BACKGROUND:As increased focus is placed on quality of care in surgery, readmission is an increasingly important metric by which hospital and surgeon quality is measured. For complex pancreatic surgery, we hypothesized that increased pancreaticoduodenectomy (PD) volume may mitigate readmission rates. METHODS:The Univer...
journal_title:Annals of surgical oncology
pub_type: 杂志文章
doi:10.1245/s10434-015-4451-1
更新日期:2015-11-01 00:00:00
abstract:BACKGROUND:The purpose of this study is to establish the validity of F-18-deoxyglucose positron emission tomography-computed tomography (FDG-PET-CT) scan staging for cutaneous melanoma when a musculoskeletal image abnormality is detected. METHODS:An institutional review board (IRB)-approved prospective database was qu...
journal_title:Annals of surgical oncology
pub_type: 临床试验,杂志文章
doi:10.1245/s10434-009-0843-4
更新日期:2010-04-01 00:00:00
abstract:METHODS:This study evaluated the effectiveness and morbidity associated with 116 peritoneovenous shunts inserted into 89 patients for symptomatic malignant ascites between 1981 and 1991. All patients had previously failed standard medical therapy of salt and fluid restriction, diuretics, and intermittent peritoneal asp...
journal_title:Annals of surgical oncology
pub_type: 临床试验,杂志文章
doi:10.1007/BF02303809
更新日期:1994-09-01 00:00:00
abstract:BACKGROUND:Residual tumor size after neoadjuvant chemotherapy is an important consideration in surgical planning. We examined the accuracy of the combination of mammography and sonography in predicting pathologic residual tumor size. METHODS:Tumor size was evaluated by physical examination, mammography, and sonography...
journal_title:Annals of surgical oncology
pub_type: 杂志文章,随机对照试验
doi:10.1245/s10434-006-9086-9
更新日期:2006-11-01 00:00:00
abstract:BACKGROUND:It is unclear whether hepatic resection (HR) or transarterial chemoembolization (TACE) is associated with better outcomes for patients with hepatocellular carcinoma (HCC) in Barcelona Clinic Liver Cancer (BCLC) stage A. The present study compared survival for patients with BCLC stage A HCC treated by HR or T...
journal_title:Annals of surgical oncology
pub_type: 杂志文章
doi:10.1245/s10434-014-3704-8
更新日期:2014-09-01 00:00:00
abstract:BACKGROUND:As tumor burden increases in colorectal cancer, treatment complexity progresses from colectomy to hepatectomy and lastly to cytoreductive surgery with heated intraperitoneal chemotherapy (CRS-HIPEC). The aim of this study was to evaluate whether disparities exist in the access to progressively more complex s...
journal_title:Annals of surgical oncology
pub_type: 杂志文章
doi:10.1245/s10434-014-4220-6
更新日期:2015-05-01 00:00:00