Abstract:
BACKGROUND:To determine the characteristics associated with improved accuracy or reliability of estimating operative blood loss. METHODS:Operating room personnel at a tertiary care hospital evaluated 3 operative simulations and provided estimations of blood loss. The simulations utilized precise, known volumes of porcine blood and saline on tapes, sponges, and in suction containers. Low volume (50 mL), mid volume (300 mL), and high volume (900 mL) blood loss scenarios were used in this simulation. Information collected included the blood loss estimation, the participant's occupation, years of experience in the operating room, confidence level in estimating blood loss, and their opinion as to which group would provide the most accurate estimation. RESULTS:Sixty practitioners participated: 17 anesthesia providers, 22 surgeons, and 21 nurses and technicians. Overall, estimations were significantly inaccurate: scenario 1, mean error 52%; scenario 2, mean error 61%; scenario 3, mean error 85%. Ninety-five percent of participants provided estimations that had >25% error in at least 1 scenario. Only 27% demonstrated consistency in over or under-estimating the blood loss. There was no association between specialty, years of experience, or confidence in ability with consistency or accuracy of estimating blood loss. CONCLUSION:This study demonstrates that visual estimation of operative blood loss is unreliable and inaccurate. No provider specialty, level of experience, or self-assessment of ability was associated with improved estimation. Blood loss estimations are not a reliable metric to judge physician performance or patient outcomes. Consideration should be given to alternative reporting of operative blood loss to better direct perioperative care.
journal_name
Surgeryjournal_title
Surgeryauthors
Rothermel LD,Lipman JMdoi
10.1016/j.surg.2016.06.006subject
Has Abstractpub_date
2016-10-01 00:00:00pages
946-953issue
4eissn
0039-6060issn
1532-7361pii
S0039-6060(16)30232-Xjournal_volume
160pub_type
杂志文章相关文献
SURGERY文献大全abstract:BACKGROUND:The objective of this study was to examine the clinicopathologic characteristics of solid pseudopapillary tumors (SPTs) of the pancreas, including the risk factors for disease recurrence and their effects on survival. METHODS:The medical records of 114 patients who underwent surgery for a pathologically con...
journal_title:Surgery
pub_type: 杂志文章
doi:10.1016/j.surg.2010.11.005
更新日期:2011-05-01 00:00:00
abstract:BACKGROUND:Recent interest in cyst fluid analysis (CFA) for carbohydrate antigen 19-9 (CA 19-9) and carcinoembryonic antigen (CEA), and the introduction of laparoscopic surgery (LS) in the management of hepatic cysts have resulted in sporadic reports of elevated CA 19-9 and CEA levels in intrahepatic biliary cystadenom...
journal_title:Surgery
pub_type: 杂志文章
doi:10.1016/j.surg.2004.06.031
更新日期:2004-10-01 00:00:00
abstract:BACKGROUND:Estimating the risk of postoperative complications can be performed by surgeons with detailed clinical information or by patients with limited information. Our objective was to compare three estimation models: (1) the All Information Model, using variables available from the American College of Surgeons Nati...
journal_title:Surgery
pub_type: 杂志文章
doi:10.1016/j.surg.2014.03.002
更新日期:2014-07-01 00:00:00
abstract::In this study we describe the investigation and treatment of 14 patients with primary hepatocellular carcinoma. Patients were treated with intra-arterial infusion of iodized oil and doxorubicin hydrochloride. Five of these patients were alive after 1 year. Twelve patients showed a fall in alpha-fetoprotein, and in sev...
journal_title:Surgery
pub_type: 杂志文章
doi:
更新日期:1991-06-01 00:00:00
abstract::Abdominal aortic reconstruction was successfully performed in three kidney transplant patients without the use of any specific measures to protect the kidney transplant during aortic cross-clamping. The cases are discussed in relation to previously published case reports describing various surgical techniques to prote...
journal_title:Surgery
pub_type: 杂志文章
doi:
更新日期:1989-07-01 00:00:00
abstract:BACKGROUND:Although task training on virtual reality (VR) simulators has been shown to transfer to the operating room, to date no VR curricula have been described for advanced laparoscopic procedures. The purpose of this study was to develop a proficiency-based VR technical skills curriculum for laparoscopic colorectal...
journal_title:Surgery
pub_type: 杂志文章
doi:10.1016/j.surg.2011.08.005
更新日期:2012-03-01 00:00:00
abstract:BACKGROUND:Physical and psychosocial morbidity of multiple endocrine neoplasia type-1 is ill-defined. How disease and treatment-related factors relate to patient-reported outcomes including health-related quality of life is unknown. We hypothesized that disease and treatment burden negatively impacts health-related qua...
journal_title:Surgery
pub_type: 杂志文章
doi:10.1016/j.surg.2017.07.023
更新日期:2017-12-01 00:00:00
abstract:BACKGROUND:Chronic pancreatitis remains a challenging inflammatory disease, causing progressive, irreversible fibrosis of the pancreatic parenchyma. Several surgical options for treatment have been established, but duodenum-preserving pancreatic head resections seem to be the most favorable option other than pancreatod...
journal_title:Surgery
pub_type: 杂志文章
doi:10.1016/j.surg.2018.11.009
更新日期:2019-05-01 00:00:00
abstract:BACKGROUND:Tumor-associated lymphatic networks are the primary routes for tumor cell dissemination and metastasis. Behind the background of possible lymphangiogenesis-associated therapies, the clinical impact of lymphangiogenesis (measured by lymphatic microvessel density [LMVD]) and specific lymphovascular invasion (L...
journal_title:Surgery
pub_type: 杂志文章
doi:10.1016/j.surg.2012.10.007
更新日期:2013-04-01 00:00:00
abstract:BACKGROUND:There are few population-based studies addressing the survival after resection for esophageal cancer. This study represents an update of a nationwide Swedish cohort initiated in 1987. METHODS:Based on data from the Swedish Patient Register, Swedish Cancer Register, and histopathologic records, 1,008 patient...
journal_title:Surgery
pub_type: 杂志文章
doi:10.1016/j.surg.2012.03.025
更新日期:2012-11-01 00:00:00
abstract:BACKGROUND:Intraoperative parathyroid hormone (IOPTH) monitoring in parathyroidectomy for multigland disease is less clear than for single-gland disease. This study assesses the role of IOPTH for hyperplasia. METHODS:A prospective database revealed 45 patients with hyperplasia undergoing parathyroidectomy utilizing IO...
journal_title:Surgery
pub_type: 杂志文章
doi:10.1016/j.surg.2004.05.060
更新日期:2004-12-01 00:00:00
abstract::From 1951 through 1975, 72 patients with congenital intrinsic duodenal obstruction were seen at the Childrens Hospital of Los Angeles. The survival rate was 55% during the first 15 years of the study, but this has increased to 88% during the last 10 years. Factors important to this increased survival rate include: ear...
journal_title:Surgery
pub_type: 杂志文章
doi:
更新日期:1977-11-01 00:00:00
abstract::An expandable intraluminal graft mounted coaxially over an angioplasty balloon catheter was used in dog arteries. The graft, a wire mesh tube that has the ability to retain its expanded shape, opposes elastic recoil of the arterial wall after maximum balloon inflation. Eighteen grafts were placed in the abdominal aort...
journal_title:Surgery
pub_type: 杂志文章
doi:
更新日期:1986-02-01 00:00:00
abstract:BACKGROUND:This study was conducted to evaluate the effects of tumor removal and body weight loss on insulin resistance. METHODS:Insulin sensitivity was examined in 12 patients with cancer and stable weight and five patients with cancer and weight loss before operation, six patients after complete tumor removal, and t...
journal_title:Surgery
pub_type: 杂志文章
doi:
更新日期:1994-07-01 00:00:00
abstract::A 30-channel pulsed Doppler vessel imaging system (MAVIS, GEC Medical, Middlesex, England), was used to obtain images and maximal Doppler velocity time waveforms in the diagnosis of stenosis of the origin of the profunda femoris artery (PFA) and in the detection of structural changes within Dacron arterial grafts. In ...
journal_title:Surgery
pub_type: 杂志文章
doi:
更新日期:1979-12-01 00:00:00
abstract:BACKGROUND:We have demonstrated that gastrin-releasing peptide (GRP) binds specifically to its cell surface receptor, GRP-R, to act as an autocrine/paracrine growth factor for neuroblastomas (NBs); an increased expression of GRP-R was found in more advanced-stage NBs. Ets family proteins are nuclear targets for intrace...
journal_title:Surgery
pub_type: 杂志文章
doi:10.1016/j.surg.2004.05.030
更新日期:2004-08-01 00:00:00
abstract::There is a growing interest in using machine learning algorithms to support surgical care, diagnostics, and public health surveillance in low- and middle-income countries. From our own experience and the literature, we share several lessons for developing such models in settings where the data necessary for algorithm ...
journal_title:Surgery
pub_type: 杂志文章
doi:10.1016/j.surg.2020.11.043
更新日期:2021-01-04 00:00:00
abstract:BACKGROUND:Adenosine released by cells during ischemia typically serves as a feedback inhibitor of further organ work. However, in ischemic intestine, adenosine appears to act via stimulatory A2b receptors to increase work in the form of chloride ion (Cl-) secretion. This unusual response may contribute to luminal flui...
journal_title:Surgery
pub_type: 杂志文章
doi:10.1016/s0039-6060(96)80295-9
更新日期:1996-08-01 00:00:00
abstract::In pigs subtotal ischemic liver cell necrosis was induced 4 days after auxiliary transplantation of 60% of the liver of an MLC-compatible donor (ATPL group, n = 13). In control animals (n = 14) temporary liver ischemia was preceded by division of the hepatic ligaments and creation of an end-to-side portacaval shunt. I...
journal_title:Surgery
pub_type: 杂志文章
doi:
更新日期:1985-11-01 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::Because high calcium concentration in vitro stimulates muscle proteolysis, calcium has been implicated in the pathogenesis of increased muscle breakdown in different catabolic conditions. Protein breakdown in skeletal muscle is increased during sepsis, but the effect of sepsis on muscle calcium uptake and content is n...
journal_title:Surgery
pub_type: 杂志文章
doi:
更新日期:1989-07-01 00:00:00
abstract::Accuracy and clinical applications of noninvasive imaging of the extracranial carotid arteries were compared using pulsed Doppler and real-time B-mode ultrasonography. During the period December, 1977, to February, 1979, 530 ultrasonograms (265 patients) were performed. Angiographic correlations were available in 90 p...
journal_title:Surgery
pub_type: 杂志文章
doi:
更新日期:1980-03-01 00:00:00
abstract::A 5 MHz continuous-wave Doppler probe was used intraoperatively to evaluate 25 in situ saphenous vein bypass grafts. At least one arteriovenous fistula per case and five retained competent posterior valvular leaflets were identified before completion angiography. The Doppler was able to distinguish a retained valve fr...
journal_title:Surgery
pub_type: 杂志文章
doi:
更新日期:1984-11-01 00:00:00
abstract:BACKGROUND:Thermal ablation by radiofrequency or laser is used increasingly for the treatment of colorectal liver metastases. Recurrence after thermal ablation is common and occurs both locally and at distant sites. One possible cause of this recurrence may be a result of growth stimulation of micrometastases in the re...
journal_title:Surgery
pub_type: 杂志文章
doi:10.1016/j.surg.2005.07.030
更新日期:2006-01-01 00:00:00
abstract:BACKGROUND:Adhesions to polypropylene mesh used for abdominal wall hernia repair may eventuate in intestinal obstruction or enterocutaneous fistula. A Seprafilm Bioresorbable Membrane translucent adhesion barrier has been shown to inhibit adhesions. This investigation was designed to determine if Seprafilm alters abdom...
journal_title:Surgery
pub_type: 杂志文章
doi:10.1067/msy.2000.106810
更新日期:2000-07-01 00:00:00
abstract:BACKGROUND:The present study evaluates 111In-pentetreotide scanning as a method for detection of gastrinomas. Operative findings serve as the benchmark for comparison of the efficacy of 111In-pentetreotide versus conventional imaging studies. METHODS:Twelve patients (seven female and five male; age, 37 to 80 years) wi...
journal_title:Surgery
pub_type: 杂志文章
doi:10.1016/s0039-6060(05)80121-7
更新日期:1995-12-01 00:00:00
abstract:BACKGROUND:Necrotizing enterocolitis is the leading case of gastrointestinal-related morbidity in premature infants. Necrotizing enterocolitis totalis is an aggressive form of necrotizing enterocolitis, which has traditionally been managed with comfort care. Recent advances in management of short bowel syndrome have re...
journal_title:Surgery
pub_type: 杂志文章
doi:10.1016/j.surg.2019.03.005
更新日期:2019-06-01 00:00:00
abstract:BACKGROUND:The increasing success of renal transplantation is paralleled by the increased size of the waiting list. Efforts to increase the donor pool have included the use of living-unrelated kidney donors (LURDs). METHODS:During a 12-year period our center performed 309 transplantation from living donors; 279 patien...
journal_title:Surgery
pub_type: 杂志文章
doi:10.1016/s0039-6060(96)80264-9
更新日期:1996-05-01 00:00:00
abstract:BACKGROUND:Although the effect of preoperative biliary drainage in patients with obstructive jaundice is controversial, bacterial or endotoxin translocation is one of the main postoperative problem in jaundiced patients. Failure in gut barrier functions causes bacterial translocation; homing and distribution of T lymph...
journal_title:Surgery
pub_type: 杂志文章
doi:10.1016/j.surg.2004.02.001
更新日期:2004-09-01 00:00:00
abstract::That the fetus swallows amniotic fluid and has the capability of intestinal absorption of protein and carbohydrate is known, but its significance in fetal nutrition is not clear. We have infused nutrient solutions of dextrose and amino acids intra-amniotically in a chronic third-trimester fetal rabbit model and examin...
journal_title:Surgery
pub_type: 杂志文章
doi:
更新日期:1985-09-01 00:00:00