Abstract：
BACKGROUND:The anatomic difficulties that we have to deal with in open surgery for rectal cancer have not been overcome with the laparoscopic approach. In the search for a solution, a change of concept arose: approaching the rectum from below. The main objectives of this study were to show the potential advantages of the hybrid transabdominal-transanal total mesorectal excision (taTME). This approach may improve quality of the mesorectal specimens. Second, proctectomy can be technically easier and more safely performed "down to up," which would result in shorter surgical times, lower conversion rates, and less morbidity. STUDY DESIGN:A prospective series of hybrid taTME was conducted from October 2011 to November 2014. RESULTS:During the study period, 140 procedures were performed. Mean operative time was 166 minutes. There were no conversions or intraoperative complications. Macroscopic quality assessment of the resected specimen was complete in 97.1% and nearly complete in 2.1%. Thirty-day morbidity was minor (Clavien-Dindo I + II) in 24.2% and major (Clavien-Dindo III + IV) in 10 %. No patient died within the first 30 days postsurgery (Clavien-Dindo V). The mean follow-up was 15 months, with a 2.3% local recurrence rate and a 7.6% rate of systemic recurrence. CONCLUSIONS:Pathologic analysis showed a very good macroscopic quality of TME specimens, which is the most important prognostic factor in rectal cancer. Intraoperative outcomes regarding conversion, surgical times, and intraoperative complications are very satisfactory. Short-term morbidity and oncologic outcomes are as good as in other laparoscopic TME series.
journal_name
J Am Coll Surgjournal_title
Journal of the American College of Surgeonsauthors
Lacy AM,Tasende MM,Delgado S,Fernandez-Hevia M,Jimenez M,De Lacy B,Castells A,Bravo R,Wexner SD,Heald RJdoi
10.1016/j.jamcollsurg.2015.03.046subject
Has Abstractpub_date
2015-08-01 00:00:00pages
415-23issue
2eissn
1072-7515issn
1879-1190pii
S1072-7515(15)00251-3journal_volume
221pub_type
临床试验,杂志文章abstract：BACKGROUND:Direct communication between an aortic prosthesis and the gastrointestinal (GI) tract may present with GI bleeding (aortoenteric fistulas [AEF]) or be incidental to a graft infection (paraprosthetic erosions [PPE]). The purposes of this study were to compare the outcomes of AEF versus PPE and to determine pr...
journal_title：Journal of the American College of Surgeons
pub_type： 杂志文章
doi：10.1016/j.jamcollsurg.2008.08.010
更新日期：2008-12-01 00:00:00
abstract：BACKGROUND:To gain additional insight into the impact of fatigue on surgery resident proficiency, we set out to quantify its impact on behavioral and neurophysiologic measures. STUDY DESIGN:Simulations were first created using a visio-haptic joystick attached to a surgical instrument (tool) that allows realistic inter...
journal_title：Journal of the American College of Surgeons
pub_type： 杂志文章
doi：10.1016/j.jamcollsurg.2011.03.028
更新日期：2011-07-01 00:00:00
abstract：BACKGROUND:In order to understand how current surgical residents feel about their training, a survey focused on perceptions regarding early entry into a subspecialty and the adequacy of training was sent to selected residency programs in general surgery (GS). STUDY DESIGN:A 36-item online anonymous survey was sent to ...
journal_title：Journal of the American College of Surgeons
pub_type： 杂志文章
doi：10.1016/j.jamcollsurg.2012.12.045
更新日期：2013-04-01 00:00:00
abstract：BACKGROUND:Few graduating residents seek surgical critical care (SCC) fellowships; fewer than half of positions fill. We hypothesized substantial differences exist in practice patterns and attitudes between SCC surgeons in academic practice (ACs) and in private practice (PVTs). STUDY DESIGN:A survey instrument was sen...
journal_title：Journal of the American College of Surgeons
pub_type： 杂志文章
doi：10.1016/j.jamcollsurg.2007.10.004
更新日期：2008-03-01 00:00:00
abstract：BACKGROUND:Liver resection is standard therapy for selected patients with metastatic colorectal cancer. Extrahepatic metastases and inability to remove all hepatic disease usually preclude curative resection and are the most common contraindications. This study analyzes irresectability in patients considered to have re...
journal_title：Journal of the American College of Surgeons
pub_type： 杂志文章
doi：10.1016/s1072-7515(98)00272-5
更新日期：1999-01-01 00:00:00
abstract：BACKGROUND:The technique of total mesorectal excision (TME) increases the risk of anastomotic leakage. The impact of postoperative morbidity of TME on longterm survival has never been described. We retrospectively analyzed factors that might influence survival after TME for rectal cancer, including postoperative morbid...
journal_title：Journal of the American College of Surgeons
pub_type： 杂志文章
doi：10.1016/j.jamcollsurg.2006.07.021
更新日期：2006-11-01 00:00:00
abstract：BACKGROUND:The majority of newly diagnosed breast cancers in the US are in women aged older than 65 years who can have additional comorbidities. Balancing the risks and benefits of treatment should take into account these competing risks of death. STUDY DESIGN:The Surveillance, Epidemiology, and End Results Program-Me...
journal_title：Journal of the American College of Surgeons
pub_type： 杂志文章,多中心研究
doi：10.1016/j.jamcollsurg.2019.03.013
更新日期：2019-07-01 00:00:00
abstract：BACKGROUND:Thyroid surgery is performed using general anesthesia by the majority of surgeons in current practice. This study was conducted to analyze the utility and safety of local anesthesia for thyroid surgery. STUDY DESIGN:Prospective data were collected for 1,025 consecutive patients undergoing thyroidectomy usin...
journal_title：Journal of the American College of Surgeons
pub_type： 杂志文章
doi：10.1016/j.jamcollsurg.2005.04.034
更新日期：2005-09-01 00:00:00
abstract：BACKGROUND:Simulation-based training can improve technical and nontechnical skills in surgery. To date, there is no consensus on the principles for design, validation, and implementation of a simulation-based surgical training curriculum. The aim of this study was to define such principles and formulate them into an in...
journal_title：Journal of the American College of Surgeons
pub_type： 共识发展会议,杂志文章
doi：10.1016/j.jamcollsurg.2012.05.035
更新日期：2012-10-01 00:00:00
abstract：BACKGROUND:There is great interest in efficiently evaluating health care quality, but there is controversy over the use of administrative versus clinical data methods. We sought to compare actual mortality with risk-adjusted expected mortality in a sample population calculated by two different methods; one based on pre...
journal_title：Journal of the American College of Surgeons
pub_type： 杂志文章
doi：10.1016/j.jamcollsurg.2007.08.013
更新日期：2007-12-01 00:00:00
abstract：:In several recent conferences, the principal questions have been whether xenotransplantation technology should be encouraged and, if so, how it should be regulated. Because the prospect of successful transplantation of animal organs into humans is still remote, the rush to achieve consensus about clinical application ...
journal_title：Journal of the American College of Surgeons
pub_type： 杂志文章
doi：10.1016/s1072-7515(98)00053-2
更新日期：1998-04-01 00:00:00
abstract：BACKGROUND:Ovarian hyperstimulation syndrome (OHSS) is one of the most serious complications of ovulation induction by exogenous gonadotropins. The pathophysiologic factors of this syndrome are not well known. Increased capillary permeability causes third space fluid shift, which is responsible for ascites, pleural flu...
journal_title：Journal of the American College of Surgeons
pub_type： 杂志文章
doi：
更新日期：1994-07-01 00:00:00
abstract：BACKGROUND:Shared decision making requires informing patients and ensuring that treatment decisions reflect their goals. It is not clear to what extent this happens for patients considering total joint replacement (TJR) for hip or knee osteoarthritis. STUDY DESIGN:We conducted a cross-sectional mail survey of osteoart...
journal_title：Journal of the American College of Surgeons
pub_type： 杂志文章
doi：10.1016/j.jamcollsurg.2013.06.002
更新日期：2013-10-01 00:00:00
abstract：BACKGROUND:The American College of Surgeons maintains that surgical care in the US has not reached optimal safety and quality. This can be driven partially by higher-risk, emergency operations in geriatric patients. We therefore sought to answer 2 questions: First, to what degree does standardized postoperative mortali...
journal_title：Journal of the American College of Surgeons
pub_type： 杂志文章
doi：10.1016/j.jamcollsurg.2019.10.018
更新日期：2020-06-01 00:00:00
abstract：:The novel coronavirus (COVID-19) was first diagnosed in Wuhan, China in December 2019 and has now spread throughout the world, being verified by the World Health Organization as a pandemic on March 11. This had led to the calling of a national emergency on March 13 in the US. Many hospitals, healthcare networks, and s...
journal_title：Journal of the American College of Surgeons
pub_type： 杂志文章
doi：10.1016/j.jamcollsurg.2020.03.019
更新日期：2020-06-01 00:00:00
abstract：BACKGROUND:E75 is an immunogenic peptide from the HER2/neu protein that is expressed in prostate cancer. High-risk prostate cancer (HRPC) patients demonstrating varying levels of HER2/neu expression were vaccinated with E75 peptide plus granulocyte-macrophage colony-stimulating factor to prevent postprostatectomy PSA a...
journal_title：Journal of the American College of Surgeons
pub_type： 杂志文章
doi：10.1016/j.jamcollsurg.2008.10.018
更新日期：2009-02-01 00:00:00
abstract：BACKGROUND:Although a risk score estimating postoperative mortality for patients undergoing gastric bypass exists, there is none predicting postoperative morbidity. Our objective was to develop a validated risk calculator for 30-day postoperative morbidity of bariatric surgery patients. STUDY DESIGN:We used the Americ...
journal_title：Journal of the American College of Surgeons
pub_type： 杂志文章
doi：10.1016/j.jamcollsurg.2010.11.003
更新日期：2011-03-01 00:00:00
abstract：BACKGROUND:The goals of quality improvement are to partner with patients and loved ones to end preventable harm, continuously improve patient outcomes and experience, and eliminate waste, yet few programs have successfully worked on of all these in concert. STUDY DESIGN:We evaluated implementation of a pathway designe...
journal_title：Journal of the American College of Surgeons
pub_type： 杂志文章
doi：10.1016/j.jamcollsurg.2015.05.008
更新日期：2015-09-01 00:00:00
abstract：BACKGROUND:The American College of Surgeons National Surgical Quality Improvement Program (ACS NSQIP) has become an important surgical quality program in the United States, yet few studies describe their methods for handling missing data. Our study examines the impact of missing data on predictive models for short-term...
journal_title：Journal of the American College of Surgeons
pub_type： 杂志文章
doi：10.1016/j.jamcollsurg.2011.05.010
更新日期：2011-09-01 00:00:00
abstract：BACKGROUND:The criteria for organ acceptance remain inconsistent, which limits the ability to standardize critical care practices. We sought to examine predictors of liver graft use and survival to better guide the selection and management of potential organ donors. STUDY DESIGN:A prospective observational study of al...
journal_title：Journal of the American College of Surgeons
pub_type： 杂志文章,多中心研究
doi：10.1016/j.jamcollsurg.2014.09.020
更新日期：2015-01-01 00:00:00
abstract：UNLABELLED:Some of the concepts contained here have been discussed and incorporated in another publication, but the data are entirely unique to this manuscript. (See: Transforming the Surgical "Time-Out" Into a Comprehensive "Preparatory Pause." Backster A, Teo A, Swift M, MD, Polk HC Jr, MD, FACS, Harken AH, MD, FACS....
journal_title：Journal of the American College of Surgeons
pub_type： 杂志文章
doi：10.1016/j.jamcollsurg.2007.01.009
更新日期：2007-04-01 00:00:00
abstract：BACKGROUND:The mortality rate of bleeding esophageal varices in cirrhosis is highest during the period of acute bleeding. This is a report of a randomized trial that compared endoscopic sclerotherapy (EST) with emergency portacaval shunt (EPCS) in cirrhotic patients with acute variceal hemorrhage. STUDY DESIGN:A total...
journal_title：Journal of the American College of Surgeons
pub_type： 杂志文章,随机对照试验
doi：10.1016/j.jamcollsurg.2009.02.059
更新日期：2009-07-01 00:00:00
abstract：BACKGROUND:Vulvar melanoma is a very rare form of cancer. The purpose of this study was to describe practice patterns for the management of vulvar melanoma. STUDY DESIGN:The National Cancer Data Base was reviewed from 1985 through 1994 for patient reports submitted with a diagnosis of vulvar melanoma. RESULTS:Five hu...
journal_title：Journal of the American College of Surgeons
pub_type： 杂志文章
doi：10.1016/s1072-7515(99)00033-2
更新日期：1999-06-01 00:00:00
abstract：BACKGROUND:Day case surgery (DCS) for uncomplicated acute appendicitis (NCAA) is evaluated. The objective of this prospective, single-center, descriptive, nonrandomized, intention-to-treat cohort study was to assess the feasibility of DCS for NCAA with a critical analysis of the reasons for exclusion and treatment fail...
journal_title：Journal of the American College of Surgeons
pub_type： 临床试验,杂志文章
doi：10.1016/j.jamcollsurg.2016.08.004
更新日期：2016-11-01 00:00:00
abstract：BACKGROUND:Use of Enhanced Recovery After Surgery (ERAS) pathways have evidenced improved outcomes in several surgical specialties. The effectiveness of ERAS pathways specific to hernia surgery, however, has not yet been investigated. We hypothesized that our ERAS pathway would accelerate functional recovery and shorte...
journal_title：Journal of the American College of Surgeons
pub_type： 杂志文章
doi：10.1016/j.jamcollsurg.2016.02.015
更新日期：2016-06-01 00:00:00
abstract：BACKGROUND:Head injury is an increasing contributor to death and disability, particularly among the elderly. Older patients are less likely to be treated at trauma centers, and head injury is the most common severe injury treated at non-trauma centers. We hypothesized that patients initially triaged to trauma centers w...
journal_title：Journal of the American College of Surgeons
pub_type： 杂志文章,多中心研究
doi：10.1016/j.jamcollsurg.2018.01.055
更新日期：2018-05-01 00:00:00
abstract：BACKGROUND:Hospital readmission is a significant contributor to increasing health care use related to caring for older trauma patients. This study was undertaken with the following aims: determine the proportion of older adult trauma patients who experience unplanned readmission, as well as risk factors for these readm...
journal_title：Journal of the American College of Surgeons
pub_type： 杂志文章
doi：10.1016/j.jamcollsurg.2014.11.012
更新日期：2015-03-01 00:00:00
abstract：BACKGROUND:Pediatric appendicitis is treated by both pediatric and general surgeons. We investigated whether specialty-dependent differences existed in patients' characteristics and outcomes. STUDY DESIGN:A retrospective chart review of 465 consecutive children treated for appendicitis at a university-affiliated child...
journal_title：Journal of the American College of Surgeons
pub_type： 杂志文章
doi：10.1016/j.jamcollsurg.2006.10.006
更新日期：2007-01-01 00:00:00
abstract：BACKGROUND:Natural orifice endoscopic full-thickness colon resection attempts to overcome the need for invasive surgery in selected colorectal indications. Because basic technical requirements have not been met so far, the aim of this study was to develop a novel technique for endolumenal colon-wedge resection addressi...
journal_title：Journal of the American College of Surgeons
pub_type： 杂志文章
doi：10.1016/j.jamcollsurg.2011.05.015
更新日期：2011-09-01 00:00:00
abstract：BACKGROUND:Individuals greater than 60 years old donate an important portion of the organs available for orthotopic liver transplantation (OLT), but use of donors in this age group remains controversial. We hypothesized that proper selection of donors older than age 60 would not disadvantage recipients in terms of pati...
journal_title：Journal of the American College of Surgeons
pub_type： 杂志文章
doi：10.1016/j.jamcollsurg.2008.08.009
更新日期：2008-12-01 00:00:00
