Abstract：
:This study evaluates the impact of the autopsy on a general surgical training program from 1984 through 1988. We have retrospectively examined the charts of all patients who died during this period. Included in this analysis are the records of patients from the general, cardiac, pediatric, and transplant surgery departments during this 5-year period. In all, 628 patients were evaluated. The overall autopsy rate was 73%. The clinical impressions prior to death are correlated with the anatomic diagnoses found during autopsy. Significant diagnostic discrepancies (errors unrecognized and directly related to or associated with the cause of death) were determined. On a yearly basis, diagnostic discrepancies range between 23% to 39%. Gross and histologic examination of surgical patients reveals significant information concerning the cause of death. These data confirm the educational benefit of autopsy despite escalating utilization of sophisticated, noninvasive diagnostic modalities. It is our opinion that the mortality conference, with formal autopsy presentation, is a vital forum for the discussion of patient care and quality assurance issues. Autopsy remains the most specific indicator of errors in diagnosis, management, judgment, and technique in surgical practice today.
journal_name
Am J Surgjournal_title
American journal of surgeryauthors
Stothert JC Jr,Gbaanador Gdoi
10.1016/0002-9610(91)90114-ssubject
Has Abstractpub_date
1991-12-01 00:00:00pages
585-8; discussion 588-9issue
6eissn
0002-9610issn
1879-1883pii
0002-9610(91)90114-Sjournal_volume
162pub_type
杂志文章abstract：:A retrospective study of colostomy closures was prompted by recent reports detailing frequent postoperative complications. In a series of 125 intraperitoneal colostomy closures there was a low incidence of complications. There were no anastomotic breakdowns, fistulas, or deaths. We conclude that closure of a well heal...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/0002-9610(78)90205-2
更新日期：1978-07-01 00:00:00
abstract：BACKGROUND:Patients with spinal cord injury (SCI) frequently have pressure ulcers. Surgery is sometimes needed to close them. In rare cases, hemipelvectomy is warranted for extremely severe complications. METHODS:We conducted a retrospective study using national Department of Veterans Affairs (DVA) computer data sets ...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/s0002-9610(02)01123-6
更新日期：2003-01-01 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: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:This 17-year review was undertaken to examine clinical outcomes and the changing trends in resource utilization for lower extremity bypass grafts performed in a managed care setting. PATIENTS AND METHODS:Between 1979 and 1995, 338 bypasses in 276 patients (199 men, 77 women; 62% diabetics) were carried out ...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/S0002-9610(96)00130-4
更新日期：1996-08-01 00:00:00
abstract：BACKGROUND:There is little evidence supporting or refuting clamping trials, a period of clamping thoracostomy tubes prior to removal. We sought to evaluate whether clamping trials reduce the need for subsequent pleural drainage procedures. METHODS:We conducted a retrospective cohort study of trauma patients who underw...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/j.amjsurg.2020.01.007
更新日期：2020-08-01 00:00:00
abstract：BACKGROUND:Fibroadenomas commonly found by palpation and routine mammography account for approximately 20% of open surgical breast biopsies. Alternatives to open surgery include tumor removal using an automated coring device and tumor ablation using heating or cooling elements. We report our initial experience with cry...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/s0002-9610(02)01010-3
更新日期：2002-11-01 00:00:00
abstract：OBJECTIVE:This study investigated the use of ultrasound (US) as a first-line diagnostic tool. METHODS:All women attending our breast center underwent bilateral whole-breast US in addition to all other investigations, and results were documented prospectively and preoperatively. RESULTS:Of 796 patients with breast can...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/j.amjsurg.2004.06.032
更新日期：2004-10-01 00:00:00
abstract：:A 5 year retrospective study of the use of cholangioscopy in 153 difficult biliary cases including stones, strictures, tumors, and anomalies has been reported. In the 88 patients (58 percent) who underwent both operative cholangiography and cholangioscopy, the cholangioscope revealed 11 lesions (13 percent) missed by ...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/0002-9610(84)90048-5
更新日期：1984-01-01 00:00:00
abstract：:Between 1982 and 1985, 83 patients with hypopharyngeal or extensive laryngeal cancers underwent pharyngoesophagectomy (48 patients), circumferential pharyngectomy (8 patients), and partial pharyngectomy (27 patients), depending on the site and extent of tumor involvement. The resultant hypopharyngeal defects were reco...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/0002-9610(89)90007-x
更新日期：1987-10-01 00:00:00
abstract：:Resection of malignancies of the upper face and skull base may result in complex bone and soft tissue defects. To better define the optimal management of these defects, we conducted a retrospective review of 75 consecutive patients who underwent closure of 76 craniofacial defects after malignant tumor excision from 19...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/0002-9610(91)90160-f
更新日期：1991-10-01 00:00:00
abstract：:Millions of people continue to smoke. Recent studies confirm the pioneering epidemiologic data that indicated that, despite the well-established effects on the lung, most of the hundreds of thousands of premature deaths annually result from extrapulmonary toxicity, particularly accelerated cardiac and vascular disease...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/0002-9610(84)90421-5
更新日期：1984-12-01 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：BACKGROUND:In the surgical management of lower gastrointestinal tract peritonitis (LGTP), drainage of the peritoneal cavity is often recommended. The objective of the study was to evaluate the impact of drainage of the abdominal cavity during management of LGTP. METHODS:From January 2009 to January 2012, patients unde...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/j.amjsurg.2016.09.031
更新日期：2017-07-01 00:00:00
abstract：:Eighty-five patients who underwent 100 transcatheter intraarterial thrombolytic infusions for occlusions of suprainguinal and infrainguinal grafts and arteries were analyzed to determine the initial and 6 month results. Analysis demonstrated that suprainguinal occlusions of arteries and grafts were most likely to both...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/0002-9610(86)90454-x
更新日期：1986-12-01 00:00:00
abstract：BACKGROUND:Five percent of patients who undergo fundoplication will require reoperation. The cause of this high failure rate and the best management for these patients remains poorly understood. The aim of this study was to identify patterns and causes of failure of primary antireflux procedures. METHODS:Retrospective...
journal_title：American journal of surgery
pub_type： 杂志文章,多中心研究
doi：10.1016/j.amjsurg.2004.08.062
更新日期：2004-12-01 00:00:00
abstract：:Of forty-three patients with carcinoma of the gallbladder discovered ih a twenty-five year period (during which 10,349 patients were diagnosed as having cholelithiasis), eighteen patients (42 per cent) had no obvious tumor outside of the gallbladder at the time of operation, nineteen patients (44 per cent) had local s...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/0002-9610(76)90439-6
更新日期：1976-12-01 00:00:00
abstract：:The mechanism of preventing intestinal regurgitation by means of a telescoped intestinal valve has been investigated in this study. Ten telescoped intestinal valves were uniformly created in dogs. A tolerance test to barium reflux was performed before the animals were sacrificed 16 weeks postoperatively, which yielded...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/0002-9610(87)90577-0
更新日期：1987-04-01 00:00:00
abstract：:Recurrence of hyperparathyroidism after initially successful primary operation is usually caused by inadequate resection of diseased tissue or recurrent carcinoma. Since it is known that normal parathyroid tissue may be autotransplanted into a muscle bed, it is plausible that inadvertent implantation of parathyroid ti...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/s0002-9610(85)80178-1
更新日期：1985-06-01 00:00:00
abstract：BACKGROUND:Epithelioid sarcoma is a rare sarcoma with a high local recurrence rate that frequently metastasizes to lymph nodes. We reviewed our experience with adjuvant therapy in patients with this disease. METHODS:Between 1990 and 2003, we treated 11 patients with epithelioid sarcoma. Patient, tumor, and treatment c...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/j.amjsurg.2007.07.029
更新日期：2008-09-01 00:00:00
abstract：BACKGROUND:Many trauma surgeons and trauma centers use routine exploration of Gerota's fascia (GE) for renal gunshot wounds (RGSW). The purpose of this study was to assess whether RGSW can be selectively explored for patients who undergo exploratory laparotomy. METHODS:Retrospective 10-year review of all patients who ...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/j.amjsurg.2015.09.023
更新日期：2016-04-01 00:00:00
abstract：:We review herein our experience in the management of bleeding esophageal varices in cirrhotic patients and consider our findings in light of the dramatic changes in the treatment of cirrhosis resulting from the more widespread use of orthotopic liver transplantation (OLT). It does not seem realistic, at present, to pr...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/s0002-9610(05)80878-5
更新日期：1990-07-01 00:00:00
abstract：BACKGROUND:The prognostic significance of the platelet (PLR) and neutrophil (NLR) to lymphocyte ratios for patients with resectable colorectal cancer liver metastases (CLM) was evaluated. METHODS:Clinicopathologic data from patients who underwent hepatectomy for CLM at two tertiary care hospitals between 1995 and 2017...
journal_title：American journal of surgery
pub_type： 杂志文章,多中心研究
doi：10.1016/j.amjsurg.2020.05.003
更新日期：2020-12-01 00:00:00
abstract：BACKGROUND:We investigated whether or not interleukin-8 (IL-8) and granulocyte elastase (GE) can be associated with pulmonary complication after esophagectomy (the most common cause of postoperative death). METHODS:We measured serial changes in the IL-8 concentration and GE activity in the plasma and bronchoalveolar l...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/s0002-9610(00)00558-4
更新日期：2001-02-01 00:00:00
abstract：:Exposed bone, even in conjunction with a fracture, will cover spontaneously with granulation tissue followed by epithelium, or will sequestrate and then cover, providing there is adequate circulation at the wound site. The healing process is lengthy but need not interfere with the reestablishment of function of the wo...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/0002-9610(79)90115-6
更新日期：1979-04-01 00:00:00
abstract：OBJECTIVE:Arterial base deficit (BD) is a commonly used marker of injury severity and endpoint of resuscitation but requires an arterial puncture and blood gas analysis. Serum bicarbonate (HCO3) is routinely obtained as part of the chemistry panel on most admissions. We hypothesized that serum HCO3 strongly correlates ...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/j.amjsurg.2005.08.024
更新日期：2005-12-01 00:00:00
abstract：BACKGROUND:Anorectal malformations represent a continuing challenge for the pediatric surgeon. A significant number of these children suffer from fecal incontinence, urinary incontinence, and sexual inadequacy. However, major advances in the management of these children have occurred during the last 10 years. The poste...
journal_title：American journal of surgery
pub_type： 杂志文章,评审
doi：10.1016/s0002-9610(00)00491-8
更新日期：2000-11-01 00:00:00
abstract：BACKGROUND:Definitive practice guidelines regarding the utility of chest x-ray (CXR) following chest tube removal in trauma patients have not been established. The authors hypothesized that the selective use of CXR following chest tube removal is safe and cost effective. METHODS:A retrospective review of chest tube in...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/j.amjsurg.2009.03.011
更新日期：2010-02-01 00:00:00
abstract：:Thymectomy was performed on 249 patients with myasthenia gravis between 1957 and 1981. During a follow-up period that ranged from 2 months to 24 years (mean 7.5 years), the remission rate for the entire group was 51 percent, and an additional 36 percent had improvement (87 percent benefited). In those 51 patients with...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/0002-9610(83)90260-x
更新日期：1983-07-01 00:00:00
abstract：BACKGROUND:Several recent studies have suggested that Braun enteroenterostomy (BEE) during conventional pancreatoduodenectomy might decrease delayed gastric emptying (DGE). However, the advantages and disadvantages of performing BEE during pylorus-preserving pancreatoduodenectomy (PPPD) remain controversial. METHODS:T...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/j.amjsurg.2014.05.007
更新日期：2015-02-01 00:00:00
