Abstract:
BACKGROUND:Postoperative pain management with a continuous preperitoneal infusion (CPI) for locoregional anesthesia has been shown to have improved postoperative outcomes. This is the first direct comparison of CPI versus epidural infusion (EPI), both in conjunction with systemic analgesia. METHODS:A retrospective review was performed of midline laparotomy cases, comparing the use of CPI with systemic patient-controlled analgesia to EPI with systemic patient-controlled analgesia for postoperative outcomes. RESULTS:A total of 240 cases from 2007 to 2009 were reviewed. There were 41.3% using CPI and 58.7% with EPI. There were no differences with respect to age, body mass index, or American Society of Anesthesiologists score between CPI and EPI cases. In a multivariate model, total hospital stay was 2 days shorter for the CPI group (P < .001), and the total admission cost was less for CPI (by $6,164; P < .001). CONCLUSIONS:The use of CPI results in decreased length of hospital stay, decreased number of days with a Foley catheter, and lower hospital costs, compared with EPI use. These findings show that the routine use of CPI for pain management after laparotomy is a safe alternative to EPI.
journal_name
Am J Surgjournal_title
American journal of surgeryauthors
Gross ME,Nelson ET,Mone MC,Hansen HJ,Sklow B,Glasgow RE,Scaife CLdoi
10.1016/j.amjsurg.2011.05.016subject
Has Abstractpub_date
2011-12-01 00:00:00pages
765-9; discussion 770issue
6eissn
0002-9610issn
1879-1883pii
S0002-9610(11)00528-9journal_volume
202pub_type
杂志文章abstract:INTRODUCTION:Our swine model of pulmonary contusion (PC) and hemorrhagic shock (HS) was initially complicated by renal failure, hyperkalemia, and premature death. To study the effects of novel therapies on organ failure, improved survival was necessary requiring the design of an aggressive treatment regimen. METHODS:A...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/j.amjsurg.2020.02.058
更新日期:2020-05-01 00:00:00
abstract::In this study we sought to assess the effect of surgeon volume on outcomes of robotic colorectal operations performed by surgeons with low or high volume across a large health system. We performed a retrospective review of colon or rectal resections performed between January 1, 2013 and January 1, 2017 within the Prov...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/j.amjsurg.2018.01.042
更新日期:2018-05-01 00:00:00
abstract:BACKGROUND:We surveyed surgeons to document their attitudes, practice, and risk tolerance regarding the treatment of appendicitis. METHODS:A web-based survey was sent to the EAST membership. The primary composite endpoint was defined as 1-year incidence of perioperative complications, antibiotic failure, infections, E...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/j.amjsurg.2018.08.019
更新日期:2019-07-01 00:00:00
abstract:BACKGROUND:Retroperitoneal vascular injury remains one of the most frequent causes of death following abdominal trauma. A risk analysis of the association between potential outcome predictors and mortality following abdominal aorta and inferior vena cava injuries was performed. METHODS:Eighty-nine patients sustaining ...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/S0002-9610(96)00231-0
更新日期:1996-11-01 00:00:00
abstract::Understanding variation in perioperative opioid exposure and its effect on patients' outcomes is critical for pain management. This study characterized perioperative exposure to morphine and its association with postoperative pain and 30-day readmissions. We utilized nationwide Veterans Healthcare Administration (VHA)...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/j.amjsurg.2019.06.022
更新日期:2020-06-01 00:00:00
abstract::Aortobrachiocephalic reconstruction was studied in 26 patients. Nine had suffered a previous stroke, and seven had residual deficity. A previous carotid endarterectomy or carotid-to-subclavian bypass had been performed in eight patients. The ascending aorta was the proximal anastomotic site in all cases. Bypass grafti...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/s0002-9610(88)80364-7
更新日期:1988-08-01 00:00:00
abstract:BACKGROUND:Over the past 15 years of war, eligible U.S. military members donated organs overseas in Germany. Our hypothesis was that outcomes at a military treatment facility were comparable to a civilian cohort. METHODS:Military donors were matched 1:3 with a donor cohort from the U.S. United Network for Organ Sharin...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/j.amjsurg.2017.01.024
更新日期:2017-08-01 00:00:00
abstract:BACKGROUND:Surgical therapy for advanced-stage pressure ulcers recalcitrant to healing is a widely accepted practice. The present study examined the incidence of wound recurrence after reconstruction with fasciocutaneous versus combined (biplanar) muscle and fasciocutaneous flaps. METHODS:A retrospective review identi...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/j.amjsurg.2011.10.007
更新日期:2012-03-01 00:00:00
abstract::In a 2 year period, 60 consecutive feeding enterostomies were placed in malnourished patients. The major complication rate was 1.6 percent. Total complications were 8 percent. Thirty day mortality was 13 percent. Nearly all patients were given isosmotic nonelemental diets. The incidence of diarrhea was 2 percent with ...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/s0002-9610(85)80102-1
更新日期:1985-03-01 00:00:00
abstract::A plan is advocated for the management of the dominant breast mass with use of local anesthesia in the outpatient setting as the primary diagnostic tool, but with selection of certain patients for immediate general anesthesia biopsy in the "conventional" manner. Experience with this plan in 2,492 patients during a per...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/0002-9610(76)90030-1
更新日期:1976-05-01 00:00:00
abstract:BACKGROUND:Research has shown that pulsed electromagnetic fields (EMFs) promote wound healing in experimental colonic anastomosis; however, the effects of static EMFs in this setting have not been investigated to date. METHODS:Fifty male Wistar rats were used. Ten served as controls for mechanical strength testing, an...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/j.amjsurg.2006.01.024
更新日期:2006-07-01 00:00:00
abstract:BACKGROUND:Contaminated abdominal wall fascial defects present a challenging problem. The use of human acellular dermal matrix (AlloDerm; LifeCell Corp., Branchburg, NJ) provides a novel method of primary closure of abdominal wall defects in this setting. The aim of the current study was to determine what factors predi...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/j.amjsurg.2006.08.017
更新日期:2006-11-01 00:00:00
abstract:BACKGROUND:The Roux-en-Y loop is an effective procedure for biliodigestive drainage. However, up to 15% of patients suffer from postoperative cholangitis or blind loop syndrome. A new technique to prevent motility abnormalities has been developed. METHODS:Male Lewis rats were used to compare gastric emptying and trans...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/j.amjsurg.2003.08.025
更新日期:2003-12-01 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:Multivisceral resection is often required in the treatment of locally advanced rectal cancers. Such resections are relatively rare and oncologic outcomes, especially when sphincter preservation is performed, are not fully demonstrated. METHODS:A retrospective review was conducted of patients who underwent m...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/j.amjsurg.2014.10.014
更新日期:2015-03-01 00:00:00
abstract::Between 1968 and 1979, 183 patients with invasive epidermoid cancer of the anal canal were treated at Institut Curie. There was 156 women, 27 men with a mean age of 67 +/- 11 years (range 40 to 85 years). The initial height of the tumor was less than 4 cm (65 patients), 4 to 6 cm (98 patients), and more than 6 cm (20 ...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/0002-9610(84)90032-1
更新日期:1984-01-01 00:00:00
abstract:BACKGROUND:We hypothesized that intravenous methylene blue will facilitate adrenal gland identification and resection during laparoscopic adrenalectomy. METHODS:Five mini-Hanford pigs were anesthetized and monitored per an approved Internal Review Board protocol. Timing of color changes in the adrenals was recorded af...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/j.amjsurg.2003.07.011
更新日期:2003-11-01 00:00:00
abstract:BACKGROUND:Identifying factors associated with resident autonomy may help improve training efficiency. This study evaluates resident and procedural factors associated with level of guidance needed in the operating room. METHODS:Intraoperative performance and yearly performance on Fundamentals of Laparoscopic Surgery (...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/j.amjsurg.2019.03.019
更新日期:2019-05-01 00:00:00
abstract:BACKGROUND:The aim of this study was to prospectively duplicate previous retrospective findings showing that prestorage leukoreduction blunts the detrimental effect of aging on banked packed red blood cells transfused after injury. METHODS:Over 19 months, trauma patients transfused with ≥4 U of packed red blood cells ...
journal_title:American journal of surgery
pub_type: 临床试验,杂志文章
doi:10.1016/j.amjsurg.2011.05.012
更新日期:2012-02-01 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: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:BACKGROUND:This study examined trends in breast conservation surgery (BCS) at our hospital and factors associated with BCS. METHODS:We retrospectively reviewed breast cancer surgeries in patients eligible for BCS (size <4 cm, N0, N1) from 1990 through 1996 (n = 634). We calculated the yearly prevalence of BCS and used...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:
更新日期:1998-12-01 00:00:00
abstract::Primary prevention is defined as the prevention of gallstone formation; secondary prevention is defined as the prevention of clinical manifestations of gallstones--symptoms or more severe complications. For primary prevention, general "wellness" measures can be recommended from a theoretic standpoint. These include el...
journal_title:American journal of surgery
pub_type: 杂志文章,评审
doi:10.1016/s0002-9610(05)80958-4
更新日期:1993-04-01 00:00:00
abstract:BACKGROUND:In this study, we explore surgical resident communication with simulated patient surrogates (SPs), in an Objective Structured Clinical Examination (OSCE). METHODS:We use discourse analysis (DA), a qualitative approach to analyzing language, to evaluate our residents' interactions with simulated patient surr...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/j.amjsurg.2017.10.041
更新日期:2018-02-01 00:00:00
abstract::We reviewed 574 endoscopic sphincterotomy procedures. Fifty-six precut papillotomies were performed. Presenting conditions included choledocholithiasis, cholangitis, benign and malignant papillary strictures, and stenosing papillitis. Complications were identified in 16 percent: perforation in 9 percent, pancreatitis ...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/s0002-9610(05)80618-x
更新日期:1990-01-01 00:00:00
abstract::Blood flow of 2 to 3 liters/min was measured in polytetrafluoroethylene (PTFE) arteriovenous dialysis grafts. The flow studies were done at the time of graft banding for high output cardiac failure or peripheral steal. Routine tapering of the arterial end of these grafts to a diameter of less than 5 mm has virtually e...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/0002-9610(80)90013-6
更新日期:1980-08-01 00:00:00
abstract::The lower extremity complications of 100 consecutive patients who required the placement of an intra-aortic balloon pump (IABP) during a 3-year period were studied. Indications for the IABP included hypotension during cardiac catheterization (33%) or coronary angioplasty (13%), hemodynamic instability after open heart...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/s0002-9610(05)81192-4
更新日期:1992-11-01 00:00:00
abstract::Over a 10 year period, 54 patients presented with pancreatic trauma. During the first 5 years of the study, when pancreatography was not utilized for the assessment of pancreatic duct injury, 55 percent of the patients had major pancreatic complications. During the subsequent 5 years, suspected proximal duct injury wa...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/0002-9610(82)90173-8
更新日期:1982-05-01 00:00:00
abstract:BACKGROUND:Immunosuppressed patients have an increased risk of developing anal cancer, but little data exists regarding outcomes of this population. METHODS:A retrospective review of anal cancer patients at a single academic institution from 2006 to 2017 was performed. RESULTS:19 (14%) of 136 anal cancer patients wer...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/j.amjsurg.2019.08.011
更新日期:2020-01-01 00:00:00
abstract::The results of transthoracic esophageal transection in 100 patients with esophageal varices are described. There were 11 operative deaths in this series, and the majority of patients died from hepatic failure. Esophageal varices disappeared completely in 81 percent of the patients and faded in 18 percent. Post-transec...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/0002-9610(80)90255-x
更新日期:1980-02-01 00:00:00