Abstract：
:Although emergency department thoracotomy (EDT) is often considered a controversial "last chance" method of resuscitation, we hypothesized that EDT performed in a busy urban Level I trauma center has significant salvage rates despite the absence of traditional survival predictors. A retrospective review revealed that 180 patients underwent EDT after traumatic arrest for penetrating injury between 2000 and 2005. All were deemed nonsalvageable by other resuscitation methods. Injury mechanism and location, signs of life (SOLs), initial cardiac rhythm, and presence of vital signs were analyzed. In total, 23 patients survived hospitalization neurologically intact. Compared to nonsurvivors, survivors more often suffered multiple stab wounds (21.7% vs. 1.9%, p = 0.001), presented with field (95.7% vs. 72.6%, p = 0.016) and ED (87.0% vs. 60.5%, p = 0.014) SOLs, had sustainable cardiac rhythms (sinus tachycardia, 43.5% vs. 10.2%, p = 0.001; normal sinus rhythm, 17.4% vs. 4.5%, p = 0.037), and had measurable vital signs (65.2% vs. 25.5%; p = 0.001). However, only 3 of 23 (13.0%) survivors had all survival predictors, and one survivor had none. Frequent predictors in survivors were field SOLs (95.7%), ED SOLs (87.0%), salvageable initial cardiac rhythms (78.3%), and obtainable vital signs (65.2%). Stabbing mechanism (30.4%) and cardiac injury location (30.4%) were least common. Had a strict policy of EDT performance based solely on the presence of survival predictors been followed and EDT withheld, several patients who ultimately survived would have died. Our study suggests that EDT is a technique that should be utilized for patients with critical penetrating injuries even in the absence of many traditional survival predictors.
journal_name
World J Surgjournal_title
World journal of surgeryauthors
Seamon MJ,Fisher CA,Gaughan JP,Kulp H,Dempsey DT,Goldberg AJdoi
10.1007/s00268-007-9392-9subject
Has Abstractpub_date
2008-04-01 00:00:00pages
604-12issue
4eissn
0364-2313issn
1432-2323journal_volume
32pub_type
杂志文章abstract：BACKGROUND:We sought to assess the status of availability of technology for trauma care in a state in India and to identify factors contributing to both adequate levels of availability and to deficiencies. We also sought to identify potential solutions to deficiencies in terms of health system management and product de...
journal_title：World journal of surgery
pub_type： 杂志文章
doi：10.1007/s00268-014-2805-7
更新日期：2015-02-01 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：:A new endoprosthesis designed for surgical intubation of neoplastic strictures of the proximal biliary tract has been developed. The technical aspects of intubation by this endoprosthesis are discussed, and the results in the first 25 patients are given. The results suggest that this device was well tolerated. Mortali...
journal_title：World journal of surgery
pub_type： 杂志文章
doi：10.1007/BF01671165
更新日期：1989-01-01 00:00:00
abstract：:The first laparoscopic Nissen fundoplication was performed 20 years ago. Surgical management of gastroesophageal reflux disease (GERD) should be offered only to appropriately studied and selected patients, with the ultimate aim of improving the well-being of the individual, the "quality of life." The choice of fundopl...
journal_title：World journal of surgery
pub_type： 杂志文章,评审
doi：10.1007/s00268-011-1050-6
更新日期：2011-07-01 00:00:00
abstract：BACKGROUND:In the past decade, Enhanced Recovery after Surgery (ERAS) protocols have been implemented in several fields of surgery. With these protocols, a faster recovery and shorter hospital stay can be accomplished without an increase in morbidity or mortality. The purpose of this study was to review systematically ...
journal_title：World journal of surgery
pub_type： 杂志文章,meta分析,评审
doi：10.1007/s00268-013-2044-3
更新日期：2013-08-01 00:00:00
abstract：:A marked change toward a more conservative approach in the treatment of abdominal trauma has been noted, especially during the last decade. This change in regimen was first seen in the handling of splenic trauma, initiated by pediatric surgeons. Later, the concept of conservative management was also introduced among a...
journal_title：World journal of surgery
pub_type： 杂志文章,评审
doi：10.1007/BF01658672
更新日期：1990-07-01 00:00:00
abstract：BACKGROUND:Patients with stage II colorectal cancer (CRC) have a higher risk of recurrence when they have certain risk factors, including clinical and pathological patterns. However, as the prognostic role of molecular patterns for stage II disease is still unclear, this study aimed to investigate it. METHODS:A total ...
journal_title：World journal of surgery
pub_type： 杂志文章
doi：10.1007/s00268-019-05158-w
更新日期：2019-12-01 00:00:00
abstract：BACKGROUND:Laparoscopic cholecystectomy (LC) is the most performed minimal invasive surgical procedure and has a relatively high complication rate. As complications are often revealed postoperatively, clear, accurate, and timely written operative notes are important in order to recall the procedure and start follow-up ...
journal_title：World journal of surgery
pub_type： 杂志文章,多中心研究
doi：10.1007/s00268-010-0422-7
更新日期：2010-05-01 00:00:00
abstract：:Ambulatory laparoscopic cholecystectomy is an established practice in our institution, with an experience of more than 800 cases. The present study is conducted to evaluate the contemporary outcomes of day-case laparoscopic cholecystectomy in the setting of a major teaching hospital. A retrospective analysis of 200 pa...
journal_title：World journal of surgery
pub_type： 杂志文章
doi：10.1007/s00268-002-6264-1
更新日期：2002-09-01 00:00:00
abstract：:Reported incidence rates of carcinoma in patients with achalasia and the prevalence of achalasia in patients with esophageal cancer vary widely in the literature. The prognosis of an "achalasia-carcinoma" is generally considered poor, although systematic studies assessing the incidence, prevalence, and prognosis of pa...
journal_title：World journal of surgery
pub_type： 杂志文章
doi：10.1007/s00268-001-0026-3
更新日期：2001-06-01 00:00:00
abstract：:Worldwide, traffic deaths are 500,000 per year and growing. Four nations, China, India, Russia, and the United States of America, have reached levels of 45,000-50,000 traffic deaths per year, although the nature of the problem is quite different in fully motorized countries from what it is in motorizing countries. In ...
journal_title：World journal of surgery
pub_type： 杂志文章,评审
doi：10.1007/BF02104436
更新日期：1992-05-01 00:00:00
abstract：BACKGROUND:Total mesorectal excision (TME) and preoperative chemoradiation therapy (PCRT) for rectal cancer are used sequentially in our center. The aim of this study was to evaluate survival of patients with stage II/III rectal cancer chronologically and to determine whether therapeutic advances associated with TME an...
journal_title：World journal of surgery
pub_type： 杂志文章
doi：10.1007/s00268-013-2168-5
更新日期：2013-11-01 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：INTRODUCTION:Gastroesophageal reflux disease is common in Western societies, although the prevalence of reflux symptoms in the community is not well described. In this study we determined the prevalence of symptoms of gastroesophageal reflux and other "esophageal" symptoms, and the consumption of medication for reflux ...
journal_title：World journal of surgery
pub_type： 杂志文章
doi：10.1007/s00268-008-9780-9
更新日期：2009-01-01 00:00:00
abstract：BACKGROUND:The decision to proceed to simple underwater seal drainage or apply active suction to the underwater seal after lung resection is mostly based on surgeon preference. The purpose of this study was to test whether routine application of active suction is necessary after lobectomy. PATIENTS AND METHODS:This wa...
journal_title：World journal of surgery
pub_type： 杂志文章,随机对照试验
doi：10.1007/s00268-008-9741-3
更新日期：2008-11-01 00:00:00
abstract：:To clarify the clinical significance of the status of surgical margins, especially the dissected margin in the transverse direction, a clinicopathologic study was performed on 60 patients with carcinoma of the bile duct who underwent radical resection. The patients in group A (n = 28) had no cancer invasion within 5 m...
journal_title：World journal of surgery
pub_type： 杂志文章
doi：10.1007/BF00298931
更新日期：1994-09-01 00:00:00
abstract：BACKGROUND:Laparoscopic resection of posterosuperior (PS) tumors of the liver is more difficult than that of anterolateral (AL) tumors, owing to the narrow surgical field in the PS location. In this retrospective cohort study, our aim was to determine if port insertion through the intercostal space would lead to improv...
journal_title：World journal of surgery
pub_type： 杂志文章
doi：10.1007/s00268-016-3867-5
更新日期：2017-05-01 00:00:00
abstract：:Familial Mediterranean fever (FMF) also known as hereditary polyserositis, is an inherited disorder commonly found in Armenians, Turks, Arabs, Balkans, and Jews originating from North African countries. The diagnosis of FMF is based on clinical findings and family history, as no specific diagnostic test is yet availab...
journal_title：World journal of surgery
pub_type： 杂志文章
doi：10.1007/BF00348205
更新日期：1994-01-01 00:00:00
abstract：:The eponym "Graves' disease" is usually applied to the condition of immunogenic hyperthyroidism, in no small part due to the promotion and influence of the French physician Armand Trousseau who wrote in 1862, "Du Goître Exophthalmique, ou Maladie de Graves." However, the distinguished Bath physician Caleb Hillier Parr...
journal_title：World journal of surgery
pub_type： 传,历史文章,杂志文章
doi：10.1007/s00268-009-0297-7
更新日期：2010-06-01 00:00:00
abstract：BACKGROUND:Pancreaticodudenectomy (PD) is a high-risk, technically demanding operation associated with substantial perioperative morbidity and mortality. This review is intended to evaluate the perioperative outcomes of PD done in a single gastrointestinal surgery unit of a university teaching hospital. PATIENTS AND M...
journal_title：World journal of surgery
pub_type： 杂志文章
doi：10.1007/s00268-010-0589-y
更新日期：2010-08-01 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：: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, directe...
journal_title：World journal of surgery
pub_type： 杂志文章,评审
doi：10.1007/pl00012362
更新日期：1999-07-01 00:00:00
abstract：:Quality of life is an important outcome measure following surgery for ulcerative colitis. Quality of life incorporates not only the physical or functional outcome; it also considers the emotional and social well-being of patients. Quality of life may be measured using disease-specific or generic quality of life measur...
journal_title：World journal of surgery
pub_type： 杂志文章,评审
doi：10.1007/s002689900400
更新日期：1998-04-01 00:00:00
abstract：:The safe and permissible limits of hepatectomy in obstructive jaundice patients and the usefulness of preoperative portal embolization (PE) for increasing the limit for safe hepatectomy were examined. We classified 416 patients with hepatectomy performed over 9 years under the following headings: normal liver function...
journal_title：World journal of surgery
pub_type： 杂志文章
doi：10.1007/s00268-004-7128-7
更新日期：2004-05-01 00:00:00
abstract：BACKGROUND:The objectives of this study were to report the clinical and radiological characteristics and outcomes of a series of acute traumatic aortic injuries (ATAIs) with associated injury to major aortic abdominal visceral branches (MAAVBs). METHODS:From January 2000 to August 2011, 10 consecutive major blunt trau...
journal_title：World journal of surgery
pub_type： 杂志文章
doi：10.1007/s00268-012-1536-x
更新日期：2012-07-01 00:00:00
abstract：BACKGROUND:The albumin-bilirubin (ALBI) score was initially developed for assessing liver dysfunction severity and was suggested to have prognostic value in patients with hepatocellular carcinoma. We aimed to evaluate the prognostic impact of ALBI grade in patients with advanced gastric cancer (GC) after radical gastre...
journal_title：World journal of surgery
pub_type： 杂志文章
doi：10.1007/s00268-017-4234-x
更新日期：2018-03-01 00:00:00
abstract：BACKGROUND:A precise understanding of anastomotic recurrence (AR) permits efficient surveillance and treatment strategies. This study aimed to evaluate the clinicopathologic characteristics of patients with AR undergoing curative resection for colorectal cancer (CRC), compare colonic with rectal tumors and investigate ...
journal_title：World journal of surgery
pub_type： 杂志文章
doi：10.1007/s00268-016-3663-2
更新日期：2017-01-01 00:00:00
abstract：:The surgical morbidity, mortality, and effectiveness of a modified nonshunting operation that includes splenic artery division instead of splenectomy, devascularization, and esophageal transection (SAD group) were evaluated. Eighteen cirrhotic patients with varices who underwent this modified procedure were compared w...
journal_title：World journal of surgery
pub_type： 杂志文章
doi：10.1007/BF00299180
更新日期：1995-05-01 00:00:00
abstract：:Papillary thyroid carcinoma is a frequent thyroid cancer. Many factors have been reported to be of prognostic importance, but the significance of biologic factors suggesting aggressiveness and proliferating activity has not been sufficiently documented. Conventional prognostic factors such as age, extrathyroidal invas...
journal_title：World journal of surgery
pub_type： 杂志文章
doi：10.1007/s002689900551
更新日期：1998-12-01 00:00:00
abstract：:Personalized genomic medicine and surgery (PGMS) represents a new approach to health care that customizes patients' medical treatment according to their own genetic information. This new approach is the result of increased knowledge of the human genome and ways this information can be applied by physicians in the medi...
journal_title：World journal of surgery
pub_type： 杂志文章,评审
doi：10.1007/s00268-011-1056-0
更新日期：2011-08-01 00:00:00
