Abstract:
:Complete axillary dissection was performed in 287 patients undergoing modified radical mastectomy between 1984 and 1987 to identify patterns of axillary node metastases, as well as discontinuous axillary node ("skip") metastases. Positive pathologic findings were compared with preoperative clinical examinations in 266 patients and showed only 60 cases (22.6%) clinically suspicious for tumor, in contrast to 131 (45.6%) with pathologically confirmed positive lymph nodes. Axillary contents were classified level I, II, or III based on their relationship to the pectoralis minor muscle. An average of 24.2 nodes was resected per patient (level I, 10; level II, 8.1; and level III, 5.3). Tumors ranged in size from 0.5 to 12.0 cm (mean, 2.6 cm), and increasing tumor size was associated with an increased likelihood of positive nodes. The data on 204 patients with complete clinical and pathologic data show that of 119 patients with negative level I nodes a limited axillary dissection (level I only) would fail to identify 6 with positive level II and 2 with positive level III nodes, whereas of 85 patients with positive level I nodes limited axillary dissection would fail to identify 17 with positive level II nodes, 7 with positive level III nodes, and 27 with positive levels II and III nodes. Complete axillary dissection (levels I, II, and III) should be performed to stage patients accurately, as well as to remove tumor-involved nodes and diminish local axillary recurrences. Clinical examination of the axilla appears to be a poor means of identifying axillary metastatic cancer.
journal_name
Surgeryjournal_title
Surgeryauthors
Chevinsky AH,Ferrara J,James AG,Minton JP,Young D,Farrar WBsubject
Has Abstractpub_date
1990-10-01 00:00:00pages
612-7; discussion 617-8issue
4eissn
0039-6060issn
1532-7361journal_volume
108pub_type
杂志文章相关文献
SURGERY文献大全abstract:BACKGROUND:The observed to expected (O:E) mortality based on Injury Severity Scores (ISS) has been used to assess quality of trauma center (TC) care. Injuries in the elderly have increased, and these patients often have advanced directives, on occasion limiting aggressive care even for potentially survivable injuries; ...
journal_title:Surgery
pub_type: 杂志文章
doi:10.1016/j.surg.2011.07.065
更新日期:2011-10-01 00:00:00
abstract::Malignant intra-abdominal neuroendocrine tumors are rare; consequently, a standard chemotherapeutic protocol for patients with unresectable disease has not been established. This prompted a review of our experience with dimethyltriazeno imidazole carboxamide (dacarbazine) (DTIC) treatment for these tumors. From 1976 t...
journal_title:Surgery
pub_type: 杂志文章
doi:
更新日期:1987-12-01 00:00:00
abstract:BACKGROUND:Adequate surgical care is lacking in many low- and middle-income countries because of diverse barriers preventing patients from reaching providers. We sought to assess perceived difficulties to accessing surgical care in Nepal using the Surgeons OverSeas Assessment of Surgical Need tool. METHODS:Fifteen of ...
journal_title:Surgery
pub_type: 杂志文章
doi:10.1016/j.surg.2016.03.012
更新日期:2016-08-01 00:00:00
abstract::Duodenobronchial fistulas are an extremely rare subgroup of abdominobronchial fistulas, which include bronchobiliary, gastrobronchial, enterobronchial, colobronchial, and splenobronchial fistulas. Only one case of a duodenobronchial fistula has been previously reported. Duodenobronchial fistulas occur as a complicatio...
journal_title:Surgery
pub_type: 杂志文章,评审
doi:
更新日期:1991-09-01 00:00:00
abstract:BACKGROUND:Noncommunicable diseases, including those requiring surgical care, are increasingly straining low- and middle-income countries. Globally, 11% of all disability-adjusted life-years lost result from conditions requiring surgery; however, little is known about country-specific burden. We piloted a household-bas...
journal_title:Surgery
pub_type: 杂志文章
doi:10.1016/j.surg.2015.05.011
更新日期:2015-09-01 00:00:00
abstract:BACKGROUND:From a post hoc analysis a hypothesis was generated that women deposit more collagen in a surrogate test wound than men. The purpose of this study has been to verify this hypothesis prospectively in a controlled study. METHODS:Post hoc analyses were done on 37 volunteers (study A). The prospective trial inc...
journal_title:Surgery
pub_type: 杂志文章
doi:10.1067/msy.2002.119986
更新日期:2002-03-01 00:00:00
abstract:BACKGROUND:Video review for assessment of surgical performance is gaining popularity but is time consuming for busy expert reviewers, making review delays inevitable. Decreasing review time and including nonexpert reviewers may facilitate more timely reviews. We hypothesized that a shorter duration video clip would not...
journal_title:Surgery
pub_type: 杂志文章,随机对照试验
doi:10.1016/j.surg.2017.11.011
更新日期:2018-04-01 00:00:00
abstract::The hemodynamic significance of stenosis was defined by intraoperative measurement of pressure and flow across 22 profunda femoris and 44 iliac artery segments. Measurements were taken at rest and during papaverine-induced vasodilation, and the mean pressure gradient across the arterial segment at double resting flow ...
journal_title:Surgery
pub_type: 杂志文章
doi:
更新日期:1981-11-01 00:00:00
abstract::The adrenal glands removed from mongrel adult dogs were used to evaluate calcitonin activity; calcitonin has been recognized since 1962 as being a potent hypocalcemic polypeptide. After removal of the glands the animals demonstrated a significant hypocalcemic period simulating a one-half maximal calcitonin effect, wh...
journal_title:Surgery
pub_type: 杂志文章
doi:
更新日期:1969-07-01 00:00:00
abstract:BACKGROUND:The electronic medical record (EMR) of a large, tertiary referral center was examined to study the prevalence of undiagnosed and unrecognized primary hyperparathyroidism (PHPT). METHODS:The EMR was queried for outpatient serum calcium >10.5 mg/dL over a 2-year period. RESULTS:Of 2.7 million patients, 54,19...
journal_title:Surgery
pub_type: 杂志文章
doi:10.1016/j.surg.2013.06.051
更新日期:2013-12-01 00:00:00
abstract::Bile peritonitis after injury to the biliary tree is a serious complication that requires exploratory laparotomy. Our patient had an obstructing ampullary carcinoma, and generalized bile peritonitis developed from attempted percutaneous transhepatic cholangiography. The patient's condition was managed by peritoneal la...
journal_title:Surgery
pub_type: 杂志文章
doi:
更新日期:1991-06-01 00:00:00
abstract::This study examines the effect of pretreatment with 10(8) ultraviolet B-irradiated donor leukocytes (UV-DL) with or without peritransplant cyclosporine (CyA) treatment (20 mg/kg on days 0, +1, and +2 relative to transplantation) on rat cardiac allograft survival across major histocompatibility loci. A single UV-DL pre...
journal_title:Surgery
pub_type: 杂志文章
doi:
更新日期:1988-08-01 00:00:00
abstract:INTRODUCTION:We hypothesized that most contralateral breast cancers (CBCs) develop ≥5 years after the primary breast cancer (PBC) and that CBCs have more favorable tumor characteristics. METHODS:This is a single-institution retrospective review of 323 patients who were diagnosed with CBC from 1990 to 2014. CBCs were d...
journal_title:Surgery
pub_type: 杂志文章
doi:10.1016/j.surg.2015.03.059
更新日期:2015-09-01 00:00:00
abstract::A patient who underwent jejunoileal bypass for morbid obesity developed servere renal failure associated with hyperoxaluria and renal oxalosis. Renal function improved and oxalate excretion decreased following hemodialysis and restoration of gastrointestinal continuity. ...
journal_title:Surgery
pub_type: 杂志文章
doi:
更新日期:1977-11-01 00:00:00
abstract:BACKGROUND:Studies of risk factors after pancreatoduodenectomy are few: some concern restricted populations and others are based on administrative data. METHODS:Multicenter clinical data were collected for 300 patients undergoing pancreatoduodenectomy to determine (by univariate and multivariate analysis) preoperative...
journal_title:Surgery
pub_type: 杂志文章,多中心研究,随机对照试验
doi:10.1016/j.surg.2005.08.012
更新日期:2006-05-01 00:00:00
abstract::Thromboxane (Tx) inhibition prevents pulmonary leukostasis after acid aspiration. This observation prompted study of polymorphonuclear leukocyte (PMN) accumulations and products of cyclooxygenase. Experiments were conducted with a skin abrasion preparation. Five groups of six rabbits were pretreated intravenously with...
journal_title:Surgery
pub_type: 杂志文章
doi:
更新日期:1986-01-01 00:00:00
abstract::A report of a 38-year-old man with a 10 month course of illness characterized by recurrent pericardial and pleural high-protein, high-amylase effusions is presented. Operative pancreatogram demonstrated fistulization from the mid-pancreas through the mediastinum into both pleural spaces and the pericardium. Surgical d...
journal_title:Surgery
pub_type: 杂志文章
doi:
更新日期:1979-04-01 00:00:00
abstract::Although cyclosporine (CsA) has been thought to act primarily on the afferent phase of the immune response, we can demonstrate that it also acts at the efferent phase. The effect of CsA on lymphocyte recruitment (LR), regional blood flow (RBF), and vascular permeability (VP) was studied in paired, healed, subcutaneous...
journal_title:Surgery
pub_type: 杂志文章
doi:
更新日期:1983-08-01 00:00:00
abstract:BACKGROUND:Interest is growing in simulation-based continuing medical education courses for practicing surgeons. However, little research has explored the instruction employed during these courses. This study examines instruction practices used during an annual simulation-based continuing medical education course. MET...
journal_title:Surgery
pub_type: 杂志文章
doi:10.1016/j.surg.2019.01.016
更新日期:2019-06-01 00:00:00
abstract::Active-specific immunotherapy with concanavalin A or with neuraminidase-modified syngeneic tumor cells has been studied in an experimental model of colon cancer. Systemic immunotherapy with concanavalin A-modified tumor cells or with neuraminidase-modified tumor cells has resulted in up to 70 percent cure of rats rece...
journal_title:Surgery
pub_type: 杂志文章
doi:
更新日期:1976-08-01 00:00:00
abstract:BACKGROUND:Operative time often has been cited as an important factor for postoperative outcomes. Despite this belief, most efforts to improve liver transplant outcomes have largely focused on only patient and donor factors, and little attention has been paid on operative time. The primary objective of this project was...
journal_title:Surgery
pub_type: 杂志文章
doi:10.1016/j.surg.2017.05.010
更新日期:2017-10-01 00:00:00
abstract:BACKGROUND:Resumption of elective surgery during the current coronavirus disease 2019 pandemic crisis has been debated widely and largely discouraged. The aim of this prospective cohort study was to assess the feasibility of resuming elective operations during the current and possible future peaks of this coronavirus d...
journal_title:Surgery
pub_type: 杂志文章
doi:10.1016/j.surg.2020.07.003
更新日期:2020-10-01 00:00:00
abstract::We report a case in which a large, postoperative, biliary cutaneous fistula was successfully treated by means of endoscopic insertion of two endoprostheses into the common bile duct. Twenty-four hours after the procedure, bile flow from the cutaneous fistula ceased completely. The endoprostheses were removed after 6 w...
journal_title:Surgery
pub_type: 杂志文章
doi:
更新日期:1987-07-01 00:00:00
abstract:BACKGROUND:The existence of primary gastrinomas in lymph nodes continues to be controversial, because distinction from metastases from occult or regressed primary tumors may be difficult to exclude with certainty. If primary nodal gastrinomas do indeed occur, precursor neuroendocrine cells should be identifiable within...
journal_title:Surgery
pub_type: 杂志文章
doi:10.1016/s0039-6060(05)80100-x
更新日期:1995-12-01 00:00:00
abstract:BACKGROUND AND AIMS:Congenital extrahepatic portosystemic shunt (CEPS) is a rare venous malformation in which mesenteric venous blood drains directly into the systemic circulation. It is still a matter of debate whether conservative or operative strategies should be used to treat symptomatic CEPS. The aim of this study...
journal_title:Surgery
pub_type: 杂志文章
doi:10.1016/j.surg.2011.07.035
更新日期:2012-03-01 00:00:00
abstract:BACKGROUND:Interleukin (IL)-10 is a potent antiinflammatory cytokine inhibiting the release of tumor necrosis factor--alpha (TNF-alpha) and IL-8 by activated macrophages and polymorphonuclear leukocytes. Cardiopulmonary bypass (CPB) represents a unique situation where an inflammatory reaction is predictably induced. Th...
journal_title:Surgery
pub_type: 杂志文章
doi:10.1016/s0039-6060(96)80217-0
更新日期:1996-01-01 00:00:00
abstract:BACKGROUND:Limited data exist regarding the downstream effects of surgical transitional care programs. We explored the impact of such programs on patient satisfaction and fiscal metrics. METHODS:A telephone-based surgical transitional care program enrolled patients undergoing complex abdominal surgery between 2015 to ...
journal_title:Surgery
pub_type: 杂志文章
doi:10.1016/j.surg.2020.09.015
更新日期:2021-02-01 00:00:00
abstract::It is now well accepted that mesoatrial bypass is an efficient treatment of Budd-Chiari syndrome and that it is indicated when the inferior vena cava is obstructed. This report presents a patient in whom the superior mesenteric vein was thrombosed after a previous mesocaval shunt. A bypass was constructed between the ...
journal_title:Surgery
pub_type: 杂志文章
doi:
更新日期:1986-03-01 00:00:00
abstract::Forty-seven patients with 50 clinically occult injuries of major arteries were studied prospectively to determine the natural history of these lesions and the safety of nonoperative management. Penetrating trauma was the predominant mechanism and lower extremity arteries were most commonly involved. The morphology of ...
journal_title:Surgery
pub_type: 杂志文章
doi:
更新日期:1991-01-01 00:00:00
abstract:BACKGROUND:Detecting metastases to the cervical lymph nodes is the main problem in the management of squamous cell carcinoma of the tongue. We investigated the ability of sentinel node (SN) biopsy to predict neck status in 11 patients with lateral T1-T2, N0, and M0 squamous cell carcinoma of the tongue who underwent ip...
journal_title:Surgery
pub_type: 杂志文章
doi:10.1067/msy.2000.106809
更新日期:2000-07-01 00:00:00