Abstract:
BACKGROUND:The relationship between hospital volume and patient outcomes remains controversial for rectal cancer. METHODS:This is a population-based database study. Patients treated with surgery for a stage I to III rectal adenocarcinoma from 2003 to 2009 were identified. High-volume hospitals (HVH) were those centers performing 20 surgeries or more per year. Primary outcomes were operative and perioperative factors that have proven influence on patient outcomes. RESULTS:In all, 2,081 patients had surgery for rectal cancer. Of these, 1,690 patients had surgery in an HVH and 391 had surgery in a low-volume hospital. On multivariate analysis, patients who had surgery in an HVH were more likely to have sphincter-preserving surgery, 12 or more lymph nodes removed with the tumor, neoadjuvant radiation therapy, and receive pre-operative or postoperative chemotherapy. CONCLUSIONS:For rectal cancer patients in British Columbia, Canada, being treated at an HVH is associated with several quality indicators linked to better patient outcomes.
journal_name
Am J Surgjournal_title
American journal of surgeryauthors
McColl RJ,McGahan CE,Cai E,Olson R,Cheung WY,Raval MJ,Phang PT,Karimuddin AA,Brown CJdoi
10.1016/j.amjsurg.2016.07.007subject
Has Abstractpub_date
2017-02-01 00:00:00pages
388-394issue
2eissn
0002-9610issn
1879-1883pii
S0002-9610(16)30386-5journal_volume
213pub_type
杂志文章abstract:BACKGROUND:To improve surgical training standards, it is necessary to first define the elements of high-quality training and methods for measuring them. METHODS:Semistructured interviews were conducted with attending (n = 10) and resident (n = 10) general surgeons. An interview topic guide was used to elicit end users...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/j.amjsurg.2013.07.044
更新日期:2014-04-01 00:00:00
abstract:BACKGROUND:The role of laparoscopic surgery in the treatment of various upper and lower gastrointestinal disorders is still under investigation. However, a variety of laparoscopic procedures may be applied in the treatment of inflammatory bowel disease (IBD). PATIENTS AND METHODS:We present our initial results of lapa...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/s0002-9610(99)80072-5
更新日期:1996-01-01 00:00:00
abstract:BACKGROUND:Infection remains a major contributor to morbidity and mortality following orthotopic liver transplantation (OLT). Selective bowel decontamination (SBD) in hospitalized patients is one strategy for prophylaxis. METHODS:A retrospective case-control study was performed using 18 consecutive hospitalized patien...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/s0002-9610(97)00185-2
更新日期:1997-12-01 00:00:00
abstract:BACKGROUND:We surveyed surgeons to document their attitudes, practice, and risk tolerance regarding the treatment of appendicitis. METHODS:A web-based survey was sent to the EAST membership. The primary composite endpoint was defined as 1-year incidence of perioperative complications, antibiotic failure, infections, E...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/j.amjsurg.2018.08.019
更新日期:2019-07-01 00:00:00
abstract::Adult male rats underwent common bile duct ligation or sham celiotomy. At intervals of 7 and 14 days postoperatively, bacteremia was induced by intravenous injection of 10(9) Escherichia coli or intraperitoneal injection of 10(6) E. coli. Serial quantitative blood cultures and quantitative whole organ cultures were ob...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/0002-9610(89)90530-8
更新日期:1989-02-01 00:00:00
abstract:BACKGROUND:To analyze our experience with laparoscopic right Mesocolectomy in right colonic cancers. METHODS:600 consecutive patients were studied. RESULTS:Mortality was 0.5%; morbidity was 35.5%. Mean mesocolic area was 15339 ± 1639 mm3, specimen length 24.3 ± 3.3 cm, distance from the tumor to high tie was 103 ± 6 ...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/j.amjsurg.2016.10.005
更新日期:2017-08-01 00:00:00
abstract::Four hundred seventy-eight patients with hand burns (786 hands) were treated at the burn service of the Massachusetts General Hospital. Long-term evaluation showed that early incision and immediate autografting of deep second degree, mixed second and third degree, and third degree full-thickness hand burns resulted in...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/s0002-9610(85)80049-0
更新日期:1985-04-01 00:00:00
abstract::The effect of preoperative irradiation on the healing of low colorectal anastomoses was studied experimentally. In 12 dogs in whom preoperative irradiation of 4,000 rads was given before low colorectal stapled anastomosis was performed, anastomotic leakage occurred in 66 percent. More than half of the anastomotic leak...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/0002-9610(84)90099-0
更新日期:1984-02-01 00:00:00
abstract:BACKGROUND:Current standard of care dictates that central venous catheter (CVC) insertion should be followed by an immediate chest radiograph to confirm appropriate position and rule out complications. We hypothesized that a subset of monitored intensive care unit patients exists that is at low risk for complications a...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/s0002-9610(00)00498-0
更新日期:2000-12-01 00:00:00
abstract:BACKGROUND:Primary laparoscopic repair of unilateral inguinal hernias has not achieved widespread recognition mainly because of concerns over safety. METHODS:Prospective cohort study using the American College of Surgeons National Surgery Quality Improvement Program between 2005 and 2010. Complications in patients und...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/j.amjsurg.2013.10.017
更新日期:2014-08-01 00:00:00
abstract:BACKGROUND:We evaluated the safety and efficacy of angioembolization to control lower gastrointestinal hemorrhage. METHODS:Retrospective chart review of patients undergoing angiography for lower gastrointestinal hemorrhage from January 2000 to December 2002. RESULTS:Seventy-seven patients with lower gastrointestinal ...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/j.amjsurg.2004.11.024
更新日期:2005-03-01 00:00:00
abstract::Three distinct forms of postoperative breakdown after Nissen fundoplication have been discussed. Disruption and recurrent reflux is most common, with slipping occurring infrequently. For the first time, three patients developing a proximal gastric pouch deformity causing partial obstruction of the fundus without recur...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/0002-9610(77)90278-1
更新日期:1977-07-01 00:00:00
abstract::A 54-year-old man on palliative treatment for disseminated cutaneous malignant melanoma presented with abdominal pain and abdominal distention. A computed tomography scan showed an area in the distal ileum suggesting intussusceptions. In an exploratory laparotomy, a 10-cm mass was found comprised of the distal ileum t...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/j.amjsurg.2008.09.018
更新日期:2009-07-01 00:00:00
abstract::When dense hemiparesis has developed appropriate to the operated vessel after carotid surgery, the patient has been immediately returned to the operating room for reexploration of the vessel and thrombectomy. Over a 5-year period, we identified four patients who developed dense hemiparesis in the recovery room postope...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/s0002-9610(05)81262-0
更新日期:1990-05-01 00:00:00
abstract::Pulmonary metastases are the primary cause of death due to bone and soft tissue sarcomas. We have previously shown that an aggressive approach and a new technique of multiple pulmonary metastasectomies have resulted in improved survival for patients with pulmonary metastases. In this follow-up study, an expanded datab...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/s0002-9610(05)81150-x
更新日期:1993-11-01 00:00:00
abstract::In an effort to assess the impact of enhanced macrophage function in acute pancreatitis, mice were subjected to a choline-deficient diet supplemented by ethionine to induce necrotizing pancreatitis. Treatment with the macrophage stimulant glucan resulted in improved survival rates (58 percent versus 14 percent) and ma...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/0002-9610(87)90197-8
更新日期:1987-01-01 00:00:00
abstract::Various reports have demonstrated that the intraoperative utilization of the choledochoscope has significantly reduced the incidence of unsuspected retained common duct stones from approximately 10 percent to 0 to 2 percent. Our series revealed a 4 percent incidence of retained stones before choledochoscopy was utiliz...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/0002-9610(83)90406-3
更新日期:1983-09-01 00:00:00
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 pa...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/j.amjsurg.2012.05.030
更新日期:2012-12-01 00:00:00
abstract:BACKGROUND:This study explores assistance-seeking and reporting behaviors in surgical residents faced with stressful circumstances. METHODS:Three surgical societies distributed a multiple choice, free-text response survey to residents. RESULTS:One hundred sixty-four residents (39% male) responded; 58% of women (43% m...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/j.amjsurg.2015.05.011
更新日期:2015-10-01 00:00:00
abstract::Thirteen published series concerning laparoscopic cholecystectomy performed in the United States were reviewed. The review was based on reports that included at least 100 patients. Three of the series are surveys of surgery chairpersons and multiple hospitals. The other 10 series are based on the experience of the inv...
journal_title:American journal of surgery
pub_type: 杂志文章,评审
doi:10.1016/s0002-9610(05)80939-0
更新日期:1993-04-01 00:00:00
abstract:BACKGROUND:Surgical coaching, with the goal of improving operative performance, has been introduced into residency and fellowship programs. This is the first systematic review on surgical coaching limited to randomized controlled trials. The objective of this review is to synthesize the existing evidence that addresses...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/j.amjsurg.2017.05.003
更新日期:2018-07-01 00:00:00
abstract:BACKGROUND:Breast cancer in a young person is considered by many to be a rare and very aggressive disease. Theories regarding the aggressiveness of the disease are varied. This study was undertaken in an attempt to help formulate guidelines regarding screening for and treatment of breast cancer in the young patient. P...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/s0002-9610(05)80007-8
更新日期:1995-09-01 00:00:00
abstract:BACKGROUND:Two decades since the advent of laparoscopic cholecystectomy, the rate of bile duct injuries still remains higher than in the open cholecystectomy era. METHODS:The rate and complexity of bile duct injuries was evaluated in 83,449 patients who underwent laparoscopic cholecystectomy between 1995 and 2008 in t...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/j.amjsurg.2011.08.018
更新日期:2012-04-01 00:00:00
abstract:BACKGROUND:We hypothesized that mandatory multidisciplinary team (MDT) participation improves process evaluation, outcomes, and technical aspects of surgery for rectal cancer in a stable practice of colorectal surgery. METHODS:A retrospective review of MDT data was conducted of all patients with colorectal cancer sinc...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/j.amjsurg.2015.08.015
更新日期:2016-01-01 00:00:00
abstract::A biochemical analysis of mitochondrial metabolism was made on biopsy specimens of fifteen jaundiced patients. In all but three jaundiced patients the phosphorylative activity based on mitochondrial protein was within normal limits or higher. In nine jaundiced patients the concentrations of cytochrome a(+a3), as repre...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/0002-9610(77)90534-7
更新日期:1977-03-01 00:00:00
abstract:BACKGROUND:This meta-analysis was performed to determine the degree to which improvements in open hernia repair (OHR) in the last decade have altered the relative benefit of laparoscopic hernia repair (LHR). METHODS:Twenty-seven comparative trials including 4,688 randomized patients were evaluated. RESULTS:Within the...
journal_title:American journal of surgery
pub_type: 杂志文章,meta分析
doi:10.1016/s0002-9610(02)00878-4
更新日期:2002-07-01 00:00:00
abstract:BACKGROUND:An assessment was made of the change and the effect of a histamine H(2)-receptor blocker (H(2)-blocker) or omeprazole on gastric pH after surgery. METHODS:Eighty patients who underwent colon resection for colorectal cancer were divided into groups of 20. Group I received neither H(2)-blocker nor omeprazole....
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/j.amjsurg.2002.10.002
更新日期:2004-01-01 00:00:00
abstract:BACKGROUND:Burnout affects surgical residents' well-being. OBJECTIVE:We sought to identify factors associated with burnout among surgery residents. METHODS:An electronic/anonymous survey was sent to surgical residents at 18 programs, consisting of demographic/programmatic questions and validated scales for burnout, d...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/j.amjsurg.2019.07.004
更新日期:2020-06-01 00:00:00
abstract::A technique is described for salvage of looped forearm polytetrafluoroethylene (PTFE) vascular access grafts that fail because of thrombosis due to cephalic vein outflow obstruction. It entails reversal of blood flow direction through the graft and construction of a new venous outflow in the medial upper arm. This pro...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/0002-9610(91)91119-4
更新日期:1991-04-01 00:00:00
abstract::Infections that involve the attention of the surgeon include those that require operations for cure as well as those that complicate emergency and elective surgical procedures. Mechanical correction is of paramount importance in the eradication of such infections with antibiotics serving an adjuvant role, primarily to...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/s0002-9610(06)80057-7
更新日期:1992-10-01 00:00:00