Abstract：
BACKGROUND:Many approaches to treat rectal prolapse exists, yet little is known regarding their safety in the elderly. METHOD:NSQIP (2008-2014) was queried to identify patients ≥ 70 years who underwent open rectopexy (OR), laparoscopic rectopexy (LR) and perineal rectosigmoidectomy (PR). Patients were selected using NSQIP's estimated probability of morbidity of ≥50th percentile. Outcomes were 30-day mortality and a composite: mortality, septic shock and organ space abscess and fascial dehiscence. RESULTS:Overall, 1361 patients underwent OR(18%), LR(15%) and PR(67%) with no difference in outcomes among 3 approaches. After adjustment of other factors, the composite was associated with PR [OR 2.5, CI 1.1, 5.7] and not with older age [OR 1.3, (CI) 0.7, 2.4]. From 2008 to 2014, LR increased from 11% to 19%; and PR decreased from 75% to 72%. CONCLUSIONS:All 3 surgical approaches carry low morbidity among the sick, elderly. PR remains the predominant approach nationally. A paradigm shift accepting the safety of abdominal approaches is needed. There should also be less focus on age in the decision-making process of surgical treatment.
journal_name
Am J Surgjournal_title
American journal of surgeryauthors
Daniel VT,Davids JS,Sturrock PR,Maykel JA,Phatak UR,Alavi Kdoi
10.1016/j.amjsurg.2019.02.010subject
Has Abstractpub_date
2019-08-01 00:00:00pages
288-292issue
2eissn
0002-9610issn
1879-1883pii
S0002-9610(18)31417-Xjournal_volume
218pub_type
杂志文章abstract：BACKGROUND:The traditional theory that pulmonary emboli (PE) originate from the lower extremity has been challenged. METHODS:All autopsies performed in Los Angeles County between 2002 and 2010 where PE was the cause of death were reviewed. RESULTS:Of the 491 PE deaths identified, 36% were surgical and 64% medical. Ve...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/j.amjsurg.2014.09.027
更新日期：2015-06-01 00:00:00
abstract：BACKGROUND:This study descriptively analyzes characteristics of general surgery residency and practice and their influence on student interest in surgical careers. METHODS:Fourth-year medical students were invited to complete an Internet-based survey. A 5-point Likert scale described characteristics of general surgery...
journal_title：American journal of surgery
pub_type： 杂志文章,多中心研究
doi：10.1016/j.amjsurg.2005.03.019
更新日期：2005-06-01 00:00:00
abstract：:In addition to its own inherent morbidity, the pain associated with chronic wounds presents a primary obstacle to healing. To initiate safe and effective therapy, we used a multidisciplinary approach that required the wound-healing clinician and pain-management practitioner to work together to diagnose and treat the p...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/S0002-9610(03)00289-7
更新日期：2004-07-01 00:00:00
abstract：:Since its inception in 1994, the National Surgical Quality Improvement Program (NSQIP) has been used to compare the performance of all Veterans Administration (VA) hospitals offering major surgical procedures. The program's outcome data are used to identify areas of both excellent and poor performance. The data can al...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/j.amjsurg.2004.10.004
更新日期：2004-12-01 00:00:00
abstract：OBJECTIVE:We incorporated a hybrid-abdominal wound simulation to teach/assess the acquisition of three essential clinical skills in the ACS/ASE Medical Student Simulation-based Surgical Skills Curriculum. METHOD:Third year students (N = 43) attended a workshop based on the ACS/ASE surgical skills curriculum for drain ...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/j.amjsurg.2018.07.039
更新日期：2019-02-01 00:00:00
abstract：:Compared with total parenteral nutrition, enteral feeding via jejunostomy reduces septic complications in patients with severe trauma. However, violation of the bowel with insertion of a jejunostomy tube may increase the risk of intra-abdominal abscess (IAA), particularly if no simultaneous gastrointestinal tract inju...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/s0002-9610(05)80680-4
更新日期：1993-12-01 00:00:00
abstract：:The clinical findings and histologic features of 154 parotid gland tumors treated at the Health Sciences Centre, Winnipeg, Canada, from 1957 to 1970 were reviewed. The study illustrates a wide variation in the natural history and degree of malignancy of parotid tumors. Approximately 80 per cent were benign; among thes...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/0002-9610(75)90344-x
更新日期：1975-06-01 00:00:00
abstract：BACKGROUND:Protection of the bronchial stump after pneumonectomy reduces the incidence of bronchopleural fistula. However, which technique provides the most satisfactory results remains open for debate. MATERIALS AND METHODS:We describe a study in which a bronchial stump coverage technique was performed using 2 layers...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/j.amjsurg.2008.01.022
更新日期：2008-10-01 00:00:00
abstract：BACKGROUND:The availability and utility of public statements and policies on gender equity from professional surgical societies has not been studied. METHODS:Professional surgical society websites were searched for publicly available statements and policies related to gender equity. These were compiled and assessed fo...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/j.amjsurg.2020.06.041
更新日期：2020-11-01 00:00:00
abstract：:It is important that physicians participate in the debate and planning process that will ultimately guide how we reform the way health care is financed and delivered in the United States. Herein is offered a perspective on the problem, one which is not necessarily appreciated by health planners. While we deliver the b...
journal_title：American journal of surgery
pub_type： 杂志文章,评审
doi：10.1016/0002-9610(94)90081-7
更新日期：1994-02-01 00:00:00
abstract：BACKGROUND:in 2008, the Surgical Council on Resident Education selected 33 residency programs to pilot its General Surgery Resident Curriculum Website Portal. The portal aims to reduce program variability in curricula, align teaching and learning with essential content, and improve resident study and performance. METH...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/j.amjsurg.2010.05.011
更新日期：2011-01-01 00:00:00
abstract：BACKGROUND:As medicinal and recreational marijuana use broadens across the United States, knowledge of its effects on the body will become increasingly important to all health care providers, including surgeons. DATA SOURCES:We performed a literature review of Pubmed for articles discussing the basic science related t...
journal_title：American journal of surgery
pub_type： 杂志文章,评审
doi：10.1016/j.amjsurg.2018.10.053
更新日期：2019-04-01 00:00:00
abstract：:This study has summarized our results with popliteal-tibial in situ saphenous vein bypass in 26 patients, 25 of whom were diabetic, over a 2 year period. Both above- and below-knee popliteal inflow sites were used for bypass of limb-threatening ischemia. Distal calf or pedal outflow sites were required in all but two ...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/0002-9610(87)90191-7
更新日期：1987-08-01 00:00:00
abstract：BACKGROUND:The objective of this study was to compare the outcome of patients presenting with heel ulcers or gangrene (HEEL group) with those having lesions in other parts of the foot (non-HEEL group). METHODS:Treatment and outcomes of all HEEL and non-HEEL patients between June 2001 and October 2006 were compared. R...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/j.amjsurg.2007.08.008
更新日期：2007-11-01 00:00:00
abstract：BACKGROUND:This study examined the impact of intraoperative myocardial acidosis and adverse postoperative outcomes on the cost of cardiac surgical care. METHODS:Myocardial tissue pH corrected to 37 degrees C (pH(37C)) was measured in 162 patients with cross-clamp (XC) duration of 119 minutes or longer. Perioperative d...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/j.amjsurg.2008.01.023
更新日期：2009-02-01 00:00:00
abstract：:A survey was made of 112 cases of gallstone ileus reported in the Japanese literature, including 3 of our cases. The ratio of males to females was 1 to 1.1, the age range was 13 to 87 years, and biliary-enteric fistulas were demonstrated in 81 percent of the patients. Although cholecystoduodenal fistula was most commo...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/0002-9610(80)90185-3
更新日期：1980-09-01 00:00:00
abstract：:The records of more than 1,000 patients who underwent colonoscopy were reviewed. The study group consisted of 55 of these 1,000 patients who had persistent unexplained bleeding per rectum and negative radiographic examinations. Colonoscopy was helpful in defining the site of bleeding in approximately 50 per cent of th...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/0002-9610(79)90332-5
更新日期：1979-11-01 00:00:00
abstract：BACKGROUND:Bile duct calculi (BDC) can be cleared or treated with modern endoscopic techniques in most patients. However, large stones, bile duct strictures, or unusual anatomy may make endoscopic clearance difficult. The purpose of the present study was to determine the efficacy of extracorporeal shock-wave lithotrips...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/s0002-9610(97)00234-1
更新日期：1998-01-01 00:00:00
abstract：:The multicentric occurrence of tumors of the upper aerodigestive tract has been well described, with an incidence ranging from 5 to 16 percent. Detection of a synchronous primary tumor at the time of initial work-up is crucial both for management and final outcome. However, there is a diversity of opinions regarding t...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/s0002-9610(88)80036-9
更新日期：1988-06-01 00:00:00
abstract：BACKGROUND:To evaluate the clinical and laboratory characteristics of patients submitted to subtotal splenectomy during the immediate and late postoperative period. METHODS:The study was conducted on 34 patients, 25 of whom were submitted to subtotal splenectomy (group I), and 9 to total splenectomy without preservati...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/s0002-9610(02)01407-1
更新日期：2003-04-01 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：:Colonoscopic examination of the entire colon was performed on 146 patients for radiographically suspected benign polypoid disease. Of thirty-six patients who did not have a neoplastic lesion at the suspected site, seven (19 per cent) had unsuspected small benign polypoid adenomas elsewhere in the colon. Of the remaini...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/0002-9610(76)90162-8
更新日期：1976-04-01 00:00:00
abstract：:Although the incidence of anastomotic false aneurysms decreased precipitously with the cessation of usage of silk sutures for vascular anastomoses, the prevalence of these aneurysms has undoubtedly increased in keeping with an ever-increasing volume of peripheral vascular operations. Most aneurysms occur at femoral an...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/0002-9610(83)90338-0
更新日期：1983-12-01 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：:Penetrating injuries to the common and internal carotid artery carry the unique potential for irreversible neurologic damage, respiratory collapse, and exsanguination. This study analyzes a recent 4 year experience with 18 cases of penetrating injury to the carotid artery to identify the factors influencing surgical d...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/s0002-9610(88)80363-5
更新日期：1988-08-01 00:00:00
abstract：INTRODUCTION:We hypothesized that the implementation of a novel mental skills curriculum (MSC) during laparoscopic simulator training would improve mental skills and performance, and decrease stress. METHODS:Sixty volunteer novices were randomized into intervention and control groups. All participants received FLS tra...
journal_title：American journal of surgery
pub_type： 杂志文章,随机对照试验
doi：10.1016/j.amjsurg.2016.10.016
更新日期：2017-02-01 00:00:00
abstract：:Following its introduction in 1993, the LAP-BAND (INAMED Health, Santa Barbara, CA) has been used extensively across the world for the treatment of obesity, and data on safety and effectiveness are now available. This review draws on the literature and our own clinical patient base to provide an overview of the early ...
journal_title：American journal of surgery
pub_type： 杂志文章,评审
doi：10.1016/s0002-9610(02)01179-0
更新日期：2002-12-01 00:00:00
abstract：BACKGROUND:Phyllodes tumors (PTs) of the breast are rare, and their prognosis and treatment are still subject of discussion. The purpose of this study is to clarify therapeutic aspects and prognostic factors of this disease. PATIENTS AND METHODS:We retrospectively reviewed the medical records of 106 patients who had h...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/j.amjsurg.2006.04.007
更新日期：2006-08-01 00:00:00
abstract：:We the undersigned editors of the member journals of the Surgery Journal Editors Group (SJEG), in the furtherance of integrity in surgical and scientific publication, agree to adopt the guidelines established by the Committee on Publication Ethics (COPE). The COPE guidelines represent a means of addressing a variety o...
journal_title：American journal of surgery
pub_type： 社论
doi：10.1016/j.amjsurg.2010.06.001
更新日期：2010-07-01 00:00:00
abstract：BACKGROUND:Michigan repealed a 35-year mandatory helmet law on April 13, 2012. We examined the early clinical impacts at a level 1 trauma center in West Michigan. METHODS:Retrospective cohort study comparing outcomes among motorcycle crash victims in a 7-month period before and after the helmet law repeal. RESULTS:On...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/j.amjsurg.2013.12.001
更新日期：2014-03-01 00:00:00
