Abstract:
BACKGROUND:Alternative methods for abdominal wall closure may be necessary after emergency laparotomy. The purpose of this study was to determine the morbidity and outcome of emergency fascial closure with polypropylene mesh. METHODS:A retrospective review was performed of all patients undergoing emergency fascial closure with polypropylene mesh from January 1990 to March 1994. RESULTS:Seventy patients were identified. Indications for mesh placement included visceral edema (40), infected/necrotic fascia (21), and planned reexploration (7). Enteric fistulas developed in five patients (7.1%). When omentum was interposed between intestine and mesh, the incidence of fistula was significantly reduced (0 of 51 vs 5 of 19, p < 0.01). Forty-two patients (60%) survived with wound closure, accomplished by skin flaps in 19 (45%), skin grafting in 11 (26%), and secondary healing in 6 (14%). The mesh was removed in six patients (14%). Complications of mesh extrusion and hernia occurred less often after skin flap closure compared with skin grafting or secondary healing (1 of 19 vs 9 of 17, p < 0.01). No mesh infection occurred. CONCLUSIONS:Polypropylene mesh placement is an effective alternative for abdominal closure after emergency laparotomy, even when intraabdominal sepsis is present. Fistulas associated with its use may be effectively eliminated by the interposition of omentum between bowel and mesh. Wound closure with full-thickness skin flaps is the preferred method for soft tissue coverage when mesh is used.
journal_name
Surgeryjournal_title
Surgeryauthors
Brandt CP,McHenry CR,Jacobs DG,Piotrowski JJ,Priebe PPdoi
10.1016/s0039-6060(05)80043-1subject
Has Abstractpub_date
1995-10-01 00:00:00pages
736-40; discussion 740-1issue
4eissn
0039-6060issn
1532-7361pii
S0039-6060(05)80043-1journal_volume
118pub_type
杂志文章,评审相关文献
SURGERY文献大全abstract::Hyperparathyroid crisis is a rare, life-threatening condition that requires prompt removal of the involved parathyroid gland(s). This report describes a patient with hyperparathyroid crisis caused by a mediastinal parathyroid adenoma, which was localized before operation and removed at the initial operation, without n...
journal_title:Surgery
pub_type: 杂志文章
doi:
更新日期:1993-05-01 00:00:00
abstract:BACKGROUND:von Hippel-Lindau disease is an autosomal dominant disorder characterized by the development of hemangioblastomas in the cerebellum, spinal cord, and retina, renal cell carcinoma and cysts, pancreatic cysts, and pheochromocytoma. METHODS:We have studied a series of 36 French patients affected with von Hippe...
journal_title:Surgery
pub_type: 杂志文章
doi:
更新日期:1994-12-01 00:00:00
abstract:BACKGROUND:The disrupted intestinal transit during endotoxemia may be mediated by nitric oxide (NO). We hypothesized that the isoforms of nitric oxide synthase (NOS) are up-regulated in intestinal smooth muscle during endotoxemia and that the scavenging of NO will normalize transit. METHODS:Rats were given Escherichia...
journal_title:Surgery
pub_type: 杂志文章
doi:
更新日期:1999-03-01 00:00:00
abstract::The hydrogen gas clearance technique was evaluated to estimate regional hepatic blood flow. Initially, the H2 gas method was compared to the indocyanine green clearance in mini pigs. The blood flow measured by the H2 gas method (0.49 +/- 0.03 ml/min/gm) was only 39% of the calculated blood flow by the indocyanine gree...
journal_title:Surgery
pub_type: 杂志文章
doi:
更新日期:1986-04-01 00:00:00
abstract:BACKGROUND:The prognostic significance of the leukocyte subsets in peripheral blood has not yet been investigated in hepatocellular carcinoma patients. We sought to clarify the prognostic value of preoperative peripheral blood leukocyte subset counts, especially the absolute monocyte count, in HCC patients who have und...
journal_title:Surgery
pub_type: 杂志文章
doi:10.1016/j.surg.2005.10.009
更新日期:2006-06-01 00:00:00
abstract:BACKGROUND:After portal vein ligation of 1 side of the liver, the other side regenerates at a slow rate. This slow growth may be accelerated to rapid growth by adding a transection between the 2 sides, i.e., performing portal vein ligation and parenchymal transection. We found that in patients undergoing portal vein li...
journal_title:Surgery
pub_type: 杂志文章
doi:10.1016/j.surg.2016.05.018
更新日期:2017-03-01 00:00:00
abstract::In this study we set out to determine, if relative to net catabolism of skeletal muscle protein as measured by phenylalanine release, the transamination of branched-chain amino acids (valine, isoleucine, and leucine) was greater in nonseptic burn patients than in controls. Arterial and femoral venous amino acid concen...
journal_title:Surgery
pub_type: 杂志文章
doi:
更新日期:1982-04-01 00:00:00
abstract::Diffuse compensatory extramedullary hematopoiesis is well known to involve the spleen and liver in certain hematologic disorders. Hematopoietic tumor masses occasionally form and usually occur paraspinally in the posterior mediastinum. A 31-year-old patient with thalassemia is described with a massive, solitary, intra...
journal_title:Surgery
pub_type: 杂志文章
doi:
更新日期:1990-06-01 00:00:00
abstract:BACKGROUND:Neuroendocrine neoplasms most commonly metastasize to the liver. Operative extirpation of neuroendocrine neoplasm hepatic metastases improves symptoms and seems to improve survival, but subsequent evidence is required. The current study evaluates the progression-free survival and overall survival of patients...
journal_title:Surgery
pub_type: 杂志文章
doi:10.1016/j.surg.2010.06.008
更新日期:2011-02-01 00:00:00
abstract:BACKGROUND:Totally implantable venous access devices (ports) are widely used, especially for cancer chemotherapy. Although their use has been associated with upper extremity deep venous thrombosis, the risk factors of upper extremity deep venous thrombosis in patients with a port are not studied adequately. METHODS:Th...
journal_title:Surgery
pub_type: 杂志文章
doi:10.1016/j.surg.2017.02.020
更新日期:2017-08-01 00:00:00
abstract::We report a patient with malignant melanoma metastatic to the supraampullar portion of the common bile duct. The unique aspects of this case include its clinical presentation masquerading as obstructive jaundice caused by a bile duct tumor and the finding of an isolated solitary recurrence metastatic to the bile duct....
journal_title:Surgery
pub_type: 杂志文章
doi:
更新日期:1990-05-01 00:00:00
abstract:BACKGROUND:Metastatic neuroendocrine tumors (NETs) can present with complications of gastrointestinal tract obstruction or ischemia and carcinoid syndrome (CS). The purpose of this study was to assess whether aggressive surgical intervention of metastatic NETs provides effective palliation from these symptoms. METHODS...
journal_title:Surgery
pub_type: 杂志文章
doi:10.1016/j.surg.2008.06.008
更新日期:2008-10-01 00:00:00
abstract:BACKGROUND:The development of effective gene transfer in utero will provide alternative approaches to the treatment of genetic disorders. For many disorders, the fetal liver and peritoneum are important target tissues. Our goals were to compare the tissue sites and duration of transferred gene expression after intraper...
journal_title:Surgery
pub_type: 杂志文章
doi:
更新日期:1999-08-01 00:00:00
abstract:BACKGROUND:Thromboprophylaxis aims to reduce venous thromboembolism but has the potential to increase bleeding. We sought to evaluate the risk of venous thromboembolism and transfusion after major abdominopelvic procedures and to quantify the association of the procedure with venous thromboembolism. METHODS:The Americ...
journal_title:Surgery
pub_type: 杂志文章
doi:10.1016/j.surg.2019.05.050
更新日期:2019-12-01 00:00:00
abstract:BACKGROUND:Anastomotic leakage represents a major complication after anterior resection of the rectum. The incidence of anastomotic leakage varies considerably among clinical studies in part owing to the lack of a standardized definition of this complication. The aim of the present article was to propose a definition a...
journal_title:Surgery
pub_type: 杂志文章,评审
doi:10.1016/j.surg.2009.10.012
更新日期:2010-03-01 00:00:00
abstract:BACKGROUND:We analyzed the demographics of high-volume surgeons (HVS) for endocrine operations. METHODS:We characterized HVS by region, specialty, gender, teaching-affiliation, American Association of Endocrine Surgeons (AAES) membership, and decade they entered practice. Providers were general surgeons (GS) and otola...
journal_title:Surgery
pub_type: 杂志文章
doi:10.1016/j.surg.2015.08.024
更新日期:2016-01-01 00:00:00
abstract:BACKGROUND:Despite development of current targeted therapies for medullary thyroid cancer (MTC), long-term survival remains unchanged. Recently isolated novel withanolide compounds from Solanaceae physalis are highly potent against MTCs. We hypothesize that these withanolides uniquely inhibit RET phosphorylation and th...
journal_title:Surgery
pub_type: 杂志文章
doi:10.1016/j.surg.2012.08.031
更新日期:2012-12-01 00:00:00
abstract::Surgical education has been exposed to increasing challenges as students have moved from the highly structured environment of a university hospital into a variety of clinical settings within the community. Presented with a general surgical service that uses ten relatively autonomous teaching services in seven hospital...
journal_title:Surgery
pub_type: 杂志文章
doi:
更新日期:1976-07-01 00:00:00
abstract::Five surgical management problems amenable to solution by decision analysis were developed to test the decision-making skills, or surgical judgment, of residents in three university-based surgical training programs. Incorporated within the problems were indicators of textbook knowledge, basic computational ability and...
journal_title:Surgery
pub_type: 杂志文章
doi:
更新日期:1982-08-01 00:00:00
abstract::Minced adult human, rat, and dog pancreatic fragments were cultured under various conditions in an attempt to selectively purify pancreatic islet tissue from exocrine digestive enzymes. Islet purification was assessed by measuring tissue insulin and amylase concentrations, proportional to islet beta cell mass and exoc...
journal_title:Surgery
pub_type: 杂志文章
doi:
更新日期:1976-08-01 00:00:00
abstract:INTRODUCTION:Computed tomography (CT) has become an essential tool in the assessment of the stable trauma patient. Intravenous (i.v.) contrast is commonly relied upon to provide superior image quality, particularly for solid-organ injury. However, a substantial proportion of injured patients have contraindications to i...
journal_title:Surgery
pub_type: 杂志文章
doi:10.1016/j.surg.2012.07.016
更新日期:2012-10-01 00:00:00
abstract:BACKGROUND:The aims of the present study were to confirm the consumption coagulopathy of disseminated intravascular coagulation with the fibrinolytic phenotype at an early phase of trauma and to test the hypothesis that thrombin-activatable fibrinolysis inhibitor, neutrophil elastase, and plasmin contribute to the incr...
journal_title:Surgery
pub_type: 杂志文章
doi:10.1016/j.surg.2010.06.010
更新日期:2011-02-01 00:00:00
abstract::In the present series, highly selective vagotomy (HSV) was used in the treatment of duodenal ulcer and the patients were followed up 1 to 3 years after operation. Three months after operation, 57% of the patients had positive insulin tests (early and late positive). Ulcer recurrence rate was approximately 6.5%, wherea...
journal_title:Surgery
pub_type: 杂志文章
doi:
更新日期:1977-08-01 00:00:00
abstract:BACKGROUND:A minimally invasive step-up approach to necrotizing biliary pancreatitis often requires multiple interventions, delaying cholecystectomy. The risk of gallstone-related complications during this time interval is unknown, as is the feasibility and safety of cholecystectomy after minimally invasive step-up tre...
journal_title:Surgery
pub_type: 杂志文章
doi:10.1016/j.surg.2020.11.002
更新日期:2020-12-12 00:00:00
abstract:BACKGROUND:A new concept of surgical stress has been proposed that consists of both aggressiveness of operation and systemic reactions to an operation. METHODS AND RESULTS:We have investigated a possible modulation of such systemic reactions to operation and have demonstrated the following 3 points: (1) coagulation an...
journal_title:Surgery
pub_type: 杂志文章
doi:10.1067/msy.2002.120116
更新日期:2002-01-01 00:00:00
abstract:BACKGROUND:To help control the coronavirus disease 2019 pandemic, elective procedures have been cancelled in most US hospitals by government order. The purpose of this study is to estimate national hospital reimbursement and net income losses owing to elective surgical procedure cancellation during the coronavirus dise...
journal_title:Surgery
pub_type: 杂志文章,多中心研究
doi:10.1016/j.surg.2020.07.014
更新日期:2020-11-01 00:00:00
abstract:BACKGROUND:Traumatic injury and the presence of a central venous catheter are 2 of the strongest risk factors for venous thromboembolism in children. The purpose of this study was to determine the incidence of symptomatic, catheter-associated thrombosis in critically injured children. We hypothesized that femoral venou...
journal_title:Surgery
pub_type: 杂志文章
doi:10.1016/j.surg.2019.05.018
更新日期:2019-12-01 00:00:00
abstract:BACKGROUND:Corticosteroid use continues to rise nationally. Studies have evaluated the impact of chronic steroid use on surgical outcomes in smaller populations. This study investigated the impact of chronic steroid use on perioperative surgical outcomes in a surgical cohort of more than 5 million surgical patients, us...
journal_title:Surgery
pub_type: 杂志文章
doi:10.1016/j.surg.2018.12.016
更新日期:2019-05-01 00:00:00
abstract::To assess the role of portal hemodynamics in the development of postshunt encephalopathy, we studied 19 patients after small-diameter portacaval H grafting (SD-PCHG). We used contrast studies as well as technetium-labeled macroaggregated albumin injected into the portal vein to assess direction of portal flow. We then...
journal_title:Surgery
pub_type: 杂志文章
doi:
更新日期:1984-08-01 00:00:00
abstract:BACKGROUND:The aim of this study was to determine if nonoperative, noninterventional expectant management of pancreatic pseudocysts is warranted in selected patients. METHODS:From 1980 to 1985, 114 patients with the diagnosis of pancreatic pseudocyst were evaluated. RESULTS:Forty-six patients underwent primary operat...
journal_title:Surgery
pub_type: 杂志文章
doi:
更新日期:1992-02-01 00:00:00