Abstract:
BACKGROUND:blood loss during liver resection and the need for perioperative blood transfusions have negative impact on perioperative morbidity, mortality, and long-term outcomes. METHODS:a randomized controlled trial was performed on patients undergoing liver resection comparing hemihepatic vascular inflow occlusion, main portal vein inflow occlusion, and Pringle maneuver. The primary endpoints were intraoperative blood loss and postoperative liver injury. The secondary outcomes were operating time, morbidity, and mortality. RESULTS:a total of 180 patients were randomized into 3 groups according to the technique used for inflow occlusion during hepatectomy: the hemihepatic vascular inflow occlusion group (n = 60), the main portal vein inflow occlusion group (n = 60), and the Pringle maneuver group (n = 60). Only 1 patient in the hemihepatic vascular occlusion group required conversion to the Pringle maneuver because of technical difficulty. The Pringle maneuver group showed a significantly shorter operating time. There were no significant differences between the 3 groups in intraoperative blood loss and perioperative mortality. The degree of postoperative liver injury and complication rates were significantly higher in the Pringle maneuver group, resulting in a significantly longer hospital stay. CONCLUSIONS:all 3 vascular inflow occlusion techniques were safe and efficacious in reducing blood loss. Patients subjected to hemihepatic vascular inflow occlusion, or main portal vein inflow occlusion responded better than those with Pringle maneuver in terms of earlier recovery of postoperative liver function. As hemihepatic vascular inflow occlusion was technically easier than main portal vein inflow occlusion, it is recommended.
journal_name
Am J Surgjournal_title
American journal of surgeryauthors
Fu SY,Lau WY,Li GG,Tang QH,Li AJ,Pan ZY,Huang G,Yin L,Wu MC,Lai EC,Zhou WPdoi
10.1016/j.amjsurg.2009.09.029subject
Has Abstractpub_date
2011-01-01 00:00:00pages
62-9issue
1eissn
0002-9610issn
1879-1883pii
S0002-9610(10)00066-8journal_volume
201pub_type
杂志文章,随机对照试验abstract:BACKGROUND:Despite the development of several prediction rules to guide head CT imaging, determining whom to screen for head trauma in the geriatric population after a ground level fall remains controversial. The purpose of this study was to assess the impact of head CT on the management of older adult patients who pre...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/j.amjsurg.2017.07.038
更新日期:2017-12-01 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:The role of frozen section (FS) in thyroid disease is controversial. The goal of this study was to identify a cohort of patients who may or may not benefit from FS. METHODS:Two hundred thirty-one patients who underwent thyroidectomy were evaluated in regard to fine-needle aspiration (FNA), FS, and the exten...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/s0002-9610(02)01074-7
更新日期:2002-12-01 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:BACKGROUND:Surgeons who have demonstrated excellence through extensive publication in the medical education literature can provide valuable guidance for new surgeons interested in educational research. METHODS:National databases identified members of the Association for Surgical Education (ASE) who have accumulated th...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/s0002-9610(00)00301-9
更新日期:2000-03-01 00:00:00
abstract:BACKGROUND:Antiphospholipid (APL) antibodies are a heterogenous group of antibodies that have been associated with an increase in bleeding complications and a marked increase in thrombotic events, both of which result in significant patient morbidity and mortality. PATIENTS AND METHODS:A retrospective analysis of pati...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/s0002-9610(99)80285-2
更新日期:1995-08-01 00:00:00
abstract::Sixty-seven cases of neck exploration for suspected hyperparathyroidism were reviewed. Thirty-nine patients underwent removal of an adenoma with biopsy of one or more other parathyroid glands. In another group, nine patients underwent removal of the adenoma only. Both groups have had no recurrences of hyperparathyroid...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/0002-9610(76)90389-5
更新日期:1976-09-01 00:00:00
abstract:BACKGROUND:Vacuum Assisted Closure (VAC; Kinetic Concepts, Inc., San Antonio, TX) has been used to successfully treat a variety of complex wounds. This technique was investigated for use in managing Fournier's gangrene following initial debridement. METHODS:Ten patients with Fournier's gangrene were treated in this st...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/j.amjsurg.2008.04.018
更新日期:2009-05-01 00:00:00
abstract:BACKGROUND:Laparoscopic transabdominal preperitoneal (TAPP) herniorrhaphy provides an opportunity to definitively evaluate both inguinal areas without the need for additional dissection. We aimed to establish the rates and contributing patient factors to errors in the preoperative assessment. METHODS:A retrospective r...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/j.amjsurg.2006.10.015
更新日期:2007-04-01 00:00:00
abstract:BACKGROUND:A history of therapeutic irradiation to the neck complicates the management of carotid artery occlusive disease. Serious surgical concerns are raised regarding alternative incisions, difficult dissections, and adequate wound closure. Pathology may be typical atherosclerotic occlusive disease or radiation-ind...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/S0002-9610(96)00150-X
更新日期:1996-08-01 00:00:00
abstract::The restitution of blood volume and plasma protein after 10 per cent hemorrhage was studied in intact dogs and in dogs subjected to adrenalectomy and infused with cortisol at basal or physiologically increased rates. The results suggest that increased extracellular osmolality, mediated by an increased secretion of cor...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/0002-9610(75)90513-9
更新日期:1975-11-01 00:00:00
abstract::Twenty-five patients were identified with non-pituitary, nonadrenal ACTH-secreting tumors (bronchial carcinoid, bronchial small cell carcinoma, pancreatic islet cell carcinoma, medullary thyroid carcinoma, thymic carcinoids, metastatic adenocarcinoma, and pancreatic cystadenoma). Clinical features were weakness, hyper...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/s0002-9610(85)80085-4
更新日期:1985-02-01 00:00:00
abstract:BACKGROUND:Extended release LCP-tacrolimus (LCPT) allows once-daily dosing in transplant recipients. The improved bioavailability may be beneficial for simultaneous pancreas-kidney recipients (SPK). METHODS:This is a study of 39 SPK recipients on standard immediate-release tacrolimus (IR-TAC, n = 21) or LCPT (n = 18)....
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/j.amjsurg.2020.02.027
更新日期:2020-04-01 00:00:00
abstract::The charts of 81 patients who underwent skull base surgery between 1982 and 1993 were reviewed retrospectively. Data relative to demographic aspects, clinical stage, previous treatment, surgical approach, type of reconstruction, histology, extent of disease, complications, and follow-up were analyzed. The craniofacial...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/s0002-9610(05)80106-0
更新日期:1994-11-01 00:00:00
abstract::Twenty-five patients were treated for retained, recurrent, or primary common duct stones by permanent drainage of the biliary tract with external choledochoduodenostomy. Twenty-one patients had common duct stones which became evident two to fifty years after the initial biliary tract procedure and which may represent ...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/0002-9610(79)90136-3
更新日期:1979-02-01 00:00:00
abstract::Surgeons need to be aware of the various options available to remove enlarged gallbladders or gallstones lost during laparoscopic cholecystectomy. Every attempt should be made to recover stones that have escaped from a ruptured gallbladder during laparoscopic cholecystectomy, short of converting to laparotomy. Initial...
journal_title:American journal of surgery
pub_type: 杂志文章,评审
doi:10.1016/s0002-9610(05)80949-3
更新日期:1993-04-01 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 discussion of congenital arteriovenous malformation of the head and neck based on five patients followed from three to twenty years is presented. Definition of the lesion and its progression as followed by angiography is described. The poor response to surgery is ascribed to the ischemic nature of the area of involv...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/0002-9610(78)90255-6
更新日期:1978-10-01 00:00:00
abstract::In the period from 1976 through 1986, 62 procedures were performed. Of these, 42 were posterior flap hemipelvectomies, 5 anterior flap hemipelvectomies, and 15 internal hemipelvectomies. The median duration of these procedures was 6.5 hours, and the median blood loss was 2,541 ml. Postoperatively, there were no wound ...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/0002-9610(89)90273-0
更新日期:1989-11-01 00:00:00
abstract:INTRODUCTION:Surgical educators' professional behavior constitutes a hidden curriculum and impacts trainee's professional identity formation. This study explores the nuances of professional behaviors as observed in varying surgical settings. METHODS:411 Transcripts originated from essays written by MS3 students during...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/j.amjsurg.2020.09.003
更新日期:2020-09-08 00:00:00
abstract::One hundred eleven patients who had undergone surgery for benign anorectal disease under spinal anesthesia were studied retrospectively to determine the incidence of postoperative urinary retention requiring catheterization and to assess possible influences on that incidence. The age group and sex of the patients did ...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/s0002-9610(05)81274-7
更新日期:1990-04-01 00:00:00
abstract::AbdCT for the evaluation of AAP in the ED in the US may be excessive and is potentially (although rarely) misleading and harmful. A selective policy of 'AbdUS first' combined with an observation unit and/or surgeon evaluation prior to AbdCT is preferred to a 'routine AbdCT' policy. Repeated AbdCTs for abdominal pain a...
journal_title:American journal of surgery
pub_type: 杂志文章,评审
doi:10.1016/j.amjsurg.2019.02.003
更新日期:2019-05-01 00:00:00
abstract:BACKGROUND:Laparoscopic Roux-en-Y gastric bypass (LRYGB) produces durable and clinically significant weight loss. We aim to characterize the trajectory of weight loss, and demonstrate the predictive ability of three-month performance on final weight loss. METHODS:Retrospective analysis of 1097 consecutive LRYGB patien...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/j.amjsurg.2017.10.024
更新日期:2018-07-01 00:00:00
abstract:BACKGROUND:Our institution utilizes an esophagectomy pathway to guide postoperative management. Our aim was to identify risk factors associated with missing pathway goals. METHODS:Retrospective review of esophagectomies from 2010 to 2015. Multivariate logistic regression models identified risk factors for missing post...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/j.amjsurg.2018.01.036
更新日期:2018-05-01 00:00:00
abstract::Seventeen cases of carcinoma of the stomach occurring late after previous gastric operation are presented. In all instances, patients had undergone gastroenterostomy, with or without gastric resection. Most patients had undergone the initial operation for peptic ulcer disease an average of 18 years before presenting w...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/0002-9610(81)90145-8
更新日期:1981-04-01 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:BACKGROUND:We evaluated coronary angiography use among patients with coronary stents suffering postoperative myocardial infarction (MI) and the association with mortality. METHODS:Patients with prior coronary stenting who underwent inpatient noncardiac surgery in Veterans Affairs hospitals between 2000 and 2012 and ex...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/j.amjsurg.2016.07.023
更新日期:2016-11-01 00:00:00
abstract::A prospective randomized clinical trial was performed in order to evaluate the results of three surgical techniques for the treatment of gastric outlet obstruction secondary to duodenal ulcer. Ninety patients with clinical and laboratory evidence of gastric retention were enrolled. After laparotomy, patients underwent...
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)80580-x
更新日期:1993-07-01 00:00:00
abstract:BACKGROUND:Pain is the most common symptom associated with hernias. The aim was to assess the frequency of pain and its effects on physical activity and quality of life in patients with inguinal and ventral hernias. METHODS:All patients undergoing elective inguinal or ventral hernia repair over a 16-month period were ...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/j.amjsurg.2014.02.011
更新日期:2014-09-01 00:00:00
abstract:BACKGROUND:Sentinel lymph node biopsy (SLNB) for the evaluation of women with invasive breast cancer is rapidly gaining acceptance. The purpose of this study was to assess how surgeons in the Department of Defense (DOD) are incorporating SLNB into practice. METHODS:Surgeons at all DOD hospitals were telephonically sur...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/s0002-9610(02)00920-0
更新日期:2002-08-01 00:00:00