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 underwent resection of metastases from melanoma from 1979 to 1994. RESULTS:There were 77 patients (44 men, 33 women, mean age 51 years). Metastases were resected from soft tissue (n = 28), abdominal viscera (n = 22), lung (n = 15), and brain (n = 12). Forty-four patients had complete resections, and 33 had incomplete resections. Sixty-five patients had solitary lesions and 12 had multiple lesions resected. The overall 5-year survival rate was 10%. Patients with solitary lesions had a 5-year survival rate of 12%, compared with 0% for patients with multiple lesions (P = 0.01). Patients with complete resection had a 5-year survival rate of 15%, compared with 4% for patients with incomplete resection (P < 0.001). Patients with complete resection of solitary lesions had a 5-year survival of 18%. There was no difference in survival between synchronous and metachronous resection. Gender, primary site, disease-free interval, and metastatic site had no impact on survival rates. CONCLUSIONS:We conclude that patients with metastatic melanoma should be resected for (1) relief of symptoms such as obstruction and bleeding, (2) solitary lesions that can be completely resected, (3) serial lesions that can be completely resected, and (4) selected cases that can be rendered macroscopically free of disease. Surgical resection is superior to any other available therapy for metastatic melanoma.
journal_name
Am J Surgjournal_title
American journal of surgeryauthors
Fletcher WS,Pommier RF,Lum S,Wilmarth TJdoi
10.1016/S0002-9610(98)00041-5subject
Has Abstractpub_date
1998-05-01 00:00:00pages
413-7issue
5eissn
0002-9610issn
1879-1883pii
S0002-9610(98)00041-5journal_volume
175pub_type
杂志文章abstract：:Twenty-three consecutive patients who had persistent respiratory symptoms of unexplained etiology were evaluated to determine the presence of gastroesophageal reflux (GER) and its relationship to their respiratory complaints. Lower esophageal sphincter (LES) and upper esophageal sphincter (UES) pressures and the chara...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/0002-9610(92)90041-o
更新日期：1992-04-01 00:00:00
abstract：:This study evaluates the penetration of cephalosporins into the peritoneal fluid. Forty-six patients scheduled for abdominal surgery were randomized into three groups. On call to the operating room each patient was given a single 1 g dose of cefazolin, cefuroxime, or ceftazidime. Samples of the peritoneal fluid and bl...
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(89)90707-1
更新日期：1989-06-01 00:00:00
abstract：:Emergency center thoracotomy is a heroic technique of resuscitation and treatment which was revived in the 1960s to improve the survival of patients presenting with cardiac wounds. With excellent survival rates attained in such patients, the technique was extended to victims of trauma with other mechanisms and locatio...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/0002-9610(86)90443-5
更新日期：1986-12-01 00:00:00
abstract：BACKGROUND:It was hypothesized that routine operative drainage is unnecessary for elective hepatic resection. METHODS:A review was made of the clinical records of patients undergoing liver resection at a tertiary referral hepatobiliary surgery center since the conclusion in April of 1994 of our previous randomized dra...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/s0002-9610(02)00998-4
更新日期：2002-11-01 00:00:00
abstract：:Curettage of lymph nodes in 36 patients with cancer of the thoracic esophagus was performed in the bilateral supraclavicular, right intrathoracic and abdominal regions. The overall metastatic ratio in lymph nodes was 52.8 percent (19 of 36). It was particularly high in the right supraclavicular nodes (26.7 percent), t...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/0002-9610(81)90160-4
更新日期：1981-02-01 00:00:00
abstract：:Thirty patients with carcinoid tumors of the ileum over a recent 10-year period have been analyzed. Seventeen patients were symptomatic and 13 others were found to have tumors incidentally at autopsy or celiotomy. Patients with symptoms almost invariably had metastatic disease, yet preoperative diagnosis was rarely ac...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/0002-9610(83)90272-6
更新日期：1983-07-01 00:00:00
abstract：BACKGROUND:Accurate intraoperative diagnosis of axillary malignancy facilitates completion axillary lymph node dissection (ALND) at the time of initial surgery. The capability to address both the primary tumor and axillary disease in a single procedure offers several advantages. This study was designed to define the pr...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/s0002-9610(03)00041-2
更新日期：2003-05-01 00:00:00
abstract：:Exposed bone, even in conjunction with a fracture, will cover spontaneously with granulation tissue followed by epithelium, or will sequestrate and then cover, providing there is adequate circulation at the wound site. The healing process is lengthy but need not interfere with the reestablishment of function of the wo...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/0002-9610(79)90115-6
更新日期：1979-04-01 00:00:00
abstract：:Recently, the role and timing of surgery for treating secondary and tertiary hyperparathyroidism (HPT) have been questioned. In order to delineate the indications for surgery in these patients, a retrospective analysis of 53 consecutive patients treated with parathyroidectomy was conducted. Subtotal thyroidectomy was ...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/s0002-9610(05)80537-9
更新日期：1990-10-01 00:00:00
abstract：BACKGROUND:HIV and AIDS continues to be a significant health problem with many patients requiring the attention of a general surgeon. METHOD:A retrospective case note review over a two-year period was undertaken. RESULTS:237 patients underwent invasive procedures. The majority 100 patients (145 procedures) were for v...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/S0002-9610(96)00054-2
更新日期：1996-07-01 00:00:00
abstract：:Infectious complications within 1 year of cadaveric kidney transplantation were compared in 45 patients treated with azathioprine, prednisone, and antilymphocyte globulin and 38 patients treated with cyclosporine and prednisone. Although there was no difference in the 1 year patient or graft survival rate, cyclosporin...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/0002-9610(87)90582-4
更新日期：1987-04-01 00:00:00
abstract：:A new technique has been described for the placement of an implantable percutaneous triple-lumen catheter. This procedure eliminates the need for a large bore introducer. It also provides a mechanism to change these catheters over a wire if necessary. This cannot be accomplished with the Hickman or Broviac catheters. ...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/s0002-9610(85)80116-1
更新日期：1985-03-01 00:00:00
abstract：BACKGROUND:Graft pancreatitis is a major complication after pancreas transplantation. Antithrombin III (AT III) is an anticoagulatory and anti-inflammatory substance. The aim of our study was to evaluate a prophylactic application of AT III in experimental pancreas transplantation. METHODS:Pancreas transplantation was...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/j.amjsurg.2004.03.017
更新日期：2005-01-01 00:00:00
abstract：BACKGROUND:Laparoscopy has played an ill-defined role as a diagnostic tool for the staging of gastric and other intra-abdominal malignancies for a long time. The widespread use of the laparoscopic approach for the treatment of some benign abdominal diseases, such as biliary lithiasis and gastroesophageal reflux disease...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/S0002-9610(97)89571-2
更新日期：1996-02-01 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：BACKGROUND:This study examined the impact of intraoperative myocardial acidosis and adverse postoperative outcomes on the cost of cardiac surgical care. METHODS:Myocardial tissue pH corrected to 37 degrees C (pH(37C)) was measured in 162 patients with cross-clamp (XC) duration of 119 minutes or longer. Perioperative d...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/j.amjsurg.2008.01.023
更新日期：2009-02-01 00:00:00
abstract：OBJECTIVE:The purpose of this study was to determine if the distance from the skin to the seroma cavity, as measured with ultrasound (US) before catheter placement, correlated with the distance from skin to MammoSite balloon catheter as measured on computerized axial tomography (CAT) after catheter placement. METHODS:...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/j.amjsurg.2007.11.012
更新日期：2008-08-01 00:00:00
abstract：:The relative merits of the anterior and posterior approaches to the adrenal gland were assessed in a series of 103 patients with bilateral cortical hyperplasia or unilateral cortical adenoma (less than 25 g). In none of the patients was additional concomitant surgery planned. Sixty-four patients were operated on throu...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/0002-9610(82)90010-1
更新日期：1982-09-01 00:00:00
abstract：:Ostomy closure following the Hartmann procedure is perceived to be associated with higher morbidity and mortality rates than is ostomy closure following divided colostomy, loop colostomy, and divided ileostomy-colostomy so that ostomy closure after Hartmann procedure may be denied to certain patients. To test that per...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/0002-9610(91)90125-w
更新日期：1991-12-01 00:00:00
abstract：BACKGROUND:The morbidity and mortality conference (M&M) is a key component of the performance improvement process. The audience response system (ARS) has been shown to improve audience participation and promote more truthful responses in various settings. We implemented the ARS in our trauma M&M and evaluated the respo...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/j.amjsurg.2008.05.015
更新日期：2009-06-01 00:00:00
abstract：BACKGROUND:Routine completion imaging after carotid endarterectomy (CEA) has been advocated by many investigators to detect and repair unsuspected defects with the goal of reducing perioperative morbidity and residual disease. However, completion imaging has been performed rarely in our practice. Our carotid registry w...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/s0002-9610(97)90079-9
更新日期：1997-08-01 00:00:00
abstract：:With the purpose of facilitating liver biopsy during upper abdominal procedures, an adaptation of the percutaneous one-second needle biopsy technic is proposed. A simple device, consisting of a three-way deviator, allows the utilization of the standard needles for percutaneous biopsy. The entire procedure requires fro...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/0002-9610(77)90551-7
更新日期：1977-03-01 00:00:00
abstract：BACKGROUND:Open and laparoscopic antireflux surgeries are standard for the treatment of gastroesophageal reflux disease (GERD). The in-hospital outcomes of laparoscopic and open antireflux procedures were analyzed and compared at US academic medical centers. METHODS:Using International Classification of Diseases, Nint...
journal_title：American journal of surgery
pub_type： 杂志文章,多中心研究
doi：10.1016/j.amjsurg.2008.07.041
更新日期：2008-12-01 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：BACKGROUND:The extent of tissue loss amenable to primary healing after revascularization is unknown. Salvage of limbs with large soft-tissue defects with exposed tendon, joint, or bone lies beyond the limits of conventional techniques. We report our results using free tissue transfer as an adjunct to lower extremity va...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/s0002-9610(97)00175-x
更新日期：1997-12-01 00:00:00
abstract：BACKGROUND:In recent years, increasingly accessible and novel genetic technologies have spurred keen interest in the application of cancer genetics in predicting prognosis and response to treatment. In particular, investigators have eagerly sought to establish and validate genetic signatures that might improve the iden...
journal_title：American journal of surgery
pub_type： 杂志文章,评审
doi：10.1016/j.amjsurg.2016.06.019
更新日期：2016-10-01 00:00:00
abstract：:Sixty-nine patients with pancreatic pseudocysts were reviewed. Chronic alcohol abuse was associated with pancreatitis in 78 percent of the patients. Presenting signs and symptoms were nonspecific. Ultrasonographic and computerized axial tomographic scans were most commonly used to established the diagnosis. Twenty pat...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/0002-9610(85)90407-6
更新日期：1985-12-01 00:00:00
abstract：BACKGROUND:The Michigan Appropriate Perioperative (MAP) criteria provide guidance regarding urinary catheter use. For Category A (e.g., laparoscopic cholecystectomy), B (e.g., hemicolectomy), and C (e.g., abdominoperineal resection) procedures, recommendations are to avoid catheter, remove POD 0 or 1, and remove POD 1-...
journal_title：American journal of surgery
pub_type： 杂志文章,多中心研究
doi：10.1016/j.amjsurg.2020.01.008
更新日期：2020-09-01 00:00:00
abstract：:A technique for the repair of inguinal hernias in elderly patients with weak abdominal muscles has been presented. It consists of the overlapping of the flaps of the aponeurosis of the external oblique muscle according to the method previously proposed by Andrews. To date, the technique has given good results, even in...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/0002-9610(83)90419-1
更新日期：1983-09-01 00:00:00
abstract：BACKGROUND:Anastomotic leakage (AL) after gastroesophageal resection for cancer is a serious complication. The aim was to evaluate mediastinal microdialysis in the detection of AL before clinical symptoms. METHODS:Sixty patients were included. Samples were collected every 4 hours in the 1st 8 postoperative days and an...
journal_title：American journal of surgery
pub_type： 临床试验,杂志文章
doi：10.1016/j.amjsurg.2013.09.026
更新日期：2014-09-01 00:00:00
