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 bowel are included. The overall mortality rate was 37%. The fistulas are classified into four types: type I-abdominal, esophagus, gastroduodenal (mortality rate, 17%); type II-small bowel (mortality rate, 33%); type III-large bowel (mortality rate, 20%), and type IV-all sites associated with a large abdominal wall defect (mortality rate, 60%). The main cause of death was intra-abdominal infection. Seventy-six percent of the patients required further operations. We conclude that despite the availability of all modern diagnostic and management facilities, postoperative external gastrointestinal fistulas treated during the 1980s continue to represent a surgical "disaster." Only prevention and improved methods in the management of the associated intra-abdominal infections could improve the results.
journal_name
Am J Surgjournal_title
American journal of surgeryauthors
Schein M,Decker GAdoi
10.1016/0002-9610(91)91107-tsubject
Has Abstractpub_date
1991-04-01 00:00:00pages
435-8issue
4eissn
0002-9610issn
1879-1883pii
0002-9610(91)91107-Tjournal_volume
161pub_type
杂志文章abstract：:The relationship between type 2 diabetes mellitus and pancreatic cancer (PC) is not clear. It has been reported that the increased release of islet amyloid polypeptides (IAPPs) is responsible for the impaired glucose tolerance in PC patients. However, no information exists on the patterns of IAPP expression in PC tiss...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/j.amjsurg.2007.05.024
更新日期：2007-10-01 00:00:00
abstract：BACKGROUND:Antibiotic prophylaxis during placement of implanted central venous access ports (CVAP) has not been studied. This retrospective review compared the rate of catheter-related infections (CRIs) with and without perioperative antibiotics. METHODS:This was a single-center study that compared patients treated wi...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/j.amjsurg.2010.07.023
更新日期：2010-12-01 00:00:00
abstract：:The records of more than 1,000 patients who underwent colonoscopy were reviewed. The study group consisted of 55 of these 1,000 patients who had persistent unexplained bleeding per rectum and negative radiographic examinations. Colonoscopy was helpful in defining the site of bleeding in approximately 50 per cent of th...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/0002-9610(79)90332-5
更新日期：1979-11-01 00:00:00
abstract：:A 5 year retrospective study of the use of cholangioscopy in 153 difficult biliary cases including stones, strictures, tumors, and anomalies has been reported. In the 88 patients (58 percent) who underwent both operative cholangiography and cholangioscopy, the cholangioscope revealed 11 lesions (13 percent) missed by ...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/0002-9610(84)90048-5
更新日期：1984-01-01 00:00:00
abstract：BACKGROUND:Routine contralateral groin exploration in infants and children with a clinically detected inguinal hernia is the subject of much debate. The detection of a patent processus vaginalis by transinguinal laparoscopy has proven advantageous. However, controversy remains regarding the true incidence of a contrala...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/s0002-9610(01)00797-8
更新日期：2001-12-01 00:00:00
abstract：BACKGROUND:Although the immunologic benefits of laparoscopic surgery have been established, effects from hand-assisted (HA) surgery have not been investigated thoroughly. We hypothesized that the HA approach maintains the immunologic advantage of laparoscopic surgery compared with the open (O) approach. METHODS:Six O,...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/j.amjsurg.2010.09.026
更新日期：2011-07-01 00:00:00
abstract：:Thymectomy was performed on 249 patients with myasthenia gravis between 1957 and 1981. During a follow-up period that ranged from 2 months to 24 years (mean 7.5 years), the remission rate for the entire group was 51 percent, and an additional 36 percent had improvement (87 percent benefited). In those 51 patients with...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/0002-9610(83)90260-x
更新日期：1983-07-01 00:00:00
abstract：:Treatment failure and survival in 209 patients with squamous cell carcinoma of the floor of the mouth treated with surgery as the single curative modality are reported. Fifty percent of the patients had stage III and IV disease. The primary tumor was excised with 1 to 2 cm margins and the mandible was resected in 73 p...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/0002-9610(89)90118-9
更新日期：1989-10-01 00:00:00
abstract：BACKGROUND:Increased anesthesia time may lead to respiratory complications in patients receiving tracheostomy, which contributes to patient morbidity. METHODS:The American College of Surgeon's National Surgical Quality Improvement Program (ACS-NSQIP) database was queried for cases of planned tracheostomy (CPT 31600) f...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/j.amjsurg.2018.07.059
更新日期：2018-10-01 00:00:00
abstract：OBJECTIVES:The OX-40 receptor (OX-40R/CD134) is expressed primarily on activated CD4(+) ("helper") T cells. We have previously reported the presence of OX-40(+) T cells in head and neck cancer and melanoma, where they appear to be restricted to tumor compartments (primary tumor infiltrating lymphocytes [TILs] and drain...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/s0002-9610(00)00361-5
更新日期：2000-05-01 00:00:00
abstract：:We have tested the interaction between serotonin and secretin in pentagastrin-induced gastric acid secretion in six dogs prepared with Thomas gastric and duodenal cannulas. We further examined the effect of methysergide, a serotonin antagonist, on gastric acid secretion. The intravenous administration of serotonin or ...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/s0002-9610(85)80007-6
更新日期：1985-01-01 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
abstract：PURPOSE:To describe the current practice and opinions held by surgeons performing colorectal surgery in Washington regarding laparoscopic colorectal surgery. METHODS:After attempting to identify all surgeons with hospital privileges in colorectal surgery in Washington, a survey was sent to 303 surgeons. The survey ask...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/s0002-9610(03)00112-0
更新日期：2003-07-01 00:00:00
abstract：:There has been a continuing evolution of the clinical spectrum of Candida infection in nonneutropenic patients. With better understanding of the predisposing factors for fungemia in critically ill patients, interest now centers on indications for early therapy, prior to the progression of colonization to fungemia. Rec...
journal_title：American journal of surgery
pub_type： 杂志文章,评审
doi：10.1016/s0002-9610(96)00350-9
更新日期：1996-12-01 00:00:00
abstract：:William Stewart Halsted and John Chalmers DaCosta are two of the most distinguished surgeons in the history of medicine in the United States. Although their personalities were completely opposite, they enjoyed a long and devoted friendship. During their relationship, a fairly continuous correspondence was maintained. ...
journal_title：American journal of surgery
pub_type： 传,历史文章,杂志文章
doi：10.1016/0002-9610(89)90622-3
更新日期：1987-09-01 00:00:00
abstract：:The role of preoperative localization tests in patients undergoing initial neck exploration for hyperparathyroidism (HPT) is controversial. The use of parathyroid ultrasonography (US) in 46 patients (7 men, 39 women; mean age: 60 years) who underwent initial neck exploration for hypercalcemia and who had the diagnosis...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/s0002-9610(05)80900-6
更新日期：1992-10-01 00:00:00
abstract：BACKGROUND:This study evaluated a simulated pages curriculum that was developed to assess communication and clinical decision making in medical students and interns. METHODS:A curriculum consisting of 14 simulated pages was administered across 5 institutions to 150 senior medical students. A 3-case subset was administ...
journal_title：American journal of surgery
pub_type： 杂志文章,多中心研究
doi：10.1016/j.amjsurg.2014.01.014
更新日期：2014-08-01 00:00:00
abstract：:The accepted approach to patients with intermittent calf claudication is nonoperative unless the symptoms are truly incapacitating, in which case arteriography and either percutaneous angioplasty or operation is indicated. Arteriography is considered a preoperative procedure. However, with improvements in percutaneous...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/s0002-9610(05)80300-9
更新日期：1990-08-01 00:00:00
abstract：BACKGROUND:Academic institutions have increasingly focused on educating physicians and surgeons in concepts of value-based care, including quality improvement (QI). The extent to which QI curricular competencies are addressed in specialty surgical residency training is unclear. METHODS:A survey instrument was develope...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/j.amjsurg.2020.09.036
更新日期：2020-09-29 00:00:00
abstract：:Significant salvage of patients with a wide variety of cysts and benign tumors of the liver and of some patients with biliary strictures can be achieved by hepatic resection in carefully selected clinical situations with a low operative mortality rate and an acceptable postoperative complication rate. Still to be dete...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/0002-9610(79)90123-5
更新日期：1979-04-01 00:00:00
abstract：BACKGROUND:Definitive practice guidelines regarding the utility of chest x-ray (CXR) following chest tube removal in trauma patients have not been established. The authors hypothesized that the selective use of CXR following chest tube removal is safe and cost effective. METHODS:A retrospective review of chest tube in...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/j.amjsurg.2009.03.011
更新日期：2010-02-01 00:00:00
abstract：:The effects of epinephrine on the vascular perfusion of solitary Walker tumors implanted in the liver were studied in Sprague-Dawley rats. Colored silicone rubber (Microfil) solutions were injected into the arterial and portal circulations in each animal, and specimens were studied under a stereomicroscope. Internal v...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/0002-9610(80)90044-6
更新日期：1980-11-01 00:00:00
abstract：BACKGROUND:The purpose of this study was to evaluate the involvement of inflammatory mediators in patients undergoing Lichtenstein tension-free hernioplasty (LH) using polypropylene prosthetic materials or conventional Bassini hernia repair (BH). METHODS:Thirty patients male with unilateral inguinal hernia without com...
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(00)00445-1
更新日期：2000-09-01 00:00:00
abstract：BACKGROUND:The relative prognostic impact of intra-aortic balloon pump (IABP) placement before versus after cardiac surgery is not well defined. METHODS:We reviewed data from all cardiac surgical patients who received perioperative IABP support at a veterans' hospital between April 1992 and April 2008. We compared out...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/j.amjsurg.2009.07.011
更新日期：2009-11-01 00:00:00
abstract：BACKGROUND:Anorectal malformations represent a continuing challenge for the pediatric surgeon. A significant number of these children suffer from fecal incontinence, urinary incontinence, and sexual inadequacy. However, major advances in the management of these children have occurred during the last 10 years. The poste...
journal_title：American journal of surgery
pub_type： 杂志文章,评审
doi：10.1016/s0002-9610(00)00491-8
更新日期：2000-11-01 00:00:00
abstract：:Recurrence of hyperparathyroidism after initially successful primary operation is usually caused by inadequate resection of diseased tissue or recurrent carcinoma. Since it is known that normal parathyroid tissue may be autotransplanted into a muscle bed, it is plausible that inadvertent implantation of parathyroid ti...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/s0002-9610(85)80178-1
更新日期：1985-06-01 00:00:00
abstract：:Percentage and levels of circulating T-lymphocytes were studied in forty-six patients with squamous cell carcinoma of the head and neck before and/or after treatment and compared with control values obtained in fifty-one healthy volunteers. Mean percentages of circulating T-cells and mean T-cell levels in cancer patie...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/0002-9610(75)90481-x
更新日期：1975-10-01 00:00:00
abstract：:Eighty-two femoropopliteal reconstructions were performed on sixty-six consecutive patients. Of seventeen late failures, thirteen were secondarily reconstructed. Clinical and angiographic studies demonstrated the reasons for failure in all patients except one. Seven patients were improved and six unimproved by reopera...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/0002-9610(78)90107-1
更新日期：1978-02-01 00:00:00
abstract：:The sphincter of Oddi has basal myogenic phasic activity that is modulated by neural and hormonal pathways. Stimulatory innervation to this organ is cholinergic, whereas the inhibitory pathways are unknown. Nitric oxide (NO), generated from L-arginine, relaxes gastrointestinal smooth muscle in vitro. We, therefore, hy...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/s0002-9610(05)80407-6
更新日期：1993-01-01 00:00:00
abstract：INTRODUCTION:Intestinal-cutaneous fistulas (ICFs) constitute a major surgical challenge. Definitive surgical treatment of ICFs continues to be associated with significant morbidity. The purpose of this study was to utilize a nationwide database to define the morbidity associated with current treatment strategies in the...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/j.amjsurg.2020.08.038
更新日期：2020-09-02 00:00:00
