Abstract：
INTRODUCTION:Intestinal-cutaneous fistulas (ICFs) constitute a major surgical challenge. Definitive surgical treatment of ICFs continues to be associated with significant morbidity. The purpose of this study was to utilize a nationwide database to define the morbidity associated with current treatment strategies in the surgical management of ICFs. METHODS:The 2006-2017 American College of Surgeon National Surgical Quality Improvement datasets (ACS-NSQIP) were used to assess 30-day morbidity and mortality after surgical repair of ICFs. Outcomes for emergent repair were compared to elective repair of ICFs. RESULTS:Overall, 4197 patients undergoing ICF-repair were identified. Mean age was 55.9 (SD 15.3). Patients were generally comorbid (62.9% were in ASA class III). The observed in-hospital mortality was 2.3%. However, the observed morbidity rate was 47.3%. Of the observed morbidity, 35.6% was due to post-operative infectious complications (superficial surgical site infections (SSI), deep SSI, organ/space SSI, wound disruption, pneumonia, urinary tract infection (UTI) sepsis or septic shock). The most common infectious complication was sepsis (13.1%). 30-day readmission rate was 15.3% and the 30-day reoperation rate was 11.0%. Emergent repair was associated with a sevenfold increase in mortality (11.9% vs 1.8%, P < 0.001) CONCLUSION: The management of patients with ICFs is complex and is associated with significant morbidity. Half of patients undergoing surgical management of ICFs developed in-hospital complications.
journal_name
Am J Surgjournal_title
American journal of surgeryauthors
Christensen MA,Gaitanidis A,Parks J,Mendoza A,Saillant N,Kaafarani HMA,Fagenholz P,Velmahos G,Fawley Jdoi
10.1016/j.amjsurg.2020.08.038subject
Has Abstractpub_date
2020-09-02 00:00:00eissn
0002-9610issn
1879-1883pii
S0002-9610(20)30530-4pub_type
杂志文章abstract：:The experience with gastrointestinal cancer at a single large hospital has been utilized as a "micro-model" of the experience for the country at large, and the reasons why such a comparison might be possible have been presented. The incidence of various lesions has been discussed in terms of sex, age, and race. The ch...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/0002-9610(78)90002-8
更新日期：1978-01-01 00:00:00
abstract：BACKGROUND:Laparoscopic Roux-en-Y gastric bypass (LRYGB) produces durable and clinically significant weight loss. We aim to characterize the trajectory of weight loss, and demonstrate the predictive ability of three-month performance on final weight loss. METHODS:Retrospective analysis of 1097 consecutive LRYGB patien...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/j.amjsurg.2017.10.024
更新日期：2018-07-01 00:00:00
abstract：:To clarify the widespread practice of preoperative transfusion to attain a 10 g/dL level of hemoglobin, the relationship between preoperative hemoglobin level, operative blood loss, and mortality was studied by analyzing the results of 113 operations in 107 consecutive Jehovah's Witness patients who underwent major el...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/s0002-9610(05)81227-9
更新日期：1990-03-01 00:00:00
abstract：BACKGROUND:Anorectal malformations represent a continuing challenge for the pediatric surgeon. A significant number of these children suffer from fecal incontinence, urinary incontinence, and sexual inadequacy. However, major advances in the management of these children have occurred during the last 10 years. The poste...
journal_title：American journal of surgery
pub_type： 杂志文章,评审
doi：10.1016/s0002-9610(00)00491-8
更新日期：2000-11-01 00:00:00
abstract：BACKGROUND:The US Food and Drug Administration recently approved a transcatheter aortic valve for patients for whom open heart surgery is prohibitively risky. METHODS:A multidisciplinary heart valve team partnered with administration to launch a transcatheter aortic valve replacement (TAVR) program. Clinical registrie...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/j.amjsurg.2012.07.017
更新日期：2012-11-01 00:00:00
abstract：BACKGROUND:Elderly patients are at an increased risk of protein-energy malnutrition (PEM) which increases the risk of morbidity/mortality. We evaluated the association between hypoalbuminemia at the time of emergency department (ED) admission and in-hospital complications among geriatric trauma patients. METHODS:This ...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/j.amjsurg.2015.06.013
更新日期：2016-07-01 00:00:00
abstract：:Infections that involve the attention of the surgeon include those that require operations for cure as well as those that complicate emergency and elective surgical procedures. Mechanical correction is of paramount importance in the eradication of such infections with antibiotics serving an adjuvant role, primarily to...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/s0002-9610(06)80057-7
更新日期：1992-10-01 00:00:00
abstract：:Emergency center thoracotomy is a heroic technique of resuscitation and treatment which was revived in the 1960s to improve the survival of patients presenting with cardiac wounds. With excellent survival rates attained in such patients, the technique was extended to victims of trauma with other mechanisms and locatio...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/0002-9610(86)90443-5
更新日期：1986-12-01 00:00:00
abstract：:A total of ninety three patients with biliary tract disease were studied to determine the concentration of the pancreatic enzymes, amylase and lipase, in bile obtained from the gallbladder and/or common bile duct. Of seventy gallbladder bile samples, amylase levels were higher than actual or predicted serum levels in ...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/0002-9610(79)90055-2
更新日期：1979-03-01 00:00:00
abstract：BACKGROUND:Work-related injuries (WRIs) represent a significant economic and logistical burden to healthcare systems. METHODS:All patients with severe WRIs (Injury Severity Score [ISS] ≥ 12) (1995 to 2013) were compared with patients with non-WRIs using standard methodology (P < .05). RESULTS:A total of 1,270 (8.5%) ...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/j.amjsurg.2015.01.023
更新日期：2015-09-01 00:00:00
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journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/0002-9610(89)90007-x
更新日期：1987-10-01 00:00:00
abstract：BACKGROUND:In 1997 the National Kidney Foundation put forth guidelines for hemoaccess through its Dialysis Outcomes Quality Initiative (DOQI). Some centers have been able to meet these standards; most have not. METHODS:A retrospective review was made of our database of more than 3,500 hemoaccess procedures from 1986 t...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/j.amjsurg.2004.01.018
更新日期：2004-05-01 00:00:00
abstract：BACKGROUND:Transluminal balloon angioplasty offers advantages to patch angioplasty. We evaluated the primary patency of thrombosed hemodialysis grafts that had undergone balloon angioplasty versus patch angioplasty as a salvage method. METHODS:We reviewed our experience with 22 consecutive intraoperative balloon angio...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/s0002-9610(97)90072-6
更新日期：1997-08-01 00:00:00
abstract：:The difficulties created by an unsuccessful initial operation can usually be avoided by choosing experienced surgeons, identifying four glands, and selectively excising grossly abnormal parathyroid tissue. Patients with multiple endocrine adenomatosis or familial hyperparathyroidism should have a subtotal parathyroide...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/0002-9610(82)90412-3
更新日期：1982-10-01 00:00:00
abstract：BACKGROUND:Current evidence-based guidelines provide recommendations for prophylaxis and treatment of venous thromboembolism (VTE) in a variety of surgical patients. DATA SOURCES:A systematic Ovid Medline search (from 1950 to the present) was conducted for relevant articles using the following search terms: "venous th...
journal_title：American journal of surgery
pub_type： 杂志文章,评审
doi：10.1016/j.amjsurg.2009.10.007
更新日期：2010-01-01 00:00:00
abstract：:Vascular control of the injured retrohepatic vena cava is invariably a surgical challenge. Herein, we describe the technical aspects of inserting a vena cava balloon shunt through the saphenofemoral junction. The advantages of this approach include relative simplicity, maintenance of perihepatic tamponade, and avoidin...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/0002-9610(89)90288-2
更新日期：1989-11-01 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：BACKGROUND:Capsule endoscopy (CE) is a new device that enables visualization of areas of the small bowel that were previously inaccessible through other noninvasive procedures. The purpose of this study is to evaluate this new diagnostic tool and its efficacy in finding occult GI tract pathology. METHODS:A single-inst...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/j.amjsurg.2005.08.015
更新日期：2005-12-01 00:00:00
abstract：:The need to effectively manage hemostasis and tissue sealing during surgery has had a strong influence on the development of modern surgical techniques. A group of agents known as surgical tissue adhesives has been developed to promote hemostasis and tissue sealing during surgery, and these comprise both natural and s...
journal_title：American journal of surgery
pub_type： 杂志文章,评审
doi：10.1016/s0002-9610(01)00770-x
更新日期：2001-08-01 00:00:00
abstract：:Noninvasive screening of the lower extremities for deep vein thrombosis was performed bilaterally on 1,118 patients. Impedance plethysmography alone was used in 868. Venography in 135 revealed an accuracy of 88%, with a false-negative rate of 5.3% and a false-positive rate of 18.6%. A combined ultrasonic Doppler and m...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/0002-9610(78)90032-6
更新日期：1978-04-01 00:00:00
abstract：BACKGROUND:Conventional wisdom teaches that small hernia defects are more likely to incarcerate. We aim to identify radiographic features of ventral hernias associated with increased risk of bowel incarceration. METHODS:We assessed all patients who underwent emergent ventral hernia repair for bowel complications from ...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/j.amjsurg.2016.09.035
更新日期：2017-07-01 00:00:00
abstract：BACKGROUND:The results and advantages of laparoscopic cholecystectomy in the geriatric population have received minimal attention. Several early reports related high conversion rates complications and mortality. This case series review is focused on the results of laparoscopic cholecystectomy in the geriatric populatio...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/j.amjsurg.2003.11.031
更新日期：2004-06-01 00:00:00
abstract：BACKGROUND:Axillary lymph node status is still considered the most significant prognostic factor for breast cancer outcome, and treatment decisions are based on the presence or absence of nodal disease. Intramammary lymph nodes (IMLNs) can be a site of regional spread. Is this a marker for more aggressive disease? MET...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/j.amjsurg.2006.05.011
更新日期：2006-10-01 00:00:00
abstract：BACKGROUND:This study was designed to compare short-term laparoscopic total gastrectomy (LTG) with open total gastrectomy (OTG) outcomes in gastric cancer. METHODS:Seventy patients who underwent total gastrectomy via LTG or OTG were included. All cases were matched for stage, age, and sex by means of statistically gen...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/j.amjsurg.2012.11.011
更新日期：2013-09-01 00:00:00
abstract：:A quantitative endotoxin assay was applied in this study of endotoxin transport from the infected abdomen. In rats with fecal peritonitis, extremely high concentrations were found in thoracic duct lymph (approximately 400 times higher than those found in arterial and portal vein plasma). Taking flow rates into account...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/0002-9610(86)90098-x
更新日期：1986-04-01 00:00:00
abstract：:A personal experience of thirty-five consecutive patients with congenital anomalies of the diaphragm is reported. The anomalies included twenty-five Bochdalek hernias, seven diaphragmatic eventrations, and three esophageal hiatal hernias. Except for the patients with esophageal hiatal hernias, virtually all patients p...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/0002-9610(76)90449-9
更新日期：1976-12-01 00:00:00
abstract：BACKGROUND:Surgical therapy for advanced-stage pressure ulcers recalcitrant to healing is a widely accepted practice. The present study examined the incidence of wound recurrence after reconstruction with fasciocutaneous versus combined (biplanar) muscle and fasciocutaneous flaps. METHODS:A retrospective review identi...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/j.amjsurg.2011.10.007
更新日期：2012-03-01 00:00:00
abstract：BACKGROUND:Studies of gender disparity in surgical training have yielded conflicting results. We hypothesize that there is no influence of gender on resident self-evaluation Milestone (SEM) scores and those assigned by the Clinical Competency Committee (CCC). METHODS:42 residents (25 male & 17 female) and faculty comp...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/j.amjsurg.2020.12.020
更新日期：2020-12-13 00:00:00
abstract：BACKGROUND:Efforts to improve surgical safety are limited by several factors and no consensus exists regarding the most effective way to improve surgical quality. The use of ISO 9001 quality standards within healthcare is recognized but has not been widely applied for improving surgical outcomes. METHODS:A surgical qu...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/j.amjsurg.2020.11.014
更新日期：2020-11-09 00:00:00
abstract：BACKGROUND:The use and outcomes of laparoscopic sigmoid resection during emergency admissions for diverticulitis are unknown. METHODS:The Nationwide Inpatient Sample was queried for colorectal resections performed for diverticulitis during emergent hospital admissions (2003-2007). Univariate and multivariate analyses ...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/j.amjsurg.2012.01.004
更新日期：2012-05-01 00:00:00
