Abstract:
BACKGROUND:Ductal carcinoma in situ (DCIS) accounts for nearly 20% of new breast cancer diagnoses and ductal carcinoma in situ with microinvasion (DCIS-MI) is found in 5% to 10% of DCIS. Controversy exists regarding the appropriate local treatment as well as whether or not examination of the axilla should be performed either by sentinel lymph node biopsy (SLNB), axillary lymph node dissection (ALND) or not at all. METHODS:A MEDLINE search was performed using the keywords ductal carcinoma in situ and microinvasion. Recent articles pertaining to the definition and characterization of DCIS-MI as well as treatment and prognosis were analyzed. CONCLUSIONS:The data at this time demonstrate no survival benefit for patients undergoing mastectomy versus lumpectomy and radiation. Numerous studies demonstrate axillary lymph node involvement to be as high as 20% with DCIS-MI; therefore, we believe that axillary sampling is essential. We recommend SLNB, which is accurate, provides information necessary for staging and treatment, and is associated with less morbidity than traditional ALND.
journal_name
Am J Surgjournal_title
American journal of surgeryauthors
Adamovich TL,Simmons RMdoi
10.1016/s0002-9610(03)00166-1subject
Has Abstractpub_date
2003-08-01 00:00:00pages
112-6issue
2eissn
0002-9610issn
1879-1883pii
S0002961003001661journal_volume
186pub_type
杂志文章,评审abstract::Of forty-three patients with carcinoma of the gallbladder discovered ih a twenty-five year period (during which 10,349 patients were diagnosed as having cholelithiasis), eighteen patients (42 per cent) had no obvious tumor outside of the gallbladder at the time of operation, nineteen patients (44 per cent) had local s...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/0002-9610(76)90439-6
更新日期:1976-12-01 00:00:00
abstract::We tested the effectiveness of a single dose of prophylactic antibiotic (gentamicin) in elective cholecystectomy in a double-blind, controlled randomized study. All patients recognized preoperatively as being at risk were excluded. The treatment group comprised of 102 patients received a single dose of gentamicin and ...
journal_title:American journal of surgery
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1016/0002-9610(86)90218-7
更新日期:1986-11-01 00:00:00
abstract::Fifty-four patients receiving peripheral parenteral nutrition consisting of 3.5 percent amino acids in a 5 percent dextrose solution were randomly assigned in a double-blind fashion to receive this solution with or without an antiphlebitic mixture (1000 IU heparin, 5 mg hydrocortisone, and 1.8 mEq sodium hydroxide as ...
journal_title:American journal of surgery
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1016/0002-9610(86)90022-x
更新日期:1986-01-01 00:00:00
abstract::A review of 143 patients with 144 feeding jejunostomies was carried out. In the 129 patients in whom catheters were utilized, only 48 (45 percent) had no complications. Seventy-one patients (55 percent) suffered one or more catheter-related complications. Ten of these complications were life-threatening or fatal, incl...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/s0002-9610(88)80267-8
更新日期:1988-01-01 00:00:00
abstract::Multiple organ failure (MOF) emerged 30 years ago and became our research focus. Over the years, we have proposed a series of cartoons that rallied multidisciplinary translational research teams around common themes to generate "win-win" hypotheses that when tested (right or wrong) have advanced our understanding of M...
journal_title:American journal of surgery
pub_type:
doi:10.1016/j.amjsurg.2010.05.009
更新日期:2010-12-01 00:00:00
abstract::Extracorporeal shock-wave lithotripsy (ESWL) in combination with adjuvant litholytic therapy using chenodeoxycholic acid and ursodeoxycholic acid (7 to 8 mg/kg body weight/day of each acid) is a safe and effective, novel nonsurgical approach to gallbladder stones, provided the patients are carefully selected. Experien...
journal_title:American journal of surgery
pub_type: 杂志文章,评审
doi:10.1016/0002-9610(89)90249-3
更新日期:1989-09-01 00:00:00
abstract::Two hundred six consecutive patients were followed from 5 to 15 years after a distal splenorenal shunt operation. Nonalcoholic patients demonstrated nearly twice the survival rate when compared with alcoholic patients. The mean duration of life for the surviving nonalcoholics was 10 years and for the alcoholics, 9 yea...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/s0002-9610(88)80250-2
更新日期:1988-01-01 00:00:00
abstract:BACKGROUND:In this study, we retrospectively assessed the performance of 18-F-fluorodeoxyglucose positron emission tomography (FDG-PET) compared with computed tomography (CT) and esophagography for assessing the response of advanced esophageal squamous cell carcinoma (SCC) to neoadjuvant chemoradiotherapy. METHODS:We ...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/s0002-9610(02)00932-7
更新日期:2002-09-01 00:00:00
abstract:BACKGROUND:Although informed consent is vital to patient-physician communication, little training is provided to surgical trainees. We hypothesized that highlighting critical aspects of informed consent would improve resident performance. METHODS:Eighty (out of 88) surgical postgraduate year 1 surgical residents were ...
journal_title:American journal of surgery
pub_type: 杂志文章,随机对照试验
doi:10.1016/j.amjsurg.2014.12.044
更新日期:2015-09-01 00:00:00
abstract::Recent progress in the surgical treatment of carcinoma of the esophagus has changed the pessimistic outlook for this malignancy. With reasonably early diagnosis, it is feasible to achieve a resectability rate of 75 to 85 percent, an operative mortality of about 5 percent and a 5 year survival rate of about 30 percent....
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/0002-9610(80)90386-4
更新日期:1980-06-01 00:00:00
abstract:BACKGROUND:This study aims to test associations between perioperative blood transfusion and postoperative morbidity and mortality after major abdominal operations. METHODS:The 2014 ACS NSQIP dataset was queried for all patients who underwent one of the ten major abdominal operations. Separate multivariable regression ...
journal_title:American journal of surgery
pub_type: 杂志文章,多中心研究
doi:10.1016/j.amjsurg.2018.02.015
更新日期:2018-09-01 00:00:00
abstract::Distal embolization of fragmented laminated thrombus and atheroma producing peripheral ischemia or gangrene is an underemphasized complication of arterial reconstruction. A set of techniques has been developed to minimize this important complication. To assess their effectiveness, the incidence of distal embolism in p...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/0002-9610(79)90293-9
更新日期:1979-12-01 00:00:00
abstract:BACKGROUND:A clear understanding of simulation-based curricula in use at American College of Surgeons Accredited Education Institutes (ACS-AEIs) is lacking. METHODS:A 25-question online survey was sent to ACS-AEIs. RESULTS:The response rate approached 60%. The most frequent specialties to use the ACS-AEIs are general...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/j.amjsurg.2016.08.011
更新日期:2017-04-01 00:00:00
abstract::The reported incidence of hypotension after carotid reconstruction ranges from 21 to 50 percent. To evaluate baroreceptor dysfunction, 283 carotid reconstructions were studied. During 181 consecutive reconstructions, a transcutaneous Teflon catheter was positioned intraoperatively at the carotid bifurcation for postop...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/0002-9610(84)90196-x
更新日期:1984-06-01 00:00:00
abstract:BACKGROUND:Surgery for Crohn's disease is not intended for cure, but rather to relieve symptoms and treat complications. Perioperative morbidity, the fear of creating short bowel syndrome, and the tendency of the disease to recur convinced many physicians to refer their Crohn's patients for surgery only when life-threa...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/s0002-9610(97)00102-5
更新日期:1997-09-01 00:00:00
abstract::Blocking factors are small polypeptide molecules that may appear in the serum of patients with cancer. These factors block the transformation of lymphocytes in culture to nonspecific mitogens such as phytohemagglutinin or concanavalin A and, therefore, may reflect changes in the immunocompetence of the patient. Blocki...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/0002-9610(75)90377-3
更新日期:1975-08-01 00:00:00
abstract:BACKGROUND:We have previously shown the inhibitory effects of keyhole limpet hemocyanin (KLH) against breast and pancreatic cancer in vitro. We hypothesize that its actions in breast and pancreas cancer cells are via apoptotic or cytokine pathways. METHODS:Two breast cancer cell lines, ZR75-1 and MCF-7, and one pancre...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/j.amjsurg.2004.10.005
更新日期:2005-06-01 00:00:00
abstract:INTRODUCTION:While women represent approximately half of all medical students, only 38% of general surgery residents are women. The objective of this study is to explore how access to mentors and organizational support affects career choices. METHODS:In June of 2016, a survey was sent to medical students at a single i...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/j.amjsurg.2017.07.005
更新日期:2017-10-01 00:00:00
abstract:BACKGROUND:The purpose of this study was to analyze the influence of age on both the risk of hepatectomy and the prognosis in patients with hepatocellular carcinoma (HCC). METHODS:Patients undergoing an initial hepatectomy for HCC were classified into 2 age groups: 75 years or over (n = 113) and less than 75 years (n ...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/j.amjsurg.2014.05.026
更新日期:2015-04-01 00:00:00
abstract:BACKGROUND:The relative prognostic impact of intra-aortic balloon pump (IABP) placement before versus after cardiac surgery is not well defined. METHODS:We reviewed data from all cardiac surgical patients who received perioperative IABP support at a veterans' hospital between April 1992 and April 2008. We compared out...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/j.amjsurg.2009.07.011
更新日期:2009-11-01 00:00:00
abstract:BACKGROUND:Two decades since the advent of laparoscopic cholecystectomy, the rate of bile duct injuries still remains higher than in the open cholecystectomy era. METHODS:The rate and complexity of bile duct injuries was evaluated in 83,449 patients who underwent laparoscopic cholecystectomy between 1995 and 2008 in t...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/j.amjsurg.2011.08.018
更新日期:2012-04-01 00:00:00
abstract::A 2.5 kg thoracopagus (Siamese) twin and a 0.73 kg premature newborn developed systemic candidiasis and were treated with intravenous miconazole. The conjoined twin was in a state of severe metabolic acidosis, respiratory distress, jaundice, anuria, abdominal distension, and shock. The 0.73 kg premature infant was als...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/0002-9610(79)90349-0
更新日期:1979-11-01 00:00:00
abstract::We devised a new technique to increase the safety of pancreaticojejunostomy in patients with an extended operation for pancreatic cancer. This new pancreaticojejunostomy was created by end-to-side anastomosis with four layers about 7 cm distal to the jejunal stump. The cut surface of the pancreas was placed on the ser...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/s0002-9610(05)80524-0
更新日期:1993-02-01 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::The relationship between type 2 diabetes mellitus and pancreatic cancer (PC) is not clear. It has been reported that the increased release of islet amyloid polypeptides (IAPPs) is responsible for the impaired glucose tolerance in PC patients. However, no information exists on the patterns of IAPP expression in PC tiss...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/j.amjsurg.2007.05.024
更新日期:2007-10-01 00:00:00
abstract:BACKGROUND:The accuracy of a molecular reverse transcriptase-polymerase chain reaction (RT-PCR)-based assay for metastases detection in axillary sentinel lymph nodes (SLNs) has recently been validated in our institution and adopted as an intraoperative test for breast cancer patient management. METHODS:Molecular assay...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/j.amjsurg.2008.09.012
更新日期:2009-08-01 00:00:00
abstract:PURPOSE:Stoma closure has been associated with a high rate of surgical site infection (SSI) and the optimal skin closure method is still controversial. The aim of this study was to compare the short-term and long-term outcomes between the conventional linear closure (CC) and the persestring closure (PC) using propensit...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/j.amjsurg.2017.09.031
更新日期:2018-01-01 00:00:00
abstract:BACKGROUND:Retractions of scientific articles represent attempts to correct the literature. Our goal was to examine retracted surgical papers. METHODS:NCBI PubMed database was queried using the search terms "surgery," "surg," or "surgical" and "retracted" or "retraction." Article details were recorded. RESULTS:There ...
journal_title:American journal of surgery
pub_type: 杂志文章,评审
doi:10.1016/j.amjsurg.2017.11.033
更新日期:2018-11-01 00:00:00
abstract::To clarify the widespread practice of preoperative transfusion to attain a 10 g/dL level of hemoglobin, the relationship between preoperative hemoglobin level, operative blood loss, and mortality was studied by analyzing the results of 113 operations in 107 consecutive Jehovah's Witness patients who underwent major el...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/s0002-9610(05)81227-9
更新日期:1990-03-01 00:00:00
abstract:BACKGROUND:Efforts to improve surgical safety are limited by several factors and no consensus exists regarding the most effective way to improve surgical quality. The use of ISO 9001 quality standards within healthcare is recognized but has not been widely applied for improving surgical outcomes. METHODS:A surgical qu...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/j.amjsurg.2020.11.014
更新日期:2020-11-09 00:00:00