Abstract:
BACKGROUND:This study is intended to ascertain if outcome of acute abdominal surgery among elderly patients with acute abdominal pain have improved. METHODS:Altogether 456 patients aged >65 years underwent emergency abdominal surgery between the years 2007 and 2009 in our hospital. After excluding emergency reoperations of elective surgery, a total of 430 consecutive patients were included in this retrospective audit. The key factors under analysis in this study were the occurrence of major complications and death from any cause within 30 days after the operation. In addition, we compared our results to our previously published data some 20 years ago. RESULTS:The most common diagnoses were cholecystitis (n = 139, 32.3 %, incidence of 125 per 100,000 elderly persons), incarcerated hernia (n = 60, 13.9 %, 54/100,000), malignancy related (n = 50, 11.6 %, 45/100,000), or acute appendicitis (n = 46, 10.7 %, 41/100,000). The majority of operations (80.7 %) were performed using open technique. Of all 112 laparoscopic procedures, 25.9 % were converted to open surgery. Reoperations were rare and postoperative surgical complications were not associated with statistically significant increase in mortality, even if reoperation was needed. The 30-day mortality and morbidity rates were 14.2 and 31.9 %, respectively. Logistic regression analysis showed that patient's age (p = 0.014), atrial fibrillation (p = 0.017), low body mass index (p = 0.001), open surgery (p = 0.029), ASA grade III or more (p < 0.001), and previous history of malignancies (p = 0.010) were likely to increase mortality. CONCLUSIONS:Despite modern diagnostics and improved surgical techniques, the results of emergency abdominal surgery still have relatively high morbidity and mortality as reported in earlier studies.
journal_name
World J Surgjournal_title
World journal of surgeryauthors
Ukkonen M,Kivivuori A,Rantanen T,Paajanen Hdoi
10.1007/s00268-015-3207-1subject
Has Abstractpub_date
2015-12-01 00:00:00pages
2854-61issue
12eissn
0364-2313issn
1432-2323pii
10.1007/s00268-015-3207-1journal_volume
39pub_type
杂志文章abstract:BACKGROUND:A small remnant liver volume is an important risk factor for posthepatectomy liver failure and can be predicted accurately by computed tomography (CT) volumetry using radiologic image analysis software. Unfortunately, this software is expensive and usually requires support by a radiologist. ImageJ is a freel...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/s00268-007-9197-x
更新日期:2007-11-01 00:00:00
abstract:BACKGROUND:Africa's health workforce crisis has recently been emphasized by major international organizations. As a part of this discussion, it has become apparent that the workforce required to deliver surgical services has been significantly neglected. METHODS:This paper reviews some of the reasons for this relative...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/s00268-008-9473-4
更新日期:2008-06-01 00:00:00
abstract::Childhood papillary thyroid carcinoma is associated with more locally aggressive and more frequent distant disease than its adult counterpart. Recurrence rates tend to be higher in children, but cause-specific mortality remains low. Optimal initial treatment of childhood papillary thyroid carcinoma should include tota...
journal_title:World journal of surgery
pub_type: 杂志文章,评审
doi:10.1007/s00268-004-7605-z
更新日期:2004-12-01 00:00:00
abstract:BACKGROUND:The prognosis of intrahepatic cholangiocarcinoma (ICC) remains poor despite improvements in treatment and post-operative clinical management. We review our experiences and evaluate our current surgical approaches by comparing patients from two consecutive treatment periods. METHODS:One hundred forty-four pa...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/s00268-016-3583-1
更新日期:2016-09-01 00:00:00
abstract::Four cases of H-type tracheoesophageal fistula are reported. The patients all had chronic aspiration from the esophagus. Although serious symptoms were present in all, definitive diagnoses were not made until the patients had reached 1, 6, 12, and 50 years of age, because ordinary radiologic methods failed to establis...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/BF01654780
更新日期:1979-09-20 00:00:00
abstract:BACKGROUND:Currently, there are no objective reports evaluating the quality of the South African surgical training. The aim of this study is to evaluate the current state of surgical training in South Africa from an external impartial point of view and to rate the experience of short-term supernumerary registrars and f...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/s00268-019-05034-7
更新日期:2019-09-01 00:00:00
abstract::Hereditary breast cancers, mainly due to BRCA1 and BRCA2 mutations, account for only 5-10% of this disease. The threshold for genetic testing is a 10% likelihood of detecting a mutation, as determined by validated models such as BOADICEA and Manchester Scoring System. A 90-95% reduction in breast cancer risk can be ac...
journal_title:World journal of surgery
pub_type: 杂志文章,评审
doi:10.1007/s00268-018-04897-6
更新日期:2019-05-01 00:00:00
abstract::There are now excellent data that patients with stage III colon cancer or stage II and III rectal cancer live longer if they receive, respectively, systemic or regional and systemic therapy after surgery. In addition, disease-free survival, particularly freedom from the symptoms of regional recurrence, in the high ris...
journal_title:World journal of surgery
pub_type: 杂志文章,评审
doi:10.1007/BF00308633
更新日期:1995-03-01 00:00:00
abstract::Incisional hernia is a serious postoperative complication of laparotomy. Selecting an appropriate suture material may lessen such morbidity. This study undertook a prospective, randomized comparison of early-absorbable polyglactin 910 suture versus late-absorbable polydioxanone loop suture for fascial closure after ab...
journal_title:World journal of surgery
pub_type: 临床试验,杂志文章,随机对照试验
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abstract::A new technique utilizing miniaturized (2 mm) instrumentation to perform laparoscopic cholecystectomy (LC) is introduced. The safety and efficacy of this mini-LC were assessed. Fifty consecutive mini-LCs were performed using one 10-mm port and three 2-mm ports (cumulative port size 16 mm). A 2-mm fiberoptic video-lapa...
journal_title:World journal of surgery
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更新日期:1999-02-01 00:00:00
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journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/s00268-005-7964-0
更新日期:2006-04-01 00:00:00
abstract::Outside Japan portosystemic shunts have been favored as the surgical procedure of choice for the management of portal hypertension of noncirrhotic etiology. Devascularization procedures have resulted in high rebleed rates probably owing to a limited extent of devascularization. We performed this study to assess the ef...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/s002689900641
更新日期:1999-11-01 00:00:00
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journal_title:World journal of surgery
pub_type: 杂志文章,多中心研究,随机对照试验
doi:10.1007/s00268-009-0047-x
更新日期:2009-07-01 00:00:00
abstract::Endocrine surgeons have had an important role in the management of hyperthyroidism due to either Graves' disease or toxic nodule(s). Since alternative treatments such as antithyroid drugs or radioiodine are also available, the decision-making for management should be based on clear assessment of advantages and limitat...
journal_title:World journal of surgery
pub_type: 杂志文章,评审
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更新日期:2000-08-01 00:00:00
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journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/s00268-019-05313-3
更新日期:2020-04-01 00:00:00
abstract::Blood loss during liver transection and ischemia-reperfusion injury associated with hepatic inflow occlusion are significant drawbacks during liver surgery. Sixteen patients underwent liver resection using the Monopolar Floating Ball (FB) plus LigaSure (LS) diathermy without occlusion of the hepatoduodenal ligament (g...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/s00268-003-7167-5
更新日期:2004-02-01 00:00:00
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journal_title:World journal of surgery
pub_type: 杂志文章,评审
doi:10.1007/BF01671147
更新日期:1989-01-01 00:00:00
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journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/s00268-016-3779-4
更新日期:2017-03-01 00:00:00
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journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/s00268-003-6893-z
更新日期:2003-10-01 00:00:00
abstract:BACKGROUND:Self-expanding metallic stents (SEMS) have been used as a bridge to surgery in patients with obstruction by colorectal cancer, but the oncologic safety of this technique has not yet been established. The aim of the present study was to compare the outcomes of bridge to surgery after SEMS insertion and nonobs...
journal_title:World journal of surgery
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journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/s00268-009-9928-2
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journal_title:World journal of surgery
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journal_title:World journal of surgery
pub_type: 杂志文章
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更新日期:2008-11-01 00:00:00
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journal_title:World journal of surgery
pub_type: 杂志文章,随机对照试验
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更新日期:2012-10-01 00:00:00
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journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/s002689900228
更新日期:1997-03-01 00:00:00
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journal_title:World journal of surgery
pub_type: 杂志文章,meta分析,评审
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更新日期:2014-09-01 00:00:00
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journal_title:World journal of surgery
pub_type: 杂志文章
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更新日期:2001-07-01 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
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更新日期:2011-08-01 00:00:00
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journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/s00268-005-0471-5
更新日期:2006-07-01 00:00:00
abstract::Surgical management of hepatic hydatid disease has been associated with an overall local recurrence rate of approximately 10%. Local recurrence is rarely seen following complete resection of an intact cyst and is usually the result of spillage of live parasites or leaving a residual cyst wall containing germinal epith...
journal_title:World journal of surgery
pub_type: 杂志文章,评审
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更新日期:2001-01-01 00:00:00