Abstract:
OBJECTIVE:The objective of this study was to determine the relationship between bowel preparation and surgical site infections (SSIs), and also other postoperative complications, after elective colorectal surgery. BACKGROUND:SSI is a major source of postoperative morbidity/costs after colorectal surgery. The value of preoperative bowel preparation to prevent SSI remains controversial. METHODS:We analyzed 32,359 patients who underwent elective colorectal resections in the American College of Surgeons National Surgery Quality Improvement Program database from 2012 to 2014. Univariable and multivariable analyses were performed; propensity adjustment using patient/procedure characteristics was used to account for nonrandom receipt of bowel preparation. RESULTS:26.7%, 36.6%, 3.8%, and 32.9% of patients received no bowel preparation, mechanical bowel preparation (MBP), oral antibiotics (OA), and MBP + OA, respectively. After propensity adjustment, MBP was not associated with decreased risk of SSI compared with no bowel preparation. In contrast, both OA and OA + MBP were associated with decreased risk of any SSI (adjusted odds ratio 0.49, 95% confidence interval 0.38-0.64; and adjusted odds ratio 0.45, 95% confidence interval 0.40-0.50, respectively) compared with no bowel preparation. OA and MBP + OA were associated with decreased risks of anastomotic leak, postoperative ileus, readmission, and also shorter length of stay (all P < 0.05). Bowel preparation was not associated with increased risk of cardiac/renal complications compared with no preparation. CONCLUSIONS:The use of MBP alone before elective colorectal resection to prevent SSI is ineffective and should be abandoned. In contrast, OA and MBP + OA are associated with decreased risks of SSI and are not associated with increased risks of other adverse outcomes compared with no preparation. Prospective studies to determine the efficacy of OA are warranted; in the interim, MBP + OA should be used routinely before elective colorectal resection to prevent SSI.
journal_name
Ann Surgjournal_title
Annals of surgeryauthors
Koller SE,Bauer KW,Egleston BL,Smith R,Philp MM,Ross HM,Esnaola NFdoi
10.1097/SLA.0000000000002159subject
Has Abstractpub_date
2018-04-01 00:00:00pages
734-742issue
4eissn
0003-4932issn
1528-1140journal_volume
267pub_type
杂志文章abstract:OBJECTIVE/BACKGROUND:There is a high risk of relapse in stage IIIB/IIIC melanoma. The utility of 2-[fluorine-18]-fluoro-2-deoxy-D-glucose positron emission tomography integrated with computed tomography (FDG-PET/CT) in these patients to evaluate response to treatment or for surveillance after treatment is currently not...
journal_title:Annals of surgery
pub_type: 杂志文章,多中心研究
doi:10.1097/SLA.0b013e318256d1f5
更新日期:2012-08-01 00:00:00
abstract:OBJECTIVE:To examine the extent to which multiple, sequential complications impacts variation in institutional postoperative mortality rates. BACKGROUND:Failure to rescue (FTR) has been proposed as an underlying factor in hospital variation in surgical mortality. However, little is currently known about hospital varia...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/SLA.0000000000001917
更新日期:2017-07-01 00:00:00
abstract:BACKGROUND:We conducted a study using an intravenous (i.v.) infusion of iloprost in the treatment of venous ulcers to verify whether the association of i.v. iloprost + local therapy + elastic compression has a favorable effect when compared with traditional treatment with local therapy and elastic compression. STUDY D...
journal_title:Annals of surgery
pub_type: 杂志文章,随机对照试验
doi:10.1097/SLA.0b013e3180caa44c
更新日期:2007-11-01 00:00:00
abstract::Primary hyperparathyroidism was studied in a well-defined geriatric population of 1129 individuals during a three-month interval. Primary hyperparathyroidism was diagnosed in 1.5%. The diagnosis was based on a morphologic and biochemic basis. From clinical material consisting of 400 patients treated surgically for pri...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-198302000-00003
更新日期:1983-02-01 00:00:00
abstract:OBJECTIVE:This study provided an objective survey by an outside auditing group of a large, complete patient population undergoing laparoscopic cholecystectomies, determined the frequency of complications, especially bile duct injuries, and presented a system for classifying and comparing the severity of bile duct injur...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-199411000-00005
更新日期:1994-11-01 00:00:00
abstract:OBJECTIVE:To assess the feasibility of developing a simulated ward environment in which to assess the ward-based care of surgical patients by clinicians of varying levels of experience (construct validation). BACKGROUND:Increasing evidence points to the importance of the postoperative or ward-based phase of surgical c...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/SLA.0b013e318288e1d4
更新日期:2014-02-01 00:00:00
abstract:OBJECTIVE:To assess our long-term complications from complete axillary lymph node dissection (AXLND) in patients with breast cancer. SUMMARY BACKGROUND DATA:Complete AXLND as part of the surgical therapy for breast cancer has come under increased scrutiny due the use of the sentinel lymph node (SLN) biopsy technique t...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/01.sla.0000129358.80798.62
更新日期:2004-07-01 00:00:00
abstract::Fifteen patients with Zollinger-Ellison syndrome followed at the National Institutes of Health with extensive metastatic disease had an actuarial 5-year survival of 20%. Therefore, in 1982 a prospective study to examine the effect and feasibility of removing all gross tumor in selected patients with extensive metastat...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-198604000-00003
更新日期:1986-04-01 00:00:00
abstract::Previous studies have demonstrated that administered antibiotics must be active against major anticipated pathogens and must have reached sufficient concentrations in the tissue or body fluid at risk by the time of bacterial challenge if prophylactic therapy is to be maximally effective in reducing the infection rate ...
journal_title:Annals of surgery
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1097/00000658-197906000-00004
更新日期:1979-06-01 00:00:00
abstract:BACKGROUND:Retrospective single-center studies have shown that diffusion-weighted magnetic resonance imaging (DWI) is promising for identification of patients with rectal cancer with a complete tumor response after neoadjuvant chemoradiotherapy (CRT), using certain volumetric thresholds. OBJECTIVE:This study aims to v...
journal_title:Annals of surgery
pub_type: 杂志文章,多中心研究
doi:10.1097/SLA.0000000000000909
更新日期:2015-12-01 00:00:00
abstract:OBJECTIVE:To evaluate the correlation between the morphologic nuclear features and clinicopathologic parameters in patients with advanced gastric cancer. SUMMARY BACKGROUND DATA:Nuclear profiles have been reported as useful prognostic predictors in various cancers. Data from computerized morphometries are objective an...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-199901000-00007
更新日期:1999-01-01 00:00:00
abstract::The aim of this study was to define the post-traumatic changes in body fluid compartments and to evaluate the effect of plasma colloid osmotic pressure (COP) on the partitioning of body fluid between these compartments. Forty-two measurements of plasma volume (green dye), extracellular volume (bromine), and total body...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-198909000-00015
更新日期:1989-09-01 00:00:00
abstract::Release of pancreatic polypeptide (PP) after a meal is biphasic, with an early transient peak believed to be under cholinergic control, and a secondary, prolonged intestinal phase thought to be mediated by hormones. Endogenous release of PP was stimulated by intraduodenal oleate (6.8 mmol/hr) or by intravenous adminis...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-198411000-00008
更新日期:1984-11-01 00:00:00
abstract::Twenty-three selected patients presenting with massive bleeding from peptic ulcers underwent emergency parietal cell vagotomy (PCV). Nineteen patients had a duodenal ulcer, two a prepyloric ulcer, and one a gastric ulcer. The patients were studied retrospectively with regard to postoperative mortality and morbidity, e...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-198711000-00005
更新日期:1987-11-01 00:00:00
abstract::Fibronectin exists in a soluble form in plasma and in an insoluble form in tissues. Plasma fibronectin can modulate phagocytic function as well as incorporate into the tissue matrix where it is believed to influence microvascular integrity and tissue repair. The temporal alterations in plasma and lung lymph fibronecti...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-198508000-00016
更新日期:1985-08-01 00:00:00
abstract:OBJECTIVE:To analyze the short- and long-term outcomes following surgical treatment for corrosive stricture of the esophagus. BACKGROUND:Surgery is a well-established treatment for corrosive strictures of the esophagus and involves either resection or bypass of the damaged esophagus and replacement by a conduit. The n...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/SLA.0b013e3182125ce7
更新日期:2011-07-01 00:00:00
abstract::This study addresses the use of decision analysis and Markov models to make contemplated decisions for surgical problems. Decision analysis and decision modeling in surgical research are increasing, but many surgeons are unfamiliar with the techniques and are skeptical of the results. The goal of this review is to fam...
journal_title:Annals of surgery
pub_type: 杂志文章,评审
doi:10.1097/SLA.0000000000001569
更新日期:2016-08-01 00:00:00
abstract:OBJECTIVE:The authors determined if more radical surgery with extended lymphadenectomy improves the results of gastrectomy in patients with adenocarcinoma of the gastric antrum. SUMMARY BACKGROUND DATA:The overall survival in patients with gastric cancer is disappointing. Improved survival has been reported by Japanes...
journal_title:Annals of surgery
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1097/00000658-199408000-00009
更新日期:1994-08-01 00:00:00
abstract::Tissue reaction to sutures was studied in 666 specimens obtained from patients from one day to 23 years after operation. Reaction to catgut depends on the stage of absorption and is mainly histocytic in type. Nonabsorbable sutures are encapsulated by a rim of connective tissue, while near the suture histocytes, giant ...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-197502000-00003
更新日期:1975-02-01 00:00:00
abstract:OBJECTIVE:To evaluate both institutional and individual learning curves with focused abdominal ultrasound for trauma (FAST) by analyzing the incidence of diagnostic inaccuracies as a function of examiner experience for a group of trauma surgeons performing the study in the setting of an urban level I trauma center. SU...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-200005000-00009
更新日期:2000-05-01 00:00:00
abstract:OBJECTIVE:We compared the effects of intravenous administration of 6% hydroxyethyl starch (maize-derived) in 0.9% saline (Voluven; Fresenius Kabi, Runcorn, United Kingdom) and a "balanced" preparation of 6% hydroxyethyl starch (potato-derived) [Plasma Volume Redibag (PVR); Baxter Healthcare, Thetford, United Kingdom] o...
journal_title:Annals of surgery
pub_type: 杂志文章,随机对照试验
doi:10.1097/SLA.0000000000000324
更新日期:2014-05-01 00:00:00
abstract::The morphologic characteristics of a scar may render it an "immunologically privileged site" providing fertile ground for tumor occurrence and growth. We sought to extend this concept and to determine the effect of different stages of wound healing on tumor occurrence. Syngeneic strain-2 guinea pigs and a methylcholan...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-197902000-00009
更新日期:1979-02-01 00:00:00
abstract:OBJECTIVE:The aim of this study is to evaluate the short-term outcomes and long-term survival of laparoscopic rectal cancer resection at a single institution with 579 cases over a 15-year period. SUMMARY BACKGROUND DATA:The use of laparoscopic resection for colon cancer has been shown to be safe with comparable oncolo...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/SLA.0b013e31818e418a
更新日期:2009-01-01 00:00:00
abstract:OBJECTIVE:This study was aimed to investigate the prognostic value of tumor-infiltrating neutrophils (TINs) and to generate a predictive model to refine postoperative risk stratification system for patients with gastric cancer. BACKGROUND:TIN presents in various malignant tumors, but its clinical significance in gastr...
journal_title:Annals of surgery
pub_type: 杂志文章,多中心研究
doi:10.1097/SLA.0000000000002058
更新日期:2018-02-01 00:00:00
abstract:OBJECTIVE:We sought to define the prognostic significance of histologic subtype for extremity/truncal liposarcoma (LPS). BACKGROUND:LPS, the most common sarcoma, is comprised of 5 histologic subtypes. Despite their distinct behaviors, LPS outcomes are frequently reported as a single entity. METHODS:We analyzed data o...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/SLA.0000000000003453
更新日期:2019-07-05 00:00:00
abstract:OBJECTIVE:To investigate differences in the quality, confidence, and consistency of intraoperative surgical decision making (DM) and using functional neuroimaging expose decision systems that operators use. SUMMARY BACKGROUND DATA:Novices are hypothesized to use conscious analysis (effortful DM) leading to activation ...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/SLA.0000000000001651
更新日期:2017-02-01 00:00:00
abstract:OBJECTIVE:Based on development of stem cell technology, newborn tissue, even undergoing cryopreservation, possesses promising potential as a donor source in the field of organ transplantation. However, the precise regeneration processes remains unclear. This study was designed to investigate the regenerative potential ...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/01.sla.0000168089.64630.94
更新日期:2005-07-01 00:00:00
abstract:OBJECTIVE:To evaluate the effect of Medicare Shared Savings Program accountable care organizations (ACOs) on hospital readmission after common surgical procedures. SUMMARY BACKGROUND DATA:Hospital readmissions following surgery lead to worse patient outcomes and wasteful spending. ACOs, and their associated hospitals,...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/SLA.0000000000002737
更新日期:2019-05-01 00:00:00
abstract:OBJECTIVE:The aim of this study was to evaluate the results of pancreatic resection in pancreatic endocrine neoplasias (PENs) in patients affected by multiple endocrine neoplasia type 1 (MEN1) syndrome. BACKGROUND:Since these tumors often show an indolent course, the role of diagnostic procedures and type of surgical ...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/01.sla.0000218073.77254.62
更新日期:2006-07-01 00:00:00
abstract:OBJECTIVE:This study aims to review the operative results and oncological outcomes of anterior resection for rectal and rectosigmoid cancer. Comparison was made between patients with total mesorectal excision (TME) for mid and distal cancer and partial mesorectal excision (PME) for proximal cancer, when a 4- to 5-cm me...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/01.sla.0000133185.23514.32
更新日期:2004-08-01 00:00:00