Abstract:
:Low mortality rates for elective surgical treatment of abdominal aortic aneurysms justify an aggressive approach in most patients. However, in high-risk patients with small aneurysms and no symptoms, the decision to operate remains a delicate balance of risk and benefit. Our observations include 99 high-risk patients with asymptomatic abdominal aortic aneurysms initially measuring 3 to 6 cm in the largest transverse diameter, who have been followed 1 to 9 years (average 2.4 years) with serial echographic measurements. Elective operations were performed for aneurysmal enlargement greater than 6 cm or symptom development. An additional 11 patients with aneurysms initially greater than 6 cm, whose initial evaluation did not result in elective surgery, were also followed. Serial data documented a mean expansion rate of 0.4 cm/year for aneurysms smaller than 6 cm. Forty-one of these 99 high-risk patients with small aneurysms eventually underwent an elective resection with two deaths (4.9%). Thirty-four patients (34%) died from causes unrelated to their unoperated aneurysms, and 21 patients (21%) are alive without symptoms. Three of the 99 patients suffered aneurysm rupture and emergency operation with two deaths. Thus, of the 99 high-risk patients with small aneurysms, four have died of elective aneurysm surgery or rupture (4%). A protocol of re-echo (or computerized tomography) examination at 3-month intervals appears to define which of these high-risk patients require elective aneurysm surgery, and has limited rupture to less than 5%. Improved criteria may emerge from recent advances in high-resolution computerized tomography.
journal_name
Ann Surgjournal_title
Annals of surgeryauthors
Bernstein EF,Chan ELdoi
10.1097/00000658-198409000-00003subject
Has Abstractpub_date
1984-09-01 00:00:00pages
255-63issue
3eissn
0003-4932issn
1528-1140journal_volume
200pub_type
杂志文章abstract:OBJECTIVE:Patients with peripheral arterial disease (PAD) have increased risk on future cerebro- and cardiovascular events. Our aim was to examine whether carotid artery reactivity (CAR; a novel, simple procedure to examine endothelial function) predicts cardiovascular events in PAD patients. BACKGROUND:Increased risk...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/SLA.0000000000002558
更新日期:2019-04-01 00:00:00
abstract:BACKGROUND:The "surgical personality" is a mostly negative academic and cultural image of the surgeon as egotistical, paternalistic, and inflexible. Because of this image, surgeons have been viewed as resistant to change and some behaviors, vulnerability, for example, are viewed as "suspect" because they seemingly thre...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/SLA.0000000000003707
更新日期:2019-12-02 00:00:00
abstract::A prospective, manometric trial of anal fissure treated by subcutaneous lateral internal sphincterotomy (SLIS) was designed to elucidate the pathophysiology of this condition. Anorectal manometry with a closed, precalibrated, water-filled microballoon using the station pull-through technique was performed on 13 patien...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-199002000-00017
更新日期:1990-02-01 00:00:00
abstract::Reframing healthcare delivery in terms of the principles of complex adaptive systems has practical implications for addressing the challenges in improving surgical care. In an Integrated Practice Unit (IPU) - such as a surgical service line, a surgical in-patient floor, or an acute care unit - a diverse group of careg...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/SLA.0000000000001251
更新日期:2015-12-01 00:00:00
abstract::Segmental hepatectomy is appealing for several reasons including preservation of liver parenchyma, reduction of intraoperative blood loss, and blood replacement by dividing tissues along the anatomic planes. A simple technique guided by intraoperative ultrasound is described here using radio-frequency energy to create...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/SLA.0b013e3181b0c38a
更新日期:2009-08-01 00:00:00
abstract:OBJECTIVE:In Western populations, long-term survival rates after curative resection of gastric cancer remain extremely poor. The lack of effective adjuvant therapy has prompted the evaluation of neoadjuvant approaches. Since 1988, we have conducted three separate phase II trials using neoadjuvant chemotherapy to treat ...
journal_title:Annals of surgery
pub_type: 临床试验,杂志文章
doi:10.1097/00000658-199903000-00001
更新日期:1999-03-01 00:00:00
abstract:OBJECTIVE:To validate the authors' initial hypothesis-generating observation that eukaryotic initiation factor 4E (eIF4E) protein elevation predicts a higher cancer recurrence rate in patients with stage 1 to 3 breast cancer. SUMMARY BACKGROUND DATA:Tumor size and nodal status continue to be the two most important ind...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-200205000-00016
更新日期:2002-05-01 00:00:00
abstract::In nonfunctioning islet cell tumors of the pancreas, hormone production is not clinically evident. This type of tumor constituted 15% of all islet cell tumors seen at the Mayo Clinic from 1960 through 1978. Although identical to functioning islet cell tumors embryologically and histologically, the nonfunctioning tumor...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-198102000-00010
更新日期:1981-02-01 00:00:00
abstract:OBJECTIVE:The authors determined the molecular mechanisms for the failure of transforming growth factor-beta (TGF-beta) to inhibit the growth of SW1116 and SW48 colon cancer cell lines. BACKGROUND:Transforming growth factor-beta is a bifunctional regulator of cell growth that typically stimulates proliferation of mese...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-199506000-00015
更新日期:1995-06-01 00:00:00
abstract:OBJECTIVE:We compared the effects of intravenous administration of 6% hydroxyethyl starch (maize-derived) in 0.9% saline (Voluven; Fresenius Kabi, Runcorn, United Kingdom) and a "balanced" preparation of 6% hydroxyethyl starch (potato-derived) [Plasma Volume Redibag (PVR); Baxter Healthcare, Thetford, United Kingdom] o...
journal_title:Annals of surgery
pub_type: 杂志文章,随机对照试验
doi:10.1097/SLA.0000000000000324
更新日期:2014-05-01 00:00:00
abstract:OBJECTIVE:The aim of this study was to show the safety and feasibility of single-port laparoscopic surgery (SPLS) by comparing its short-term outcomes with those following conventional laparoscopic surgery. SUMMARY BACKGROUND DATA:Single-port laparoscopic surgery maximizes the advantages of laparoscopic surgery, and t...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/SLA.0b013e318237826b
更新日期:2011-12-01 00:00:00
abstract:BACKGROUND:The advice to individuals with identified CDH1 mutations is generally to undertake prophylactic total gastrectomy (PTG). This study evaluated the effect of PTG on health-related quality of life (HRQL) in asymptomatic individuals with identified CDH1 mutations at high risk for gastric cancer. METHODS:Individ...
journal_title:Annals of surgery
pub_type: 杂志文章,多中心研究
doi:10.1097/SLA.0000000000000446
更新日期:2014-07-01 00:00:00
abstract::The case records of the Connecticut Tumor Registry were reviewed from 1952-1982. There were 37 cases of adenoid cystic carcinoma of the breast (ACC) from a total of 40,350 invasive breast tumors. Patient survival, complications, and pathologic sections were reviewed. Only 14 of 27 surgical pathology slides available f...
journal_title:Annals of surgery
pub_type: 杂志文章,评审
doi:10.1097/00000658-198703000-00013
更新日期:1987-03-01 00:00:00
abstract::Two types of 4 mm ID prostheses were studied in the carotid arteries of the dog. These were noncrimped polypropylene-supported filamentous velour knitted Dacron (PPSFV) and expanded polytetrafluoroethylene (e-PTFE, Gore-Tex). Thrombus-"Free" Surface TFS) areas and patency rates were determined at the end of the implan...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-198003000-00016
更新日期:1980-03-01 00:00:00
abstract:OBJECTIVE:To define the natural history of, and treatment strategy for, blunt traumatic internal carotid artery (ICA) pseudoaneurysms. BACKGROUND:The natural history and management of traumatic ICA pseudoaneurysms is controversial. METHODS:We retrospectively identified all traumatic ICA pseudoaneurysms diagnosed on h...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/SLA.0000000000001158
更新日期:2016-04-01 00:00:00
abstract::Measurement of cytochrome a(+a(3)) contents in liver mitochondria was made on 52 biopsy specimens of patients with liver tumor. Patients having higher cytochrome a(+a(3)) contents in mitochondria from remaining liver than those of normal human liver mitochondria could survive well major liver resections whether or not...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-197412000-00013
更新日期:1974-12-01 00:00:00
abstract:OBJECTIVE:To examine the financial impact of quality improvement using Medicare payment data. BACKGROUND:Demonstrating a business case for quality improvement--that is, that fewer complications translates into lower costs--is essential to justify investment in quality improvement. Prior research is limited to cross-se...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/SLA.0000000000001069
更新日期:2015-08-01 00:00:00
abstract:BACKGROUND:Over the past 2 decades, there has been an increase in opioid use and subsequently, opioid deaths. The amount of opioid prescribed to surgical patients has also increased. The aim of this systematic review was to determine postdischarge opioid consumption in surgical patients compared with the amount of opio...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/SLA.0000000000002591
更新日期:2018-06-01 00:00:00
abstract:OBJECTIVE:To evaluate both institutional and individual learning curves with focused abdominal ultrasound for trauma (FAST) by analyzing the incidence of diagnostic inaccuracies as a function of examiner experience for a group of trauma surgeons performing the study in the setting of an urban level I trauma center. SU...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-200005000-00009
更新日期:2000-05-01 00:00:00
abstract::In a prospective, block-randomized, multicenter study, the safety and efficacy of cefoxitin in preoperative prophylaxis were studied. 1735 patients undergoing appendectomy were evaluable, and half of these patients received 2 g of cefoxitin before undergoing operation. The patients were divided into three groups: pati...
journal_title:Annals of surgery
pub_type: 临床试验,杂志文章,多中心研究,随机对照试验
doi:10.1097/00000658-198903000-00010
更新日期:1989-03-01 00:00:00
abstract:OBJECTIVE:To compare surgical versus medical treatment of type 2 diabetes mellitus (T2DM) remission and comorbidities in patients with a body mass index (BMI) less than 35 kg/m2. BACKGROUND:Obesity surgery can achieve remission of T2DM and its comorbidities. Metabolic surgery has been proposed as a treatment option fo...
journal_title:Annals of surgery
pub_type: 杂志文章,meta分析,评审
doi:10.1097/SLA.0000000000001014
更新日期:2015-03-01 00:00:00
abstract::Release of pancreatic polypeptide (PP) after a meal is biphasic, with an early transient peak believed to be under cholinergic control, and a secondary, prolonged intestinal phase thought to be mediated by hormones. Endogenous release of PP was stimulated by intraduodenal oleate (6.8 mmol/hr) or by intravenous adminis...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-198411000-00008
更新日期:1984-11-01 00:00:00
abstract::An analysis of 584 operations for recurrent inguinal hernia was made in an attempt to determine the cause of the recurrence based on the anatomic findings. The recurrence was indirect in 300, direct in 241, and various other in 43 operations. The causes of the indirect recurrences appeared to be an unrecognized hernia...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-198512000-00019
更新日期:1985-12-01 00:00:00
abstract:OBJECTIVE:This study investigated the pathogenesis of water and sodium metabolism derangements in obstructive jaundice. SUMMARY BACKGROUND DATA:Obstructive jaundice is associated with hypodipsia, depletion of extracellular water, alterations of the water and sodium regulating hormones, and an increased incidence of re...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-199401000-00012
更新日期:1994-01-01 00:00:00
abstract:OBJECTIVE:To analyze the feasibility and safety of Natural Orifice Transluminal Endoscopic Surgery (NOTES) appendectomy, and to analyze separately the transvaginal appendectomy (TVAE) and the transgastric appendectomy (TGAE) procedures. BACKGROUND:Laparoscopic appendectomy has rare but relevant complications, namely i...
journal_title:Annals of surgery
pub_type: 杂志文章,多中心研究
doi:10.1097/SLA.0000000000001742
更新日期:2017-03-01 00:00:00
abstract::One hundred and forty patients with an intractable ascites complicating a chronic liver disease received a peritoneovenous shunt (PVS) using the LeVeen valve. Operative mortality was ten per cent but was 25% in patients with severe liver failure. Intraoperative drainage of ascites sharply decreased postoperative compl...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-198504000-00014
更新日期:1985-04-01 00:00:00
abstract:OBJECTIVE:To determine the proportion of registered trials published in the surgical literature, to compare, in registered trials, the primary outcomes registered with those published and to determine whether outcome-reporting bias favored significant primary outcomes. BACKGROUND:Trial protocol registration before pat...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/SLA.0b013e318299d00b
更新日期:2014-01-01 00:00:00
abstract:OBJECTIVE:To construct and validate a scoring system for evidence-based selection of bariatric and metabolic surgery procedures according to severity of type 2 diabetes (T2DM). BACKGROUND:Roux-en-Y gastric bypass (RYGB) and sleeve gastrectomy (SG) account for >95% of bariatric procedures in United States in patients w...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/SLA.0000000000002407
更新日期:2017-10-01 00:00:00
abstract:OBJECTIVE:We aimed to determine whether the severity of inhalation injury evokes an immune response measurable at the systemic level and to further characterize the balance of systemic pro- and anti-inflammation early after burn and inhalation injury. BACKGROUND:Previously, we reported that the pulmonary inflammatory ...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/SLA.0b013e318275f424
更新日期:2013-06-01 00:00:00
abstract:OBJECTIVE:To assess the feasibility of developing a simulated ward environment in which to assess the ward-based care of surgical patients by clinicians of varying levels of experience (construct validation). BACKGROUND:Increasing evidence points to the importance of the postoperative or ward-based phase of surgical c...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/SLA.0b013e318288e1d4
更新日期:2014-02-01 00:00:00