Abstract:
BACKGROUND:Controversy exists over the relative advantages of open mesh repair compared with open stitching methods and the laparoscopic approach. STUDY DESIGN:Two thousand nine hundred six (2,906) consecutive unselected adult patients underwent 3,175 primary inguinal hernia repairs using polypropylene mesh, under local anesthesia on an ambulatory basis. The age range was 15-92 years. The study specifically investigated the postoperative course with regard to pain, complications, and time of return to work. RESULTS:There were no postoperative deaths and no cases of urinary retention. Two percent of patients developed a hematoma. The incidence of deep infection was 0.3%. No case of testicular atrophy occurred. Postoperatively 19% of patients used no analgesia at all; 60% used oral analgesics for up to 7 days. There was a gradual decrease in time of return to work over four successive 1-year periods. Manual workers returned to work in 15 days (median) in the first year, reducing to 9 days in the fourth year. The overall median time of return to work across the whole group was 9 days. There were eight recurrences with an 18-month to 5-year followup. CONCLUSIONS:Open mesh repair under local anesthesia is an effective day case technique, particularly in the elderly and medically unfit. The economic benefits are enhanced by low morbidity, early return to normal activities and low recurrence rates.
journal_name
J Am Coll Surgjournal_title
Journal of the American College of Surgeonsauthors
Kark AE,Kurzer MN,Belsham PAdoi
10.1016/s1072-7515(98)00057-xsubject
Has Abstractpub_date
1998-04-01 00:00:00pages
447-55; discussion 456issue
4eissn
1072-7515issn
1879-1190pii
S107275159800057Xjournal_volume
186pub_type
杂志文章abstract:BACKGROUND:Hospital readmissions are gathering increasing attention as a measure of health care quality and as a cost-saving target. The American College of Surgeons National Surgical Quality Improvement Program (ACS NSQIP) recently began collecting data related to 30-day postoperative readmissions. Our objectives were...
journal_title:Journal of the American College of Surgeons
pub_type: 杂志文章
doi:10.1016/j.jamcollsurg.2012.11.013
更新日期:2013-03-01 00:00:00
abstract:BACKGROUND:Although RBC transfusions can be lifesaving, recent evidence suggests that their use is associated with added morbidity and mortality and that a lower transfusion threshold is safe. It is unclear if this new evidence has translated into decreased RBC use among surgical patients. The purpose of this study is ...
journal_title:Journal of the American College of Surgeons
pub_type: 杂志文章
doi:10.1016/j.jamcollsurg.2008.04.002
更新日期:2008-09-01 00:00:00
abstract:BACKGROUND:Transcutaneous techniques to measure serum bilirubin have been validated in neonates but not in adult patients. We evaluated transcutaneous bilirubinometry (TcB) in adults at risk for or diagnosed with hepatic dysfunction to determine if this technology has clinical use in quantifying the presence and magnit...
journal_title:Journal of the American College of Surgeons
pub_type: 杂志文章
doi:10.1016/j.jamcollsurg.2008.01.014
更新日期:2008-06-01 00:00:00
abstract:BACKGROUND:Pancreatic resection can be performed to ameliorate the sequelae of chronic pancreatitis in selected patients. The perceived risk of pancreatectomy may limit its use. Using a national database, this study compared mortality after pancreatic resections for chronic pancreatitis with those performed for neoplas...
journal_title:Journal of the American College of Surgeons
pub_type: 杂志文章
doi:10.1016/j.jamcollsurg.2009.05.030
更新日期:2009-10-01 00:00:00
abstract:BACKGROUND:To prevent wrong-site surgery, multiple organizations have endorsed the practice of signing the operative site with an indelible marker. Potential contamination of the surgical field and the inability to prepare the area under the ink film raises concerns. The purpose of this study was to determine if the us...
journal_title:Journal of the American College of Surgeons
pub_type: 杂志文章
doi:10.1016/j.jamcollsurg.2007.02.029
更新日期:2007-08-01 00:00:00
abstract:BACKGROUND:Reprocessing of single-use medical instruments has been proposed as a mechanism for managing the rising costs of health care. We compared the performance of new and reprocessed laparoscopic trocars. STUDY DESIGN:New and reprocessed laparoscopic trocars were evaluated. Testing consisted of visual and microsc...
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.2010.08.003
更新日期:2010-12-01 00:00:00
abstract:BACKGROUND:As compared with open distal pancreatectomy, laparoscopic distal pancreatectomy (LDP) is associated with lower morbidity and shorter hospital stays. Existing reports do not elucidate trends in patient selection, technique, and outcomes over time. We aimed to determine outcomes after LDP at a specialized cent...
journal_title:Journal of the American College of Surgeons
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doi:10.1016/j.jamcollsurg.2012.03.023
更新日期:2012-08-01 00:00:00
abstract:BACKGROUND:Many remote-access approaches (RAAs) to the thyroid have been described to circumvent anterior neck scarring, including the transaxillary, robotic facelift, and transoral endoscopic vestibular approaches. These techniques have been popularized in Asia, but adoption has been slow in North America. We aimed to...
journal_title:Journal of the American College of Surgeons
pub_type: 杂志文章
doi:10.1016/j.jamcollsurg.2018.12.005
更新日期:2019-04-01 00:00:00
abstract:BACKGROUND:Incisional hernia repair is a frequent surgical procedure, but perioperative risk factors and outcomes have not been prospectively assessed in large-scale studies. The aim of this nationwide study was to analyze surgical risk factors for early and late outcomes after incisional hernia repair. STUDY DESIGN:W...
journal_title:Journal of the American College of Surgeons
pub_type: 杂志文章
doi:10.1016/j.jamcollsurg.2012.10.013
更新日期:2013-02-01 00:00:00
abstract:BACKGROUND:This study was undertaken to compare safety, outcome, and costs of laparoscopic (LS) and open splenectomy (OS) for a variety of hematologic diseases. STUDY DESIGN:The records of 137 patients who underwent splenectomy (63 LS and 74 OS) at a large private teaching hospital between March 1991 and April 1996 we...
journal_title:Journal of the American College of Surgeons
pub_type: 杂志文章
doi:
更新日期:1997-07-01 00:00:00
abstract:BACKGROUND:The surgical management of esophageal perforation (EP) often results in mortality and significant morbidity. Recent less invasive approaches to EP management include endoscopic luminal stenting and minimally invasive surgical therapies. We wished to establish therapeutic efficacy of minimally invasive therap...
journal_title:Journal of the American College of Surgeons
pub_type: 杂志文章
doi:10.1016/j.jamcollsurg.2013.12.033
更新日期:2014-04-01 00:00:00
abstract:BACKGROUND:Previous studies have documented significant differences between administrative data and registry data in the determination of postoperative MI. The goal of this study was to characterize discordance between administrative and registry data in the determination of postoperative myocardial infarction (MI). S...
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.2017.09.016
更新日期:2018-01-01 00:00:00
abstract:BACKGROUND:Biliary stricture with dilatation is a putative cause of intrahepatic bile duct stones. However, this hypothesis has never been proved. STUDY DESIGN:Fifty-six patients had operative cholangiography, underwent standard excision of a choledochal cyst, and were reviewed at follow-up clinics at a mean follow-up...
journal_title:Journal of the American College of Surgeons
pub_type: 杂志文章
doi:
更新日期:1996-12-01 00:00:00
abstract:BACKGROUND:Although effective at detecting locally recurrent colorectal cancer, the accuracy of fluorine-18 fluorodeoxyglucose positron emission tomography (FDG-PET) for detecting rectal cancer recurrence in an irradiated pelvis has not been systematically studied. STUDY DESIGN:Records of surgically resected rectal ca...
journal_title:Journal of the American College of Surgeons
pub_type: 杂志文章
doi:10.1016/S1072-7515(03)00337-5
更新日期:2003-07-01 00:00:00
abstract:BACKGROUND:Studies have shown that racial and socioeconomic differences lead to inequality in access to health care. It is unknown whether insurance status and race affect the choice of surgical treatment for patients presenting with appendicitis. STUDY DESIGN:Patients with primary ICD-9 procedure codes for laparoscop...
journal_title:Journal of the American College of Surgeons
pub_type: 杂志文章
doi:10.1016/j.jamcollsurg.2004.06.023
更新日期:2004-10-01 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:BACKGROUND:There are few reports comparing the variety and frequency of postoperative complications between patients with a major clinical leak requiring emergency abdominal reoperation and those with a minor leak diagnosed from clinical signs and managed expectantly without reoperation. This study examined the associa...
journal_title:Journal of the American College of Surgeons
pub_type: 杂志文章
doi:10.1016/j.jamcollsurg.2007.05.031
更新日期:2007-11-01 00:00:00
abstract:BACKGROUND:Determining the negative predictive value of benign large-core needle biopsy of nonpalpable mammographically detected breast abnormalities has been difficult because benign results generally preclude surgical excision. Longterm followup of these patients is important to ensure timely diagnosis of new abnorma...
journal_title:Journal of the American College of Surgeons
pub_type: 杂志文章
doi:10.1016/s1072-7515(02)01320-0
更新日期:2002-10-01 00:00:00
abstract:BACKGROUND:There has been a dramatic increase in the use of endovascular technology for treatment of abdominal aortic aneurysms (AAA), but practice patterns have not been well-evaluated. Hospital resource use and outcomes after elective endovascular abdominal aortic repair (EVAR) and open surgical repair were assessed ...
journal_title:Journal of the American College of Surgeons
pub_type: 杂志文章
doi:10.1016/j.jamcollsurg.2009.05.024
更新日期:2009-09-01 00:00:00
abstract:BACKGROUND:The aim of this study is to investigate patient-centered quality of life (QOL) outcomes in patients undergoing laparoscopic paraesophageal hernia repair. STUDY DESIGN:We prospectively followed patients who underwent laparoscopic paraesophageal hernia repair between 2009 and 2016. The QOL outcomes were measu...
journal_title:Journal of the American College of Surgeons
pub_type: 杂志文章
doi:10.1016/j.jamcollsurg.2017.12.054
更新日期:2018-07-01 00:00:00
abstract:BACKGROUND:Many surgeons believe that primary fascial closure with mesh reinforcement should be the goal of abdominal wall reconstruction (AWR), yet others have reported acceptable outcomes when mesh is used to bridge the fascial edges. It has not been clearly shown how the outcomes for these techniques differ. We hypo...
journal_title:Journal of the American College of Surgeons
pub_type: 杂志文章
doi:10.1016/j.jamcollsurg.2013.08.015
更新日期:2013-12-01 00:00:00
abstract::One hundred and seventy consecutive patients undergoing parathyroid gland exploration and bilateral thyroidectomy received, postoperatively, routine oral calcium supplementation, close monitoring of total serum calcium, and addition of vitamin D for specific criteria, all to accomplish a postoperative course free of s...
journal_title:Journal of the American College of Surgeons
pub_type: 杂志文章
doi:
更新日期:1994-01-01 00:00:00
abstract:BACKGROUND:Many laparoscopic procedures are currently performed on an outpatient basis. Laparoscopic appendectomy, however, continues to require postoperative hospitalization at most institutions. A treatment protocol for outpatient laparoscopic appendectomy was developed to determine if this could be successfully perf...
journal_title:Journal of the American College of Surgeons
pub_type: 杂志文章
doi:10.1016/j.jamcollsurg.2012.02.024
更新日期:2012-07-01 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:Wedge or other nonanatomic hepatic resections, performed in an attempt to spare functional parenchyma, often are not accomplished with clear resection margins and may be complicated by hemorrhage from the depth of the resection. STUDY DESIGN:The current study describes a technique of cryoassisted hepatic re...
journal_title:Journal of the American College of Surgeons
pub_type: 临床试验,杂志文章
doi:
更新日期:1995-02-01 00:00:00
abstract:BACKGROUND:The purpose of this study was to determine how often patients with ductal carcinoma in situ and T1a/b N0 cancer are offered and accept tamoxifen for secondary chemoprevention. STUDY DESIGN:A retrospective review of 284 patients with T1a/b N0 invasive cancer treated between February 1995 and December 2001 an...
journal_title:Journal of the American College of Surgeons
pub_type: 杂志文章
doi:10.1016/j.jamcollsurg.2005.06.195
更新日期:2005-11-01 00:00:00
abstract:BACKGROUND:Sepsis from bloodstream infection (BSI) is an important cause of morbidity and mortality among surgical patients. Our hypothesis was that fever and leukocytosis during BSI would be associated with gram-negative pathogens and worse outcomes among hospitalized surgical patients. STUDY DESIGN:A prospectively c...
journal_title:Journal of the American College of Surgeons
pub_type: 杂志文章
doi:10.1016/j.jamcollsurg.2007.01.033
更新日期:2007-05-01 00:00:00
abstract:BACKGROUND:The concept of hemodilution after blood loss and crystalloid infusion is a surgical maxim that remains unproven in humans. We sought to quantify the effect of hemodilution after crystalloid administration in voluntary blood donors as a model for acute hemorrhage. STUDY DESIGN:A prospective, randomized contr...
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.2018.05.005
更新日期:2018-09-01 00:00:00
abstract:BACKGROUND:Recently, several reports in the United States have demonstrated remarkable improvement in the patency of axillofemoral (AXF) bypass with an externally supported prosthesis. The purpose of this study was to review the prognoses regarding graft patency, limb salvage, and survival of patients who underwent AXF...
journal_title:Journal of the American College of Surgeons
pub_type: 杂志文章
doi:10.1016/s1072-7515(98)00084-2
更新日期:1998-05-01 00:00:00
abstract::Technical modification of the DSRS by using the end-to-end splenoadrenal anastomosis allows for effective selective decompression of portal hypertension in children, can be accomplished with no perioperative mortality, and has demonstrated longterm patency and minimal morbidity. Clinical encephalopathy was seen in onl...
journal_title:Journal of the American College of Surgeons
pub_type: 杂志文章
doi:10.1016/s1072-7515(98)00244-0
更新日期:1998-12-01 00:00:00