Abstract:
OBJECTIVE:The primary aim of this study was to delineate the role of computed tomography (CT) in patients undergoing NOM for AGSW. BACKGROUND:Nonoperative management (NOM) of abdominal gunshot wounds (AGSWs) remains controversial. METHODS:This prospective study included all patients with abdominal gunshot injuries admitted to our trauma center from April 1, 2004 to September 30, 2009. Exclusion criteria included patients with peritonitis, hemodynamic instability, unreliable physical examination, head and spinal cord injury with an AGSW underwent immediate laparotomy. The remaining patients were selected for NOM. Nonperitonitic stable patients with right-sided thoracoabdominal/right upper quadrant gunshots and/or hematuria underwent mandatory CT with intravenous contrast. CT to detect missile trajectory was optional. The primary outcome measure was failure of NOM. Secondary outcomes were unnecessary laparotomy rates and mortality. RESULTS:A total of 1106 patients with abdominal gunshot injuries were admitted. Of these, 834 (75.4%) underwent immediate laparotomy, whereas 272 (24.6%) were selected for NOM. In the former group, there were 56 (6.7%) deaths and 29 (3.5%) unnecessary laparotomies, whereas in the latter NOM group, 82 (30.1%) patients were managed by serial clinical examination alone, whereas 190 (69.9%) patients underwent abdominal CT scanning, in addition to serial clinical examination. The overall NOM success rate was 95.2%. Of the 13 patients undergoing delayed laparotomy, there were 10 therapeutic, 2 nontherapeutic, and 1 negative laparotomy. CONCLUSIONS:The NOM of appropriately selected patients with AGSW with selective use of CT scanning is feasible, safe, and effective, but largely based on findings from serial clinical examinations.
journal_name
Ann Surgjournal_title
Annals of surgeryauthors
Navsaria PH,Nicol AJ,Edu S,Gandhi R,Ball CGdoi
10.1097/SLA.0000000000000879subject
Has Abstractpub_date
2015-04-01 00:00:00pages
760-4issue
4eissn
0003-4932issn
1528-1140journal_volume
261pub_type
临床试验,杂志文章abstract::The postoperative function of "free" jejunal autotransplants for replacement of the pharyngoesophagus after palliative resection was evaluated in nine patients using clinical assessment, cinefluoroscopy, manometry, and electrical studies. After an initial period of adjustment, all patients swallowed solids and liquids...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-198010000-00002
更新日期:1980-01-01 00:00:00
abstract::A series of patients showing a previously unrecognized type of sliding hiatus hernia is presented and analyzed. This type of hernia is characterized by reflux of the mucous membrane of the Hiss angle into the lumen of the esophagus. The occurrence of mucosal prolapse is a secondary phase of gastroesophageal reflux. Th...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-198508000-00004
更新日期:1985-08-01 00:00:00
abstract::Two experimental models were utilized to study the efficacy of intraperitoneal povidone-iodine in an established peritonitis. In both models, there was a 100% mortality in the povidone-iodine treated group. In laboratories which have reported favorable results, the animals were treated before peritonitis was allowed t...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-197806000-00005
更新日期:1978-06-01 00:00:00
abstract:OBJECTIVE:The authors assess the effect of surgical margin width on recurrence rates after intestinal resection of Crohn's Disease (CD). BACKGROUND:The optimal width of margins when resecting DC of the small bowel is controversial. Most studies have been retrospective and have had conflicting results. METHODS:Patient...
journal_title:Annals of surgery
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1097/00000658-199610000-00014
更新日期:1996-10-01 00:00:00
abstract::Twenty-seven patients with postoperative enterocutaneous fistulas were treated with parenteral nutrition and SMS 201-995 (100 micrograms/8 hours, subcutaneously), a long half-life somatostatin analogue. At the time SMS 201-995 was started, 11 patients had low output fistulas (less than 1000 ml/48 hours), 11 patients h...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-198907000-00009
更新日期:1989-07-01 00:00:00
abstract::The etiology of hepatic insufficiency associated with the multiple systems organ failure (MSOF) syndrome is unclear. The authors have investigated the possibility that a macrophage/Kupffer cell mediated modulation of hepatocyte function may play a role in this phenomenon. Isolated rat hepatocytes were cultured, and th...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:
更新日期:1985-01-01 00:00:00
abstract::Fifteen mini-pigs were bled to a mean aortic blood pressure of 40 mm Hg and maintained at that level for three hours. The control group consisted of eight animals with shock for three hours, while the test group was comprised of seven animals with a similar shock period but which had undergone splanchnicectomy 14 days...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-197712000-00019
更新日期:1977-12-01 00:00:00
abstract::From July 1983 through December 1987, 300 consecutive patients with penetrating gunshot wounds of the abdomen causing visceral or vascular injuries were treated. Resuscitative thoracotomy was required in 20 patients (6.6%), and only two survived. The most commonly injured organs were the small bowel (60%), colon (41.6...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-198809000-00014
更新日期:1988-09-01 00:00:00
abstract:OBJECTIVES:Surgical simulation has been shown to enhance the training of general surgery residents. Since catheter-based techniques have become an important part of the vascular surgeon's armamentarium, we explored whether simulation might impact the acquisition of catheter skills by surgical residents. METHODS:Twenty...
journal_title:Annals of surgery
pub_type: 杂志文章,随机对照试验
doi:10.1097/01.sla.0000234932.88487.75
更新日期:2006-09-01 00:00:00
abstract::An experience with 69 patients who underwent 72 common bile duct reoperations for retained or recurrent choledocholithiasis is presented. The mean age of the patients was 57 years, and 35 patients had associated conditions. In this series six patients (8.3%) had minor complications and no patient developed major compl...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-198102000-00004
更新日期:1981-02-01 00:00:00
abstract::This study sought to minimize juxta-anastomotic neointimal hyperplasia (JNIH) following the use of polytetrafluorethylene (PTFE) conduits. PTFE anastomoses to canine carotid arteries (noncuff grafts) were compared with grafts with vein cuffs interposed proximally and distally between the graft and native artery. This ...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-198806000-00011
更新日期:1988-06-01 00:00:00
abstract:OBJECTIVE:The objective of this pilot study was to investigate the potential for long-term overall survival (OS) after liver transplantation for colorectal liver metastases (CLMs). BACKGROUND:Patients with nonresectable CLMs have poor prognosis, and few survive beyond 5 years. CLMs are currently considered an absolute...
journal_title:Annals of surgery
pub_type: 临床试验,杂志文章
doi:10.1097/SLA.0b013e3182823957
更新日期:2013-05-01 00:00:00
abstract:BACKGROUND:EVAR for abdominal aortic aneurysm has an initial survival advantage over OR, but more frequent complications increase costs and long-term aneurysm-related mortality. Randomized controlled trials of EVAR versus OR have shown EVAR is not cost-effective over a patient's lifetime. However, in the EVAR-1 trial, ...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/SLA.0000000000003625
更新日期:2019-10-07 00:00:00
abstract::In a series of 112 patients who underwent reoperation for primary hyperparathyroidism at the Massachusetts General Hospital between 1930 and 1975, all but 10 were treated successfully. Seventy-five initial explorations had been performed elsewhere, and 37 in our hospital. A total of 110 diseased parathyroids were unco...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-197708000-00004
更新日期:1977-08-01 00:00:00
abstract:OBJECTIVE:To evaluate the short-term outcomes for laparoscopic Roux-en-Y gastric bypass in 275 patients with a follow-up of 1 to 31 months. SUMMARY BACKGROUND DATA:The Roux-en-Y gastric bypass is a highly successful approach to morbid obesity but results in significant perioperative complications. A laparoscopic appro...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-200010000-00007
更新日期:2000-10-01 00:00:00
abstract::Stress ulcer has become an important clinical entity and its two major complications--bleeding and perforation--are among the most baffling problems, in terms of management, in clinical practice. Perforation, though the less common of the two, is perhaps the most formidable particularly when this occurs in a very sick...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-197912000-00006
更新日期:1979-12-01 00:00:00
abstract:OBJECTIVE:To compare the outcomes of TransCarotid Artery Revascularization with flow reversal (TCAR) to the gold standard carotid endarterectomy (CEA) using data from the Society for Vascular Surgery Vascular Quality Initiative TCAR Surveillance Project. SUMMARY BACKGROUND DATA:TCAR is a novel minimally invasive proce...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/SLA.0000000000004496
更新日期:2020-09-15 00:00:00
abstract:OBJECTIVES:Although weight loss following Roux-en-Y gastric bypass is acceptable in patients with preoperative body mass index (BMI) between 35 and 50 kg/m, results from several series demonstrate that failure rates approach 40% when BMI is > or =50 kg/m. Here we report the first large single institution series directl...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/01.sla.0000239086.30518.2a
更新日期:2006-10-01 00:00:00
abstract:OBJECTIVE:Using a prospective randomized study to assess postoperative morbidity and pancreatic function after pancreaticoduodenectomy with pancreaticojejunostomy and duct occlusion without pancreaticojejunostomy. SUMMARY BACKGROUND DATA:Postoperative complications after pancreaticoduodenectomy are largely due to leak...
journal_title:Annals of surgery
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1097/00000658-200210000-00004
更新日期:2002-10-01 00:00:00
abstract::Transplantation of the intrathoracic inferior vena cava into the abdominal inferior vena cava of the recipient was performed in inbred rat strains of the following combinations: Syngeneic F344 leads to F344, RT-1-identical allogeneic LEW leads to F344, and RT-1-different allogeneic CAP leads to F344. In the RT-1-diffe...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-198103000-00006
更新日期:1981-03-01 00:00:00
abstract::Because of important differences in prognosis and treatment, prompt and accurate diagnosis of fever, decreasing function, and pain and tenderness around a renal allograft is crucial for differentiation between acute rejection and other post-operative conditions which may give a similar picture. Ultrasound examinations...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-197704000-00012
更新日期:1977-04-01 00:00:00
abstract::This study evaluated a possible protective and therapeutic effect of moderate hypothermia in the treatment of severe hemorrhagic shock. A modified Wiggers shock preparation was used. Normothermic dogs (Group I, N = 6) were maintained at normal body temperature throughout hemorrhagic shock and resuscitation. In Group I...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-198804000-00015
更新日期:1988-04-01 00:00:00
abstract::The role of the antrum on vagally mediated pancreatic secretion was studied in 8 conscious dogs prepared with chronic pancreatic and gastric fistulae. After completion of control studies 6 were subjected to antrectomy and 2 to antroneurolysis (to interrupt submucosal nerve connections); secretory studies were repeated...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-197603000-00005
更新日期:1976-03-01 00:00:00
abstract::Renal scintiphotography with (131)I-hippurate was the primary diagnostic procedure in evaluating renal failure and complications in over 500 transplant patients. This diagnostic test has become our principal method of evaluation and followup of renal transplants, especially in the early post-transplant period. It has ...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-197409000-00014
更新日期:1974-09-01 00:00:00
abstract::MINI: In cases of true short esophagus diagnosed intraoperatively with an endoscopic-laparoscopic method, Collis-Nissen and stomach around stomach fundoplication procedures achieved similar results. The notion that the gastric fundus must be wrapped around a conveniently long segment of the tubular esophagus to obtain...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/SLA.0000000000003582
更新日期:2019-09-03 00:00:00
abstract:OBJECTIVES:The authors determined the effect of complications on length of stay (LOS) in surgical patients. SETTING:From 1987 to 1990, in the Professional General Surgical Unit of Royal Victoria Hospital, a retrospective survey was conducted on 5128 consecutively admitted patients with 396 different diagnosis; 228 dif...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-199412000-00006
更新日期:1994-12-01 00:00:00
abstract::Midgestation fetal wound healing is characterized by healing without fibrosis or scar formation. The mechanisms that underlie this remarkable process are mediated in part through a fetal wound extracellular matrix rich in hyaluronic acid. In this study a newly developed assay was used to determine the hyaluronic acid ...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-199104000-00003
更新日期:1991-04-01 00:00:00
abstract::The understanding of the association of mammalian ovarian function with lactation was common knowledge to dairy-men early in the 19th century or earlier. This thesis reviews the application of these empiric observations to lactation in humans by Beatson of Glasgow, supported by his preliminary laboratory investigation...
journal_title:Annals of surgery
pub_type: 传,历史文章,杂志文章
doi:10.1097/00000658-197612000-00009
更新日期:1976-12-01 00:00:00
abstract:OBJECTIVE:We developed and validated a nomogram predicting the likelihood of occult lymph node metastases in surgically resectable esophageal cancers. BACKGROUND:Patients with esophageal cancer with positive lymph nodes benefit from neoadjuvant therapy, but limitations in current clinical staging techniques mean nodal...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/SLA.0000000000003450
更新日期:2019-07-03 00:00:00
abstract:OBJECTIVE:To evaluate the independent prognostic ability of the American Joint Committee on Cancer (AJCC) tumor regression scores within pathologic stage II and III rectal cancers. BACKGROUND:Response to neoadjuvant chemoradiation (nCRT) has been debated as a biologic surrogate for tumor biology and prognosis in recta...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/SLA.0000000000002719
更新日期:2019-06-01 00:00:00