Abstract:
OBJECTIVE:To determine the prevalence of clinically significant decision conflict (CSDC) among patients undergoing cancer surgery and associations with postoperative physical activity, as measured through smartphone accelerometer data. BACKGROUND:Patients with cancer face challenging treatment decisions, which may lead to CSDC. CSDC negatively affects patient-provider relationships, psychosocial functioning, and health-related quality of life; however, physical manifestations of CSDC remain poorly characterized. METHODS:Adult smartphone-owners undergoing surgery for breast, skin-soft-tissue, head-and-neck, or abdominal cancer (July 2017-2019) were approached. Patients downloaded the Beiwe application that delivered the Decision Conflict Scale (DCS) preoperatively and collected smartphone accelerometer data continuously from enrollment through 6 months postoperatively. Restricted-cubic-spline regression, adjusting for a priori potential confounders (age, type of surgery, support status, and postoperative complications) was used to determine trends in postoperative daily physical activity among patients with and without CSDC (DCS score≥25/100). RESULTS:Among 99 patients who downloaded the application, 85 completed the DCS (86% participation rate). Twenty-three (27%) reported CSDC. These patients were younger (mean age 48.3 [standard deviation 14.2]-vs.-55.0 [13.3],p = 0.047) and more frequently lived alone (22%-vs.-6%,p = 0.042). There were no differences in preoperative physical activity (115.4 minutes [95%CI 90.9,139.9]-vs.-110.8 [95% 95.7,126.0],p = 0.753). Adjusted postoperative physical activity was lower among patients reporting CSDC at 30 days (difference 33.1 minutes [95%CI 5.93,60.2],p = 0.017), 60 days (35.5[95%CI 8.50,62.5],p = 0.010) and 90 days (31.8[95%CI 5.44,58.1],p = 0.018) postoperatively. CONCLUSIONS:CSDC was prevalent among patients who underwent cancer surgery and associated with lower postoperatively daily physical activity. These data highlight the importance of addressing modifiable decisional needs of patients through enhanced shared decision-making.
journal_name
Ann Surgjournal_title
Annals of surgeryauthors
Panda N,Solsky I,Cauley CE,Lipsitz S,Desai EV,Huang EJ,Benjamin EM,Lubitz CC,Onnela JP,Haynes ABdoi
10.1097/SLA.0000000000004487subject
Has Abstractpub_date
2020-09-15 00:00:00eissn
0003-4932issn
1528-1140pub_type
杂志文章abstract:OBJECTIVE:To evaluate the effect of peptide receptor radionuclide therapy (PRRT) on somatostatin receptor (SSR)-transfected colon carcinoma cells in a rat liver metastases model. SUMMARY BACKGROUND DATA:Previously the authors have shown highly effective therapy with PRRT of SSR-positive tumors. This treatment is SSR-m...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-200212000-00004
更新日期:2002-12-01 00:00:00
abstract:OBJECTIVE:To prospectively characterize changes in body weight, satiety, and postprandial gut hormone profiles following esophagectomy. BACKGROUND:With improved oncologic outcomes in esophageal cancer, there is an increasing focus on functional status and health-related quality of life in survivorship. Early satiety a...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/SLA.0000000000001918
更新日期:2017-07-01 00:00:00
abstract::Three methods of closing bronchial stumps were evaluated in 90 dogs undergoing left pneumonectomy:interrupted 3-0 silk sutures, interrupted 3-0 nylon sutures, and stapling with an automatic device. The dogs were sacrificed at 24 hours, 3, 5, 7, 10, and 14 days after pneumonectomy. Brochial stump leakage pressures and ...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-197608000-00012
更新日期:1976-08-01 00:00:00
abstract::Ambulatory venous pressure (AVP) and ascending and retro-grade phlebography have been used to elucidate the precise pathogenetic factors in cases of venous stasis. On the bases of this information, procedures aimed at the correction of the particular pathophysiological alterations were carried out. Fifty-two lower ext...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-198201001-00004
更新日期:1982-01-01 00:00:00
abstract:OBJECTIVE:The objective of this study was to elucidate the significance and limitations of serum amylase levels in the diagnosis of blunt injury to the pancreas. SUMMARY BACKGROUND DATA:Several recently published reports of analyses of patients with blunt abdominal trauma have indicated that determination of the serum...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-199707000-00010
更新日期:1997-07-01 00:00:00
abstract::Eight patients after vagotomy and Jaboulay gastroduodenostomy had their gastroduodenostomy closed to treat dumping and diarrhea. Eight gastroduodenostomies were closed once and four were closed twice, a total of 12 procedures. Of these, ten were "simple" closures (direct suture of the opening into the duodenum via a g...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-198308000-00005
更新日期:1983-08-01 00:00:00
abstract::The objective of this study was to define the patterns of myoelectric activity that occur throughout the gastrointestinal tract during normal recovery from laparotomy. Electrodes were placed on the stomach, jejunum, and transverse colon of 44 patients undergoing laparotomy. Basal electric rhythms in all areas showed n...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-199006000-00018
更新日期:1990-06-01 00:00:00
abstract::As a consequence of an experience with 175 patients undergoing reoperation for persistent or recurrent hyperparathyroidism, the authors have evolved an approach to management. The emphasis is on the confirmation of the diagnosis; the critical evaluation of invasive and noninvasive localization tests, techniques of int...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:
更新日期:1985-01-01 00:00:00
abstract::Seventeen patients with femoral arteriovenous bovine shunts (FAVBS) were evaluated to delineate the cardiovascular consequences of the procedure. The resting cardiac index (CI), as estimated by echocardiography, was increased in 8 patients (47%). Twelve of the 17 patients (71%) had more than a 20% reduction in CI afte...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-197607000-00017
更新日期:1976-07-01 00:00:00
abstract:OBJECTIVE:To evaluate the diagnostic potential of smooth muscle protein of 22 kDa (SM22) as plasma biomarker for the detection of transmural intestinal ischemia. BACKGROUND:Acute mesenteric ischemia is an abdominal emergency requiring rapid diagnosis and treatment. Especially, detection of transmural damage is imperat...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/SLA.0000000000002278
更新日期:2018-07-01 00:00:00
abstract::Neurologic events following carotid reconstructive surgery for symptomatic cerebral occlusive disease are generally reported to be one to two per cent. One of the events leading to this incidence is thrombosis of the endarterectomized internal carotid artery (ICA) after surgery. Since antiplatelet drugs have been foun...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-198506000-00014
更新日期:1985-06-01 00:00:00
abstract:OBJECTIVE:The authors review the results and outcomes of esophagectomy (prophylactic esophagectomy) for patients with Barrett's esophagus and high-grade epithelial dysplasia (HGD). SUMMARY BACKGROUND DATA:The role of prophylactic esophagectomy for Barrett's esophagus with HGD is controversial, with some authors recomm...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-199607000-00010
更新日期:1996-07-01 00:00:00
abstract:OBJECTIVE:The authors determined which combination of computed tomography scans is most helpful for preoperative assessment of patients with liver tumors. SUMMARY BACKGROUND DATA:Multi-institutional studies have shown that the most important prognostic factors for selection of patients with metastatic colorectal cance...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-199303000-00002
更新日期:1993-03-01 00:00:00
abstract:OBJECTIVE:We have previously demonstrated that P. aeruginosa can have profound effects on the intestinal epithelial barrier via one of its virulence factors, the PA-I lectin/adhesin. The aims of the present study were to further characterize the interaction of P. aeruginosa and the intestinal epithelium using both in v...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/01.sla.0000094551.88143.f8
更新日期:2003-11-01 00:00:00
abstract:OBJECTIVE:To determine whether insulinlike growth factor-I (IGF-I) and hepatocyte growth factor (HGF) cooperate to induce migration and invasion of human colorectal carcinoma (CRC) cells and whether the effects of IGF-I and/or HGF are mediated through activation of the urokinase plasminogen activator (uPA)/uPA receptor...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/01.sla.0000160699.59061.92
更新日期:2005-05-01 00:00:00
abstract:OBJECTIVE:This study was undertaken to define the incidence and etiology of small bowel obstruction (SBO) after nephrectomy for Wilms' tumor. SUMMARY BACKGROUND DATA:Intestinal obstruction is one of the most common postoperative complications after nephrectomy for nephroblastoma. However, few reports have evaluated ri...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-199321850-00011
更新日期:1993-11-01 00:00:00
abstract:OBJECTIVES:The aim of this study was to compare morbidity and mortality between nonoperative and operative treatment of pneumoperitoneum. BACKGROUND:Pneumoperitoneum is a potentially life-threatening condition that has been traditionally treated with surgical intervention. Adequately powered studies comparing treatmen...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/SLA.0000000000003492
更新日期:2019-07-23 00:00:00
abstract::This study evaluated a possible protective and therapeutic effect of moderate hypothermia in the treatment of severe hemorrhagic shock. A modified Wiggers shock preparation was used. Normothermic dogs (Group I, N = 6) were maintained at normal body temperature throughout hemorrhagic shock and resuscitation. In Group I...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-198804000-00015
更新日期:1988-04-01 00:00:00
abstract:OBJECTIVE:To assess outcome and prognostic factors for survival of adults with Ewing's sarcoma/primitive neuroectodermal tumor (PNET). BACKGROUND:Ewing's sarcoma/PNET is a disease of childhood rarely seen in adults. Accordingly, there is a relative paucity of published literature pertaining to outcome for adults with ...
journal_title:Annals of surgery
pub_type: 临床试验,杂志文章
doi:10.1097/00000658-199907000-00012
更新日期:1999-07-01 00:00:00
abstract::Nasogastric (NG) decompression after colorectal surgery is practiced commonly. Our aim was to determine whether routine NG decompression benefitted patients undergoing this type of surgery. Five hundred thirty-five patients were randomized prospectively to either NG decompression or no decompression. Stratification wa...
journal_title:Annals of surgery
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1097/00000658-198906000-00003
更新日期:1989-06-01 00:00:00
abstract::Seventy-seven patients with a primary complaint of persistent cough, wheezing, and/or recurrent pneumonia were evaluated for the presence of occult gastroesophageal reflux disease. Fifty-four patients (70%) had increased esophageal acid exposure on 24-hour pH monitoring of the distal esophagus. In 28% of these patient...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-199003000-00005
更新日期:1990-03-01 00:00:00
abstract::One hundred and forty patients with an intractable ascites complicating a chronic liver disease received a peritoneovenous shunt (PVS) using the LeVeen valve. Operative mortality was ten per cent but was 25% in patients with severe liver failure. Intraoperative drainage of ascites sharply decreased postoperative compl...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-198504000-00014
更新日期:1985-04-01 00:00:00
abstract::CLINICAL AND LABORATORY STUDIES OF AFP PRODUCING HEPATOMAS DEMONSTRATED THAT: 1) serum AFP levels correlated directly with tumor growth; 2) circulating AFP could be cleared by passive administration of an. excess of anti-AFP; and 3) highly specific anti-AFP functioned as a carrier to localize diagnostic and possibly t...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-197410000-00025
更新日期:1974-10-01 00:00:00
abstract::From 1969 to 1985, 129 patients with combined pancreatoduodenal injuries were treated at one urban trauma center. A total of 104 patients (80.6%) had penetrating wounds, and multiple visceral and vascular injuries were usually associated with the pancreatoduodenal injury. Primary repair or resection of one or both org...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-198706000-00009
更新日期:1987-06-01 00:00:00
abstract:BACKGROUND:Although a randomized trial demonstrated a survival benefit of cytoreductive surgery (CRS) and intraperitoneal chemotherapy (IPC) over systemic chemotherapy alone, the treatment of peritoneal carcinomatosis from colorectal cancer (CRPC) is still a matter of debate. The aims of this study were to evaluate lon...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/SLA.0b013e31827e9289
更新日期:2013-06-01 00:00:00
abstract::Hypermetabolism characterizes the metabolic response to thermal injury and the extent of energy production is positively related to the rate of urinary catecholamine excretion. Alpha and beta adrenergic blockade decreased metabolism from 69.6 +/- 5.3 Kcal/m(2)/hr to 57.4 +/- 5.2 (p < 0.01), and infusion of 6 microgm e...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-197410000-00031
更新日期:1974-10-01 00:00:00
abstract:BACKGROUND:The American Academy of Pediatrics has established guidelines for optimal, age-appropriate child occupant restraint. While optimal restraint has been shown to reduce the risk of injuries overall, its effect on specific types of injuries, in particular abdominal injuries, has not been demonstrated. METHODS:C...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/01.sla.0000103068.51037.20
更新日期:2004-01-01 00:00:00
abstract:OBJECTIVE:To analyze the impact of a conservative strategy of management in patients with necrotizing pancreatitis, reserving intervention for patients with documented infection or the late complications of organized necrosis. SUMMARY BACKGROUND DATA:The role of surgery in patients with sterile pancreatic necrosis rem...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-200110000-00016
更新日期:2001-10-01 00:00:00
abstract::Twelve prognostic features of melanoma were examined in a series of 185 patients with nodal metastases (Stage II), who underwent surgical treatment at our institution during the past 20 years. Forty-four per cent of the patients presented with synchronous nodal metastases (substage IIA), 44% of the patients had delaye...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-198103000-00023
更新日期:1981-03-01 00:00:00
abstract:OBJECTIVE:To evaluate the accuracy of touch imprint and frozen section analysis of sentinel nodes after neoadjuvant chemotherapy. SUMMARY BACKGROUND DATA:Intraoperative evaluation of the sentinel node can determine the need for axillary dissection at the time of initial operation and therefore spare the patient a seco...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/SLA.0b013e3181ba845c
更新日期:2010-02-01 00:00:00