Abstract:
BACKGROUND:Patients with HIV/AIDS on antiretroviral therapy (ART) live longer and now require surgery for indications similar to those described for the general population. They have been previously reported to carry higher mortality and complication rates, especially septic complications. The aim of this study was to compare the outcome of major abdominal surgery in three groups of patients with different CD4 counts. METHODS:This is a prospective study comparing HIV-negative patients and two groups of HIV-infected patients on ART with different CD4 counts. The primary outcomes considered were mortality and complication rates after abdominal surgery. We emphasised on the value of CD4 as a predictor of outcome and the impact of the indication for surgery (septic versus non-septic). RESULTS:We included 63 patients (21 per group). The majority of patients (71 %) were operated on as an emergency and the indications were similar in all groups. The overall and the septic complication rates were both higher in the group with a low CD4 count. This resulted in a significantly longer admission period but did not result in a higher mortality rate. The duration of ART and the World Health Organisation stage of the disease did not significantly influence surgical outcomes. CONCLUSIONS:HIV-infected patients on ART can now safely undergo major abdominal surgery with encouraging results though still relatively poorer than those of HIV-negative subjects. CD4 count remains a significant predictor of outcome and patients with a low CD4 count, however, still require closer pre- and post-operative monitoring.
journal_name
World J Surgjournal_title
World journal of surgeryauthors
Chichom-Mefire A,Azabji-Kenfack M,Atashili Jdoi
10.1007/s00268-015-2994-8subject
Has Abstractpub_date
2015-07-01 00:00:00pages
1692-9issue
7eissn
0364-2313issn
1432-2323journal_volume
39pub_type
杂志文章abstract::The moral dilemmas faced by surgeons worldwide who treat patients infected with the human immunodeficiency virus (HIV) can be viewed against the background of experience in sub-Saharan countries, where the community prevalence is in excess of 25% (90% of hospital inpatients). When seeking consent for an HIV test befor...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/s00268-003-7101-x
更新日期:2003-08-01 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
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abstract:INTRODUCTION:Gastroesophageal reflux disease (GERD) may present with heartburn, regurgitation, dysphagia, chronic cough, laryngitis, or even asthma. The clinical presentation of GERD is therefore varied and poses certain challenges to the physician, especially given the limitations of the diagnostic testing. DISCUSSIO...
journal_title:World journal of surgery
pub_type: 杂志文章,评审
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更新日期:2017-07-01 00:00:00
abstract:INTRODUCTION:In this retrospective cohort single-institutional study, we report the outcomes of implementing a standardized protocol of multimodal pain management with thoracic epidural analgesia via the acute pain service (APS) for patients undergoing ventral hernia repair with mesh placement and abdominal wall recons...
journal_title:World journal of surgery
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更新日期:2021-01-16 00:00:00
abstract:PURPOSE:Recurrent laryngeal nerve (RLN) palsy is the major concern of reoperative thyroid surgery, and the introduction of neuromonitoring could reduce the rate of this complication. The present study is a retrospective analysis of the experience with completion thyroidectomy with and without neuromonitoring in a refer...
journal_title:World journal of surgery
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更新日期:2012-06-01 00:00:00
abstract::Noninvasive diagnosis of cavernous hemangioma of the liver is an important step in the investigation of patients with focal hepatic lesions since biopsy may result in life-threatening hemorrhage. To determine the diagnostic accuracy of 99m-technetium red blood cell (99mTc-RBC) imaging with tomography, 50 patients with...
journal_title:World journal of surgery
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更新日期:1990-07-01 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 goal of the present study was to evaluate the effects of preoperative oral carbohydrate supplementation (OCH) on the postoperative metabolic stress response of patients undergoing elective abdominal surgery. METHODS:The study was designed as a controlled, prospective, cohort study including 38 patients ...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/s00268-012-1590-4
更新日期:2012-08-01 00:00:00
abstract::This paper describes a model humanitarian mission to Guyana; it illustrates the value of excellent ongoing care in collaboration with local physicians and surgeons, cooperation with local government and medical officials, and frequent periodic follow-up missions (always to the same hospital, working with the same staf...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/s00268-015-3049-x
更新日期:2015-08-01 00:00:00
abstract:BACKGROUND:Surgical care is critical to establish effective healthcare systems in low- and middle-income countries, yet the unmet need for surgical conditions is as high as 65% in Ugandan children. Financial burden and geographical distance are common barriers to help-seeking in adult populations and are unmeasured in ...
journal_title:World journal of surgery
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更新日期:2018-11-01 00:00:00
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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::Although pancreatectomy is still performed in a few patients with pancreatic cancer, and nearly all patients who develop pancreatic cancer eventually die of their disease, significant improvements have been made recently. Pancreatectomy is now safer, with major morbidity (hemorrhage, pancreatic anastomotic leak, intra...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/s002689900599
更新日期:1999-09-01 00:00:00
abstract::Although widely practiced, laparoscopic appendectomy (LA) has not met with universal approval. Several controlled trials have been conducted, some in favor, others not. The goal of this review was to ascertain (1) if laparoscopy was capable of improving the diagnostic and therapeutic difficulties encountered during op...
journal_title:World journal of surgery
pub_type: 杂志文章,评审
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更新日期:1999-08-01 00:00:00
abstract:BACKGROUND:The prognosis of advanced hepatocellular carcinoma (HCC) remains poor, particularly in patients with tumor thrombi (TT) in the major vessels. PATIENTS AND METHODS:From July 1992 to October 2004, 161 patients diagnosed as having advanced HCC with major vascular involvement were seen consecutively at our hosp...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/s00268-005-0250-3
更新日期:2006-03-01 00:00:00
abstract:BACKGROUND:The only potential cure for neuroendocrine tumors (NETs) is operative resection, which may also offer a survival benefit for advanced disease. We aimed to assess the role of 68Ga-DOTATATE PET/CT in preoperative planning and compared its performance to CT with IV contrast and MRI with Eovist®, for abdominal N...
journal_title:World journal of surgery
pub_type: 杂志文章
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更新日期:2020-02-01 00:00:00
abstract::To characterize hepatocellular carcinoma (HCC) cells with mutant (m) p53 protein histologically, we examined 68 main nodules and 20 accessory lesions of 72 patients with HCC who underwent hepatic resection between October 1990 and September 1993. Some sections were fixed in periodate-lysine-paraformaldehyde, embedded ...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/s002689900033
更新日期:1996-02-01 00:00:00
abstract:INTRODUCTION:Recently, more aggressive variants of so-called well-differentiated thyroid carcinomas have been identified such as the tall cell variant, columnar cell variant, diffuse sclerosing variant, insular carcinoma, and Hürthle cell (oncocytic, oxyphilic) carcinomas. METHODS:An evidence-based review was performe...
journal_title:World journal of surgery
pub_type: 杂志文章,评审
doi:10.1007/s00268-006-0837-3
更新日期:2007-05-01 00:00:00
abstract:BACKGROUND:The objective of this study was to determine whether rat insulin promoter (RIP) could, in a mouse model, direct expression of an adenovirus-mediated reporter gene specifically into pancreatic islets via systemic delivery. METHODS:Five hundred and eight base pairs of the RIP DNA sequence were constructed int...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/s00268-005-0688-3
更新日期:2006-08-01 00:00:00
abstract:BACKGROUND:Intraoperative parathyroid hormone assay (IOPTH) has been suggested to have value in predicting the development of postoperative hypoparathyroidism after thyroid surgery. IOPTH has been validated in identification of patients at risk of postoperative hypocalcemia requiring early onset of calcium supplementat...
journal_title:World journal of surgery
pub_type: 杂志文章,随机对照试验
doi:10.1007/s00268-007-9405-8
更新日期:2008-05-01 00:00:00
abstract::There are three basic roles of laparoscopic surgery for patients with colorectal cancer. First, although infrequently needed prior to therapy, diagnostic or staging laparoscopy may be valuable in certain colorectal cancer patients. Second, the laparoscopic approach may offer several attractive features for the palliat...
journal_title:World journal of surgery
pub_type: 杂志文章,评审
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更新日期:1997-09-01 00:00:00
abstract::Aerodigestive tract injuries in the neck are found in about 7% of penetrating neck injuries and are very rare in blunt trauma. A combination of a good physical examination with endoscopy and esophagography can reliably diagnose all significant injuries. Airway control in laryngotracheal trauma is the most urgent prior...
journal_title:World journal of surgery
pub_type: 杂志文章,评审
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更新日期:2001-08-01 00:00:00
abstract:BACKGROUND:Distal splenorenal shunt and coronary caval shunt are commonly used for selective decompression of esophagogastric varices, but they may not solve severe hypersplenism and their application may be hampered by the presence of splenic venous thrombosis or a left gastric vein (LGV) situated deeply behind the pa...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/s00268-018-4796-2
更新日期:2019-02-01 00:00:00
abstract:BACKGROUND:The objective of the cross-sectional study reported here was to compare the quality of life of patients with an appropriate stoma site and with that of patients with an inappropriate stoma site. MATERIALS AND METHODS:Two groups of patients with permanent intestinal stomas were assessed, 174 patients with ap...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/s00268-009-0275-0
更新日期:2010-01-01 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::Transsphenoidal pituitary surgery has radically modified the management of pituitary-dependent hypercortisolism (Cushing's disease). Bilateral adrenalectomy may, however, represent the ultimate treatment in some cases of hypercortisolism. In the present study we report our experience of bilateral adrenalectomy in 82 p...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/s002689900118
更新日期:1996-09-01 00:00:00
abstract::Precise localization of cervical node metastasis of papillary thyroid carcinoma is rarely described. The aim of this retrospective study was to map their cervical involvement. Between 1974 and 1996 a series of 119 patients had total thyroidectomy with bilateral cervical lymph node dissection. Patients who had secondar...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/s002689900609
更新日期:1999-09-01 00:00:00
abstract::Despite a slow decline in the incidence of gastric cancer over the last 90 years, we can still expect to see over 100,000 patients die of this disease each decade in England and Wales. The 5-year survival rate has not improved during this century, which is largely due to the stage at diagnosis being unchanged. There a...
journal_title:World journal of surgery
pub_type: 杂志文章,评审
doi:10.1007/BF00294709
更新日期:1995-07-01 00:00:00
abstract:BACKGROUND:Complications are important indicators of immediate postoperative outcomes. The Clavien-Dindo classification (CDC) is a widely used index for the classification of surgical complications. More recently, the comprehensive complication index (CCI) has also been introduced for classifying postoperative complica...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/s00268-020-05859-7
更新日期:2021-03-01 00:00:00
abstract:INTRODUCTION:An increasing body of evidence is being published about single-incision laparoscopic cholecystectomy (SILC), but there are no well-powered trials with an adequate evaluation of post-operative pain. This randomized trial compares SILC against four-port laparoscopic cholecystectomy (LC) with post-operative p...
journal_title:World journal of surgery
pub_type: 杂志文章,随机对照试验
doi:10.1007/s00268-014-2903-6
更新日期:2015-04-01 00:00:00
abstract:BACKGROUND:Closure of loop ileostomy can be safely performed using sutures or staplers. The aim of the present study was to compare the cost effectiveness of three different techniques. METHODS:A total of 128 consecutive patients who underwent closure of loop ileostomy between January 2002 and December 2008 were analy...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/s00268-010-0787-7
更新日期:2010-12-01 00:00:00