51
|
Fanning J. Understanding the pneumatic flow of oxygen. Biomed Instrum Technol 2005; 39:437-8. [PMID: 17432465 DOI: 10.2345/0899-8205(2005)39[437:utpfoo]2.0.co;2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/14/2023]
|
52
|
Fanning J. Illumination in the operating room. Biomed Instrum Technol 2005; 39:361-2. [PMID: 16248442 DOI: 10.2345/0899-8205(2005)39[361:iitor]2.0.co;2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/05/2023]
|
53
|
Fanning J. Troubleshooting therapeutic ultrasound: measuring output power and caring for transducers. Biomed Instrum Technol 2005; 39:278-9. [PMID: 16111402 DOI: 10.2345/0899-8205(2005)39[278:mopacf]2.0.co;2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/04/2023]
|
54
|
Fanning J. Three things to consider when troubleshooting equipment. Biomed Instrum Technol 2005; 39:204-5. [PMID: 15915598 DOI: 10.2345/0899-8205(2005)39[204:tttcwt]2.0.co;2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/02/2023]
|
55
|
Akram T, Maseelall P, Fanning J. Carboplatin and paclitaxel for the treatment of advanced or recurrent endometrial cancer. Am J Obstet Gynecol 2005; 192:1365-7. [PMID: 15902110 DOI: 10.1016/j.ajog.2004.12.032] [Citation(s) in RCA: 54] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
OBJECTIVE The purpose of this study was to determine the activity and toxicity of carboplatin and paclitaxel (taxol) in the treatment of advanced or recurrent endometrial cancer. STUDY DESIGN This was a retrospective review of 18 consecutive patients with advanced (stage 4) or recurrent endometrial adenocarcinoma that had been treated with outpatient carboplatin and taxol. Taxol was delivered at 135 mg/m 2 over 3 hours, and carboplatin was delivery at an area under the curve of 5 over 1 hour. Cycles were repeated every 21 days. RESULTS The overall response rate was 63% with 28% of patients who had a partial response and 35% of patients who had a complete response. Kaplan-Meier test was used to estimate the median survival time of 27 months and the median progression free survival time of 24 months. No patient had neutropenia, thrombocytopenia or grade 3 vomiting, neurosensory toxicity, or renal toxicity. CONCLUSION Carboplatin and taxol for the treatment of advanced or recurrent endometrial cancer appear to be active regimens with minimal toxicity.
Collapse
|
56
|
Fanning J. Safety and the gas supply: focus on anesthesia systems. Biomed Instrum Technol 2005; 39:141-2. [PMID: 15810787 DOI: 10.2345/0899-8205(2005)39[141:satgsf]2.0.co;2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/02/2023]
|
57
|
Fanning J, Hoffman ML, Andrews SJ, Harrah AW, Feldmeier JJ. Cost-effectiveness analysis of the treatment for intermediate risk endometrial cancer: postoperative brachytherapy vs. observation1. Gynecol Oncol 2004; 93:632-6. [PMID: 15196856 DOI: 10.1016/j.ygyno.2004.03.002] [Citation(s) in RCA: 28] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2003] [Indexed: 11/15/2022]
Abstract
OBJECTIVE To compare the survival, morbidity, and cost of treating women with intermediate risk endometrial cancer with postoperative vaginal cuff brachytherapy versus observation followed by treatment for vaginal recurrence. METHODS A cost-effectiveness analysis was performed comparing two treatment strategies for intermediate risk endometrial cancer (Stage IC, IG3, II-tumors limited to the uterus with greater than 50% myometrial invasion or poor differentiation or cervical metastasis). All patients undergo hysterectomy, oophorectomy, and lymphadenectomy: strategy 1-postoperative vaginal cuff brachytherapy, strategy 2-observation. Strategy 2 patients who develop vaginal recurrence undergo diagnostic work-up followed by teletherapy and brachytherapy. All six principles of cost-effectiveness analysis were employed. Importantly, actual payer costs were evaluated, not charges. RESULTS Although the treatment for vaginal cuff recurrence is expensive, since only 8% of patients develop a vaginal recurrence, there was a 31% decreased cost by not treating patients with postoperative low-dose rate brachytherapy (strategy 2). Also, although the complication rate for teletherapy is greater than brachytherapy, since only 8% of patients develop a vaginal recurrence and require teletherapy, projected complication rates for the two strategies are similar. Survival would be decreased 3% by withholding postoperative brachytherapy (strategy 2). With postoperative high-dose rate brachytherapy (strategy 1), the cost per life saved would be 38,764 US dollars. CONCLUSION Using a cost-effectiveness analysis, we have shown that withholding postoperative brachytherapy for patients with intermediate risk endometrial cancer results in a 31% decrease in cost, has a similar radiation complication rate, and results in a 3% decrease in survival.
Collapse
|
58
|
Trinh H, Ott C, Fanning J. Feasibility of laparoscopic debulking with electrosurgical loop excision procedure and argon beam coagulator at recurrence in patients with previous laparotomy debulking. Am J Obstet Gynecol 2004; 190:1394-7. [PMID: 15167847 DOI: 10.1016/j.ajog.2004.02.034] [Citation(s) in RCA: 36] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
OBJECTIVES Our purpose is to assess the feasibility and success of laparoscopic ovarian debulking with electrosurgical loop excision procedure (LEEP) and argon beam coagulator (ABC). METHODS Thirty-six consecutive asymptomatic patients with chemosensitive stage III or IV ovarian cancer who had undergone prior laparotomy debulking and chemotherapy, underwent laparoscopic debulking at the time of elevated CA 125. Preoperative abdominal/pelvic computed tomography was negative. Operative laparoscopy was performed through an open technique in the left upper quadrant. Tumors were debulked laparoscopically by using the LEEP and the ABC. RESULTS Of 36 patients, 34 (94%) underwent successful laparoscopic debulking without requiring laparotomy. Of 34 patients, 32 (94%) had all visible disease resected at laparoscopy; 6% had surgical complications. Median time for surgery was 2.6 hours, median blood loss 70 mL, and median hospital stay 1 day. Seventy-four percent had a complete response after laparoscopic debulking and chemotherapy with a median progression free survival of 1.1 years. CONCLUSION We present the first report of laparoscopic ovarian debulking using LEEP and ABC after elevation of CA 125 in chemosensitive, asymptomatic patients who had undergone prior laparotomy debulking. Laparoscopic debulking appears feasible (94%), successful (94%), and safe (6% complications). Prospective randomized trials are needed to determine the optimal management of asymptomatic, chemosensitive patients with elevated CA 125.
Collapse
|
59
|
Willis FL, Fanning J. Digital rectal fecal occult blood screening during gynecologic examination. Am J Obstet Gynecol 2004; 190:1422-3. [PMID: 15167856 DOI: 10.1016/j.ajog.2004.01.072] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Abstract
OBJECTIVE The purpose of this study was to test the feasibility of digital rectal fecal occult blood screening during pelvic examination. STUDY DESIGN We reviewed the data for 232 consecutive women who underwent digital rectal fecal occult blood screening during routine pelvic examination and who had had at least 1-year of follow-up visits: 59% of the women were followed for gynecologic cancer, and 41% of the women were followed for benign gynecologic disease. The median age was 62 years. Patients with positive digital rectal fecal occult blood screening were sent for gastroenterologic examination. RESULTS Sixteen of 232 patients (7%) had a positive digital rectal fecal occult blood screening result. On gastroenterologic examination, 5 of the 16 patients (31%) were found to have disease (2 polyps, 1 diverticular disease, 2 radiation proctitis). At 1-year follow-up, no patient had colon cancer. CONCLUSION Until better compliance can be obtained with home stool sample fecal occult blood testing, we recommend a larger study of digital rectal fecal occult blood screening during gynecologic examination to verify our results.
Collapse
|
60
|
Fanning J, Tsukada Y, Piver MS. Intraoperative frozen section diagnosis of depth of myometrial invasion in endometrial adenocarcinoma. Int J Gynaecol Obstet 2004. [DOI: 10.1016/0020-7292(90)90548-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
|
61
|
Fanning J, Brewer J. Delay of hospital discharge secondary to postoperative fever--is it necessary? THE JOURNAL OF THE AMERICAN OSTEOPATHIC ASSOCIATION 2002; 102:660-1. [PMID: 12501983] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/28/2023]
Abstract
Although postoperative fever is common after major gynecologic surgery, the majority of patients have no identifiable infectious or pathologic etiology. Traditional management has been to delay hospital discharge until the patient is afebrile. The authors evaluate the outcome of patients discharged with postoperative fever after major gynecologic surgery. In a retrospective review of 537 women undergoing major gynecologic surgery, 211 (39%) had postoperative fever. The authors identified all patients who were discharged despite having a temperature of 38 degrees C or higher (> or = 100.4 degrees F) in the preceding 12 hours. All outpatient and inpatient records for a period of 30 days were reviewed. Thirty-eight (18%) of 211 patients who were febrile postoperatively were discharged despite having a fever within the preceding 12 hours. One patient was lost to follow-up. Two (5%) of 37 patients had a documented infection (one urinary tract infection and one postoperative wound infection). Four (11%) were readmitted within 30 days for noninfectious causes. None of the patients discharged on oral antibiotics had an antibiotic-related complication. Eighty-four percent of patients discharged with a postoperative fever did not have a documented infectious or pathologic cause for the fever while at home.
Collapse
|
62
|
Fanning J. Prevention of femoral nerve injuries in gynecologic surgery. Am J Obstet Gynecol 2002; 187:1117; author reply 1117-8. [PMID: 12389013 DOI: 10.1067/mob.2002.126630] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
|
63
|
Fanning J, Brown S, Phibbs G, Kramer T, Zaher A. Immunohistochemical evaluation is not prognostic for recurrence in fully staged high-risk endometrial cancer. Int J Gynecol Cancer 2002; 12:286-9. [PMID: 12060450 DOI: 10.1046/j.1525-1438.2002.t01-1-01103.x] [Citation(s) in RCA: 17] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
The objective of this study was to determine the prognostic significance of common immunohistochemical pathologic risk factors in fully staged high-risk endometrial cancers. Sixty-two of 265 consecutive endometrioid adenocarcinomas were considered high risk for recurrence because of deep myometrial invasion and poor differentiation (stage IC, G3), cervical metastasis (stage II), ovarian metastasis (stage IIIA) or lymph node metastasis (stage IIIC). All patients underwent complete surgical staging with bilateral pelvic and aortic lymphadenectomy. Expression of estrogen receptors, progesterone receptors, p53, HER-2/neu, c-myc, bcl-2, FVIII, and Ki-67 were analyzed by immunohistochemistry using commercially available monoclonal antibodies. A general linear model multiple regression analysis was used to determine if any of the immunostains, along with grade or stage, were predictors of recurrence. Mean age was 68 years and mean weight 188 pounds. Sixty-eight percent of patients had associated medical illness. The majority of tumors were poorly differentiated (44%) and were stage IIIC (29%). Mean follow-up was 4.3 years. Fourteen patients (22%) developed tumor recurrence. Using multiple regression analysis, none of the immunostains were predictive for recurrence (P = 0.19-.96). Only stage and grade were predictive of tumor recurrence (P = 0.04,.02). We conclude that in completely staged high risk endometrial cancer, commonly used immunohistochemical risk factors are not predictive for recurrence.
Collapse
|
64
|
Pohlod-Miller S, Fanning J, Gu P, Crist KA, You M. Detection of genomic alterations in human endometrial cancer by two-dimensional gel electrophoresis. Am J Obstet Gynecol 2002; 186:855-7. [PMID: 12015494 DOI: 10.1067/mob.2002.121722] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
OBJECTIVE The purpose of this study was to detect genomic alterations in human endometrial cancer by two-dimensional gel electrophoresis. STUDY DESIGN With use of a newly developed two-dimensional gel electrophoresis assay, we scanned 19 high-risk DNA fragments for alterations in human endometrial hyperplasias and adenocarcinomas. This method includes cleaving of high-molecular-weight DNA, radioactive labeling, and separating DNA fragments by two-dimensional gel electrophoresis. By comparing the two-dimensional gel electrophoresis profile (spots) of neoplastic with normal endometrium, genetic alterations such as amplification, allelic loss, and hypermethylation or hypomethylation can be detected. RESULTS Seven of 8 human endometrial adenocarcinoma (88%) and 1 of 2 hyperplasias (50%) revealed changes in spot density. The number of spots changed per specimen was 4. The median percentage of specimens with changes in an individual spot was 30%. Eleven spots had a reduction or loss of spot density, and 8 spots had an increase in spot density. CONCLUSION By use of a novel two-dimensional gel electrophoresis assay, we identified genetic alterations in 50% of hyperplasias and 88% of endometrial adenocarcinomas.
Collapse
|
65
|
Fanning J, Brown S, Phibbs G, Kramer T, Zaher A. Immunohistochemical evaluation is not prognostic for recurrence in fully staged high-risk endometrial cancer. Int J Gynecol Cancer 2002. [DOI: 10.1136/ijgc-00009577-200205000-00008] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
Abstract.Fanning J, Brown S, Phibbs G, Kramer T, Zaher A. Immunohistochemical evaluation is not prognostic for recurrence in fully staged high-risk endometrial cancer.The objective of this study was to determine the prognostic significance of common immunohistochemical pathologic risk factors in fully staged high-risk endometrial cancers. Sixty-two of 265 consecutive endometrioid adenocarcinomas were considered high risk for recurrence because of deep myometrial invasion and poor differentiation (stage IC, G3), cervical metastasis (stage II), ovarian metastasis (stage IIIA) or lymph node metastasis (stage IIIC). All patients underwent complete surgical staging with bilateral pelvic and aortic lymphadenectomy. Expression of estrogen receptors, progesterone receptors, p53, HER-2/neu, c-myc, bcl-2, FVIII, and Ki-67 were analyzed by immunohistochemistry using commercially available monoclonal antibodies. A general linear model multiple regression analysis was used to determine if any of the immunostains, along with grade or stage, were predictors of recurrence. Mean age was 68 years and mean weight 188 pounds. Sixty-eight percent of patients had associated medical illness. The majority of tumors were poorly differentiated (44%) and were stage IIIC (29%). Mean follow-up was 4.3 years. Fourteen patients (22%) developed tumor recurrence. Using multiple regression analysis, none of the immunostains were predictive for recurrence (P = 0.19-.96). Only stage and grade were predictive of tumor recurrence (P = 0.04, .02). We conclude that in completely staged high risk endometrial cancer, commonly used immunohistochemical risk factors are not predictive for recurrence.
Collapse
|
66
|
Fanning J, Padratzik J. Cold knife conization vs. LEEP. Are they the same procedure? THE JOURNAL OF REPRODUCTIVE MEDICINE 2002; 47:33-5. [PMID: 11838307] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/23/2023]
Abstract
OBJECTIVE To prospectively evaluate the amount of tissue removed at loop electrosurgical excision procedure (LEEP) vs. cold knife conization. STUDY DESIGN Forty consecutive LEEP or cold knife conization specimens were prospectively measured and weighed by a single pathology technician. Diameter, length and weight of the specimens were compared using Student's t test. RESULTS Mean diameter of cold knife cone specimens was 2.6 vs. 2.2 cm for LEEP (P = .07). Mean length of cold knife cone specimens was 1.5 vs. 1.0 cm for LEEP (P = .001). Mean weight for cold knife cone specimens was 4.4 vs. 2.0 g for LEEP (P = .001). CONCLUSION In a prospective evaluation, cold knife cone specimens were 50% longer and 100% heavier than LEEP specimens.
Collapse
|
67
|
Fanning J. Long-term survival of intermediate risk endometrial cancer (stage IG3, IC, II) treated with full lymphadenectomy and brachytherapy without teletherapy. Gynecol Oncol 2001; 82:371-4. [PMID: 11531297 DOI: 10.1006/gyno.2001.6276] [Citation(s) in RCA: 91] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
OBJECTIVES The aim of this study was to determine long-term survival and late complications of intermediate risk endometrial cancer (Stage IG3, IC, and II) treated with full lymphadenectomy and brachytherapy without teletherapy. METHODS Two-hundred sixty-five consecutive patients underwent surgical staging for endometrial cancer consisting of hysterectomy, oophorectomy, and bilateral pelvic and periaortic lymphadenectomy. Sixty-six patients had intermediate risk endometrial cancer (Stage IG3, IC, and II) and received postoperative brachytherapy without teletherapy. Mean age was 68 years and mean weight was 188 lb. Seventy-seven percent had associated medical illness. RESULTS At a mean follow-up of 4.4 years, Kaplan-Meier estimated 5-year progression free survival is 97%. Two patients (3%) developed distant recurrence (abdomen, lungs) with no vaginal or pelvic recurrence. Major complications occurred in 6% of patients. CONCLUSIONS Complete lymphadenectomy with brachytherapy without teletherapy for intermediate risk endometrial cancer results in excellent progression-free survival and minimal major morbidity.
Collapse
|
68
|
Fanning J, Andrews S. Early postoperative feeding after major gynecologic surgery: evidence-based scientific medicine. Am J Obstet Gynecol 2001; 185:1-4. [PMID: 11483895 DOI: 10.1067/mob.2001.113911] [Citation(s) in RCA: 21] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Postoperative gastrointestinal care after major gynecologic surgery has evolved considerably over the last decade. According to evidence-based scientific medicine, the following conclusions can be drawn: (1) Postoperative colonic stasis occurs after major abdominal surgery and persists for approximately 3 days (classes I and IIA). (2) Elective postoperative nasogastric decompression after major abdominal surgery is unnecessary (class I). (3) Early feeding after major gynecologic surgery results in emesis but does not increase the incidence of aspiration pneumonia, dehiscence, or intestinal leaks and decreases hospital stay (class I). (4) Slow advancement of postoperative diet after major gynecologic surgery is probably unnecessary (class III). (5) After major abdominal gynecologic surgery, there appear to be minimal medical benefits (decreased infection rate) of early postoperative feeding (class III). (6) After radical hysterectomy, postoperative bowel stimulation decreases length of hospital stay (class IIA).
Collapse
|
69
|
Katz LA, Andrews SJ, Fanning J. Survival after multimodality treatment for stage IIIC endometrial cancer. Am J Obstet Gynecol 2001; 184:1071-3. [PMID: 11349160 DOI: 10.1067/mob.2001.115225] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
OBJECTIVE Our purpose was to review our results of multimodality treatment of lymph node metastasis in endometrial cancer (stage IIIC). STUDY DESIGN All patients underwent surgical staging for endometrial cancer with complete pelvic and aortic lymphadenectomy. All macroscopic nodal metastases were resected. Patients with microscopic nodal metastasis received adjuvant teletherapy, whereas those with macroscopic nodal metastasis received chemotherapy (carboplatin AUC 5 and paclitaxel 135 mg/m2 every 3 weeks for 6 courses) followed by teletherapy. RESULTS Twenty-one patients had stage IIIC disease, and one had stage IVB (inguinal nodal metastasis). Sixty-four percent of tumors were poorly differentiated. Fifty-five percent of patients had pelvic nodal metastasis only and 41% had macroscopic nodal metastasis. At a median follow-up of 3.8 years, 32% of patients had recurrence, all extrapelvic. Overall mean survival was 48 months and progression-free survival was 40 months. Overall survival for microscopic nodal metastasis was >60 months versus 35 months for macroscopic metastasis. Overall survival for pelvic nodal metastasis was 53 months versus 42 months for aorticinguinal metastasis. There were no complications from lymphadenectomy, a 22% chemotherapeutic toxicity, and a 14% radiation toxicity. CONCLUSION Our surgical, chemotherapeutic, and radiation treatment protocol for stage IIIC endometrial cancer produced minimal toxicity and good survival.
Collapse
|
70
|
Schwandt A, Andrews SJ, Fanning J. Prospective analysis of a fever evaluation algorithm after major gynecologic surgery. Am J Obstet Gynecol 2001; 184:1066-7. [PMID: 11349158 DOI: 10.1067/mob.2001.115227] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
OBJECTIVE We performed a prospective trial to evaluate the feasibility, accuracy, and safety of a postoperative fever algorithm that is based on symptoms and physical examination in an attempt to decrease the random use of urine cultures, blood cultures, and chest radiographs. STUDY DESIGN Our fever algorithm consisted of assessing all febrile postoperative patients for signs and symptoms of infection. If none were present, no tests were ordered. RESULTS Twenty-eight of 105 consecutive patients (27%) had postoperative fever after major gynecologic surgery. Three of 28 febrile patients (11%) were evaluated with tests according to the algorithm. Two of 28 febrile patients (7%) were evaluated in violation of the algorithm. Four febrile patients (14%) had documented infections. Two patients had infections within the first 30 days after discharge. Compared with our previous retrospective review, significantly fewer febrile patients were evaluated with testing with a significantly increased yield of positive test results. CONCLUSIONS Our postoperative fever evaluation algorithm that is based on symptoms and physical examination is feasible, is safe, decreases random testing, and increases the yield of positive test results.
Collapse
|
71
|
MacLaughlin WS, Youngs DD, Fanning J. Biopsy proven rectal endometriosis demonstrating early decidual reaction. Gastrointest Endosc 2001; 36:82-3. [PMID: 2311900 DOI: 10.1016/s0016-5107(90)70946-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
|
72
|
Fanning J. Reply. Am J Obstet Gynecol 2001. [DOI: 10.1067/mob.2001.110951] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
|
73
|
Fanning J. Questions about case report on vaginal dysplasia. Am J Obstet Gynecol 2000; 183:1592-3. [PMID: 11120542 DOI: 10.1067/mob.2000.109866] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
|
74
|
Fanning J, Kraus K. Surgical stapling technique for radical hysterectomy: survival, recurrence, and late complications. Gynecol Oncol 2000; 79:281-3. [PMID: 11063657 DOI: 10.1006/gyno.2000.5948] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
OBJECTIVE The aim of this study was to conduct a long-term follow-up of the surgical stapling technique of radical hysterectomy to determine survival, recurrence, and late complications. METHODS One hundred consecutive eligible patients treated with the surgical stapling technique of radical hysterectomy were prospectively evaluated. RESULTS Median operative time was 3.2 h. Median blood loss was 500 ml. There was an 18% acute postoperative complication rate and a 10% long-term complication rate. There was a 6% recurrence rate and a 92% disease-free survival. CONCLUSION The surgical stapling technique of radical hysterectomy results in acceptable survival, recurrence, and complication rates, which appear similar to those of the traditional type of radical hysterectomy, while operative time and blood loss appear to be reduced.
Collapse
|
75
|
Fanning J, Colgrove M, Phibbs G. Cisplatin-paclitaxel-cyclophosphamide with G-CSF in primary advanced epithelial ovarian cancer. Gynecol Oncol 2000; 79:97-100. [PMID: 11006039 DOI: 10.1006/gyno.2000.5899] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
INTRODUCTION In an attempt to increase survival, we performed a prospective trial of high-dose cisplatin-paclitaxel-cyclophosphamide with granulocyte colony-stimulating factor (G-CSF) for three cycles followed by carboplatin-paclitaxel for three cycles after cytoreduction of primary advanced epithelial ovarian cancer. MATERIALS AND METHODS Thirty consecutive women with Stage 3 or 4 invasive primary epithelial ovarian cancer were treated with cytoreductive surgery. Postoperatively patients received 100 mg/m(2) of cisplatin, 200 mg/m(2) of paclitaxel, and 500 mg/m(2) of cyclophosphamide IV q 21 days x 3 cycles with 300 microg of G-CSF daily x5 beginning the first day following chemotherapy. This was followed by carboplatin AUC-5 and 135 mg/m(2) of paclitaxel IV q 21 days x3. All administration was outpatient and paclitaxel was administered over 3 h. RESULTS Eighty percent of tumors were Stage 3C, 77% were serous, and 60% were Grade 3. Maximum cytoreduction to <2 cm was performed in 96%. Median follow-up is 30 months. Sixty-three percent of patients developed recurrence. Currently 50% of patients are alive with no evidence of disease. Estimated mean survival is 61 months and estimated mean progression-free survival is 29 months. No patient developed thrombocytopenia, neutropenic sepsis, significant neuropathy, or renal toxicity. CONCLUSION This treatment regimen resulted in minimal toxicity and, following aggressive cytoreduction, produced good progression-free and overall survival.
Collapse
|