Abstract：
BACKGROUND:Penetrating injuries of the subclavian artery occurs infrequently but represent a surgical challenge. We reviewed our experience with penetrating injury of the subclavian artery and identify factors that influenced morbidity and mortality. METHODS:A retrospective review was performed on 54 consecutive patients who sustained penetrating injury to the subclavian artery during a 10-year period. RESULTS:The causes of injuries were gunshot wounds in 46 patients (85%), stab wounds in 5 patients (9%), and shotgun wounds in 3 patients (6%). The overall mortality was 39%. Operative management of the subclavian artery injury included primary repair in 38 patients, interposition grafting in 13 patients, and ligation in 3 patients. The most common associated injury was subclavian vein (44%) followed by brachial plexus (31%). Predictors of survivability include mechanism of penetrating injuries, hemodynamic status of patients on arrival, and three or more associated injuries involving other structures. Associated brachial plexus injury accounts for the majority of long-term morbidity in survivors. CONCLUSIONS:Penetrating injuries of the subclavian artery are associated with high morbidity and mortality. Multiple concomitant injuries, unstable vital signs upon presentation, and gun shot injuries greatly increase mortality.
journal_name
Am J Surgjournal_title
American journal of surgeryauthors
Lin PH,Koffron AJ,Guske PJ,Lujan HJ,Heilizer TJ,Yario RF,Tatooles CJdoi
10.1016/s0002-9610(03)00070-9subject
Has Abstractpub_date
2003-06-01 00:00:00pages
580-4issue
6eissn
0002-9610issn
1879-1883pii
S0002961003000709journal_volume
185pub_type
杂志文章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：BACKGROUND:The aim of this study was to characterize patients readmitted following inpatient general surgery procedures. We hypothesized that a decreased length of stay would increase risk for readmission. METHODS:We utilized our institutional National Surgical Quality Improvement Project database from 2006 to 2011. T...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/j.amjsurg.2013.10.022
更新日期：2014-04-01 00:00:00
abstract：:Patients who have undergone recent abdominal surgery and have generalized obliterative adhesions provide a major management problem if they require urgent ileostomy for sepsis or fistulization, particularly when there is an associated abdominal wall defect. This report describes a technique for creating an ileostomy t...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/s0002-9610(00)00414-1
更新日期：2000-07-01 00:00:00
abstract：BACKGROUND:Magnetic resonance cholangiopancreatography (MRCP) is a newly developing noninvasive examination of the biliopancreatic trees. Roles of MRCP in the diagnosis of pancreatic diseases have not been scrutinized. METHODS:Endoscopic retrograde cholangiopancreatography (ERCP) and MRCP were reviewed in 52 Japanese ...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/s0002-9610(97)00287-0
更新日期：1998-03-01 00:00:00
abstract：BACKGROUND:Michigan repealed a 35-year mandatory helmet law on April 13, 2012. We examined the early clinical impacts at a level 1 trauma center in West Michigan. METHODS:Retrospective cohort study comparing outcomes among motorcycle crash victims in a 7-month period before and after the helmet law repeal. RESULTS:On...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/j.amjsurg.2013.12.001
更新日期：2014-03-01 00:00:00
abstract：:Gut glutamine utilization after massive small bowel resection was studied to gain further insight into the alterations and adaptations in intestinal glutamine metabolism that occur during the development of post-resectional hyperplasia. After resection of the middle 60% of the small intestine in the rat, gut glutamine...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/s0002-9610(05)80603-8
更新日期：1990-01-01 00:00:00
abstract：BACKGROUND:Recent cognitive research in medicine has demonstrated that expert diagnosticians solve many clinical problems through "pattern recognition" rather than deductive reasoning strategies. Development of the ability to recognize and diagnose common surgical problems is a critical objective of undergraduate surgi...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/S0002-9610(99)80172-X
更新日期：1995-03-01 00:00:00
abstract：BACKGROUND:Studies on stress hyperglycemia in trauma patients have largely ignored diabetes, a potential confounder. The purpose of this study was to assess the relationship between diabetes and outcome in trauma patients. METHODS:Data were obtained from the National Trauma Data Bank (version 4.0). The primary outcome...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/j.amjsurg.2006.08.031
更新日期：2006-12-01 00:00:00
abstract：:Recent developments in protein and genetic engineering methods have allowed the production of antibody-derived molecules that have important potential as therapeutic agents. Although monoclonal antibodies of murine origin have been used for therapeutic purposes, limitations due to anti-antibody responses and suboptima...
journal_title：American journal of surgery
pub_type： 杂志文章,评审
doi：10.1016/s0002-9610(05)80653-1
更新日期：1992-07-01 00:00:00
abstract：BACKGROUND:Endoscopic retrograde cholangiopancreatography is a challenging procedure performed by surgeons and gastroenterologists. We employed cognitive task analysis to identify steps and decision points for this procedure. METHODS:Standardized interviews were conducted with expert gastroenterologists (7) and surgeo...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/j.amjsurg.2015.05.006
更新日期：2015-10-01 00:00:00
abstract：BACKGROUND:Rectal cancer treatment has become multimodal as a result of significant advances in imaging, staging, surgery, radiotherapy, and chemotherapy. Multidisciplinary teams can incorporate these developments into tailor-made treatment plans and offer state-of-the-art services for rectal cancer patients. METHODS:...
journal_title：American journal of surgery
pub_type： 杂志文章,评审
doi：10.1016/j.amjsurg.2009.09.023
更新日期：2010-09-01 00:00:00
abstract：BACKGROUND:Elderly patients are at an increased risk of protein-energy malnutrition (PEM) which increases the risk of morbidity/mortality. We evaluated the association between hypoalbuminemia at the time of emergency department (ED) admission and in-hospital complications among geriatric trauma patients. METHODS:This ...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/j.amjsurg.2015.06.013
更新日期：2016-07-01 00:00:00
abstract：:The social, economic and political challenges accompanying our rapidly transforming global health environments have created unique social challenges that demand cross-sector solutions. Four cross-sector partnerships are reviewed with a special focus on sector roles, change management, phases of partnership development...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/s0002-9610(02)01143-1
更新日期：2003-01-01 00:00:00
abstract：:Thirty-two rats had truncal vagotomy either with or without pyloroplasty. After 2 or 4 weeks, respectively, the pancreas was excised and weighed. Measurements of amylase, trypsin, lipase, total protein, and DNA were obtained from the homogenated pancreatic tissue. Isolated pancreatic lobules were incubated with and wi...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/0002-9610(89)90615-6
更新日期：1987-09-01 00:00:00
abstract：BACKGROUND:This study aimed to assess the transferability of basic laparoscopic skills between a virtual reality simulator (MIST-VR) and a video trainer box (D-Box). METHODS:Forty-six medical students were randomized into 2 groups, training on MIST-VR or D-Box. After training with one modality, a crossover assessment ...
journal_title：American journal of surgery
pub_type： 杂志文章,随机对照试验
doi：10.1016/j.amjsurg.2009.05.016
更新日期：2010-06-01 00:00:00
abstract：:Parastomal hernia repair remains a significant surgical challenge. Recurrence after standard "keyhole" or primary suture repair is common. We adopted and modified a new technique using a construct shaped like an inverted top hat. We review our experience over the last six years in the first 30 patients (31 consecutive...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/j.amjsurg.2018.02.018
更新日期：2018-09-01 00:00:00
abstract：BACKGROUND:Trastuzumab has been found to have potent antiproliferative effects in human epidermal growth factor receptor 2 (HER-2)-overexpressing human breast tumors. Inhibition of vascular endothelial growth factor receptor (VEGFR), a protein often overexpressed in breast carcinoma, has been shown to induce apoptosis....
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/j.amjsurg.2008.10.009
更新日期：2009-03-01 00:00:00
abstract：BACKGROUND:The objective of this study was to compare middle authorships between male and female general surgeons in the United States. METHODS:A stratified random sample of American College of Surgeons general surgery fellows was identified. Relevant author demographic, affiliation, and publication metrics were colle...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/j.amjsurg.2020.04.025
更新日期：2020-12-01 00:00:00
abstract：:A review has been made of the records of 208 patients operated on for complications of diverticulitis of the colon. One hundred forty patients had emergency operations and 68, elective operations. Resection and anastomosis, with or without temporary diverting colostomy, practiced in the majority of emergency cases in ...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/0002-9610(87)90605-2
更新日期：1987-03-01 00:00:00
abstract：BACKGROUND:The Centers for Disease Control and Prevention reported that surgical site infections (SSIs) create a significant hospital burden. To date, few multi-institutional studies have been performed to evaluate the risk factors for SSIs in mastectomy patients. METHODS:By using the American College of Surgeons' Nat...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/j.amjsurg.2012.05.007
更新日期：2013-02-01 00:00:00
abstract：BACKGROUND:Capsule endoscopy (CE) is a new device that enables visualization of areas of the small bowel that were previously inaccessible through other noninvasive procedures. The purpose of this study is to evaluate this new diagnostic tool and its efficacy in finding occult GI tract pathology. METHODS:A single-inst...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/j.amjsurg.2005.08.015
更新日期：2005-12-01 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:Port placement injuries are a potentially devastating complication of laparoscopic surgery. Ultrasound assessment for visceral slide has the ability to preoperatively determine adhesion-free areas. The utility of this technique has not been studied when performed by surgeons. METHODS:Surgeons without expert...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/j.amjsurg.2014.12.020
更新日期：2015-05-01 00:00:00
abstract：BACKGROUND:Transjugular intrahepatic portosystemic stent shunt (TIPS) has become the modality of choice for complicated portal decompression. This study was undertaken to determine outcomes after TIPS and the usefulness of TIPS as a "bridge" to transplantation. METHODS:Patients undergoing TIPS from 2001 to 2010 at a t...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/j.amjsurg.2012.06.005
更新日期：2013-04-01 00:00:00
abstract：BACKGROUND:A gender-neutral threshold aneurysm diameter (AD) of more than 5.5 cm for surgical intervention in abdominal aortic aneurysms (AAA) ignores the fact that women have a smaller baseline AD. We hypothesized that women have a greater AD relative to body surface area (BSA) at the time of surgery and that this wor...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/j.amjsurg.2014.07.008
更新日期：2015-02-01 00:00:00
abstract：:Among 400 patients with adenocarcinoma of the distal large bowel, anterior resection resulted in more anastomotic leaks, postoperative urinary retention and diarrhea when used for lesions of the mid-rectum than when used for lesions of the proximal rectum or sigmoid colon. However, the operative mortality, long-term m...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/0002-9610(80)90235-4
更新日期：1980-01-01 00:00:00
abstract：:Experiments were designed to examine the functional characteristics of lymphocytes harvested from the human intestine. Lymphocytes were harvested from the intestines of patients undergoing intestinal resection for a variety of gut disorders. The mitogenic and allogeneic responses of gut lymphocytes were found to be co...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/0002-9610(83)90184-8
更新日期：1983-01-01 00:00:00
abstract：:An improved technic has been developed to predict rapidly the critical number of bacteria in tissues. This technic gave reliable and accurate measurements for wounds containing more than 2 X 10(5) organisms per gram of tissue. It is fortuitous that 10(6) bacteria is the critical number of bacteria that will induced cl...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/0002-9610(77)90174-x
更新日期：1977-06-01 00:00:00
abstract：BACKGROUND:The anastomotic leak and stricture formation after esophagectomy and cervical esophagogastric anastomosis deny patients with esophageal carcinoma the benefits of surgery. The present study was designed to ascertain whether a wide cross-sectional area at the site of anastomosis leads to lesser anastomotic com...
journal_title：American journal of surgery
pub_type： 临床试验,杂志文章,随机对照试验
doi：10.1016/s0002-9610(01)00616-x
更新日期：2001-06-01 00:00:00
abstract：BACKGROUND:Cervical spine injuries can occur in as many as 10% of patients with blunt trauma with mental status changes from closed head injuries. Despite normal results on cervical spine computed tomography (CT), magnetic resonance imaging (MRI) is often recommended to exclude ligamentous or soft tissue injury. METHO...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/j.amjsurg.2008.07.040
更新日期：2008-12-01 00:00:00
