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, ED visits, and readmissions. RESULTS:A total of 563 of 1645 surveys were completed (34% response). Mean age was 47 ± 10 years and 98% were from the United States. Most (72%) were employed at academic teaching hospitals and 66% practiced in an urban setting. There were significant differences in treatment recommendations for different presentations of appendicitis. Regarding the primary composite endpoint, surgeons would tolerate a median 17% [10%-25%] excess morbidity in order to avoid an operation (i.e. non-inferiority) and would require a median 24% [10%-50% lower morbidity for the surgical approach in order to declare it a superior treatment (i.e. superiority). CONCLUSIONS:To be considered non-inferior, antibiotic therapy of appendicitis cannot have >17% excess morbidity and appendectomy must have at least 24% lower morbidity to be considered superior.
journal_name
Am J Surgjournal_title
American journal of surgeryauthors
Yeh DD,Sakran JV,Rattan R,Mehta A,Ruiz G,Lieberman H,Mulder M,Namias N,Zakrison T,Pust GDdoi
10.1016/j.amjsurg.2018.08.019subject
Has Abstractpub_date
2019-07-01 00:00:00pages
106-112issue
1eissn
0002-9610issn
1879-1883pii
S0002-9610(18)31090-0journal_volume
218pub_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：:Extracorporeal shock-wave lithotripsy (ESWL) in combination with adjuvant litholytic therapy using chenodeoxycholic acid and ursodeoxycholic acid (7 to 8 mg/kg body weight/day of each acid) is a safe and effective, novel nonsurgical approach to gallbladder stones, provided the patients are carefully selected. Experien...
journal_title：American journal of surgery
pub_type： 杂志文章,评审
doi：10.1016/0002-9610(89)90249-3
更新日期：1989-09-01 00:00:00
abstract：:During the last 100 years, since César Roux began utilizing his "Ansa-en-Y" procedure for gastric outlet obstruction, the procedure at first fell into disuse but was later adapted for other applications. This article discusses the background of the procedure and compares the original indications with the author's curr...
journal_title：American journal of surgery
pub_type： 传,历史文章,杂志文章
doi：10.1016/0002-9610(91)91142-6
更新日期：1991-02-01 00:00:00
abstract：:The experience with gastrointestinal cancer at a single large hospital has been utilized as a "micro-model" of the experience for the country at large, and the reasons why such a comparison might be possible have been presented. The incidence of various lesions has been discussed in terms of sex, age, and race. The ch...
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
abstract：BACKGROUND:The laparoscopic approach to surgical diseases of the foregut is rapidly gaining acceptance. These new approaches, however, pit the unwary surgeon against potentially devastating complications. PATIENTS AND METHODS:Based on a retrospective review of 153 consecutive laparoscopic foregut surgeries performed a...
journal_title：American journal of surgery
pub_type： 临床试验,杂志文章
doi：10.1016/S0002-9610(99)80206-2
更新日期：1995-05-01 00:00:00
abstract：BACKGROUND:It has been suggested that division of the short gastric vessels (SGV) provides a more floppy Nissen fundoplication, for the treatment of reflux disease. The aim of the study was to assess whether Nissen fundoplication with division of SGV is associated with improved clinical outcome and laboratory findings....
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(01)00695-x
更新日期：2001-09-01 00:00:00
abstract：:A prospective study of 390 indwelling central venous catheters placed by way of the subclavian route identified bacteremia and tracheostomy as the only significant variables associated with the colonization of the catheters by pathogenic microorganisms. Catheter-related sepsis was likely in only 3 of 33 episodes of pr...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/0002-9610(79)90085-0
更新日期：1979-06-01 00:00:00
abstract：BACKGROUND:Hepatic portal venous gas is an unusual entity associated with a variety of abdominal catastrophes. There is usually a grave prognosis when hepatic portal venous gas is associated with ischemic bowel disease. We reported a 57-year-old man with hepatic portal venous gas associated with extensive infarction of...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/j.amjsurg.2004.09.014
更新日期：2005-04-01 00:00:00
abstract：INTRODUCTION:Surgical educators' professional behavior constitutes a hidden curriculum and impacts trainee's professional identity formation. This study explores the nuances of professional behaviors as observed in varying surgical settings. METHODS:411 Transcripts originated from essays written by MS3 students during...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/j.amjsurg.2020.09.003
更新日期：2020-09-08 00:00:00
abstract：:The clinical efficacy and safety of cefotetan was assessed in two multicenter clinical trials involving 335 evaluable patients hospitalized with obstetric and gynecologic infections. In Study I, cefotetan was compared with moxalactam and in Study II, cefotetan was compared with cefoxitin. The clinical response rate in...
journal_title：American journal of surgery
pub_type： 临床试验,杂志文章
doi：10.1016/s0002-9610(88)80214-9
更新日期：1988-05-31 00:00:00
abstract：BACKGROUND:In about 30% of patients, chronic pancreatitis leads to an inflammatory enlargement of the pancreatic head with subsequent obstruction of the pancreatic duct, common bile duct, and duodenum. METHODS:In a prospective, randomized controlled trial, we compared duodenum-preserving pancreatic head resection (DPP...
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(99)80111-1
更新日期：1995-01-01 00:00:00
abstract：:Other indicators of hormone sensitivity, besides estrogen receptor (ER) content, such as response to oophorectomy, antiestrogens, prolactin suppression, and correlation with progesterone receptors (PR), were evaluated in the hope of further improving selectivity and response of patients undergoing endocrine ablation f...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/0002-9610(80)90435-3
更新日期：1980-07-01 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：:Allergy to metal implants is under study at the Dartmouth-Hitchcock Medical Center using in vitro examination of white blood cell migration. Retrospective data from 121 patients confirm that allergic responses do occur. Prospective data are being gathered to investigate the incidence, prevalence and relation to morbid...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/0002-9610(80)90323-2
更新日期：1980-04-01 00:00:00
abstract：BACKGROUND:To assess the impact of adding a surgical oncologist to our faculty we examined the operative experience in our program before and after the addition. METHODS:Operative case numbers reported to the American Board of Surgery over a 10-year period were analyzed. This time period encompassed 5 years before and...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/j.amjsurg.2003.01.001
更新日期：2004-01-01 00:00:00
abstract：BACKGROUND:Previous studies on the efficacy of primary treatments for ductal carcinoma-in-situ (DCIS) have focused on local recurrence rates. Our objective was to detail the outcomes of local invasive recurrence, distant recurrence, and breast cancer mortality in patients previously treated for DCIS. METHODS:Clinical,...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/j.amjsurg.2006.06.005
更新日期：2006-10-01 00:00:00
abstract：BACKGROUND:Management of the open abdomen with polyglactin 910 mesh followed by split-thickness skin grafts allows safe, early closure of abdominal wounds. This technique can be modified to manage enteroatmospheric fistulae. Staged ventral hernia is performed in a less inflamed surgical field. METHODS:A retrospective ...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/j.amjsurg.2013.07.040
更新日期：2014-04-01 00:00:00
abstract：:A review of 143 patients with 144 feeding jejunostomies was carried out. In the 129 patients in whom catheters were utilized, only 48 (45 percent) had no complications. Seventy-one patients (55 percent) suffered one or more catheter-related complications. Ten of these complications were life-threatening or fatal, incl...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/s0002-9610(88)80267-8
更新日期：1988-01-01 00:00:00
abstract：:The wire introducer method is a satisfactory technique for management of central venous catheters if bacteriologic monitoring of the removed catheter is used to determine whether the introduced catheter should be allowed to remain. The data indicate that when central venous catheters become infected, they do so throug...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/0002-9610(81)90327-5
更新日期：1981-12-01 00:00:00
abstract：:Massive doses of methylprednisolone were given to dogs prior to severe, lethal, hemorrhagic shock. An untreated group of dogs subjected to hemorrhagic shock served as controls. No persistent significant differences were seen in cardiac output, mean arterial blood pressure, superior mesenteric artery flow, and survival...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/0002-9610(75)90394-3
更新日期：1975-09-01 00:00:00
abstract：BACKGROUND:Leakage from esophageal anastomoses is higher than that for other gastrointestinal anastomoses. An intrathoracic anastomotic leak is a potentially catastrophic event. METHODS:Patients with and without thoracic anastomotic leakage were compared for predisposing factors. Leak-related mortality was analyzed. ...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/s0002-9610(01)00559-1
更新日期：2001-03-01 00:00:00
abstract：BACKGROUND:The feasibility and safety of low-pressure pneumoperitoneum in laparoscopic cholecystectomy remain unclear. METHODS:A meta-analysis of randomized controlled trials comparing low-pressure with standard-pressure pneumoperitoneum was performed. RESULTS:A total of 1,263 patients were included. Low-pressure pne...
journal_title：American journal of surgery
pub_type： 杂志文章,meta分析,评审
doi：10.1016/j.amjsurg.2013.09.027
更新日期：2014-07-01 00:00:00
abstract：:We reviewed 574 endoscopic sphincterotomy procedures. Fifty-six precut papillotomies were performed. Presenting conditions included choledocholithiasis, cholangitis, benign and malignant papillary strictures, and stenosing papillitis. Complications were identified in 16 percent: perforation in 9 percent, pancreatitis ...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/s0002-9610(05)80618-x
更新日期：1990-01-01 00:00:00
abstract：BACKGROUND:The aim of this study was to determine whether minimally invasive radioguided parathyroidectomy (MIRP) and intraoperative parathyroid hormone-guided parathyroidectomy (ioPTH) have equivalent intermediate-term outcomes in primary hyperparathyroidism (PHPT). METHODS:A retrospective study of 244 patients who u...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/j.amjsurg.2010.10.015
更新日期：2012-02-01 00:00:00
abstract：BACKGROUND:As laparoscopic experience increases, ever more challenging cases are attempted. Enlarged surgeon experience, along with better technology, has been lauded as improving outcomes. The purpose of this study is to see if this applies to the management of acute cholecystitis. METHODS:We reviewed our experience ...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/s0002-9610(02)01089-9
更新日期：2002-12-01 00:00:00
abstract：BACKGROUND:Management of patients with thoracic empyema ranges from tube thoracostomy drainage, with or without fibrinolytics, to operative intervention, with the optimal intervention remaining uncertain. Streptococcus milleri, typically a benign bacterium colonizing the oropharynx, has recently been reported as a pote...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/j.amjsurg.2006.08.050
更新日期：2006-12-01 00:00:00
abstract：:Fistula-in-ano is a common surgical problem. Various materials have been used to perform the seton technique in the treatment of fistula-in-ano. In this study, a novel material, a self-locking cable tie, was used regardless of the fistula type. Seventeen consecutive patients with anal fistula underwent surgery with th...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/j.amjsurg.2006.06.048
更新日期：2007-06-01 00:00:00
abstract：:The accuracy of the hepatobiliary scan in the diagnosis of acute cholecystitis was determined at a major United States Army Medical Center. Forty-two patients with complete medical records were selected for the study. There was 18 positive findings and 24 negative findings. The accuracy rate for the positive findings ...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/0002-9610(84)90333-7
更新日期：1984-11-01 00:00:00
abstract：:The first case of a carotid body chemodectoma that was diagnosed using dynamic radionuclide perfusion angiography and subsequently excised is presented. The value of this technic in the investigation of pulsatile tumors is emphasized. ...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/0002-9610(79)90043-6
更新日期：1979-05-01 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
