Abstract：
BACKGROUND:Traditional management of symptomatic paraesophageal herniation involves hernia reduction, hiatal closure, and an antireflux procedure or gastropexy. Patients with significant comorbidities may not tolerate operative repair. A new technique, laparoscopic-assisted endoscopic reduction and fixation of the stomach, may provide a minimally invasive treatment alternative. METHODS:Eleven elderly patients with symptomatic paraesophageal herniation were managed with flexible endoscopy and double percutaneous endoscopic gastrostomy (PEG) tube insertion with or without laparoscopic assistance. RESULTS:All patients presented with a symptomatic paraesophageal hernia. Mean age was 78.3 years (range 72 to 84). Each was deemed at high risk for definitive repair due to preexisting coronary artery disease as well as at least two other serious comorbidities. Hernia reduction and intra-abdominal fixation of the stomach was achieved in each case using flexible endoscopy and double PEG insertion. Laparoscopic assistance for reduction and gastropexy was utilized in 9 cases. Mean operative time was 61 minutes (range 28 to 104). Average length of stay was 2.8 days (range 0 to 12). One minor and three major postoperative complications occurred. Over a mean follow-up of 4.1 months (range 2 to 7), all patients have resumed oral intake and achieved weight gain. CONCLUSIONS:Patients with symptomatic paraesophageal herniation require intervention to alleviate symptoms and avoid the complications of gastric incarceration. For the high-risk patient, endoscopic reduction and PEG with laparoscopic assistance appears to provide effective treatment.
journal_name
Am J Surgjournal_title
American journal of surgeryauthors
Kercher KW,Matthews BD,Ponsky JL,Goldstein SL,Yavorski RT,Sing RF,Heniford BTdoi
10.1016/s0002-9610(01)00760-7subject
Has Abstractpub_date
2001-11-01 00:00:00pages
510-4issue
5eissn
0002-9610issn
1879-1883pii
S0002-9610(01)00760-7journal_volume
182pub_type
杂志文章abstract：:A case of unicystic ameloblastoma of the mandible in a 10-year-old child is described. In addition to the mandibular swelling the patient also had a proliferative lesion over the alveolus that masqueraded as a neoplastic lesion. ...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/j.amjsurg.2007.07.036
更新日期：2008-09-01 00:00:00
abstract：BACKGROUND:This is a retrospective study analyzing data of normocalcemic patients with enlarged parathyroid glands discovered during thyroid surgery and comparing it with data of patients operated on for proved primary hyperparathyroidism. METHODS:The records of patients with enlarged parathyroid glands (group 1) and ...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/j.amjsurg.2007.01.033
更新日期：2008-01-01 00:00:00
abstract：OBJECTIVE:The purpose of our study is to further clarify the incidence of ductal carcinoma in situ (DCIS) patients that are upstaged upon final pathology and/or have metastatic disease in the axilla. METHODS:All patients were diagnosed with DCIS or DCIS with microinvasion (DCISm) on their diagnostic biopsy and receive...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/j.amjsurg.2005.06.011
更新日期：2005-10-01 00:00:00
abstract：BACKGROUND:Leakage from esophageal anastomoses is higher than that for other gastrointestinal anastomoses. An intrathoracic anastomotic leak is a potentially catastrophic event. METHODS:Patients with and without thoracic anastomotic leakage were compared for predisposing factors. Leak-related mortality was analyzed. ...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/s0002-9610(01)00559-1
更新日期：2001-03-01 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：BACKGROUND:Considering the surgical safety and perioperative complications, simultaneous resection after neoadjuvant therapy is not commonly recommended. METHODS:A total of 253 patients were included in study. Comparison of the short-term outcomes was performed after propensity score adjustment in Group A (n = 96) and...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/j.amjsurg.2018.09.019
更新日期：2019-11-01 00:00:00
abstract：:The records of 123 patients with squamous cell cancer of the lip presenting to the Vancouver Clinic of the British Columbia Cancer Agency from 1984 and 1988 were reviewed, and 4 were excluded from the study for various reasons. Initial treatment was surgery in 40, radiotherapy in 61, and combined in 18 patients. The p...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/0002-9610(92)90389-9
更新日期：1992-05-01 00:00:00
abstract：:Fourteen infants with intestinal stenosis as a late sequela of necrotizing enterocolitis were treated at Texas Children's and Ben Taub General Hospitals from 1972 to 1979. Barium enema studies are the keystone in making the diagnosis and should be performed in any infant with abdominal distention or poor feeding after...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/0002-9610(81)90320-2
更新日期：1981-12-01 00:00:00
abstract：:The aim of this study was to evaluate whether total gastrectomy performed for gastric cancer leads to an increased risk of cholelithiasis and whether the method of reconstruction of the digestive tract influences that risk. A total of 102 patients who had undergone total gastrectomy for gastric cancer between 1980 and...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/s0002-9610(05)80573-2
更新日期：1993-07-01 00:00:00
abstract：:Careful intraoperative surgical staging should be considered routine for all patients undergoing thoracotomy for lung cancer. In addition, conservative resection is indicated for T1N0 lesions. Surgical adjuvant immunotherapy has not proved as effective as originally hoped. However, the advent of more effective combina...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/0002-9610(82)90037-x
更新日期：1982-06-01 00:00:00
abstract：:The results achieved by liver resection for metastatic cancer in more than 400 patients have been studied in a collected review. Certain conclusions seem justified: The liver is no longer the surgeon's "no-man's-land," and local excision of metastatic tumor can achieve clinical cure in some patients. The risk-benefit ...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/0002-9610(78)90072-7
更新日期：1978-03-01 00:00:00
abstract：:A plan is advocated for the management of the dominant breast mass with use of local anesthesia in the outpatient setting as the primary diagnostic tool, but with selection of certain patients for immediate general anesthesia biopsy in the "conventional" manner. Experience with this plan in 2,492 patients during a per...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/0002-9610(76)90030-1
更新日期：1976-05-01 00:00:00
abstract：BACKGROUND:Splenic artery aneurysms (SAA) are rare clinical entities that carry the risk of rupture and fatal hemorrhage. They are being detected with increased frequency and often cause a clinical dilemma, particularly when small lesions occur in compromised patients. This paper relates our experience in the managemen...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/s0002-9610(99)80225-6
更新日期：1995-06-01 00:00:00
abstract：:The management of the failing myocardium was primarily empirical for centuries, until Withering introduced foxglove (digitalis) in 1785 as an effective medication. Gradually, the medical treatment included, besides digitalis preparations, the use of diuretics to reduce excessive sodium and water retention; limiting sa...
journal_title：American journal of surgery
pub_type： 历史文章,杂志文章
doi：10.1016/0002-9610(84)90186-7
更新日期：1984-06-01 00:00:00
abstract：:A seven day old dehydrated male infant was found to have acute ischemia of the leg due to acute thrombotic occlusion of an external iliac, common and superficial femoral, and popliteal arteries. Early thrombectomy and arterioplasty resulted in complete remission of ischemia. Our success with direct vascular surgery pr...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/0002-9610(75)90254-8
更新日期：1975-03-01 00:00:00
abstract：:Fifty-one cervical nodes from 19 patients with advanced head and neck cancer were stimulated with phorbol dibutyrate and ionomycin (PDBu + Io) to determine the effect of such stimulation on the generation of cytotoxic T cells and whether this stimulation could bypass the need for autologous tumor stimulation. Lymphocy...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/s0002-9610(05)80718-4
更新日期：1992-12-01 00:00:00
abstract：:The effects of cyclosporin A on the regenerating liver were studied in rats after partial hepatectomy and were compared with those of conventional immunosuppressants such as methylprednisolone and azathioprine. In Group I, a standard hepatectomy removing two thirds of the organ was performed. In Group II, an oral dose...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/s0002-9610(88)80705-0
更新日期：1988-02-01 00:00:00
abstract：BACKGROUND:The relative prognostic impact of intra-aortic balloon pump (IABP) placement before versus after cardiac surgery is not well defined. METHODS:We reviewed data from all cardiac surgical patients who received perioperative IABP support at a veterans' hospital between April 1992 and April 2008. We compared out...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/j.amjsurg.2009.07.011
更新日期：2009-11-01 00:00:00
abstract：INTRODUCTION:This review was performed to evaluate the outcome of patients undergoing pancreaticoduodenectomy (PD) for isolated metastatic or locally advanced nonperiampullary tumors at a single institution over a 13-year period. METHODS:Between 1983 and 1996, patients undergoing PD for metastatic or locally advanced ...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/s0002-9610(97)00121-9
更新日期：1997-10-01 00:00:00
abstract：BACKGROUND:The aim of this study was to identify stage II colon cancer patients with a high risk of recurrence. METHODS:All patients who underwent surgery for stage II colon cancer (CC) were retrospectively enrolled and sub-grouped according to TNM staging (IIa-b-c) and stage IIa in high (IIaHR) and low risk (IIaLR) a...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/j.amjsurg.2017.03.038
更新日期：2018-01-01 00:00:00
abstract：:A number of factors are known to be related to increased mortality of surgery in obstructive jaundice, yet precise identification of patients at greatest risk is difficult. We have studied the elimination of the minor analgesic antipyrine as a dynamic measure of hepatic metabolic function in patients with obstructive ...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/s0002-9610(85)80023-4
更新日期：1985-01-01 00:00:00
abstract：BACKGROUND:Since 1977, we have studied preoperative treatments using 5-fluorouracil (5-FU) suppositories alone or in combination with radiation to reduce local recurrence and improve survival of patients with rectal cancer. PATIENTS AND METHODS:We developed a novel preoperative therapy combining radiation, intralumina...
journal_title：American journal of surgery
pub_type： 临床试验,杂志文章
doi：10.1016/S0002-9610(97)89639-0
更新日期：1996-03-01 00:00:00
abstract：:Evaluation of postoperative swallowing ability in thirty-eight patients having had partial laryngectomy indicates that there are marked differences in the degree of dysphagia among individuals with similar surgical defects. This variation in swallowing disability, however, appears to have definable limits. Rehabilitat...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/0002-9610(78)90266-0
更新日期：1978-10-01 00:00:00
abstract：BACKGROUND:We evaluated the effect of neoadjuvant therapy (NAT) on lymph node harvest in rectal cancer patients undergoing anatomic resection with curative intent. METHODS:A prospectively maintained database was retrospectively queried for rectal cancer cases from 1990 to 2010. Demographic data, NAT, and lymph node yi...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/j.amjsurg.2012.10.020
更新日期：2013-03-01 00:00:00
abstract：:An analysis of unsuccessful extractions of retained biliary calculi using basket catheters reveals more than half the failures are related to the selection, placement, and size of the T tube. A new T tube has been developed which will improve postoperative access to the common duct and facilitate removal of retained c...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/0002-9610(78)90164-2
更新日期：1978-06-01 00:00:00
abstract：:(1) Carcinoma of the lip occurs predominantly in men in their seventh and eighth decades of life. (2) Epidermoid carcinoma is the most common malignant lip tumor. (3) Metastases to cervical lymph nodes are uncommon. (4) Elective neck dissection is not indicated. (5) Therapeutic radical neck dissection can benefit the ...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/0002-9610(79)90427-6
更新日期：1979-10-01 00:00:00
abstract：:The records of 104 patients with primary adenocarcinoma of the duodenum were reviewed. All patients were followed up to the date of this report, 91 for at least 5 years. Melena was an ominous preoperative finding. Survival was directly related to nodal status, the grade of the lesion, and the ability of the surgeon to...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/0002-9610(81)90163-x
更新日期：1981-02-01 00:00:00
abstract：:Fine-needle aspiration (FNA) biopsy of a thyroid nodule was performed in 797 patients. Ninety-six patients had resection of the thyroid nodule performed subsequent to a one-time FNA biopsy. The surgical pathology of these 96 cases demonstrated a 5.8% false-negative rate and a 9.9% false-positive rate. As a consequence...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/s0002-9610(05)80330-7
更新日期：1993-10-01 00:00:00
abstract：:A successfully treated case of a duodenal hamartoma is presented. A review of the literature has shown that this is the largest such tumor so far described, and the first time a mass was palpable on abdominal examination. Its large size resulted in pyloric obstruction, and its wide attachment to the duodenum necessita...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/0002-9610(77)90090-3
更新日期：1977-02-01 00:00:00
abstract：:A persistent perineal sinus may develop in patients undergoing proctocolectomy for inflammatory bowel disease. Healing may resist the traditional methods of wound management. Wide excision including coccygectomy, transposition of the vascularized gracilis muscle flap into the rigid cavity, and wound closure have led t...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/0002-9610(84)90290-3
更新日期：1984-07-01 00:00:00
