Choice of abdominal operative incision in the obese patient: a study using blood gas measurements.


: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.


Ann Surg


Annals of surgery


Vaughan RW,Wise L




Has Abstract


1975-06-01 00:00:00












  • Ten-year experience with cyclosporine as primary immunosuppression in recipients of renal allografts.

    abstract::Cyclosporine has been used as primary immunosuppression in renal allograft recipients in our unit for the past decade. The overall clinical experience and long-term effects of the agent are reviewed. There were 461 consecutive recipients of kidney grafts; 379 received grafts from cadaver donors (CAD) and 82 from livin...

    journal_title:Annals of surgery

    pub_type: 杂志文章


    authors: Tilney NL,Chang A,Milford EL,Whitley WD,Lazarus JM,Ramos EL,Strom TB,Carpenter CB,Kirkman RL

    更新日期:1991-07-01 00:00:00

  • Conversion for Unfavorable Intraoperative Events Results in Significantly Worse Outcomes During Laparoscopic Liver Resection: Lessons Learned From a Multicenter Review of 2861 Cases.

    abstract:OBJECTIVE:To investigate the risk factors for conversion during laparoscopic liver resection and its effect on patient outcome in a large cohort of patients. Additional analysis of outcomes in patients who required conversion for unfavorable intraoperative findings and conversion for unfavorable intraoperative events w...

    journal_title:Annals of surgery

    pub_type: 杂志文章,多中心研究


    authors: Halls MC,Cipriani F,Berardi G,Barkhatov L,Lainas P,Alzoubi M,D'Hondt M,Rotellar F,Dagher I,Aldrighetti L,Troisi RI,Edwin B,Abu Hilal M

    更新日期:2018-12-01 00:00:00

  • Laparoscopic resection for rectal cancers: lessons learned from 579 cases.

    abstract:OBJECTIVE:The aim of this study is to evaluate the short-term outcomes and long-term survival of laparoscopic rectal cancer resection at a single institution with 579 cases over a 15-year period. SUMMARY BACKGROUND DATA:The use of laparoscopic resection for colon cancer has been shown to be safe with comparable oncolo...

    journal_title:Annals of surgery

    pub_type: 杂志文章


    authors: Ng KH,Ng DC,Cheung HY,Wong JC,Yau KK,Chung CC,Li MK

    更新日期:2009-01-01 00:00:00

  • The evolution of the concept of the use of surgical castration in the palliation of breast cancer in pre-menopausal females.

    abstract::The understanding of the association of mammalian ovarian function with lactation was common knowledge to dairy-men early in the 19th century or earlier. This thesis reviews the application of these empiric observations to lactation in humans by Beatson of Glasgow, supported by his preliminary laboratory investigation...

    journal_title:Annals of surgery

    pub_type: 传,历史文章,杂志文章


    authors: Macmahon CE,Cahill JL

    更新日期:1976-12-01 00:00:00

  • A prospective pathologic analysis using whole-mount sections of rectal cancer following preoperative combined modality therapy: implications for sphincter preservation.

    abstract:OBJECTIVE:The aims of this study were to use a comprehensive whole-mount pathologic analysis to characterize microscopic patterns of residual disease, as well as circumferential and distal resection margins, in rectal cancer treated with preoperative CMT; and to identify clinicopathologic factors associated with residu...

    journal_title:Annals of surgery

    pub_type: 杂志文章


    authors: Guillem JG,Chessin DB,Shia J,Suriawinata A,Riedel E,Moore HG,Minsky BD,Wong WD

    更新日期:2007-01-01 00:00:00

  • Recovery of fasted and fed gastrointestinal motility after open versus laparoscopic cholecystectomy in dogs.

    abstract:OBJECTIVE:The authors investigate the recovery of gastrointestinal motility in the fed and fasted state after laparoscopic and open cholecystectomy. SUMMARY BACKGROUND DATA:Clinical recovery after laparoscopic cholecystectomy is known to be more rapid than after conventional open cholecystectomy. However, the actual e...

    journal_title:Annals of surgery

    pub_type: 杂志文章


    authors: Hotokezaka M,Combs MJ,Mentis EP,Schirmer BD

    更新日期:1996-04-01 00:00:00

  • The Primary Aldosteronism Surgical Outcome Score for the Prediction of Clinical Outcomes After Adrenalectomy for Unilateral Primary Aldosteronism.

    abstract:OBJECTIVE:To develop a prediction model for clinical outcomes after unilateral adrenalectomy for unilateral primary aldosteronism. SUMMARY BACKGROUND DATA:Unilateral primary aldosteronism is the most common surgically curable form of endocrine hypertension. Surgical resection of the dominant overactive adrenal in unil...

    journal_title:Annals of surgery

    pub_type: 杂志文章


    authors: Burrello J,Burrello A,Stowasser M,Nishikawa T,Quinkler M,Prejbisz A,Lenders JWM,Satoh F,Mulatero P,Reincke M,Williams TA

    更新日期:2020-12-01 00:00:00

  • Therapeutic delay and survival after surgery for cancer of the pancreatic head with or without preoperative biliary drainage.

    abstract:OBJECTIVE:To evaluate the relation between delay in surgery because of preoperative biliary drainage (PBD) and survival in patients scheduled for surgery for pancreatic head cancer. BACKGROUND:Patients with obstructive jaundice due to pancreatic head cancer can undergo PBD. The associated delay of surgery can lead to ...

    journal_title:Annals of surgery

    pub_type: 杂志文章,多中心研究,随机对照试验


    authors: Eshuis WJ,van der Gaag NA,Rauws EA,van Eijck CH,Bruno MJ,Kuipers EJ,Coene PP,Kubben FJ,Gerritsen JJ,Greve JW,Gerhards MF,de Hingh IH,Klinkenbijl JH,Nio CY,de Castro SM,Busch OR,van Gulik TM,Bossuyt PM,Gouma DJ

    更新日期:2010-11-01 00:00:00

  • Effect of optimization of hemodynamics on fibrinolytic activity and antithrombotic efficacy of external pneumatic calf compression.

    abstract::External pneumatic calf compression is effective but imperfect for antithrombotic prophylaxis in surgical patients. In preliminary studies, sequential filling of multisegmented leggings with graded pressure decreasing from ankle to knee increased venous flow velocity and wall shear stress, decreased residual venous vo...

    journal_title:Annals of surgery

    pub_type: 临床试验,杂志文章,随机对照试验


    authors: Salzman EW,McManama GP,Shapiro AH,Robertson LK,Donovan AS,Blume HW,Sweeney J,Kamm RD,Johnson MC,Black PM

    更新日期:1987-11-01 00:00:00

  • The relationship between extent of thyroid cancer surgery and use of radioactive iodine.

    abstract:UNLABELLED:By linking surgeon surveys to the National Cancer Database, we found that surgeons' tendency to perform more extensive thyroid resection is associated with greater use of radioactive iodine for stage I thyroid cancer. OBJECTIVE:To determine the relationships between surgeon recommendations for extent of res...

    journal_title:Annals of surgery

    pub_type: 杂志文章


    authors: Haymart MR,Banerjee M,Yang D,Stewart AK,Doherty GM,Koenig RJ,Griggs JJ

    更新日期:2013-08-01 00:00:00

  • The effects of regionalization on cost and outcome for one general high-risk surgical procedure.

    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


    authors: Gordon TA,Burleyson GP,Tielsch JM,Cameron JL

    更新日期:1995-01-01 00:00:00

  • Chenodeoxycholic acid induced liver injury in pregnant and neonatal baboons.

    abstract::The prolonged feeding of chenodeoxycholic acid produces hepatic injury in both pregnant and non-pregnant baboons. CDC feeding does not adversely affect ovarina function and no teratogenic effects of this bile acid were noted in 16 live birth and two stillborn progeny of CDC fed animals. However, 10 of the 16 live birt...

    journal_title:Annals of surgery

    pub_type: 杂志文章


    authors: McSherry CK,Morrissey KP,Swarm RL,May PS,Niemann WH,Glenn F

    更新日期:1976-10-01 00:00:00

  • Selective gastric vagotomy and drainage for duodenal ulcer: a 10-13-year follow-up study.

    abstract::From 1964 to 1968 selective gastric vagotomy (SGV) and drainage was performed in 174 patients. Of these, 105 patients were followed-up 10-13 years after operation; 56 were dead. Ulcers recurred in 18 patients. The cumulated recurrence rate after 13 years (life table method) was 15% (95% confidence limits: 8-23). The m...

    journal_title:Annals of surgery

    pub_type: 杂志文章


    authors: Siim C,Lublin HK,Jensen HE

    更新日期:1981-12-01 00:00:00

  • The Australian and New Zealand Audit of Surgical Mortality-birth, deaths, and carriage.

    abstract:OBJECTIVE:This article outlines the formation of the Australian and New Zealand Audit of Surgical Mortality (ANZASM) and describes its objectives, governance, functioning and challenges. BACKGROUND:A nationwide audit of surgical mortality provides an overview of the leading causes of death in patients who require surg...

    journal_title:Annals of surgery

    pub_type: 杂志文章


    authors: Raju RS,Guy GS,Majid AJ,Babidge W,Maddern GJ

    更新日期:2015-02-01 00:00:00

  • Carotid Artery Reactivity Predicts Events in Peripheral Arterial Disease Patients.

    abstract:OBJECTIVE:Patients with peripheral arterial disease (PAD) have increased risk on future cerebro- and cardiovascular events. Our aim was to examine whether carotid artery reactivity (CAR; a novel, simple procedure to examine endothelial function) predicts cardiovascular events in PAD patients. BACKGROUND:Increased risk...

    journal_title:Annals of surgery

    pub_type: 杂志文章


    authors: van Mil ACCM,Pouwels S,Wilbrink J,Warlé MC,Thijssen DHJ

    更新日期:2019-04-01 00:00:00

  • Impact of Surgical Resection of the Primary Tumor on Overall Survival in Patients With Metastatic Pheochromocytoma or Sympathetic Paraganglioma.

    abstract:OBJECTIVE:To determine whether primary tumor resection in patients with metastatic pheochromocytoma or paraganglioma (PPG) is associated with longer overall survival (OS). BACKGROUND:Patients with metastatic PPG have poor survival outcomes. The impact of surgical resection of the primary tumor on OS is not known. MET...

    journal_title:Annals of surgery

    pub_type: 杂志文章


    authors: Roman-Gonzalez A,Zhou S,Ayala-Ramirez M,Shen C,Waguespack SG,Habra MA,Karam JA,Perrier N,Wood CG,Jimenez C

    更新日期:2018-07-01 00:00:00

  • Pathologic complete response of primary tumor following preoperative chemoradiotherapy for locally advanced rectal cancer: long-term outcomes and prognostic significance of pathologic nodal status (KROG 09-01).

    abstract:OBJECTIVE:To investigate long-term outcomes of locally advanced rectal cancer (LARC) patients with postchemoradiotherapy (post-CRT) pathologic complete response of primary tumor (ypT0) and determine prognostic significance of post-CRT pathologic nodal (ypN) status. BACKGROUND:LARC patients with post-CRT pathologic com...

    journal_title:Annals of surgery

    pub_type: 杂志文章


    authors: Yeo SG,Kim DY,Kim TH,Chang HJ,Oh JH,Park W,Choi DH,Nam H,Kim JS,Cho MJ,Kim JH,Park JH,Kang MK,Koom WS,Kim JS,Nam TK,Chie EK,Kim JS,Lee KJ

    更新日期:2010-12-01 00:00:00

  • A prospective, randomized, controlled trial of preoperative transarterial chemoembolization for resectable large hepatocellular carcinoma.

    abstract:OBJECTIVE:To evaluate the effect of preoperative transarterial chemoembolization (TACE) for resectable large hepatocellular carcinoma (HCC). SUMMARY BACKGROUND DATA:Resection of HCC is potentially curative, but local recurrence is very common. There is currently no effective neoadjuvant or adjuvant therapy. METHODS:F...

    journal_title:Annals of surgery

    pub_type: 杂志文章,随机对照试验


    authors: Zhou WP,Lai EC,Li AJ,Fu SY,Zhou JP,Pan ZY,Lau WY,Wu MC

    更新日期:2009-02-01 00:00:00

  • Challenges and Opportunities for the Academic Mission Within Expanding Health Systems: A Qualitative Study.

    abstract:OBJECTIVE:To explore challenges and opportunities for surgery departments' academic missions as they become increasingly affiliated with expanding health systems. SUMMARY BACKGROUND DATA:Academic medicine is in the midst of unprecedented change. In addition to facing intense competition, narrower margins, and decrease...

    journal_title:Annals of surgery

    pub_type: 杂志文章


    authors: Chhabra KR,Diaz A,Byrnes MA,Rajkumar A,Yang P,Dimick JB,Nathan H

    更新日期:2020-11-12 00:00:00

  • Major hepatectomy for the treatment of complex bile duct injury.

    abstract:BACKGROUND:Postcholecystectomy complex bile duct injuries involving the hilar confluence, which are often associated with vascular injuries and liver atrophy, remain a considerable surgical challenge. The aim of this study is to report our experience of major hepatectomy with long-term outcome in these patients. METHO...

    journal_title:Annals of surgery

    pub_type: 杂志文章


    authors: Laurent A,Sauvanet A,Farges O,Watrin T,Rivkine E,Belghiti J

    更新日期:2008-07-01 00:00:00

  • A statewide, population-based time-series analysis of the outcome of ruptured abdominal aortic aneurysm.

    abstract:OBJECTIVES:The purpose of this study was to perform the first statewide, population-based, time-series analysis of the frequency of ruptured abdominal aortic aneurysm (RAAA), to determine the outcomes of RAAA, and to assess the association of patient, physician, and hospital factors with survival after RAAA. The hypoth...

    journal_title:Annals of surgery

    pub_type: 杂志文章


    authors: Rutledge R,Oller DW,Meyer AA,Johnson GJ Jr

    更新日期:1996-05-01 00:00:00

  • Influence of the postoperative state on the intracellular free amino acids in human muscle tissue.

    abstract::Five patients were studied before and two to three days after major, uncomplicated abdominal operation. Muscle tissue was obtained by needle biopsy from m. quadriceps femoris after eight hours overnight fast. Plasma free amino acids were analyzed in simultaneously obtained samples. In the homogenized muscle samples th...

    journal_title:Annals of surgery

    pub_type: 杂志文章


    authors: Vinnars E,Bergstöm J,Fürst P

    更新日期:1975-12-01 00:00:00

  • The physiologic effects of pneumoperitoneum in the morbidly obese.

    abstract:OBJECTIVE:To review the physiologic effects of carbon dioxide (CO2) pneumoperitoneum in the morbidly obese. SUMMARY BACKGROUND DATA:The number of laparoscopic bariatric operations performed in the United States has increased dramatically over the past several years. Laparoscopic bariatric surgery requires abdominal in...

    journal_title:Annals of surgery

    pub_type: 杂志文章,评审


    authors: Nguyen NT,Wolfe BM

    更新日期:2005-02-01 00:00:00

  • Surgical Techniques and Long-term Outcomes of Living-donor Liver Transplantation With Inferior Vena Cava Replacement Using Atriocaval Synthetic Interposition Graft for Budd-Chiari Syndrome.

    abstract:OBJECTIVE:We aimed to describe our living-donor liver transplantation (LDLT) surgical technique and its long-term patency for patients with Budd-Chiari syndrome (BCS) and retrohepatic inferior vena cava (IVC) obstruction that extends up to the atrium. BACKGROUND:From a technical perspective, LDLT for BCS with an IVC o...

    journal_title:Annals of surgery

    pub_type: 信件


    authors: Yoon YI,Lee SG,Moon DB,Ahn CS,Hwang S,Kim KH,Ha TY,Song GW,Jung DH,Park GC,Kim DS,Choo SJ

    更新日期:2019-04-01 00:00:00

  • Aortoenteric fistula. Incidence, presentation recognition, and management.

    abstract::Twenty-two patients developed one or more aortoenteric fistulae following aortic reconstruction with a dacron graft. Endoscopy was performed on 11 of these patients on 17 occasions and a preoperative diagnosis was made in eight patients. Fistulous communication was most common between the aorta and duodenum (60%), and...

    journal_title:Annals of surgery

    pub_type: 杂志文章


    authors: Champion MC,Sullivan SN,Coles JC,Goldbach M,Watson WC

    更新日期:1982-03-01 00:00:00

  • Cumulative Metformin Use and Its Impact on Survival in Gastric Cancer Patients After Gastrectomy.

    abstract:OBJECTIVE:The aim of this study was to evaluate the association between metformin and survival of gastric cancer (GC) patients. BACKGROUND:Metformin has recently received attention as a potential anticancer treatment. However, no study has shown the survival benefit of metformin for GC patients. METHODS:A total of 19...

    journal_title:Annals of surgery

    pub_type: 杂志文章


    authors: Lee CK,Jung M,Jung I,Heo SJ,Jeong YH,An JY,Kim HI,Cheong JH,Hyung WJ,Noh SH,Kim HS,Rha SY,Chung HC

    更新日期:2016-01-01 00:00:00

  • Bariatric Surgery and the Risk of Cancer in a Large Multisite Cohort.

    abstract:OBJECTIVE:To determine whether bariatric surgery is associated with a lower risk of cancer. BACKGROUND:Obesity is strongly associated with many types of cancer. Few studies have examined the relationship between bariatric surgery and cancer risk. METHODS:We conducted a retrospective cohort study of patients undergoin...

    journal_title:Annals of surgery

    pub_type: 杂志文章,多中心研究


    authors: Schauer DP,Feigelson HS,Koebnick C,Caan B,Weinmann S,Leonard AC,Powers JD,Yenumula PR,Arterburn DE

    更新日期:2019-01-01 00:00:00

  • Healing of esophagojejunal anastomoses after experimental total gastrectomy. A comparative study using manually sutured or stapled anastomoses.

    abstract::In construction of the eosphagojejunostomy after total gastrectomy, the EEA stapled (US Surgical Corporation, Norwalk, CT) and the two-layer interrupted 3-0 Dexon anastomoses are compared concerning the radiological appearance, breaking strength, circulation, and collagen concentration. Thirty female pigs were used. A...

    journal_title:Annals of surgery

    pub_type: 杂志文章


    authors: Walther B,Löwenhielm P,Strand SE,Ståhlberg F,Uvelius B,Oscarson J,Evander A

    更新日期:1986-04-01 00:00:00

  • Optimization of staging of the neck with prophylactic central and lateral neck dissection for papillary thyroid carcinoma.

    abstract:OBJECTIVE:To analyze the yield and rate of node metastases (pN1) for prophylactic central (CND) and lateral neck dissection (LND) for papillary thyroid carcinoma, the risk factors for pN1, and outcomes. BACKGROUND:Prophylactic CND and LND are not routinely employed. Adjuvant radioiodine treatment may be modulated, how...

    journal_title:Annals of surgery

    pub_type: 杂志文章


    authors: Hartl DM,Leboulleux S,Al Ghuzlan A,Baudin E,Chami L,Schlumberger M,Travagli JP

    更新日期:2012-04-01 00:00:00

  • The impact of neural invasion severity in gastrointestinal malignancies: a clinicopathological study.

    abstract:OBJECTIVES:Because neural invasion (NI) is still inconsistently reported and not well characterized within gastrointestinal malignancies (GIMs), our aim was to determine the exact prevalence and severity of NI and to elucidate the true impact of NI on patient's prognosis. BACKGROUND:The union internationale contre le ...

    journal_title:Annals of surgery

    pub_type: 杂志文章


    authors: Liebl F,Demir IE,Mayer K,Schuster T,DʼHaese JG,Becker K,Langer R,Bergmann F,Wang K,Rosenberg R,Novotny AR,Feith M,Reim D,Friess H,Ceyhan GO

    更新日期:2014-11-01 00:00:00