Abstract：
:Organ transplantation continues to be hindered by a limited supply of organs. A significant percentage of potential organ donors are lost to either medical failure or inability to obtain consent for donation. In a surgical intensive care unit (ICU) we have refocused our efforts toward aggressive resuscitation, directed by control of coagulopathy, invasive monitoring, and dedicated ICU management while implementing a rapid brain death determination protocol. Over a 6-year period the length of stay until the legal determination of brain death is made has been significantly shortened (12.0 vs. 3.4 hours; p < 0.05), as have associated charges despite this more aggressive approach. As a result, we have eliminated medical failures prior to donation (13% vs. 0%) and increased consent rates (44% vs. 71%; p < 0.05). These efforts have significantly improved the number of organs harvested per eligible donor (1.8 vs. 3.4; p < 0.05). In addition, the number of organs per actual donor has increased and is now markedly greater than the U.S. national average (4.7 vs. 3.7). We believe the approach presented, if widely applied, could potentially improve the current organ supply shortage.
journal_name
World J Surgjournal_title
World journal of surgeryauthors
Jenkins DH,Reilly PM,Schwab CWdoi
10.1007/pl00012362keywords:
subject
Has Abstractpub_date
1999-07-01 00:00:00pages
644-9issue
7eissn
0364-2313issn
1432-2323pii
4978journal_volume
23pub_type
杂志文章,评审abstract：BACKGROUND:There is emerging evidence indicating that distractions in the operating room (OR) are prevalent. Studies have shown a negative impact of distractions, but they have been conducted mostly with residents in simulated environments. We tested the hypothesis that intraoperative distractions are associated with d...
journal_title：World journal of surgery
pub_type： 杂志文章
doi：10.1007/s00268-013-2315-z
更新日期：2014-04-01 00:00:00
abstract：BACKGROUND:Recurrent spontaneous pneumothorax is widely treated by video-assisted thoracoscopic (VATS) bullectomy and pleurodesis. Treatment of postoperative pain with nonsteroidal antiinflammatory drugs (NSAIDs) is controversial as many surgeons believe that it reduces the efficacy of pleurodesis and increases the pne...
journal_title：World journal of surgery
pub_type： 杂志文章
doi：10.1007/s00268-011-1207-3
更新日期：2011-11-01 00:00:00
abstract：:Dissemination of new surgical knowledge, skills, and techniques across the wide spectrum of practicing surgeons in the community is often difficult and slow. This is even more problematic in countries such as Canada, where geographic distances separate a large portion of community surgeons from the large teaching cent...
journal_title：World journal of surgery
pub_type： 杂志文章
doi：10.1007/s00268-007-9076-5
更新日期：2007-08-01 00:00:00
abstract：:The serum hyaluronate (HA) level reflects sinusoidal endothelial cell function correlated with liver function. We have reviewed multiple liver function indicators from 37 patients who underwent hepatectomy for various liver diseases. The serum HA level was well correlated with the indocyanine green retention rate at 1...
journal_title：World journal of surgery
pub_type： 杂志文章
doi：10.1007/s00268-004-7389-1
更新日期：2004-10-01 00:00:00
abstract：:Distinguishing cellular follicular adenomas (FA) from minimally invasive follicular carcinomas (FC) continues to plague even experienced thyroid pathologists. DNA ploidy analysis has been promoted as a means of making this differentiation; however, the finding of DNA aneuploidy in FA has caused concern that they may d...
journal_title：World journal of surgery
pub_type： 杂志文章
doi：10.1007/BF01658504
更新日期：1990-05-01 00:00:00
abstract：BACKGROUND:Papillary thyroid carcinoma (PTC) frequently recurs to the lymph nodes, which may not be fatal immediately but is a stressor for physicians and patients. Recurrence to the distant organs, although less frequent, is often life-threatening, and the lung and bone are organs to which PTC is likely to recur. In t...
journal_title：World journal of surgery
pub_type： 杂志文章
doi：10.1007/s00268-012-1423-5
更新日期：2012-06-01 00:00:00
abstract：:Endoscopic sphincterotomy (EST) is an established method for treatment of retained or recurrent common bile duct (CBD) calculi after cholecystectomy. Present experience shows that few patients have recurrent biliary tract complications, but follow-up periods are most often short. EST was performed in 147 patients with...
journal_title：World journal of surgery
pub_type： 杂志文章
doi：10.1007/s002689900043
更新日期：1996-03-01 00:00:00
abstract：:A review of the literature describing the management of hepatic and splenic injuries indicates that as many as 67% of exploratory celiotomies for blunt trauma are reported as nontherapeutic. Avoiding unnecessary surgery through nonoperative management offers an attractive alternative. Nonetheless, nonoperative managem...
journal_title：World journal of surgery
pub_type： 杂志文章,评审
doi：10.1007/s00268-001-0138-9
更新日期：2001-11-01 00:00:00
abstract：OBJECTIVE:Radical lymph node dissection (LND) along the bilateral recurrent laryngeal nerve (RLN) is a surgically challenging procedure with a high rate of morbidity. Here, we assessed in a retrospective manner the adequacy of LND along the RLN performed with robot-assisted thoracoscopic esophagectomy (RATE) versus vid...
journal_title：World journal of surgery
pub_type： 杂志文章
doi：10.1007/s00268-017-4179-0
更新日期：2018-02-01 00:00:00
abstract：BACKGROUND:Ultrasound (US) and sestamibi (MIBI) are traditionally considered positive or negative. The purpose of this study was to define and test a new scoring system for MIBI and US and to determine whether this can improve their accuracy for primary hyperparathyroidism. METHODS:This is a prospective study of 200 c...
journal_title：World journal of surgery
pub_type： 杂志文章
doi：10.1007/s00268-012-1666-1
更新日期：2012-10-01 00:00:00
abstract：BACKGROUND:Due to advances in operative methods and perioperative care, mortality and morbidity following major hepatic resection have decreased substantially, making long-term quality of life (QoL) an increasingly prominent issue. We evaluated whether postoperative diagnosis was associated with long-term QoL and healt...
journal_title：World journal of surgery
pub_type： 杂志文章
doi：10.1007/s00268-009-0032-4
更新日期：2009-07-01 00:00:00
abstract：BACKGROUND:We aimed to systematically review the literature on the educational impact of Advanced Trauma Life Support (ATLS) courses and their effects on death rates of multiple trauma patients. METHODS:All Medline, Pubmed, and the Cochrane Library English articles on the educational impact of ATLS courses and their e...
journal_title：World journal of surgery
pub_type： 杂志文章,评审
doi：10.1007/s00268-013-2294-0
更新日期：2014-02-01 00:00:00
abstract：:There is little information on the pharmacokinetics and pharmacodynamics of doxorubicin (DXR) administered during locoregional treatments of colon carcinoma under hyperthermic conditions. The aim of this study was to evaluate distribution and activity of DXR in healthy tissue and tumor tissues under hyperthermic condi...
journal_title：World journal of surgery
pub_type： 杂志文章
doi：10.1007/s00268-003-6804-3
更新日期：2003-06-01 00:00:00
abstract：BACKGROUND:The impact of time to readmission (TTR) on post-discharge mortality has not been well examined. We sought to define the impact of TTR on postoperative mortality after liver or pancreas surgery. METHODS:A retrospective cohort analysis of liver and pancreas surgical patients was conducted using 2013-2015 Medi...
journal_title：World journal of surgery
pub_type： 杂志文章
doi：10.1007/s00268-018-4766-8
更新日期：2019-01-01 00:00:00
abstract：OBJECTIVES:Postoperative pancreatic fistula (POPF) is a major complication and main cause of mortality after pancreaticoduodenectomy (PD). Afferent loop decompression technique (ALDT) has theoretical feasibility to reduce the rate of POPF. The aim of this study is to determine whether ALDT is a protective factor for PO...
journal_title：World journal of surgery
pub_type： 杂志文章
doi：10.1007/s00268-018-4679-6
更新日期：2018-11-01 00:00:00
abstract：BACKGROUND:The goal of the present study was to determine the frequency, mode of presentation, and need for reoperation in the treatment of recurrent inguinal hernia at Liaquat University Hospital, Jamshoro, Sindh, Pakistan. METHODS:This descriptive, cross-sectional study was conducted over a period of four years, fro...
journal_title：World journal of surgery
pub_type： 杂志文章
doi：10.1007/s00268-012-1897-1
更新日期：2013-03-01 00:00:00
abstract：:Neoadjuvant therapy for locally advanced breast cancer improves disease control, but the complications of treatment are not well established. The aim of this study was to assess the operative morbidity in 20 consecutive patients with locally advanced, noninflammatory breast cancer treated with preoperative chemotherap...
journal_title：World journal of surgery
pub_type： 杂志文章
doi：10.1007/BF01658934
更新日期：1993-03-01 00:00:00
abstract：:During the past four decades, especially in recent years, various active adjuvant therapies combined with surgery have improved the outcome in cases of cancer of the esophagus. However, no optimum adjuvant therapy has been determined. From 1981 to 1992, 341 patients with regional and distant node metastasis who underw...
journal_title：World journal of surgery
pub_type： 杂志文章,评审
doi：10.1007/BF00316819
更新日期：1994-05-01 00:00:00
abstract：BACKGROUND:Laparoscopic cholecystectomy is first-line treatment for uncomplicated gallstone disease in high-income countries due to benefits such as shorter hospital stays, reduced morbidity, more rapid return to work, and lower mortality as well-being considered cost-effective. However, there persists a lack of uptake...
journal_title：World journal of surgery
pub_type： 杂志文章
doi：10.1007/s00268-016-3851-0
更新日期：2017-05-01 00:00:00
abstract：BACKGROUND:Below knee amputation (BKA) is often required in patients with critical limb ischemia. When such a procedure fails, an above knee revision (AKA) is required. This can cause further complications in this group of patients, who already have a high incidence of medical co-morbidities. METHODS:Case records of 4...
journal_title：World journal of surgery
pub_type： 杂志文章
doi：10.1007/s00268-005-0737-y
更新日期：2006-06-01 00:00:00
abstract：BACKGROUND:Unilateral vocal fold paralysis (UVFP) may present as an uncommon complication of extralaryngeal neoplasms, requiring diagnostic scrutiny to seek occult tumors or diseases. The aim of this study was to examine the utility of computed tomography (CT) in evaluating adult UVFP of unknown etiology. METHODS:From...
journal_title：World journal of surgery
pub_type： 杂志文章
doi：10.1007/s00268-013-1991-z
更新日期：2013-06-01 00:00:00
abstract：INTRODUCTION:Rectus sheath hematoma is rare. It can present to physicians in many specialties, but invariably the surgeon is contacted regarding management. It is frequently difficult to diagnose, which can result in delay of treatment or unnecessary surgery. Its incidence is on the rise. METHODS:We present a series o...
journal_title：World journal of surgery
pub_type： 杂志文章,评审
doi：10.1007/s00268-005-0702-9
更新日期：2006-11-01 00:00:00
abstract：BACKGROUND:The most important problem in pancreatic fistula is whether one can distinguish clinical pancreatic fistula, grade B + C fistula by the International Study Group on Pancreatic Fistula (ISGPF), from transient pancreatic fistula (grade A), in the early period after pancreaticoduodenectomy (PD). It remains uncl...
journal_title：World journal of surgery
pub_type： 杂志文章
doi：10.1007/s00268-009-0220-2
更新日期：2009-12-01 00:00:00
abstract：BACKGROUND:The technical complexity of pancreatic resection has made it a specialized procedure performed in high-volume centers. It has been shown that patients operated on in high-volume pancreatobiliary centers have fewer complications and better survival. The purpose of this study was to share our experience with a...
journal_title：World journal of surgery
pub_type： 杂志文章
doi：10.1007/s00268-014-2644-6
更新日期：2014-10-01 00:00:00
abstract：INTRODUCTION:Large incisional hernias with loss of domain (LIHLD) of the abdominal wall remain a therapeutic challenge due to the difficulty of replacing the contents of the hernia sac into the peritoneal cavity. Preoperative progressive pneumoperitoneum (PPP) is a valuable option. The purpose of this study was to eval...
journal_title：World journal of surgery
pub_type： 杂志文章
doi：10.1007/s00268-015-3206-2
更新日期：2015-12-01 00:00:00
abstract：BACKGROUND:The profile and management of self-inflicted abdominal stab wounds (SI-ASW) patients is still obscure. METHODS:The National Trauma Data Bank (2012) was queried for adults with abdominal stab wounds (n = 9544). Patients with SI-ASW (n = 1724) and non-SI-ASW (n = 7820) were compared. Predictors for non-therap...
journal_title：World journal of surgery
pub_type： 杂志文章
doi：10.1007/s00268-017-4083-7
更新日期：2017-11-01 00:00:00
abstract：:Large ventral hernias are a significant surgical challenge. "Loss of domain" (LOD) expresses the relationship between hernia and abdominal volume, and is used to predict operative difficulty and success. This systematic review assessed whether different definitions of LOD are used in the literature. The PubMed databas...
journal_title：World journal of surgery
pub_type： 杂志文章
doi：10.1007/s00268-018-4783-7
更新日期：2019-02-01 00:00:00
abstract：BACKGROUND:The benefit of resection of gastric cancer with locoregional invasion is still under debate. This study aimed to investigate the impact of surgery on patients with gastric cancer with locoregional invasion. METHODS:From January 1988 to December 2009, a total of 2,678 patients with gastric cancer underwent s...
journal_title：World journal of surgery
pub_type： 杂志文章
doi：10.1007/s00268-011-1246-9
更新日期：2011-11-01 00:00:00
abstract：BACKGROUND:The impact of preoperative enteral nutrition (EN) on postoperative complications and recurrence in Crohn's disease (CD) has not been investigated to date. The purpose of the present study was to determine the effect of preoperative exclusive EN on postoperative complications and recurrence after bowel resect...
journal_title：World journal of surgery
pub_type： 杂志文章
doi：10.1007/s00268-016-3488-z
更新日期：2016-08-01 00:00:00
abstract：:Met protein is a tyrosine kinase receptor for hepatocyte growth factor (HGF). c-Met has morphogenic, mitogenic, and motogenic properties and is overexpressed in many solid tumors. We studied c-met mRNA and protein expression in papillary thyroid carcinomas and nonneoplastic thyroid tissue. The c-met mRNA was detected ...
journal_title：World journal of surgery
pub_type： 杂志文章
doi：10.1007/s002680020167
更新日期：2001-05-01 00:00:00
