Abstract：
:Gaucher's disease is an inherited metabolic disorder caused by the defective activity of acid beta-glucosidase and the resultant accumulation of glucosyl ceramide-laden macrophages in the liver, bone, and spleen. Splenectomy is the preferred treatment for patients with Gaucher's disease who develop massive splenomegaly with accompanying hypersplenism and/or mechanical pressure symptoms. The charts of 48 patients with Gaucher's disease undergoing splenectomy at our institution between January 1963 and December 1989 were analyzed to determine the short- and long-term results of this procedure. Thirty-five (73%) patients had total splenectomy, whereas 13 (27%) patients had partial splenectomy. There was one postoperative death (after total splenectomy), and 13 patients (27%) had postoperative complications. Eleven patients (23%) presented with accelerated bone disease after total splenectomy (mean follow-up: 96 months). No patients having partial splenectomy (mean follow-up: 25 months) developed progressive bone disease. Eight patients have died since surgery. All four deaths due to malignant disease occurred in patients after total splenectomy. The results of this largest-ever reported series of splenectomy for Gaucher's disease confirm that while either total or partial splenectomy can be performed with minimal morbidity and mortality, total splenectomy is accompanied by more aggressive bone disease and a predisposition to malignancy. Prospective, randomized trials are needed to substantiate whether partial splenectomy is indeed the treatment of choice for splenomegaly associated with Gaucher's disease.
journal_name
Am J Surgjournal_title
American journal of surgeryauthors
Fleshner PR,Aufses AH Jr,Grabowski GA,Elias Rdoi
10.1016/0002-9610(91)90363-isubject
Has Abstractpub_date
1991-01-01 00:00:00pages
69-75issue
1eissn
0002-9610issn
1879-1883pii
0002-9610(91)90363-Ijournal_volume
161pub_type
杂志文章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：:Millions of people continue to smoke. Recent studies confirm the pioneering epidemiologic data that indicated that, despite the well-established effects on the lung, most of the hundreds of thousands of premature deaths annually result from extrapulmonary toxicity, particularly accelerated cardiac and vascular disease...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/0002-9610(84)90421-5
更新日期：1984-12-01 00:00:00
abstract：:Transplantation of adult kidneys into very small children is not performed in most centers because of concerns regarding the technical difficulty of the procedure. Advantages of the procedure include the possibility of living related donor transplantation and the increased availability of adult donor kidneys as compar...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/0002-9610(83)90071-5
更新日期：1983-02-01 00:00:00
abstract：BACKGROUND:Acute traumatic rupture of the descending thoracic aorta is usually considered a surgical emergency; a conventional surgical approach carries high morbidity and mortality rates in the perioperative period. Endovascular surgery has recently been considered as providing a new therapeutic strategy for these pat...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/j.amjsurg.2006.01.048
更新日期：2006-09-01 00:00:00
abstract：:Desmoid tumors of the head and neck are uncommon and associated with a posttreatment recurrence rate as high as 70 percent. This study was undertaken to determine cure rates achievable by surgery and radiotherapy and the factors influencing failure. A chart review of all patients at our institution with desmoid tumors...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/s0002-9610(88)80305-2
更新日期：1988-10-01 00:00:00
abstract：:Lower esophageal sphincter (LES) effects produced by the mammalian tachykinins were evaluated in anesthetized dogs. The distribution and content of substance P (SP) and neurokinin A (NKA) in the region of the canine gastroesophageal junction was also studied. SP and NKA stimulated a linear dose-dependent contraction o...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/0002-9610(91)90379-r
更新日期：1991-01-01 00:00:00
abstract：BACKGROUND:The efficacy of carotid endarterectomy (CEA) in octogenarians is controversial. Recent reports have examined this question in the general population, but little data exist on veterans. With the emergence of carotid artery stenting, we need to evaluate the role of CEA in treating elderly veterans with carotid...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/j.amjsurg.2005.07.022
更新日期：2005-11-01 00:00:00
abstract：:Sebaceous cell carcinoma of the parotid gland is a rare lesion. A review of the English literature reveals nine previously reported cases. Two cases are presented in which the tumor was originally diagnosed as mucoepidermoid carcinoma. Aggressive treatment of the recurrence, which was subsequently recognized as sebace...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/0002-9610(75)90494-8
更新日期：1975-10-01 00:00:00
abstract：:A total of ninety three patients with biliary tract disease were studied to determine the concentration of the pancreatic enzymes, amylase and lipase, in bile obtained from the gallbladder and/or common bile duct. Of seventy gallbladder bile samples, amylase levels were higher than actual or predicted serum levels in ...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/0002-9610(79)90055-2
更新日期：1979-03-01 00:00:00
abstract：:Thirty extrathoracic operations in twenty-six patients with occlusive disease involving the primary branches of the aortic arch were reviewed. Spanning a fourteen year experience, these operations included carotid-subclavian artery bypass, retrograde common carotid artery thrombectomy, carotid-carotid artery bypass, a...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/0002-9610(76)90056-8
更新日期：1976-08-01 00:00:00
abstract：BACKGROUND:Several anecdotal papers suggest that laparoscopic cholecystectomy can be done safely in pregnant patients, but few patients are reported and other patients such as those who underwent laparoscopic appendectomy are often included. A larger series would help clarify the situation. METHODS:The Connecticut Lap...
journal_title：American journal of surgery
pub_type： 临床试验,杂志文章,多中心研究
doi：10.1016/s0002-9610(99)00007-0
更新日期：1999-03-01 00:00:00
abstract：:Surgical extirpation of the primary tumor has traditionally been utilized as initial treatment for sarcomas in children. The present report, however, demonstrates that sarcomas are optimally treated by means of a coordianted multidisciplinary approach. The latter offers the potential for achieving improved survival an...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/0002-9610(77)90123-4
更新日期：1977-04-01 00:00:00
abstract：BACKGROUND:Mesenteric vein thrombosis (MVT) is an uncommon type of intestinal ischemia associated with significant mortality and morbidity because of its delay in diagnosis. METHODS:A retrospective analysis of 9 patients treated surgically for MVT during 1982 to 1997 was performed. RESULTS:Nine patients underwent sur...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/s0002-9610(00)00532-8
更新日期：2001-01-01 00:00:00
abstract：INTRODUCTION:While women represent approximately half of all medical students, only 38% of general surgery residents are women. The objective of this study is to explore how access to mentors and organizational support affects career choices. METHODS:In June of 2016, a survey was sent to medical students at a single i...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/j.amjsurg.2017.07.005
更新日期：2017-10-01 00:00:00
abstract：:Mesenteric vascular disease continues to be associated with an extremely high mortality. It is not necessarily a disease of old age: 20 of the 75 patients in our series were less than 60 years of age. In retrospect, earlier diagnosis and a more aggressive approach could have improved the survival rate of 17.3 percent....
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/0002-9610(80)90251-2
更新日期：1980-02-01 00:00:00
abstract：:Splenectomy was performed in 20 patients with refractory cytopenias associated with systemic lupus erythematosus. An immediate and sustained increase in platelet count (greater than 150,000 cells/mm3) was achieved in 12 of 18 patients whose principal indication for operation was thrombocytopenia. Of seven patients wit...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/s0002-9610(88)80097-7
更新日期：1988-03-01 00:00:00
abstract：BACKGROUND:Hawaii has the highest incidence of hepatocellular cancer (HCC) in the United States and the largest proportion of Asians and Pacific Islanders. HCC studies generally combine these groups into 1 ethnicity, and we sought to examine differences between Asian and Pacific Islander subpopulations. METHODS:Demogr...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/j.amjsurg.2011.06.055
更新日期：2012-06-01 00:00:00
abstract：:Recently, carotid plaque factors, specifically intraplaque hemorrhage, have been studied with respect to the production of cerebrovascular symptoms. Ninety-five carotid endarterectomies were performed and the plaques that were removed were examined for intraplaque hemorrhage. Patients were separated into three groups:...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/0002-9610(84)90450-1
更新日期：1984-12-01 00:00:00
abstract：:We found clinical phlebitis in 57 of 88 patients with peripheral hyperalimentation (65%). To determine if this was a problem common to all intravenous fluid therapy at our hospital, we performed a point-prevalence study. The prevalence of phlebitis in nonhyperalimentation intravenous patients was 18% (84 of 456 patien...
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(05)80266-1
更新日期：1990-02-01 00:00:00
abstract：:This investigation was designed to study the effects of home health care (HHC) on patients who have been hospitalized with peripheral vascular disease. For a patient to have HHC, the patient had to have a defined wound, educational needs, or both. Sixty patients, 30 with HHC and 30 without, were contacted approximatel...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/s0002-9610(05)80302-2
更新日期：1990-08-01 00:00:00
abstract：INTRODUCTION:Medical students applying for general surgery residencies often require a letter of recommendation (LOR) from the Surgical Chair. However, LORs may reveal gender and ethnic bias. This study examines the presence of implicit bias in general surgery resident selection by evaluating chair LORs. METHODS:A ret...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/j.amjsurg.2020.08.010
更新日期：2020-08-15 00:00:00
abstract：:Over 10 years, 8 infants required surgery for central diaphragmatic herniation. Contrast peritoneography and technetium-99m-sulfur colloid radionuclide scanning were the most definitive diagnostic aids. Associated anomalies included variations of the pentalogy of Cantrell. A midline gastroduodenal loop was found in tw...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/0002-9610(84)90009-6
更新日期：1984-04-01 00:00:00
abstract：BACKGROUND:Diabetes mellitus (DM) is associated with adverse events or complications in various gastrointestinal diseases. In this study, we examined whether diabetic patients had higher risk for the development of complicated acute appendicitis than nondiabetic patients. The relevant risk factors also were determined....
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/j.amjsurg.2007.05.042
更新日期：2008-07-01 00:00:00
abstract：BACKGROUND:Most studies of trauma deaths include non-preventable deaths, potentially limiting successful intervention efforts. In this study we aimed to compare the potentially preventable trauma deaths between 2 time periods at our institution. METHODS:Trauma patients who died in our hospital in 2005-2006 or 2012-201...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/j.amjsurg.2018.12.022
更新日期：2019-09-01 00:00:00
abstract：BACKGROUND:Laparoscopic cholecystectomy is increasingly being employed as the initial surgical approach in patients with acute cholecystitis. Gangrenous cholecystitis will be unexpectedly encountered in a proportion of these patients. The applicability of laparoscopic techniques and its outcome in this group of patient...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/s0002-9610(00)00525-0
更新日期：2001-01-01 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:The availability and utility of public statements and policies on gender equity from professional surgical societies has not been studied. METHODS:Professional surgical society websites were searched for publicly available statements and policies related to gender equity. These were compiled and assessed fo...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/j.amjsurg.2020.06.041
更新日期：2020-11-01 00:00:00
abstract：:Several recent reviews have suggested that aggressive surgical intervention can reduce morbidity and mortality associated with intra-abdominal crises in AIDS patients. We reviewed our experience with 57 AIDS patients with 63 emergent laparotomies performed at 4 hospitals affiliated with the University of California in...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/s0002-9610(05)80194-1
更新日期：1994-09-01 00:00:00
abstract：:In a prospective randomized clinical trial, whole gut lavage was evaluated against conventional mechanical cleansing for colonic operations. The lavage took less time to perform, was better tolerated by patients, and resulted in more satisfactory preparation as judged by frequency of collapsed intestines. There was no...
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(79)90014-x
更新日期：1979-01-01 00:00:00
abstract：BACKGROUND:Patients with diverticulitis have a 20% risk of requiring urgent/emergent treatment. Since morbidity and mortality rates differ between elective and urgent/emergent care, understanding associated disparities is critical. We compared factors associated with treatment setting for diverticulitis and evaluated d...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/j.amjsurg.2019.09.005
更新日期：2020-06-01 00:00:00
