Abstract：
:This article attempts to put into a risk-related perspective modern red blood cell (RBC) transfusion therapy. When making the decision to transfuse, RBCs or blood products, it is important to weigh the risks and benefits of the proposed therapy. It is equally important to evaluate the risk of not transfusing and the morbidity and mortality associated with that decision. After nearly a century of use, RBC transfusions continue to be associated with a variety of risks. Although the initial risks of mismatch and infectious disease transmission are ever decreasing, new risk considerations, particularly immunosuppression, are being uncovered. Because of the nearly universal worldwide fear of transfusion-related transmission of infectious disease a more conservative transfusion policy has generally taken hold. Transfusion avoidance philosophies and then increased use of autologous RBCs have become commonplace. This article puts a decision-oriented slant on the risk and benefit of transfusion therapy. The issues behind the inability to discern a defined benefit as well as a commentary on the newly perceived risks is provided. Overall, when increased oxygen delivery is required, the addition of RBCs has an apparent survival benefit in some specific patients. In these patients the risk of transfusion-related complication is minimized compared to the mortality outcome. For cancer and trauma patients, if transfusion is immunosuppressive and therefore detrimental, alternatives must be considered. The newest question is whether the act of transfusion, independent of the form, allogeneic or autologous, is of itself immunosuppressive.
journal_name
World J Surgjournal_title
World journal of surgeryauthors
Greenburg AGdoi
10.1007/s002689900181subject
Has Abstractpub_date
1996-11-01 00:00:00pages
1189-93issue
9eissn
0364-2313issn
1432-2323journal_volume
20pub_type
杂志文章abstract：:A wide range of clinical symptoms and signs are observed with venous thrombosis. Nonetheless, clinical diagnosis has been found to be unreliable and accurate diagnostic methods must be used before potent therapy such as anticoagulation is instituted, since the complications of treatment themselves can be life-threaten...
journal_title：World journal of surgery
pub_type： 杂志文章,评审
doi：10.1007/BF01658825
更新日期：1990-09-01 00:00:00
abstract：BACKGROUND:Mutations in BRCA1 and BRCA2 confer an increased risk to breast and other cancers, but to date there have only been limited numbers of studies of BRCA1- and BRCA2-associated cancers among Asians. Malaysia is a multiracial country with three main races: Malays, Chinese, Indians. We determined whether tumor pa...
journal_title：World journal of surgery
pub_type： 杂志文章
doi：10.1007/s00268-009-0146-8
更新日期：2009-10-01 00:00:00
abstract：BACKGROUND:We aimed to systematically review the literature on the educational impact of Advanced Trauma Life Support (ATLS) courses and their effects on death rates of multiple trauma patients. METHODS:All Medline, Pubmed, and the Cochrane Library English articles on the educational impact of ATLS courses and their e...
journal_title：World journal of surgery
pub_type： 杂志文章,评审
doi：10.1007/s00268-013-2294-0
更新日期：2014-02-01 00:00:00
abstract：:Endoscopic management of polypoid early colonic cancer (malignant polyps and polypoid carcinomas) is no longer controversial. When the endoscopist is satisfied that excision is complete and histology is "favorable" (a resection margin of 2 mm and well or moderately well differentiated tumor), surgery is unnecessary. W...
journal_title：World journal of surgery
pub_type： 杂志文章,评审
doi：10.1007/s002680010144
更新日期：2000-09-01 00:00:00
abstract：:Hepatobiliary (HB) surgery is a challenging surgical subspecialty that requires highly specialized training and an adequate level of experience in order to be performed safely. As a result, minimally invasive HB surgery has been met with slower acceptance as compared to other subspecialties, with many surgeons in the ...
journal_title：World journal of surgery
pub_type： 杂志文章,评审
doi：10.1007/s00268-013-2276-2
更新日期：2013-12-01 00:00:00
abstract：BACKGROUND:Hernia is especially prevalent in developing countries where the population is obliged to undertake strenuous work in order to survive, and International Cooperation Programmes are helping to solve this problem. However, the quality of surgical interventions is unknown. The objective of the present study was...
journal_title：World journal of surgery
pub_type： 杂志文章
doi：10.1007/s00268-012-1768-9
更新日期：2012-12-01 00:00:00
abstract：BACKGROUND:The change in the route of food passage after pancreaticoduodenectomy (PD) is quite similar to the change after gastric bypass surgery; both procedures bypass the duodenum and directly connect to the distal jejunum. Moreover, both procedures result in resolution of type 2 diabetes mellitus. Therefore, more d...
journal_title：World journal of surgery
pub_type： 杂志文章
doi：10.1007/s00268-015-3157-7
更新日期：2015-11-01 00:00:00
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
doi：10.1007/s00268-017-3953-3
更新日期：2017-07-01 00:00:00
abstract：:We investigated the effect of radiofrequency ablation (RFA) of the liver on cell-mediated immunity in rats. Sprague-Dawley rats were divided into five groups: control group that did not have any procedure, a sham-operation group that underwent laparotomy, a lobectomy group that had left lateral lobectomy of the liver,...
journal_title：World journal of surgery
pub_type： 杂志文章
doi：10.1007/s00268-005-7728-x
更新日期：2005-06-01 00:00:00
abstract：INTRODUCTION:Accidental intraoperative gallbladder perforation is a problem in laparoscopic surgery, especially in cases with incidental gallbladder carcinoma (IGBC). The question is whether intraoperative gallbladder perforation has a prognostic disadvantage or a retrieval bag provides protection against tumor dissemi...
journal_title：World journal of surgery
pub_type： 杂志文章
doi：10.1007/s00268-009-0163-7
更新日期：2009-10-01 00:00:00
abstract：:In 1947, a patient with metastatic islet cell tumor was treated for intractable ulcer disease at the University of Chicago Medical Center. Eight years later, in retrospect, it was recognized that he and another patient had the Zollinger-Ellison syndrome (ZE). From 1947 until the present, 30 patients with the ZE syndro...
journal_title：World journal of surgery
pub_type： 杂志文章
doi：10.1007/BF01658530
更新日期：1990-05-01 00:00:00
abstract：INTRODUCTION:Response rates to systemic chemotherapy for patients who have failed irinotecan-based chemotherapy for liver-dominant metastatic colorectal cancer range between 10 and 18 % with overall survival between 7 and 9 months. The aim of this study was to assess the efficacy and safety of hepatic arterial irinotec...
journal_title：World journal of surgery
pub_type： 杂志文章,多中心研究
doi：10.1007/s00268-015-3386-9
更新日期：2016-05-01 00:00:00
abstract：BACKGROUND:We sought to assess the status of availability of technology for trauma care in a state in India and to identify factors contributing to both adequate levels of availability and to deficiencies. We also sought to identify potential solutions to deficiencies in terms of health system management and product de...
journal_title：World journal of surgery
pub_type： 杂志文章
doi：10.1007/s00268-014-2805-7
更新日期：2015-02-01 00:00:00
abstract：BACKGROUND AND STUDY AIMS:Post-lobectomy bronchopleural fistula is a rare complication of lung resection surgery, and proper management is crucial for the successful resolution. Most published papers deal with surgical treatment. We report our experience with a new interventional management, endobronchial naso-bronchia...
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
abstract：INTRODUCTION:The association between socioeconomic status (SES) and relative survival of rectal cancer is little investigated. We hypothesized that the impact on risk of death by SES would be much smaller when differences in background mortality (comorbidity, lifestyle factors) were taken into account, i.e. in modellin...
journal_title：World journal of surgery
pub_type： 杂志文章
doi：10.1007/s00268-014-2735-4
更新日期：2014-12-01 00:00:00
abstract：OBJECTIVE:The use of pulmonary artery catheter (PAC) is controversial. The purpose of this study was to document the changing pattern of PAC use and to determine its effect on outcome. METHODS:The use of PAC was analyzed in patients ≥16 years old admitted to the surgical intensive care unit (SICU) over a 9-year period...
journal_title：World journal of surgery
pub_type： 杂志文章
doi：10.1007/s00268-011-1149-9
更新日期：2011-08-01 00:00:00
abstract：BACKGROUND:Burns are a major public health concern, affecting mostly low- and middle-income countries. However, there is a lack of epidemiological studies on burns in these countries, particularly in Latin American countries. Our aim was to analyze nationwide demographic, epidemiological and economic characteristics of...
journal_title：World journal of surgery
pub_type： 杂志文章
doi：10.1007/s00268-017-3988-5
更新日期：2017-08-01 00:00:00
abstract：:Congenital diaphragmatic hernia (CDH) is one of the most common causes of neonatal morbidity and mortality. The clinical spectrum of CDH ranges from minimally affected infants who do well with modern neonatal care to severely affected infants who die despite all interventions. Two decades of research have led to advan...
journal_title：World journal of surgery
pub_type： 杂志文章,评审
doi：10.1007/s00268-002-6739-0
更新日期：2003-01-01 00:00:00
abstract：BACKGROUND:Laparoscopic resection of posterosuperior (PS) tumors of the liver is more difficult than that of anterolateral (AL) tumors, owing to the narrow surgical field in the PS location. In this retrospective cohort study, our aim was to determine if port insertion through the intercostal space would lead to improv...
journal_title：World journal of surgery
pub_type： 杂志文章
doi：10.1007/s00268-016-3867-5
更新日期：2017-05-01 00:00:00
abstract：BACKGROUND:Esophagectomy remains the standard treatment for resectable esophageal cancer, but the cure rate is low. Neoadjuvant therapy has been tried in attempts to prolong survival and reduce tumor recurrence. The aim of this study was to assess the surgical outcomes with and without neoadjuvant treatment for resecta...
journal_title：World journal of surgery
pub_type： 杂志文章
doi：10.1007/s00268-006-0016-6
更新日期：2006-12-01 00:00:00
abstract：BACKGROUND:The aim of this study was to compare the perioperative outcomes when using a micropuncture access set (MS) to those when using a conventional puncture set (CS) for implantation of totally implantable venous access device (TAVID). METHODS:A total of 314 patients undergoing chemotherapy for colorectal cancer ...
journal_title：World journal of surgery
pub_type： 杂志文章
doi：10.1007/s00268-019-05336-w
更新日期：2020-04-01 00:00:00
abstract：:Surgical exposure of the recurrent laryngeal nerve decreases the incidence of nerve injuries during thyroid surgery. Intraoperative neuromonitoring was introduced to facilitate identification and protection of the recurrent laryngeal nerve. Between February 1996 and June 2002 a total of 288 patients underwent thyroid ...
journal_title：World journal of surgery
pub_type： 杂志文章
doi：10.1007/s00268-004-7226-6
更新日期：2004-06-01 00:00:00
abstract：BACKGROUND:Because the feasibility and safety of laparoscopic approaches for the treatment of perforated peptic ulcer (PPU) have been fully recognized, laparoscopic repair of PPU (LPPU) has become a widely accepted procedure. Following closure of a PPU, the rationale to add an omental patch is based on the assumptions ...
journal_title：World journal of surgery
pub_type： 杂志文章
doi：10.1007/s00268-014-2503-5
更新日期：2014-08-01 00:00:00
abstract：BACKGROUND:It has been suggested that gender and age could be factors that influence the likelihood of success following antireflux surgery, and our anecdotal impression has been that the outcome following Nissen fundoplication in older women is often disappointing. If correct, characterization of the extent of any dif...
journal_title：World journal of surgery
pub_type： 杂志文章
doi：10.1007/s00268-009-0216-y
更新日期：2009-12-01 00:00:00
abstract：BACKGROUND:Flow disruptions (FDs) are deviations from the progression of care that compromise safety or efficiency. The frequency and specific causes of FDs remain poorly documented in trauma care. We undertook this study to identify and quantify the rate of FDs during various phases of trauma care. METHODS:Seven trai...
journal_title：World journal of surgery
pub_type： 杂志文章
doi：10.1007/s00268-013-2306-0
更新日期：2014-02-01 00:00:00
abstract：PURPOSE:Management of anal fistula represents a balance between curing the condition and maintaining anal continence. Recent reports of the results of the porcine anal fistula plug have demonstrated excellent fistula healing rates without reporting significant complications. METHODS:The outcome of patients who underwe...
journal_title：World journal of surgery
pub_type： 杂志文章
doi：10.1007/s00268-008-9504-1
更新日期：2008-06-01 00:00:00
abstract：BACKGROUND:The majority of small bowel obstructions (SBO) are the result of adhesions caused by a previous abdominal operation. On rare occasions, adhesional SBO occurs in the absence of such an operation. Our objective was to describe the management, findings, and outcomes of unexplained adhesional SBO (UA-SBO) and ex...
journal_title：World journal of surgery
pub_type： 杂志文章
doi：10.1007/s00268-009-0200-6
更新日期：2009-11-01 00:00:00
abstract：INTRODUCTION:Gastroesophageal reflux disease is common in Western societies, although the prevalence of reflux symptoms in the community is not well described. In this study we determined the prevalence of symptoms of gastroesophageal reflux and other "esophageal" symptoms, and the consumption of medication for reflux ...
journal_title：World journal of surgery
pub_type： 杂志文章
doi：10.1007/s00268-008-9780-9
更新日期：2009-01-01 00:00:00
abstract：BACKGROUND:The role of lymphadenectomy in adrenocortical carcinoma resection is controversial. Therefore, we conducted a population-based study to assess the association between positive lymph nodes (LN) and survival. METHODS:The Surveillance, Epidemiology, and End Results set of cancer registries were utilized. The a...
journal_title：World journal of surgery
pub_type： 杂志文章
doi：10.1007/s00268-020-05801-x
更新日期：2021-01-01 00:00:00
abstract：BACKGROUND:Continuous vagal intraoperative neuromonitoring (CIONM) of the recurrent laryngeal nerve (RLN) may reduce the risk of RLN lesions during high-risk endocrine neck surgery such as operation for large goiter potentially requiring transsternal surgery, advanced thyroid cancer, and recurrence. METHODS:Fifty-five...
journal_title：World journal of surgery
pub_type： 杂志文章
doi：10.1007/s00268-015-3368-y
更新日期：2016-03-01 00:00:00
