Abstract:
:A prospective clinical trial was designed to evaluate the efficacy of postoperative jejunostomy feedings using high (44 percent) and low (15 percent) branched-chain amino acid elemental diet formulations compared with no jejunostomy feedings in a homogeneous surgical population. Twenty-eight patients undergoing radical cystectomy and ileal diversion were randomized to the high branched-chain amino acid formula (11 patients) or the low branched-chain amino acid formula (9 patients). Eight patients received a 5 percent dextrose in water solution intravenously and served as a control group. Mean caloric intake per day in each group was 1,543 calories, 1,697 calories, and 550 calories, respectively; whereas the mean nitrogen intake of each group was 6.5 +/- 2.1 g/day, 8.2 +/- 2.4 g/day, and 0 g/day, respectively. Mean weight changes were minus 0.7 percent, 0.7 percent, and minus 0.3 percent, respectively. The mean daily nitrogen balance was minus 1.6 +/- 3.5 g/day, minus 1.1 +/- 4.4 g/day, and minus 6.6 +/- 1 g/day (p less than 0.001). Five patients (25 percent) in the jejunostomy groups progressed to an oral diet more rapidly than the control group, but gastrointestinal complications occurred in 11 patients (55 percent). Immediate postoperative jejunostomy feedings resulted in improved nitrogen balance compared with the control group values, but no metabolic advantage was noted by infusing a high branched-chain amino acid formula. Improved return to normal gastrointestinal function was noted in 25 percent of jejunostomy patients, but the gastrointestinal complications noted limited the overall usefulness of this technique.
journal_name
Am J Surgjournal_title
American journal of surgeryauthors
Daly JM,Bonau R,Stofberg P,Bloch A,Jeevanandam M,Morse Mdoi
10.1016/0002-9610(87)90815-4subject
Has Abstractpub_date
1987-02-01 00:00:00pages
198-206issue
2eissn
0002-9610issn
1879-1883pii
0002-9610(87)90815-4journal_volume
153pub_type
临床试验,杂志文章,随机对照试验abstract::A patient with the classic manifestations of the glucagonoma syndrome and hepatic metastases is presented. Clinical improvement occurred after removal of the primary tumor by distal pancreatectomy and splenectomy. No further antitumor therapy has been needed over a 15 month postoperative follow-up despite metastatic d...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/0002-9610(80)90306-2
更新日期:1980-03-01 00:00:00
abstract:BACKGROUND:Ultrasonography (USG) and technetium-99m sestamibi (MIBI) scintigraphy are commonly used imaging modalities in the era of minimally invasive parathyroidectomy (MIP) for primary hyperparathyroidism (pHPT). However, their relative importance and actual contribution to MIP have not been prospectively assessed. ...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/j.amjsurg.2006.04.020
更新日期:2007-02-01 00:00:00
abstract::Ileal water and electrolyte absorption exceed jejunal absorption in both the basal and meal-stimulated states. The purposes of these experiments were to determine: (1) if luminal bile acids alter basal or meal-stimulated intestinal absorption, and (2) if there is site specificity or meal stimulation of intestinal bile...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/s0002-9610(05)80792-5
更新日期:1993-06-01 00:00:00
abstract:BACKGROUND:Pancreatoduodenectomy is the only effective treatment for cancers of the periampullary region. Because surgeons usually grasp tumors during pancreatoduodenectomy, this procedure may increase the risk of squeezing and shedding the cancer cells into the portal vein, retroperitoneum, and/or peritoneal cavity. I...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/j.amjsurg.2008.06.035
更新日期:2010-05-01 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::Feeding gastrostomy and jejunostomy provide effective access for long-term enteral nutrition. Traditional operative techniques for the performance of these procedures requires laparotomy and often, general anesthesia. This report describes our experience with two relatively new methods, percutaneous endoscopic gastros...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/s0002-9610(85)80017-9
更新日期:1985-01-01 00:00:00
abstract::Forty-eight patients with acute cholangitis who presented with postcholocystectomy choledocholithiasis are reported on in this study. As soon as the general condition of the patients had improved, or as soon as the fluid balance was established, usually within 48 hours of admission, the patients were divided into two ...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/0002-9610(82)90096-4
更新日期:1982-03-01 00:00:00
abstract::Three hundred patients who underwent upper abdominal operations were studied. One hundred fifty patients were treated by insertion of a nasogastric tube, and 150 patients were treated without it. The incidence of postoperative pneumonia was 10 times higher in the patients treated with a nasogastric tube. Pneumonia was...
journal_title:American journal of surgery
pub_type: 临床试验,杂志文章
doi:10.1016/0002-9610(80)90395-5
更新日期:1980-06-01 00:00:00
abstract:BACKGROUND:We conducted a national survey of general surgeons to address the association between surgeon characteristics and the tendency to recommend surgery. METHODS:We used a web-based survey with 25 hypothetical clinical scenarios with clinical equipoise regarding the decision to operate. The respondent-level tend...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/j.amjsurg.2013.08.018
更新日期:2013-12-01 00:00:00
abstract:BACKGROUND:Patients with spinal cord injury (SCI) frequently have pressure ulcers. Surgery is sometimes needed to close them. In rare cases, hemipelvectomy is warranted for extremely severe complications. METHODS:We conducted a retrospective study using national Department of Veterans Affairs (DVA) computer data sets ...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/s0002-9610(02)01123-6
更新日期:2003-01-01 00:00:00
abstract:BACKGROUND:Advantages of laparoscopic cholecystectomy (LC) such as less pain and short hospital stay make it the treatment of choice for cholelithiasis. There are limited data about LC under spinal anesthesia. This study was designed to evaluate LC under spinal anesthesia. METHODS:Twenty-nine patients underwent surger...
journal_title:American journal of surgery
pub_type: 临床试验,杂志文章
doi:10.1016/j.amjsurg.2007.05.043
更新日期:2008-04-01 00:00:00
abstract:BACKGROUND:Transjugular intrahepatic portosystemic stent shunt (TIPS) has become the modality of choice for complicated portal decompression. This study was undertaken to determine outcomes after TIPS and the usefulness of TIPS as a "bridge" to transplantation. METHODS:Patients undergoing TIPS from 2001 to 2010 at a t...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/j.amjsurg.2012.06.005
更新日期:2013-04-01 00:00:00
abstract:BACKGROUND:Post-traumatic splenic pseudocysts are uncommon. The optimal treatment is not well defined. METHODS:A retrospective chart review was conducted at the three adult hospitals in the Calgary Health Region. RESULTS:Six cases of splenic pseudocysts were found over a 6-year period. One splenic pseudocyst spontane...
journal_title:American journal of surgery
pub_type: 杂志文章,多中心研究
doi:10.1016/j.amjsurg.2006.01.034
更新日期:2006-05-01 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:BACKGROUND:Traumatic vascular injuries are infrequent but can be devastating. This study characterized their incidence and the need for vascular surgeons in their repair. Outcomes for patients repaired by vascular and trauma surgeons were compared. METHODS:Patients age ≥14, needing operations for acute traumatic vascu...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/j.amjsurg.2015.11.011
更新日期:2016-03-01 00:00:00
abstract:BACKGROUND:Two decades since the advent of laparoscopic cholecystectomy, the rate of bile duct injuries still remains higher than in the open cholecystectomy era. METHODS:The rate and complexity of bile duct injuries was evaluated in 83,449 patients who underwent laparoscopic cholecystectomy between 1995 and 2008 in t...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/j.amjsurg.2011.08.018
更新日期:2012-04-01 00:00:00
abstract::Gaucher's disease is an inherited metabolic disorder caused by the defective activity of acid beta-glucosidase and the resultant accumulation of glucosyl ceramide-laden macrophages in the liver, bone, and spleen. Splenectomy is the preferred treatment for patients with Gaucher's disease who develop massive splenomegal...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/0002-9610(91)90363-i
更新日期:1991-01-01 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:To prevent hepatic failure after major hepatectomy, it is important to assess preoperative factors related to liver failure. METHODS:We examined 80 patients who underwent right-sided hepatectomy. Hyperbilirubinemia, uncontrolled ascites, and prolonged postoperative hospital stay were defined as liver failur...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/j.amjsurg.2012.12.013
更新日期:2013-09-01 00:00:00
abstract::Hepatic rupture as a late complication of toxemic pregnancy is a rare yet lethal condition requiring rapid recognition and surgical management. The clinical triad of toxemia, right upper quadrant pain, and sudden hypotension is the diagnostic hallmark of presentation. Most patients present near the time of delivery an...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/0002-9610(77)90333-6
更新日期:1977-12-01 00:00:00
abstract:BACKGROUND:Gastrointestinal stromal tumors (GISTs), the specific kit-positive mesenchymal tumors of the gastrointestinal tract, are rarely found in the anorectum and account for only 0.1% of all colorectal tumors. The main stem of therapy remains surgical excision. The standard surgical approach for anorectal GISTs inc...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/j.amjsurg.2005.10.013
更新日期:2006-01-01 00:00:00
abstract::DVT involving the lower extremities is a frequent (25-40 percent of patients) complication of major thoracic, abdominal, and pelvic surgery in patients beyond the age of 40 years. Herein, we have reported a recently completed large prospective, randomized multicenter investigation of the prophylaxis of postoperative D...
journal_title:American journal of surgery
pub_type: 临床试验,杂志文章,随机对照试验
doi:
更新日期:1985-10-08 00:00:00
abstract:INTRODUCTION:Patient Reported Outcomes (PROs) capture peri-operative fatigue, pain, and quality of life and influence outcomes in gastrointestinal surgery. We compared peri-operative PROs in patients undergoing colorectal operations for neoplastic versus non-neoplastic processes. METHODS:Patients undergoing colectomy ...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/j.amjsurg.2020.08.017
更新日期:2020-12-01 00:00:00
abstract::The integrity of the normal mature intestinal mucosal barrier to unaltered proteins was evaluated with tritiated bovine albumin in rats. Intact H3-BSA placed into either colon or small intestinal lumen regularly reached the bloodstream in quantities sufficient to be antigenic or toxigenic, although the fraction of H3-...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/0002-9610(77)90193-3
更新日期:1977-01-01 00:00:00
abstract:INTRODUCTION:The few series of synchronous lung cancers have included small cell and carcinoid tumors. We wished to determine the prognosis for patients with synchronous non-small cell lung cancer (NSCLC). METHODS:A database of 3034 lung cancer patients was reviewed for synchronous NSCLC. Survival was determined by Ka...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/S0002-9610(96)00019-0
更新日期:1996-05-01 00:00:00
abstract:INTRODUCTION:Despite the use of radiologic, endoscopic, and laparoscopic staging techniques, the rate of nontherapeutic laparotomies in patients with hilar cholangiocarcinoma remains high. This study evaluated the accuracy of preoperative high-resolution computed tomography (HRCT) to determine resectability in this set...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/j.amjsurg.2006.10.024
更新日期:2007-06-01 00:00:00
abstract:BACKGROUND:Specific International Classification of Diseases, Ninth Revision, codes for laparoscopic procedures introduced in 2008 allow a more accurate evaluation of laparoscopic colorectal surgery. METHODS:Using the Nationwide Inpatient Sample 2009, a retrospective analysis of surgical colorectal cancer and divertic...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/j.amjsurg.2012.07.031
更新日期:2012-12-01 00:00:00
abstract:BACKGROUND:Recurrent laryngeal nerve (RLN) injury is a serious complication of thyroidectomy. The purpose of this study is to determine the predictors and consequences of RLN injury during thyroidectomy. METHODS:A retrospective analysis was conducted using the ACS-NSQIP 2016-2017 main and thyroidectomy targeted proced...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/j.amjsurg.2020.07.023
更新日期:2021-01-01 00:00:00
abstract::In a model of severe hemorrhagic shock in rats, blood culture findings became positive within 2 to 4 hours of shock. The organisms cultured were primarily gram-negative. To test the hypothesis that the gut was the source of the bacteria, E. coli labeled with carbon-14 oleic acid were fed to rats undergoing hemorrhagic...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/s0002-9610(88)80691-3
更新日期:1988-02-01 00:00:00
abstract::Significant arterial trauma can result from femoral arterial cannulation for cardiopulmonary bypass or intraaortic balloon pumping. Threat of imminent loss of limb or suture line disruption requires prompt surgical intervention. Delayed appearance of claudication, characteristically at 1 to 2 weeks postoperatively, is...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/0002-9610(80)90026-4
更新日期:1980-08-01 00:00:00