Abstract：
BACKGROUND:Following appendectomy, management is often guided by surgeon determination of whether the appendicitis is uncomplicated or complicated. Our objectives were to determine the incidence of discordance between intraoperative and pathological findings and determine effect on outcomes. METHODS:We performed a retrospective five-year cohort analysis of adults who underwent appendectomy for acute appendicitis. Outcomes examined were length of stay (LOS), return to ED, and 30-day readmission. We reported p-values from logistic regression. RESULTS:Of 1479 cases, 36.4% were labeled complicated appendicitis, among which, 58.2% were discordant. When intraoperative findings underestimated pathological findings, there was a decreased LOS (p < 0.001) compared to concordant diagnoses. There was no significant difference for readmission (p = 0.592) or ED (p = 0.857). CONCLUSION:Operative underestimation of appendicitis severity was associated with a shorter LOS. Discordance did not adversely affect hospital readmission or rate of return to ED. These findings suggest reliance on intraoperative findings is sufficient in guiding management. SUMMARY:We wanted determine the incidence of discordance between operative and pathological findings and determine effect on outcomes. Operative underestimation of appendicitis severity was associated with a shorter LOS. Discordance did not adversely affect hospital readmission or rate of return to ED. These findings suggest reliance on intraoperative findings is sufficient in guiding management.
journal_name
Am J Surgjournal_title
American journal of surgeryauthors
Holloway JJ,Lett LA,Kim DY,Saltzman DJ,Ferebee MP,Macqueen IT,de Virgilio CMdoi
10.1016/j.amjsurg.2019.05.004subject
Has Abstractpub_date
2020-01-01 00:00:00pages
71-74issue
1eissn
0002-9610issn
1879-1883pii
S0002-9610(19)30088-1journal_volume
219pub_type
杂志文章abstract：BACKGROUND:Circumportal pancreas is a rare congenital pancreatic anomaly. The aim of this study was to clarify the clinical characteristics of patients with circumportal pancreases undergoing pancreatectomy. METHODS:The medical records of 508 patients who underwent pancreatectomy were retrospectively reviewed. The pre...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/j.amjsurg.2016.11.018
更新日期：2017-08-01 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:The term secondary abdominal compartment syndrome (ACS) has been applied to describe trauma patients who develop ACS but do not have abdominal injuries. The purpose of this study was to describe major trauma victims who developed secondary ACS during standardized shock resuscitation. METHODS:Our prospective...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/s0002-9610(02)01050-4
更新日期：2002-12-01 00:00:00
abstract：BACKGROUND:Few patients with priapism require inpatient management unless they are refractory to intracavernosal therapy. Their risk factors and outcomes are poorly characterized. METHODS:This is a retrospective analysis of the Nationwide Inpatient Sample (1998-2006). Priapism patients were identified and analyzed ove...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/j.amjsurg.2010.03.017
更新日期：2011-04-01 00:00:00
abstract：:The correlation between serum amylase and pancreatic amylase secretion was studied in two patients. Both patients underwent sphincterotomy, and the pancreatic duct was cannulated with a polyethylene tube. The tube was left in place for 15 to 21 days. The rate of amylase secretion over 7 days was studied in response to...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/0002-9610(82)90178-7
更新日期：1982-05-01 00:00:00
abstract：BACKGROUND:This 17-year review was undertaken to examine clinical outcomes and the changing trends in resource utilization for lower extremity bypass grafts performed in a managed care setting. PATIENTS AND METHODS:Between 1979 and 1995, 338 bypasses in 276 patients (199 men, 77 women; 62% diabetics) were carried out ...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/S0002-9610(96)00130-4
更新日期：1996-08-01 00:00:00
abstract：:Paraplegia or paraparesis after operations on the thoracic and abdominal aorta is a devastating event, both for the patient and the surgeon. While its incidence varies from under 1% with operations at the top and bottom of the aorta, its occurrence in the midportion of the aorta, just above the diaphragm, even in the ...
journal_title：American journal of surgery
pub_type： 杂志文章,评审
doi：10.1016/s0002-9610(98)00133-0
更新日期：1998-08-01 00:00:00
abstract：BACKGROUND:Recent cognitive research in medicine has demonstrated that expert diagnosticians solve many clinical problems through "pattern recognition" rather than deductive reasoning strategies. Development of the ability to recognize and diagnose common surgical problems is a critical objective of undergraduate surgi...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/S0002-9610(99)80172-X
更新日期：1995-03-01 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：BACKGROUND:Core biopsy finding of atypical ductal hyperplasia (ADH) are generally followed by open biopsy to avoid underestimation of malignant disease. METHODS:Retrospective examination of 11 gauge stereotactic-guided vacuum-assisted core biopsies was made with respect to ADH diagnosis, follow-up open biopsy, and upg...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/s0002-9610(01)00727-9
更新日期：2001-10-01 00:00:00
abstract：BACKGROUND:Colonic inertia (CI) is a disturbance of colonic motility characterized by severe constipation and abdominal pain. This study was conducted to assess the results of total abdominal colectomy (TAC) in the management of CI. METHODS:A retrospective chart review of 55 patients who underwent TAC for CI was condu...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/s0002-9610(01)00820-0
更新日期：2001-12-01 00:00:00
abstract：BACKGROUND:Perihilar cholangiocarcinoma is usually unresectable at the time of diagnosis. Only few patients are candidates for a potential curative treatment. For those patients, prognosis is strongly related to negative resection margin and lymph node status. Thus, a certain benchmark of lymph node count is necessary ...
journal_title：American journal of surgery
pub_type： 杂志文章,评审
doi：10.1016/j.amjsurg.2015.05.015
更新日期：2015-10-01 00:00:00
abstract：:The social, economic and political challenges accompanying our rapidly transforming global health environments have created unique social challenges that demand cross-sector solutions. Four cross-sector partnerships are reviewed with a special focus on sector roles, change management, phases of partnership development...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/s0002-9610(02)01143-1
更新日期：2003-01-01 00:00:00
abstract：BACKGROUND:Teletrauma programs allow rural patients access to advanced trauma and emergency medical services that are often limited to urban areas. METHODS:A retrospective analysis of 59 teleconsults between 5 rural hospitals and a level I trauma center was performed. The objectives of this study were to report the in...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/j.amjsurg.2009.08.011
更新日期：2009-12-01 00:00:00
abstract：BACKGROUND:The impact of axillary node dissection on breast cancer survival is unclear. Limited axillary surgery has been proposed but may increase regional recurrence rates. Optimal management for axillary recurrence is poorly understood. METHODS:Axillary recurrences were initial treatment failure sites in 44 of 4,25...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/s0002-9610(00)00456-6
更新日期：2000-10-01 00:00:00
abstract：:Between 1979 and 1988, we created intestinal anastomoses in 1,000 patients using a single-layer, continuous suturing technique and a polypropylene suture. The technique is easily learned, flexible in its application, and incurs less cost than most other techniques. The anastomoses involved all levels of the colon and ...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/0002-9610(91)90262-c
更新日期：1991-11-01 00:00:00
abstract：:One hundred seventy-five patients underwent restorative proctocolectomy between November 1984 and December 1992. The pathologic results were reviewed by two pathologists, one being a gastrointestinal pathologist. One hundred fifty-eight patients had a confirmed diagnosis of ulcerative colitis, and 16 patients were dia...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/0002-9610(94)90248-8
更新日期：1994-05-01 00:00:00
abstract：:Specific circulating serum proteins may reflect unique properties governing the growth and progression of head and neck cancers. One hundred three previously untreated patients with squamous cell carcinoma of the head and neck were prospectively evaluated for serum IgA, IgG, and IgM and C1q-binding macromolecules. Imm...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/s0002-9610(05)80560-4
更新日期：1990-10-01 00:00:00
abstract：:Abdominal muscular contractions may have a protective influence against the development of indirect inguinal hernia. A portion of the transversus abdominus muscles acts on the internal inguinal rings and produces a closure mechanism during voluntary abdominal muscular activity. It follows, therefore, that injury or in...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/0002-9610(82)90108-8
更新日期：1982-03-01 00:00:00
abstract：BACKGROUND:Factors that determine recurrence and complications following primary tissue repair of umbilical hernias (UHs) and the approach to repair UHs in obese patients need further analysis. METHODS:A retrospective review of UH repair (UHR) conducted at our institution was undertaken. Patients were grouped by body ...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/j.amjsurg.2015.03.014
更新日期：2016-01-01 00:00:00
abstract：BACKGROUND:This study evaluated a simulated pages curriculum that was developed to assess communication and clinical decision making in medical students and interns. METHODS:A curriculum consisting of 14 simulated pages was administered across 5 institutions to 150 senior medical students. A 3-case subset was administ...
journal_title：American journal of surgery
pub_type： 杂志文章,多中心研究
doi：10.1016/j.amjsurg.2014.01.014
更新日期：2014-08-01 00:00:00
abstract：:Over 10 years, 8 infants required surgery for central diaphragmatic herniation. Contrast peritoneography and technetium-99m-sulfur colloid radionuclide scanning were the most definitive diagnostic aids. Associated anomalies included variations of the pentalogy of Cantrell. A midline gastroduodenal loop was found in tw...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/0002-9610(84)90009-6
更新日期：1984-04-01 00:00:00
abstract：:In this 6-year study of 101 limbs requiring surgical intervention for upper-extremity vascular trauma, most patients were male, young, and injured by penetrating objects. Injured vessels included 13 axillary/subclavian, 23 brachial, 40 radial, and 25 ulnar arteries. Concomitant injuries included nerve injury in 50 cas...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/s0002-9610(05)80313-7
更新日期：1990-08-01 00:00:00
abstract：BACKGROUND:No studies to date exist regarding the attire of physicians on a surgical service. The objective of this study was to determine patient, surgeon, and nonhospitalized public (NHP) attitudes and preferences regarding surgeons' attire and mannerisms. METHODS:A questionnaire was developed to survey each group. ...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/j.amjsurg.2005.04.003
更新日期：2005-07-01 00:00:00
abstract：:DNA is the fundamental guide for the cell's processes. The alterations in DNA that can lead to abnormal or absent proteins and the role of chromosomal alterations in changing the function of the DNA are reviewed. The role of viruses in derailing a cell's normal functions, the major mechanisms of oncogene action, and t...
journal_title：American journal of surgery
pub_type： 杂志文章,评审
doi：10.1016/s0002-9610(05)80911-0
更新日期：1992-10-01 00:00:00
abstract：BACKGROUND:Laparoscopic donor nephrectomy (LDN) is a new technique. While the short-term recipient renal function is equivalent to that of the traditional open nephrectomy (ODN), long-term function and potential exclusion criteria, such as the presence of multiple renal arteries, are as yet unknown. METHODS:Retrospect...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/s0002-9610(98)00260-8
更新日期：1998-12-01 00:00:00
abstract：:Three patients who underwent 95 percent removal of the pancreas for chronic pancreatitis with autotransplantation of the body and tail of the gland to the femoral area are described. The follow-up periods are 18, 6, and 2 months. Pain lessened in all patients and none required exogenous insulin. Patency of the graft w...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/0002-9610(83)90036-3
更新日期：1983-04-01 00:00:00
abstract：BACKGROUND:The appropriate management of gallstones in patients undergoing renal transplantation is controversial. Screening for gallstones and subsequent prophylactic cholecystectomy has been recommended by some authors for kidney transplant candidates. Our program does not practice routine pretransplant screening for...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/s0002-9610(98)00009-9
更新日期：1998-04-01 00:00:00
abstract：BACKGROUND:Crohn's disease is an aggressive chronic inflammatory disorder, and despite medical advances no cure exists. There is a great risk of requiring an operative intervention, with evidence of recurrence developing in up to 80-90% of cases. Therefore, we sought to systematically review the current status in the p...
journal_title：American journal of surgery
pub_type： 杂志文章,评审
doi：10.1016/j.amjsurg.2017.04.016
更新日期：2017-11-01 00:00:00
abstract：:1. Approximately 40,000 cases of cancer of the head and neck (excluding skin) are diagnosed each year. 2. Approximately 20,000 of these cases and 30,000 cases of skin cancer are treated by 366 head and neck cancer surgeons. 3. Ninety per cent of the cases are treated by 63 per cent of the surgeons. 4. Fifty-eight per ...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/0002-9610(75)90239-1
更新日期：1975-03-01 00:00:00
