Abstract：
BACKGROUND:Laparoscopic transabdominal preperitoneal (TAPP) herniorrhaphy provides an opportunity to definitively evaluate both inguinal areas without the need for additional dissection. We aimed to establish the rates and contributing patient factors to errors in the preoperative assessment. METHODS:A retrospective review of consecutive patients undergoing laparoscopic TAPP herniorrhaphy at 2 tertiary-care centers. Preoperative history and physical examination were used to classify the presence of hernia as "definite," "questionable," or "negative." Any discrepancies between preoperative and intraoperative findings were viewed as errors in preoperative assessment. RESULTS:Two hundred sixty-two patients underwent 328 laparoscopic TAPP hernia repairs. Of the 283 hernias diagnosed as "definite" preoperatively, 276 were confirmed at operation (97.8%). An additional 19 of 173 (11.0%) clinically unrecognized hernias were repaired at the time of surgery. Overall, our approach avoided unnecessary groin explorations and/or repairs in up to 16.4% patients and may have prevented inappropriate delays of herniorrhaphy in up to 19.8% of patients. The sensitivity, specificity, and positive predictive value of the clinical assessment of inguinal hernia were 94.5%, 80%, and 88.9%, respectively. Symptom and/or examination findings of inguinal mass were the only significant independent predictor of accuracy (P < .001). CONCLUSION:A high rate of discordance exists between the preoperative clinical assessment and true presence of inguinal hernias. Given the unique ability of laparoscopy to accurately evaluate the contralateral side and the limited added morbidity of bilateral repair, TAPP herniorrhaphy is beneficial in avoiding unnecessary explorations and allowing timely repairs in patients with occult inguinal hernias.
journal_name
Am J Surgjournal_title
American journal of surgeryauthors
Novitsky YW,Czerniach DR,Kercher KW,Kaban GK,Gallagher KA,Kelly JJ,Heniford BT,Litwin DEdoi
10.1016/j.amjsurg.2006.10.015subject
Has Abstractpub_date
2007-04-01 00:00:00pages
466-70issue
4eissn
0002-9610issn
1879-1883pii
S0002-9610(07)00008-6journal_volume
193pub_type
杂志文章abstract：:Breast symptoms of pain, tenderness, and engorgement correlate with objective findings of nodularity on physical examination. Like all other factors for breast disease, they are not a single determinant of diagnosis, as shown by the 3 X 3 contingency table, but they are a useful addition to our understanding. From the...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/0002-9610(85)90135-7
更新日期：1985-08-01 00:00:00
abstract：:Feeding gastrostomy and jejunostomy provide effective access for long-term enteral nutrition. Traditional operative techniques for the performance of these procedures requires laparotomy and often, general anesthesia. This report describes our experience with two relatively new methods, percutaneous endoscopic gastros...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/s0002-9610(85)80017-9
更新日期：1985-01-01 00:00:00
abstract：BACKGROUND:Historically, tertiary syphilis infection has been the most common cause of thoracic aortic aneurysm, resulting in 5% to 10% of cardiovascular deaths until the era of antibiotics. METHODS:A 49-year-old Caucasian man presented to our institution with progressive dysphagia, weight loss, incomplete bladder emp...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/j.amjsurg.2010.02.017
更新日期：2010-11-01 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：BACKGROUND:To establish feasibility, reliability and validity of a newly designed basic surgical training (BST) assessment form. METHODS:The assessment form was evaluated among trainees on the South-east Scotland BST rotation over 18 months. Feasibility was indicated by response rate. Reliability was determined using ...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/s0002-9610(01)00647-x
更新日期：2001-07-01 00:00:00
abstract：BACKGROUND:Motility disturbances in the Roux loop can negatively influence the outcome of reflux gastritis; the uncut Roux loop does not have these disadvantages, but is less suitable for clinical application because of staple dehiscence. The reported "cut-closed-reconnected" Roux loop has the same physiological starti...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/s0002-9610(00)00246-4
更新日期：2000-02-01 00:00:00
abstract：:After a biliary-enteric anastomosis, the development of cholangitis is usually assumed to be due to obstruction of the stoma. Six patients in whom this was not the case are described. Achlorhydria, duodenal diverticula, and foreign bodies are important predisposing factors. When bacterial contamination is severe in an...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/0002-9610(83)90038-7
更新日期：1983-04-01 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:The aims of the study are three-dimensional analysis of mode and distance of local spread of oral tongue carcinoma. METHODS:The glossectomy specimens were examined in the coronal plane in 3 mm thickness section. RESULTS:There were 50 glossectomy specimens. The maximum spread was 1.8 cm. Ninety-six percent ...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/s0002-9610(97)00282-1
更新日期：1998-03-01 00:00:00
abstract：:Experience with seven cases of pancreatic abscess is reviewed. All patients were treated with radical pancreatic debridement, large sump drainage with postoperative irrigation, gastrointestinal defunctionalization, antibiotic therapy and nutritional support. One patient died, for a mortality rate of 14 percent. We fee...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/0002-9610(81)90307-x
更新日期：1981-12-01 00:00:00
abstract：:Silver biopsies of the common bile duct were obtained from 15 patients with clinical and surgical evidence of cholangitis. The most pronounced histologic changes were edema, congestion, and marked mucous gland hypertrophy and hyperplasia. No ulceration, intramural abscess, or areas of necrosis were found. Clinical cho...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/0002-9610(79)90089-8
更新日期：1979-06-01 00:00:00
abstract：:The clinical course of 39 patients on HPN for 5.5 years at The Cleveland Clinic Foundation were reviewed. Rehospitalization and mortality rates were relatively low in this group of patients who had significant disease processes. Rehospitalization and mortality were usually due to the primary underlying disease process...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/0002-9610(83)90174-5
更新日期：1983-01-01 00:00:00
abstract：:The obturator hernia is rare, accounting for only 0.05% of all hernias and 0.2% of all small-bowel obstructions requiring laparotomy at our institution. Typically, there is a delay in diagnosis and surgical intervention, despite the presence of a bowel obstruction. A laparotomy is needed, not a preoperative diagnosis....
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/s0002-9610(99)80256-6
更新日期：1995-07-01 00:00:00
abstract：:Aortobrachiocephalic reconstruction was studied in 26 patients. Nine had suffered a previous stroke, and seven had residual deficity. A previous carotid endarterectomy or carotid-to-subclavian bypass had been performed in eight patients. The ascending aorta was the proximal anastomotic site in all cases. Bypass grafti...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/s0002-9610(88)80364-7
更新日期：1988-08-01 00:00:00
abstract：:Forty-nine patients had conservative treatment of an appendix mass without interval appendectomy. Five were lost to follow-up within 6 months, and 44 patients were followed for between 6 months and 22 years. In nine patients (20 percent) recurrent appendicitis developed, and six (14 percent) suffered chronic pain not ...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/0002-9610(84)90476-8
更新日期：1984-09-01 00:00:00
abstract：:The difficulties created by an unsuccessful initial operation can usually be avoided by choosing experienced surgeons, identifying four glands, and selectively excising grossly abnormal parathyroid tissue. Patients with multiple endocrine adenomatosis or familial hyperparathyroidism should have a subtotal parathyroide...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/0002-9610(82)90412-3
更新日期：1982-10-01 00:00:00
abstract：BACKGROUND:No studies to date exist regarding the attire of physicians on a surgical service. The objective of this study was to determine patient, surgeon, and nonhospitalized public (NHP) attitudes and preferences regarding surgeons' attire and mannerisms. METHODS:A questionnaire was developed to survey each group. ...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/j.amjsurg.2005.04.003
更新日期：2005-07-01 00:00:00
abstract：BACKGROUND:Computed tomography (CT) is an important diagnostic modality in the evaluation of blunt head and abdominal injuries, but it has not been routinely used to evaluate blunt chest trauma. METHODS:One hundred seventy stable patients with blunt thoracic trauma were evaluated with chest x-ray (CXR), and subsequent...
journal_title：American journal of surgery
pub_type： 临床试验,杂志文章
doi：10.1016/s0002-9610(05)80146-1
更新日期：1994-12-01 00:00:00
abstract：BACKGROUND:Hypercapnia and local pressure effects unique to CO(2) base minimally invasive surgery alter renal blood flow. We have demonstrated laparoscopic antireflux surgery to have an additional impact upon hemodynamics (decreased cardiac output), potentially extending known effects upon renal blood flow. METHODS:We...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/s0002-9610(02)00824-3
更新日期：2002-04-01 00:00:00
abstract：:The palliative management of malignant obstruction of the biliary tree continues to challenge clinicians. The technique of PTBD has become increasingly popular to decompress the obstructed biliary system. Our initial experience with 30 consecutive patients treated with PTBD has been retrospectively reviewed. Internal ...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/0002-9610(84)90125-9
更新日期：1984-05-01 00:00:00
abstract：BACKGROUND:Crohn's disease is an aggressive chronic inflammatory disorder, and despite medical advances no cure exists. There is a great risk of requiring an operative intervention, with evidence of recurrence developing in up to 80-90% of cases. Therefore, we sought to systematically review the current status in the p...
journal_title：American journal of surgery
pub_type： 杂志文章,评审
doi：10.1016/j.amjsurg.2017.04.016
更新日期：2017-11-01 00:00:00
abstract：BACKGROUND:This study was undertaken to evaluate the accuracy of touch preparation (touch prep) in the evaluation of sentinel lymph nodes (SLNs). METHODS:We performed a retrospective review of 402 breast cancer patients who underwent SLN biopsy. RESULTS:A SLN was identified in 381 patients. Of 61 patients with a true...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/j.amjsurg.2009.06.020
更新日期：2010-06-01 00:00:00
abstract：BACKGROUND:Besides alcohol and gallstones, pancreatic ischemia can cause acute pancreatitis (AP). This entity should be considered when no other reasons can be defined. The aim of the current study was to define ischemic AP with its pathophysiologic, radiologic, and clinical conditions. METHODS:Eleven patients with is...
journal_title：American journal of surgery
pub_type： 杂志文章,评审
doi：10.1016/j.amjsurg.2008.04.011
更新日期：2009-04-01 00:00:00
abstract：BACKGROUND:Obesity is a risk factor for many comorbid conditions that increase the cost of health care. We sought to examine the effect of obesity on surgical complications and cost in a group of patients undergoing intestinal surgery. METHODS:Using the Veterans Affairs Surgical Quality Improvement Program (VASQIP), w...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/j.amjsurg.2012.01.013
更新日期：2012-10-01 00:00:00
abstract：:Adult male rats underwent common bile duct ligation or sham celiotomy. At intervals of 7 and 14 days postoperatively, bacteremia was induced by intravenous injection of 10(9) Escherichia coli or intraperitoneal injection of 10(6) E. coli. Serial quantitative blood cultures and quantitative whole organ cultures were ob...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/0002-9610(89)90530-8
更新日期：1989-02-01 00:00:00
abstract：BACKGROUND:Several reports have indicated the benefits of the acute care surgery (ACS) model in surgical outcomes. We tried to delineate the impact of the ACS model on surgical efficiency and quality. METHODS:Before the ACS model was implemented, abdominal surgical emergencies were evaluated by an on-call nontrauma ge...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/j.amjsurg.2013.04.016
更新日期：2014-11-01 00:00:00
abstract：BACKGROUND:Recurrent laryngeal nerve (RLN) palsy is one of the most serious complications in thyroid surgery. No prospective studies are available that evaluate if the additional use of intraoperative neuromonitoring reduces the rate of RLN palsy. METHODS:Between January 1 and December 31, 1998, surgery for histologic...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/s0002-9610(02)00856-5
更新日期：2002-06-01 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:Advantages of laparoscopic cholecystectomy (LC) such as less pain and short hospital stay make it the treatment of choice for cholelithiasis. There are limited data about LC under spinal anesthesia. This study was designed to evaluate LC under spinal anesthesia. METHODS:Twenty-nine patients underwent surger...
journal_title：American journal of surgery
pub_type： 临床试验,杂志文章
doi：10.1016/j.amjsurg.2007.05.043
更新日期：2008-04-01 00:00:00
abstract：BACKGROUND:The purpose of this paper is to review the experience of a community surgeon performing laparoscopic antireflux procedures (LAP). The experience has been difficult and at times unsettling, and underscores the need for advanced laparoscopic expertise not normally obtained performing laparoscopic cholecystecto...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/S0002-9610(97)89608-0
更新日期：1996-05-01 00:00:00
