Abstract:
BACKGROUND:Despite significant advantages to patients, less than 5% of all colorectal surgeries for cancer are performed laparoscopically. A minimally invasive colorectal cancer program was created in our Veterans' Affairs hospital with the intent of increasing access and improving quality of patient care while maintaining patient safety and oncologic standards. METHODS:Sixty consecutive laparoscopic colorectal cancer resections and 60 age-matched open resections were identified. Our prospective database was queried for demographic, clinical outcomes, and oncologic data. RESULTS:Patients undergoing laparoscopic resections experienced a shorter hospital stay and a quicker return of bowel function. Both groups had similar intraoperative blood loss and surgical times. Laparoscopic resections achieved equivalent lymph node retrieval and resection completeness compared with open resections. Laparoscopic resections resulted in fewer wounds and fewer complications requiring reoperation. CONCLUSIONS:Establishment of a minimally invasive colorectal cancer program in a Veterans Affairs Medical Center leads to increased access to laparoscopic colorectal resections and improved patient care while maintaining patient safety.
journal_name
Am J Surgjournal_title
American journal of surgeryauthors
Wilks JA,Balentine CJ,Berger DH,Anaya D,Awad S,Lee L,Haderxhanaj K,Albo Ddoi
10.1016/j.amjsurg.2009.07.016subject
Has Abstractpub_date
2009-11-01 00:00:00pages
685-92issue
5eissn
0002-9610issn
1879-1883pii
S0002-9610(09)00443-7journal_volume
198pub_type
杂志文章abstract:BACKGROUND:The laparoscopic approach to surgical diseases of the foregut is rapidly gaining acceptance. These new approaches, however, pit the unwary surgeon against potentially devastating complications. PATIENTS AND METHODS:Based on a retrospective review of 153 consecutive laparoscopic foregut surgeries performed a...
journal_title:American journal of surgery
pub_type: 临床试验,杂志文章
doi:10.1016/S0002-9610(99)80206-2
更新日期:1995-05-01 00:00:00
abstract:PURPOSE:Transanal endoscopic microsurgery (TEM) is a minimally invasive technique for full-thickness excision of benign and malignant rectal neoplasms located 4 to 24 cm above the anal verge. Entrance into the peritoneal cavity during TEM has been regarded as a complication that mandates conversion to open laparotomy f...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/j.amjsurg.2004.01.004
更新日期:2004-05-01 00:00:00
abstract:BACKGROUND:Lymphoepithelial cyst of the pancreas is a rare but distinctive cystic lesion lined by a mature, keratinizing squamous epithelium and surrounded by lymphoid tissue. METHODS:To gain more insights into this entity, we describe 5 examples of lymphoepithelial cyst of the pancreas (2 of which were briefly descri...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/s0002-9610(99)80247-5
更新日期:1995-07-01 00:00:00
abstract:BACKGROUND:Luminal pressure may injure the gut mucosa in obstruction, ileus, or inflammatory bowel disease. METHODS:We formed Roux-en-Y anastomoses in 19 mice, creating proximal and defunctionalized partially obstructed limbs and a distal limb to vary luminal pressure and flow. We induced mucosal ulcers by serosal ace...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/j.amjsurg.2008.07.016
更新日期:2008-11-01 00:00:00
abstract:BACKGROUND:The Estimation of Physiologic Ability and Surgical Stress (E-PASS) score was designed on the premise that the balance between the patient's physiologic reserve capacity and the surgical stress inflicted at operation was important in the occurrence of postoperative complications. The aim of this study was to ...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/j.amjsurg.2006.10.032
更新日期:2007-08-01 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::Although few trauma patients sustain fatal pulmonary embolism, a large population is at risk from nonfatal embolism due to unrecognized deep vein thrombosis (DVT). Thirty-eight of 39 immobilized trauma patients at bed rest for 10 days or longer had venographic study of their lower extremities to evaluate for the prese...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/0002-9610(89)90182-7
更新日期:1989-12-01 00:00:00
abstract:BACKGROUND:Accurate intraoperative diagnosis of axillary malignancy facilitates completion axillary lymph node dissection (ALND) at the time of initial surgery. The capability to address both the primary tumor and axillary disease in a single procedure offers several advantages. This study was designed to define the pr...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/s0002-9610(03)00041-2
更新日期:2003-05-01 00:00:00
abstract:BACKGROUND:Since the introduction of the laparoscopic live donor nephrectomy in 1995, attempts have been made to depart from the total laparoscopic approach to the hand-assisted approach to decrease surgical time and complications. We present our 6-year experience with the total laparoscopic approach. METHODS:Between ...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/j.amjsurg.2005.10.030
更新日期:2006-03-01 00:00:00
abstract:INTRODUCTION:Damage control laparotomy with vacuum assisted closure (VAC) is used for selective cases in trauma. In liver transplantation, VAC has also been applied for management of intra-operative hemorrhage. The primary objective was to evaluate peri-operative blood loss and blood product utilization in VAC compared...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/j.amjsurg.2017.12.012
更新日期:2018-05-01 00:00:00
abstract::The ability of the liver to control blood glucose levels was studied in relation to the blood ketone body ratio, which reflects the hepatic mitochondrial redox state. In partially hepatectomized rabbits, postoperative continuous administration of a hyperosmolar glucose solution revealed the following findings: (1) The...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/s0002-9610(88)80410-0
更新日期:1988-04-01 00:00:00
abstract:BACKGROUND:Appropriate therapy for women over 70 years of age with breast cancer is currently a highly debated topic. The aim of this study was to determine whether a subset of patients could be identified in which lumpectomy alone, followed by tamoxifen, would offer adequate local, regional, and long-term control of d...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/s0002-9610(00)00474-8
更新日期:2000-09-01 00:00:00
abstract::The human papillomavirus (HPV) has been shown to be associated with neoplasms of the human colon using immunohistochemistry and in situ hybridization. We now report our use of the polymerase chain reaction and Southern blotting to investigate that same association. We selected 38 carcinomas, 21 adenomas, and 24 normal...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/s0002-9610(05)80690-7
更新日期:1993-12-01 00:00:00
abstract::Postoperative gastric retention may be minimized by avoiding the use of the Billroth I reconstruction when a large duodenal ulcer must be retained. Postoperative gastric retention is more likely to remit with conservative therapy if the procedure was a Billroth I reconstruction with a vagotomy. In other instances wher...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/0002-9610(86)90262-x
更新日期:1986-09-01 00:00:00
abstract:BACKGROUND:Multimodality monitoring and goal-directed therapy may not prevent blood flow and brain oxygen (Flow/BrOx) crisis. We sought to determine the impact of these events on outcome in patients with severe traumatic brain injury (sTBI). METHODS:Twenty-four patients with sTBI were treated to maintain intracranial ...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/j.amjsurg.2014.08.003
更新日期:2014-12-01 00:00:00
abstract:BACKGROUND:Penetrating injuries of the subclavian artery occurs infrequently but represent a surgical challenge. We reviewed our experience with penetrating injury of the subclavian artery and identify factors that influenced morbidity and mortality. METHODS:A retrospective review was performed on 54 consecutive patie...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/s0002-9610(03)00070-9
更新日期:2003-06-01 00:00:00
abstract:BACKGROUND:This study was designed to evaluate the impact of changes made to our morbidity and mortality (M&M) conference. METHODS:A 23-item survey using corresponding Likert-type scales was created. Faculty and residents were asked to anonymously complete the surveys in June 1999. Based on this information, specific ...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/s0002-9610(02)00791-2
更新日期:2002-03-01 00:00:00
abstract:BACKGROUND:Medical schools are undergoing major curricular reform, partly in attempts to increase the number of graduates pursuing careers in the generalist disciplines. These reforms have often resulted in a shortening of the surgery clerkship, decreasing students' experiences in several domains important to the gener...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/s0002-9610(97)89595-5
更新日期:1997-03-01 00:00:00
abstract::The transition from surgical training to surgical practice is a critical juncture in the career progression of surgeons. This period is associated with myriad challenges that need to be addressed through specific educational interventions to ensure delivery of safe care to patients and to support the career aspiration...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/j.amjsurg.2018.09.012
更新日期:2019-03-01 00:00:00
abstract::Only 3 per cent of all melanomas arise in the mucosa of the head and neck region. Melanomas of mucosal origin in this series differed from their cutaneous counterpart in that size of the primary lesion did not influence prognosis. Regional lymph node metastases were infrequent and did not seem to influence prognosis. ...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/0002-9610(77)90393-2
更新日期:1977-10-01 00:00:00
abstract:BACKGROUND:Current standard of care dictates that central venous catheter (CVC) insertion should be followed by an immediate chest radiograph to confirm appropriate position and rule out complications. We hypothesized that a subset of monitored intensive care unit patients exists that is at low risk for complications a...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/s0002-9610(00)00498-0
更新日期:2000-12-01 00:00:00
abstract:BACKGROUND:Prior studies have demonstrated that African-American (AA) donor kidneys are independently associated with an increased risk for graft loss. METHODS:We examined outcomes in comparable groups of AA deceased-donor (DD) kidney transplant patients receiving an AA donor (n=35) versus a Caucasian donor (C group; ...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/j.amjsurg.2009.08.025
更新日期:2010-03-01 00:00:00
abstract:BACKGROUND:Surgical length of stay (LOS) has been correlated with quality of care, with shorter stays implying better care. The relationship between LOS and postdischarge complications (PDCs) has not been evaluated effectively. METHODS:The 2005 to 2007 National Surgical Quality Improvement Program data were queried fo...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/j.amjsurg.2012.04.006
更新日期:2013-01-01 00:00:00
abstract:BACKGROUND:In women undergoing breast conserving surgery (BCS), up to 60% can require re-excision. Our objective is to develop an optically based technology which can differentiate benign from malignant breast tissues intraoperatively through differences in tissue composition factors. METHODS:A prospective study of op...
journal_title:American journal of surgery
pub_type: 临床试验,杂志文章
doi:10.1016/j.amjsurg.2009.06.018
更新日期:2009-10-01 00:00:00
abstract::A simplified technique for insertion of a peritoneovenous shunt is described. By using a "peel-away" sheath at both ends of the shunt, the insertion is much quicker and less traumatic to the patient. ...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/s0002-9610(06)80078-4
更新日期:1990-06-01 00:00:00
abstract:BACKGROUND:Few data exist regarding melanoma metastasis to the adrenal gland. We reviewed our experience to determine the natural history of this condition and the appropriate role for surgical intervention. METHODS:A retrospective review of melanoma patients with adrenal metastasis was performed. Clinical presentatio...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/j.amjsurg.2007.12.018
更新日期:2008-03-01 00:00:00
abstract:BACKGROUND:The aim of this study was to identify patient-related and/or disease-related factors that influence outcomes in patients with vascular prosthetic graft infections. METHODS:Through the hospital patient administration system, between January 1997 and December 2007, a total of 44 patients were diagnosed with c...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/j.amjsurg.2009.05.018
更新日期:2010-07-01 00:00:00
abstract::During a fourteen year period, diagnostic peritoneal lavage was 98.5 per cent accurate in determining the presence or absence of blunt intraabdominal injuries among 2,586 patients. Of these, 69.4 per cent had a negative lavage and 29.2 per cent a positive lavage. Six patients (0.2 per cent) had a false-positive lavage...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/0002-9610(78)90339-2
更新日期:1978-12-01 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:OBJECTIVE:Surgeons' vigilance regarding patient condition was assessed using eye-tracking techniques during a simulated laparoscopic procedure. METHODS:Surgeons were required to perform a partial cholecystectomy in a virtual reality trainer (SurgicalSim; METI Inc, Sarasota, FL) while wearing a lightweight head-mounted...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/j.amjsurg.2011.01.016
更新日期:2011-05-01 00:00:00