Abstract:
:Microvascular free tissue transfer has provided a variety of methods of restoring vascularized bone and soft tissue to difficult defects created by tumor resection and trauma. Over 7 years, 26 patients have undergone 28 free flaps for mandibular reconstruction, 15 for primary squamous cell carcinoma of the floor of the mouth or tongue, 7 for recurrent tumor, and 6 for other reasons [lymphangioma (1), infection (1), gunshot wound (1), and osteoradionecrosis (3)]. Primary reconstruction was performed in 19 cases and secondary in 9. All repairs were composite flaps including 12 scapula, 5 radial forearm, 3 fibula, 2 serratus, and 6 deep circumflex iliac artery. Mandibular defects included the symphysis alone (7), symphysis and body (5), symphysis-body-ramus condyle (2), body or ramus (13), and bilateral body (1). Fourteen patients had received prior radiotherapy to adjuvant or curative doses. Eight received postoperative radiotherapy. All patients had initially successful vascularized reconstruction by clinical examination (28) and positive radionuclide scan (22 of 22). Bony stability was achieved in 25 of 26 patients and oral continence in 24 of 26. One complete flap loss occurred at 14 days. Complications of some degree developed in 22 patients including partial skin necrosis (3), orocutaneous fistula (3), plate exposure (1), donor site infection (3), fracture of reconstruction (1), and fracture of the radius (1). Microvascular transfer of bone and soft tissue allows a reliable reconstruction--despite previous radiotherapy, infection, foreign body, or surgery--in almost every situation in which mandible and soft tissue are absent. Bony union, a healed wound, and reasonable function and appearance are likely despite early fistula, skin loss, or metal plate or bone exposure.
journal_name
Am J Surgjournal_title
American journal of surgeryauthors
Coleman JJ 3rd,Wooden WAdoi
10.1016/s0002-9610(05)80550-1subject
Has Abstractpub_date
1990-10-01 00:00:00pages
390-5issue
4eissn
0002-9610issn
1879-1883pii
S0002-9610(05)80550-1journal_volume
160pub_type
杂志文章abstract::The application of systems analysis and flow charting technics to abdominal incision and closure allow a complete display of objectives and alternatives. A route of alternatives has been chosen and supported by the best available principles in the surgical literature. The choices include an unconventional large bite m...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/0002-9610(76)90160-4
更新日期:1976-04-01 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:PURPOSE:Hepatic mitochondrial response to oral glucose load (redox tolerance test) was evaluated as an indicator of hepatic functional reserve of patients with obstructive jaundice. PATIENTS AND METHODS:The redox tolerance test was performed in 29 patients with obstructive jaundice before percutaneous transhepatic bil...
journal_title:American journal of surgery
pub_type: 临床试验,杂志文章
doi:10.1016/S0002-9610(99)80162-7
更新日期:1995-03-01 00:00:00
abstract::Serum transferrin is an important protein used to assess visceral protein status in patients requiring nutritional support. Since serum transferrin assays are not readily available in all institutions and there is a correlation between the serum transferrin level and TIBC, Blackburn's formula to compute the serum tran...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/0002-9610(84)90337-4
更新日期:1984-11-01 00:00:00
abstract:BACKGROUND:The Physiological and Operative Severity Score for the enUmeration of Mortality and morbidity (POSSUM) model and its Portsmouth modification (P-POSSUM) are used extensively to predict postoperative mortality and morbidity in general surgery. The aim of this study was to undertake the first systematic review ...
journal_title:American journal of surgery
pub_type: 杂志文章,评审
doi:10.1016/j.amjsurg.2012.06.011
更新日期:2013-04-01 00:00:00
abstract::The lecture activity of neurology and neurosurgery faculty at allopathic medical schools during the academic years 1985-1986 through 1987-1988 was surveyed. Lectures were categorized into three combinations for analysis: first- and second-year basic science, first- and second-year clinical, and third- and fourth-year ...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/0002-9610(94)90213-5
更新日期:1994-03-01 00:00:00
abstract:BACKGROUND:Native arterial venous fistulas (NAVF) are generally considered preferable to synthetic grafts for chronic dialysis access. As increasing numbers of diabetic and elderly patients are treated, adequate NAVFs become more difficult to establish. Vascular ultrasonography (US) prior to NAVF surgery has received l...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/s0002-9610(02)01103-0
更新日期:2002-12-01 00:00:00
abstract:BACKGROUND:The aim of this study was to characterize patients readmitted following inpatient general surgery procedures. We hypothesized that a decreased length of stay would increase risk for readmission. METHODS:We utilized our institutional National Surgical Quality Improvement Project database from 2006 to 2011. T...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/j.amjsurg.2013.10.022
更新日期:2014-04-01 00:00:00
abstract::A study by questionnaire was sent to 134 Surgical Services at Veterans Administration Hospitals to ascertain the prevalence of the practice of preoperative hydration during the period of hydropenia preceding surgery. A 92.5 per cent response was noted and the following conclusions are drawn: (1) The majority of Vetera...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/0002-9610(77)90075-7
更新日期:1977-02-01 00:00:00
abstract::The accuracy of the hepatobiliary scan in the diagnosis of acute cholecystitis was determined at a major United States Army Medical Center. Forty-two patients with complete medical records were selected for the study. There was 18 positive findings and 24 negative findings. The accuracy rate for the positive findings ...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/0002-9610(84)90333-7
更新日期:1984-11-01 00:00:00
abstract::A 5 year retrospective study of the use of cholangioscopy in 153 difficult biliary cases including stones, strictures, tumors, and anomalies has been reported. In the 88 patients (58 percent) who underwent both operative cholangiography and cholangioscopy, the cholangioscope revealed 11 lesions (13 percent) missed by ...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/0002-9610(84)90048-5
更新日期:1984-01-01 00:00:00
abstract:BACKGROUND:Training and experience vary widely among surgeons performing laparoscopic surgery (LS). Visual perceptual demands are greater for LS than for traditional surgery, necessitating greater understanding of surgeon variables in skill acquisition and performance. METHODS:During an LS skills course incorporating ...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/s0002-9610(01)00574-8
更新日期:2001-04-01 00:00:00
abstract:BACKGROUND:Many trauma surgeons and trauma centers use routine exploration of Gerota's fascia (GE) for renal gunshot wounds (RGSW). The purpose of this study was to assess whether RGSW can be selectively explored for patients who undergo exploratory laparotomy. METHODS:Retrospective 10-year review of all patients who ...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/j.amjsurg.2015.09.023
更新日期:2016-04-01 00:00:00
abstract::Controversy continues about how often a negative laparotomy should be accepted in the management of patients with blunt and penetrating trauma. A key issue is the complications, especially small bowel obstruction. To define these complications, the charts of 248 patients who underwent negative laparotomy for trauma we...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/s0002-9610(88)80549-x
更新日期:1988-12-01 00:00:00
abstract::Fourteen operations were performed in 13 patients with total carotid artery occlusion. All patients had symptoms ranging in duration from a few hours to several months. Flow wa reestablished in 10 of the 14 arteries operated on, a success rate of 74 percent. Complication included one operative death and one permanent ...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/0002-9610(80)90366-9
更新日期:1980-05-01 00:00:00
abstract:BACKGROUND:The management of surgical sepsis is challenging because of the complexity of interventions. The authors therefore created a computerized clinical decision support program to facilitate this process, with the goal of improving abdominal sepsis mortality. METHODS:The authors evaluated a prospective database ...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/j.amjsurg.2010.07.036
更新日期:2010-12-01 00:00:00
abstract:BACKGROUND:Mucinous Cystic Neoplasms are mucin producing cysts of the pancreas with malignant potential. The existing literature on treatment outcomes is limited to relatively small surgical series. METHODS:We reviewed the National Cancer Database assessing the outcomes of patients with mucinous cystic neoplasms betwe...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/j.amjsurg.2020.09.006
更新日期:2020-12-01 00:00:00
abstract::Significant salvage of patients with a wide variety of cysts and benign tumors of the liver and of some patients with biliary strictures can be achieved by hepatic resection in carefully selected clinical situations with a low operative mortality rate and an acceptable postoperative complication rate. Still to be dete...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/0002-9610(79)90123-5
更新日期:1979-04-01 00:00:00
abstract:BACKGROUND:Despite efforts at standardization, evaluation and reporting of clerkships remains highly variable. This study reviews the current spectrum of surgical clerkship grading. METHODS:Data were reviewed for every medical school from which an application was received to a single surgery residency program in 2017 ...
journal_title:American journal of surgery
pub_type: 杂志文章,多中心研究
doi:10.1016/j.amjsurg.2018.09.024
更新日期:2019-02-01 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:BACKGROUND:Biopsy of nonpalpable lesions has increased during the last decade. Commonly these lesions are excised using preoperative wire localization. We describe a technique of intraoperative ultrasound-guided breast biopsy that allows easier excision and aids in obtaining surgical margins in breast cancer. METHODS:...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/s0002-9610(00)00500-6
更新日期:2000-12-01 00:00:00
abstract::Thymectomy was performed on 249 patients with myasthenia gravis between 1957 and 1981. During a follow-up period that ranged from 2 months to 24 years (mean 7.5 years), the remission rate for the entire group was 51 percent, and an additional 36 percent had improvement (87 percent benefited). In those 51 patients with...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/0002-9610(83)90260-x
更新日期:1983-07-01 00:00:00
abstract:BACKGROUND:Despite blood-conservation techniques, hemorrhage during burn excision remains substantial. It is difficult to predict the blood loss that will occur per operation and how many units the patient will require during surgery. This may result in high cross-match-to-transfusion ratios (CMTRs). METHODS:A retrosp...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/j.amjsurg.2004.11.030
更新日期:2005-03-01 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::Twenty-five patients with ulcerative colitis were treated between 1959 and 1986 at the Mount Sinai Hospital, with severe gastrointestinal hemorrhage as their major complaint. Twenty-two patients required operation, while three patients were treated medically. Total proctocolectomy with ileostomy was carried out in 5 p...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/s0002-9610(06)80064-4
更新日期:1990-06-01 00:00:00
abstract:BACKGROUND:Phyllodes tumors (PTs) of the breast are rare, and their prognosis and treatment are still subject of discussion. The purpose of this study is to clarify therapeutic aspects and prognostic factors of this disease. PATIENTS AND METHODS:We retrospectively reviewed the medical records of 106 patients who had h...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/j.amjsurg.2006.04.007
更新日期:2006-08-01 00:00:00
abstract:BACKGROUND:Choledochal cysts (CDC) are rare congenital cystic lesions of the biliary tract. In North America the incidence of CDC is estimated as 1/150,000; it is not clear that the disease pattern in North America is similar to that in Asia. METHODS:Retrospective chart review. Statistical analysis was under taken usi...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/j.amjsurg.2005.01.025
更新日期:2005-05-01 00:00:00
abstract:BACKGROUND:Human pancreatic cancers exhibit a high frequency of K-ras mutations. METHODS:In this study we used oligonucleotide specific hybridization to compare the frequency of K-ras mutations in genomic DNA samples prepared from 21 normal pancreatic tissues, 26 chronic pancreatitis tissues, and 24 pancreatic cancers...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/s0002-9610(97)00133-5
更新日期:1997-09-01 00:00:00
abstract::This study has summarized our results with popliteal-tibial in situ saphenous vein bypass in 26 patients, 25 of whom were diabetic, over a 2 year period. Both above- and below-knee popliteal inflow sites were used for bypass of limb-threatening ischemia. Distal calf or pedal outflow sites were required in all but two ...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/0002-9610(87)90191-7
更新日期:1987-08-01 00:00:00
abstract::There is still considerable controversy among surgeons regarding the most opportune moment for surgical intervention in the case of acute cholecystitis. For this reason, 471 patients cholecystectomized for acute cholecystitis from 1970 through 1982 were studied. During the first period, there were two types of surgica...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/0002-9610(84)90334-9
更新日期:1984-11-01 00:00:00