Abstract:
PURPOSE:Transanal endoscopic microsurgery (TEM) is a minimally invasive technique for full-thickness excision of benign and malignant rectal neoplasms located 4 to 24 cm above the anal verge. Entrance into the peritoneal cavity during TEM has been regarded as a complication that mandates conversion to open laparotomy for adequate repair of the defect. This study compares the rate of complications arising from TEM with and without intraperitoneal entry. METHODS:Patients undergoing peritoneal entry were compared to those who did not. RESULTS:No perioperative deaths occurred. There was no significant difference in the incidence of postoperative complications. No major complications occurred with peritoneal entry, and all peritoneal entries were closed transanally via endoscope. CONCLUSIONS:Entry into the peritoneum during TEM is not associated with an increased incidence of complication. Entry into the peritoneum during TEM excision does not mandate conversion to open laparotomy but may be safely repaired endoscopically. Lesions likely to be above the peritoneal reflection and within reach of the endoscope (4 to 24 cm) should be considered for TEM excision.
journal_name
Am J Surgjournal_title
American journal of surgeryauthors
Gavagan JA,Whiteford MH,Swanstrom LLdoi
10.1016/j.amjsurg.2004.01.004subject
Has Abstractpub_date
2004-05-01 00:00:00pages
630-4issue
5eissn
0002-9610issn
1879-1883pii
S0002961004000212journal_volume
187pub_type
杂志文章abstract::In the period from 1976 through 1986, 62 procedures were performed. Of these, 42 were posterior flap hemipelvectomies, 5 anterior flap hemipelvectomies, and 15 internal hemipelvectomies. The median duration of these procedures was 6.5 hours, and the median blood loss was 2,541 ml. Postoperatively, there were no wound ...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/0002-9610(89)90273-0
更新日期:1989-11-01 00:00:00
abstract::Histiocytosis X describes a disease characterized by histiocytic infiltration of the reticuloendothelial system, skin, bones, and pituitary gland. The disseminated form frequently occurs in infants and children. Chemotherapy has significantly improved the prognosis in this disorder. Sixty-three per cent of survivors, ...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/0002-9610(76)90431-1
更新日期:1976-01-01 00:00:00
abstract:BACKGROUND:It is unknown whether surgical residents who learn minimal-access surgery skills in an unstructured environment (ie, at home), will develop a technical skill set that rivals that of those trained in the more traditional, structured learning environment. METHODS:Seven surgery residents were provided structur...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/j.amjsurg.2010.08.028
更新日期:2011-03-01 00:00:00
abstract::Vascular control of the injured retrohepatic vena cava is invariably a surgical challenge. Herein, we describe the technical aspects of inserting a vena cava balloon shunt through the saphenofemoral junction. The advantages of this approach include relative simplicity, maintenance of perihepatic tamponade, and avoidin...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/0002-9610(89)90288-2
更新日期:1989-11-01 00:00:00
abstract::Measurement of arterial and liver tissue oxygen tension (PO2) in animals subjected to hemorrhagic shock demonstrates a significant (p less than 0.001) decrease in tissue PO2 while PaO2 remains essentially unchanged. In fact, marked increase in PaO2 fail to increase tissue PO2 to control levels, demonstrating that the ...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/0002-9610(77)90020-4
更新日期:1977-05-01 00:00:00
abstract:OBJECTIVE:The purpose of this study was to evaluate graft patency and limb salvage rates for infrainguinal polytetrafluoroethylene (PTFE) bypass grafts using distal anastomotic Taylor vein patch in patients lacking suitable vein conduit. METHODS:We reviewed 44 patients who underwent infrainguinal bypass between Januar...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/s0002-9610(01)00791-7
更新日期:2001-12-01 00:00:00
abstract::Ten patients with a discharging perineal sinus that developed after proctectomy were treated with a new fibrin adhesive system in order to close the sinus. Four of the patients also had a fistula that extended from the sinus to the vagina. Treatment was unsuccessful in two patients: one had retained foreign bodies in ...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/0002-9610(83)90142-3
更新日期:1983-06-01 00:00:00
abstract::It has been shown that truncal vagotomy with pyloroplasty (TVP), but not highly selective vagotomy (HSV), delays the onset, decreases the extent, and changes the pattern of gallbladder emptying. The aim of the present study was to investigate any alterations in gallbladder emptying after a variety of antiulcer gastric...
journal_title:American journal of surgery
pub_type: 临床试验,杂志文章
doi:10.1016/s0002-9610(05)80160-6
更新日期:1994-10-01 00:00:00
abstract::When dense hemiparesis has developed appropriate to the operated vessel after carotid surgery, the patient has been immediately returned to the operating room for reexploration of the vessel and thrombectomy. Over a 5-year period, we identified four patients who developed dense hemiparesis in the recovery room postope...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/s0002-9610(05)81262-0
更新日期:1990-05-01 00:00:00
abstract::Common duct stones retained after choledocholithotomy were removed in 11 patients under intravenous sedation using the Olympus fiberoptic choledochoscope passed through a T-tube tract. A total of 39 stones were removed during 12 procedures, with one patient requiring 2 procedures for complete stone removal. All common...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/0002-9610(80)90332-3
更新日期:1980-04-01 00:00:00
abstract:BACKGROUND:The effect of the number of lymph nodes harvested on the long-term survival of gastric cancer according to Tumor, Node, and Metastasis (TNM) stage and tumor location remains unclear. METHODS:Patients who underwent gastrectomy for gastric cancer (1998 to 2009) were evaluated retrospectively (1,637 patients)....
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/j.amjsurg.2015.01.029
更新日期:2015-09-01 00:00:00
abstract:BACKGROUND:Training future rural surgeons is critical, but training needs are unclear. We hypothesize perspectives on necessity of subspecialty training differ among rural surgeons by generational cohort. METHODS:An online survey was sent to ACS Rural Surgery Listserv subscribers. Closed-ended elements were analyzed u...
journal_title:American journal of surgery
pub_type: 杂志文章,多中心研究
doi:10.1016/j.amjsurg.2018.11.026
更新日期:2019-02-01 00:00:00
abstract::A new technique has been described for the placement of an implantable percutaneous triple-lumen catheter. This procedure eliminates the need for a large bore introducer. It also provides a mechanism to change these catheters over a wire if necessary. This cannot be accomplished with the Hickman or Broviac catheters. ...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/s0002-9610(85)80116-1
更新日期:1985-03-01 00:00:00
abstract::From 1971 through 1975, 104 patients with squamous carcinoma of the anterior and anterolateral floor of the mouth underwent surgery, irradiation therapy or a combination of both with the purpose of eliminating their tumors. No patient had received treatment before, and this effort was considered primary and definitive...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/0002-9610(80)90212-3
更新日期:1980-10-01 00:00:00
abstract::The value of barium enema examination in diagnosing acute appendicitis in patients with equivocal findings has been confirmed by our experience with five patients. Cecal spasm, extrinsic compression of the cecum, nonvisualization of the appendix, and partial visualization of the appendix appear to be useful roentgenog...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/0002-9610(79)90306-4
更新日期:1979-12-01 00:00:00
abstract::Pretreatment staging and posttreatment follow-up of the breast cancer patient consists of physical examination of the breasts and regional node-bearing areas, routine laboratory studies, chest radiography, and bilateral mammography. For palpable tumors, mammography is used to determine tumor size and to identify nonpa...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/0002-9610(89)90539-4
更新日期:1989-02-01 00:00:00
abstract::Technetium 99m-pyridoxylideneglutamate (99mTc-PG) administered intravenously is excreted by hepatocytes into the bile canaliculi and enters the gallbladder through the cystic duct and consequently, can be used for scanning the hepatobiliary ductal system. A total of 166 patients representing 27 normal subjects, 84 pat...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/0002-9610(77)90204-5
更新日期:1977-01-01 00:00:00
abstract::Massive venous thromboses of the extremities, although uncommon, are responsible for many of the long-term sequelae associated with venous disease. The charts of all patients with a diagnosis of iliofemoral venous thrombosis or subclavian vein thrombosis over a 6-year period were reviewed. There were 59 patients with ...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/0002-9610(89)90361-9
更新日期:1989-08-01 00:00:00
abstract:BACKGROUND:To prevent hepatic failure after major hepatectomy, it is important to assess preoperative factors related to liver failure. METHODS:We examined 80 patients who underwent right-sided hepatectomy. Hyperbilirubinemia, uncontrolled ascites, and prolonged postoperative hospital stay were defined as liver failur...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/j.amjsurg.2012.12.013
更新日期:2013-09-01 00:00:00
abstract:BACKGROUND:Teaching professionalism effectively to fully engaged residents is a significant challenge. A key question is whether the integration of professionalism into residency education leads to a change in resident culture. METHODS:The goal of this study was to assess whether professionalism has taken root in the ...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/j.amjsurg.2011.05.007
更新日期:2012-01-01 00:00:00
abstract:BACKGROUND:Over the past 15 years of war, eligible U.S. military members donated organs overseas in Germany. Our hypothesis was that outcomes at a military treatment facility were comparable to a civilian cohort. METHODS:Military donors were matched 1:3 with a donor cohort from the U.S. United Network for Organ Sharin...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/j.amjsurg.2017.01.024
更新日期:2017-08-01 00:00:00
abstract:BACKGROUND:Few studies have evaluated the role of computed tomography-guided percutaneous drainage (PD) in the management of gastrointestinal (GI) anastomotic leaks. METHODS:Ten-year review of an interventional radiology database identified patients with symptomatic GI anastomotic leaks. Clinical, laboratory, radiogra...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/j.amjsurg.2013.08.050
更新日期:2014-07-01 00:00:00
abstract:PURPOSE:Hanging has become the second most common method of attempted suicide among adolescents, but there is little relevant epidemiologic or outcome data in the trauma literature. Additionally, there are no studies examining the degree of functional disability among survivors of hanging injury. METHODS:The National ...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/j.amjsurg.2005.05.051
更新日期:2005-12-01 00:00:00
abstract:BACKGROUND:Accurate assessment is imperative for learning, feedback and progression. The aim of this study was to examine whether surgeons can accurately self-assess their technical and nontechnical skills compared with expert faculty members' assessments. METHODS:Twenty-five surgeons performed a laparoscopic cholecys...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/j.amjsurg.2011.01.024
更新日期:2011-10-01 00:00:00
abstract:BACKGROUND:This study examined trends in breast conservation surgery (BCS) at our hospital and factors associated with BCS. METHODS:We retrospectively reviewed breast cancer surgeries in patients eligible for BCS (size <4 cm, N0, N1) from 1990 through 1996 (n = 634). We calculated the yearly prevalence of BCS and used...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:
更新日期:1998-12-01 00:00:00
abstract::Twenty patients underwent placement of a jejunal catheter for early postoperative feeding at the time of upper abdominal operations, and a control group of 11 patients underwent operative procedures of similar magnitude without jejunostomy. Advancement of the rate of feeding to target intake over 6 to 7 days was attem...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/0002-9610(85)90009-1
更新日期:1985-07-01 00:00:00
abstract::Microvascular free tissue transfer has provided a variety of methods of restoring vascularized bone and soft tissue to difficult defects created by tumor resection and trauma. Over 7 years, 26 patients have undergone 28 free flaps for mandibular reconstruction, 15 for primary squamous cell carcinoma of the floor of th...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/s0002-9610(05)80550-1
更新日期:1990-10-01 00:00:00
abstract:BACKGROUND:In this study, we explore surgical resident communication with simulated patient surrogates (SPs), in an Objective Structured Clinical Examination (OSCE). METHODS:We use discourse analysis (DA), a qualitative approach to analyzing language, to evaluate our residents' interactions with simulated patient surr...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/j.amjsurg.2017.10.041
更新日期:2018-02-01 00:00:00
abstract::Severe fasting hypoglycemia and hypoinsulinemia occurred in a sixty-six year old woman with an intrahepatic mesenchymal tumor. An extract from the tumor was potent in inhibiting the arginine-induced glucagon secretion from the isolated perfused porcine pancreas. This observation supports the theory recently advanced t...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/0002-9610(78)90095-8
更新日期:1978-02-01 00:00:00
abstract::A review of 143 patients with 144 feeding jejunostomies was carried out. In the 129 patients in whom catheters were utilized, only 48 (45 percent) had no complications. Seventy-one patients (55 percent) suffered one or more catheter-related complications. Ten of these complications were life-threatening or fatal, incl...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/s0002-9610(88)80267-8
更新日期:1988-01-01 00:00:00