Abstract：
BACKGROUND:We propose a simple algorithm for management of patients with challenging abdominal fascial defects. METHODS:The medical records of 64 patients with complicated abdominal wall defects representing a consecutive series by a single surgeon over a 4-year period were reviewed. Group I patients presented with massive fascial defects and closed wounds. They were reconstructed with autogenous tissue using either the separation of parts (SOP) procedure or free tensor fascia lata (TFL) grafts. Group 2 patients had fascial defects with open wounds. Wound closure was first accomplished with either STSG or primary skin closure over viscera. These patients, now "converted" into patients with closed wounds, were reconstructed months later as in group 1. RESULTS:Average defect size was 320 cm2. Wound closure was achieved in one procedure in all patients with open wounds. Time to discharge after this procedure averaged 9 days. The only morbidity of wound closure was skin graft donor site pain. Average time from temporary staged closure with skin grafts to definitive closure with autogenous tissue was 5 months. Repair of closed fascial defects with autogenous tissue was performed in 51 patients. Average time to discharge after autogenous tissue repair was 6.6 days. Recurrence of hernia was noted in 2 (3.9%) patients with an average follow-up of 24 months. CONCLUSIONS:Treatment of challenging abdominal wall defects can be accomplished simply and safely utilizing the above surgical algorithm. Open wounds are converted into closed wounds and fascial defects are repaired with autogenous tissue. This treatment plan has proved to be effective in a wide variety of situations.
journal_name
Am J Surgjournal_title
American journal of surgeryauthors
Sukkar SM,Dumanian GA,Szczerba SM,Tellez MGdoi
10.1016/s0002-9610(00)00566-3subject
Has Abstractpub_date
2001-02-01 00:00:00pages
115-21issue
2eissn
0002-9610issn
1879-1883pii
S0002-9610(00)00566-3journal_volume
181pub_type
杂志文章abstract：BACKGROUND:To establish feasibility, reliability and validity of a newly designed basic surgical training (BST) assessment form. METHODS:The assessment form was evaluated among trainees on the South-east Scotland BST rotation over 18 months. Feasibility was indicated by response rate. Reliability was determined using ...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/s0002-9610(01)00647-x
更新日期：2001-07-01 00:00:00
abstract：:Recently, carotid plaque factors, specifically intraplaque hemorrhage, have been studied with respect to the production of cerebrovascular symptoms. Ninety-five carotid endarterectomies were performed and the plaques that were removed were examined for intraplaque hemorrhage. Patients were separated into three groups:...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/0002-9610(84)90450-1
更新日期：1984-12-01 00:00:00
abstract：BACKGROUND:Strategies for the effective application of palliative procedures are infrequently standardized and incompletely understood. The effect on patient outcome as determined by elements such as resolution of chief complaints, quality of life, pain control, morbidity of therapy, and resource utilization should pre...
journal_title：American journal of surgery
pub_type： 杂志文章,评审
doi：10.1016/s0002-9610(98)00323-7
更新日期：1999-02-01 00:00:00
abstract：BACKGROUND:The aim of this study is to assess the clinical utility of routine preoperative computed tomography (CT) scanning in patients with cancer of the intraperitoneal colon. METHODS:From November 1997 to June 2001, all patients at VA Puget Sound Healthcare System with a diagnosis of colon cancer were referred for...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/s0002-9610(02)00841-3
更新日期：2002-05-01 00:00:00
abstract：BACKGROUND:Skin-sparing mastectomy represents a new surgical approach that allows a mastectomy while preserving the natural skin envelope of the breast. It facilitates immediate breast reconstruction using an implant or myocutaneous flap, resulting in excellent cosmesis. DATA SOURCES:A PubMed database literature searc...
journal_title：American journal of surgery
pub_type： 杂志文章,评审
doi：10.1016/j.amjsurg.2004.02.004
更新日期：2004-07-01 00:00:00
abstract：BACKGROUND:Because of the increase in the geriatric population, an increasing number of elderly patients are being treated for colorectal cancer. The purpose of this study was to evaluate perioperative morbidity and mortality in this population. METHODS:A retrospective chart review was performed for patients 80 years ...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/j.amjsurg.2007.12.022
更新日期：2008-03-01 00:00:00
abstract：:Examples of the use of endoscopic pancreatography in the preoperative evaluation and postoperative follow-up study of patients with pancreatic disease are presented and discussed. Six cases selected from a total experience of forty-eight patients have been summarized. The direct role of pancreatography in the manageme...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/0002-9610(75)90164-6
更新日期：1975-01-01 00:00:00
abstract：BACKGROUND:This report describes estimated 4-year tumor bed and ipsilateral breast recurrence-free intervals, event-free survival, disease-specific survival, and overall survival in a cohort of MammoSite brachytherapy (MBT) patients with mature follow-up treated at a single institution over a 6-year period. METHODS AN...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/j.amjsurg.2009.03.005
更新日期：2010-02-01 00:00:00
abstract：BACKGROUND:This study defines the entity of the hypertensive lower esophageal sphincter (HLES) and its treatment, including surgical implications. METHODS:Esophageal manometry was performed on 1,300 patients. Of these, 53 (4%) had HLES with resting pressure > 26.5 mm Hg, defined as the upper limit of normal resting LE...
journal_title：American journal of surgery
pub_type： 临床试验,杂志文章
doi：10.1016/S0002-9610(96)00219-X
更新日期：1996-11-01 00:00:00
abstract：:Twenty-three consecutive patients who had persistent respiratory symptoms of unexplained etiology were evaluated to determine the presence of gastroesophageal reflux (GER) and its relationship to their respiratory complaints. Lower esophageal sphincter (LES) and upper esophageal sphincter (UES) pressures and the chara...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/0002-9610(92)90041-o
更新日期：1992-04-01 00:00:00
abstract：:A new S-shaped cystic duct metal cannula was developed and used successfully in 200 cystic duct cholangiograms. It has the advantage of being easy to manipulate because the configuration does not obscure the vision and the resistance is less than that of plastic tubes, facilitating injection with lower pressure. It is...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/0002-9610(79)90106-5
更新日期：1979-06-01 00:00:00
abstract：BACKGROUND:Professionalism and ethics are Accreditation Council for Graduate Medical Education (ACGME) core competencies, but there is little evidence regarding the effectiveness of ethics education. METHODS:General surgery residents at the University of Pittsburgh completed questionnaires measuring attitudes and know...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/j.amjsurg.2010.08.002
更新日期：2010-11-01 00:00:00
abstract：:The relative roles of bacterial infection, fluid loss and myocardial failure were investigated in 24 patients in whom circulatory shock appeared as a complication of purulent peritonitis. The 13 acute survivors, including 6 hospital survivors, had strikingly lower initial plasma volumes and total blood volumes than th...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/0002-9610(81)90290-7
更新日期：1981-08-01 00:00:00
abstract：BACKGROUND:Prospective evaluation of the percutaneous tracheostomy by the guide wire dilating forceps (GWDF) technique. METHODS:In 50 selected patients percutaneous tracheostomy with fiberscopic control was performed and evaluated. RESULTS:Most percutaneous tracheostomies were performed without any adverse effect. No...
journal_title：American journal of surgery
pub_type： 临床试验,杂志文章
doi：10.1016/s0002-9610(99)00049-5
更新日期：1999-04-01 00:00:00
abstract：BACKGROUND:The generative learning model posits that individuals remember content they have generated better than materials created by others. The goals of this study were to evaluate question generation as a study method for the American Board of Surgery In-Training Examination (ABSITE) and determine whether practice ...
journal_title：American journal of surgery
pub_type： 杂志文章,随机对照试验
doi：10.1016/j.amjsurg.2015.08.033
更新日期：2016-02-01 00:00:00
abstract：BACKGROUND:Recurrent laryngeal nerve (RLN) injury is a serious complication of thyroidectomy. The purpose of this study is to determine the predictors and consequences of RLN injury during thyroidectomy. METHODS:A retrospective analysis was conducted using the ACS-NSQIP 2016-2017 main and thyroidectomy targeted proced...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/j.amjsurg.2020.07.023
更新日期：2021-01-01 00:00:00
abstract：BACKGROUND:To analyze our experience with laparoscopic right Mesocolectomy in right colonic cancers. METHODS:600 consecutive patients were studied. RESULTS:Mortality was 0.5%; morbidity was 35.5%. Mean mesocolic area was 15339 ± 1639 mm3, specimen length 24.3 ± 3.3 cm, distance from the tumor to high tie was 103 ± 6 ...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/j.amjsurg.2016.10.005
更新日期：2017-08-01 00:00:00
abstract：:The reported incidence of hypotension after carotid reconstruction ranges from 21 to 50 percent. To evaluate baroreceptor dysfunction, 283 carotid reconstructions were studied. During 181 consecutive reconstructions, a transcutaneous Teflon catheter was positioned intraoperatively at the carotid bifurcation for postop...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/0002-9610(84)90196-x
更新日期：1984-06-01 00:00:00
abstract：BACKGROUND:Graft pancreatitis is a major complication after pancreas transplantation. Antithrombin III (AT III) is an anticoagulatory and anti-inflammatory substance. The aim of our study was to evaluate a prophylactic application of AT III in experimental pancreas transplantation. METHODS:Pancreas transplantation was...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/j.amjsurg.2004.03.017
更新日期：2005-01-01 00:00:00
abstract：:Peripheral vascular complications after cardiac catheterization constitute an increasing portion of traumatic vascular injuries. To determine the incidence of these complications and the sequelae of their treatment, we reviewed 7,690 catheterizations performed over a 40-month period. One hundred eleven vascular compli...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/0002-9610(94)90119-8
更新日期：1994-04-01 00:00:00
abstract：:An improved technic for total thyroidectomy, utilizing magnification, is described. A method of preservation of the parathyroid glands with intact blood supply has been developed. The completeness of total thyroidectomy has been confirmed in 91 per cent of patients studied by postoperative radioactive iodine scan. ...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/0002-9610(75)90472-9
更新日期：1975-10-01 00:00:00
abstract：BACKGROUND:Rurality adversely impacts the continuum of cancer care. However, investigations of rural cancer surgery are notably absent. We examined patterns and outcomes of oncologic resections at rural US hospitals. METHODS:We identified 928,370 hospital admissions in which 1 of 20 oncologic resections was performed ...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/j.amjsurg.2012.07.012
更新日期：2012-11-01 00:00:00
abstract：:Vertical banded gastroplasty creates a channel by two applications of the TA-90 stapler from an end-to-end anastomosis window above the crow's foot to the angle of His, against a 32 F. tube along the lesser curvature. The caudad end of the channel is restricted by a 5 cm collar. Thirty-one obese patients more than 45 ...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/s0002-9610(88)80125-9
更新日期：1988-03-01 00:00:00
abstract：BACKGROUND:This study defines the clinical settings in which extended radical neck dissection (ERND) was performed and determines its impact on control of disease in the neck and on survival. METHODS:We reviewed the records of 106 patients undergoing ERND between 1984 and 1993. Most (76) had metastatic squamous cell c...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/s0002-9610(97)00163-3
更新日期：1997-11-01 00:00:00
abstract：INTRODUCTION:The purpose of this study was to determine if there are clinical features that raise suspicion for parathyroid hyperplasia. MATERIALS & METHODS:We retrospectively reviewed patients with primary hyperparathyroidism who underwent parathyroidectomy from 1991 to 2017, analyzing demographics, calcium and PTH, ...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/j.amjsurg.2017.10.051
更新日期：2018-03-01 00:00:00
abstract：BACKGROUND:A method of augmenting host defenses against bacterial pathogens could result in a decrease in postoperative infections. Given its effects on leukocyte proliferation and function, it is possible that prophylactic granulocyte-macrophage colony-stimulating factor (GM-CSF) could reduce the incidence and severit...
journal_title：American journal of surgery
pub_type： 临床试验,杂志文章
doi：10.1016/s0002-9610(96)00106-7
更新日期：1996-09-01 00:00:00
abstract：:This review of the literature has revealed that isotonic fluids, such as 0.9 percent sodium chloride and Ringer's lactate, are effective plasma volume expanders. Despite the continued use of a variety of colloid solutions in resuscitation, there is no good evidence to document a benefit of these solutions over the cry...
journal_title：American journal of surgery
pub_type： 杂志文章,评审
doi：10.1016/s0002-9610(88)80106-5
更新日期：1988-03-01 00:00:00
abstract：:Vertebral arteriovenous fistulas are rare. A report of two cases is presented with problems related to diagnosis and therapy. An alternative approach to surgical management is given. ...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/0002-9610(79)90320-9
更新日期：1979-12-01 00:00:00
abstract：:DVT involving the lower extremities is a frequent (25-40 percent of patients) complication of major thoracic, abdominal, and pelvic surgery in patients beyond the age of 40 years. Herein, we have reported a recently completed large prospective, randomized multicenter investigation of the prophylaxis of postoperative D...
journal_title：American journal of surgery
pub_type： 临床试验,杂志文章,随机对照试验
doi：
更新日期：1985-10-08 00:00:00
abstract：:Blocking factors are small polypeptide molecules that may appear in the serum of patients with cancer. These factors block the transformation of lymphocytes in culture to nonspecific mitogens such as phytohemagglutinin or concanavalin A and, therefore, may reflect changes in the immunocompetence of the patient. Blocki...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/0002-9610(75)90377-3
更新日期：1975-08-01 00:00:00
