Abstract：
PURPOSE:This study aimed to determine one-year outcomes and the impact of various factors on the need for readmission and reoperation following abdominoperineal resection (APR). METHOD:A multivariate logistic regression analysis was conducted to determine predictors of readmission and/or reoperation within one year of APR performed between January-2000 and December-2013. RESULTS:536 patients were analyzed for whom the most common indication for surgery was rectal cancer(86.4%). Within one year of operation, 14.2% (n = 76) of patients have major (grade III/IV of Clavien-Dindo [CD]) and 26.1%(n = 140) of patients have minor complications (grade I/II of CD). Respective major and minor perineal wound complication(PWC) rates were 10.4% and 5.6%.Readmission and reoperation rates within 90 days following discharge were 25% and 8.8%, respectively. While PWC (n = 53,39.2%) and small bowel obstruction(n = 23,17%) were the most common causes of readmission within 90 days,PWC(n = 20,23.3%) and distant metastasis(n = 20,23.3%) were the main causes of long-term readmission(90-day to 1 year). CONCLUSION:Perineal wound complications were the most common cause of readmission and reoperation within one year of APR. Well-coordinated efforts aimed at decreasing the perineal wound morbidity may impact the need for readmission and reoperation.
journal_name
Am J Surgjournal_title
American journal of surgeryauthors
Rencuzogullari A,Abbas MA,Steele S,Stocchi L,Hull T,Binboga S,Gorgun Edoi
10.1016/j.amjsurg.2018.08.021subject
Has Abstractpub_date
2019-07-01 00:00:00pages
119-124issue
1eissn
0002-9610issn
1879-1883pii
S0002-9610(18)30821-3journal_volume
218pub_type
杂志文章abstract：:Definitive therapy for variceal hemorrhage has evolved during the past half century. Only completely decompressing shunts (nonselective shunts) were available before 1967. Additional options now include selective shunts, devascularization procedures, endoscopic sclerotherapy, pharmacotherapy, and hepatic transplantati...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/s0002-9610(05)80873-6
更新日期：1990-07-01 00:00:00
abstract：:Fifty-four patients receiving peripheral parenteral nutrition consisting of 3.5 percent amino acids in a 5 percent dextrose solution were randomly assigned in a double-blind fashion to receive this solution with or without an antiphlebitic mixture (1000 IU heparin, 5 mg hydrocortisone, and 1.8 mEq sodium hydroxide as ...
journal_title：American journal of surgery
pub_type： 临床试验,杂志文章,随机对照试验
doi：10.1016/0002-9610(86)90022-x
更新日期：1986-01-01 00:00:00
abstract：:Reoperation to remove an aortic graft was performed in 18 patients. The need for removal was infection in the majority. A changing flora was seen in aortic graft infection with gram-negative organisms predominating. Despite a standardized approach with total graft removal, aortic closure, and extraanatomic reconstruct...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/0002-9610(83)90371-9
更新日期：1983-08-01 00:00:00
abstract：BACKGROUND:To determine the current surgical management of bleeding duodenal ulcers in our program, faculty (FAC) and residents (RES) were surveyed. METHODS:FAC (n = 33) and RES (n = 42) were surveyed regarding their surgery of choice between oversew (OS) or acid-reducing procedures (ARPs) in 4 scenarios. FAC who had ...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/j.amjsurg.2006.08.021
更新日期：2006-11-01 00:00:00
abstract：:We found that the mortality rate was no greater in patients with necrotizing enterocolitis complicated by perforation compared with the rate in those with other causes of perforation in similar weight classes. Iatrogenic injuries had a 50 percent mortality rate in all gestational age and birth weight categories and, t...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/s0002-9610(88)80111-9
更新日期：1988-03-01 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：:The results of aggressive surgical treatment of primary lip cancer and advanced and recurrent carcinoma of the lip are illustrated and discussed. Early detection of involved lymph nodes before capsular penetration occurs and careful and complete dissection of the submental and submandibular regions are advocated as po...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/0002-9610(76)90326-3
更新日期：1976-10-01 00:00:00
abstract：:A prospective randomized clinical trial was performed in order to evaluate the results of three surgical techniques for the treatment of gastric outlet obstruction secondary to duodenal ulcer. Ninety patients with clinical and laboratory evidence of gastric retention were enrolled. After laparotomy, patients underwent...
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(05)80580-x
更新日期：1993-07-01 00:00:00
abstract：BACKGROUND:Surgical quality improvement (QI) is a global priority. We report the design and proof-of concept testing of a QI skills curriculum for urology residents. METHODS:'Umbrella review' of QI curricula (Phase-1); development of draft QI curriculum (Phase-2); curriculum review by Steering Committee of urologists ...
journal_title：American journal of surgery
pub_type： 杂志文章,多中心研究
doi：10.1016/j.amjsurg.2018.11.008
更新日期：2019-02-01 00:00:00
abstract：:Rectal prolapse that is intractable to the usual medical therapy was successfully managed without significant complications in 10 patients by simple subcutaneous encirclement of the anus with a heavy nonabsorbable suture, which was in place until the suture was removed or broke after 4 to 6 months. Four patients requi...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/s0002-9610(05)81022-0
更新日期：1990-11-01 00:00:00
abstract：BACKGROUND:Penetrating injury independently predicts the need for surgeon presence (NSP) upon arrival. Penetrating injury is often used as a trauma triage indicator, however, it includes a wide range of specific mechanisms of injury. We sought to compare firearm-related and non-firearm related pediatric penetrating inj...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/j.amjsurg.2020.06.003
更新日期：2021-01-01 00:00:00
abstract：BACKGROUND:Restoration of the abdominal wall's integrity after postoperative wound dehiscence is frequently performed in a delayed fashion, necessitating a temporary dressing of the dehisced wound. METHODS:The Vacuum Assisted Closure (VAC) system (Kinetic Concepts, Inc., San Antonio, TX) was used in 21 patients with p...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/j.amjsurg.2005.09.003
更新日期：2006-02-01 00:00:00
abstract：BACKGROUND:Virtual reality simulators provide an effective learning environment and are widely used. This study evaluated the Endoscopic Sinus Surgery Simulator (ES3; Lockheed Martin) as a tool for anatomic education. METHODS:Two medical student groups (experimental, n = 8; control, n = 7) studied paranasal sinus anat...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/j.amjsurg.2007.06.026
更新日期：2008-07-01 00:00:00
abstract：BACKGROUND:Achieving a higher hemoglobin (Hb) level might allow the anemic, critically ill, trauma patient to have an improved outcome during rehabilitation therapy. METHODS:Patients with major blunt trauma orthopedic injuries were administered epoetin alfa or placebo weekly both in hospital and for up to 12 weeks aft...
journal_title：American journal of surgery
pub_type： 杂志文章,多中心研究,随机对照试验
doi：10.1016/j.amjsurg.2011.08.006
更新日期：2012-04-01 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：:In the present study, the incidence of severe brain injury was 600 percent higher for patients riding without a helmet and the incidence of all brain injuries was nearly twice as high in the nonhelmeted riders. All surviving patients with severe brain injury sustained residual long-term disability. The incidence of in...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/s0002-9610(88)80151-x
更新日期：1988-05-01 00:00:00
abstract：BACKGROUND:While vascular patency and overall viability of the gut can be evaluated perioperatively, damage to the mucosal barrier can hardly be judged in the perioperative setting and, moreover, will probably determine the clinical course. METHODS:In 19 consecutive cases with intestinal ischemia, the clinical course ...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/s0002-9610(97)00048-2
更新日期：1997-07-01 00:00:00
abstract：BACKGROUND:Academic institutions have increasingly focused on educating physicians and surgeons in concepts of value-based care, including quality improvement (QI). The extent to which QI curricular competencies are addressed in specialty surgical residency training is unclear. METHODS:A survey instrument was develope...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/j.amjsurg.2020.09.036
更新日期：2020-09-29 00:00:00
abstract：BACKGROUND:Endoscopic retrograde cholangiopancreatography and laparoscopic common bile duct exploration are safe and efficient methods that have recently been used for the treatment of bile duct stones. The aim of this study was to compare the efficacy, safety, and surgical outcomes of the laparoscopic common bile duct...
journal_title：American journal of surgery
pub_type： 杂志文章,随机对照试验
doi：10.1016/j.amjsurg.2013.02.004
更新日期：2013-10-01 00:00:00
abstract：:Seven patients who had typical and persistent symptoms of gallbladder disease but repeatedly normal oral cholecystograms were seen in an 18 month period. Ultrasound examination of the gallbladder was diagnostic of cholelithiasis in all seven patients. Six patients were found to have gallstones at operation, and the se...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/0002-9610(79)90339-8
更新日期：1979-11-01 00:00:00
abstract：BACKGROUND:The role of sentinel lymph node status (SLNS) in thick melanoma is evolving. The purpose of this study was to determine the prognostic value of SLNS in thick melanoma. METHODS:A retrospective analysis of 120 prospectively collected clinically node-negative thick melanomas over 5 years was performed. Patient...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/j.amjsurg.2013.12.022
更新日期：2014-05-01 00:00:00
abstract：:Review of the diagnosis and treatment of patients with pancreatic pseudocysts over the past 8 years has led us to three conclusions regarding controversial aspects of their treatment. We found that patients who present with chronic pseudocysts can be identified with the help of computerized axial tomography and prompt...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/s0002-9610(88)80275-7
更新日期：1988-01-01 00:00:00
abstract：BACKGROUND:Burnout affects surgical residents' well-being. OBJECTIVE:We sought to identify factors associated with burnout among surgery residents. METHODS:An electronic/anonymous survey was sent to surgical residents at 18 programs, consisting of demographic/programmatic questions and validated scales for burnout, d...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/j.amjsurg.2019.07.004
更新日期：2020-06-01 00:00:00
abstract：:Histologic material from 42 cases diagnosed as gastric lymphoma at Hartford Hospital was reviewed, confirming the diagnosis in 37. Three cases of pseudolymphoma were found. The incidence of gastric lymphoma has increased steadily over the past 50 years: 35 percent of cases occurred during the past decade. Most patient...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/0002-9610(82)90194-5
更新日期：1982-04-01 00:00:00
abstract：:Reports in the surgical literature are conflicting as to whether appendectomy "in passing" during laparotomy for trauma or for some other disease state does or does not significantly increase patient morbidity or mortality. A chart survey of all appendectomies (342 for acute appendicitis and 146 as incidental procedur...
journal_title：American journal of surgery
pub_type： 临床试验,杂志文章,随机对照试验
doi：10.1016/0002-9610(83)90150-2
更新日期：1983-06-01 00:00:00
abstract：BACKGROUND:In women undergoing breast conserving surgery (BCS), up to 60% can require re-excision. Our objective is to develop an optically based technology which can differentiate benign from malignant breast tissues intraoperatively through differences in tissue composition factors. METHODS:A prospective study of op...
journal_title：American journal of surgery
pub_type： 临床试验,杂志文章
doi：10.1016/j.amjsurg.2009.06.018
更新日期：2009-10-01 00:00:00
abstract：BACKGROUND:Identifying factors associated with resident autonomy may help improve training efficiency. This study evaluates resident and procedural factors associated with level of guidance needed in the operating room. METHODS:Intraoperative performance and yearly performance on Fundamentals of Laparoscopic Surgery (...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/j.amjsurg.2019.03.019
更新日期：2019-05-01 00:00:00
abstract：BACKGROUND:Currently, the management strategy of pancreatic cyst (PC) remains controversial because of the inability to diagnose this type of cyst accurately and the limited knowledge of its natural history. Previously, many clinicians have advocated an aggressive resectional policy. This approach is no longer appropri...
journal_title：American journal of surgery
pub_type： 杂志文章,评审
doi：10.1016/j.amjsurg.2006.07.019
更新日期：2007-06-01 00:00:00
abstract：:This laboratory study compared the biomechanical and biochemical healing of microvascular free skin flaps in irradiated and nonirradiated recipient areas. In the adult rat, the skin of the right groin region was exposed to a single fraction dose of 20 Gy, using a linear megavoltage accelerator. The left groin was shie...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/s0002-9610(05)80730-5
更新日期：1992-12-01 00:00:00
abstract：BACKGROUND:Injury epidemiology fluctuates with economic activity in many countries. These relationships remain unclear in Canada. METHODS:The annual risk of admission for major injury (Injury Severity Score ≥12) to a high-volume, level-1 Canadian trauma center was compared with indicators of economic activity over a 1...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/j.amjsurg.2013.12.011
更新日期：2014-05-01 00:00:00
