Abstract:
:A study of 90 cases of esophageal perforation in the antibiotic era emphasizes individualized treatment and options of therapy based on a fundamental understanding of modifying pathophysiologic factors. If the patient is seen during the first 24 hours, surgical repair and irrigating tube drainage continue to be the treatment of choice in the thoracic and abdominal regions, with certain exceptions. The exceptions include small perforations proved by a thin media esophagram or esophagoscopy without pleural involvement or constitutional symptoms. Such patients may be treated nonoperatively, with gastric drainage, antibiotics, and parenteral alimentation. However, for large perforations with extensive contamination of the mediastinum and pleura, an esophageal exclusion operation may be life saving. In the cervical region, irrigating tube drainage may be just as effectual as repair and drainage. In patients seen after 24 hours, size of the perforation and the amount of mediastinopleural infection, rather than the time that has elapsed, dictate optimal treatment.
journal_name
Am J Surgjournal_title
American journal of surgeryauthors
Brewer LA 3rd,Carter R,Mulder GA,Stiles QRdoi
10.1016/0002-9610(86)90144-3subject
Has Abstractpub_date
1986-07-01 00:00:00pages
62-9issue
1eissn
0002-9610issn
1879-1883pii
0002-9610(86)90144-3journal_volume
152pub_type
杂志文章abstract::Chronic anal fissure is the main cause of anal pain and is very common. Many treatment modalities have been tried-none is ideal. Recently, topical nitric oxide releasing agents and botulin toxin injections have been used, trying to replace surgery. No long-term experience is available. Personal experience with 2,108 o...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/s0002-9610(00)00307-x
更新日期:2000-03-01 00:00:00
abstract::Real-time ultrasound scanning was used during operations on the biliary tract and pancreas. The principal application in biliary surgery was to evaluate the common bile duct for presence of calculi. Our initial experience indicates that operative ultrasonography compares favorably with operative cholangiography. In pa...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/0002-9610(81)90017-9
更新日期:1981-01-01 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:Little is known regarding medical school curricular variability regarding safe prescribing of post-operative opioids for students entering surgical residency. METHODS:Surveys were administered to general surgery residency interviewees at an accredited academic institution for 2018-2019 application season. R...
journal_title:American journal of surgery
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doi:10.1016/j.amjsurg.2019.10.024
更新日期:2020-03-01 00:00:00
abstract:BACKGROUND:This study aimed to assess the transferability of basic laparoscopic skills between a virtual reality simulator (MIST-VR) and a video trainer box (D-Box). METHODS:Forty-six medical students were randomized into 2 groups, training on MIST-VR or D-Box. After training with one modality, a crossover assessment ...
journal_title:American journal of surgery
pub_type: 杂志文章,随机对照试验
doi:10.1016/j.amjsurg.2009.05.016
更新日期:2010-06-01 00:00:00
abstract::Our experience from 1960 to 1976 with total infrarenal aortic thrombosis (Leriche syndrome) was reviewed. Sixteen heavy smokers (14 men and 2 women) with an average age of fifty-four years underwent thrombectomy with aortoiliac (12 patients) or aortofemoral (4) Dacron bypasses. The last ten patients were hydrated for ...
journal_title:American journal of surgery
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doi:10.1016/0002-9610(77)90331-2
更新日期:1977-12-01 00:00:00
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journal_title:American journal of surgery
pub_type: 杂志文章
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更新日期:2020-09-01 00:00:00
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journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/0002-9610(76)90431-1
更新日期:1976-01-01 00:00:00
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journal_title:American journal of surgery
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journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/0002-9610(80)90262-7
更新日期:1980-02-01 00:00:00
abstract::One hundred seven patients with pseudocyst managed during the past decade were reviewed. The mortality rate of 11.2 percent compares favorably with the rates in other recent series. Twenty-two percent of the patients were managed conservatively, and 76 underwent exploration. None of the nonoperative patients died from...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/0002-9610(81)90052-0
更新日期:1981-05-01 00:00:00
abstract:OBJECTIVE:To evaluate the outcomes for laparoscopic Roux-en-Y gastric bypass in a newly developed bariatric surgery program. METHODS:A prospective analysis of the initial 100 patients who underwent laparoscopic Roux-en-Y gastric bypass at a community based teaching hospital between December 2000 and October 2001 was p...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/s0002-9610(02)01098-x
更新日期:2002-12-01 00:00:00
abstract:BACKGROUND:Prior studies have demonstrated that African-American (AA) donor kidneys are independently associated with an increased risk for graft loss. METHODS:We examined outcomes in comparable groups of AA deceased-donor (DD) kidney transplant patients receiving an AA donor (n=35) versus a Caucasian donor (C group; ...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/j.amjsurg.2009.08.025
更新日期:2010-03-01 00:00:00
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journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/s0002-9610(05)80573-2
更新日期:1993-07-01 00:00:00
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journal_title:American journal of surgery
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更新日期:2003-04-01 00:00:00
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journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/s0002-9610(02)01074-7
更新日期:2002-12-01 00:00:00
abstract::A patient with pancreatic ascites is presented who had neither a pseudocyst nor demonstrable pancreatic duct disruption, despite the presence of both calculi and strictures in a dilated duct of Wirsung. Concurrently, the patient exhibited intractable abdominal pain characteristic of end-stage chronic alcoholic pancrea...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/0002-9610(79)90356-8
更新日期:1979-11-01 00:00:00
abstract:PURPOSE:We examined the efficacy of extended lymph node dissection for prolonging survival in macroscopically or histologically proven incurable gastric cancer. PATIENTS AND METHODS:We analyzed clinico-pathologic data on 119 patients with serosally invasive gastric cancer who underwent noncurative gastrectomy, with re...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/S0002-9610(99)80147-0
更新日期:1995-02-01 00:00:00
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journal_title:American journal of surgery
pub_type: 杂志文章,评审
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更新日期:2005-08-01 00:00:00
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journal_title:American journal of surgery
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更新日期:1985-02-01 00:00:00
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更新日期:1994-09-01 00:00:00
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journal_title:American journal of surgery
pub_type: 杂志文章
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更新日期:2008-03-01 00:00:00
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journal_title:American journal of surgery
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更新日期:2018-04-01 00:00:00
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journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/s0002-9610(00)00406-2
更新日期:2000-07-01 00:00:00
abstract:BACKGROUND:Trastuzumab has been found to have potent antiproliferative effects in human epidermal growth factor receptor 2 (HER-2)-overexpressing human breast tumors. Inhibition of vascular endothelial growth factor receptor (VEGFR), a protein often overexpressed in breast carcinoma, has been shown to induce apoptosis....
journal_title:American journal of surgery
pub_type: 杂志文章
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更新日期:2009-03-01 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: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:Residents are more likely to learn from educational experiences when properly prepared from the start of instruction and expectations are clear and consistent. The purpose of this study was to examine what first year residents need to know and be able to perform before starting their rotation in the intensiv...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/s0002-9610(96)00029-3
更新日期:1996-06-01 00:00:00
abstract:BACKGROUND:Recent rapid increases in the aging population have created an impending "Silver Tsunami" in advanced countries. The overall prevalence of gallstone disease and its related complications will soon increase, and there will be a larger demand for gallbladder surgery. METHODS:We examined the outcomes of cholec...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/j.amjsurg.2019.01.021
更新日期:2019-09-01 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