Abstract:
BACKGROUND:The purpose of the current study was to define the rate of underlying malignancy in endoscopically unresectable polyps. METHODS:An institutional review board-approved review identified all patients undergoing colectomy for radiologically identified or endoscopically unresectable polyps between 1997 and 2006. Patients were included if the endoscopic impression and biopsy findings suggested an adenomatous polyp without invasive cancer. Patient information was abstracted. RESULTS:Eighty procedures in 79 patients were identified. Median patient age was 66 (range 38 to 85) years, and patients were predominately male (98%) and Caucasian (73%). The median endoscopic size of polyps was 3.0 cm (range 0.8 to 10 cm). Polyps were most frequently proximal to the splenic flexure (72%). Biopsy histology included 36 (51%) tubulovillous and villous adenomas. Invasive cancer was identified in 13 of 80 (16%) subsequent surgical specimens, but only 3 of 71 (4%) were lymph node-positive. Surgical morbidity was 37% and in-hospital mortality 3%. Size of polyp (P = .81) and histologic type (P = .34) were not significantly associated with invasive cancer. Compared with polyps proximal to the splenic flexure, polyps located distally were more likely to harbor malignancy (rate; P < .02), by both univariate and multivariate analysis (odds ratio [OR] 1.38 [95% confidence interval 1.07 to 1.8]). CONCLUSION:The cancer risk in polyps deemed inappropriate for endoscopic resection was lower than previously reported. Neither polyp size nor histologic type appeared to be significantly associated with invasive cancer. Location of an endoscopically unresectable polyp distal to the splenic flexure confers an increased risk for occult malignancy.
journal_name
Am J Surgjournal_title
American journal of surgeryauthors
Alder AC,Hamilton EC,Anthony T,Sarosi GA Jrdoi
10.1016/j.amjsurg.2006.08.004subject
Has Abstractpub_date
2006-11-01 00:00:00pages
644-8issue
5eissn
0002-9610issn
1879-1883pii
S0002-9610(06)00508-3journal_volume
192pub_type
杂志文章abstract::A retrospective review of 58 rare breast neoplasms encountered at the British Columbia Cancer Agency between 1972 and 1992 was undertaken. There were 38 cystosarcoma phyllodes tumors, 6 carcinosarcomas, and 14 other sarcomas. Initial management involved total mastectomy in 37 cases, wide excision in 14, and excision b...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/0002-9610(94)90238-0
更新日期:1994-05-01 00:00:00
abstract:INTRODUCTION:The purpose of this study was to determine if there are clinical features that raise suspicion for parathyroid hyperplasia. MATERIALS & METHODS:We retrospectively reviewed patients with primary hyperparathyroidism who underwent parathyroidectomy from 1991 to 2017, analyzing demographics, calcium and PTH, ...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/j.amjsurg.2017.10.051
更新日期:2018-03-01 00:00:00
abstract:BACKGROUND:The aim of this study was to assess the impact of previous abdominal surgery (PAS) on single-port laparoscopic colectomy (SPLC). METHODS:We studied 429 consecutive patients who underwent SPLC in our department from May 2009 to December 2013. Patients were divided into 2 groups: those with PAS (PAS group) an...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/j.amjsurg.2014.06.015
更新日期:2015-06-01 00:00:00
abstract::The first case of a carotid body chemodectoma that was diagnosed using dynamic radionuclide perfusion angiography and subsequently excised is presented. The value of this technic in the investigation of pulsatile tumors is emphasized. ...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/0002-9610(79)90043-6
更新日期:1979-05-01 00:00:00
abstract::Performing a timely fasciotomy for compartment syndrome prevents ischemic injury to muscles and nerves. Fasciotomy entails incision of the overlying skin and investing fascia of the compartment, relieving pressure and enhancing tissue perfusion. Delayed primary closure is ideal, but because of skin edge retraction, th...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/0002-9610(94)90130-9
更新日期:1994-04-01 00:00:00
abstract::There is a steady increase in the number of patients with chronic renal insufficiency undergoing long-term hemodialysis, and an increasing number of these patients have exhausted veins due to multiple vascular access and salvage procedures. These patients may be candidates for an alternative vascular access procedure,...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/0002-9610(94)90110-4
更新日期:1994-06-01 00:00:00
abstract::The success of gastric restriction procedures for morbid obesity depends on a persistently small gastric pouch and stoma, an intact staple line, and, of equal importance, dietary compliance. Evaluation of patients with either excessive or inadequate weight loss should be directed at determining both the technical adeq...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/0002-9610(83)90200-3
更新日期:1983-03-01 00:00:00
abstract:BACKGROUND:The aim of this study was to analyze the associations between the degree of postoperative leukocytosis and major morbidity after elective distal pancreatectomy with splenectomy (DPS). METHODS:Retrospective review of patients undergoing DPS for pancreatic diseases (2013-2016). Receiver operating characterist...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/j.amjsurg.2019.12.004
更新日期:2020-08-01 00:00:00
abstract:BACKGROUND:A review of 1993 data on length of stay (LOS) and charges for diagnosis-related group (DRG) 195 (complicated cholecystectomies) showed that Maricopa Medical Center charged more and had longer LOS than all other area hospitals. METHODS:Twenty DRG 195 charts were analyzed for the causes of the inefficiencies....
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/s0002-9610(99)80035-x
更新日期:1995-12-01 00:00:00
abstract::Mean fasting preoperative pancreatic polypeptide levels in a group of 18 patients with duodenal ulcer disease were 462 +/- 88 pg/ml, with 13 patients having markedly elevated levels (mean 600 +/- 106 pg/ml) and 5 patients having normal or minimally elevated levels (mean 112 +/- 32 pg/ml). Mean fasting postoperative pa...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/0002-9610(86)90040-1
更新日期:1986-06-01 00:00:00
abstract::The transition from surgical training to surgical practice is a critical juncture in the career progression of surgeons. This period is associated with myriad challenges that need to be addressed through specific educational interventions to ensure delivery of safe care to patients and to support the career aspiration...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/j.amjsurg.2018.09.012
更新日期:2019-03-01 00:00:00
abstract:BACKGROUND:Increased anesthesia time may lead to respiratory complications in patients receiving tracheostomy, which contributes to patient morbidity. METHODS:The American College of Surgeon's National Surgical Quality Improvement Program (ACS-NSQIP) database was queried for cases of planned tracheostomy (CPT 31600) f...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/j.amjsurg.2018.07.059
更新日期:2018-10-01 00:00:00
abstract:PURPOSE:Hanging has become the second most common method of attempted suicide among adolescents, but there is little relevant epidemiologic or outcome data in the trauma literature. Additionally, there are no studies examining the degree of functional disability among survivors of hanging injury. METHODS:The National ...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/j.amjsurg.2005.05.051
更新日期:2005-12-01 00:00:00
abstract:BACKGROUND:HIV and AIDS continues to be a significant health problem with many patients requiring the attention of a general surgeon. METHOD:A retrospective case note review over a two-year period was undertaken. RESULTS:237 patients underwent invasive procedures. The majority 100 patients (145 procedures) were for v...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/S0002-9610(96)00054-2
更新日期:1996-07-01 00:00:00
abstract::A 14 year retrospective study of perigraft seroma, defined as an enlarging sterile fluid collection at the site of a prosthetic graft, revealed well-documented cases in 5 of 118 extraanatomical bypasses (4.2 percent), 3 of 248 aortic reconstructive procedures (1.2 percent), and 1 of 395 femoropopliteal bypasses (0.3 p...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/0002-9610(87)90173-5
更新日期:1987-08-01 00:00:00
abstract:BACKGROUND:The study investigates the relationship between motor coordination errors and total errors using a human factors framework. We hypothesize motor coordination errors will correlate with total errors and provide validity evidence for error tolerance as a performance metric. METHODS:Residents' laparoscopic ski...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/j.amjsurg.2016.07.003
更新日期:2016-10-01 00:00:00
abstract:BACKGROUND:Despite recent increased indications for infrapopliteal prosthetic bypass grafts with complementary arteriovenous fistulas, objective documentation of improved perfusion to the foot is lacking. In addition, the value of post operative noninvasive testing in the prediction of bypass success remains unclear. ...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/s0002-9610(99)80264-5
更新日期:1995-08-01 00:00:00
abstract:BACKGROUND:Pneumomediastinum following blunt trauma is often observed on CT imaging, and concern for associated aerodigestive injury often prompts endoscopy and/or fluoroscopy. In recent years, adoption of multi-detector CT technology has resulted in high resolution images that may clearly identify aerodigestive injuri...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/j.amjsurg.2018.11.002
更新日期:2019-06-01 00:00:00
abstract:BACKGROUND:The availability and utility of public statements and policies on gender equity from professional surgical societies has not been studied. METHODS:Professional surgical society websites were searched for publicly available statements and policies related to gender equity. These were compiled and assessed fo...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/j.amjsurg.2020.06.041
更新日期:2020-11-01 00:00:00
abstract:BACKGROUND:The effect of sex on fine-needle aspiration (FNA) diagnosis of thyroid cancer remains unknown. This study determines the reliability of FNA when evaluating thyroid nodules ≥4 cm in women and men. METHODS:Prospectively collected data of 1,068 patients who underwent FNA and thyroidectomy at a tertiary medical...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/j.amjsurg.2013.04.001
更新日期:2013-11-01 00:00:00
abstract:BACKGROUND:Decrease in blood pressure (BP) is the major goal of adrenalectomy for primary aldosteronism. Nevertheless, the optimal timing to assess these outcomes and the needed duration of follow-up are uncertain. We systematically reviewed the literature regarding trends in BP-related outcomes during follow-up after ...
journal_title:American journal of surgery
pub_type: 杂志文章,评审
doi:10.1016/j.amjsurg.2020.12.003
更新日期:2020-12-03 00:00:00
abstract::A 24-year-old woman with no significant past medical or surgical history presented with diffuse abdominal pain and distention with decreased frequency of bowel movements for 1 month. A computerized tomography scan showed a massively dilated cecum suggesting obstruction. Exploratory laparotomy revealed bowel obstructio...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/j.amjsurg.2009.10.030
更新日期:2012-11-01 00:00:00
abstract:BACKGROUND:Physiologic variables used in trauma triage criteria may be significantly affected by age, decreasing their predictive value in geriatric trauma. METHODS:The study population was all adult patients in the Washington State Trauma Registry from 2000 to 2004. Elderly patients were defined as those aged >65 yea...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/j.amjsurg.2008.12.037
更新日期:2009-05-01 00:00:00
abstract:BACKGROUND:Multimodality monitoring and goal-directed therapy may not prevent blood flow and brain oxygen (Flow/BrOx) crisis. We sought to determine the impact of these events on outcome in patients with severe traumatic brain injury (sTBI). METHODS:Twenty-four patients with sTBI were treated to maintain intracranial ...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/j.amjsurg.2014.08.003
更新日期:2014-12-01 00:00:00
abstract:BACKGROUND:Accuracy of (18)F-fluorodeoxyglucose positron emission tomography (FDG-PET) and contribution to surgical decision making in recurrent or metastatic colorectal cancer were evaluated. METHODS:One hundred whole-body PET tests in colorectal cancer patients (1994 to 1998) were compared with computed tomography (...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/s0002-9610(00)00406-2
更新日期:2000-07-01 00:00:00
abstract:BACKGROUND:Bioethics education has been recommended as a formal component of surgical residency training. The best method for teaching bioethics to residents is unclear. We compared the effectiveness of a standardized patient (SP)-based seminar to a traditional seminar format for teaching bioethics to surgical resident...
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/j.amjsurg.2004.08.066
更新日期:2005-04-01 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::A prospective clinical trial was designed to evaluate the efficacy of postoperative jejunostomy feedings using high (44 percent) and low (15 percent) branched-chain amino acid elemental diet formulations compared with no jejunostomy feedings in a homogeneous surgical population. Twenty-eight patients undergoing radica...
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(87)90815-4
更新日期:1987-02-01 00:00:00
abstract:BACKGROUND:The optimal number of sentinel lymph nodes (SLN) that need to be harvested to achieve favorable survival outcome during a SLN biopsy (SLNB) has not yet been established. METHODS:Six hundred and thirteen patients with clinically node-negative breast cancer who underwent SLNB were reviewed. Survival outcomes ...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/j.amjsurg.2016.10.019
更新日期:2017-10-01 00:00:00
abstract:BACKGROUND:Current standard of care dictates that central venous catheter (CVC) insertion should be followed by an immediate chest radiograph to confirm appropriate position and rule out complications. We hypothesized that a subset of monitored intensive care unit patients exists that is at low risk for complications a...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/s0002-9610(00)00498-0
更新日期:2000-12-01 00:00:00