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 47 patients (51 procedures performed) with BKA for peripheral vascular diseases during a 4-year period were reviewed. Clinical factors were analyzed using bi- and multi-variate analysis against the procedure outcome. Degree of social deprivation was evaluated with DEPCAT score in relation to amputation failure. Each arterial segment of the pre-operative arteriograms was scored based on a 3-point scoring system (0=normal, 1=stenosis, and 2=cclusion). With the assignment of an arbitrary weight for each segment, a total arterial score (TAS) was derived for each patient. RESULTS:Eighteen percent of BKA (n=9) failed. Absence of popliteal pulse (failure vs. success: 100% vs. 63%, P=0.04), calf rest pain (67% vs. 20%, P=0.01), combination of calf rest pain and feet tissue loss (CRPFTL; 67% vs. 3%, P=0.00), postoperative stump trauma (44% vs. 10%, P=0.03), and wound infection (WI; 89% vs. 26%, P=0.00) were factors associated with the failure of a BKA in bivariate analysis. Using multiple logistic regression, WI (OR=14) and CRPFTL (OR=47) were found to be independent predictors for the outcome of BKA. No statistical significance was found between the DEPCAT score and the failure rate. TAS was significantly higher in the failure group (median=17 vs. 9; P=0.00). CONCLUSIONS:This study suggests that CRPFTL and postoperative WI are predictor variables for the failure of a BKA. In addition, there is the potential role of arteriogram scoring in predicting the outcome of a BKA.
journal_name
World J Surgjournal_title
World journal of surgeryauthors
Yip VS,Teo NB,Johnstone R,Robertson AG,Robertson JH,Welch GH,Kettlewell Sdoi
10.1007/s00268-005-0737-ysubject
Has Abstractpub_date
2006-06-01 00:00:00pages
1081-7issue
6eissn
0364-2313issn
1432-2323journal_volume
30pub_type
杂志文章abstract：:Malignant melanoma is notoriously resistant to chemotherapy. Standard single agents include dacarbazine and the nitrosoureas, but most series treating patients with metastatic melanoma report response rates of about 20%. Occasional patients, however, achieve long term remission, amounting to cure, after such treatment...
journal_title：World journal of surgery
pub_type： 杂志文章,评审
doi：10.1007/BF02071532
更新日期：1992-03-01 00:00:00
abstract：:Histologically differentiated adenocarcinoma satisfies one of the criteria for limited surgery for mucosal carcinoma of the stomach: however, the histology of the endoscopic biopsy specimen is often different from that of the resected specimen. The medical records of 1018 early gastric carcinomas were retrospectively ...
journal_title：World journal of surgery
pub_type： 杂志文章
doi：10.1007/s002689900483
更新日期：1998-08-01 00:00:00
abstract：:Endoscopic management of polypoid early colonic cancer (malignant polyps and polypoid carcinomas) is no longer controversial. When the endoscopist is satisfied that excision is complete and histology is "favorable" (a resection margin of 2 mm and well or moderately well differentiated tumor), surgery is unnecessary. W...
journal_title：World journal of surgery
pub_type： 杂志文章,评审
doi：10.1007/s002680010144
更新日期：2000-09-01 00:00:00
abstract：INTRODUCTION:Thyroid cancer (TC) incidence has been increasing in recent years. The aim of this study was to investigate our institution-based estimates of operative volumes for TC over the last three decades. MATERIALS AND METHODS:This was a retrospective cohort study of patients undergoing thyroid surgery at our ins...
journal_title：World journal of surgery
pub_type： 杂志文章
doi：10.1007/s00268-015-3322-z
更新日期：2016-03-01 00:00:00
abstract：:This paper summarizes the place of thoracic surgery in the management of hydatid disease. Although based on the author's 31-year personal experience, it draws on the experience of others where that of the author is deficient. The treatment of pulmonary, pleural, liver, and cardiac cysts is discussed. The importance of...
journal_title：World journal of surgery
pub_type： 杂志文章
doi：10.1007/s002689900631
更新日期：1999-11-01 00:00:00
abstract：BACKGROUND:This study aimed to evaluate the clinical relevance of hepatectomy for Barcelona Clinic Liver Cancer (BCLC) stages B and C advanced hepatocellular carcinoma (HCC). METHODS:A total of 314 patients (149 and 165 BCLC stages B and C, respectively) who underwent hepatectomy were included. Complete hepatectomy (w...
journal_title：World journal of surgery
pub_type： 杂志文章
doi：10.1007/s00268-019-05052-5
更新日期：2019-10-01 00:00:00
abstract：:There is debate regarding use of the stereotactic core-needle biopsy (SCNB) for highly suspicious mammographic lesions. This study compares a serial group of mammography-detected breast cancer patients treated before and after the use of SCNB. We studied 113 consecutive nonpalpable breast cancers between 1994 and 1996...
journal_title：World journal of surgery
pub_type： 杂志文章
doi：10.1007/s002689900510
更新日期：1998-10-01 00:00:00
abstract：BACKGROUND:Frailty is a customized marker of biological age that helps to gauge an individual's functional physiologic reserve and ability to react to stress and is associated with increased postoperative morbidity and mortality. In order to mitigate frailty preoperatively, the concept of prehabilitation has entered th...
journal_title：World journal of surgery
pub_type： 杂志文章,评审
doi：10.1007/s00268-020-05658-0
更新日期：2020-11-01 00:00:00
abstract：:The purpose of this study was to evaluate the surgical outcome of completion thyroidectomy in patients with presumed unilateral well-differentiated thyroid cancer (WDTC). The medical records of all patients having had unilateral thyroid lobectomy for WDTC, who subsequently underwent completion thyroidectomy, were revi...
journal_title：World journal of surgery
pub_type： 杂志文章
doi：10.1007/BF02067365
更新日期：1992-07-01 00:00:00
abstract：BACKGROUND:There is a proven relationship between obesity and several cancers including breast, endometrium, colorectal, and esophagus. With the increasing incidence of both obesity and thyroid cancer, we designed the present study to investigate a causal relationship between leptin, which is one of the well known adip...
journal_title：World journal of surgery
pub_type： 杂志文章
doi：10.1007/s00268-014-2634-8
更新日期：2014-10-01 00:00:00
abstract：:The metabolic changes in cancer cachexia appear to be mediated by a complex network of proinflammatory cytokines, neuroendocrine hormones, neurotransmitters, eicosanoids, and tumor-derived factors produced by the body in response to the tumor and by the tumor itself. The relative importance of these various mediator p...
journal_title：World journal of surgery
pub_type： 杂志文章,评审
doi：10.1007/s002689910110
更新日期：2000-06-01 00:00:00
abstract：BACKGROUND:The aim of this study was to compare single-port access cholecystectomy (SPA) with the standard laparoscopic technique (LC) regarding the duration of the operation, complications, learning curve, late postoperative quality of life (QoL) and the incidence of incisional hernias. METHODS:Between June 2009 and ...
journal_title：World journal of surgery
pub_type： 临床试验,杂志文章
doi：10.1007/s00268-013-1946-4
更新日期：2013-05-01 00:00:00
abstract：BACKGROUND:It has been thirty years since Bianchi introduced the technique that made intestinal lengthening possible. The last three decades have seen lengthening procedures established as vital components of intestinal rehabilitation programs. The goal of the present study was to use a systematic literature review to ...
journal_title：World journal of surgery
pub_type： 杂志文章,评审
doi：10.1007/s00268-012-1879-3
更新日期：2013-03-01 00:00:00
abstract：BACKGROUND:Pain syndromes of somatic and neuropathic origin are considered to be the main causes of chronic pain after open inguinal hernia repair. Nerve-identification during open hernia repair is suggested to be associated with less postoperative chronic pain. The aim of this study was to define clinically relevant s...
journal_title：World journal of surgery
pub_type： 杂志文章
doi：10.1007/s00268-006-0376-y
更新日期：2007-02-01 00:00:00
abstract：BACKGROUND:Selective nonoperative management (SNOM) of penetrating neck injuries (PNI) has steadily gained favor, but indications for surgery and adjunctive diagnostic studies remain debated. The purpose of the present study is to validate a protocol of SNOM of PNI based on physical examination, which further dictates ...
journal_title：World journal of surgery
pub_type： 杂志文章
doi：10.1007/s00268-008-9766-7
更新日期：2008-12-01 00:00:00
abstract：BACKGROUND:This study assessed the APACHE II (Acute Physiology and Chronic Health Evaluation II), SAPS II (Simplified Acute Physiology Score-II), POSSUM (Physiologic and Operative Severity Score for Enumeration of Morbidity and Mortality), and P-POSSUM (Portsmouth-POSSUM) in patients with colorectal cancer undergoing c...
journal_title：World journal of surgery
pub_type： 杂志文章
doi：10.1007/s00268-007-9321-y
更新日期：2008-04-01 00:00:00
abstract：BACKGROUND:Intraoperative identification of the difficult-to-spot parathyroid gland is critical during surgery for thyroid and parathyroid disease. Recently, intrinsic fluorescence of the parathyroid gland was identified, and a new method was developed for intraoperative detection of the parathyroid with an original fl...
journal_title：World journal of surgery
pub_type： 杂志文章
doi：10.1007/s00268-017-3903-0
更新日期：2017-06-01 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：BACKGROUND:Skeletal muscle depletion, referred to as sarcopenia, has been shown to be an independent predictor of lower disease-free and overall survivals in various kinds of diseases. The quality of skeletal muscle has recently attracted much attention as a new parameter of sarcopenia, but its impact on surgical compl...
journal_title：World journal of surgery
pub_type： 杂志文章
doi：10.1007/s00268-016-3504-3
更新日期：2016-08-01 00:00:00
abstract：PURPOSE:Restorative surgery for rectal cancer is usually criticized by its functional outcomes. The aim of this study is to assess the efficacy "taeniectomy" pouch in comparison with transverse coloplasty pouch. STUDY DESIGN:This was a prospective controlled study. Most patients who were candidate for low rectal resec...
journal_title：World journal of surgery
pub_type： 杂志文章
doi：10.1007/s00268-018-04890-z
更新日期：2019-04-01 00:00:00
abstract：BACKGROUND:The open abdomen (OA) is commonly utilized as a technique during damage control laparotomy (DCL). We propose that a selected group of these OA patients can be extubated prior to abdominal closure to decrease ventilator days and risk of pneumonia. METHODS:A retrospective chart review was performed at a Level...
journal_title：World journal of surgery
pub_type： 杂志文章
doi：10.1007/s00268-018-4610-1
更新日期：2018-10-01 00:00:00
abstract：:A family history of colorectal cancer is a known risk factor for the disease. As a result of different study designs from different populations, the strength of this association varies in the literature. We intended to define the incidence and the risk predictors in first-degree relatives of patients with colorectal c...
journal_title：World journal of surgery
pub_type： 杂志文章
doi：10.1007/s002689900217
更新日期：1997-02-01 00:00:00
abstract：BACKGROUND:Routine preoperative staging in pancreas cancer is controversial. We sought to evaluate the rates of diagnostic laparoscopy (DLAP) for pancreatic cancer. METHODS:We queried the National Surgical Quality Improvement Program for patients with pancreas cancer (2005-2013) and compared groups who underwent DLAP,...
journal_title：World journal of surgery
pub_type： 杂志文章
doi：10.1007/s00268-018-4855-8
更新日期：2019-03-01 00:00:00
abstract：:Cancers of the distal rectum (less than 7.5 cm from the anal verge) that are freely mobile, moderately well or well differentiated, less than 4 cm in size, limited to the bowel wall, and without evidence of metastasis should be considered candidates for treatment with electrocoagulation for cure. Tumor cell ploidy and...
journal_title：World journal of surgery
pub_type： 杂志文章,评审
doi：10.1007/BF02104447
更新日期：1992-05-01 00:00:00
abstract：:A total of 143 patients who underwent hepatic resection for hepatocellular carcinoma in our department were reviewed. The review was conducted for two periods: 1970-1982 (early period) and 1983-1990 (late period), that is, the periods before and after introduction of the hepatic surgical technique involving the use of...
journal_title：World journal of surgery
pub_type： 杂志文章
doi：10.1007/BF01659138
更新日期：1993-09-01 00:00:00
abstract：:Breast cancer is a common disease, and the surgical management is continually evolving. The objective of this study was to describe the current breast cancer practice patterns among Canadian surgeons. All active General Surgeons (n=1172), as accredited by the Royal College of Physicians and Surgeons of Canada, were se...
journal_title：World journal of surgery
pub_type： 杂志文章
doi：10.1007/s00268-003-7040-6
更新日期：2004-01-01 00:00:00
abstract：BACKGROUND:Delayed access to surgical care for congenital conditions in low- and middle-income countries is associated with increased risk of death and life-long disabilities, although the actual burden of delayed access to care is unknown. Our goal was to quantify the burden of disease related to delays to surgical ca...
journal_title：World journal of surgery
pub_type： 杂志文章
doi：10.1007/s00268-019-05239-w
更新日期：2020-03-01 00:00:00
abstract：:Transjugular intrahepatic portosystemic shunt (TIPS) is being increasingly utilized prior to liver transplantation for portal hypertensive bleeding refractory to sclerotherapy or as initial management of variceal bleeding. The impact of TIPS on subsequent orthotopic liver transplantation (OLT) is uncertain. The purpos...
journal_title：World journal of surgery
pub_type： 临床试验,杂志文章
doi：10.1007/BF00299089
更新日期：1994-11-01 00:00:00
abstract：:The radiological features of common benign conditions of the breast and the radiological procedures used in the investigation of benign breast disorders are presented. ...
journal_title：World journal of surgery
pub_type： 杂志文章,评审
doi：10.1007/BF01658415
更新日期：1989-11-01 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
