Abstract：
BACKGROUND:There is a paucity of literature concerning general anesthesia and surgery in patients with amyotrophic lateral sclerosis (ALS or Lou Gehrig's disease). This report summarizes the largest series of surgical cases in ALS during multicenter prospective trials of the laparoscopic diaphragm pacing system (DPS) to delay respiratory failure. METHOD:The overall strategy outlined includes the use of rapidly reversible short-acting analgesic and amnestic agents with no neuromuscular relaxants. RESULTS:Fifty-one patients were implanted from March 2005 to March 2008 at 2 sites. Age at implantation ranged from 42 to 73 years and the percent predicted forced vital capacity (FVC) ranged from 20% to 87%. On preoperative blood gases, Pco(2) was as high as 60. Using this protocol, there were no failures to extubate or 30-day mortalities. The DPS system increases the respiratory system compliance by decreasing posterior lobe atelectasis and can stimulate respirations at the end of each case. CONCLUSIONS:Laparoscopic surgery with general anesthesia can be safely performed in patients with ALS undergoing DPS.
journal_name
Am J Surgjournal_title
American journal of surgeryauthors
Onders RP,Carlin AM,Elmo M,Sivashankaran S,Katirji B,Schilz Rdoi
10.1016/j.amjsurg.2008.11.008subject
Has Abstractpub_date
2009-03-01 00:00:00pages
386-90issue
3eissn
0002-9610issn
1879-1883pii
S0002-9610(08)00800-3journal_volume
197pub_type
杂志文章abstract：:In this 6-year study of 101 limbs requiring surgical intervention for upper-extremity vascular trauma, most patients were male, young, and injured by penetrating objects. Injured vessels included 13 axillary/subclavian, 23 brachial, 40 radial, and 25 ulnar arteries. Concomitant injuries included nerve injury in 50 cas...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/s0002-9610(05)80313-7
更新日期：1990-08-01 00:00:00
abstract：:During the last 100 years, since César Roux began utilizing his "Ansa-en-Y" procedure for gastric outlet obstruction, the procedure at first fell into disuse but was later adapted for other applications. This article discusses the background of the procedure and compares the original indications with the author's curr...
journal_title：American journal of surgery
pub_type： 传,历史文章,杂志文章
doi：10.1016/0002-9610(91)91142-6
更新日期：1991-02-01 00:00:00
abstract：BACKGROUND:Letters of recommendation (LoR) are considered one of the most important predictors of matching into a pediatric surgery fellowship. We determined if gendered differences exist in LoR written for resident candidates. METHODS:A retrospective review of blinded LoR to a fellowship program between 2015 and 2017...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/j.amjsurg.2019.08.005
更新日期：2020-06-01 00:00:00
abstract：:A new break-away needle for subclavian catheter insertion has been described. This needle functions exactly as the usual 14 gauge needle, but it can be completely removed from the catheter while leaving the integral Luer adaptor intact. ...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/0002-9610(84)90210-1
更新日期：1984-06-01 00:00:00
abstract：BACKGROUND:Administrative data can be used to identify cases of postoperative respiratory failure (PRF). We aimed to determine if recent changes to the Agency for Healthcare Research and Quality Patient Safety Indicator 11 (PSI 11) and adoption of clinical documentation improvement programs have improved the validity o...
journal_title：American journal of surgery
pub_type： 杂志文章,多中心研究
doi：10.1016/j.amjsurg.2019.11.019
更新日期：2020-07-01 00:00:00
abstract：:A biochemical analysis of mitochondrial metabolism was made on biopsy specimens of fifteen jaundiced patients. In all but three jaundiced patients the phosphorylative activity based on mitochondrial protein was within normal limits or higher. In nine jaundiced patients the concentrations of cytochrome a(+a3), as repre...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/0002-9610(77)90534-7
更新日期：1977-03-01 00:00:00
abstract：:A small bore feeding tube may be readily introduced into the stomach by splinting it internally, before insertion, with a flexible arteriographic guide wire, which is removed when the tube is in place. Gentle placement of the tube is recommended. ...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/0002-9610(80)90374-8
更新日期：1980-05-01 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：:Part II of this two-part article (See The American Journal of Surgery 1992; 164: 85-9) reviews the current definition of the role of immunosuppressive therapy in inflammatory bowel disease (IBD) and the use of antibiotics in IBD, as well as summarizes the uses of the new agents on the horizon for the treatment of IBD....
journal_title：American journal of surgery
pub_type： 杂志文章,评审
doi：10.1016/s0002-9610(05)80381-2
更新日期：1992-08-01 00:00:00
abstract：:We performed a large single-center prospective randomized controlled study to assess the role of peritoneal drainage in simple elective cholecystectomy. In 248 patients, drains were omitted; 122 patients had closed suction drains and 124 had Penrose drains. There were no deaths, and no patient required reoperation or ...
journal_title：American journal of surgery
pub_type： 临床试验,杂志文章,随机对照试验,评审
doi：10.1016/s0002-9610(05)80271-5
更新日期：1990-02-01 00:00:00
abstract：:One hundred thirty-six patients meeting our criteria for one or more of eight clinical conditions were prospectively observed for the development of the adult respiratory distress syndrome. A high risk population was identified, including those with sepsis syndrome (38 percent), documented aspiration of gastric conten...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/0002-9610(82)90612-2
更新日期：1982-07-01 00:00:00
abstract：BACKGROUND:We hypothesized that early use of external mechanical compression (EMC) reduces hemorrhage and mortality associated with pelvic fractures. METHODS:Patients with pelvic fractures and one of the following risk factors for hemorrhage were studied retrospectively: (1) unstable fracture pattern, or (2) any fract...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/j.amjsurg.2007.08.040
更新日期：2007-12-01 00:00:00
abstract：BACKGROUND:Medical student mistreatment remains a concern, particularly in the surgery clerkship. This is a single academic institution's report of medical student perceptions of a mistreatment program embedded in the surgery clerkship. METHODS:Students who completed the surgery clerkship and the mistreatment program ...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/j.amjsurg.2018.01.001
更新日期：2018-04-01 00:00:00
abstract：:The correlation between serum amylase and pancreatic amylase secretion was studied in two patients. Both patients underwent sphincterotomy, and the pancreatic duct was cannulated with a polyethylene tube. The tube was left in place for 15 to 21 days. The rate of amylase secretion over 7 days was studied in response to...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/0002-9610(82)90178-7
更新日期：1982-05-01 00:00:00
abstract：BACKGROUND:We sought to compare outcomes 6-12 months post-injury between patients discharged to an inpatient rehabilitation facility (IRF) and a skilled nursing facility (SNF). METHODS:Trauma patients admitted to 3 Level-I trauma centers were interviewed to evaluate the presence of daily pain requiring medication, fun...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/j.amjsurg.2020.05.019
更新日期：2021-01-01 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：:With the aid of ultrasonography, representative percutaneous biopsy specimens were obtained from 20 of 21 patients (95 percent) with liver metastases of carcinoids and endocrine pancreatic tumors. The specimens were examined with silver stains and immunocytochemically after the application of monoclonal serotonin anti...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/0002-9610(84)90470-7
更新日期：1984-09-01 00:00:00
abstract：:Despite undergoing a curative resection, many patients with colorectal cancer will develop and die of metastatic disease. It has been shown clinically and experimentally that surgery causes a transient period of immunosuppression, and it is postulated that this may encourage both the implantation of surgically dissemi...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/0002-9610(94)90070-1
更新日期：1994-01-01 00:00:00
abstract：BACKGROUND:The LigaSure system (Valleylab, Boulder, CO) seals vessels by reforming collagen and elastin in vessel walls. We studied the feasibility and effectiveness of LigaSure in dividing porcine small bowel. METHODS:Twelve porcine small bowel portions were randomized to division with either endoscopic linear staple...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/j.amjsurg.2005.05.045
更新日期：2006-06-01 00:00:00
abstract：:Much of the confusion surrounding the repair of asymptomatic abdominal aortic aneurysms related to inaccuracies in their measurement, both preoperatively and intraoperatively. Multiple measurements of aneurysms at operation have convinced us that the largest and least variable diameter is the anteroposterior diameter ...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/0002-9610(82)90539-6
更新日期：1982-12-01 00:00:00
abstract：BACKGROUND:Pancreatoduodenectomy is the only effective treatment for cancers of the periampullary region. Because surgeons usually grasp tumors during pancreatoduodenectomy, this procedure may increase the risk of squeezing and shedding the cancer cells into the portal vein, retroperitoneum, and/or peritoneal cavity. I...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/j.amjsurg.2008.06.035
更新日期：2010-05-01 00:00:00
abstract：BACKGROUND:The purpose of the current study was to evaluate whether a totally implanted valved subcutaneous port system would have fewer complications as compared to a standard nonvalved port. METHODS:Study subjects requiring port placement were randomized to receive a valved port (PASV; Boston Scientific, Natick, MA)...
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/j.amjsurg.2004.08.041
更新日期：2004-12-01 00:00:00
abstract：:A quantitative endotoxin assay was applied in this study of endotoxin transport from the infected abdomen. In rats with fecal peritonitis, extremely high concentrations were found in thoracic duct lymph (approximately 400 times higher than those found in arterial and portal vein plasma). Taking flow rates into account...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/0002-9610(86)90098-x
更新日期：1986-04-01 00:00:00
abstract：:To establish criteria for laparotomy, the records of 224 patients admitted with an acute pelvic fracture were reviewed. Forty-four patients underwent laparotomy; 2 had no intraabdominal injury. The mechanisms of injury was blunt trauma in 31 patients and gunshot wound in 13. All four patients who died had blunt trauma...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/0002-9610(80)90129-4
更新日期：1980-12-01 00:00:00
abstract：:The superiority of the minimally invasive approach to adrenal resections has been well documented for benign pathology. With technical advances and increased experience, surgeons have successfully performed laparoscopic adrenalectomies for metastatic and primary malignancies of the adrenal gland. The technique of lapa...
journal_title：American journal of surgery
pub_type： 杂志文章,评审
doi：10.1016/j.amjsurg.2005.01.021
更新日期：2005-04-01 00:00:00
abstract：:Tube pancreatostomy for complete external drainage of pancreatic juice following pancreatoduodenectomy and a subsequent second-stage pancreatojejunostomy were carried out in four high-risk patients without morbidity. This procedure avoids the fatal outcome associated with pancreatojejunal anastomotic leakage following...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/s0002-9610(05)80073-x
更新日期：1994-07-01 00:00:00
abstract：:Ten patients with a discharging perineal sinus that developed after proctectomy were treated with a new fibrin adhesive system in order to close the sinus. Four of the patients also had a fistula that extended from the sinus to the vagina. Treatment was unsuccessful in two patients: one had retained foreign bodies in ...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/0002-9610(83)90142-3
更新日期：1983-06-01 00:00:00
abstract：BACKGROUND:Etiologies contributing to failure to wean from mechanical ventilation (MV) are multiple, resulting in morbid and costly outcomes. Diaphragm pacing (DP) is used in spinal cord injury to replace MV. Temporary DP could be utilized in acute respiratory failure to reduce MV. METHODS:A prospective FDA feasibilit...
journal_title：American journal of surgery
pub_type： 临床试验,杂志文章
doi：10.1016/j.amjsurg.2017.10.054
更新日期：2018-03-01 00:00:00
abstract：BACKGROUND:Medical malpractice is a source of stress and cost to physicians. Little is known about how it impacts resident physicians. METHODS:We analyzed data from the Comparative Benchmarking System between 2007 and 2016. We also surveyed surgery residents at our institution regarding malpractice in training. RESUL...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/j.amjsurg.2018.08.006
更新日期：2019-02-01 00:00:00
abstract：BACKGROUND:Outpatient surgery is cost effective and convenient. The aim of this study was to determine the safety and feasibility of outpatient thyroidectomy. METHODS:Retrospective review was performed of all thyroidectomy patients from a tertiary care center between January 2004 and March 2010. RESULTS:One hundred f...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/j.amjsurg.2011.01.023
更新日期：2011-05-01 00:00:00
