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-induced arteritis. In order to establish guidelines for the treatment of these patients, we have reviewed our operative experience. PATIENTS AND METHODS:A review of our operative experience over the past 15 years revealed 10 patients with a history of prior irradiation to the neck who underwent 14 carotid operations. RESULTS:The indications for radiation included laryngeal carcinoma and lymphoma. Five patients had undergone previous radical neck dissections, and four patients had permanent tracheostomies. The surgical indications were asymptomatic high-grade stenosis in 7 cases, transient ischemic attack in 4 cases, stroke in 2 cases, and a pseudoaneurysm in 1 case. Conventional carotid endarterectomy with patch angioplasty was used in 10 of the 14 operations. In the remaining four operations, saphenous vein interposition grafting was utilized to replace the diseased segment of carotid artery secondary to a panarteritis. Wound closure required dermal grafting in two of five cases where surgery was performed ipsilateral to a prior radical neck dissection. One perioperative cerebral infarction occurred; there were no other neurologic or non-neurologic complications. All patients are doing well in one- to five-year follow-up, with serial postoperative duplex scans demonstrating no signs of recurrent stenosis. CONCLUSIONS:Patients with a history of irradiation to the neck should be screened for the presence of carotid disease. Carotid occlusive disease should be treated surgically in these patients with the usual indications. Intraoperative surgical management is similar to that of non-irradiated patients. Concerns about difficulty in achieving an adequate endarterectomy plane and about problems with wound closure have generally been unfounded.
journal_name
Am J Surgjournal_title
American journal of surgeryauthors
Rockman CB,Riles TS,Fisher FS,Adelman MA,Lamparello PJdoi
10.1016/S0002-9610(96)00150-Xsubject
Has Abstractpub_date
1996-08-01 00:00:00pages
191-5issue
2eissn
0002-9610issn
1879-1883pii
S0002-9610(96)00150-Xjournal_volume
172pub_type
杂志文章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::Operative liver biopsy findings were reviewed in 164 consecutive, unselected patients with alcoholic cirrhosis who had bleeding from esophageal varices and underwent emergency portacaval shunt. The survival rate up to 10 years in 49 patients with acute alcoholic hepatitis and alcoholic cirrhosis was not significantly ...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/0002-9610(84)90038-2
更新日期:1984-01-01 00:00:00
abstract:BACKGROUND:The survival of patients with metastatic melanoma is poor. The response rates for chemotherapy and immunotherapy have been low, with no real improvement in survival. We reviewed the results of surgical resection. METHODS:We performed a retrospective review of the medical records of all patients who underwen...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/S0002-9610(98)00041-5
更新日期:1998-05-01 00:00:00
abstract:BACKGROUND:The accuracy of a molecular reverse transcriptase-polymerase chain reaction (RT-PCR)-based assay for metastases detection in axillary sentinel lymph nodes (SLNs) has recently been validated in our institution and adopted as an intraoperative test for breast cancer patient management. METHODS:Molecular assay...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/j.amjsurg.2008.09.012
更新日期:2009-08-01 00:00:00
abstract:OBJECTIVE:Minority patients are at risk for delayed breast cancer treatment. Using nonsurgical breast specialists could improve access but requires appropriate referral to ensure prompt cancer care. Our objective was to evaluate a referral triage system in a combined medical/surgical breast health program (BHP). METHO...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/j.amjsurg.2007.06.014
更新日期:2007-10-01 00:00:00
abstract:BACKGROUND:Bloodstream infections in critically ill patients are associated with mortality as high as 60% and a prolonged hospital stay. We evaluated the impact of inappropriate antibiotic therapy (IAAT) in a critically ill surgical cohort with bacteremia. METHODS:This retrospective study evaluated adults with intensi...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/j.amjsurg.2015.10.025
更新日期:2016-03-01 00:00:00
abstract::Information illustrating the benefits of fracture stabilization after multiple trauma has been gathering for almost a century. At the turn of the last century, the introduction of the Thomas splint clearly demonstrated the importance of skeletal stabilization in the management of these patients. The introduction of st...
journal_title:American journal of surgery
pub_type: 历史文章,杂志文章,评审
doi:10.1016/s0002-9610(02)00865-6
更新日期:2002-06-01 00:00:00
abstract::A successfully treated case of a duodenal hamartoma is presented. A review of the literature has shown that this is the largest such tumor so far described, and the first time a mass was palpable on abdominal examination. Its large size resulted in pyloric obstruction, and its wide attachment to the duodenum necessita...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/0002-9610(77)90090-3
更新日期:1977-02-01 00:00:00
abstract:BACKGROUND:The American Association of Endocrine Surgeons initiated a fellowship match in 2007. The profile of applicants who successfully match into an endocrine surgery (ES) fellowship has not previously been characterized. METHODS:An institutional review board-approved, web-based survey was distributed to recent an...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/j.amjsurg.2014.03.013
更新日期:2014-10-01 00:00:00
abstract:BACKGROUND:Percutaneous endoscopic gastrostomy and jejunostomy tube placement have long been considered the standard for supplying enteral nutrition when oral intake is not possible. Both have well-documented roles and limitations and are associated with a higher than generally appreciated incidence of aspiration. A di...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/s0002-9610(98)00298-0
更新日期:1999-01-01 00:00:00
abstract:BACKGROUND:To evaluate readmissions to determine predictors and patterns of readmission. METHODS:Prospective database review identified readmitted and non-readmitted patients after colorectal surgery. Variables for the index and readmission episode were examined. RESULTS:A total of 212 readmissions and 3,292 nonreadm...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/j.amjsurg.2013.09.008
更新日期:2014-03-01 00:00:00
abstract:BACKGROUND:Primary hyperparathyroidism (HPT) is an undertreated disease. This study's purpose is to determine if the calcium levels correlate with prevalence of symptoms and surgical treatment in patients with primary HPT. METHOD:Patients treated in 2006-2015 with serum calcium≥10.0 mg/dL and PTH>65 pg/mL were identif...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/j.amjsurg.2018.09.010
更新日期:2019-03-01 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::The clinical efficacy and safety of cefotetan was assessed in two multicenter clinical trials involving 335 evaluable patients hospitalized with obstetric and gynecologic infections. In Study I, cefotetan was compared with moxalactam and in Study II, cefotetan was compared with cefoxitin. The clinical response rate in...
journal_title:American journal of surgery
pub_type: 临床试验,杂志文章
doi:10.1016/s0002-9610(88)80214-9
更新日期:1988-05-31 00:00:00
abstract::A prospective randomized clinical trial was performed in order to evaluate the results of three surgical techniques for the treatment of gastric outlet obstruction secondary to duodenal ulcer. Ninety patients with clinical and laboratory evidence of gastric retention were enrolled. After laparotomy, patients underwent...
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/s0002-9610(05)80580-x
更新日期:1993-07-01 00:00:00
abstract:BACKGROUND:Response evaluation criteria in solid tumors (RECIST) is the accepted method for determining tumor progression. However, RECIST may not estimate disease burden accurately because the axial plane often does not produce the actual longest diameter. Volumetric measurements may be an alternative to better determ...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/j.amjsurg.2012.07.007
更新日期:2012-11-01 00:00:00
abstract:PURPOSE:Transanal endoscopic microsurgery (TEM) is a minimally invasive technique for full-thickness excision of benign and malignant rectal neoplasms located 4 to 24 cm above the anal verge. Entrance into the peritoneal cavity during TEM has been regarded as a complication that mandates conversion to open laparotomy f...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/j.amjsurg.2004.01.004
更新日期:2004-05-01 00:00:00
abstract::A case of unicystic ameloblastoma of the mandible in a 10-year-old child is described. In addition to the mandibular swelling the patient also had a proliferative lesion over the alveolus that masqueraded as a neoplastic lesion. ...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/j.amjsurg.2007.07.036
更新日期:2008-09-01 00:00:00
abstract::The current study suggests the need for routine post-discharge surveillance to improve reliability on surgical site infection incidence rates. Surveillance only during hospitalization may not provide precise data on the incidence of surgical site infection, underestimating a true postoperative infection rate. ...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/j.amjsurg.2006.05.016
更新日期:2007-02-01 00:00:00
abstract:BACKGROUND:Controversy still exists concerning the impact of patient and tumor characteristics on anastomotic dehiscence after resection for rectal cancer. METHODS:Between January 1986 and July 2006, 472 patients underwent curative rectal resection. Patient and tumor characteristics, details of treatment, and postoper...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/j.amjsurg.2007.10.023
更新日期:2008-10-01 00:00:00
abstract::After a biliary-enteric anastomosis, the development of cholangitis is usually assumed to be due to obstruction of the stoma. Six patients in whom this was not the case are described. Achlorhydria, duodenal diverticula, and foreign bodies are important predisposing factors. When bacterial contamination is severe in an...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/0002-9610(83)90038-7
更新日期:1983-04-01 00:00:00
abstract::Mentoring has been recognized as a critical aspect of the professional and/or personal development of the student, resident or faculty member. This career development resource discusses strategies for building effective mentoring relationships and outlines some of the challenges to contemporary mentoring. ...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/j.amjsurg.2013.08.001
更新日期:2013-11-01 00:00:00
abstract:BACKGROUND:This analysis was performed in order to determine whether primary tumor location in breast cancer affects the axillary sentinel lymph node (SLN) identification (ID) rate, the false negative (FN) rate, incidence of axillary nodal metastases, or the number of SLN identified. METHODS:In this prospective multi-...
journal_title:American journal of surgery
pub_type: 杂志文章,多中心研究
doi:10.1016/s0002-9610(01)00717-6
更新日期:2001-10-01 00:00:00
abstract::Sebaceous cell carcinoma of the parotid gland is a rare lesion. A review of the English literature reveals nine previously reported cases. Two cases are presented in which the tumor was originally diagnosed as mucoepidermoid carcinoma. Aggressive treatment of the recurrence, which was subsequently recognized as sebace...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/0002-9610(75)90494-8
更新日期:1975-10-01 00:00:00
abstract::Stapling instruments have been used for gastrointestinal anastomoses and reconstruction with increasing regularity. A technique for loop colostomy closure employing a stapling device is described. This approach provides a secure closure while avoiding major contaimination. ...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/0002-9610(79)90398-2
更新日期:1979-08-01 00:00:00
abstract:BACKGROUND:Strategies for the effective application of palliative procedures are infrequently standardized and incompletely understood. The effect on patient outcome as determined by elements such as resolution of chief complaints, quality of life, pain control, morbidity of therapy, and resource utilization should pre...
journal_title:American journal of surgery
pub_type: 杂志文章,评审
doi:10.1016/s0002-9610(98)00323-7
更新日期:1999-02-01 00:00:00
abstract:BACKGROUND:Currently, the management strategy of pancreatic cyst (PC) remains controversial because of the inability to diagnose this type of cyst accurately and the limited knowledge of its natural history. Previously, many clinicians have advocated an aggressive resectional policy. This approach is no longer appropri...
journal_title:American journal of surgery
pub_type: 杂志文章,评审
doi:10.1016/j.amjsurg.2006.07.019
更新日期:2007-06-01 00:00:00
abstract::Definitive therapy for variceal hemorrhage has evolved during the past half century. Only completely decompressing shunts (nonselective shunts) were available before 1967. Additional options now include selective shunts, devascularization procedures, endoscopic sclerotherapy, pharmacotherapy, and hepatic transplantati...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/s0002-9610(05)80873-6
更新日期:1990-07-01 00:00:00
abstract::Surgeons have a history of almost 100 years of being in the forefront of efforts to standardize medical care and improve patients' health outcomes. Recently, increases in the "for-profit" sector have made it more difficult for patients to receive quality medical care. In this new era, surgeons need to stay involved in...
journal_title:American journal of surgery
pub_type: 社论
doi:10.1016/s0002-9610(97)00101-3
更新日期:1997-09-01 00:00:00
abstract:BACKGROUND:Circumportal pancreas is a rare congenital pancreatic anomaly. The aim of this study was to clarify the clinical characteristics of patients with circumportal pancreases undergoing pancreatectomy. METHODS:The medical records of 508 patients who underwent pancreatectomy were retrospectively reviewed. The pre...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/j.amjsurg.2016.11.018
更新日期:2017-08-01 00:00:00