ISRN surgery最新文献_第10页

Using nodal ratios to predict risk of regional recurrences in patients treated with breast conservation therapy with 4 or more positive lymph nodes. 用淋巴结比例预测4个或更多阳性淋巴结行保乳治疗患者局部复发的风险。

ISRN surgery Pub Date : 2011-01-01 Epub Date: 2011-06-30 DOI: 10.5402/2011/874814

William Castrucci, Donald Lannin, Bruce G Haffty, Susan A Higgins, Meena S Moran

{"title":"Using nodal ratios to predict risk of regional recurrences in patients treated with breast conservation therapy with 4 or more positive lymph nodes.","authors":"William Castrucci, Donald Lannin, Bruce G Haffty, Susan A Higgins, Meena S Moran","doi":"10.5402/2011/874814","DOIUrl":"https://doi.org/10.5402/2011/874814","url":null,"abstract":"Purpose. The value of nodal ratios (NRs) as a prognostic variable in breast cancer is continually being demonstrated. The purpose of this study was to use NR in patients with ≥4+ nodes to assess a correlation of NR with regional (lymph node) recurrence. Methods. Inclusion criteria was ≥8 nodes dissected with ≥4+ nodes after breast conservation therapy. Of 1060 patients treated from 1975 to 2003 who had a minimum of 8 nodes dissected, 273 were node+; 56 patients had ≥4+ involved nodes and were the focus of this study. Nodal ratios were calculated for each patient and grouped into 3 categories: high (≥70%), intermediate (40%-69%) and low (<40%). Each nodal ratio was correlated with patterns of local, regional, and distant failures and OS. Results. Outcomes for the entire cohort were BRFS-83%, NRFS-93%, DMFS-61%, and OS 63% at 10 yrs. The OS, DMFS, and NRFS correlated with N2 (4-9 nodes+) versus N3 (≥10+) status but did not correlate with BRFS, as expected. When evaluating NR, 18 pts had high NR (>70%). Only 3 patients experienced nodal recurrences, all within previously radiated supraclavicular fields. All 3 in-field regional failures occurred in the N3 group of patients with NR >70%. All were treated with a single AP field prescribed to a dose of 46 Gy at a standard depth of 3 cm. Conclusions. In this group of N2/N3 patients treated with BCT, we were able to identify patients at high risk for regional failures as those with high NR of >70% and ≥10+ nodes. While these findings need to be reproduced in larger datasets, this group of patients with NR of >70% in 4 or more positive axillary lymph nodes may benefit from meticulous targeting of regional nodes, dose escalation, and/or more intensive systemic therapies.","PeriodicalId":89400,"journal":{"name":"ISRN surgery","volume":"2011 ","pages":"874814"},"PeriodicalIF":0.0,"publicationDate":"2011-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.5402/2011/874814","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"30254954","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 3

Giant gastrointestinal stromal tumor presenting as a palpable abdominal mass: an unusual presentation. 巨大的胃肠道间质瘤表现为可触及的腹部肿块:一种不寻常的表现。

ISRN surgery Pub Date : 2011-01-01 Epub Date: 2011-06-16 DOI: 10.5402/2011/894829

Sachin Patil, Sudhir Jain, R C M Kaza, Ronald S Chamberlain

{"title":"Giant gastrointestinal stromal tumor presenting as a palpable abdominal mass: an unusual presentation.","authors":"Sachin Patil, Sudhir Jain, R C M Kaza, Ronald S Chamberlain","doi":"10.5402/2011/894829","DOIUrl":"https://doi.org/10.5402/2011/894829","url":null,"abstract":"Gastrointestinal stromal tumors (GIST-) account for the majority of mesenchymal tumors arising within the gastrointestinal tract. GIST presenting as a palpable abdominal mass is extremely rare. We report four additional cases of a GIST presenting as an abdominal mass along with a pertinent review of the literature. Twenty five cases of GISTs presenting with an abdominal mass, including 4 cases discussed here, have been reported in the world literature since 2001. The mean duration of symptoms was 152.7 days. Twenty one of 25 (84%) patients received surgical resection. The mean tumor size was 17.2 cm, with an average mitotic index of 7.6 per 50 high power fields. Thirteen of 14 (92.9%) patients had a high-risk tumor. Five patients were disease-free at a mean followup of 11 months, 2 patients had stable disease and 2 patients had progressive disease, and one patient had a partial response. In conclusion, symptomatic patents have an increased incidence of high-risk tumors and metastases at presentation. Adjuvant therapy with imatinib improves disease-free survival in patients with large abdominal GIST tumors, but no change in overall survival was noted. Finally, GISTs should be considered in the differential diagnosis of an abdominal mass in an elderly patient.","PeriodicalId":89400,"journal":{"name":"ISRN surgery","volume":"2011 ","pages":"894829"},"PeriodicalIF":0.0,"publicationDate":"2011-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.5402/2011/894829","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"30254955","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 17

Oromandibular reconstruction: the history, operative options and strategies, and our experience. 下颌重建:历史，手术选择和策略，以及我们的经验。

ISRN surgery Pub Date : 2011-01-01 Epub Date: 2011-12-12 DOI: 10.5402/2011/824251

Pao-Yuan Lin, Kevin C Lin, Seng-Feng Jeng

{"title":"Oromandibular reconstruction: the history, operative options and strategies, and our experience.","authors":"Pao-Yuan Lin, Kevin C Lin, Seng-Feng Jeng","doi":"10.5402/2011/824251","DOIUrl":"https://doi.org/10.5402/2011/824251","url":null,"abstract":"Oromandibular reconstruction resulting from resection of benign tumor, malignant cancer, osteomyelitic or osteoradionecrotic mandible remains a challenge for plastic surgeons today. At present, fibula osteocutaneous flap is the perhaps most commonly used technique for oromandibular reconstruction because of its potential for contouring, immediate dental implant placement, and favorable donor site morbidity. In this study, we review the history of oromandibular reconstruction, summarize the characteristics of different osteocutaneous flaps, offer surgical options of different osteocutaneous flaps, and provide reconstructive strategies for different locations of mandibular defects. Furthermore, we give a detailed description of various modifications in oromandibular reconstruction: (1) the myoosseous flap for lateral segmental defect repair may reduce donor site complication; (2) to improve the function of oral commissure in patients with obscure recipient vessels, we modify the fibula osteocutaneous flap with anterolateral thigh flap and combine the tensor fascia lata using one set of recipient vessel for composite oromandibular reconstruction; (3) to decrease the likelihood of neck infection and improve aesthetic result, we add the segmental soleus muscle to the fibula osteocutaneous flap to obliterate and augment submandibular dead space. Lastly, dental rehabilitation considerations associated with mandibular reconstruction have been given to help assist in surgical treatment planning.","PeriodicalId":89400,"journal":{"name":"ISRN surgery","volume":"2011 ","pages":"824251"},"PeriodicalIF":0.0,"publicationDate":"2011-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.5402/2011/824251","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"30372612","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 35

Pilot study on the efficiency of the biostimulation with autologous plasma rich in platelet growth factors in otorhinolaryngology: otologic surgery (tympanoplasty type I). 富含血小板生长因子的自体血浆在耳鼻喉科生物刺激效率的初步研究：耳科手术（I型鼓室成形术）。

ISRN surgery Pub Date : 2011-01-01 Epub Date: 2011-06-20 DOI: 10.5402/2011/451020

María Luisa Navarrete Álvaro, N Ortiz, L Rodriguez, R Boemo, J F Fuentes, A Mateo, P Ortiz

引用次数: 40

Recurrent chest pain, as a presenting sign of ovarian endometrioma. 反复发作的胸痛，是卵巢子宫内膜异位瘤的表现。

ISRN surgery Pub Date : 2011-01-01 Epub Date: 2011-05-02 DOI: 10.5402/2011/837501

Mehmet Yildirim, Ozgur Oztekin, Deniz Oztekin

引用次数: 0

Diffuse cutaneous metastases as the only sign of extranodal tumor spread in a patient with adenocarcinoma of the colon. 弥漫性皮肤转移是结外肿瘤扩散的唯一征象。

ISRN surgery Pub Date : 2011-01-01 Epub Date: 2011-06-14 DOI: 10.5402/2011/902971

Serenella Civitelli, Barbara Civitelli, Jacopo Martellucci, Gabriello Tanzini

引用次数: 5

Collateral tissue damage by several types of coagulation (monopolar, bipolar, cold plasma and ultrasonic) in a minimally invasive, perfused liver model. 在微创灌注肝模型中，几种凝血(单极、双极、冷等离子体和超声)对侧支组织的损伤。

ISRN surgery Pub Date : 2011-01-01 Epub Date: 2011-07-18 DOI: 10.5402/2011/518924

Thomas Carus, Klaas Rackebrandt

{"title":"Collateral tissue damage by several types of coagulation (monopolar, bipolar, cold plasma and ultrasonic) in a minimally invasive, perfused liver model.","authors":"Thomas Carus, Klaas Rackebrandt","doi":"10.5402/2011/518924","DOIUrl":"https://doi.org/10.5402/2011/518924","url":null,"abstract":"Hemostasis in minimally invasive surgery causes tissue damage. Regardless of the method of production of thermal energy, a quick and safe coagulation is essential for its clinical use. In this study we examined the tissue damage in the isolated perfused pig liver using monopolar, bipolar, cold plasma, and ultrasonic coagulation. In a minimally invasive in vitro setup, a 2-3 cm slice of the edge of the perfused pig liver was resected. After hemostasis was achieved, liver tissue of the coagulated area was given to histopathological examination. The depth of tissue necrosis, the height of tissue loss, and the time until sufficient hemostasis was reached were analyzed. The lowest risk for extensive tissue damage could be shown for the bipolar technique, combined with the highest efficiency in hemostasis. Using cold plasma, coagulation time was longer with a deeper tissue damage. Monopolar technique showed the worst results with the highest tissue damage and a long coagulation time. Ultrasonic coagulation was not useful for coagulation of large bleeding areas. In summary, bipolar technique led to less tissue damage and best coagulation results in our minimally invasive model. These results could be important to recommend bipolar coagulation for clinical use in minimally invasive surgery.","PeriodicalId":89400,"journal":{"name":"ISRN surgery","volume":"2011 ","pages":"518924"},"PeriodicalIF":0.0,"publicationDate":"2011-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.5402/2011/518924","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"30255724","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 20

Synchronous Laparoscopic Radical Nephrectomy Left and Contralateral Right Hemicolectomy during the Same Endoscopic Procedure. 腹腔镜下同步根治性左肾切除术和对侧右半结肠切除术。

ISRN surgery Pub Date : 2011-01-01 Epub Date: 2011-04-26 DOI: 10.5402/2011/179456

G M Veenstra, L M C L Fossion, K de Laet, A A P M Luijten

引用次数: 16

Emergency pancreaticoduodenectomy in duodenal paraganglioma: case report. 紧急胰十二指肠切除术治疗十二指肠副神经节瘤1例。

ISRN surgery Pub Date : 2011-01-01 Epub Date: 2011-04-12 DOI: 10.5402/2011/268674

Fazl Q Parray, Iqbal M Lone, Nisar A Chowdri, Imtiaz Wani, Mehmood A Wani, G M Gulzar, Natasha Thakur

引用次数: 7

Giant splenic artery aneurysm: case report. 脾巨动脉瘤1例。

ISRN surgery Pub Date : 2011-01-01 Epub Date: 2011-04-27 DOI: 10.5402/2011/383450

Sadaf Ali, Vibha Verma, Sastry R, Imtiaz Wani

引用次数: 26