Abstract:
BACKGROUND:Post-operative nausea and vomiting (PONV) is often encountered following corrective scoliosis surgery in children, frequently attributed to high-dose opiate administration. PONV is a frequent cause of prolonged hospital stay. Mechanisms related to transient partial duodenal compression by narrow angulation of the superior mesenteric artery (SMA) and aorta following scoliosis surgery are poorly understood and might be implicated in PONV. This study investigates relationships between biomechanical anatomic variations of the SMA and aorta, and its relationship with clinically significant PONV following scoliosis surgery in children. METHODS:Children undergoing elective spinal arthrodesis for adolescent idiopathic scoliosis were assessed by preoperative abdominal ultrasound and spinal X-ray prior to surgery. Post-operative assessment of clinically significant PONV is compared to preoperative imaging and clinical variables. RESULTS:Thirteen patients (11 female and two male), with a mean age of 14 years and 1 month were included. Five patients (38.5%) developed clinically significant PONV. A significant association was observed between the coronal aorto-mesenteric orientation and PONV (P = 0.035). Of the five patients who developed PONV, two had direct coronal angulation of the SMA, one had left angulation and two had right angulation. Patients with significant PONV had narrower aorto-mesenteric distances which approached significance (P = 0.06). No other preoperative variable reached significance. CONCLUSION:Patients with coronal aorto-mesenteric orientation preoperatively appear at greater risk of developing significant PONV following scoliosis surgery, independent of opiate requirements, prompting consideration of transient partial duodenal obstruction as an important factor in the mechanisms of PONV. A coronal aorto-mesenteric orientation theory (CAMOT) is proposed to explain this biomechanical vascular 'scissor'.
journal_name
ANZ J Surgjournal_title
ANZ journal of surgeryauthors
Dounas GD,Cundy TP,Smith ML,Gent R,Antoniou G,Sutherland LM,Cundy PJdoi
10.1111/ans.16438subject
Has Abstractpub_date
2020-11-26 00:00:00eissn
1445-1433issn
1445-2197pub_type
杂志文章abstract:PURPOSE:The present study was undertaken to assess the degree of myocardial injury, using troponin T (TnT), in off-pump coronary artery surgery (OPCAB) and in a comparable patient group undergoing conventional coronary artery graft surgery (CABG). METHODS:Twenty-seven OPCAB and 27 CABG patients were investigated. Bloo...
journal_title:ANZ journal of surgery
pub_type: 杂志文章
doi:10.1046/j.1445-2197.2002.02317.x
更新日期:2002-02-01 00:00:00
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journal_title:ANZ journal of surgery
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journal_title:ANZ journal of surgery
pub_type: 传,历史文章,杂志文章
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journal_title:ANZ journal of surgery
pub_type: 杂志文章,评审
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journal_title:ANZ journal of surgery
pub_type: 杂志文章,多中心研究
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journal_title:ANZ journal of surgery
pub_type: 杂志文章
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pub_type: 杂志文章
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journal_title:ANZ journal of surgery
pub_type: 杂志文章
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journal_title:ANZ journal of surgery
pub_type: 杂志文章
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更新日期:2017-12-01 00:00:00
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journal_title:ANZ journal of surgery
pub_type: 临床试验,杂志文章
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更新日期:2007-06-01 00:00:00
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journal_title:ANZ journal of surgery
pub_type: 杂志文章
doi:10.1046/j.1445-2197.2002.02516.x
更新日期:2002-09-01 00:00:00
abstract:AIM:To examine the outcomes and complications of surgery for recurrent carotid stenosis. METHODS:From 1974 to 2000, 1922 carotid endarterectomies were performed in our unit. A retrospective cohort analysis of these records identified 24 patients (1.2%) who underwent surgery for recurrent stenosis. RESULTS:There were ...
journal_title:ANZ journal of surgery
pub_type: 杂志文章
doi:10.1046/j.1445-2197.2003.t01-8-.x
更新日期:2003-12-01 00:00:00
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journal_title:ANZ journal of surgery
pub_type: 杂志文章
doi:10.1046/j.1445-2197.2002.02552.x
更新日期:2002-11-01 00:00:00
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journal_title:ANZ journal of surgery
pub_type: 杂志文章
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更新日期:2005-06-01 00:00:00
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pub_type: 杂志文章,随机对照试验
doi:10.1111/j.1445-2197.2009.05200.x
更新日期:2010-03-01 00:00:00
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pub_type: 杂志文章
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journal_title:ANZ journal of surgery
pub_type: 杂志文章
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journal_title:ANZ journal of surgery
pub_type: 杂志文章
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pub_type: 杂志文章
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更新日期:2019-12-01 00:00:00
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journal_title:ANZ journal of surgery
pub_type: 杂志文章
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更新日期:2020-11-08 00:00:00
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journal_title:ANZ journal of surgery
pub_type: 杂志文章
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更新日期:2016-03-01 00:00:00
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journal_title:ANZ journal of surgery
pub_type: 杂志文章
doi:10.1111/j.1445-2197.2007.04036.x
更新日期:2007-04-01 00:00:00
abstract::With the widespread use of abdominal imaging, the detection and therefore incidence of adrenal tumours is increasing. The laparoscopic approach to primary surgical resection of adrenal tumours has now become the standard of care. There is scarce published literature regarding the management and outcomes of recurrent a...
journal_title:ANZ journal of surgery
pub_type: 杂志文章
doi:10.1111/j.1445-2197.2009.04892.x
更新日期:2009-05-01 00:00:00
abstract::Currently in Australasia, concomitant cholecystolithiasis and choledocholithiasis are usually managed with two procedures: laparoscopic cholecystectomy (LC) and pre or postoperative endoscopic retrograde cholangiopancreatography (ERCP). This approach exposes the patient to the risk of complications from the common bil...
journal_title:ANZ journal of surgery
pub_type: 杂志文章,评审
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更新日期:2016-11-01 00:00:00
abstract:BACKGROUND:Gallstone disease is a worldwide problem causing morbidity, mortality and a drain on health-care resources. This prospective study aimed to investigate the spectrum of gallstone types in New Zealand and relate these to known risk factors. METHODS:Gallstone samples were collected from 107 patients undergoing...
journal_title:ANZ journal of surgery
pub_type: 杂志文章
doi:10.1111/j.1445-2197.2012.06234.x
更新日期:2013-07-01 00:00:00
abstract:BACKGROUND:Hepatic haemangiomas are congenital vascular malformations. They are the most common benign tumours of the liver and are often asymptomatic. Spontaneous or traumatic rupture, intratumoral bleeding, consumption coagulopathy and rapid growth are the mandatory surgical indications. We present our experience ove...
journal_title:ANZ journal of surgery
pub_type: 杂志文章
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更新日期:2006-09-01 00:00:00
abstract:BACKGROUND:This study aimed to investigate incidence of surgical site infection (SSI) following the surgery of intra-articular fractures of distal femur. METHODS:Between July 2014 and December 2017, inpatient medical records of consecutive patients who had intra-articular fractures of distal femur treated by open redu...
journal_title:ANZ journal of surgery
pub_type: 杂志文章
doi:10.1111/ans.15263
更新日期:2019-06-01 00:00:00