Biomedical subjects

K M Ferry

Publications and source records attributed to K M Ferry.

3 recordsLinked to original sources

PubMed2000

Changing management trends in penetrating colon trauma.

PURPOSE: Recent prospective studies have recommended primary repair for all penetrating colon injuries. We evaluated our management trends given these recommendations and assessed our results of primary repair. METHODS: A retrospective review was conducted of 145 patients with penetrating colon injuries received between January 1, 1991, and December 31, 1997. The patients were characterized according to demographics and severity of injury. Morbidity was defined as failure of a primary repair, abscess, fistula, wound dehiscence, fasciitis, sepsis, organ failure, or coagulopathy. The periods 1991 to 1993 (early period) and 1994 to 1997 (late period) were chosen for comparison. RESULTS: Primary repairs were performed in 53 of 75 patients (71 percent) during the early period and in 61 of 70 patients (87 percent) during the late period (P = 0.03). No significant differences in demographics or injury severity were found to account for the increased rate of primary repairs. The number of suture repairs was nearly equal in both periods (59 vs. 61 percent). The number of resections and anastomoses for destructive colon injuries was significantly higher in the late period (26 percent) compared with the early period (12 percent; P = 0.05). Morbidity was equal (24 percent) in the two periods. There were no failures of resections and anastomoses and one failure of suture repair. CONCLUSIONS: Increased primary repair occurred because of more liberal use of resection and anastomosis for destructive injuries. Suture repair was performed for the amenable colonic injury throughout the study period. Risk factors for failure of resection and anastomosis cannot be defined from our study. Further investigation is needed to determine if resection and anastomosis is safe for the most severely injured patients.

Adolescent↗

PubMed2000

The effect of surgical office-based thyroid ultrasound on clinical decision making.

An important diagnostic tool for the evaluation of thyroid disease, thyroid ultrasound has recently become available for use in surgical offices. The purpose of this report is to determine the lesional sensitivity of office-based thyroid ultrasound and its impact on clinical decision making. Surgical office-based thyroid ultrasound was performed on 49 consecutive patients who presented with thyroid disease. Indications for sonography included a solitary palpable nodule (n = 32), multiple palpable nodules (n = 3), diffuse enlargement (n = 5), or other hormonal or radiologic abnormalities (n = 9). Thyroid ultrasound demonstrated 104 lesions compared with 38 lesions found on physical examination (P < 0.0001). In the subpopulation who underwent scintigraphy (n = 10), 24 nodules were identified by ultrasound and only 10 nodules were identified by scan (P < 0.01). Overall, office-based thyroid ultrasound impacted the clinical management of 40 patients (80%): in 16 patients, thyroid ultrasound was the only modality that demonstrated a multinodular condition, thus contributing to a decision to avoid surgery; 19 patients had ultrasound-guided fine-needle aspiration of vaguely palpable or nonpalpable lesions; and 5 patients underwent ultrasound-guided cyst aspiration and follow-up. Office-based thyroid ultrasound performed by surgeons is a highly accurate imaging modality that identified significantly more lesions than physical examination or scintigraphy. Clinical management was affected through the identification of a multinodular process or through facilitation of accurate image-guided biopsy.

Journal Article↗

PubMed1998

Sentinel lymph node biopsy for melanoma.

BACKGROUND: The most powerful predictor of survival for patients with melanoma is the status of the regional lymph nodes. Sentinel lymph node biopsy may provide improved staging accuracy without the morbidity of elective lymph node dissection (ELND). METHODS: Sixty-eight patients with intermediate thickness melanoma underwent gamma probe guided sentinel node biopsy without ELND and were followed up over a mean of 22 months. RESULTS: A sentinel node was found in all patients. Six patients (9%) had positive sentinel nodes; all underwent complete lymphadenectomy. Two patients (3%) with negative sentinel nodes developed nodal recurrence; 1 of these patients was found to have microscopic disease on reexamination of the sentinel node. Two patients (3%) developed systemic disease. CONCLUSION: Gamma probe guided sentinel node biopsy can be performed with a high rate of technical success. It provides accurate pathological staging with a low incidence of nodal basin failure.

Adult↗