Abstract：
BACKGROUND:Pediatric umbilical hernia repair is a common procedure that requires minimal tissue disruption. We examined variation in opioid prescription fills after repair of uncomplicated umbilical hernias to characterize the types and doses of medication used and persistent postsurgical use. METHODS:Using the Truven Health Analytics MarketScan© Research Database for June 2012-September 2015, we identified pediatric patients undergoing umbilical hernia repair. We excluded patients with obstruction, gangrene, an earlier repair or a concurrent surgical procedure, and those without available pharmacy claim data. Analyses describe filled outpatient prescriptions by age, geographic region, drug type, quantity, and second prescriptions/refills. RESULTS:Of 4,407 procedures performed, 2,292 patients (52%) filled a prescription for postoperative opioids (age 0-1 years: 21.6%, age 2-3 years: 51.5%, age 4-5 years: 54.3%, 6 years or older: 57.9% [P < .0001]). In the northeast United States, 42% of patients filled narcotic prescriptions, compared with 59% of patients in the south (P < .0001). Hydrocodone/acetaminophen was most commonly prescribed (51%), followed by codeine/acetaminophen (30%). Durations were ≤3 days (50%), 4-10 days (46%), and >10 days (4%). A total of 6% of patients filled a second opioid prescription within 30 days. CONCLUSION:Although many patients do not require opioids for umbilical hernia repair, most pediatric patients fill opioid prescriptions, including for prolonged courses and refills. Guidelines for appropriate prescribing of opioids after common, simple procedures, such as umbilical hernia repair, could improve the quality of care for children and impact the US epidemic of opioid abuse.
journal_name
Surgeryjournal_title
Surgeryauthors
Cartmill RS,Yang DY,Fernandes-Taylor S,Kohler JEdoi
10.1016/j.surg.2018.10.029subject
Has Abstractpub_date
2019-04-01 00:00:00pages
838-842issue
4eissn
0039-6060issn
1532-7361pii
S0039-6060(18)30745-1journal_volume
165pub_type
杂志文章相关文献
SURGERY文献大全abstract：BACKGROUND:Surgery for pancreatic necrosis is associated with a high morbidity and mortality. The aim of this study was to review the incidence of early and late complications after pancreatic necrosectomy in a large contemporary series of patients. METHODS:The clinical outcomes of 88 patients who underwent pancreatic...
journal_title：Surgery
pub_type： 杂志文章
doi：10.1016/j.surg.2005.01.003
更新日期：2005-05-01 00:00:00
abstract：BACKGROUND:The long-term consequences of in-hospital complications remain largely unknown. We sought to study the effect of complications on the long-term functional outcome of trauma patients. METHODS:Patients with an Injury Severity Score ≥ 9 admitted to 3, level I trauma centers between 2015 and 2017 were contacted...
journal_title：Surgery
pub_type： 杂志文章,多中心研究
doi：10.1016/j.surg.2019.04.026
更新日期：2019-09-01 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:Small intestinal submucosa (SIS) represents a novel bio-scaffolding material that may be used to repair hollow-organ defects. However, it is unclear whether neurophysiologic responses return to SIS-grafted areas in the gut. We evaluated the functional recovery of a stomach defect grafted with the porcine-der...
journal_title：Surgery
pub_type： 杂志文章
doi：10.1016/j.surg.2007.04.019
更新日期：2007-09-01 00:00:00
abstract：BACKGROUND:Failure to achieve primary fascial closure (PFC) after damage control laparotomy is costly and carries great morbidity. We hypothesized that time from the initial laparotomy to the first take-back operation would be predictive of successful PFC. METHODS:Trauma patients managed with open abdominal techniques...
journal_title：Surgery
pub_type： 临床试验,杂志文章,多中心研究
doi：10.1016/j.surg.2014.04.019
更新日期：2014-08-01 00:00:00
abstract：:A prospective study to evaluate the accuracy of early diagnosis and the efficacy of early operation for biliary tract stone disease was performed. One hundred fifty-two consecutive patients with signs and symptoms compatible with biliary colic or acute cholecystitis were admitted to the hospital and promptly evaluated...
journal_title：Surgery
pub_type： 杂志文章
doi：
更新日期：1983-10-01 00:00:00
abstract：:Solid tumors constantly require a vascular supply for their progression and metastasis. Hepatocellular carcinoma (HCC) is known to gain its hypervascularity during the process of dedifferentiation and progression. Various angiogenic growth factors and inhibitors regulate this angiogenic switch of HCC. The known endoth...
journal_title：Surgery
pub_type： 杂志文章,评审
doi：10.1067/msy.2002.119365
更新日期：2002-01-01 00:00:00
abstract：:A long-acting somatostatin analog, SMS 201-995, is now available to treat the hormonal manifestations of islet cell tumors. We report its use in a patient with a metastatic glucagonoma refractory to conventional therapy. This patient, who was severely disabled by the rash of necrolytic migratory erythema and brittle d...
journal_title：Surgery
pub_type： 杂志文章
doi：
更新日期：1986-12-01 00:00:00
abstract：BACKGROUND:Complex anal fistulas are unsuitable for fistulotomy because of the risk of fecal incontinence. The anal fistula plug (AFP) has demonstrated fistula healing without sphincter division. This study aims to evaluate the cost-effectiveness of the AFP compared to the endoanal advancement flap (EAAF) as an alterna...
journal_title：Surgery
pub_type： 杂志文章
doi：10.1016/j.surg.2009.05.018
更新日期：2010-01-01 00:00:00
abstract：BACKGROUND:Posttransplantation diabetes mellitus (PTDM), a common complication of current immunosuppressive regimens, has been attributed to the diabetogenic effects of prednisone and cyclosporine. We report our experience with steroid withdrawal (SW) in renal allograft recipients with PTDM. METHODS:SW was attempted o...
journal_title：Surgery
pub_type： 杂志文章
doi：
更新日期：1994-10-01 00:00:00
abstract：:We prospectively sampled 38 large soft tissue masses in 37 patients with both core needle biopsy (CNBX) and fine-needle aspiration (FNA) to determine the diagnostic utility of these biopsy methods. In 27 cases the histologic diagnosis made from the resected specimen was compared with the diagnosis based on the biopsy....
journal_title：Surgery
pub_type： 杂志文章
doi：
更新日期：1992-09-01 00:00:00
abstract：BACKGROUND:The risk of dying from primary hyperparathyroidism (pHPT) is controversial and has been explored mainly in single parathyroid gland disease. The present study investigates mortality in pHPT due to multiple parathyroid gland disease. METHODS:We used the nationwide Swedish In-patient Register and Cause-of-Dea...
journal_title：Surgery
pub_type： 杂志文章,多中心研究
doi：10.1016/j.surg.2004.05.044
更新日期：2004-11-01 00:00:00
abstract：BACKGROUND:The aim of this study was to assess validity of a human factors error assessment method for evaluating resident performance during a simulated operative procedure. METHODS:Seven postgraduate year 4-5 residents had 30 minutes to complete a simulated laparoscopic ventral hernia (LVH) repair on day 1 of a nati...
journal_title：Surgery
pub_type： 杂志文章
doi：10.1016/j.surg.2015.04.010
更新日期：2015-11-01 00:00:00
abstract：:Aspiration devices can persistently malfunction if moderate (not just high) suction causes mucosal occlusion of every opening. The standard pattern of uniformly large orifices was modified by supplementing half the nasal tubes with smaller (one tenth of the area) openings. Ten pairs of postoperative patients sipped wa...
journal_title：Surgery
pub_type： 杂志文章
doi：
更新日期：1992-07-01 00:00:00
abstract：:This is a report of a patient with a thrombosed Warren shunt and recurrent variceal hemorrhage who demonstrated compartmentalized venous hypertension in the mesenteric and gastrosplenic systems. Although the mesenteric presssure was normalized by the construction of a mesocaval interposition shunt, the gastrosplenic v...
journal_title：Surgery
pub_type： 杂志文章
doi：
更新日期：1979-05-01 00:00:00
abstract：BACKGROUND:Reoperative neck exploration for hyperparathyroidism is often difficult even for experienced surgeons. Recent advances in preoperative and intraoperative localization techniques have improved successful resection rates. This prospective study evaluates the accuracy and clinical utility of intraoperative tech...
journal_title：Surgery
pub_type： 临床试验,杂志文章
doi：10.1067/msy.2000.109533
更新日期：2000-10-01 00:00:00
abstract：:The purpose of this study was to develop a method that would provide baseline data for the ongoing assessment of surgical clerkships at The University of Michigan Medical School. Of specific concern was the comparability of clerkship experiences among five different sites and the degree of variability in student exper...
journal_title：Surgery
pub_type： 杂志文章
doi：
更新日期：1982-06-01 00:00:00
abstract：:With an ex vivo, isolated, ventilated, perfused canine pulmonary lobe, the effects of various levels of positive end-expiratory pressure (PEEP) were evaluated following acid injury. Following intrabronchial instillation of hydrochloric acid, eight lobes were ventilated with 5 cm of H2O of PEEP, 12 lobes with 10 cm of ...
journal_title：Surgery
pub_type： 杂志文章
doi：
更新日期：1977-08-01 00:00:00
abstract：CONTEXT:The rate and the extent of bone remineralization at cancellous versus cortical sites after treatment of hyperthyroidism is unclear. Few studies have examined the effect of operative management of hyperthyroidism on recovery of bone mass. OBJECTIVE:To evaluate prospectively the bone mineral density (BMD), bone ...
journal_title：Surgery
pub_type： 杂志文章
doi：10.1016/j.surg.2015.10.002
更新日期：2016-03-01 00:00:00
abstract：:Teratomas were observed in 85 infants and children. Fifty-eight (68%) were girls and 27 (32%) boys. Site of origin was sacrococcygeal in 55 patients (64.8%), mediastinal in ten (11.7%), gonadal in ten (11.7%), presacral in four (4.8%), retroperitoneal in three (3.5%), and cervical in three (3.5%). Sixty-seven (78.8%) ...
journal_title：Surgery
pub_type： 杂志文章
doi：
更新日期：1976-09-01 00:00:00
abstract：BACKGROUND:The objective of the current study was to define the incidence, as well as time course of mortality within the first year after liver transplantation. METHODS:Data on adult, first-time liver transplant recipients transplanted between February 2002 and June 2016 were obtained from the United Network for Orga...
journal_title：Surgery
pub_type： 杂志文章
doi：10.1016/j.surg.2018.04.039
更新日期：2018-10-01 00:00:00
abstract：:To reevaluate the validity of our policy of mandatory surgical exploration of penetrating zone II neck injuries, the charts of 110 patients who underwent surgical exploration for such injuries were reviewed. Fifty-three percent of the patients had normal findings at exploration, whereas 33% had injuries involving vasc...
journal_title：Surgery
pub_type： 杂志文章
doi：
更新日期：1986-10-01 00:00:00
abstract：BACKGROUND:The aim of this prospective study was to elucidate the features, indications, and surgical treatment in patients affected by complications of Crohn's disease. METHODS:Between January 1985 and July 1996, 513 consecutive patients (248 male, 265 female; mean age, 38 years) were operated on for 542 occurrences ...
journal_title：Surgery
pub_type： 杂志文章
doi：10.1016/s0039-6060(97)90071-4
更新日期：1997-10-01 00:00:00
abstract：BACKGROUND:The management of large thyroid nodules remains unclear. Ultrasonography is a central tool in the assessment of thyroid nodules, yet its role in risk stratification of large thyroid nodules has been studied only seldomly. OBJECTIVE:The aim of this study was to determine the utility of ultrasonography in cha...
journal_title：Surgery
pub_type： 杂志文章
doi：10.1016/j.surg.2019.06.011
更新日期：2019-12-01 00:00:00
abstract：BACKGROUND:Prolonged warm ischemic injury in non-heart-beating donors (NHBDs) significantly affects hepatic allograft function after liver transplantation (LTx). METHODS:The effects of FK506 and the platelet activating factor antagonist E5880 on postoperative function of hepatic allografts procured from NHBDs were eva...
journal_title：Surgery
pub_type： 杂志文章
doi：
更新日期：1998-06-01 00:00:00
abstract：BACKGROUND:After resection of advanced abdominal neuroblastoma, children may have persistent postoperative diarrhea. Until recently, the magnitude of this problem had not been appreciated. METHODS:To assess the incidence, severity, and management of chronic postoperative diarrhea in these patients, we reviewed the cas...
journal_title：Surgery
pub_type： 杂志文章
doi：10.1067/msy.1998.88092
更新日期：1998-05-01 00:00:00
abstract：BACKGROUND:Hypoparathyroidism after cervical exploration is a rare but problematic complication. Cryopreservation and subsequent autotransplantation of parathyroid tissue are infrequently used to combat this problem; effective usage of this surgical adjunct remains variable. METHODS:From 1981 through 1995 we performed...
journal_title：Surgery
pub_type： 杂志文章
doi：10.1016/s0039-6060(97)90209-9
更新日期：1997-12-01 00:00:00
abstract：BACKGROUND:We report pharmacokinetic (PK) data, evaluation of modifications for increased stability, evaluation for cellular uptake, and mediation of regression of breast cancer for the aptamer OPN-R3. METHODS:The OPN-R3 aptamer was assessed for PK data in vivo with additional comparison of IV and subcutaneous dosing....
journal_title：Surgery
pub_type： 杂志文章
doi：10.1016/j.surg.2011.05.015
更新日期：2011-08-01 00:00:00
abstract：BACKGROUND:T cells that receive T-cell antigen receptor signals but do not undergo mitosis become unresponsive to subsequent antigenic stimulation. This can be achieved by antigen presentation to T cells in the absence of critical costimulatory signals from antigen-presenting cells (APC) or in the presence of the antip...
journal_title：Surgery
pub_type： 杂志文章
doi：
更新日期：1994-08-01 00:00:00
abstract：BACKGROUND:Glucagon-like peptide-2 induces small intestine mucosal epithelial cell proliferation and may have benefit for patients who suffer from short bowel syndrome. However, glucagon-like peptide-2 is inactivated rapidly in vivo by dipeptidyl peptidase IV. Therefore, we hypothesized that selectively inhibiting dipe...
journal_title：Surgery
pub_type： 杂志文章
doi：10.1016/j.surg.2011.05.013
更新日期：2011-08-01 00:00:00
