Abstract:
SUMMARY BACKGROUND DATA:High rate of complications has been reported following revascularization for acute limb ischemia (ALI). No adjuvant pharmacologic treatment, apart from anticoagulation and standard perioperative care, has been shown clinically effective. OBJECTIVE:Aim of this study was to evaluate the effects of the prostacyclin analog iloprost as adjuvant to surgery for ALI. METHODS:A total of 300 patients were randomly assigned to receive perioperative iloprost (intra-arterial, intraoperative bolus of 3000 ng, plus intravenous infusion of 0.5-2.0 ng/kg/min for 6 hours/day for 4-7 days following surgery), or placebo. The primary endpoint was the combined incidence of death and amputation at 3-month follow-up. Secondary endpoints were the incidence of each single major complication, total event rate, symptomatology, and tolerability. RESULTS:The combined incidence of death and amputation was 19.9% in the placebo and 14.1% in the iloprost group (relative risk, 1.56; 95% confidence interval, 0.89-2.75, P = 0.12, Cox regression analysis). A statistically significant lower mortality (4.7%) was reported in patients receiving iloprost, compared with controls (10.6%; relative risk, 2.61; 95% confidence interval, 1.07-6.37, P = 0.03). The overall incidence of fatal plus major cardiovascular events was 33.1% and 22.8% in placebo and iloprost groups, respectively (relative risk, 1.61; 95% confidence interval, 1.04-2.49, P = 0.03). No serious adverse reactions occurred after iloprost administration, nor differences in the incidence of bleeding or hypotension between treatment groups. CONCLUSIONS:Although at lower levels than previously reported, our results confirm the severity of ALI. Iloprost as adjuvant to surgery significantly reduced mortality and overall major event rate. Further data are needed to support this finding, and to face a still open medical issue.
journal_name
Ann Surgjournal_title
Annals of surgeryauthors
de Donato G,Gussoni G,de Donato G,Andreozzi GM,Bonizzoni E,Mazzone A,Odero A,Paroni G,Setacci C,Settembrini P,Veglia F,Martini R,Setacci F,Palombo Ddoi
10.1097/01.sla.0000217555.49001.casubject
Has Abstractpub_date
2006-08-01 00:00:00pages
185-93issue
2eissn
0003-4932issn
1528-1140pii
00000658-200608000-00004journal_volume
244pub_type
杂志文章,随机对照试验abstract::We reviewed 37 consecutive, hemodynamically stable patients (16 adults, 21 children) who had splenic injuries diagnosed by computed tomography (CT) scan to compare the CT evaluation with operative assessment of injury and eventual treatment. Computed tomographic scans and operative findings were graded by a splenic in...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-199005000-00009
更新日期:1990-05-01 00:00:00
abstract:OBJECTIVE:Cetuximab, a monoclonal antibody targeting epidermal growth factor receptor (EGFR), has been proven to be efficient in metastatic colorectal cancer (mCRC); however, the therapeutic response is variable and markers predictive of response are urgently required. This study was conducted to determinate the predic...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/SLA.0b013e3181bc9d96
更新日期:2010-02-01 00:00:00
abstract::Eight patients after vagotomy and Jaboulay gastroduodenostomy had their gastroduodenostomy closed to treat dumping and diarrhea. Eight gastroduodenostomies were closed once and four were closed twice, a total of 12 procedures. Of these, ten were "simple" closures (direct suture of the opening into the duodenum via a g...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-198308000-00005
更新日期:1983-08-01 00:00:00
abstract:OBJECTIVE:To determine very late clinical outcomes at up to 20 years follow-up from a randomized controlled trial of Nissen vs. anterior 180-degree partial fundoplication. SUMMARY BACKGROUND DATA:Nissen fundoplication for gastroesophageal reflux can be followed by troublesome side effects. To address this, partial fun...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/SLA.0000000000004643
更新日期:2020-11-18 00:00:00
abstract:BACKGROUND AND OBJECTIVE:Factors that control pancreatic regenerating (reg I) gene expression are unknown, but it is believed that its expression may correspond with cellular differentiation. The authors recently demonstrated that reg I is expressed in AR42J, a rat acinar cell line whose state of differentiation can be...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-199703000-00013
更新日期:1997-03-01 00:00:00
abstract:OBJECTIVE:Planned perioperative endoscopic retrograde cholangiography (ERC) and sphincterotomy (ES) for suspected or proven common bile duct stones (CBDS) has been attempted in 63 of 540 consecutive patients undergoing laparoscopic cholecystectomy (LC). Experience with this intervention has been studied with respect to...
journal_title:Annals of surgery
pub_type: 杂志文章,评审
doi:10.1097/00000658-199307000-00010
更新日期:1993-07-01 00:00:00
abstract:BACKGROUND:Hospitals increasingly rely on surgical quality assessment programs that require considerable resources to capture outcomes after hospital discharge. However, it is unclear whether capturing postdischarge complications and deaths is important. Our objectives were (1) to determine the frequency of postdischar...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/SLA.0b013e3181e4846e
更新日期:2010-07-01 00:00:00
abstract:OBJECTIVE:To report on the long-term follow-up of a randomized clinical trial comparing pancreatic head resection according to Beger and limited pancreatic head excision combined with longitudinal pancreatico-jejunostomy according to Frey for surgical treatment of chronic pancreatitis. SUMMARY BACKGROUND DATA:Resectio...
journal_title:Annals of surgery
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1097/01.sla.0000157268.78543.03
更新日期:2005-04-01 00:00:00
abstract::Hypermetabolism characterizes the metabolic response to thermal injury and the extent of energy production is positively related to the rate of urinary catecholamine excretion. Alpha and beta adrenergic blockade decreased metabolism from 69.6 +/- 5.3 Kcal/m(2)/hr to 57.4 +/- 5.2 (p < 0.01), and infusion of 6 microgm e...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-197410000-00031
更新日期:1974-10-01 00:00:00
abstract::The pattern of failure was studied in 1012 patients with resected Stage I or II non-small-cell carcinoma of the lung. Initial intrathoracic failure (41%) was more common than initial extrathoracic failure (34%) even though a complete resection was the intent in all patients. The most frequent sites of initial failure ...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-198701000-00012
更新日期:1987-01-01 00:00:00
abstract:OBJECTIVES:We aimed to examine the association between total number of resected nodes and survival in patients after esophagectomy with and without nCRT. BACKGROUND:Most studies concerning the potentially positive effect of extended lymphadenectomy on survival have been performed in patients who underwent surgery alon...
journal_title:Annals of surgery
pub_type: 杂志文章,随机对照试验
doi:10.1097/SLA.0000000000000965
更新日期:2014-11-01 00:00:00
abstract::Reservoir and ileostomies were performed in 54 patients between 1972 and 1975. Primary colonic pathology included chronic ulcerative colitis in 47 patients, Crohn's colitis in one, familial polyposes in 5 and Gardner's Syndrome in one. Followup is complete and varies from 6 months to three years. All but three patient...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-197702000-00008
更新日期:1977-02-01 00:00:00
abstract:OBJECTIVE:This study aims at improving diagnosis of intestinal ischemia, by measuring plasma and urinary fatty acid binding protein (FABP) levels. METHODS:Fifty consecutive patients suspected of intestinal ischemia were included and blood and urine were sampled at time of suspicion. Plasma and urinary concentrations o...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/SLA.0b013e318207a767
更新日期:2011-02-01 00:00:00
abstract:OBJECTIVE:Create and validate diverticulitis surgical site infection prediction scale. BACKGROUND:Surgical site infections cause significant morbidity after colorectal surgery. An infection prediction scale could target infection prevention bundles to high-risk patients. METHODS:Prospectively collected National Surgi...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/SLA.0000000000002859
更新日期:2019-12-01 00:00:00
abstract:OBJECTIVE:To assess whether elective colon and rectal surgery can be safely performed without preoperative mechanical bowel preparation. SUMMARY BACKGROUND DATA:Mechanical bowel preparation is routinely done before colon and rectal surgery, aimed at reducing the risk of postoperative infectious complications. However,...
journal_title:Annals of surgery
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1097/01.SLA.0000055222.90581.59
更新日期:2003-03-01 00:00:00
abstract:OBJECTIVE:To examine the first decade of experience with minimal access surgery, with particular attention to issues of training surgeons already in practice, and to provide a set of recommendations to improve technical training for surgeons in practice. SUMMARY BACKGROUND DATA:Concerns about the adequacy of training ...
journal_title:Annals of surgery
pub_type: 杂志文章,评审
doi:10.1097/00000658-200102000-00003
更新日期:2001-02-01 00:00:00
abstract::We studied a series of 26 cases of carcinoma of the ampulla of Vater. There were 24 adenocarcinomas and two neuroendocrine tumors. Histologically the carcinomas could be divided into tumors arising from periampullary duodenal mucosa and those arising within the ampulla. True ampullary tumors had a significantly better...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-198908000-00006
更新日期:1989-08-01 00:00:00
abstract:OBJECTIVE:To identify factors that have contributed to reduced rates of death and complications after esophageal resection in a 17-year period at a tertiary referral center. SUMMARY BACKGROUND DATA:There has been an evolving refinement in surgical technique and perioperative management of patients undergoing esophagea...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-200103000-00006
更新日期:2001-03-01 00:00:00
abstract::Controversy exists concerning the proper therapy for bleeding gastroesophageal varices secondary to noncirrhotic portal vein thrombosis. Disparity of opinion exists regarding the significance of hepatic portal blood flow and the consequences of total portal-systemic shunts in this condition. One patient is presented w...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-198009000-00009
更新日期:1980-09-01 00:00:00
abstract:OBJECTIVE:The primary objective was to compare overall survival (OS) in patients with colorectal cancer (CRC) with nonresectable liver-only metastases treated by liver transplantation or chemotherapy. BACKGROUND:CRC is the third most common cancer worldwide. About 50% of patients will develop metastatic disease primar...
journal_title:Annals of surgery
pub_type: 杂志文章,多中心研究,随机对照试验
doi:10.1097/SLA.0000000000000786
更新日期:2015-05-01 00:00:00
abstract:OBJECTIVE:To determine whether glutamine (GLN)-supplemented parenteral nutrition (PN) improves clinical outcomes in surgical intensive care unit (SICU) patients. SUMMARY BACKGROUND DATA:GLN requirements may increase with critical illness. GLN-supplemented PN may improve clinical outcomes in SICU patients. METHODS:A p...
journal_title:Annals of surgery
pub_type: 杂志文章,多中心研究,随机对照试验
doi:10.1097/SLA.0000000000001487
更新日期:2016-04-01 00:00:00
abstract:OBJECTIVE:The aim of this study was to determine whether weekday of esophagectomy impacts 30-day mortality, and short- and long-term oncologic outcomes in esophageal cancer. SUMMARY OF BACKGROUND DATA:Recent literature suggests a relationship between the weekday of esophagectomy and overall survival. This finding coul...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/SLA.0000000000001909
更新日期:2017-07-01 00:00:00
abstract::Transplantation of the intrathoracic inferior vena cava into the abdominal inferior vena cava of the recipient was performed in inbred rat strains of the following combinations: Syngeneic F344 leads to F344, RT-1-identical allogeneic LEW leads to F344, and RT-1-different allogeneic CAP leads to F344. In the RT-1-diffe...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-198103000-00006
更新日期:1981-03-01 00:00:00
abstract::From 1966 to 1975, 38 patients underwent 42 procedures for renovascular hypertension; 35 operations were aortorenal bypasses and 7 were nephrectomies. Forty-five per cent of the patients were cured, 43% were improved and 12% were unimproved. There were no operative deaths and only three late deaths. Two grafts occlude...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-197512000-00019
更新日期:1975-12-01 00:00:00
abstract:BACKGROUND:Since 2005, the American College of Surgeons has administered the Jacobson Promising Investigator Award (JPIA), which recognizes surgeon-scientists at the "tipping point" of their research careers. OBJECTIVE:We retrospectively reviewed JPIA applicants to identify factors associated with selection for the aw...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/SLA.0000000000004142
更新日期:2020-07-07 00:00:00
abstract::The abilities of polymorphonuclear leukocytes (PMN) and pulmonary alveolar macrophages (PAM), to demonstrate chemotaxis, phagocytosis, and superoxide release after bile duct ligation in the rat were investigated to determine the effect of cholestasis on nonspecific cellular immune mechanisms. Chemotactic response to C...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-198711000-00004
更新日期:1987-11-01 00:00:00
abstract:OBJECTIVE:Esophagectomy for esophageal cancer is associated with substantial postoperative morbidity as a result of infectious complications. In a prior phase II study, granulocyte colony-stimulating factor (G-CSF) was shown to improve leukocyte function and to reduce infection rates after esophagectomy. The aim of the...
journal_title:Annals of surgery
pub_type: 临床试验,杂志文章,多中心研究,随机对照试验
doi:10.1097/01.sla.0000129705.00210.24
更新日期:2004-07-01 00:00:00
abstract:OBJECTIVE:To analyze the impact of a conservative strategy of management in patients with necrotizing pancreatitis, reserving intervention for patients with documented infection or the late complications of organized necrosis. SUMMARY BACKGROUND DATA:The role of surgery in patients with sterile pancreatic necrosis rem...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-200110000-00016
更新日期:2001-10-01 00:00:00
abstract:OBJECTIVE:This study aimed to explore the impact of a human factors intervention bundle on the quality of ward-based surgical care in a UK hospital. SUMMARY OF BACKGROUND DATA:Improving the culture of a surgical team is a difficult task. Engagement with stakeholders before intervention is key. Studies have shown that ...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/SLA.0000000000002089
更新日期:2018-01-01 00:00:00
abstract:OBJECTIVE:To determine the clinical features, natural history, and role of surgery for gastrointestinal manifestations of the multiple endocrine neoplasia type 2 (MEN 2) syndromes. SUMMARY BACKGROUND DATA:The MEN 2 syndromes are characterized by medullary thyroid carcinoma and other endocrinopathies. In addition, some...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-200205000-00006
更新日期:2002-05-01 00:00:00