Abstract：
BACKGROUND:Splenectomy is generally a second-line therapy in patients with immune thrombocytopenic purpura (ITP) and autoimmune hemolytic anemia (AHA) refractory to medical therapy. Our objective was to evaluate outcomes after splenectomy for these disorders. METHODS:A retrospective review of the medical records of patients who underwent splenectomy for ITP or AHA from January 1, 1996, to December 31, 2010 was completed. RESULTS:Sixty patients met the study criteria: 45 with ITP and 15 with AHA. The mean age was 49.4 ± 21.7 years; 63% were women. Initially, 91% and 93% of ITP and AHA patients experienced a complete response (P = .999); however, 17% of ITP and 29% of AHA patients relapsed (P = .443). Sixty-four percent of patients responded after relapse for a complete response rate of 85% (82% in ITP and 93% in AHA, P = .427). Thirty-day and long-term complication rates were 10% and 5%, respectively. There were no splenectomy-related 30-day mortalities. CONCLUSIONS:Splenectomy for ITP and AHA resulted in favorable response rates with low morbidity and is an effective adjunct in the management course of patients failing to achieve or sustain responses with medical therapy.
journal_name
Am J Surgjournal_title
American journal of surgeryauthors
Patel NY,Chilsen AM,Mathiason MA,Kallies KJ,Bottner WAdoi
10.1016/j.amjsurg.2012.05.030subject
Has Abstractpub_date
2012-12-01 00:00:00pages
1014-9; discussion 1019-20issue
6eissn
0002-9610issn
1879-1883pii
S0002-9610(12)00505-3journal_volume
204pub_type
杂志文章abstract：BACKGROUND:Changes in the surgical training landscape have sparked an interest in developing new educational models anchored on entrustment assessment. We sought to optimize the validated OpTrust entrustment assessment tool by comparing ratings from short-course video reviews to previously validated intraoperative asse...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/j.amjsurg.2017.10.036
更新日期：2018-07-01 00:00:00
abstract：BACKGROUND:Academic institutions have increasingly focused on educating physicians and surgeons in concepts of value-based care, including quality improvement (QI). The extent to which QI curricular competencies are addressed in specialty surgical residency training is unclear. METHODS:A survey instrument was develope...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/j.amjsurg.2020.09.036
更新日期：2020-09-29 00:00:00
abstract：INTRODUCTION:We hypothesized that the implementation of a novel mental skills curriculum (MSC) during laparoscopic simulator training would improve mental skills and performance, and decrease stress. METHODS:Sixty volunteer novices were randomized into intervention and control groups. All participants received FLS tra...
journal_title：American journal of surgery
pub_type： 杂志文章,随机对照试验
doi：10.1016/j.amjsurg.2016.10.016
更新日期：2017-02-01 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:The results and advantages of laparoscopic cholecystectomy in the geriatric population have received minimal attention. Several early reports related high conversion rates complications and mortality. This case series review is focused on the results of laparoscopic cholecystectomy in the geriatric populatio...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/j.amjsurg.2003.11.031
更新日期：2004-06-01 00:00:00
abstract：:Feeding gastrostomy and jejunostomy provide effective access for long-term enteral nutrition. Traditional operative techniques for the performance of these procedures requires laparotomy and often, general anesthesia. This report describes our experience with two relatively new methods, percutaneous endoscopic gastros...
journal_title：American journal of surgery
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更新日期：1985-01-01 00:00:00
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journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/0002-9610(92)90018-m
更新日期：1992-03-01 00:00:00
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pub_type： 杂志文章,多中心研究
doi：10.1016/j.amjsurg.2008.07.041
更新日期：2008-12-01 00:00:00
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journal_title：American journal of surgery
pub_type： 杂志文章,多中心研究
doi：10.1016/j.amjsurg.2017.04.011
更新日期：2017-11-01 00:00:00
abstract：:The dose response curves for acid and pepsin output to increasing intravenous doses of pentagastrin (0.01, 0.02, 2, 8, and 16 micrograms/kg per hour) were determined in six male patients with duodenal ulcer and six with type 1 corporeal gastric ulcer before and 3 to 6 months after selective proximal vagotomy and excis...
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更新日期：1985-11-01 00:00:00
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journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/j.amjsurg.2014.02.003
更新日期：2014-08-01 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...
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doi：10.1016/s0002-9610(00)00301-9
更新日期：2000-03-01 00:00:00
abstract：:Chronic anal fissure is the main cause of anal pain and is very common. Many treatment modalities have been tried-none is ideal. Recently, topical nitric oxide releasing agents and botulin toxin injections have been used, trying to replace surgery. No long-term experience is available. Personal experience with 2,108 o...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/s0002-9610(00)00307-x
更新日期：2000-03-01 00:00:00
abstract：:Nitric oxide (NO), a paracrine-acting gas enzymatically synthesized from L-arginine, is a unique biologic mediator that has been implicated in a myriad of physiologic and pathophysiologic states. It is an important regulator of vascular tone and may be the mediator of the hemodynamic changes involved in sepsis and cir...
journal_title：American journal of surgery
pub_type： 杂志文章,评审
doi：10.1016/s0002-9610(05)80017-0
更新日期：1995-09-01 00:00:00
abstract：BACKGROUND:Data on the hemoglobin (Hb) after transfusion, or the "target," which reflects the "dose" of blood given are not well studied. We sought to examine the incidence and causes of "over transfusion" of red blood cells after surgery. METHODS:Data on blood utilization including Hb triggers and targets were obtain...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/j.amjsurg.2015.12.020
更新日期：2016-07-01 00:00:00
abstract：:Histiocytosis X describes a disease characterized by histiocytic infiltration of the reticuloendothelial system, skin, bones, and pituitary gland. The disseminated form frequently occurs in infants and children. Chemotherapy has significantly improved the prognosis in this disorder. Sixty-three per cent of survivors, ...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/0002-9610(76)90431-1
更新日期：1976-01-01 00:00:00
abstract：BACKGROUND:Recent rapid increases in the aging population have created an impending "Silver Tsunami" in advanced countries. The overall prevalence of gallstone disease and its related complications will soon increase, and there will be a larger demand for gallbladder surgery. METHODS:We examined the outcomes of cholec...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/j.amjsurg.2019.01.021
更新日期：2019-09-01 00:00:00
abstract：:Between September 1982 and April 1988, 60 cirrhotic patients with prior variceal hemorrhage were randomized to undergo the placement of an elective shunt (distal splenorenal: 26; nonselective: 4) or long-term endoscopic sclerotherapy (n = 30). Eighty-six percent of patients had alcoholic cirrhosis, and 33% were classi...
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)80400-3
更新日期：1993-01-01 00:00:00
abstract：BACKGROUND:Anorectal malformations represent a continuing challenge for the pediatric surgeon. A significant number of these children suffer from fecal incontinence, urinary incontinence, and sexual inadequacy. However, major advances in the management of these children have occurred during the last 10 years. The poste...
journal_title：American journal of surgery
pub_type： 杂志文章,评审
doi：10.1016/s0002-9610(00)00491-8
更新日期：2000-11-01 00:00:00
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journal_title：American journal of surgery
pub_type： 杂志文章
doi：
更新日期：2000-02-01 00:00:00
abstract：:Following its introduction in 1993, the LAP-BAND (INAMED Health, Santa Barbara, CA) has been used extensively across the world for the treatment of obesity, and data on safety and effectiveness are now available. This review draws on the literature and our own clinical patient base to provide an overview of the early ...
journal_title：American journal of surgery
pub_type： 杂志文章,评审
doi：10.1016/s0002-9610(02)01179-0
更新日期：2002-12-01 00:00:00
abstract：BACKGROUND:ACS-NSQIP classifies hospitals as "high outliers" if their performance is significantly worse than expected. We determined how often hospitals return to as-expected performance after being newly identified as outliers. METHODS:Outlier status was identified in ACS-NSQIP semi-annual reports (SARs) 2008-2011 f...
journal_title：American journal of surgery
pub_type： 杂志文章,多中心研究
doi：10.1016/j.amjsurg.2017.07.026
更新日期：2018-08-01 00:00:00
abstract：BACKGROUND:Although 90% of patients with neurogenic thoracic outlet syndrome (NTOS) experience "excellent" or "good" results after thoracic outlet decompression, recurrent symptoms may develop in certain patients. METHODS:This is a retrospective review of patients with NTOS who developed recurrent symptoms of upper ex...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/j.amjsurg.2003.12.050
更新日期：2004-04-01 00:00:00
abstract：:One hundred seventeen patients with threatened limb loss were evaluated. Seventy-three of these patients underwent vascular reconstruction. Diabetics had a significantly higher incidence of ischemic ulceration and gangrene when compared with nondiabetics. Nondiabetics typically presented with rest pain. The outcome of...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/s0002-9610(88)80534-8
更新日期：1988-12-01 00:00:00
abstract：BACKGROUND:Patient factors impact laparoscopic cholecystectomy (LC) difficulty, specifically operative duration. This study quantifies the impact of patient factors on LC duration. METHODS:The national surgery database (American College of Surgeons National Surgical Quality Improvement Program) was reviewed for all el...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/j.amjsurg.2016.01.024
更新日期：2016-08-01 00:00:00
abstract：:Peripheral vascular complications after cardiac catheterization constitute an increasing portion of traumatic vascular injuries. To determine the incidence of these complications and the sequelae of their treatment, we reviewed 7,690 catheterizations performed over a 40-month period. One hundred eleven vascular compli...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/0002-9610(94)90119-8
更新日期：1994-04-01 00:00:00
abstract：:The management of primary varicose veins is evolving. Recovery time, cost, recurrence rate, and cosmesis are critical determinants. Classic "high ligation" and ankle-to-groin stripping is expensive, results in a long convalescence, and may produce unacceptable scarring and possible permanent nerve injury. This report ...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/0002-9610(91)90182-d
更新日期：1991-08-01 00:00:00
abstract：BACKGROUND:Nipple discharge occurs in 2% to 5% of women. We evaluated the effectiveness of a previously proposed treatment algorithm for these patients. METHODS:Patients with pathologic nipple discharge and a negative mammogram and subareolar ultrasound were offered follow-up from 2005 to 2011 according to the algorit...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/j.amjsurg.2013.12.035
更新日期：2014-08-01 00:00:00
abstract：BACKGROUND:Patients often have an incomplete understanding of the levels of training and roles of the various surgical providers in teaching hospitals, leading to patient confusion and dissatisfaction. METHODS:Pre-intervention discharge surveys were administered to gastrointestinal surgery inpatients (10/2016-02/2017)...
journal_title：American journal of surgery
pub_type： 临床试验,杂志文章
doi：10.1016/j.amjsurg.2018.07.056
更新日期：2018-10-01 00:00:00
abstract：BACKGROUND:Incisional hernias are common. Optimal repair is one of the most analyzed and debated topics; however, there is no consensus as to the appropriate surgical technique. METHODS:An Institutional Review Board-approved protocol was designed using an Internet-based survey site (www.surveymonkey.com) to assess pra...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/j.amjsurg.2007.08.002
更新日期：2007-11-01 00:00:00
