Abstract:
BACKGROUND:Few data exist regarding melanoma metastasis to the adrenal gland. We reviewed our experience to determine the natural history of this condition and the appropriate role for surgical intervention. METHODS:A retrospective review of melanoma patients with adrenal metastasis was performed. Clinical presentation, surgical treatment, and survival were determined. RESULTS:One hundred fifty-four patients with adrenal metastasis were identified. The median survival for the entire group was 6.4 months and was negatively impacted by the presence of synchronous metastasis or an elevated LDH. Twenty-two patients underwent surgery including 20 patients rendered disease free, either by adrenalectomy alone (14) or adrenalectomy with concomitant metastectomy (6). Patients who underwent surgery had an improved survival compared with those managed nonoperatively (P < .0001). CONCLUSIONS:Patients with melanoma adrenal metastasis have a poor prognosis. Surgical treatment should be considered only in highly selected patients, such as those with limited extra-adrenal metastatic disease who can be rendered disease free.
journal_name
Am J Surgjournal_title
American journal of surgeryauthors
Mittendorf EA,Lim SJ,Schacherer CW,Lucci A,Cormier JN,Mansfield PF,Gershenwald JE,Ross MI,Lee JEdoi
10.1016/j.amjsurg.2007.12.018subject
Has Abstractpub_date
2008-03-01 00:00:00pages
363-8; discussion 368-9issue
3eissn
0002-9610issn
1879-1883pii
S0002-9610(07)00987-7journal_volume
195pub_type
杂志文章abstract:BACKGROUND:Acellular dermal matrix (ADM) represents a promising new fascial substitute for repairing abdominal wall defects. METHODS:We retrospectively studied 63 patients who underwent fascial reconstruction with ADM and analyzed risk factors for recurrence and infectious wound complications. RESULTS:Postoperative w...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/j.amjsurg.2007.11.019
更新日期:2009-01-01 00:00:00
abstract:BACKGROUND:Gastrointestinal stromal tumors (GISTs), the specific kit-positive mesenchymal tumors of the gastrointestinal tract, are rarely found in the anorectum and account for only 0.1% of all colorectal tumors. The main stem of therapy remains surgical excision. The standard surgical approach for anorectal GISTs inc...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/j.amjsurg.2005.10.013
更新日期:2006-01-01 00:00:00
abstract:BACKGROUND:We hypothesized that medical experts would concur the American College of Surgeons/Association for Surgical Education Medical Student Simulation-based Surgical Skills Curriculum ("ACS/ASE Curriculum") could be used to teach and assess Entrustable Professional Activities (EPAs). METHODS:A "crosswalk" was cre...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/j.amjsurg.2018.10.012
更新日期:2019-02-01 00:00:00
abstract::Between July 1973 and October 1984, we performed proctectomy either as part of a primary proctocolectomy or as a secondary staged procedure in 388 patients with ulcerative colitis and in 39 patients with Crohn's disease. The proctectomies were performed using a two-team synchronous approach. An intersphincteric or per...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/0002-9610(86)90026-7
更新日期:1986-01-01 00:00:00
abstract:PURPOSE:During general surgery (GS) training, residents are expected to accurately interpret radiologic images. Objective evidence evaluating residents' ability to provide accurate interpretation of imaging studies is currently lacking. METHODS:A 30-item web-based test was developed using images from different radiolo...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/j.amjsurg.2016.11.029
更新日期:2017-03-01 00:00:00
abstract:BACKGROUND:The extent of tissue loss amenable to primary healing after revascularization is unknown. Salvage of limbs with large soft-tissue defects with exposed tendon, joint, or bone lies beyond the limits of conventional techniques. We report our results using free tissue transfer as an adjunct to lower extremity va...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/s0002-9610(97)00175-x
更新日期:1997-12-01 00:00:00
abstract::Thrombocytopenic patients with surgically correctable lesions such as radial clubhands are too often repeatedly transfused with randomly pooled platelets. This is followed by a clinical rejection of the foreign protein and rapid destruction of the platelets. There may be excessive bleeding episodes. Tissue typing tech...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/0002-9610(77)90010-1
更新日期:1977-05-01 00:00:00
abstract:BACKGROUND:Surgeons who have demonstrated excellence through extensive publication in the medical education literature can provide valuable guidance for new surgeons interested in educational research. METHODS:National databases identified members of the Association for Surgical Education (ASE) who have accumulated th...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/s0002-9610(00)00301-9
更新日期:2000-03-01 00:00:00
abstract:BACKGROUND:Short bowel syndrome, secondary to a variety of causes, can be lethal in infancy and childhood. Isoperistaltic bowel lengthening, performed by longitudinal division of dilated small bowel with end-to-end anastomosis, has shown early promise but long-term outcome is unknown. METHODS:Sixteen infants and child...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/s0002-9610(99)00218-4
更新日期:1999-12-01 00:00:00
abstract::A 5 year retrospective study of the use of cholangioscopy in 153 difficult biliary cases including stones, strictures, tumors, and anomalies has been reported. In the 88 patients (58 percent) who underwent both operative cholangiography and cholangioscopy, the cholangioscope revealed 11 lesions (13 percent) missed by ...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/0002-9610(84)90048-5
更新日期:1984-01-01 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::A controlled prospective study was conducted to compare the results of kidney preservation and transplantation in regard to the type of perfusate used for perfusion preservation. Cryoprecipitated plasma, plasma protein fraction and serum albumin solution were used as perfusate. Between February 1979 and July 1980, 176...
journal_title:American journal of surgery
pub_type: 临床试验,杂志文章
doi:10.1016/0002-9610(81)90137-9
更新日期:1981-04-01 00:00:00
abstract::One hundred thirty-six patients meeting our criteria for one or more of eight clinical conditions were prospectively observed for the development of the adult respiratory distress syndrome. A high risk population was identified, including those with sepsis syndrome (38 percent), documented aspiration of gastric conten...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/0002-9610(82)90612-2
更新日期:1982-07-01 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
abstract:BACKGROUND:A history of therapeutic irradiation to the neck complicates the management of carotid artery occlusive disease. Serious surgical concerns are raised regarding alternative incisions, difficult dissections, and adequate wound closure. Pathology may be typical atherosclerotic occlusive disease or radiation-ind...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/S0002-9610(96)00150-X
更新日期:1996-08-01 00:00:00
abstract::A number of factors are known to be related to increased mortality of surgery in obstructive jaundice, yet precise identification of patients at greatest risk is difficult. We have studied the elimination of the minor analgesic antipyrine as a dynamic measure of hepatic metabolic function in patients with obstructive ...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/s0002-9610(85)80023-4
更新日期:1985-01-01 00:00:00
abstract::From 1941 through 1983, a total of 66 patients with sacrococcygeal teratoma were seen, representing 41 percent of the total of 162 patients with teratomas from all anatomic sites seen over this period. Forty-six (70 percent) of the patients with sacrococcygeal teratomas were female and 34 (52 percent) were neonates. Y...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/0002-9610(85)90082-0
更新日期:1985-09-01 00:00:00
abstract::A study of 90 cases of esophageal perforation in the antibiotic era emphasizes individualized treatment and options of therapy based on a fundamental understanding of modifying pathophysiologic factors. If the patient is seen during the first 24 hours, surgical repair and irrigating tube drainage continue to be the tr...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/0002-9610(86)90144-3
更新日期:1986-07-01 00:00:00
abstract::Forty-nine patients had conservative treatment of an appendix mass without interval appendectomy. Five were lost to follow-up within 6 months, and 44 patients were followed for between 6 months and 22 years. In nine patients (20 percent) recurrent appendicitis developed, and six (14 percent) suffered chronic pain not ...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/0002-9610(84)90476-8
更新日期:1984-09-01 00:00:00
abstract:BACKGROUND:The aim of the current study was to identify predictors of pathologic complete response (pCR) following neoadjuvant therapy. METHODS:From 2000 to 2007, 518 breast cancer patients received neoadjuvant therapy. Data were compared using chi(2) and Fisher's exact tests and multivariate analysis of variance, as ...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/j.amjsurg.2009.06.004
更新日期:2009-10-01 00:00:00
abstract::Exposed bone, even in conjunction with a fracture, will cover spontaneously with granulation tissue followed by epithelium, or will sequestrate and then cover, providing there is adequate circulation at the wound site. The healing process is lengthy but need not interfere with the reestablishment of function of the wo...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/0002-9610(79)90115-6
更新日期:1979-04-01 00:00:00
abstract::Despite intensive investigation, the pathogenesis of postinjury multiple organ failure (MOF) remains elusive. Laboratory and clinical research strongly implicate that the gastrointestinal tract plays a pivotal role. Shock with resulting gut hypoperfusion appears to be one important inciting event. While early studies ...
journal_title:American journal of surgery
pub_type: 杂志文章,评审
doi:10.1016/s0002-9610(99)00231-7
更新日期:1999-12-01 00:00:00
abstract:BACKGROUND:Phyllodes tumors (PTs) of the breast are rare, and their prognosis and treatment are still subject of discussion. The purpose of this study is to clarify therapeutic aspects and prognostic factors of this disease. PATIENTS AND METHODS:We retrospectively reviewed the medical records of 106 patients who had h...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/j.amjsurg.2006.04.007
更新日期:2006-08-01 00:00:00
abstract:BACKGROUND:Respiratory failure secondary to a variety of causes remains a significant cause of morbidity and mortality in the pediatric population. Newer therapies are appearing frequently in an attempt to decrease the number of deaths from this disease state. We briefly review the current literature on some of the new...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/s0002-9610(96)00057-8
更新日期:1996-07-01 00:00:00
abstract::To establish criteria for laparotomy, the records of 224 patients admitted with an acute pelvic fracture were reviewed. Forty-four patients underwent laparotomy; 2 had no intraabdominal injury. The mechanisms of injury was blunt trauma in 31 patients and gunshot wound in 13. All four patients who died had blunt trauma...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/0002-9610(80)90129-4
更新日期:1980-12-01 00:00:00
abstract:BACKGROUND:The purpose of this study was to assess how the practice patterns of breast surgeons affect their income and job satisfaction. METHODS:A 19-question survey regarding practice patterns and income and job satisfaction was mailed to all active US members of the American Society of Breast Surgeons. RESULTS:The...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/j.amjsurg.2009.09.006
更新日期:2010-03-01 00:00:00
abstract:BACKGROUND:Since 1977, we have studied preoperative treatments using 5-fluorouracil (5-FU) suppositories alone or in combination with radiation to reduce local recurrence and improve survival of patients with rectal cancer. PATIENTS AND METHODS:We developed a novel preoperative therapy combining radiation, intralumina...
journal_title:American journal of surgery
pub_type: 临床试验,杂志文章
doi:10.1016/S0002-9610(97)89639-0
更新日期:1996-03-01 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::Miliary tuberculosis is the most lethal form of tubercular disease. If dissemination of tubercle bacilli occurs without therapy, death is almost certain. The importance of establishing an etiologic diagnosis as promptly as possible in patients receiving immunosuppressive therapy is self-explanatory. The presence of a ...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/0002-9610(75)90402-x
更新日期:1975-09-01 00:00:00
abstract::In addition to its own inherent morbidity, the pain associated with chronic wounds presents a primary obstacle to healing. To initiate safe and effective therapy, we used a multidisciplinary approach that required the wound-healing clinician and pain-management practitioner to work together to diagnose and treat the p...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/S0002-9610(03)00289-7
更新日期:2004-07-01 00:00:00