Abstract：
BACKGROUND:Breast cancer-related lymphedema remains a significant complication post mastectomy. Identifying patients at highest risk may better inform targeted healthcare resource allocation and improve outcomes. This study aims to identify lymphedema predictors after mastectomy to develop a simple, accurate risk assessment tool. METHODS:An institutional retrospective review identified all women with breast cancer undergoing mastectomy between January 2000 and July 2013 with postmastectomy lymphedema as the primary outcome. Stepwise multivariate Cox regression identified independent predictors of lymphedema. A simplified risk assessment tool was derived and composite risk estimated for each patient. RESULTS:Of 3,136 patients included, 325 (10.4%) developed lymphedema after a follow-up of 4.2 years. Significant predictors included invasive cancer diagnosis (hazard ratio [HR] = 2.25), postmastectomy radiation (HR = 2.05), age over 65 years (HR = 1.90), and axillary dissection (HR = 1.79). Stratified lymphedema risk by group was defined as follows: low 6.2%, moderate 10.0%, high 16.4%, and extreme 36.4%. The model demonstrated excellent risk discrimination (C = .78). CONCLUSIONS:Postmastectomy lymphedema incidence was 10.4%. Invasive cancer diagnosis, chemoradiation, and axillary dissection imparted significant risk. The Risk Assessment Tool Evaluating Lymphedema offers accurate risk discrimination ranging from 6.2% to 36.4%. Selective treatment approaches may improve outcomes and delivery of cost-effective healthcare.
journal_name
Am J Surgjournal_title
American journal of surgeryauthors
Basta MN,Wu LC,Kanchwala SK,Serletti JM,Tchou JC,Kovach SJ,Fosnot J,Fischer JPdoi
10.1016/j.amjsurg.2016.08.016subject
Has Abstractpub_date
2017-06-01 00:00:00pages
1125-1133.e1issue
6eissn
0002-9610issn
1879-1883pii
S0002-9610(16)30515-3journal_volume
213pub_type
杂志文章abstract：INTRODUCTION:Sleeve gastrectomy (SG) can be associated with inadequate weight loss, insufficient resolution of co-morbidities and severe reflux. Conversion to Roux-en-Y Gastric Bypass (RYGB) is a potential solution. The aim of this study was to determine the common indications for conversion from SG to RYGB at our cent...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/j.amjsurg.2017.04.003
更新日期：2017-05-01 00:00:00
abstract：BACKGROUND:Post-traumatic splenic pseudocysts are uncommon. The optimal treatment is not well defined. METHODS:A retrospective chart review was conducted at the three adult hospitals in the Calgary Health Region. RESULTS:Six cases of splenic pseudocysts were found over a 6-year period. One splenic pseudocyst spontane...
journal_title：American journal of surgery
pub_type： 杂志文章,多中心研究
doi：10.1016/j.amjsurg.2006.01.034
更新日期：2006-05-01 00:00:00
abstract：BACKGROUND:The aim of this study was to determine whether differing neoadjuvant chemotherapy (NAC) regimens for HER2 positive breast cancer (HER2+ BC) are associated with differing surgical complications. Our goal was to evaluate postoperative complications in HER2+ BC patients receiving NAC with Herceptin (trastuzumab...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/j.amjsurg.2020.06.053
更新日期：2020-11-01 00:00:00
abstract：BACKGROUND:Splenectomy is generally a second-line therapy in patients with immune thrombocytopenic purpura (ITP) and autoimmune hemolytic anemia (AHA) refractory to medical therapy. Our objective was to evaluate outcomes after splenectomy for these disorders. METHODS:A retrospective review of the medical records of pa...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/j.amjsurg.2012.05.030
更新日期：2012-12-01 00:00:00
abstract：:Twenty-six patients with advanced melanoma metastases confined to the lower extremity underwent 28 therapeutic limb perfusions without a major complication or treatment-related death. A complete response to treatment occurred in 21 patients (81 percent). Of 16 patients, response persisted until death in 13 and was not...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/0002-9610(85)90006-6
更新日期：1985-07-01 00:00:00
abstract：:A quantitative endotoxin assay was applied in this study of endotoxin transport from the infected abdomen. In rats with fecal peritonitis, extremely high concentrations were found in thoracic duct lymph (approximately 400 times higher than those found in arterial and portal vein plasma). Taking flow rates into account...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/0002-9610(86)90098-x
更新日期：1986-04-01 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：:A survey was made of 112 cases of gallstone ileus reported in the Japanese literature, including 3 of our cases. The ratio of males to females was 1 to 1.1, the age range was 13 to 87 years, and biliary-enteric fistulas were demonstrated in 81 percent of the patients. Although cholecystoduodenal fistula was most commo...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/0002-9610(80)90185-3
更新日期：1980-09-01 00:00:00
abstract：BACKGROUND:The prognostic significance of tumor location in breast cancer remains unclear. To better understand this relationship, we evaluated the Department of Defense tumor registry. METHODS:Patients with infiltrating ductal adenocarcinoma or lobular carcinoma over a 10-year period were identified and analyzed. RE...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/j.amjsurg.2007.12.039
更新日期：2008-05-01 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：BACKGROUND:Because the implications of micrometastases found on sentinel node biopsy (SNB) for ductal carcinoma in situ (DCIS) or ductal carcinoma in situ with microinvasion (DCISM) are largely unknown, we wished to determine if SNB pathology predicted recurrence risk in DCIS/DCISM. METHODS:Retrospective chart review ...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/j.amjsurg.2008.06.011
更新日期：2008-10-01 00:00:00
abstract：:Seven pairs of rats were simultaneously infused with a chemically formulated nutritionally complete amino acid-glucose diet which was delivered, at the same rate, into a central vein or into a feeding gastrostomy. The intragastrically infused rats showed greater weight gain than did the intravenously infused rats. Thi...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/0002-9610(78)90092-2
更新日期：1978-02-01 00:00:00
abstract：:Seven patients with carcinoma in a thyroglossal duct cyst have received treatment over a 15 year period. Findings in all of these patients reflect the likelihood of carcinoma arising within thyroglossal duct tissue. In each patient there was sufficient histologic evidence of the presence of a thyroglossal duct cyst an...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/0002-9610(83)90077-6
更新日期：1983-02-01 00:00:00
abstract：:Substitution of segments of traumatized or diseased ureter has been attempted often with little success. The ideal ureteral subsitute has yet to be found, and experiments with the newer biologically inert prosthetic materials such as the bovine carotid artery heterograft are warranted. ...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/0002-9610(76)90010-6
更新日期：1976-05-01 00:00:00
abstract：:In a random double-blind trial monitored by 125I-fibrinogen leg scan, impedance plethysmography, and contrast phleobograms if impedance became abnormal, hydroxycholoroquine was shown to be no more effective than placebo for prevention of venous thrombosis after total hip replacement. Subsequently, the combination of h...
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(77)90125-8
更新日期：1977-04-01 00:00:00
abstract：BACKGROUND:Few data exist regarding surveillance for multiple primary melanoma (MPM) in elderly patients or whether the incidence and risk factors are the same as for younger patients. Thus, we studied the frequency and characteristics of MPM in the elderly melanoma patients. METHODS:From our prospective melanoma regi...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/j.amjsurg.2015.05.023
更新日期：2016-01-01 00:00:00
abstract：:Two patients with coexisting neurofibromatosis and hyperparathyroidism are described, bringing the total number of such cases in the world literature to seven. Other more classic examples of the association of tumorous conditions of neuroectodermal and entodermal origin are discussed to support the suggestion that the...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/0002-9610(79)90079-5
更新日期：1979-03-01 00:00:00
abstract：:Eighty-two femoropopliteal reconstructions were performed on sixty-six consecutive patients. Of seventeen late failures, thirteen were secondarily reconstructed. Clinical and angiographic studies demonstrated the reasons for failure in all patients except one. Seven patients were improved and six unimproved by reopera...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/0002-9610(78)90107-1
更新日期：1978-02-01 00:00:00
abstract：BACKGROUND:Retroperitoneal vascular injury remains one of the most frequent causes of death following abdominal trauma. A risk analysis of the association between potential outcome predictors and mortality following abdominal aorta and inferior vena cava injuries was performed. METHODS:Eighty-nine patients sustaining ...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/S0002-9610(96)00231-0
更新日期：1996-11-01 00:00:00
abstract：BACKGROUND:Patients often have an incomplete understanding of the levels of training and roles of the various surgical providers in teaching hospitals, leading to patient confusion and dissatisfaction. METHODS:Pre-intervention discharge surveys were administered to gastrointestinal surgery inpatients (10/2016-02/2017)...
journal_title：American journal of surgery
pub_type： 临床试验,杂志文章
doi：10.1016/j.amjsurg.2018.07.056
更新日期：2018-10-01 00:00:00
abstract：:A phase I clinical trial of immunotherapy with "Immune" RNA was undertaken fifteen months ago. Twenty-six cancer patients were treated with RNA extracted from the lymphoid organs of sheep immunized with either autologous tumor cells or allogeneic tumor cells of the same histologic type. Eighteen patients had gross dis...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/0002-9610(76)90360-3
更新日期：1976-11-01 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：:Percutaneous transluminal laser angioplasty is a new method for treating atherosclerotic disease previously not amenable to routine percutaneous transluminal angioplasty techniques. Our results compared favorably with other clinical trials. Patient selection criteria include lesions in the superficial femoral or popli...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/0002-9610(87)90240-6
更新日期：1987-12-01 00:00:00
abstract：BACKGROUND:Breast cancer in a young person is considered by many to be a rare and very aggressive disease. Theories regarding the aggressiveness of the disease are varied. This study was undertaken in an attempt to help formulate guidelines regarding screening for and treatment of breast cancer in the young patient. P...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/s0002-9610(05)80007-8
更新日期：1995-09-01 00:00:00
abstract：BACKGROUND:In view of the indolent nature of most cancers of the thyroid, particularly of the papillary and follicular variety, the decision to remove a segment of the upper aerodigestive tract when the cancer is either close to or invading this area is a difficult one. It was felt relevant to review the experience at ...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/s0002-9610(05)80136-9
更新日期：1994-12-01 00:00:00
abstract：BACKGROUND:In hepato-pancreato-biliary (HPB) surgery higher volumes are associated with improved outcomes; however, there are limitations to regionalization. Here we report our experience establishing multidisciplinary HPB program at a university-affiliated community hospital. METHODS:This is a retrospective review of...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/j.amjsurg.2019.03.015
更新日期：2019-11-01 00:00:00
abstract：BACKGROUND:One of the issues in the debate surrounding the extent of thyroid excision for localized, well-differentiated thyroid cancer is the low morbidity rate reported after all degrees of thyroid resection. This study was conducted to determine morbidity and mortality after surgical resection for thyroid cancer. M...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/s0002-9610(05)80085-6
更新日期：1994-11-01 00:00:00
abstract：BACKGROUND:Cervical spine injuries can occur in as many as 10% of patients with blunt trauma with mental status changes from closed head injuries. Despite normal results on cervical spine computed tomography (CT), magnetic resonance imaging (MRI) is often recommended to exclude ligamentous or soft tissue injury. METHO...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/j.amjsurg.2008.07.040
更新日期：2008-12-01 00:00:00
abstract：BACKGROUND:Rurality adversely impacts the continuum of cancer care. However, investigations of rural cancer surgery are notably absent. We examined patterns and outcomes of oncologic resections at rural US hospitals. METHODS:We identified 928,370 hospital admissions in which 1 of 20 oncologic resections was performed ...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/j.amjsurg.2012.07.012
更新日期：2012-11-01 00:00:00
abstract：BACKGROUND:Thyroglossal duct cysts (TGDCs) are common in children but also present in adults. This study evaluates the preoperative management and postoperative outcomes in patients with a resected TGDC. METHODS:A retrospective analysis was performed on patients with a surgically treated TGDC. Clinicopathologic variab...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/j.amjsurg.2013.06.018
更新日期：2014-06-01 00:00:00
