Abstract:
BACKGROUND:Preoperative imaging for early-stage cutaneous melanoma is not recommended by current guidelines. Our goal was to investigate our institutional usage and utility. METHODS:Patients with clinically node-negative cutaneous melanoma undergoing surgery with sentinel lymph node biopsy were identified retrospectively. Any melanoma-related imaging after diagnosis and before surgery was considered a staging study. RESULTS:Five hundred fifteen studies were performed in 409 of 546 (75%) patients. Chest x-rays was performed in 70% and advanced imaging in 14% (computed tomography imaging, magnetic resonance imaging, ultrasound, and positron-emission computed tomography imaging). No metastatic lesions were identified. A Breslow thickness greater than 4 mm (odds ratio = 6.46 vs <1 mm; 95% confidence interval, 2.07 to 20.15) and male sex (odds ratio = 2.62 vs female; 95% confidence interval, 1.26 to 5.46) were associated with an increased likelihood of advanced imaging. CONCLUSIONS:Preoperative imaging was performed in the majority of patients with node-negative melanoma, with 14% undergoing advanced studies. No metastatic lesions were identified, confirming the limited utility in this setting.
journal_name
Am J Surgjournal_title
American journal of surgeryauthors
Haddad D,Garvey EM,Mihalik L,Pockaj BA,Gray RJ,Wasif Ndoi
10.1016/j.amjsurg.2013.08.017subject
Has Abstractpub_date
2013-12-01 00:00:00pages
979-85; discussion 985-6issue
6eissn
0002-9610issn
1879-1883pii
S0002-9610(13)00499-6journal_volume
206pub_type
杂志文章abstract:BACKGROUND:Chest wall recurrence (CWR) in the setting of previous mastectomy and breast reconstruction can pose complex management dilemmas for clinicians. We examined the impact of breast reconstruction on the treatment and outcomes of patients who subsequently developed a CWR. METHODS:Between 1988 and 1998, 155 brea...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/j.amjsurg.2003.11.006
更新日期:2004-02-01 00:00:00
abstract:OBJECTIVE:A large number of necrotizing soft tissue infections (NSTI) treated at a single institution over an 8-year period were analyzed with respect to microbial pathogens recovered, treatment administered, and outcome. Based on this analysis, optimal empiric antibiotic coverage is proposed. METHODS:A retrospective ...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/s0002-9610(00)00360-3
更新日期:2000-05-01 00:00:00
abstract::The use of percutaneous transluminal angioplasty as the primary treatment of renovascular stenosis in adults has recently been described. Previously, only three children have been reported to have undergone transluminal angioplasty for stenosis of the renal artery and hypertension. At our hospital, transluminal angiop...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/0002-9610(83)90114-9
更新日期:1983-05-01 00:00:00
abstract:BACKGROUND:To analyze our experience with laparoscopic right Mesocolectomy in right colonic cancers. METHODS:600 consecutive patients were studied. RESULTS:Mortality was 0.5%; morbidity was 35.5%. Mean mesocolic area was 15339 ± 1639 mm3, specimen length 24.3 ± 3.3 cm, distance from the tumor to high tie was 103 ± 6 ...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/j.amjsurg.2016.10.005
更新日期:2017-08-01 00:00:00
abstract::Diabetic foot wounds affect an estimated 15% of all patients with diabetes. These wounds are typically multifactorial in origin. Neuropathy of the foot and impaired wound healing are frequently associated with peripheral arterial occlusive disease. These factors combine to contribute to the development of foot ulcers....
journal_title:American journal of surgery
pub_type: 杂志文章,评审
doi:10.1016/S0002-9610(03)00302-7
更新日期:2004-05-01 00:00:00
abstract::Percentage and levels of circulating T-lymphocytes were studied in forty-six patients with squamous cell carcinoma of the head and neck before and/or after treatment and compared with control values obtained in fifty-one healthy volunteers. Mean percentages of circulating T-cells and mean T-cell levels in cancer patie...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/0002-9610(75)90481-x
更新日期:1975-10-01 00:00:00
abstract::A prospective study designed specifically to analyze errors in management and iatrogenic complications was conducted on 234 consecutive patients with penetrating chest trauma. Eleven percent of penetrating pleural injuries were incorrectly diagnosed on initial physical and radiologic examination, but this led to wrong...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/0002-9610(89)90577-1
更新日期:1989-04-01 00:00:00
abstract::Enteral (gut) alimentation appears to offer greater benefit for patients than calories delivered via a parenteral (intravenous) route. Enteral alimentation prevents mucosal atrophy, maintains normal gut flora, decreases bacterial translocation, and enhances enteral immunological competence. Reliable delivery into the ...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/s0002-9610(99)80235-9
更新日期:1995-06-01 00:00:00
abstract:BACKGROUND:Robotic assistance may offer unique advantages over conventional laparoscopy in colorectal operations. METHODS:This prospective observational study compared operative measures and postoperative outcomes between laparoscopic and robotic abdominal and pelvic resections for benign and malignant disease. RESUL...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/j.amjsurg.2013.08.028
更新日期:2014-07-01 00:00:00
abstract::Herein, we have described the surgical management of 23 patients with chronic intestinal ischemia. The patients presented most commonly with postprandial pain and weight loss. Diagnosis was confirmed by angiography, including lateral aortography. Surgery included bypass with Dacron being the most common graft material...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/0002-9610(84)90301-5
更新日期:1984-07-01 00:00:00
abstract::By means of intragastric instillation of meat extract, two groups of duodenal ulcer patients were identified--antral responders and antral nonresponders. Antral response was abolished ater vagotomy and drainage or vagotomy-antrectomy. The differentiation would allow for selective surgery for duodenal ulcer patients. ...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/0002-9610(77)90355-5
更新日期:1977-08-01 00:00:00
abstract:BACKGROUND:Approximately 91% of urologists are male and 9% female. We aim to characterize gender differences amongst urology society awardees over the past six decades. METHODS:We queried 16 American urology societies. Inclusion criteria were active membership enrollment, majority urologist members, and awards provide...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/j.amjsurg.2020.06.062
更新日期:2020-11-01 00:00:00
abstract::We present a patient with pseudo-Meigs syndrome (PMS) secondary to sigmoid colon cancer metastasis to the ovary with elevated serum levels of carcinoembryonic antigen, CA19-9, and CA-125 who showed a marked change in pleural effusion before and after surgery. We have to consider PMS associated with colon cancer in pat...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/j.amjsurg.2010.09.007
更新日期:2012-01-01 00:00:00
abstract:BACKGROUND:The use of 5 or more medications is defined as polypharmacy (PPM). The clinical impact of PPM on the isolated severe traumatic brain injury (TBI) patient has not been defined. METHODS:A retrospective cohort study was performed at our academic level 1 trauma center examining patients with isolated TBI. Pre-i...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/j.amjsurg.2016.07.010
更新日期:2017-06-01 00:00:00
abstract::Resection of malignancies of the upper face and skull base may result in complex bone and soft tissue defects. To better define the optimal management of these defects, we conducted a retrospective review of 75 consecutive patients who underwent closure of 76 craniofacial defects after malignant tumor excision from 19...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/0002-9610(91)90160-f
更新日期:1991-10-01 00:00:00
abstract::In an effort to determine the current incidence and clinical course of Buerger's disease, we reviewed the records of over 700 patients with small artery disease who were evaluated at Oregon Health Sciences University during a 15 year period. We identified 26 patients who met rigid criteria for the diagnosis of Buerger...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/0002-9610(87)90301-1
更新日期:1987-07-01 00:00:00
abstract:BACKGROUND:For locally advanced Siewert type II and III tumors we have performed total gastrectomy including resection of the distal 2/3 of the esophagus, through separate abdominal and right chest incisions (THX-ABD). The procedure involves wide lymphadenectomy in the abdomen/chest and a Roux-en-Y jejunostomy to the l...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/j.amjsurg.2018.11.049
更新日期:2019-08-01 00:00:00
abstract:BACKGROUND:Mobile atheromas of the aortic arch are associated with otherwise unexplained strokes and transient ischemic attacks (TIA). They are associated with increased perioperative strokes in patients undergoing coronary artery bypass surgery. Peripheral embolization is an additional risk. Transesophageal echocardio...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/s0002-9610(99)00115-4
更新日期:1999-09-01 00:00:00
abstract::During the past 5 years, extended cholecystectomy and/or more radical procedures, including pancreatoduodenectomy and extended hepatic lobectomy, were performed on 48 patients with carcinoma of the gallbladder in an attempt to cure the disease. It was retrospectively proven from microscopic analysis of the surgical sp...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/0002-9610(92)90109-5
更新日期:1992-02-01 00:00:00
abstract::From 1972 to 1981, 430 patients were treated for bleeding peptic ulcer. Two hundred ten of the patients were treated surgically and 220 medically. In the surgically treated patients, mortality was high among those with posterior duodenal peptic ulcer and after gastrectomy rather than after vagotomy. Mortality after em...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/0002-9610(84)90170-3
更新日期:1984-03-01 00:00:00
abstract:BACKGROUND:The Affordable Care Act (ACA) dramatically changed the healthcare system in the United States. This study aims to analyze the impact of the ACA on general surgery clinic visits and resultant procedures. METHODS:A retrospective review was conducted on new patients who presented to the elective general surger...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/j.amjsurg.2018.11.004
更新日期:2019-06-01 00:00:00
abstract:BACKGROUND:The changing environment in academic medical centers has had a major effect on the recruitment and the demographic characteristics of leadership positions in academic surgery. Categorization of "cultures" from the business model has been extrapolated into the academic surgical model. METHODS:The types of cu...
journal_title:American journal of surgery
pub_type: 历史文章,杂志文章
doi:10.1016/s0002-9610(02)00814-0
更新日期:2002-04-01 00:00:00
abstract::An experimental wound model has been used to evaluate the effectiveness of cefazolin and cefoxitin in the prevention of wound infection. Incisions were contaminated with Staph. aureus, E. coli, or a standardized fecal suspension. Regardless of the contaminant employed, the prophylactic use of either cefazolin or cefox...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/0002-9610(86)90072-3
更新日期:1986-02-01 00:00:00
abstract::Reoperation to remove an aortic graft was performed in 18 patients. The need for removal was infection in the majority. A changing flora was seen in aortic graft infection with gram-negative organisms predominating. Despite a standardized approach with total graft removal, aortic closure, and extraanatomic reconstruct...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/0002-9610(83)90371-9
更新日期:1983-08-01 00:00:00
abstract:BACKGROUND:The pathophysiology of adrenal insufficiency, common in surgical intensive care units, has not been fully elucidated. METHODS:Patients at risk (age > 55 years, in the surgical intensive care unit >1 week, baseline cortisol < 20 μg/dL) were enrolled. After measuring cortisol and adrenocorticotropic hormone (...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/j.amjsurg.2010.11.015
更新日期:2012-02-01 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:Intestinal obstruction (IO) is a common pediatric surgical emergency in sub-Saharan Africa with high morbidity and mortality, but little is known about its etiopathogenesis in Malawi. METHODS:Retrospective analysis of patients seen from February 2012 to June 2014 at Kamuzu Central Hospital in Lilongwe, Mala...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/j.amjsurg.2015.11.024
更新日期:2016-04-01 00:00:00
abstract::Our experience with 184 previously untreated patients who had adenoid cystic carcinoma of salivary gland origin is reviewed. Retrospective staging was possible in all but nine patients who had minor salivary gland primary tumors. Sixty-three percent of patients were diagnosed as having stage I or stage II disease (sta...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/s0002-9610(05)80721-4
更新日期:1992-12-01 00:00:00
abstract:BACKGROUND:Laparoscopic transabdominal preperitoneal (TAPP) herniorrhaphy provides an opportunity to definitively evaluate both inguinal areas without the need for additional dissection. We aimed to establish the rates and contributing patient factors to errors in the preoperative assessment. METHODS:A retrospective r...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/j.amjsurg.2006.10.015
更新日期:2007-04-01 00:00:00
abstract:OBJECTIVE:The purpose of our study is to further clarify the incidence of ductal carcinoma in situ (DCIS) patients that are upstaged upon final pathology and/or have metastatic disease in the axilla. METHODS:All patients were diagnosed with DCIS or DCIS with microinvasion (DCISm) on their diagnostic biopsy and receive...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/j.amjsurg.2005.06.011
更新日期:2005-10-01 00:00:00