Abstract:
:Although many factors may influence the choice of the operative incision, physiologic safety in terms of the degree of postoperative hypoxemia should be considered. No data currently exist to delineate in markedly obese patients the effect of the operative incision on the extent or duration of this hypoxemia. Fifty-four consecutive patients of both sexes, scheduled for elective jejunoileal bypass for morbid exogenous obesity, were studied. In 23 patients the operation was performed through a transverse incision and in 25 patients through a vertical incision. In 6 patients, cholecystectomy was also performed in addition to the jejunoileal bypass. Postoperatively there was a significant fall in PAO2 both in the transverse and vertical incision groups and this continued through day 4. On day 5 statistically significant hypoxemia was present only in the vertical incision group. In addition, the decrease in PaO2 was significantly greater on days 4 and 5 in the vertical group than in the transverse group. On days 2 and 3 again the mean decrease in PaO2 was greater in the vertical group but this was not statistically significant. The effect of added cholecystectomy on PaO2 was studied in 6 women with midline incisions. The results were compared with 6 subjects who had small bowel bypass without cholecystectomy and who were matched for incision, age weight, girth/height ratio, weight/height ratio, smoking habit, and percentage of predicted ERV. In both groups there was a significant fall of PAO2 from day 1 through day 4, but there was no significant difference between the two groups. Although the numbers studied were small, these limited results would suggest that the type of incesion rather than the intraoperative procedure is the important factor in determining postoperative PAO2 changes. These studies also suggest that in patients with an increased potential for postoperative hypoxemia (i.e., markedly obese), the transverse abdominal approach shoudl always be seriously considered.
journal_name
Ann Surgjournal_title
Annals of surgeryauthors
Vaughan RW,Wise Ldoi
10.1097/00000658-197506000-00012subject
Has Abstractpub_date
1975-06-01 00:00:00pages
829-35issue
6eissn
0003-4932issn
1528-1140journal_volume
181pub_type
临床试验,杂志文章abstract:OBJECTIVE:To examine the development of acute kidney injury (AKI) after burn injury as an independent risk factor for increased morbidity and mortality over initial hospitalization and 1-year follow-up. BACKGROUND:Variability in fluid resuscitation and difficulty recognizing early sepsis are major barriers to preventi...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/SLA.0000000000001979
更新日期:2017-08-01 00:00:00
abstract::In an attempt to determine the best provocative test for the diagnosis of gastrinoma, ten normal subjects, 13 patients with known gastrinoma, and one patient with presumed gastrinoma were administered four regimens: (1) rapid calcium infusion (2 mg Ca++/kg/min), (2) secretin (2 clinical units (CU)/kg/bolus), (3) long ...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-198305000-00015
更新日期:1983-05-01 00:00:00
abstract::A history of caustic injury was obtained in 12 of 846 patients with squamous cell carcinoma of the esophagus. The average age was 52.8 years; the interval from injury to development of carcinoma was 45.8 years. Nine of the 12 carcinomas were in the midthoracic segment. Resection was possible in nine patients, with two...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-198108000-00005
更新日期:1981-08-01 00:00:00
abstract::Inclusion of vagotomy and pyloroplasty in the surgical treatment of gastroesophageal reflux associated with hiatal hernia has long been controversial. To evaluate the morbidity of vagotomy in the treatment of reflux esophagitis, a retrospective study of 311 patients treated by the Hill posterior gastropexy technique o...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-197606000-00003
更新日期:1976-06-01 00:00:00
abstract:PURPOSE:The effects of regionalization of tertiary care were studied by analyzing cost and outcome for pancreaticoduodenectomies in a state in which the majority of these high-risk procedures were performed in one hospital. METHODS:Using Maryland inpatient discharge data via a retrospective study, the authors compared...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-199501000-00005
更新日期:1995-01-01 00:00:00
abstract:OBJECTIVE:The authors evaluated the morbidity, mortality, and quality of life after pancreatic debridement for necrosis and compared these values to those for quality of life after elective medical and surgical management for chronic pancreatitis. SUMMARY BACKGROUND DATA:Quality of life after pancreatic debridement fo...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-199606000-00005
更新日期:1996-06-01 00:00:00
abstract:OBJECTIVE:Cancer patients are at a relatively high risk of venous thromboembolism (VTE), and this has implications for surgical outcome. DATA SOURCE:English literature search including the keywords cancer, surgery and VTE was undertaken to review the risk, etiology, prevention and treatment of VTE in surgical oncology...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/SLA.0b013e318195c50c
更新日期:2009-03-01 00:00:00
abstract:OBJECTIVE:To assess the mechanistic role of group IIA phospholipase A2 (PLA2) in the process of local and distant organ injury after intestinal ischemia-reperfusion. SUMMARY BACKGROUND DATA:Intestinal ischemia-reperfusion produces lung injury by a mechanism that involves PLA2 activation, but it is unclear which isozym...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-200007000-00013
更新日期:2000-07-01 00:00:00
abstract:OBJECTIVE:The aim of this study was to determine inguinal hernia recurrence rates 5 years after endoscopic totally extraperitoneal (TEP) inguinal hernia repair when either lightweight or heavyweight mesh was used. BACKGROUND:Recurrence is an important complication of inguinal hernia surgery. Higher recurrence rates of...
journal_title:Annals of surgery
pub_type: 杂志文章,随机对照试验
doi:10.1097/SLA.0000000000002649
更新日期:2018-08-01 00:00:00
abstract::The healing of 3-cm longitudinal colotomies closed with either Czerny-Lembert suture lines (CLSL) or TA-30 staple lines (SSL) were studied in 28 mongrel dogs using bursting strength (BS) measurements. Dogs from each group were sacrificed on postoperative days (POD) 1 through 7. Mean BS for the SSL in all 14 dogs was 1...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-198503000-00019
更新日期:1985-03-01 00:00:00
abstract:OBJECTIVE:To determine the DNA replication error (RER) status in young patients with colorectal cancer (CRC), and to compare the clinical and pathologic characteristics of RER-positive and RER-negative cases. SUMMARY BACKGROUND DATA:Recent studies suggest that patients with RER-positive CRC have an improved prognosis....
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-199801000-00008
更新日期:1998-01-01 00:00:00
abstract:OBJECTIVE:To assess the safety and efficacy of the ultrasonic dissection (UC) compared with standard electrosurgery (ES) in laparoscopic colorectal surgery. BACKGROUND DATA:High-frequency ultrasound energy was introduced in laparoscopic surgery to improve dissection and coagulation. Very limited data have been publish...
journal_title:Annals of surgery
pub_type: 杂志文章,随机对照试验
doi:10.1097/01.sla.0000189607.38763.c5
更新日期:2005-12-01 00:00:00
abstract::The hospital records of 41 patients with a diagnosis of early postoperative small bowel obstruction were reviewed in an attempt to identify criteria which could be used to separate those patients who would require an operation to resolve their obstruction, from those who would resolve with nonoperative therapy. The us...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-198001000-00014
更新日期:1980-01-01 00:00:00
abstract:OBJECTIVE:This study tested the validity of the hypothesis that eradication of esophageal varices by repeated injection sclerotherapy would reduce recurrent variceal bleeding and death from bleeding varices in a high-risk cohort of alcoholic patients with cirrhosis. SUMMARY BACKGROUND DATA:Although banding of esophage...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/01.sla.0000231704.45005.4e
更新日期:2006-11-01 00:00:00
abstract:BACKGROUND:Although a randomized trial demonstrated a survival benefit of cytoreductive surgery (CRS) and intraperitoneal chemotherapy (IPC) over systemic chemotherapy alone, the treatment of peritoneal carcinomatosis from colorectal cancer (CRPC) is still a matter of debate. The aims of this study were to evaluate lon...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/SLA.0b013e31827e9289
更新日期:2013-06-01 00:00:00
abstract::The aim of this study was to define the post-traumatic changes in body fluid compartments and to evaluate the effect of plasma colloid osmotic pressure (COP) on the partitioning of body fluid between these compartments. Forty-two measurements of plasma volume (green dye), extracellular volume (bromine), and total body...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-198909000-00015
更新日期:1989-09-01 00:00:00
abstract::In nonfunctioning islet cell tumors of the pancreas, hormone production is not clinically evident. This type of tumor constituted 15% of all islet cell tumors seen at the Mayo Clinic from 1960 through 1978. Although identical to functioning islet cell tumors embryologically and histologically, the nonfunctioning tumor...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-198102000-00010
更新日期:1981-02-01 00:00:00
abstract:OBJECTIVE:Compare emergency general surgery (EGS) patient outcomes following index and non-index hospital readmissions, and explore predictive factors for non-index readmission. BACKGROUND:Readmission to a different hospital leads to fragmentation of care. The impact of non-index readmsision on patient outcomes follow...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/SLA.0000000000004628
更新日期:2020-11-17 00:00:00
abstract:OBJECTIVE:The authors addressed whether a repeat hepatic operation is warranted in patients with recurrent isolated hepatic metastases. Are the results as good after second operation as after first hepatic operation? SUMMARY BACKGROUND DATA:Five-year survival after initial hepatic operation for colorectal metastases i...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-199606000-00015
更新日期:1996-06-01 00:00:00
abstract:OBJECTIVE:To evaluate the effect of inhalation of aerosolized opsonized dead Escherichia coli on inflammatory pulmonary neutrophil (PMN) apoptosis, lung injury, and survival in a PMN-mediated lung injury model in vivo. SUMMARY BACKGROUND DATA:Neutrophils that have transmigrated into an inflammatory focus display incre...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-200202000-00018
更新日期:2002-02-01 00:00:00
abstract:OBJECTIVE:To evaluate effects of preoperative high-dose glucocorticoid on the inflammatory response and recovery after endovascular aortic aneurysm repair (EVAR). BACKGROUND:The postimplantation syndrome after EVAR may delay recovery due to the release of proinflammatory mediators. Glucocorticoids may reduce postopera...
journal_title:Annals of surgery
pub_type: 杂志文章,随机对照试验
doi:10.1097/SLA.0000000000000895
更新日期:2014-09-01 00:00:00
abstract:OBJECTIVE:To assess the distant metastatic potential of duodeno-pancreatic neuroendocrine tumors (DP-NETs) in patients with MEN1, according to functional status and size. SUMMARY BACKGROUND DATA:DP-NETs, with their numerous lesions and endocrine secretion-related symptoms, continue to be a medical challenge; unfortuna...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/SLA.0000000000003162
更新日期:2020-12-01 00:00:00
abstract::This prospective study describes the current prognosis of patients in acute Organ System Failure (OSF). Objective definitions were developed for five OSFs, and then 5677 ICU admissions from 13 hospitals were monitored. The number and duration of OSF were linked to outcome at hospital discharge for each of the 2719 ICU...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-198512000-00004
更新日期:1985-12-01 00:00:00
abstract:OBJECTIVE:To analyze the histopathological indicators significantly associated with surgical outcome and the pattern of recurrence in the setting of preoperative gemcitabine-based chemoradiation therapy (CRT) and subsequent pancreatectomy. BACKGROUND:Clinicopathological assessment of the resected specimen is an indisp...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/SLA.0b013e31823d813c
更新日期:2012-01-01 00:00:00
abstract::The role of the antrum on vagally mediated pancreatic secretion was studied in 8 conscious dogs prepared with chronic pancreatic and gastric fistulae. After completion of control studies 6 were subjected to antrectomy and 2 to antroneurolysis (to interrupt submucosal nerve connections); secretory studies were repeated...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-197603000-00005
更新日期:1976-03-01 00:00:00
abstract:BACKGROUND:Gastrectomy remains a major operation with potential for significant deterioration in patients' health-related quality of life (QOL). This study assessed differences in QOL among patients after distal (DG), proximal (PG), or total (TG) gastrectomy. METHODS:We prospectively enrolled patients undergoing gastr...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/SLA.0b013e31828c4a19
更新日期:2013-06-01 00:00:00
abstract:OBJECTIVE:This study aimed at: (1) documenting the evolution of surgical results of esophagectomy in a high-volume center, (2) identifying predictive factors of pulmonary complications and mortality, and (3) examining whether preoperative chemoradiation therapy would complicate postoperative recovery. SUMMARY BACKGROU...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/01.sla.0000143123.24556.1c
更新日期:2004-11-01 00:00:00
abstract::The diagnosis of intra-abdominal abscess by radiographic means often relies on combining the results of several different imaging modalities. Computed tomography (CT) has been shown to be a safe, accurate and rapid diagnostic method of diagnosing these abscesses. Five patients with a variety of intra-abdominal abscess...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-197901000-00006
更新日期:1979-01-01 00:00:00
abstract::The effects of pH on the tensile properties of eight commonly used 2-0 suture materials--plain catgut, Dexon, Vicryl, silk, Nurolon, Ethilon, Mersilene, and Prolene--were examined. The pH level ranged from 3.0 to 10.0. In general, absorbable suture materials were more sensitive to pH than non-absorbable suture materia...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-198308000-00019
更新日期:1983-08-01 00:00:00
abstract::Low mortality rates for elective surgical treatment of abdominal aortic aneurysms justify an aggressive approach in most patients. However, in high-risk patients with small aneurysms and no symptoms, the decision to operate remains a delicate balance of risk and benefit. Our observations include 99 high-risk patients ...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-198409000-00003
更新日期:1984-09-01 00:00:00