Abstract:
BACKGROUND:Accurate intraoperative diagnosis of axillary malignancy facilitates completion axillary lymph node dissection (ALND) at the time of initial surgery. The capability to address both the primary tumor and axillary disease in a single procedure offers several advantages. This study was designed to define the predictive value of intraoperative touch preparation analysis of sentinel lymph nodes for axillary metastasis in breast cancer and to evaluate the ability of the technique to facilitate accurate synchronous ALND. METHODS:A consecutive cohort of patients with breast cancer at an Army medical center underwent intraoperative touch preparation analysis of sentinel lymph nodes concordant with initial excision. Those found to have sentinel nodes positive by touch preparation analysis underwent ALND at the initial procedure. Patients with negative sentinel nodes by touch preparation analysis, but positive by final pathology, underwent subsequent ALND. Results of the touch preparation analysis were compared with the final pathology. RESULTS:Over a 16-month period, 71 consecutive patients with breast cancer underwent initial excision and touch preparation analysis of 162 sentinel lymph nodes. Final pathology confirmed axillary metastasis in 32% (23 of 71) of patients. Of these, intraoperative touch preparation analysis identified 48% (11 of 23). There were no false positives or unnecessary axillary dissections based upon touch preparation results. Per sentinel node, the positive predictive value was 100%, the sensitivity was 47%, and the specificity was 100%. On a per patient basis, the positive predictive value was 100%, and the sensitivity and specificity were 48% and 100%, respectively. CONCLUSIONS:Intraoperative touch preparation analysis is an effective adjunct to sentinel lymph node biopsy. In our series, it facilitated a definitive cancer operation at the time of initial surgery in nearly 50% of patients, and ensured that no patient underwent an unnecessary axillary dissection.
journal_name
Am J Surgjournal_title
American journal of surgeryauthors
Mullenix PS,Carter PL,Martin MJ,Steele SR,Scott CL,Walts MJ,Beitler ALdoi
10.1016/s0002-9610(03)00041-2subject
Has Abstractpub_date
2003-05-01 00:00:00pages
420-4issue
5eissn
0002-9610issn
1879-1883pii
S0002961003000412journal_volume
185pub_type
杂志文章abstract::We report our experience with 65 patients with congenital duodenal obstruction, 36 with intrinsic and 29 with extrinsic lesions. Seventeen patients had trisomy 21 syndrome. Eight pregnancies were complicated by polyhydramnios. The diagnostic features encountered, the operative procedures used, and the postoperative ma...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/0002-9610(79)90305-2
更新日期:1979-12-01 00:00:00
abstract:BACKGROUND:Among patients with adhesive small bowel obstruction (ASBO) initially managed with a conservative strategy, predicting risk of operation is difficult. METHODS:We investigated ASBO patients at 2 different periods to derive and validate a clinical prediction model for risk of operation. RESULTS:One hundred f...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/j.amjsurg.2009.07.045
更新日期:2010-08-01 00:00:00
abstract:INTRODUCTION:Despite the use of radiologic, endoscopic, and laparoscopic staging techniques, the rate of nontherapeutic laparotomies in patients with hilar cholangiocarcinoma remains high. This study evaluated the accuracy of preoperative high-resolution computed tomography (HRCT) to determine resectability in this set...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/j.amjsurg.2006.10.024
更新日期:2007-06-01 00:00:00
abstract::The effect of sulindac, a nonsteroid antiinflammatory drug, on colon polyposis has been evaluated in seven patients after subtotal colectomy and ileoproctostomy and in four patients with intact colons. The patients all had Gardner's syndrome or familial polyposis coli. All polyps were eliminated, except for a few that...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/0002-9610(89)90442-x
更新日期:1989-01-01 00:00:00
abstract:BACKGROUND:We hypothesized that mandatory multidisciplinary team (MDT) participation improves process evaluation, outcomes, and technical aspects of surgery for rectal cancer in a stable practice of colorectal surgery. METHODS:A retrospective review of MDT data was conducted of all patients with colorectal cancer sinc...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/j.amjsurg.2015.08.015
更新日期:2016-01-01 00:00:00
abstract:BACKGROUND:The influence of blood transfusions in the risk of postoperative infection remains controversial. We examined the association between autologous (AB) and homologous (HB) blood transfusions with postoperative infection in elective surgery. METHODS:The medical records of 991 Medicare patients aged > or =65 ye...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/s0002-9610(99)00242-1
更新日期:1999-12-01 00:00:00
abstract::This study of 89 women who underwent 100 consecutive needle localization procedures for nonpalpable breast lesions revealed a 19 percent malignancy rate. These lesions tended to be small and had a 6.2 percent incidence of nodal metastasis. Needle localization also identified 19 additional patients who were at increase...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/0002-9610(87)90223-6
更新日期:1987-12-01 00:00:00
abstract:BACKGROUND:Traditional management of symptomatic paraesophageal herniation involves hernia reduction, hiatal closure, and an antireflux procedure or gastropexy. Patients with significant comorbidities may not tolerate operative repair. A new technique, laparoscopic-assisted endoscopic reduction and fixation of the stom...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/s0002-9610(01)00760-7
更新日期:2001-11-01 00:00:00
abstract::Two cases of hepatoma are presented in which the clinical manifestations of biliary obstruction resulted from growth of hepatoma into the extrahepatic bile duct. Recognition of such a manifestation of the hepatoma may allow for surgical extirpation of the tumor combined with radiation therapy, which may result in long...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/0002-9610(77)90088-5
更新日期:1977-02-01 00:00:00
abstract:BACKGROUND:Patients with recurrent pelvic malignancy have few treatment options, and surgery is fraught with complications. We sought to characterize the relationship between radiographic pelvic volume and postoperative complications after pelvic salvage surgery. METHODS:A retrospective chart review of all patients un...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/j.amjsurg.2014.08.015
更新日期:2014-12-01 00:00:00
abstract::This study has summarized our results with popliteal-tibial in situ saphenous vein bypass in 26 patients, 25 of whom were diabetic, over a 2 year period. Both above- and below-knee popliteal inflow sites were used for bypass of limb-threatening ischemia. Distal calf or pedal outflow sites were required in all but two ...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/0002-9610(87)90191-7
更新日期:1987-08-01 00:00:00
abstract::The mesocaval graft for portal decompression is applicable in infants and children with portal hypertension secondary to extrahepatic or intrahepatic causes. It is recommended in patients in whom extensive previous surgery in the portahepatis (Kasai procedure) would make dissection of the portal vein difficult and end...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/0002-9610(78)90011-9
更新日期:1978-01-01 00:00:00
abstract:BACKGROUND:Mucinous Cystic Neoplasms are mucin producing cysts of the pancreas with malignant potential. The existing literature on treatment outcomes is limited to relatively small surgical series. METHODS:We reviewed the National Cancer Database assessing the outcomes of patients with mucinous cystic neoplasms betwe...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/j.amjsurg.2020.09.006
更新日期:2020-12-01 00:00:00
abstract:BACKGROUND:We hypothesized that team communication with unmatched grammatical form and communicative intent (mixed mode communication) would correlate with worse trauma teamwork. METHODS:Interdisciplinary trauma simulations were conducted. Team performance was rated using the TEAM tool. Team communication was coded fo...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/j.amjsurg.2017.11.008
更新日期:2018-02-01 00:00:00
abstract:BACKGROUND:Despite impressive results with the Lap-Band in Europe and Australia, the early Food and Drug Administration A trial in the United States showed fairly poor results. This prospective study attempts to determine if the Lap-Band can produce effective weight loss in morbidly obese Americans. METHODS:Five hundr...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/j.amjsurg.2004.08.059
更新日期:2004-12-01 00:00:00
abstract:BACKGROUND:The ability of characteristics to predict first time performance in laparoscopic tasks is not well described. Videogame experience predicts positive performance in laparoscopic experiences but its mechanism and confounding-association with aptitude remains to be elucidated. This study sought to evaluate for ...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/j.amjsurg.2017.04.015
更新日期:2018-04-01 00:00:00
abstract::Treatment failure and survival in 209 patients with squamous cell carcinoma of the floor of the mouth treated with surgery as the single curative modality are reported. Fifty percent of the patients had stage III and IV disease. The primary tumor was excised with 1 to 2 cm margins and the mandible was resected in 73 p...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/0002-9610(89)90118-9
更新日期:1989-10-01 00:00:00
abstract::Hemorrhage is a major cause of trauma deaths. Coagulopathy exacerbates hemorrhage and is commonly seen during major trauma resuscitation, suggesting that current practice of coagulation factor transfusion is inadequate. Reversal of coagulopathy involves normalization of body temperature, elimination of the causes of d...
journal_title:American journal of surgery
pub_type: 杂志文章,评审
doi:10.1016/j.amjsurg.2005.03.034
更新日期:2005-09-01 00:00:00
abstract::Thirty-one patients with melanoma of the head and neck received split-course radiation therapy (5,000 to 6,000 rads/30 fractions) for loco-regional disease. There was no difference in survival in patients with gross tumors versus patients with no clinical evidence of disease at the start of radiation therapy. The prog...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/0002-9610(79)90428-8
更新日期:1979-10-01 00:00:00
abstract:BACKGROUND:It was hypothesized that splenectomy following trauma results in hypercoagulability. METHODS:A prospective, nonrandomized, single-center study was performed to evaluate coagulation parameters in trauma patients with splenic injury. RESULTS:Patients with splenectomy (n = 30) and nonoperative management (n =...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/j.amjsurg.2010.01.015
更新日期:2010-05-01 00:00:00
abstract:BACKGROUND:Surgical observation is an integral part of surgical training. Junior residents, who have limited understanding of the procedures being performed, use observation to gain an initial exposure to surgical techniques. This study explores the challenges junior residents face from a cognitive standpoint when they...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/j.amjsurg.2018.11.031
更新日期:2019-08-01 00:00:00
abstract:INTRODUCTION:Our swine model of pulmonary contusion (PC) and hemorrhagic shock (HS) was initially complicated by renal failure, hyperkalemia, and premature death. To study the effects of novel therapies on organ failure, improved survival was necessary requiring the design of an aggressive treatment regimen. METHODS:A...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/j.amjsurg.2020.02.058
更新日期:2020-05-01 00:00:00
abstract:BACKGROUND:Since the introduction of the laparoscopic live donor nephrectomy in 1995, attempts have been made to depart from the total laparoscopic approach to the hand-assisted approach to decrease surgical time and complications. We present our 6-year experience with the total laparoscopic approach. METHODS:Between ...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/j.amjsurg.2005.10.030
更新日期:2006-03-01 00:00:00
abstract:BACKGROUND:Core biopsy finding of atypical ductal hyperplasia (ADH) are generally followed by open biopsy to avoid underestimation of malignant disease. METHODS:Retrospective examination of 11 gauge stereotactic-guided vacuum-assisted core biopsies was made with respect to ADH diagnosis, follow-up open biopsy, and upg...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/s0002-9610(01)00727-9
更新日期:2001-10-01 00:00:00
abstract:BACKGROUND:We developed a model for capitation and global pricing for carotid endarterectomy. METHODS:A care algorithm for diagnosis, perioperative management, and postoperative care using cost data was developed. Perioperative care charges were extrapolated from a 1-year experience and applied to models to determine ...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/s0002-9610(98)00128-7
更新日期:1998-08-01 00:00:00
abstract::A phase I clinical trial of immunotherapy with "Immune" RNA was undertaken fifteen months ago. Twenty-six cancer patients were treated with RNA extracted from the lymphoid organs of sheep immunized with either autologous tumor cells or allogeneic tumor cells of the same histologic type. Eighteen patients had gross dis...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/0002-9610(76)90360-3
更新日期:1976-11-01 00:00:00
abstract:BACKGROUND:The novel coronavirus (COVID-19) strain has resulted in restrictions potentially impacting patients presenting with acute appendicitis and their disease burden. METHODS:All acute appendicitis admissions (281 patients) between 1/1/2018-4/30/2020 were reviewed. Two groups were created: 6 weeks before (Group A...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/j.amjsurg.2020.09.026
更新日期:2020-09-28 00:00:00
abstract:BACKGROUND:Penetrating injuries of the subclavian artery occurs infrequently but represent a surgical challenge. We reviewed our experience with penetrating injury of the subclavian artery and identify factors that influenced morbidity and mortality. METHODS:A retrospective review was performed on 54 consecutive patie...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/s0002-9610(03)00070-9
更新日期:2003-06-01 00:00:00
abstract::Thymectomy was performed on 249 patients with myasthenia gravis between 1957 and 1981. During a follow-up period that ranged from 2 months to 24 years (mean 7.5 years), the remission rate for the entire group was 51 percent, and an additional 36 percent had improvement (87 percent benefited). In those 51 patients with...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/0002-9610(83)90260-x
更新日期:1983-07-01 00:00:00
abstract::The incidence of postoperative wound complications and early cancer recurrence was studied in 289 patients who had mastectomy alone and in 113 patients who underwent immediate reconstruction following mastectomy. Patients undergoing immediate reconstruction were younger and had less advanced disease than patients who ...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/s0002-9610(05)80572-0
更新日期:1993-07-01 00:00:00