Abstract:
INTRODUCTION:Damage control laparotomy with vacuum assisted closure (VAC) is used for selective cases in trauma. In liver transplantation, VAC has also been applied for management of intra-operative hemorrhage. The primary objective was to evaluate peri-operative blood loss and blood product utilization in VAC compared to primary abdominal closure (PAC) at the index transplant operation. METHODS:Retrospective review of all adults undergoing deceased donor liver transplantation (2007-2011) at a single center tertiary care institution. RESULTS:201 deceased donor liver transplantations were performed, with 167 PAC and 34 VAC cases. Intra-operative blood loss (4.4L vs 10.7L), cell saver return (1399 ml vs 3998 ml), FFP (7.6U vs 15.9U) and PLT requirements (8.5U vs 18.3U), were all significantly elevated in VAC compared to PAC. VAC patients had significantly increased RBC, FFP, PLT, and total volume requirements during initial ICU admission. 30 PAC cases required on demand laparotomy and most commonly for post-operative bleeding. CONCLUSION:In liver transplantation, application of VAC secondary to massive intra-operative exsanguination was safely utilized. Further evaluation is required to identify long-term morbidity and mortality.
journal_name
Am J Surgjournal_title
American journal of surgeryauthors
Chan T,Bleszynski MS,Youssef DS,Segedi M,Chung S,Scudamore CH,Buczkowski AKdoi
10.1016/j.amjsurg.2017.12.012subject
Has Abstractpub_date
2018-05-01 00:00:00pages
782-785issue
5eissn
0002-9610issn
1879-1883pii
S0002-9610(17)31624-0journal_volume
215pub_type
杂志文章abstract:BACKGROUND:Over the past 15 years of war, eligible U.S. military members donated organs overseas in Germany. Our hypothesis was that outcomes at a military treatment facility were comparable to a civilian cohort. METHODS:Military donors were matched 1:3 with a donor cohort from the U.S. United Network for Organ Sharin...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/j.amjsurg.2017.01.024
更新日期:2017-08-01 00:00:00
abstract:BACKGROUND:Traumatic injuries during pregnancy are the leading cause of nonobstetric maternal mortality. We aimed to determine hospital charges for trauma activations during pregnancy. METHODS:We used the Illinois State Trauma Registry data from 1999 to 2003. Using STATA for bivariate and regression analyses, we compa...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/j.amjsurg.2013.10.018
更新日期:2014-07-01 00:00:00
abstract:BACKGROUND:Accurate intraoperative diagnosis of axillary malignancy facilitates completion axillary lymph node dissection (ALND) at the time of initial surgery. The capability to address both the primary tumor and axillary disease in a single procedure offers several advantages. This study was designed to define the pr...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/s0002-9610(03)00041-2
更新日期:2003-05-01 00:00:00
abstract::Surgical extirpation of the primary tumor has traditionally been utilized as initial treatment for sarcomas in children. The present report, however, demonstrates that sarcomas are optimally treated by means of a coordianted multidisciplinary approach. The latter offers the potential for achieving improved survival an...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/0002-9610(77)90123-4
更新日期:1977-04-01 00:00:00
abstract:BACKGROUND:Appropriate therapy for women over 70 years of age with breast cancer is currently a highly debated topic. The aim of this study was to determine whether a subset of patients could be identified in which lumpectomy alone, followed by tamoxifen, would offer adequate local, regional, and long-term control of d...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/s0002-9610(00)00474-8
更新日期:2000-09-01 00:00:00
abstract::Careful intraoperative surgical staging should be considered routine for all patients undergoing thoracotomy for lung cancer. In addition, conservative resection is indicated for T1N0 lesions. Surgical adjuvant immunotherapy has not proved as effective as originally hoped. However, the advent of more effective combina...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/0002-9610(82)90037-x
更新日期:1982-06-01 00:00:00
abstract::Fourteen infants with intestinal stenosis as a late sequela of necrotizing enterocolitis were treated at Texas Children's and Ben Taub General Hospitals from 1972 to 1979. Barium enema studies are the keystone in making the diagnosis and should be performed in any infant with abdominal distention or poor feeding after...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/0002-9610(81)90320-2
更新日期:1981-12-01 00:00:00
abstract::Six patients with intestinal obstruction secondary to benign adhesions so dense and vascular that the operating surgeon could not free them, were placed on a home total parenteral nutrition program. Four patients had enterocutaneous fistulas, and two had their bowels divided and stomas created to divert intestinal con...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/0002-9610(83)90331-8
更新日期:1983-12-01 00:00:00
abstract::Resection of malignancies of the upper face and skull base may result in complex bone and soft tissue defects. To better define the optimal management of these defects, we conducted a retrospective review of 75 consecutive patients who underwent closure of 76 craniofacial defects after malignant tumor excision from 19...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/0002-9610(91)90160-f
更新日期:1991-10-01 00:00:00
abstract::Between 1971 and 1976, ninety-three patients with a clinical diagnosis of pseudocyst confirmed by ultrasonography were identified from a group of 923 patients admitted for pancreatic disease. Uncertainties in diagnosis and/or rapid progression of underlying pancreatitis led to urgent laparotomy and drainage in eleven ...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/0002-9610(79)90024-2
更新日期:1979-01-01 00:00:00
abstract:BACKGROUND:Antiphospholipid (APL) antibodies are a heterogenous group of antibodies that have been associated with an increase in bleeding complications and a marked increase in thrombotic events, both of which result in significant patient morbidity and mortality. PATIENTS AND METHODS:A retrospective analysis of pati...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/s0002-9610(99)80285-2
更新日期:1995-08-01 00:00:00
abstract:BACKGROUND:Few studies have evaluated the role of computed tomography-guided percutaneous drainage (PD) in the management of gastrointestinal (GI) anastomotic leaks. METHODS:Ten-year review of an interventional radiology database identified patients with symptomatic GI anastomotic leaks. Clinical, laboratory, radiogra...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/j.amjsurg.2013.08.050
更新日期:2014-07-01 00:00:00
abstract:BACKGROUND:Nipple discharge occurs in 2% to 5% of women. We evaluated the effectiveness of a previously proposed treatment algorithm for these patients. METHODS:Patients with pathologic nipple discharge and a negative mammogram and subareolar ultrasound were offered follow-up from 2005 to 2011 according to the algorit...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/j.amjsurg.2013.12.035
更新日期:2014-08-01 00:00:00
abstract:BACKGROUND:Five percent of patients who undergo fundoplication will require reoperation. The cause of this high failure rate and the best management for these patients remains poorly understood. The aim of this study was to identify patterns and causes of failure of primary antireflux procedures. METHODS:Retrospective...
journal_title:American journal of surgery
pub_type: 杂志文章,多中心研究
doi:10.1016/j.amjsurg.2004.08.062
更新日期:2004-12-01 00:00:00
abstract::A significant amount of red blood cells were conserved with use of the Cell Saver in cardiac surgery patients and in some orthopedic and vascular surgery patients. No major complications have been associated with its use in our cases. Our results are similar to those of others who have reported on the use of this devi...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/0002-9610(82)90600-6
更新日期:1982-07-01 00:00:00
abstract:BACKGROUND:The Roux-en-Y loop is an effective procedure for biliodigestive drainage. However, up to 15% of patients suffer from postoperative cholangitis or blind loop syndrome. A new technique to prevent motility abnormalities has been developed. METHODS:Male Lewis rats were used to compare gastric emptying and trans...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/j.amjsurg.2003.08.025
更新日期:2003-12-01 00:00:00
abstract::Aortoesophageal fistula secondary to a thoracic aortic aneurysm is usually a fatal disease with few survivors reported previously. We encountered 2 consecutive patients who were treated successfully with esophagectomy and in situ aorta reconstruction using cryopreserved homograft that was wrapped completely with oment...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/j.amjsurg.2005.09.011
更新日期:2006-07-01 00:00:00
abstract:BACKGROUND:In 1997 the National Kidney Foundation put forth guidelines for hemoaccess through its Dialysis Outcomes Quality Initiative (DOQI). Some centers have been able to meet these standards; most have not. METHODS:A retrospective review was made of our database of more than 3,500 hemoaccess procedures from 1986 t...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/j.amjsurg.2004.01.018
更新日期:2004-05-01 00:00:00
abstract::Vertebral arteriovenous fistulas are rare. A report of two cases is presented with problems related to diagnosis and therapy. An alternative approach to surgical management is given. ...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/0002-9610(79)90320-9
更新日期:1979-12-01 00:00:00
abstract:BACKGROUND:Antibiotic prophylaxis is controversial in patients undergoing axillary lymph node dissection (ALND). We determined whether preoperative antibiotics decreased incidence or treatment cost of infectious complications following ALND. METHODS:Two hundred patients entered this prospective, randomized, double-bli...
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/s0002-9610(98)00154-8
更新日期:1998-09-01 00:00:00
abstract:BACKGROUND:The aim of this analysis is to compare the postoperative outcomes of resection and enucleation of small pancreatic neuroendocrine tumors (PNETs). METHODS:The 2014-17 American College of Surgeons-NSQIP dataset was queried. Patients undergoing pancreatoduodenectomy (N = 297) or distal pancreatectomy (N = 712)...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/j.amjsurg.2020.12.013
更新日期:2020-12-08 00:00:00
abstract::This article reviews the philosophy and principles of the National Surgical Quality Improvement Program (NSQIP) that the founders of the program had in mind when they developed the program; explains how the philosophy and principles led to the design and statistical methods that were chosen for the program; and review...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/j.amjsurg.2009.07.025
更新日期:2009-11-01 00:00:00
abstract::The influence of preoperative liver scans and liver function tests on surgical decision-making was analyzed in 196 patients who underwent surgical therapy for colorectal cancer. One hundred and thirteen patients who had preoperative liver scans were compared with 83 patients who did not. No statistically significant d...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/0002-9610(86)90101-7
更新日期:1986-04-01 00:00:00
abstract:BACKGROUND:Establishment of an instant, reproducible, and reliable rat model of a refined 3-cuff technique for performing orthotopic intestinal transplantation is reported, and the surgical skills required to perform modified surgical procedure are discussed. METHODS:A retrospective analysis was used to study 270 rat ...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/j.amjsurg.2008.07.057
更新日期:2009-07-01 00:00:00
abstract:BACKGROUND:This study examined the clinical value of intraoperative peritoneal lavage for cytological examination in patients with gastric cancer. Peritoneal dissemination is the most frequent mode of recurrence for this tumor. METHODS:A retrospective of lavage findings, other factors, and outcome was performed in 1,2...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/s0002-9610(99)00162-2
更新日期:1999-09-01 00:00:00
abstract:BACKGROUND:The management of surgical sepsis is challenging because of the complexity of interventions. The authors therefore created a computerized clinical decision support program to facilitate this process, with the goal of improving abdominal sepsis mortality. METHODS:The authors evaluated a prospective database ...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/j.amjsurg.2010.07.036
更新日期:2010-12-01 00:00:00
abstract::The accepted approach to patients with intermittent calf claudication is nonoperative unless the symptoms are truly incapacitating, in which case arteriography and either percutaneous angioplasty or operation is indicated. Arteriography is considered a preoperative procedure. However, with improvements in percutaneous...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/s0002-9610(05)80300-9
更新日期:1990-08-01 00:00:00
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::The management of primary varicose veins is evolving. Recovery time, cost, recurrence rate, and cosmesis are critical determinants. Classic "high ligation" and ankle-to-groin stripping is expensive, results in a long convalescence, and may produce unacceptable scarring and possible permanent nerve injury. This report ...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/0002-9610(91)90182-d
更新日期:1991-08-01 00:00:00
abstract:BACKGROUND:Hawaii has the highest incidence of hepatocellular cancer (HCC) in the United States and the largest proportion of Asians and Pacific Islanders. HCC studies generally combine these groups into 1 ethnicity, and we sought to examine differences between Asian and Pacific Islander subpopulations. METHODS:Demogr...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/j.amjsurg.2011.06.055
更新日期:2012-06-01 00:00:00