Abstract：
:Ostomy closure following the Hartmann procedure is perceived to be associated with higher morbidity and mortality rates than is ostomy closure following divided colostomy, loop colostomy, and divided ileostomy-colostomy so that ostomy closure after Hartmann procedure may be denied to certain patients. To test that perception, the charts of 59 patients undergoing a Hartmann procedure and 43 patients having ostomy closure after divided colostomy, loop colostomy, or divided ileostomy-colostomy were reviewed. Ostomy closure after Hartmann procedure was accomplished in 46 patients. These 46 patients (Group I) were compared with the 43 patients having ostomy closure following divided colostomy, loop colostomy and divided ileostomy-colostomy (Group II). No deaths occurred in either group. The morbidity rate was 30% for Group I and was 19% for Group II. This difference is not significant. Major complications involved wound, lung, small bowel, and colonic anastomoses. Anastomotic stricture rate was 9% for Group I and 5% for Group II. Small bowel and anastomotic complications in both groups occurred only when ostomy closure was performed after a delay of less than 6 months after ostomy construction. Stricture occurred only after end-to-end colocolostomy and coloproctostomy and did not occur after ileocolostomy or ileoproctostomy. All strictures were successfully treated by reoperation. Anastomotic leak and pelvic abscess did not occur in either group. We conclude that ostomy closure after Hartmann procedure may be more difficult and time consuming than is ostomy closure after loop colostomy, divided colostomy, or divided ileostomy-colostomy, but ostomy closure after Hartmann procedure does not have a higher morbidity rate. We advise a delay of 6 months between ostomy construction and ostomy closure and submit that all patients whose general condition permits reoperation may safely undergo ostomy closure.
journal_name
Am J Surgjournal_title
American journal of surgeryauthors
Mosdell DM,Doberneck RCdoi
10.1016/0002-9610(91)90125-wsubject
Has Abstractpub_date
1991-12-01 00:00:00pages
633-6; discussion 636-7issue
6eissn
0002-9610issn
1879-1883pii
0002-9610(91)90125-Wjournal_volume
162pub_type
杂志文章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 term secondary abdominal compartment syndrome (ACS) has been applied to describe trauma patients who develop ACS but do not have abdominal injuries. The purpose of this study was to describe major trauma victims who developed secondary ACS during standardized shock resuscitation. METHODS:Our prospective...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/s0002-9610(02)01050-4
更新日期：2002-12-01 00:00:00
abstract：:Breast cyst fluid from 35 women was stratified into risk groups based on personal and family history of breast cancer. Mitogenic activity in breast cyst fluid of women at highest risk to develop breast cancer was significantly higher than the activity in the lowest-risk group. There was a direct dose-dependent relatio...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/s0002-9610(05)81249-8
更新日期：1990-05-01 00:00:00
abstract：:Most series dealing with external gastrointestinal fistulas cover experience of many years and include a heterogeneous sample of fistulas. We present our experience with 117 cases of postoperative external alimentary tract fistulas treated since 1980. Only fistulas caused by anastomotic leaks and operative injury to b...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/0002-9610(91)91107-t
更新日期：1991-04-01 00:00:00
abstract：BACKGROUND:Performance feedback or debriefing in surgery is increasingly recognized as an essential means to optimize learning in the operating room (OR). However, there is a lack of evidence regarding the current practice and barriers to debriefing in the OR. METHODS:Phase 1 consisted of semistructured interviews wit...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/j.amjsurg.2013.01.007
更新日期：2013-04-01 00:00:00
abstract：BACKGROUND:Survival in breast cancer maybe more accurately predicted by a scoring system based on the biologic characteristics of the tumor such as diameter, number of involved nodes, and hormone receptor status than by conventional staging. METHODS:Medical records of 419 patients with a diagnosis of breast cancer fro...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/s0002-9610(03)00283-6
更新日期：2003-10-01 00:00:00
abstract：BACKGROUND:A history of therapeutic irradiation to the neck complicates the management of carotid artery occlusive disease. Serious surgical concerns are raised regarding alternative incisions, difficult dissections, and adequate wound closure. Pathology may be typical atherosclerotic occlusive disease or radiation-ind...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/S0002-9610(96)00150-X
更新日期：1996-08-01 00:00:00
abstract：BACKGROUND:The Roux-en-Y loop is an effective procedure for biliodigestive drainage. However, up to 15% of patients suffer from postoperative cholangitis or blind loop syndrome. A new technique to prevent motility abnormalities has been developed. METHODS:Male Lewis rats were used to compare gastric emptying and trans...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/j.amjsurg.2003.08.025
更新日期：2003-12-01 00:00:00
abstract：:The purpose of this experimental study was to test the potential value of heat welding to cut the ends of knotted surgical sutures. This heat process resulted in knot security in a coated polyglactin suture with fewer throws than those needed for the same suture with knotted ends cut by scissors. Results of mechanical...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/0002-9610(85)90069-8
更新日期：1985-09-01 00:00:00
abstract：BACKGROUND:Decrease in blood pressure (BP) is the major goal of adrenalectomy for primary aldosteronism. Nevertheless, the optimal timing to assess these outcomes and the needed duration of follow-up are uncertain. We systematically reviewed the literature regarding trends in BP-related outcomes during follow-up after ...
journal_title：American journal of surgery
pub_type： 杂志文章,评审
doi：10.1016/j.amjsurg.2020.12.003
更新日期：2020-12-03 00:00:00
abstract：BACKGROUND:Predicting length of stay (LOS) is difficult for trauma and emergency general surgery (TEGS) patients. Our aim was to determine the accuracy of LOS predictions by TEGS team members and the NSQIP Risk Calculator and the patient factors associated with inaccurate predictions. METHODS:LOS for 200 TEGS patients...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/j.amjsurg.2020.01.055
更新日期：2020-09-01 00:00:00
abstract：BACKGROUND:Training surgeons in vital decision-making skills remains unstructured. We aimed to map a process of care from the perspective of surgical decision making and test whether it could be deconstructed into an accessible format for trainees. METHODS:Semistructured interviews were conducted with 10 experienced s...
journal_title：American journal of surgery
pub_type： 杂志文章,多中心研究
doi：10.1016/j.amjsurg.2007.02.016
更新日期：2008-05-01 00:00:00
abstract：:Three patients who underwent 95 percent removal of the pancreas for chronic pancreatitis with autotransplantation of the body and tail of the gland to the femoral area are described. The follow-up periods are 18, 6, and 2 months. Pain lessened in all patients and none required exogenous insulin. Patency of the graft w...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/0002-9610(83)90036-3
更新日期：1983-04-01 00:00:00
abstract：:Surgical experience with adrenal disease from 1970 to 1979 was reviewed in 315 patients. The pathologic conditions that were encountered were hypercortisolism (74 patients), hyperaldosteronism (46 patients), adrenocortical carcinoma (35 patients), pheochromocytoma (77 patients), and nonfunctioning adenoma (47 patients...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/0002-9610(82)90571-2
更新日期：1982-11-01 00:00:00
abstract：:Acute recurrent pancreatitis in the absence of alcoholism and gallstones is a frustrating illness for both the patient and the physician. Over a 10 year period, 33 patients were operated on and found to have a duct of Wirsung entering the duodenum through the fibers of the sphincter of Oddi. Recurrent pancreatitis of ...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/0002-9610(87)90808-7
更新日期：1987-02-01 00:00:00
abstract：:A 78-year-old healthy woman with no previous surgeries or history of trauma presented with a painful abdominal mass for 1 day. The computed tomography (CT) scan of the abdomen demonstrated a partial herniation and strangulation of the cecum (Richter's hernia) between the internal and external oblique muscles through t...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/j.amjsurg.2006.02.028
更新日期：2007-01-01 00:00:00
abstract：BACKGROUND:The laparoscopic approach to surgical diseases of the foregut is rapidly gaining acceptance. These new approaches, however, pit the unwary surgeon against potentially devastating complications. PATIENTS AND METHODS:Based on a retrospective review of 153 consecutive laparoscopic foregut surgeries performed a...
journal_title：American journal of surgery
pub_type： 临床试验,杂志文章
doi：10.1016/S0002-9610(99)80206-2
更新日期：1995-05-01 00:00:00
abstract：BACKGROUND:Local custom, rather than evidence-based medicine, dictates how a surgeon closes abdominal wounds. Closures might be more secure if grounded on statistical data. MATERIALS AND METHODS:A meta-analysis of 12,249 patients with abdominal wound closures was made. Infections, hernias, and dehiscences were compare...
journal_title：American journal of surgery
pub_type： 杂志文章,meta分析
doi：10.1016/s0002-9610(98)00277-3
更新日期：1998-12-01 00:00:00
abstract：:A successful method for controlling intractable bleeding after endoscopic sphincterotomy is described. By passing a Fogarty catheter into the duodenum, balloon tamponade of the bleeding point is possible. By such a technique, major resective surgery can be avoided. ...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/0002-9610(94)90092-2
更新日期：1994-02-01 00:00:00
abstract：BACKGROUND:Making a conflict of interest declaration is now mandatory at continuing medical education CME accredited events. However, these declarations tend to be largely perfunctory. This study sought to better understand physician perceptions surrounding conflict of interest. METHODS:The same PowerPoint (Microsoft,...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/j.amjsurg.2013.01.012
更新日期：2013-05-01 00:00:00
abstract：:Mentoring has been recognized as a critical aspect of the professional and/or personal development of the student, resident or faculty member. This career development resource discusses strategies for building effective mentoring relationships and outlines some of the challenges to contemporary mentoring. ...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/j.amjsurg.2013.08.001
更新日期：2013-11-01 00:00:00
abstract：BACKGROUND:Administrative databases oversimplify the relationship of factors such as volume or training on surgical outcomes. METHODS:A prospective statewide surgeon-initiated database was queried to obtain incident cases of rectal cancer in Vermont from April 1999 to June 2001. Demographics, procedure performed, meth...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/j.amjsurg.2007.01.029
更新日期：2007-10-01 00:00:00
abstract：:The American Board of Surgery was established in 1937 to certify surgeons who through training, experience, and examination meet the highest standards of surgical care. This lecture was given as the Edgar Poth lecture at the April 2015 meeting of the Southwestern Surgical Congress. Dr Poth was a surgical educator from...
journal_title：American journal of surgery
pub_type： 历史文章,杂志文章
doi：10.1016/j.amjsurg.2015.05.038
更新日期：2015-12-01 00:00:00
abstract：:A biochemical analysis of mitochondrial metabolism was made on biopsy specimens of fifteen jaundiced patients. In all but three jaundiced patients the phosphorylative activity based on mitochondrial protein was within normal limits or higher. In nine jaundiced patients the concentrations of cytochrome a(+a3), as repre...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/0002-9610(77)90534-7
更新日期：1977-03-01 00:00:00
abstract：:Recent progress in the surgical treatment of carcinoma of the esophagus has changed the pessimistic outlook for this malignancy. With reasonably early diagnosis, it is feasible to achieve a resectability rate of 75 to 85 percent, an operative mortality of about 5 percent and a 5 year survival rate of about 30 percent....
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/0002-9610(80)90386-4
更新日期：1980-06-01 00:00:00
abstract：:The experience with gastrointestinal cancer at a single large hospital has been utilized as a "micro-model" of the experience for the country at large, and the reasons why such a comparison might be possible have been presented. The incidence of various lesions has been discussed in terms of sex, age, and race. The ch...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/0002-9610(78)90002-8
更新日期：1978-01-01 00:00:00
abstract：BACKGROUND:Etiologies contributing to failure to wean from mechanical ventilation (MV) are multiple, resulting in morbid and costly outcomes. Diaphragm pacing (DP) is used in spinal cord injury to replace MV. Temporary DP could be utilized in acute respiratory failure to reduce MV. METHODS:A prospective FDA feasibilit...
journal_title：American journal of surgery
pub_type： 临床试验,杂志文章
doi：10.1016/j.amjsurg.2017.10.054
更新日期：2018-03-01 00:00:00
abstract：BACKGROUND:The association of pancreatitis with neuroendocrine tumors of the pancreas is uncommon, whereas its association with exocrine pancreatic cancer is well recognized. Since the latter, but not the islet cell tumor, is thought to originate within the ductal system, it is not surprising that pancreatitis is less ...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/s0002-9610(96)00032-3
更新日期：1996-06-01 00:00:00
abstract：:A prospective clinical trial was designed to evaluate the efficacy of postoperative jejunostomy feedings using high (44 percent) and low (15 percent) branched-chain amino acid elemental diet formulations compared with no jejunostomy feedings in a homogeneous surgical population. Twenty-eight patients undergoing radica...
journal_title：American journal of surgery
pub_type： 临床试验,杂志文章,随机对照试验
doi：10.1016/0002-9610(87)90815-4
更新日期：1987-02-01 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
