Abstract:
INTRODUCTION:Newborns with gastroschisis have historically undergone surgical repair under general anesthesia. Our institution recently transitioned to the sutureless umbilical closure for gastroschisis. We sought to evaluate the feasibility of bedside gastroschisis repair without endotracheal intubation. METHODS:A retrospective review was performed of neonates with gastroschisis who underwent sutureless umbilical closure from 2011 to 2015. Clinical characteristics and outcomes between groups were compared. RESULTS:In total, 53 infants underwent sutureless umbilical closure. Closure without endotracheal intubation was attempted in 23 (43%) babies and was successful in 15 (65%) infants. Two of the 8 patients who required intubation needed a temporary silo. Neonates successfully repaired without intubation were more premature (p < 0.01), smaller at birth (p = 0.01), and repaired nearly an hour sooner (p < 0.01). There were no differences in time to full enteral nutrition, length of stay, bowel ischemia, or sepsis. CONCLUSION:Bedside sutureless umbilical closure without intubation is feasible and effective in newborns with gastroschisis. The procedure decreases time to gastroschisis closure. Smaller and more premature neonates were more likely to be successfully closed without intubation.
journal_name
Am J Surgjournal_title
American journal of surgeryauthors
Pet GE,Stark RA,Meehan JJ,Javid PJdoi
10.1016/j.amjsurg.2017.03.017subject
Has Abstractpub_date
2017-05-01 00:00:00pages
958-962issue
5eissn
0002-9610issn
1879-1883pii
S0002-9610(16)31050-9journal_volume
213pub_type
杂志文章abstract::Mesenteric vascular disease continues to be associated with an extremely high mortality. It is not necessarily a disease of old age: 20 of the 75 patients in our series were less than 60 years of age. In retrospect, earlier diagnosis and a more aggressive approach could have improved the survival rate of 17.3 percent....
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/0002-9610(80)90251-2
更新日期:1980-02-01 00:00:00
abstract::A successful method for controlling intractable bleeding after endoscopic sphincterotomy is described. By passing a Fogarty catheter into the duodenum, balloon tamponade of the bleeding point is possible. By such a technique, major resective surgery can be avoided. ...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/0002-9610(94)90092-2
更新日期:1994-02-01 00:00:00
abstract:BACKGROUND:Accurate assessment is imperative for learning, feedback and progression. The aim of this study was to examine whether surgeons can accurately self-assess their technical and nontechnical skills compared with expert faculty members' assessments. METHODS:Twenty-five surgeons performed a laparoscopic cholecys...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/j.amjsurg.2011.01.024
更新日期:2011-10-01 00:00:00
abstract:BACKGROUND:Few studies have assessed the impact of pre-existing medical comorbidities on long-term survival after major trauma. This study investigated the influence of comorbidities as measured by the Charlson Comorbidity Index (CCI) on the 1-year mortality after major traumatic injury. METHODS:Adult patients who sur...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/j.amjsurg.2012.02.014
更新日期:2012-08-01 00:00:00
abstract::Gastric emptying was delayed preoperatively in 9 of 19 patients with duodenal ulcer disease, but all 9 patients with evidence of retention by scan were asymptomatic; gastric emptying was normal in the remaining 10 patients. A significant delay in gastric emptying was documented by scan in 17 of 19 patients immediately...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/0002-9610(82)90134-9
更新日期:1982-01-01 00:00:00
abstract:BACKGROUND:Because the abdominal insufflation and desufflation associated with laparoscopic procedures may adversely effect a compromised myocardium, patients with significant cardiopulmonary disease should be closely monitored during these procedures. The utility of intraoperative pulmonary artery catheter (PAC) and t...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/s0002-9610(99)80137-8
更新日期:1995-02-01 00:00:00
abstract::After partial or total esophagectomy, total gastrectomy, pancolectomy, and urinary cystectomy, it becomes necessary to reestablish continuity and/or replace function by the creation of a substitute organ obtianed from the various portions of the gastrointestinal tract. Ideally, the creation of the substitute organ sho...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/0002-9610(77)90458-5
更新日期:1977-11-01 00:00:00
abstract:BACKGROUND:The presence of an "open abdomen" after a trauma laparotomy can complicate the nutritional management of injured patients. METHODS:The medical records of patients admitted to an American College of Surgeons-verified level 1 trauma center were evaluated. The timing of nutritional support was noted. The metho...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/j.amjsurg.2009.08.033
更新日期:2010-03-01 00:00:00
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journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/j.amjsurg.2016.08.011
更新日期:2017-04-01 00:00:00
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journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/j.amjsurg.2012.08.014
更新日期:2013-07-01 00:00:00
abstract::Despite the advantages of aseptic nonoperative intubation of the small intestine for decompression of obstructed loops, 48% of the attempts lead to failure to pass the tube through the pylorus. The difficulty and inconvenience of passage beyond the stomach have been overcome by the development of a special tube attach...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/0002-9610(76)90427-x
更新日期:1976-01-01 00:00:00
abstract::Patients who have undergone recent abdominal surgery and have generalized obliterative adhesions provide a major management problem if they require urgent ileostomy for sepsis or fistulization, particularly when there is an associated abdominal wall defect. This report describes a technique for creating an ileostomy t...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/s0002-9610(00)00414-1
更新日期:2000-07-01 00:00:00
abstract:BACKGROUND:Coagulopathy is frequently encountered during supraceliac aortic clamping. Patients are routinely heparinized during these operations. This experiment was undertaken to evaluate the effect of supraceliac aortic cross-clamping (XC) on heparin pharmacodynamics. MATERIAL AND METHODS:Fourteen mongrel dogs were ...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/S0002-9610(96)00140-7
更新日期:1996-08-01 00:00:00
abstract::Prophylactic bypass of the common duct and duodenum at the time of pancreatojejunostomy for chronic pancreatitis (triple bypass) has been recommended. If the subsequent development of parapancreatic obstruction were sufficiently frequent, such a recommendation would deserve more wide-spread application. In a group of ...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/0002-9610(86)90081-4
更新日期:1986-02-01 00:00:00
abstract:BACKGROUND:The effect of the number of lymph nodes harvested on the long-term survival of gastric cancer according to Tumor, Node, and Metastasis (TNM) stage and tumor location remains unclear. METHODS:Patients who underwent gastrectomy for gastric cancer (1998 to 2009) were evaluated retrospectively (1,637 patients)....
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/j.amjsurg.2015.01.029
更新日期:2015-09-01 00:00:00
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journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/0002-9610(85)90082-0
更新日期:1985-09-01 00:00:00
abstract::A small bore feeding tube may be readily introduced into the stomach by splinting it internally, before insertion, with a flexible arteriographic guide wire, which is removed when the tube is in place. Gentle placement of the tube is recommended. ...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/0002-9610(80)90374-8
更新日期:1980-05-01 00:00:00
abstract:BACKGROUND:Thirty-five percent of hemodialysis patients with polytetrafluoroethylene grafts lose their access secondary to infection. We hypothesized that partial graft excision (PGE) for infection increases the incidence of vascular anastomotic complications when compared with total graft excision (TGE). METHODS:The ...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/j.amjsurg.2006.09.028
更新日期:2007-03-01 00:00:00
abstract::The lower esophageal high pressure zone (HPZ) was characterized manometrically and reflux status determined in eight male rhesus monkeys. The studies were repeated six weeks and six months after 50 per cent distal small bowel resection. At the same time fasting serum gastrin and gastric inhibitory polypeptide values w...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/0002-9610(77)90002-2
更新日期:1977-05-01 00:00:00
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journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/j.amjsurg.2019.11.026
更新日期:2020-07-01 00:00:00
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journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/0002-9610(78)90002-8
更新日期:1978-01-01 00:00:00
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journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/j.amjsurg.2012.11.022
更新日期:2013-08-01 00:00:00
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journal_title:American journal of surgery
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1016/0002-9610(83)90300-8
更新日期:1983-11-01 00:00:00
abstract::Axillary node dissection was performed in 212 patients with malignant melanoma. For 212 initial dissections plus 49 repeat procedures (261 operations), wound infection occurred in 25 (10%) and arm edema in 10 (4%), with other complications being infrequent. The arm edema resolved promptly and completely six (2%) patie...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/0002-9610(91)90069-p
更新日期:1991-09-01 00:00:00
abstract:BACKGROUND:The transformation of a trainee into a surgeon is influenced strongly by communication patterns in the operating room (OR). In the current era of limited educational opportunities, elucidation of teaching and learning strategies in this environment is critical. The aim of this study was to further understand...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/j.amjsurg.2008.01.004
更新日期:2008-05-01 00:00:00
abstract:BACKGROUND:Our aim was to determinate the prognostic value of neutrophil-lymphocyte ratio (NLR) and platelet-lymphocyte ratio (PLR) in primary operable patients with non-small cell lung cancer (NSCLC). METHODS:Six hundred seventy-eight NSCLC patients were enrolled in this study. The prognostic significance of both mar...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/j.amjsurg.2015.03.022
更新日期:2015-09-01 00:00:00
abstract::An experimental wound model has been used to evaluate the effectiveness of cefazolin and cefoxitin in the prevention of wound infection. Incisions were contaminated with Staph. aureus, E. coli, or a standardized fecal suspension. Regardless of the contaminant employed, the prophylactic use of either cefazolin or cefox...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/0002-9610(86)90072-3
更新日期:1986-02-01 00:00:00
abstract:BACKGROUND:We hypothesized that intravenous methylene blue will facilitate adrenal gland identification and resection during laparoscopic adrenalectomy. METHODS:Five mini-Hanford pigs were anesthetized and monitored per an approved Internal Review Board protocol. Timing of color changes in the adrenals was recorded af...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/j.amjsurg.2003.07.011
更新日期:2003-11-01 00:00:00
abstract::Evaluation of postoperative swallowing ability in thirty-eight patients having had partial laryngectomy indicates that there are marked differences in the degree of dysphagia among individuals with similar surgical defects. This variation in swallowing disability, however, appears to have definable limits. Rehabilitat...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/0002-9610(78)90266-0
更新日期:1978-10-01 00:00:00
abstract::Studies using a refined substrate, n-acetyl-L-phenylalanyl-L-diiodotyrosine [n-APDT], demonstrate that bile salts inhibit pepsin activity in vitro by a noncompetitive effect on the enzyme. ...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/0002-9610(80)90262-7
更新日期:1980-02-01 00:00:00