Abstract:
BACKGROUND:Currently, >200 meshes are commercially available in the United States. To help guide appropriate mesh selection, the investigators examined the postsurgical experiences of all patients undergoing ventral hernia repair at their facility from 2008 to 2011 with ≥12 months of follow-up. METHODS:A retrospective review of prospectively collected data was conducted. All returns (surgical readmission, office or emergency visit) for complications or recurrences were examined. The impact of demographics (age, gender, and body mass index [BMI]), risk factors (hernia grade, hernia size, concurrent and past bariatric surgery, concurrent and past organ transplantation, any concurrent surgery, and American Society of Anesthesiologists score), and prosthetic type (polypropylene, other synthetic, human acellular dermal matrix, non-cross-linked porcine-derived acellular dermal matrix, other biologic, or none) on the frequency of return was evaluated. RESULTS:A total of 564 patients had 12 months of follow-up, and 417 patients had 18 months of follow-up. In a univariate regression analysis, study arm (biologic, synthetic, or primary repair), hernia grade, hernia size, past bariatric surgery, and American Society of Anesthesiologists score were significant predictors of recurrence (P < .05). Multivariate analysis, stepwise regression, and interaction tests identified three variables with significant predictive power: hernia grade, hernia size, and BMI. The adjusted odds ratios vs hernia grade 2 for surgical readmission were 2.6 (95% confidence interval [CI], 1.3 to 5.1) for grade 3 and 2.6 (95% CI, 1.1 to 6.4) for grade 4 at 12 months and 2.3 (95% CI, 1.1 to 4.6) for grade 3 and 4.2 (95% CI, 1.7 to 10.0) for grade 4 at 18 months. Large hernia size (adjusted odds ratio vs small size, 3.2; 95% CI, 1.6 to 6.2) and higher BMI (adjusted odds ratio for BMI ≥50 vs 30 to 34.99 kg/m(2), 5.7; 95% CI, 1.2 to 26.2) increased the likelihood of surgical readmission within 12 months. CONCLUSIONS:The present data support the hypothesis that careful matching of patient characteristics to choice of prosthetic will minimize complications, readmissions, and the number of postoperative office visits.
journal_name
Am J Surgjournal_title
American journal of surgeryauthors
Le D,Deveney CW,Reaven NL,Funk SE,McGaughey KJ,Martindale RGdoi
10.1016/j.amjsurg.2013.01.026subject
Has Abstractpub_date
2013-05-01 00:00:00pages
602-7; discussion 607issue
5eissn
0002-9610issn
1879-1883pii
S0002-9610(13)00130-Xjournal_volume
205pub_type
杂志文章abstract::Our experience from 1960 to 1976 with total infrarenal aortic thrombosis (Leriche syndrome) was reviewed. Sixteen heavy smokers (14 men and 2 women) with an average age of fifty-four years underwent thrombectomy with aortoiliac (12 patients) or aortofemoral (4) Dacron bypasses. The last ten patients were hydrated for ...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/0002-9610(77)90331-2
更新日期:1977-12-01 00:00:00
abstract::Compared with total parenteral nutrition, enteral feeding via jejunostomy reduces septic complications in patients with severe trauma. However, violation of the bowel with insertion of a jejunostomy tube may increase the risk of intra-abdominal abscess (IAA), particularly if no simultaneous gastrointestinal tract inju...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/s0002-9610(05)80680-4
更新日期:1993-12-01 00:00:00
abstract::Prophylactic bypass of the common duct and duodenum at the time of pancreatojejunostomy for chronic pancreatitis (triple bypass) has been recommended. If the subsequent development of parapancreatic obstruction were sufficiently frequent, such a recommendation would deserve more wide-spread application. In a group of ...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/0002-9610(86)90081-4
更新日期:1986-02-01 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::Recent developments in protein and genetic engineering methods have allowed the production of antibody-derived molecules that have important potential as therapeutic agents. Although monoclonal antibodies of murine origin have been used for therapeutic purposes, limitations due to anti-antibody responses and suboptima...
journal_title:American journal of surgery
pub_type: 杂志文章,评审
doi:10.1016/s0002-9610(05)80653-1
更新日期:1992-07-01 00:00:00
abstract:BACKGROUND:This study was designed to compare short-term laparoscopic total gastrectomy (LTG) with open total gastrectomy (OTG) outcomes in gastric cancer. METHODS:Seventy patients who underwent total gastrectomy via LTG or OTG were included. All cases were matched for stage, age, and sex by means of statistically gen...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/j.amjsurg.2012.11.011
更新日期:2013-09-01 00:00:00
abstract:BACKGROUND:Biopsy of a breast abscess wall has been performed for years without evidence. Aspiration of breast abscesses has been increasing in popularity without widespread acceptance. METHODS:A 10-year retrospective review of 206 surgical biopsies after incision and drainage of breast abscesses. A literature review ...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/j.amjsurg.2006.08.060
更新日期:2006-12-01 00:00:00
abstract::Surgical clips (metallic or plastic) are frequently used for hemostasis and tumor marking. This study evaluated the radiographic and computerized tomographic appearance of different clips and their relative interference with computerized tomographic scans. Metallic clips (stainless steel, tantalum, and titanium) can a...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/0002-9610(84)90142-9
更新日期:1984-05-01 00:00:00
abstract::Despite intensive investigation, the pathogenesis of postinjury multiple organ failure (MOF) remains elusive. Laboratory and clinical research strongly implicate that the gastrointestinal tract plays a pivotal role. Shock with resulting gut hypoperfusion appears to be one important inciting event. While early studies ...
journal_title:American journal of surgery
pub_type: 杂志文章,评审
doi:10.1016/s0002-9610(99)00231-7
更新日期:1999-12-01 00:00:00
abstract:BACKGROUND:Stress can negatively impact surgical performance, but mental skills may help. We hypothesized that a comprehensive mental skills curriculum (MSC) would minimize resident performance deterioration under stress. METHODS:Twenty-four residents were stratified then randomized to receive mental skills and FLS tr...
journal_title:American journal of surgery
pub_type: 杂志文章,随机对照试验
doi:10.1016/j.amjsurg.2017.09.039
更新日期:2018-02-01 00:00:00
abstract::Since its inception in 1994, the National Surgical Quality Improvement Program (NSQIP) has been used to compare the performance of all Veterans Administration (VA) hospitals offering major surgical procedures. The program's outcome data are used to identify areas of both excellent and poor performance. The data can al...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/j.amjsurg.2004.10.004
更新日期:2004-12-01 00:00:00
abstract:BACKGROUND:We describe the presentation, diagnostic pathway, and management of 28 patients with benign retroperitoneal schwannomas. METHODS:A prospectively kept soft-tissue tumor database was reviewed to identify patients who presented to the Royal Marsden Hospital with retroperitoneal schwannomas. RESULTS:From 2001 ...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/j.amjsurg.2010.06.036
更新日期:2011-08-01 00:00:00
abstract::One hundred thirty-four patients suspected of having pancreas cancer successfully underwent gray scale ultrasound examination of the pancreas. The prospective ultrasound findings were correlated with the final diagnoses, laparotomy findings, and pathology findings. Fifty-four patients had pancreas cancer, confirmed by...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/0002-9610(78)90313-6
更新日期:1978-11-01 00:00:00
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 rev...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/j.amjsurg.2011.05.016
更新日期:2011-12-01 00:00:00
abstract::The lower esophageal high pressure zone (HPZ) was characterized manometrically and reflux status determined in eight male rhesus monkeys. The studies were repeated six weeks and six months after 50 per cent distal small bowel resection. At the same time fasting serum gastrin and gastric inhibitory polypeptide values w...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/0002-9610(77)90002-2
更新日期:1977-05-01 00:00:00
abstract:BACKGROUND:Hemorrhage during hepatectomy remains the major cause of morbidity and mortality associated with this surgery. Traditionally, a Pringle technique is employed to reduce vascular inflow during parenchymal transection. METHODS:This paper describes a simple method to achieve unilateral vascular control during h...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/s0002-9610(01)00697-3
更新日期:2001-09-01 00:00:00
abstract::Twenty patients underwent placement of a jejunal catheter for early postoperative feeding at the time of upper abdominal operations, and a control group of 11 patients underwent operative procedures of similar magnitude without jejunostomy. Advancement of the rate of feeding to target intake over 6 to 7 days was attem...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/0002-9610(85)90009-1
更新日期:1985-07-01 00:00:00
abstract:BACKGROUND:We propose a simple algorithm for management of patients with challenging abdominal fascial defects. METHODS:The medical records of 64 patients with complicated abdominal wall defects representing a consecutive series by a single surgeon over a 4-year period were reviewed. Group I patients presented with ma...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/s0002-9610(00)00566-3
更新日期:2001-02-01 00:00:00
abstract::Blunt trauma to the neck requires a systematic analysis of the laryngotrachea, the esophagus and the cervical spine in addition to general trauma considerations. Acute airway decompensation is best managed by tracheotomy, although if the situation permits, an orderly physical examination including indirect laryngoscop...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/0002-9610(81)90132-x
更新日期:1981-04-01 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::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:BACKGROUND:Previous reports of minimally invasive antireflux surgery for gastroesophageal reflux disease (GERD) have been small, short-term series utilizing only a laparoscopic approach. We conducted a retrospective review and report our 66-month experience with more than 1,000 laparoscopic and thoracoscopic antireflux...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/s0002-9610(98)00034-8
更新日期:1998-04-01 00:00:00
abstract:BACKGROUND:This study defines the entity of the hypertensive lower esophageal sphincter (HLES) and its treatment, including surgical implications. METHODS:Esophageal manometry was performed on 1,300 patients. Of these, 53 (4%) had HLES with resting pressure > 26.5 mm Hg, defined as the upper limit of normal resting LE...
journal_title:American journal of surgery
pub_type: 临床试验,杂志文章
doi:10.1016/S0002-9610(96)00219-X
更新日期:1996-11-01 00:00:00
abstract:BACKGROUND:The Limberg flap (LF) procedure is widely performed for the treatment of sacrococcygeal pilonidal sinus (SPS); however, recurrences continues to be observed. The aim of this study was to assess the relationship between LF designs and the risk of SPS recurrence. METHODS:Sixty-one cases with recurrent disease...
journal_title:American journal of surgery
pub_type: 杂志文章,多中心研究
doi:10.1016/j.amjsurg.2017.02.008
更新日期:2017-11-01 00:00:00
abstract:BACKGROUND:Little is known regarding medical school curricular variability regarding safe prescribing of post-operative opioids for students entering surgical residency. METHODS:Surveys were administered to general surgery residency interviewees at an accredited academic institution for 2018-2019 application season. R...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/j.amjsurg.2019.10.024
更新日期:2020-03-01 00:00:00
abstract:BACKGROUND:Head injuries are common in the pediatric population, but when an isolated skull fracture is found, there are no guidelines for repeat imaging. This study evaluated the need for repeat head computed tomography (CT) for isolated skull fracture. METHODS:A 10-year retrospective review was conducted of patients...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/j.amjsurg.2014.11.011
更新日期:2015-08-01 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:INTRODUCTION:Patient Reported Outcomes (PROs) capture peri-operative fatigue, pain, and quality of life and influence outcomes in gastrointestinal surgery. We compared peri-operative PROs in patients undergoing colorectal operations for neoplastic versus non-neoplastic processes. METHODS:Patients undergoing colectomy ...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/j.amjsurg.2020.08.017
更新日期:2020-12-01 00:00:00
abstract::In his presidential address to the Southwestern Surgical Congress, he examines surgery as a profession from three different perspectives: his experience as a patient, a surgeon, and a photographer. He uses photography to illustrate the importance of perspective and illumination. He respectfully suggests that we should...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/j.amjsurg.2015.09.002
更新日期:2015-12-01 00:00:00
abstract::Silver biopsies of the common bile duct were obtained from 15 patients with clinical and surgical evidence of cholangitis. The most pronounced histologic changes were edema, congestion, and marked mucous gland hypertrophy and hyperplasia. No ulceration, intramural abscess, or areas of necrosis were found. Clinical cho...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/0002-9610(79)90089-8
更新日期:1979-06-01 00:00:00