Abstract:
:The role and effectiveness of intraoperative enteroscopy in the evaluation of gastrointestinal (GI) bleeding of obscure origin is not clearly defined. Our aim was to determine if intraoperative enteroscopy is effective in identifying a source, which would lead to therapy and prevent recurrent gastrointestinal hemorrhage. Forty-four patients (median age: 64 years) underwent intraoperative enteroscopy. Median number of preoperative blood transfusions, duration of bleeding (months), and prior hospitalizations for GI hemorrhage were 19, 15, and 2, respectively. Many patients had risk factors associated with bleeding. All had undergone an extensive preoperative evaluation. Intraoperative enteroscopy was completely negative in 13 (30%). A site-specific source was seen in the small bowel in 31 patients (70%); 27 patients had lesions amenable to segmental resection with or without other means of definitive management. Only 6 of 31 patients (19%) had lesions that were actively bleeding. Twenty-three (52%) patients have had recurrent bleeding requiring transfusion (median follow-up: 21 months). Although intraoperative enteroscopy identified specific mucosal abnormalities in 70% of patients, the therapeutic efficacy in preventing recurrent hemorrhage was only 41%. Intraoperative enteroscopy is an effective tool in selected patients with occult GI bleeding and correctly identifies a treatable source and prevents recurrent bleeding in 41% of patients.
journal_name
Am J Surgjournal_title
American journal of surgeryauthors
Ress AM,Benacci JC,Sarr MGdoi
10.1016/0002-9610(92)90259-tsubject
Has Abstractpub_date
1992-01-01 00:00:00pages
94-8; discussion 98-9issue
1eissn
0002-9610issn
1879-1883pii
0002-9610(92)90259-Tjournal_volume
163pub_type
杂志文章abstract:BACKGROUND:The aim of this study was to evaluate the incidence of severe complications of adult inguinal hernia surgery from 2003 to 2007 using data from the Finnish National Patient Insurance Association. METHODS:All major surgical complications are reported to the association because it handles financial compensatio...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/j.amjsurg.2009.04.018
更新日期:2010-06-01 00:00:00
abstract::Over a 2 year period, 34 limbs were revascularized in 33 patients. The in situ saphenous vein technique was used. Improved instrumentation and patency rates have encouraged the use of this method. Eighteen patients were insulin-dependent diabetics. The indication for operation was limb salvage in 25 limbs (73 percent)...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/0002-9610(83)90108-3
更新日期:1983-05-01 00:00:00
abstract:BACKGROUND:Native arterial venous fistulas (NAVF) are generally considered preferable to synthetic grafts for chronic dialysis access. As increasing numbers of diabetic and elderly patients are treated, adequate NAVFs become more difficult to establish. Vascular ultrasonography (US) prior to NAVF surgery has received l...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/s0002-9610(02)01103-0
更新日期:2002-12-01 00:00:00
abstract:BACKGROUND:The purpose of this study was to investigate the impact of subcarinal dissection on short-term outcomes and survival after esophagectomy in patients with thoracic esophageal squamous cell carcinoma. METHODS:Patients without subcarinal dissection were matched randomly to patients with subcarinal dissection i...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/j.amjsurg.2012.10.044
更新日期:2013-09-01 00:00:00
abstract::Five hundred twenty-six patients who underwent carotid endarterectomy were separated by reviewing those 81 (15%) patients with an occluded contralateral carotid artery and those 445 (85%) with nonocclusion. The population characteristics and surgical indications were similar between the occluded and nonoccluded groups...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/s0002-9610(05)81050-5
更新日期:1993-08-01 00:00:00
abstract:BACKGROUND:Accurate intraoperative diagnosis of axillary malignancy facilitates completion axillary lymph node dissection (ALND) at the time of initial surgery. The capability to address both the primary tumor and axillary disease in a single procedure offers several advantages. This study was designed to define the pr...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/s0002-9610(03)00041-2
更新日期:2003-05-01 00:00:00
abstract:BACKGROUND:Circumportal pancreas is a rare congenital pancreatic anomaly. The aim of this study was to clarify the clinical characteristics of patients with circumportal pancreases undergoing pancreatectomy. METHODS:The medical records of 508 patients who underwent pancreatectomy were retrospectively reviewed. The pre...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/j.amjsurg.2016.11.018
更新日期:2017-08-01 00:00:00
abstract:BACKGROUND:HIV and AIDS continues to be a significant health problem with many patients requiring the attention of a general surgeon. METHOD:A retrospective case note review over a two-year period was undertaken. RESULTS:237 patients underwent invasive procedures. The majority 100 patients (145 procedures) were for v...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/S0002-9610(96)00054-2
更新日期:1996-07-01 00:00:00
abstract:BACKGROUND:The transformation of a trainee into a surgeon is influenced strongly by communication patterns in the operating room (OR). In the current era of limited educational opportunities, elucidation of teaching and learning strategies in this environment is critical. The aim of this study was to further understand...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/j.amjsurg.2008.01.004
更新日期:2008-05-01 00:00:00
abstract::A retrospective study of 316 patients with a diagnosis of intestinal obstruction admitted to the University of Benin Teaching Hospital over a 5 year period is presented. The overall mortality was 10.6 percent. Attention is called to the unacceptably high morbidity and mortality associated with volvulus in this and oth...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/0002-9610(80)90300-1
更新日期:1980-03-01 00:00:00
abstract:BACKGROUND:Necrotizing pancreatitis is a common condition with high mortality; the acute care surgeon is frequently consulted for management recommendations. Furthermore, there has been substantial change in the timing, approach, and frequency of surgical intervention for this group of patients. METHODS:In this articl...
journal_title:American journal of surgery
pub_type: 杂志文章,评审
doi:10.1016/j.amjsurg.2020.08.027
更新日期:2020-08-26 00:00:00
abstract::Though morbidity and mortality rates following pancreatic resection have improved in recent years, they are still around 35% and 5%, respectively. Typical complications, such as pancreatic fistula, abscess, and subsequent sepsis, are chiefly associated with exocrine pancreatic secretion. In order to clarify whether th...
journal_title:American journal of surgery
pub_type: 临床试验,杂志文章,多中心研究,随机对照试验
doi:10.1016/0002-9610(92)90264-r
更新日期:1992-01-01 00:00:00
abstract:BACKGROUND:We propose a simple algorithm for management of patients with challenging abdominal fascial defects. METHODS:The medical records of 64 patients with complicated abdominal wall defects representing a consecutive series by a single surgeon over a 4-year period were reviewed. Group I patients presented with ma...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/s0002-9610(00)00566-3
更新日期:2001-02-01 00:00:00
abstract:BACKGROUND:The tension-free hernioplasty as introduced by Lichtenstein has gained increasing acceptance during the last decade although the technique has not been evaluated in a randomized trial. METHODS:This randomized study compares the 2-year follow-up results after 102 tension-free hernioplasties with implantation...
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(96)00188-2
更新日期:1996-10-01 00:00:00
abstract:BACKGROUND:Urinary retention following inguinal hernia surgery is common and is believed to be associated with adrenergic over-stimulation of the smooth muscle in the bladder neck and prostate. The efficacy of prophylactic alpha-blockade in the prevention of urinary retention following elective inguinal hernia repair i...
journal_title:American journal of surgery
pub_type: 杂志文章,meta分析,评审
doi:10.1016/j.amjsurg.2017.02.017
更新日期:2018-08-01 00:00:00
abstract::A new catheter has been developed that can be accurately and precisely positioned using duplex ultrasonography alone. A piezoelectric transducer that functions as a passive, omnidirectional receiver is attached to the mid-balloon region of an angioplasty catheter. Integration to a standard duplex imaging system allows...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/0002-9610(91)90171-9
更新日期:1991-08-01 00:00:00
abstract:BACKGROUND:This study evaluated the outcomes of the first 5 years of sentinel node biopsy (SNB) in British Columbia (BC), Canada, 1996 to 2001. METHODS:There were 547 SNB procedures for breast cancer performed by 29 surgeons at 12 hospitals in BC between October 1996 and July 2001. Identification, accuracy, and false-...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/s0002-9610(02)01215-1
更新日期:2003-02-01 00:00:00
abstract::In this retrospective study, a cohort of gastric ulcer patients treated with antacids was compared with a well-matched group of patients treated with a combination of antacids and cimetidine. Cimetidine combined with antacids enhanced gastric ulcer healing, thereby significantly reducing the number of gastric ulcer op...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/s0002-9610(85)80151-3
更新日期:1985-05-01 00:00:00
abstract::Controversy continues about how often a negative laparotomy should be accepted in the management of patients with blunt and penetrating trauma. A key issue is the complications, especially small bowel obstruction. To define these complications, the charts of 248 patients who underwent negative laparotomy for trauma we...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/s0002-9610(88)80549-x
更新日期:1988-12-01 00:00:00
abstract:BACKGROUND:Metabolic syndrome (MetS) is defined by numerous comorbidities. We sought to assess MetS's effect on the 7 main emergency general surgery (EGS) procedures that constitute 80% of EGS procedures, mortalities, complications, and costs. METHODS:Data were acquired from the ACS-NSQIP database from 2005 to 2017. C...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/j.amjsurg.2019.12.021
更新日期:2020-08-01 00:00:00
abstract:PURPOSE:Vascular smooth muscle cell (VSMC) proliferation is an early event in the pathogenesis of atherosclerosis. Insulin and glucose are known to stimulate the growth of VSMC. Cell membrane receptors play an important role in the proliferation of VSMC in response to growth factors. Insulin and insulin-like growth fac...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/s0002-9610(99)00150-6
更新日期:1999-08-01 00:00:00
abstract:BACKGROUND:Hemorrhage during hepatectomy remains the major cause of morbidity and mortality associated with this surgery. Traditionally, a Pringle technique is employed to reduce vascular inflow during parenchymal transection. METHODS:This paper describes a simple method to achieve unilateral vascular control during h...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/s0002-9610(01)00697-3
更新日期:2001-09-01 00:00:00
abstract::In this study, we sought to identify changes in the picture of a selected surgical condition during an interval of time that has brought about radical departures from previously established policies and programs. As a direct consequence, the patients take a more circuitous route to the surgeon. A significant number of...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/0002-9610(89)90549-7
更新日期:1989-03-01 00:00:00
abstract::Although the use of shunts for carotid artery surgery remains controversial, the hemodynamics of the shunts currently available have not been carefully evaluated in vivo. We developed an animal model using contralateral carotid artery ligation, which produced ipsilateral carotid blood flows (640 +/- 44 ml/min) and int...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/0002-9610(89)90354-1
更新日期:1989-08-01 00:00:00
abstract::The portal-superior mesenteric vein (PV/SMV) is occasionally involved by a microscopic level of cancer invasion from pancreatic cancer even when it seems to be intact by a macroscopic inspection during surgery. Therefore, contact endoscopy, with which a high-magnification image of the methylene blue-stained PV/SMV wal...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/j.amjsurg.2009.03.009
更新日期:2009-11-01 00:00:00
abstract::Magnetic resonance angiography (MRA) has recently been shown to be more sensitive than contrast arteriography in the detection of patent distal runoff vessels. This study compares MRA and contrast arteriography in evaluating the severity of stenotic lesions in peripheral arteries, which has not been previously investi...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/s0002-9610(05)81040-2
更新日期:1993-08-01 00:00:00
abstract::Orthopedic surgery is a specialty of surgery dedicated to the prevention, diagnosis, and treatment of diseases and injuries of the musculoskeletal system in all age groups. Careers in orthopedic surgery span the spectrum from general orthopedics to those of subspecialty expertise in orthopedic trauma, hand, pediatrics...
journal_title:American journal of surgery
pub_type: 历史文章,杂志文章
doi:10.1016/j.amjsurg.2011.06.007
更新日期:2011-09-01 00:00:00
abstract:BACKGROUND:Saline-linked electric cautery (SLC) is introduced as an effective device to reduce blood loss in liver surgery. The aim of the current study was to evaluate the safety and efficacy of a 2-surgeon technique using SLC and the Cavitron Ultrasonic Surgical Aspirator (CUSA; Valleylab, Boulder, CO) in living dono...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/j.amjsurg.2008.01.019
更新日期:2009-02-01 00:00:00
abstract:BACKGROUND:Pancreatic neoplasms can be difficult to diagnose and stage preoperatively. Accurate staging allows the surgeon to select which patients can benefit from resection versus palliative therapy. Endoscopic ultrasound (EUS) with endoscopic ultrasound-guided fine needle aspiration (EUS-FNA) is a diagnostic modalit...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/s0002-9610(97)80928-2
更新日期:1997-12-01 00:00:00
abstract:BACKGROUND:Bariatric patients may not always obtain long-term care by their primary surgeon. Our aim was to evaluate weight loss outcomes in patients who had surgery elsewhere. METHODS:We conducted a retrospective analysis. Postreferral management included nonsurgical, revision, or conversion. Primary outcomes were pe...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/j.amjsurg.2015.04.025
更新日期:2016-07-01 00:00:00