Abstract:
OBJECTIVES:The aim of this study was to compare morbidity and mortality between nonoperative and operative treatment of pneumoperitoneum. BACKGROUND:Pneumoperitoneum is a potentially life-threatening condition that has been traditionally treated with surgical intervention. Adequately powered studies comparing treatment outcomes are lacking. METHODS:Chart review and computer-assisted abstraction were used to identify patients with pneumoperitoneum at 5 hospitals from 2010 to 2015. Patients with recent abdominal procedures or contained perforation were excluded. Patients were grouped by treatment modality: comfort measures only (CMO), nonoperative treatment, or operative intervention. CMO included only symptom-palliation, whereas nonoperative therapy included all interventions (antibiotics, peritoneal drains, resuscitation) excluding surgery. Outcomes were mortality, discharge disposition, and 30-day complications. Covariates included demographics, comorbidities, and acuity at presentation. RESULTS:Forty patients received CMO, 202 underwent nonoperative treatment, and 199 underwent operative intervention. CMO patients had 98% 30-day mortality. There was no difference in 30-day (P = 0.64) or 2-year mortality (P = 0.53) between patients treated nonoperatively and operatively. Compared with patients treated operatively, patients treated nonoperatively were more likely to have a colorectal source of pneumoperitoneum (37% vs 31%; P = 0.03). Using logistic regression, operative treatment was associated with increased dependence on enteral tube feeding or total parenteral nutrition [odds ratio (OR) 4.30, 95% confidence interval (CI), 1.99-9.29] and nonhome discharge (OR 3.61, 95% CI, 1.81-7.17). Among patients with clinical peritonitis, operative treatment was associated with reduced mortality (OR 0.17, 95% CI, 0.04-0.80). CONCLUSIONS:Operative intervention is associated with reduced mortality in patients with pneumoperitoneum and peritonitis. In the absence of peritonitis, operative treatment is associated with increased morbidity and nonhome discharge.
journal_name
Ann Surgjournal_title
Annals of surgeryauthors
Udelsman B,Lee K,Qadan M,Lillemoe KD,Chang D,Lindvall C,Cooper Zdoi
10.1097/SLA.0000000000003492subject
Has Abstractpub_date
2019-07-23 00:00:00eissn
0003-4932issn
1528-1140pub_type
杂志文章abstract::The pattern of failure was studied in 1012 patients with resected Stage I or II non-small-cell carcinoma of the lung. Initial intrathoracic failure (41%) was more common than initial extrathoracic failure (34%) even though a complete resection was the intent in all patients. The most frequent sites of initial failure ...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-198701000-00012
更新日期:1987-01-01 00:00:00
abstract::Fibronectin exists in a soluble form in plasma and in an insoluble form in tissues. Plasma fibronectin can modulate phagocytic function as well as incorporate into the tissue matrix where it is believed to influence microvascular integrity and tissue repair. The temporal alterations in plasma and lung lymph fibronecti...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-198508000-00016
更新日期:1985-08-01 00:00:00
abstract::This is the first reported case of mumps hemorrhagic pancreatitis in a child, documented at operation, and by rising mumps titers and complicated by a pseudocyst. In severe cases when surgery is indicated, drainage of the lesser sac usually prevents pseudocyst formation. If a pseudocyst occurs, drainage is required to...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-197407000-00012
更新日期:1974-07-01 00:00:00
abstract:OBJECTIVE:To report on the long-term follow-up of a randomized clinical trial comparing pancreatic head resection according to Beger and limited pancreatic head excision combined with longitudinal pancreatico-jejunostomy according to Frey for surgical treatment of chronic pancreatitis. SUMMARY BACKGROUND DATA:Resectio...
journal_title:Annals of surgery
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1097/01.sla.0000157268.78543.03
更新日期:2005-04-01 00:00:00
abstract:OBJECTIVE:Our objective was to evaluate the safety and durability of biologic mesh for single-staged reconstruction of contaminated fields. INTRODUCTION:The presence of contamination during ventral hernia repair (VHR) poses a significant challenge. Some advocate for a multistaged reconstructive approach with delayed d...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/SLA.0b013e3182849871
更新日期:2013-06-01 00:00:00
abstract:OBJECTIVE:Determine whether absorbable or nonabsorbable mesh in repair of large hiatus hernias reduces the risk of recurrence, compared with suture repair. BACKGROUND:Repair of large hiatus hernia is associated with radiological recurrence rates of up to 30%, and to improve outcomes mesh repair has been recommended. P...
journal_title:Annals of surgery
pub_type: 杂志文章,多中心研究,随机对照试验
doi:10.1097/SLA.0000000000000842
更新日期:2015-02-01 00:00:00
abstract:OBJECTIVE:Length of stay (LOS) is an important outcome as a marker of resource consumption. Determining which factors increase LOS may provide information on reducing costs and improving the delivery of care. The purpose of this study was to determine the independent association of intraoperative process of care and po...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-199908000-00016
更新日期:1999-08-01 00:00:00
abstract:OBJECTIVE:The central question tested in this study was whether dichloromethylene-diphosphonate (CL2MDP) liposome-mediated elimination of hepatic and splenic macrophages would influence zymosan-induced bacterial translocation and the zymosan-induced generalized inflammatory response. SUMMARY BACKGROUND DATA:Both an un...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-199312000-00014
更新日期:1993-12-01 00:00:00
abstract:OBJECTIVE:To evaluate readmissions following laparoscopic adjustable gastric banding (LAGB), laparoscopic sleeve gastrectomy (LSG), and laparoscopic Roux-en-Y gastric bypass (LRYGB). BACKGROUND:Few studies have evaluated national readmission rates for primary bariatric surgery with national, bariatric-specific data. ...
journal_title:Annals of surgery
pub_type: 杂志文章,多中心研究
doi:10.1097/SLA.0000000000002079
更新日期:2018-01-01 00:00:00
abstract:OBJECTIVE:Two techniques of duodenum-preserving resection of the head of the pancreas were compared in a prospective, randomized trial. The technical feasibility and effects on quality of life were assessed. SUMMARY BACKGROUND DATA:Drainage and resection are the principles of surgery in chronic pancreatitis. The techn...
journal_title:Annals of surgery
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1097/00000658-199504000-00004
更新日期:1995-04-01 00:00:00
abstract::Percutaneous transhepatic bile drainage was performed in 13 patients with obstructive jaundice, using a combination of the PTC technique and a Seldinger angiography catheter. In 11 cases, the outflow of bile through the catheter was satisfactory and complications were few. Since the risk of the procedure is low and it...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-197701000-00018
更新日期:1977-01-01 00:00:00
abstract:OBJECTIVE:To determine prevalence of documented preoperative code status discussions and post-operative outcomes (specifically mortality, readmission and discharge disposition) of patients with completed Medical Orders for Life-Sustaining Treatments (MOLST) forms before surgery. SUMMARY OF BACKGROUND DATA:A MOLST form...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/SLA.0000000000004675
更新日期:2020-12-18 00:00:00
abstract:OBJECTIVE:To assess the impact of the 80-hour resident workweek restrictions on surgical residents and attending surgeons. SUMMARY BACKGROUND DATA:The ACGME mandated resident duty hour restrictions have required a major workforce restructuring. The impact of these changes needs to be critically evaluated for both the ...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/01.sla.0000220042.48310.66
更新日期:2006-06-01 00:00:00
abstract:OBJECTIVE:We sought to gain a comprehensive understanding of the current methods for conflict resolution and the ways in which women surgeons would prefer workplace conflicts to be adjudicated. SUMMARY OF BACKGROUND DATA:Interprofessional workplace conflicts are poorly studied, particularly for women in surgery. These...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/SLA.0000000000004074
更新日期:2020-07-07 00:00:00
abstract:OBJECTIVE:The current pathological lymph node (pN) staging is based on the number of positive lymph nodes but does not take into consideration characteristics of the involved lymph nodes itself. The current study aims to examine the prognostic value of extracapsular lymph node involvement (EC-LNI) and intracapsular lym...
journal_title:Annals of surgery
pub_type: 杂志文章,多中心研究,随机对照试验
doi:10.1097/SLA.0000000000001463
更新日期:2015-11-01 00:00:00
abstract:BACKGROUND:Acute abdominal pain is the most common indication for surgical admission. Nonspecific abdominal pain (NSAP) may account for up to 40% of cases. There has been no published prospective study in which adult patients presenting with acute abdominal pain are investigated for celiac disease. AIMS:We aimed to as...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/01.sla.0000171301.35513.cf
更新日期:2005-08-01 00:00:00
abstract::Two patients with aortic abdominal aneurysms in association with horseshoe kidney are presented, making a total of 34 cases recorded in the literature. In 29 patients, the aneurysm was resected and five patients were non-resectable. Because of the abnormalities in vascular supply to the abnormal kidney, it is importan...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-197503000-00015
更新日期:1975-03-01 00:00:00
abstract:OBJECTIVE:To evaluate the long-term outcome of aggressive surgery incorporating hepatic resection and systematic nodal dissection for advanced carcinoma involving the hepatic hilus. SUMMARY BACKGROUND DATA:Few long-term results are available regarding radical surgery incorporating major hepatectomy and nodal dissectio...
journal_title:Annals of surgery
pub_type: 杂志文章,评审
doi:10.1097/00000658-199911000-00008
更新日期:1999-11-01 00:00:00
abstract:PURPOSE:To assess the efficacy of isolated pelvic perfusion (IPP) with tumor necrosis factor (TNF)-α and melphalan in patients with locally advanced cancers in the pelvic and groin area requiring mutilating surgery. METHODS:A total of 27 patients were enrolled (carcinoma, n = 17; sarcoma/melanoma, n = 4; and endocrine...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/SLA.0b013e318242ebe7
更新日期:2012-02-01 00:00:00
abstract:OBJECTIVE:The aim of the study was to report 10+ year outcome of laparoscopic biliopancreatic diversion with duodenal switch (LDS), with special focus on quality of life. BACKGROUND::Reports on long-term morbidity and quality of life after LDS are rare. METHODS:Records of all patients who underwent LDS 10+ years ago ...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/SLA.0000000000001622
更新日期:2016-12-01 00:00:00
abstract:OBJECTIVE:This study was designed to determine whether the volume and type of fluid administered for pancreaticoduodenectomy impacts postoperative outcomes. BACKGROUND:Three percent hypertonic saline (HYS) has been suggested as a means of reducing the volume of fluid required to sustain tissue perfusion in the periope...
journal_title:Annals of surgery
pub_type: 杂志文章,随机对照试验
doi:10.1097/SLA.0000000000000872
更新日期:2014-09-01 00:00:00
abstract:OBJECTIVE:This case control study is a detailed analysis of the causes of death and the risk factors of short-term mortality after appendectomy. SUMMARY BACKGROUND DATA:Although death is a rare event after appendectomy, we found a 7-fold excess mortality after appendectomy overall and a 9-fold excess mortality after n...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/SLA.0b013e31821ad9c4
更新日期:2011-07-01 00:00:00
abstract:OBJECTIVE:To evaluate the impact of improved surgical management of hepatocellular carcinoma (HCC) on the survival of patients with screened HCC. SUMMARY BACKGROUND DATA:It is unclear whether the advent of new treatment modalities such as liver transplantation and radiofrequency ablation (RFA) in recent years have imp...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/SLA.0b013e31816a747a
更新日期:2008-04-01 00:00:00
abstract::A biochemical assay of renal viability previously described for rabbits is validated in a canine model using anoxia, hypothermia, and hypothermic perfusion. The assay correlated well with the decree of anoxic injury and protective effect of hypothermia. It was found to be unable to document significant injury when pul...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-197412000-00008
更新日期:1974-12-01 00:00:00
abstract::A retrospective study of 910 patients surviving at least five years after cervical irradiation for Hodgkin's disease, non-Hodgkin's lymphoma, or primary head an neck neoplasms showed the incidence of stroke following cervical irradiation was 63 of 910 patients (6.3%) during a mean period of observation of nine years. ...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-198111000-00009
更新日期:1981-11-01 00:00:00
abstract:OBJECTIVE:To evaluate the independent prognostic ability of the American Joint Committee on Cancer (AJCC) tumor regression scores within pathologic stage II and III rectal cancers. BACKGROUND:Response to neoadjuvant chemoradiation (nCRT) has been debated as a biologic surrogate for tumor biology and prognosis in recta...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/SLA.0000000000002719
更新日期:2019-06-01 00:00:00
abstract:OBJECTIVE:To identify factors that have contributed to reduced rates of death and complications after esophageal resection in a 17-year period at a tertiary referral center. SUMMARY BACKGROUND DATA:There has been an evolving refinement in surgical technique and perioperative management of patients undergoing esophagea...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-200103000-00006
更新日期:2001-03-01 00:00:00
abstract:OBJECTIVE:Our study aims to provide a paradigm when it is ethical to perform cardiopulmonary resuscitation (CPR) on patients during the COVID-19 pandemic. SUMMARY BACKGROUND DATA:Hospitals around the nation are enacting systems to limit CPR in caring for COVID+ patients for a variety of legitimate reasons and based on...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/SLA.0000000000004318
更新日期:2020-12-01 00:00:00
abstract::The present work was performed to clarify the effects of epidermal growth factor (EGF) on the growth of human breast cancer and carcinoma of the esophagus. Human breast cancer MX-1, UM-1, and esophageal cancer ES-4 were transplanted to the subcutaneous tissue of nude mice. Human EGF (2 micrograms) was injected locally...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:
更新日期:1990-03-01 00:00:00
abstract:OBJECTIVE:The authors assess the effect of surgical margin width on recurrence rates after intestinal resection of Crohn's Disease (CD). BACKGROUND:The optimal width of margins when resecting DC of the small bowel is controversial. Most studies have been retrospective and have had conflicting results. METHODS:Patient...
journal_title:Annals of surgery
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1097/00000658-199610000-00014
更新日期:1996-10-01 00:00:00