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 complementary investigations and management. PATIENTS AND METHODS:A prospective observational study was conducted in a South African tertiary urban trauma center with a high prevalence of penetrating trauma. All consecutive patients admitted with penetrating neck injuries over a 13-month period were included. RESULTS:A total of 203 patients were included in the study: 159 with stab wounds and 42 with gunshot wounds. A vascular injury was identified in 27 (13.3%) patients, pharyngoesophageal injury in 18 (8.9%) patients, and an upper airway injury in 8 (3.9%) patients. Only 25 (12.3%) patients required surgical intervention. A further 8 (3.9%) patients had therapeutic endovascular procedures. The remaining 158 (77.8%) patients, either asymptomatic or with negative work-up, were managed expectantly. There were no clinically relevant missed injuries. CONCLUSIONS:Selective nonoperative management of neck injuries based on clinical examination and selective use of adjunctive investigational studies is safe in a high-volume trauma center.
journal_name
World J Surgjournal_title
World journal of surgeryauthors
Thoma M,Navsaria PH,Edu S,Nicol AJdoi
10.1007/s00268-008-9766-7subject
Has Abstractpub_date
2008-12-01 00:00:00pages
2716-23issue
12eissn
0364-2313issn
1432-2323journal_volume
32pub_type
杂志文章abstract：BACKGROUND:Small bowel obstruction (SBO) is characterized by a high rate of recurrence. In the present study, we aimed to compare the outcomes of patients managed either by conservative treatment or surgical operation for an episode of SBO. METHODS:The outcomes of all patients hospitalized at a single center for acute...
journal_title：World journal of surgery
pub_type： 杂志文章
doi：10.1007/s00268-014-2733-6
更新日期：2014-12-01 00:00:00
abstract：:Thyrotoxicosis is the clinical syndrome that results when tissues are exposed to high levels of circulating thyroid hormones. In most instances thyrotoxicosis is due to hyperthyroidism, a term reserved for disorders characterized by overproduction of thyroid hormones by the thyroid gland. Nevertheless, thyrotoxicosis ...
journal_title：World journal of surgery
pub_type： 杂志文章,评审
doi：10.1007/s002680010228
更新日期：2000-11-01 00:00:00
abstract：:Trends are changing in the management of infants and children with indirect inguinal hernias. Advances in neonatal intensive care have resulted in the survival of many small premature infants who have a high incidence of inguinal hernia. The rate of incarceration, strangulation, and gonadal infarction in these babies ...
journal_title：World journal of surgery
pub_type： 杂志文章,评审
doi：10.1007/BF01658863
更新日期：1989-09-01 00:00:00
abstract：BACKGROUND:Sentinel lymph node biopsy (SLNB) plays an essential role in the evaluation of lymph node (LN) metastasis status and the extent of LN dissection in gastric cancer. The aim of our study was to perform a systematic review and meta-analysis for corresponding identification rate and sensitivity of different SLNB...
journal_title：World journal of surgery
pub_type： 杂志文章,评审
doi：10.1007/s00268-020-05900-9
更新日期：2021-01-03 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：BACKGROUND:It is generally believed that the accompanying conditions in patients with inflammatory bowel disease (IBD) are associated with a high incidence of surgical site infection (SSI), and sometimes these patients are classified as compromised hosts without definitive clinical evidence. The aim of this study was t...
journal_title：World journal of surgery
pub_type： 杂志文章
doi：10.1007/s00268-009-9934-4
更新日期：2009-05-01 00:00:00
abstract：BACKGROUND:Primary hyperparathyroidism (PHPT) is a common endocrine disorder that predominantly affects patients >60 and is increasing in prevalence. Identifying risk factors for poor outcomes after parathyroidectomy in older adults will help tailor operative decision making. The impact of frailty on surgical outcomes ...
journal_title：World journal of surgery
pub_type： 杂志文章
doi：10.1007/s00268-018-4629-3
更新日期：2018-10-01 00:00:00
abstract：BACKGROUND:Human factors research has suggested benefits of consistent teams yet no surgical team consistency measures have been established for teamwork improvement initiatives. METHODS:Retrospective analysis was conducted of teams performing consecutive elective procedures of unilateral primary total knee and hip re...
journal_title：World journal of surgery
pub_type： 杂志文章
doi：10.1007/s00268-014-2866-7
更新日期：2015-04-01 00:00:00
abstract：BACKGROUND:Strictures at the pharyngoesophageal junction represent a subgroup of corrosive esophageal strictures requiring a specialized management approach. Non-dilatable cricopharyngeal strictures need surgical intervention. We report the use of the sternocleidomastoid muscle myocutaneous inlay flap (SCMMIF) for reco...
journal_title：World journal of surgery
pub_type： 杂志文章
doi：10.1007/s00268-007-9120-5
更新日期：2007-08-01 00:00:00
abstract：:The development of laparoscopic surgery has provided minimally invasive surgeons with advanced laparoscopic instrumentation and high definition imaging. The resulting surgical expertise and technology has now been extended to gastric endoluminal surgery. Laboratory and clinical investigations have been initiated for v...
journal_title：World journal of surgery
pub_type： 杂志文章,评审
doi：10.1007/pl00012311
更新日期：1999-04-01 00:00:00
abstract：:This paper reviews aspects of head injury management and research in the United Kingdom (UK). We discuss evidence about the scale and etiology of head injury in Britain and how this information has supported a triage-based approach, incorporating risk analysis. A Cohesive organization based upon nationally accepted, y...
journal_title：World journal of surgery
pub_type： 杂志文章,评审
doi：10.1007/s00268-001-0084-6
更新日期：2001-09-01 00:00:00
abstract：:Patients with early-stage non-small-cell lung cancer (NSCLC) should be treated with complete surgical resection whenever possible. Incomplete resections do not cure, and the optimal pulmonary resection is anatomic lobectomy. Limited resections (wedge resection and segmentectomy) are associated with a threefold increas...
journal_title：World journal of surgery
pub_type： 杂志文章,评审
doi：10.1007/s002680020017
更新日期：2001-02-01 00:00:00
abstract：BACKGROUND:The present study was designed to evaluate the relationship between preoperative Toll-like receptor (TLR) expression in peripheral blood monocytes (PBMC) and the postoperative inflammatory cytokine secretion from PBMC, as well as the postoperative infectious complications in patients with gastrointestinal ca...
journal_title：World journal of surgery
pub_type： 杂志文章
doi：10.1007/s00268-010-0839-z
更新日期：2011-02-01 00:00:00
abstract：BACKGROUND:Stapled anopexia was introduced as a surgical method in 1993. Long-term data with special interest in functional results and relapse symptoms are rarely presented. Urinary discomfort and problems with fecal urge incontinence are addressed as severe side effects. We present our long-term results (using data f...
journal_title：World journal of surgery
pub_type： 杂志文章
doi：10.1007/s00268-008-9818-z
更新日期：2009-02-01 00:00:00
abstract：BACKGROUND:In gastric cancer, the recurrence rate is high even after curative surgery. A relevant issue is the identification of independent prognostic factors to select high-risk patients; such features can be used as predictive factors for tailored therapies. In this study we have investigated the role of epidermal g...
journal_title：World journal of surgery
pub_type： 杂志文章
doi：10.1007/s00268-007-9016-4
更新日期：2007-07-01 00:00:00
abstract：:Previous analysis of this prospective randomized trial and meta-analysis of published randomized trials of adjuvant intraperitoneal chemotherapy demonstrated improved survival in patients with advanced gastric cancer. Simple criteria applicable at the time of surgery for patient selection were sought in this analysis....
journal_title：World journal of surgery
pub_type： 临床试验,杂志文章,随机对照试验
doi：10.1007/s00268-001-0067-7
更新日期：2001-08-01 00:00:00
abstract：BACKGROUND:Team familiarity has been shown to be important for operative efficiency and number of complications, but it is unclear for which types of operations and for which team members familiarity matters the most. The objective of this study is to further our understanding of familiarity in the OR by quantifying th...
journal_title：World journal of surgery
pub_type： 杂志文章
doi：10.1007/s00268-020-05657-1
更新日期：2020-11-01 00:00:00
abstract：BACKGROUND:The recent development and spread of ultrasonography and ultrasonography-guided fine needle aspiration biopsy (FNAB) has facilitated the detection of small papillary microcarcinomas of the thyroid measuring 1 cm or less (PMC). The marked difference in prevalence between clinical thyroid carcinoma and PMC det...
journal_title：World journal of surgery
pub_type： 杂志文章
doi：10.1007/s00268-009-0303-0
更新日期：2010-01-01 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：:The loss or failure of an organ or tissue is one of the most frequent, devastating, and costly problems in healthcare. Current treatment modalities include transplantation of organs, surgical reconstruction, use of mechanical devices, or supplementation of metabolic products. A new field, tissue engineering, applies t...
journal_title：World journal of surgery
pub_type： 杂志文章,评审
doi：10.1007/s00268-001-0131-3
更新日期：2001-11-01 00:00:00
abstract：BACKGROUND:Few details of the clinical features of hepatocellular carcinoma (HCC) developing extrahepatic recurrence after a curative resection have been published. The purpose of this study was to clarify the clinicopathologic findings of patients with HCC who experienced extrahepatic metastases. METHODS:Clinicopatho...
journal_title：World journal of surgery
pub_type： 杂志文章
doi：10.1007/s00268-008-9613-x
更新日期：2008-08-01 00:00:00
abstract：BACKGROUND:The incidence of thyroid cancer is increasing globally. This is mainly due to the increase in the detection of small papillary carcinomas, including papillary microcarcinomas (PMC) 1 cm or smaller. It was suggested recently that PMCs are overdiagnosed and overtreated. METHODS:In 1993, the author proposed a ...
journal_title：World journal of surgery
pub_type： 杂志文章
doi：10.1007/s00268-015-3392-y
更新日期：2016-03-01 00:00:00
abstract：BACKGROUND:Parathyroid glands can mimic thyroid follicular lesions on fine-needle aspiration (FNA) cytology and can lead to unnecessary or incorrect surgery. Newer molecular panel tests using next-generation sequencing (NGS) include analysis of cell type-specific gene expression profiles such as parathyroid. The study ...
journal_title：World journal of surgery
pub_type： 杂志文章
doi：10.1007/s00268-018-4548-3
更新日期：2018-09-01 00:00:00
abstract：BACKGROUND:Low-risk papillary thyroid carcinoma is commonly treated surgically. However, uncertainties exist in regard to the optimal extent of surgery. We approached this question using a decision-analysis model. METHODS:A Markov model was used to compare outcome between patients with small (1-2 cm) low-risk PTC trea...
journal_title：World journal of surgery
pub_type： 杂志文章
doi：10.1007/s00268-015-3167-5
更新日期：2015-11-01 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：:Percutaneous dilatational tracheostomy (PDT) is being increasingly used. Concerns have been raised as to its safety, especially when it is done at the bedside. A prospective evaluation was conducted of 100 consecutive, unselected critically ill patients with PDT. The mean intensive care unit (ICU) stay before PDT was ...
journal_title：World journal of surgery
pub_type： 杂志文章
doi：10.1007/s002680010180
更新日期：2000-09-01 00:00:00
abstract：:Left untreated, aneurysmal disease of the abdominal aorta is a highly lethal condition. Standard transabdominal repair of aortic aneurysm, although successful and durable, continues to be plagued by significant morbidity, mortality, and cost. Placement of an endovascular graft through a femoral arteriotomy is a new te...
journal_title：World journal of surgery
pub_type： 杂志文章,评审
doi：10.1007/s002689900101
更新日期：1996-07-01 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：BACKGROUND:Treatment of peripherally located liver tumors with diaphragmatic invasion is technically demanding but does not preclude resection for cure. The aim of the present study was to compare patients undergoing combined liver and diaphragmatic resection with those submitted to hepatectomy alone so as to evaluate ...
journal_title：World journal of surgery
pub_type： 杂志文章
doi：10.1007/s00268-013-2083-9
更新日期：2013-09-01 00:00:00
abstract：INTRODUCTION:Urogenital dysfunction is a well recognized complication of rectal cancer surgery. The aim of this study was to assess the impact of autonomic nerve preservation (ANP) and lateral node dissection (LND) on male urogenital function after total mesorectal excision for lower rectal cancer. METHODS:We studied,...
journal_title：World journal of surgery
pub_type： 杂志文章
doi：10.1007/s00268-005-0050-9
更新日期：2006-06-01 00:00:00
