Abstract：
BACKGROUND:Although neoadjuvant chemotherapy is increasingly used for breast cancer, if a patient has a complete clinical response, it is often difficult for the surgeon to know exactly where and how much breast tissue to remove. METHODS:A method is described where the edges of the tumor are tattooed prior to chemotherapy, allowing all tissue initially involved with tumor to be resected following the chemotherapy. RESULTS:Thirty-four cases have been tattooed prior to neoadjuvant chemotherapy, and the clinical and pathological complete response rates were 56% and 22%, respectively. The tattoos allowed very accurate localization of the residual tumor location and extent. Of the 22 patients who have so far undergone lumpectomy, 77% had residual pathologic evidence of tumor, but the margins were negative in 91% at the first operation. Only 2 patients had to undergo a mastectomy because of persistently positive margins. CONCLUSIONS:The technique of breast tattooing is a simple and practical method to guide the extent of breast surgery following neoadjuvant chemotherapy. In contrast to placement of clips, the technique does not require needle localization, and it allows accurate determination of the initial tumor size and margins.
journal_name
Am J Surgjournal_title
American journal of surgeryauthors
Lannin DR,Grube B,Black DS,Ponn Tdoi
10.1016/j.amjsurg.2007.07.009subject
Has Abstractpub_date
2007-10-01 00:00:00pages
518-20issue
4eissn
0002-9610issn
1879-1883pii
S0002-9610(07)00550-8journal_volume
194pub_type
杂志文章abstract：:The purpose of this research was to assess reliability and construct validity of the objective structured clinical examination (OSCE) for evaluating the clinical skills of surgical residents. Reliability refers to precision of the examination and construct validity to the degree to which the examination can discrimina...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/s0002-9610(06)80029-2
更新日期：1990-09-01 00:00:00
abstract：BACKGROUND:The morbidity and mortality conference (M&M) is a key component of the performance improvement process. The audience response system (ARS) has been shown to improve audience participation and promote more truthful responses in various settings. We implemented the ARS in our trauma M&M and evaluated the respo...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/j.amjsurg.2008.05.015
更新日期：2009-06-01 00:00:00
abstract：INTRODUCTION:Patient Reported Outcomes (PROs) capture peri-operative fatigue, pain, and quality of life and influence outcomes in gastrointestinal surgery. We compared peri-operative PROs in patients undergoing colorectal operations for neoplastic versus non-neoplastic processes. METHODS:Patients undergoing colectomy ...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/j.amjsurg.2020.08.017
更新日期：2020-12-01 00:00:00
abstract：BACKGROUND:Laparoscopy has played an ill-defined role as a diagnostic tool for the staging of gastric and other intra-abdominal malignancies for a long time. The widespread use of the laparoscopic approach for the treatment of some benign abdominal diseases, such as biliary lithiasis and gastroesophageal reflux disease...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/S0002-9610(97)89571-2
更新日期：1996-02-01 00:00:00
abstract：BACKGROUND:Hemorrhage during hepatectomy remains the major cause of morbidity and mortality associated with this surgery. Traditionally, a Pringle technique is employed to reduce vascular inflow during parenchymal transection. METHODS:This paper describes a simple method to achieve unilateral vascular control during h...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/s0002-9610(01)00697-3
更新日期：2001-09-01 00:00:00
abstract：:The difficulties created by an unsuccessful initial operation can usually be avoided by choosing experienced surgeons, identifying four glands, and selectively excising grossly abnormal parathyroid tissue. Patients with multiple endocrine adenomatosis or familial hyperparathyroidism should have a subtotal parathyroide...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/0002-9610(82)90412-3
更新日期：1982-10-01 00:00:00
abstract：BACKGROUND:Occult primary breast cancer (OPBC) represents less than 1% of breast cancer. In only a third of cases, mammography identifies a primary tumor. We hypothesized that rotating delivery of excitation off-resonance breast magnetic resonance imaging (MRI) would identify or exclude the breast as a primary site in ...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/s0002-9610(99)00221-4
更新日期：1999-12-01 00:00:00
abstract：BACKGROUND:Nipple discharge occurs in 2% to 5% of women. We evaluated the effectiveness of a previously proposed treatment algorithm for these patients. METHODS:Patients with pathologic nipple discharge and a negative mammogram and subareolar ultrasound were offered follow-up from 2005 to 2011 according to the algorit...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/j.amjsurg.2013.12.035
更新日期：2014-08-01 00:00:00
abstract：:From April 1, 1990, to March 31, 1992, 8,899 patients who were 65 years of age and older underwent an anesthetic and surgical procedure in a 1,000-bed community hospital in Victoria, British Columbia, Canada. The hospital has been using a proprietary system called MedisGroups for assessing the severity of illness on a...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/s0002-9610(05)80438-6
更新日期：1993-05-01 00:00:00
abstract：:A case of hepatic hemangioma is reported in which preoperative diagnosis, with the combined aid of serial selective hepatic arteriography and laparoscopy, was necessary. The patient underwent right hepatic lobectomy after extensive extrahepatic individual ligations with no severe postoperative complications. The combi...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/0002-9610(75)90350-5
更新日期：1975-06-01 00:00:00
abstract：BACKGROUND:This study was undertaken to evaluate the accuracy of touch preparation (touch prep) in the evaluation of sentinel lymph nodes (SLNs). METHODS:We performed a retrospective review of 402 breast cancer patients who underwent SLN biopsy. RESULTS:A SLN was identified in 381 patients. Of 61 patients with a true...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/j.amjsurg.2009.06.020
更新日期：2010-06-01 00:00:00
abstract：:A significant amount of red blood cells were conserved with use of the Cell Saver in cardiac surgery patients and in some orthopedic and vascular surgery patients. No major complications have been associated with its use in our cases. Our results are similar to those of others who have reported on the use of this devi...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/0002-9610(82)90600-6
更新日期：1982-07-01 00:00:00
abstract：:Preoperative embolization of highly vascular soft tissue tumors was performed in four patients. Selective catheterization of branch vessels supplying the tumors successfully avoided inadvertent embolization of adjacent normal tissue. Operative blood loss was significantly less than anticipated, permitting an easier, m...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/0002-9610(83)90429-4
更新日期：1983-09-01 00:00:00
abstract：BACKGROUND:The effect of the number of lymph nodes harvested on the long-term survival of gastric cancer according to Tumor, Node, and Metastasis (TNM) stage and tumor location remains unclear. METHODS:Patients who underwent gastrectomy for gastric cancer (1998 to 2009) were evaluated retrospectively (1,637 patients)....
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/j.amjsurg.2015.01.029
更新日期：2015-09-01 00:00:00
abstract：BACKGROUND:Achieving a higher hemoglobin (Hb) level might allow the anemic, critically ill, trauma patient to have an improved outcome during rehabilitation therapy. METHODS:Patients with major blunt trauma orthopedic injuries were administered epoetin alfa or placebo weekly both in hospital and for up to 12 weeks aft...
journal_title：American journal of surgery
pub_type： 杂志文章,多中心研究,随机对照试验
doi：10.1016/j.amjsurg.2011.08.006
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：OBJECTIVE:To assess the oncologic effectiveness of the selective neck dissection (SND) in patients with both clinically and pathologically proven regional metastases. METHODS:A 4-year retrospective medical chart review was conducted in an academic tertiary care referral center. Twenty-nine patients with a newly diagno...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/s0002-9610(96)00296-6
更新日期：1996-12-01 00:00:00
abstract：:The social, economic and political challenges accompanying our rapidly transforming global health environments have created unique social challenges that demand cross-sector solutions. Four cross-sector partnerships are reviewed with a special focus on sector roles, change management, phases of partnership development...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/s0002-9610(02)01143-1
更新日期：2003-01-01 00:00:00
abstract：BACKGROUND:Studies on stress hyperglycemia in trauma patients have largely ignored diabetes, a potential confounder. The purpose of this study was to assess the relationship between diabetes and outcome in trauma patients. METHODS:Data were obtained from the National Trauma Data Bank (version 4.0). The primary outcome...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/j.amjsurg.2006.08.031
更新日期：2006-12-01 00:00:00
abstract：:The popliteal artery entrapment syndrome is increasingly recognized as a cause of arterial insufficiency in the leg. Diagnosis is based on a clinical history of claudication, which may be atypical, physical examination, noninvasive exercise testing and angiography. Patients with normal ankle pulses and resting ankle/b...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/0002-9610(80)90285-8
更新日期：1980-03-01 00:00:00
abstract：BACKGROUND:The aim of this study was to evaluate the incidence of severe complications of adult inguinal hernia surgery from 2003 to 2007 using data from the Finnish National Patient Insurance Association. METHODS:All major surgical complications are reported to the association because it handles financial compensatio...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/j.amjsurg.2009.04.018
更新日期：2010-06-01 00:00:00
abstract：PURPOSE:The goal of this study was to evaluate the efficacy, morbidity and safety of local parastomal hernia repair using biological mesh. PATIENTS AND METHODS:A retrospective analysis of a prospectively maintained database was performed for parastomal hernia repairs. All patients who underwent local parastomal hernia...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/j.amjsurg.2017.05.005
更新日期：2018-01-01 00:00:00
abstract：:Desmoid tumors of the head and neck are uncommon and associated with a posttreatment recurrence rate as high as 70 percent. This study was undertaken to determine cure rates achievable by surgery and radiotherapy and the factors influencing failure. A chart review of all patients at our institution with desmoid tumors...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/s0002-9610(88)80305-2
更新日期：1988-10-01 00:00:00
abstract：BACKGROUND:Virtual reality simulators provide an effective learning environment and are widely used. This study evaluated the Endoscopic Sinus Surgery Simulator (ES3; Lockheed Martin) as a tool for anatomic education. METHODS:Two medical student groups (experimental, n = 8; control, n = 7) studied paranasal sinus anat...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/j.amjsurg.2007.06.026
更新日期：2008-07-01 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：BACKGROUND:Following appendectomy, management is often guided by surgeon determination of whether the appendicitis is uncomplicated or complicated. Our objectives were to determine the incidence of discordance between intraoperative and pathological findings and determine effect on outcomes. METHODS:We performed a ret...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/j.amjsurg.2019.05.004
更新日期：2020-01-01 00:00:00
abstract：BACKGROUND:Standard two-dimensional (2D) specimen radiography may guide intraoperative re-excision of margins in patients undergoing breast conserving surgery. We sought to determine the impact of three-dimensional (3D) specimen imaging in further reducing positive margin rates. METHODS:A prospective study of 100 pati...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/j.amjsurg.2015.05.018
更新日期：2015-11-01 00:00:00
abstract：:Twenty-two cirrhotic patients who underwent hepatic resection from July 1989 to March 1991 at Vancouver General Hospital were analyzed prospectively in order to determine whether there was any preoperative evaluation of liver function that would help identify those patients who would not survive hepatic resection. Pat...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/0002-9610(92)90400-l
更新日期：1992-05-01 00:00:00
abstract：:Patients with cirrhosis and esophagogastric varices have a 25% to 33% risk of initial variceal bleeding, a risk of up to 70% for recurrent variceal bleeding, and an associated mortality of up to 50%. Based on a review of prospective randomized trials, control of acute variceal bleeding should involve vasopressin plus ...
journal_title：American journal of surgery
pub_type： 杂志文章,评审
doi：10.1016/s0002-9610(05)80864-5
更新日期：1990-07-01 00:00:00
abstract：:A retrospective study of 316 patients with a diagnosis of intestinal obstruction admitted to the University of Benin Teaching Hospital over a 5 year period is presented. The overall mortality was 10.6 percent. Attention is called to the unacceptably high morbidity and mortality associated with volvulus in this and oth...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/0002-9610(80)90300-1
更新日期：1980-03-01 00:00:00
