Abstract:
BACKGROUND:As the use of Papanicolaou cytologic screening became widespread in the United States of America, there was a shift toward diagnosis of earlier clinical stages in patients with carcinoma of the cervix. This increase in early stage disease has also resulted in increased use of surgery as the primary treatment. Thus, it seems appropriate to investigate the role of hysterectomy in the modern treatment of patients with invasive carcinoma of the cervix, including survival rates and the role of the gynecologic oncologist. STUDY DESIGN:Approximately 1,800 hospitals were sent invitations to submit data on a standard collection form designed by a multidisciplinary committee of specialists. Cancer registrars at 703 hospitals submitted anonymous data on 11,721 patients with carcinoma of the cervix who were diagnosed or treated, or both, in 1984 and 1990. RESULTS:There were 6,570 (56.1 percent) women who had major operations. An operation with curative intent, either total hysterectomy (TAH) or radical type II or III hysterectomy with pelvic node dissection PND (RHPND), was carried out in 5,105 (43.6 percent) women, constituting 38.9 percent of the patients in 1984, and 48.2 percent of the patients in 1990. Overall (both years), 66.5 percent of patients had squamous cell carcinomas and 21.1 percent had adenocarcinomas. The type of operation performed was judged appropriate in 95.6 percent of the patients who underwent RHPND, but in only 80.0 percent of the patients who underwent TAH. Gynecologic oncologists performed 46.8 percent of the hysterectomies in 1984, and 63.8 percent in 1990. Recurrence and long-term survival data are available for the 1984 patients; five-year survival rates for women who underwent TAH (n = 1,013) and RHPND (n = 1,279) were 89 and 85 percent, respectively. A RHPND with negative nodes resulted in a 90 percent five-year survival rate (n = 916) as compared to 70 percent in those with positive nodes (n = 194). CONCLUSIONS:The use of hysterectomy as definitive therapy increased markedly from 1984 to 1990 and was associated with low complication and high five-year survival rates. Gynecologic oncologists now perform the majority of hysterectomies for this type of carcinoma, with general gynecologists playing a lesser role than in the earlier study year. Guidelines should be developed for the use of TAH in patients with invasive carcinoma of the cervix.
journal_name
J Am Coll Surgjournal_title
Journal of the American College of Surgeonsauthors
Shingleton HM,Jones WB,Russell A,Fremgen A,Chmiel JS,Ocwieja K,Winchester DP,Clive Rsubject
Has Abstractpub_date
1996-10-01 00:00:00pages
393-400issue
4eissn
1072-7515issn
1879-1190journal_volume
183pub_type
杂志文章abstract:BACKGROUND:Deceased-donor kidneys are often exposed to ischemic events from donor instability, as evidenced by acute kidney injury (AKI). Clinicians may be reluctant to transplant kidneys with AKI that also have prolonged cold ischemia time (CIT) for fear of an additional deleterious effect. STUDY DESIGN:We evaluated ...
journal_title:Journal of the American College of Surgeons
pub_type: 杂志文章
doi:10.1016/j.jamcollsurg.2015.05.003
更新日期:2015-08-01 00:00:00
abstract:BACKGROUND:Cecal leak or disruption after appendectomy for complicated appendicitis is a consequence of severity of disease and is related to residual abscess cavity, inflammation, phlegmon, and nonviable intestine. In an attempt to improve results, we have begun to resect the cecum and other localized infected tissue ...
journal_title:Journal of the American College of Surgeons
pub_type: 杂志文章
doi:
更新日期:1994-08-01 00:00:00
abstract:BACKGROUND:Protecting future childbearing motivates young women with breast cancer to seek oocyte or embryo cryopreservation. Concerns about delays in cancer treatment may influence patients and practitioners considering these procedures. In this study, we compared timing of chemotherapy in women who underwent ovarian ...
journal_title:Journal of the American College of Surgeons
pub_type: 杂志文章
doi:10.1016/j.jamcollsurg.2009.08.006
更新日期:2009-11-01 00:00:00
abstract::Although his primacy was subsequently challenged by a student, it is now known that Johann Georg Wirsüng, the prosector of Padua, Italy, discovered the human pancreatic duct in 1642 during the dissection of an executed murderer. Instead of publishing his discovery, he engraved a drawing of the duct on a copper plate, ...
journal_title:Journal of the American College of Surgeons
pub_type: 传,历史文章,杂志文章
doi:10.1016/s1072-7515(98)00136-7
更新日期:1998-08-01 00:00:00
abstract:BACKGROUND:Recent changes in the educational environment and in the content of specialty surgical education have highlighted limitations, both educational and logistic, of the current system of graduate surgical education. To address these issues, the Graduate Medical Education Committee of the American College of Surg...
journal_title:Journal of the American College of Surgeons
pub_type: 杂志文章
doi:10.1016/s1072-7515(97)00130-0
更新日期:1998-01-01 00:00:00
abstract:BACKGROUND:Hereditary predisposition to colorectal cancer most often manifests itself as familial adenomatous polyposis from mutations of APC, or hereditary nonpolyposis colorectal cancer, resulting from mutations of MSH2, MLH1, MSH6, or other genes. Previously, we described a rare founder mutation MSH2*1906C > G in As...
journal_title:Journal of the American College of Surgeons
pub_type: 杂志文章
doi:10.1016/S1072-7515(02)01808-2
更新日期:2003-02-01 00:00:00
abstract:BACKGROUND:A new proprietary negative pressure wound device has been developed to apply negative pressure therapy to closed wounds (closed-NPWT). We postulated that closed-NPWT management of contaminated and dirty wounds would lead to faster wound healing and no significant difference in wound complications. STUDY DES...
journal_title:Journal of the American College of Surgeons
pub_type: 杂志文章,随机对照试验
doi:10.1016/j.jamcollsurg.2017.12.008
更新日期:2018-04-01 00:00:00
abstract:BACKGROUND:Recurrent laryngeal nerve injury caused by esophageal cancer surgery is worrisome but often temporary; it is unclear when and how the paralysis is resolved. Hoarseness of voice from vocal cord paralysis (VCP) can have detrimental effects on postoperative patients. The aims of this study were to clarify the p...
journal_title:Journal of the American College of Surgeons
pub_type: 杂志文章
doi:10.1016/s1072-7515(98)00295-6
更新日期:1999-03-01 00:00:00
abstract:BACKGROUND:The anatomic difficulties that we have to deal with in open surgery for rectal cancer have not been overcome with the laparoscopic approach. In the search for a solution, a change of concept arose: approaching the rectum from below. The main objectives of this study were to show the potential advantages of t...
journal_title:Journal of the American College of Surgeons
pub_type: 临床试验,杂志文章
doi:10.1016/j.jamcollsurg.2015.03.046
更新日期:2015-08-01 00:00:00
abstract:BACKGROUND:Frailty is an objective method of quantifying a patient's fitness for surgery. Its clinical use is limited by the time needed to complete, as well as a lack of evidence-based interventions to improve outcomes in identified frail patients. The purpose of this study was to critically analyze the components of ...
journal_title:Journal of the American College of Surgeons
pub_type: 临床试验,杂志文章
doi:10.1016/j.jamcollsurg.2015.01.053
更新日期:2015-05-01 00:00:00
abstract:BACKGROUND:Since 1968, there have been three published reports in the United States literature of 41, 118, and 145 consecutive patients undergoing pancreaticoduodenectomy without mortality. In all of these series, the pancreatic remnant was anastomosed to the jejunum. STUDY DESIGN:This study was designed to review 152...
journal_title:Journal of the American College of Surgeons
pub_type: 杂志文章
doi:10.1016/S1072-7515(03)00331-4
更新日期:2003-08-01 00:00:00
abstract:BACKGROUND:Controversy persists regarding digestive reconnection following subtotal gastrectomy for carcinoma. A randomized prospective trial comparing Billroth I and Billroth II procedures for mortality, digestive comfort, survival, and patterns of recurrence was conducted. STUDY DESIGN:Thirty patients underwent Bill...
journal_title:Journal of the American College of Surgeons
pub_type: 临床试验,杂志文章,随机对照试验
doi:
更新日期:1996-09-01 00:00:00
abstract:BACKGROUND:Many remote-access approaches (RAAs) to the thyroid have been described to circumvent anterior neck scarring, including the transaxillary, robotic facelift, and transoral endoscopic vestibular approaches. These techniques have been popularized in Asia, but adoption has been slow in North America. We aimed to...
journal_title:Journal of the American College of Surgeons
pub_type: 杂志文章
doi:10.1016/j.jamcollsurg.2018.12.005
更新日期:2019-04-01 00:00:00
abstract:BACKGROUND:To gain additional insight into the impact of fatigue on surgery resident proficiency, we set out to quantify its impact on behavioral and neurophysiologic measures. STUDY DESIGN:Simulations were first created using a visio-haptic joystick attached to a surgical instrument (tool) that allows realistic inter...
journal_title:Journal of the American College of Surgeons
pub_type: 杂志文章
doi:10.1016/j.jamcollsurg.2011.03.028
更新日期:2011-07-01 00:00:00
abstract:BACKGROUND:After excision of an abnormal gland, the dynamics of intraoperative parathyroid hormone (PTH) levels signal whether or not more hypersecreting tissue is present. This quantitative assurance of operative success has led to targeted exploration of the hyperfunctioning gland(s). Some have questioned the need fo...
journal_title:Journal of the American College of Surgeons
pub_type: 杂志文章
doi:10.1016/j.jamcollsurg.2006.02.003
更新日期:2006-05-01 00:00:00
abstract:BACKGROUND:The Michigan Trauma Quality Improvement Program (MTQIP) is a collaborative quality initiative sponsored by Blue Cross Blue Shield of Michigan and Blue Care Network (BCBSM/BCN). The MTQIP benchmark reports identified our trauma center as a high outlier for venous thromboembolism (VTE) episodes. This study out...
journal_title:Journal of the American College of Surgeons
pub_type: 杂志文章
doi:10.1016/j.jamcollsurg.2015.05.006
更新日期:2015-09-01 00:00:00
abstract:BACKGROUND:An intraoperative adverse event (iAE) is often directly attributable to the surgeon's technical error and/or suboptimal intraoperative judgment. We aimed to examine the psychological impact of iAEs on surgeons as well as the surgeons' attitude about iAE reporting. STUDY DESIGN:We conducted a web-based cross...
journal_title:Journal of the American College of Surgeons
pub_type: 杂志文章,多中心研究
doi:10.1016/j.jamcollsurg.2016.12.039
更新日期:2017-06-01 00:00:00
abstract:BACKGROUND:The Affordable Care Act (ACA)'s Medicaid expansion has increased access to surgical care overall. Whether it was associated with reduced disparities in use of regionalized surgery at high-volume hospitals (HVH) remains unknown. Quasi-experimental evaluations of this expansion were performed to examine the us...
journal_title:Journal of the American College of Surgeons
pub_type: 杂志文章
doi:10.1016/j.jamcollsurg.2018.08.693
更新日期:2018-11-01 00:00:00
abstract:BACKGROUND:Although the overall incidence of venous thromboembolism (VTE) after open aortic surgery is low, it is not known whether specific factors can place patients at increased risk for this complication. The goal of our study was to identify patient and procedure characteristics that are associated with increased ...
journal_title:Journal of the American College of Surgeons
pub_type: 杂志文章
doi:10.1016/j.jamcollsurg.2011.12.031
更新日期:2012-04-01 00:00:00
abstract:BACKGROUND:Treatment of early gastric cancer may be an ideal application for laparoscopic surgery. But laparoscopic surgery has various limitations derived from the lack of tactile feedback and a two-dimensional display of the operative field. So, laparoscopic surgery is technically challenging and requires a more deta...
journal_title:Journal of the American College of Surgeons
pub_type: 杂志文章
doi:10.1016/j.jamcollsurg.2003.07.021
更新日期:2003-12-01 00:00:00
abstract:BACKGROUND:Obese patients are more prone to post-injury multiple organ failure (MOF). Obesity pathophysiology includes an adipose-tissue-derived, renin-angiotensin-aldosterone system affecting inflammatory responses via leukocyte angiotensin receptors. We hypothesized that obese patients receiving pre-injury angiotensi...
journal_title:Journal of the American College of Surgeons
pub_type: 杂志文章
doi:10.1016/j.jamcollsurg.2015.03.051
更新日期:2015-08-01 00:00:00
abstract:BACKGROUND:Identifying iatrogenic injuries using existing data sources is important for improved transparency in the occurrence of intraoperative events. There is evidence that procedure codes are reliably recorded in claims data. The objective of this study was to assess whether concurrent splenic procedure codes in p...
journal_title:Journal of the American College of Surgeons
pub_type: 杂志文章
doi:10.1016/j.jamcollsurg.2014.02.029
更新日期:2014-08-01 00:00:00
abstract:BACKGROUND:In hepatic resection, it is important to control intrahepatic blood flow to minimize blood loss. Intermittent and selective vascular occlusion, if possible, are advisable. STUDY DESIGN:For this purpose, we created the double balloon catheter, which when introduced into a lobar or a smaller branch of the int...
journal_title:Journal of the American College of Surgeons
pub_type: 杂志文章
doi:
更新日期:1994-12-01 00:00:00
abstract:BACKGROUND:The value of frozen sections in the intraoperative examination of sentinel nodes (SN) remains controversial. Accurate frozen sections will spare those patients with node metastasis from a second procedure to complete the axillary dissection. We examined our own experience with intraoperative examination of S...
journal_title:Journal of the American College of Surgeons
pub_type: 杂志文章
doi:10.1016/j.jamcollsurg.2008.06.341
更新日期:2008-11-01 00:00:00
abstract:BACKGROUND:Near infrared autofluorescence (NIRAF) can guide intraoperative parathyroid gland (PG) identification. NIRAF detection devices typically rely on imaging and fiber probe-based approaches. Imaging modalities provide NIRAF pictures on adjacent display monitors, and fiber probe-based systems measure tissue NIRAF...
journal_title:Journal of the American College of Surgeons
pub_type: 杂志文章
doi:10.1016/j.jamcollsurg.2019.09.003
更新日期:2019-12-01 00:00:00
abstract:BACKGROUND:Intraluminally placed polytetrafluoroethylene grafts are associated with enhanced graft endothelialization and diminished intimal hyperplasia when compared with interposition grafts. This study determined the role of platelet-derived growth factor in intraluminal graft healing. STUDY DESIGN:Thirty dogs unde...
journal_title:Journal of the American College of Surgeons
pub_type: 杂志文章
doi:
更新日期:1997-01-01 00:00:00
abstract:BACKGROUND:The efficacy and safety of magnetic sphincter augmentation (MSA) with the LINX device (Torax Medical) has been reported in several short-and long-term studies, rivaling historic results of laparoscopic Nissen fundoplication (LNF), but with fewer side effects. However, there have been no studies comparing pat...
journal_title:Journal of the American College of Surgeons
pub_type: 杂志文章
doi:10.1016/j.jamcollsurg.2015.02.025
更新日期:2015-07-01 00:00:00
abstract:BACKGROUND:Pediatric liver transplantation (pLTx) has been the standard of care for children with liver failure since the 1980s. This study examined the world's largest single-center experience and aimed to identify unique preoperative predictors of early graft and patient survival for primary transplantation (1°-pLTx)...
journal_title:Journal of the American College of Surgeons
pub_type: 杂志文章
doi:10.1016/j.jamcollsurg.2017.12.042
更新日期:2018-04-01 00:00:00
abstract:BACKGROUND:This study was undertaken to compare safety, outcome, and costs of laparoscopic (LS) and open splenectomy (OS) for a variety of hematologic diseases. STUDY DESIGN:The records of 137 patients who underwent splenectomy (63 LS and 74 OS) at a large private teaching hospital between March 1991 and April 1996 we...
journal_title:Journal of the American College of Surgeons
pub_type: 杂志文章
doi:
更新日期:1997-07-01 00:00:00
abstract:BACKGROUND:Health care reform goals involve more cost-effective methods of delivering health care. The cost-effectiveness of axillary ultrasound-guided core needle biopsy (AUS-CNB) was compared with sentinel lymph node biopsy (SLNB) when evaluating the status of the axilla in operable invasive breast cancer. STUDY DES...
journal_title:Journal of the American College of Surgeons
pub_type: 杂志文章
doi:10.1016/j.jamcollsurg.2014.12.033
更新日期:2015-04-01 00:00:00