Abstract:
INTRODUCTION:The need for diverting loop ileostomies to protect high-risk anastomoses has been questioned recently by several authors. This study was designed to evaluate the potential benefits and complications of diverting loop ileostomies in a high-risk anastomosis population. METHODS:Ninety-four consecutive patients undergoing diverting loop ileostomy were evaluated from a prospective database between 2003 and 2006. Criteria for diversion were: anastomosis less than 5 cm from the anal verge, previous pelvic radiation therapy, obstruction, and infection. Data regarding patient demographics, underlying pathology, anastomotic problems, and ileostomy-related problems were gathered. RESULTS:Indications for surgery were malignancy (n = 40), ulcerative colitis (n = 37), acute diverticulitis (n = 12), perirectal fistulas (n = 3), and familial polyposis (n = 2). There were 5 anastomotic complications. One required permanent stoma and 4 required delay in diverting ileostomy closure but no other intervention. Ileostomy-related problems were limited to minor stoma and pouch complaints requiring stoma nurse evaluation (n = 23), dehydration requiring outpatient (n = 8) or inpatient (n = 4) intravenous fluids, stricture at stoma closure site (n = 2), and bleeding at stoma closure site (n = 1). Four stoma site hernias (4.3%) have been identified to date. CONCLUSION:The use of diverting loop ileostomy in patients undergoing colon and rectal surgery with high-risk anastomoses is beneficial. Their selected use has resulted in a 1% anastomotic loss rate with an acceptably low rate of complications related to the ileostomy.
journal_name
Am J Surgjournal_title
American journal of surgeryauthors
Bax TW,McNevin MSdoi
10.1016/j.amjsurg.2007.01.005subject
Has Abstractpub_date
2007-05-01 00:00:00pages
585-7; discussion 587-8issue
5eissn
0002-9610issn
1879-1883pii
S0002-9610(07)00051-7journal_volume
193pub_type
杂志文章abstract:BACKGROUND:Since any intraductal papillary mucinous neoplasm (IPMN) is at least premalignant, avoiding conversion to invasion by pancreatic resection should provide a survival advantage-but how much? METHODS:We reviewed 100 cases of IPMN that were resected. Survival was compared between 3 groups: noninvasive IPMN (n =...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/j.amjsurg.2005.01.020
更新日期:2005-05-01 00:00:00
abstract:BACKGROUND:Gastric stump carcinoma (GSC) has been studied after primary gastrectomy for benign disease but few studies have evaluated its correlation with gastric cancer. PATIENTS:We assessed 541 patients submitted to subtotal gastrectomy for early gastric cancer at least 15 years ago. RESULTS:GSC was diagnosed in 16...
journal_title:American journal of surgery
pub_type: 杂志文章,多中心研究
doi:10.1016/j.amjsurg.2014.06.021
更新日期:2015-06-01 00:00:00
abstract::Twenty-five patients with ulcerative colitis were treated between 1959 and 1986 at the Mount Sinai Hospital, with severe gastrointestinal hemorrhage as their major complaint. Twenty-two patients required operation, while three patients were treated medically. Total proctocolectomy with ileostomy was carried out in 5 p...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/s0002-9610(06)80064-4
更新日期:1990-06-01 00:00:00
abstract::Over the last decade, significant technological advancements have occurred in cardiac surgery. One such breakthrough has been the use of robotic telemanipulation systems, which allow the surgeon to perform cardiac surgery through a minimally invasive approach. As a result, surgery for atrial fibrillation and resynchro...
journal_title:American journal of surgery
pub_type: 杂志文章,评审
doi:10.1016/j.amjsurg.2004.08.001
更新日期:2004-10-01 00:00:00
abstract::The value of barium enema examination in diagnosing acute appendicitis in patients with equivocal findings has been confirmed by our experience with five patients. Cecal spasm, extrinsic compression of the cecum, nonvisualization of the appendix, and partial visualization of the appendix appear to be useful roentgenog...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/0002-9610(79)90306-4
更新日期:1979-12-01 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:Colonic inertia (CI) is a disturbance of colonic motility characterized by severe constipation and abdominal pain. This study was conducted to assess the results of total abdominal colectomy (TAC) in the management of CI. METHODS:A retrospective chart review of 55 patients who underwent TAC for CI was condu...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/s0002-9610(01)00820-0
更新日期:2001-12-01 00:00:00
abstract:BACKGROUND:This study aims to analyze the risk factors for anastomotic leakage after low anterior resection with the technique of total mesorectal excision (TME). METHODS:From September 1993 to November 1998, 196 patients with rectal cancer from 3 to 12 cm from the anal verge were treated with low anterior resection w...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/s0002-9610(00)00252-x
更新日期:2000-02-01 00:00:00
abstract:BACKGROUND:Bile duct calculi (BDC) can be cleared or treated with modern endoscopic techniques in most patients. However, large stones, bile duct strictures, or unusual anatomy may make endoscopic clearance difficult. The purpose of the present study was to determine the efficacy of extracorporeal shock-wave lithotrips...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/s0002-9610(97)00234-1
更新日期:1998-01-01 00:00:00
abstract:BACKGROUND:This study aimed to determine whether pre-operative medication use is associated with unplanned 30-day readmission in elderly people undergoing cancer surgery. METHODS:Patients aged 65 years or older who were scheduled for cancer surgery and presented for comprehensive geriatric assessment were included. Co...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/j.amjsurg.2019.06.020
更新日期:2020-06-01 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:BACKGROUND:Although several methods of repair of extremity venous injuries have been shown to be efficacious, patency rates have varied significantly from center to center. METHODS:A retrospective review was made of treatment outcomes of adult and pediatric patients with major venous injuries of the lower extremity. ...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/j.amjsurg.2003.08.006
更新日期:2003-12-01 00:00:00
abstract::Review of the diagnosis and treatment of patients with pancreatic pseudocysts over the past 8 years has led us to three conclusions regarding controversial aspects of their treatment. We found that patients who present with chronic pseudocysts can be identified with the help of computerized axial tomography and prompt...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/s0002-9610(88)80275-7
更新日期:1988-01-01 00:00:00
abstract::Quercetin exhibits antitumor activity. We investigated the effect of quercetin on the in vitro and in vivo growth of two squamous cell carcinoma cell lines and a normal human lung fibroblast-like cell line. The in vivo effect was evaluated using implantable cell growth chambers implanted subcutaneously in immunocompet...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/0002-9610(89)90132-3
更新日期:1989-10-01 00:00:00
abstract::The incidence of postoperative wound complications and early cancer recurrence was studied in 289 patients who had mastectomy alone and in 113 patients who underwent immediate reconstruction following mastectomy. Patients undergoing immediate reconstruction were younger and had less advanced disease than patients who ...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/s0002-9610(05)80572-0
更新日期:1993-07-01 00:00:00
abstract::Although the importance of the profunda femoris artery in maintenance of lower extremity integrity was recognized in the earliest days of modern vascular surgery, disappointment with the performance of primary profundaplasty has emerged fully only in recent years. During the 10 year period from 1977 to 1987, only 17 p...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/s0002-9610(88)80371-4
更新日期:1988-08-01 00:00:00
abstract::One hundred patients with advanced, recurrent, or metastatic squamous cell carcinoma of the head and neck were treated with chemotherapy and BCG as adjuvant immunotherapy. The overall response rate was 35 per cent, and the median duration of response was seventeen weeks. BCG does not prolong duration of remission or s...
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(77)90381-6
更新日期:1977-10-01 00:00:00
abstract:BACKGROUND:Magnetic resonance cholangiopancreatography (MRCP) is a noninvasive method for diagnosing choledocholithiasis. It is said to be as accurate as the gold standard endoscopic retrograde cholangiopancreatography (ERCP) for detecting common bile duct (CBD) stones. A study was needed to look at the accuracy of MRC...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/j.amjsurg.2012.07.033
更新日期:2013-04-01 00:00:00
abstract:BACKGROUND:The novel coronavirus (COVID-19) strain has resulted in restrictions potentially impacting patients presenting with acute appendicitis and their disease burden. METHODS:All acute appendicitis admissions (281 patients) between 1/1/2018-4/30/2020 were reviewed. Two groups were created: 6 weeks before (Group A...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/j.amjsurg.2020.09.026
更新日期:2020-09-28 00:00:00
abstract::Reports in the surgical literature are conflicting as to whether appendectomy "in passing" during laparotomy for trauma or for some other disease state does or does not significantly increase patient morbidity or mortality. A chart survey of all appendectomies (342 for acute appendicitis and 146 as incidental procedur...
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(83)90150-2
更新日期:1983-06-01 00:00:00
abstract:INTRODUCTION:Native Americans (NA) form a unique cohort of colon cancer (CC) patients among whom the variability in demographics and cancer characteristics remains unclear. METHODS:We abstracted the national estimates for NA with CC using the Surveillance, Epidemiology, and End Result (SEER) database. Trend analysis o...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/j.amjsurg.2016.11.033
更新日期:2017-08-01 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 study was to examine the outcomes of checklist-driven preoperative briefings and postoperative debriefings during the Veterans Health Administration (VHA) medical team training program. METHODS:A briefing score (1, never started; 2, started then discontinued; 3, maintained on original ta...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/j.amjsurg.2010.07.011
更新日期:2010-11-01 00:00:00
abstract:BACKGROUND:Physiologic variables used in trauma triage criteria may be significantly affected by age, decreasing their predictive value in geriatric trauma. METHODS:The study population was all adult patients in the Washington State Trauma Registry from 2000 to 2004. Elderly patients were defined as those aged >65 yea...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/j.amjsurg.2008.12.037
更新日期:2009-05-01 00:00:00
abstract:BACKGROUND:The appropriate surgical approach of a pancreatic multifocal disease that skips the body of the gland remains unknown. We sought to analyze a parenchyma-sparing surgical technique consisting of a middle-preserving pancreatectomy (MPP) evaluating feasibility, safety, and oncological and functional outcomes. ...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/j.amjsurg.2009.02.017
更新日期:2009-09-01 00:00:00
abstract:BACKGROUND:Human immunodeficiency virus (HIV), hepatitis B (HBV), and hepatitis C (HCV) infections are transmitted by blood exposure. Surgeons have been concerned about the risks of blood exposure in the operating room as a potential source of occupational infections from these viruses. The actual risk and frequency of...
journal_title:American journal of surgery
pub_type: 杂志文章,评审
doi:10.1016/j.amjsurg.2005.05.021
更新日期:2005-08-01 00:00:00
abstract::Follicular carcinoma of the thyroid usually metastasizes through a hematogenous route to the bone, lung, and central nervous system. Metastasis to subcutaneous tissues and retro-orbital region is unusual. We report an unusual case of follicular thyroid carcinoma with metastasis to subcutaneous tissues in the right tem...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/j.amjsurg.2009.07.048
更新日期:2010-06-01 00:00:00
abstract:BACKGROUND:The aim of this study was to determine whether differing neoadjuvant chemotherapy (NAC) regimens for HER2 positive breast cancer (HER2+ BC) are associated with differing surgical complications. Our goal was to evaluate postoperative complications in HER2+ BC patients receiving NAC with Herceptin (trastuzumab...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/j.amjsurg.2020.06.053
更新日期:2020-11-01 00:00:00
abstract:BACKGROUND:Laparoscopy has played an ill-defined role as a diagnostic tool for the staging of gastric and other intra-abdominal malignancies for a long time. The widespread use of the laparoscopic approach for the treatment of some benign abdominal diseases, such as biliary lithiasis and gastroesophageal reflux disease...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/S0002-9610(97)89571-2
更新日期:1996-02-01 00:00:00
abstract::Metastatic malignancies of the hand are rare and usually develop from lung, breast, or kidney tumors. Metastases from tumors and sarcomas of the gastrointestinal system are even more uncommon. The authors report a case of differentiated adenocarcinoma of the colon in a 76-year-old man who presented with distal phalang...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/j.amjsurg.2010.02.016
更新日期:2010-11-01 00:00:00