Abstract:
:Analysis of experience with chronic bleeding peptic ulcer in 504 patients, admitted from 1960 to 1971, shows a hospital mortality of 12%. This retrospective review suggested that early endoscopic diagnosis, adequate resuscitation and a policy of early selective surgery was necessary if mortality was to be reduced. With this policy, there were 37 deaths in 633 patients admitted during the period of prospective study from 1972 to 1982 (5.8%). There were 25 deaths after emergency surgery in 206 patients, 56% of postoperative deaths were related to technical factors and 44% to nontechnical complications. Comparison with the retrospective study from 1961 to 1970 showed, matching in terms of incidence of shock, sex distribution and number of patients over 60 years of age. During this period, 142 emergency operations were performed, with 25 postoperative deaths, an operative mortality of 17.6%. Thirty-five deaths occurred in conservatively treated patients (9.5%) compared with 12 deaths in conservatively treated patients from 1972 to 1982 (2.6%). Within the period of prospective study, there was a significant reduction in mortality from 8%, for the first 5 years, to 3.9% for the second 5 years of study. These two periods matched except for a significant increase in the proportion of patients 60 years and over. This was mainly due to a rise in incidence of aged patients with gastric ulcer. Also noted was a decrease in mortality in patients 60 years and over which reached significance, and a significant decrease in the number of deaths in shocked patients. A significant fall in technically related postoperative complications was noted, from 44 (11 causing death) to 12 (three causing death) during the second 5 years of prospective study. There were 444 patients admitted with bleeding duodenal ulcer with 20 deaths in hospital (4.5%), and 17 deaths in 189 patients admitted with bleeding gastric ulcer, a mortality of 9%. No single factor could be isolated as the reason for the improved results. Possibly the most significant reason is the application of a defined policy in a special unit where staff became familiar with all aspects of the problem of bleeding chronic peptic ulceration.
journal_name
Ann Surgjournal_title
Annals of surgeryauthors
Hunt PSdoi
10.1097/00000658-198401000-00008subject
Has Abstractpub_date
1984-01-01 00:00:00pages
44-50issue
1eissn
0003-4932issn
1528-1140journal_volume
199pub_type
杂志文章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:BACKGROUND:Retroperitoneal sarcomas (RPS) are rare tumors composed of several well defined histologic subtypes. The aim of this study was to analyze patterns of recurrence and treatment variations in a large population of patients, treated at reference centers. METHODS:All consecutive patients with primary RPS treated...
journal_title:Annals of surgery
pub_type: 杂志文章,多中心研究
doi:10.1097/SLA.0000000000001447
更新日期:2016-05-01 00:00:00
abstract:OBJECTIVE:To compare surgical safety and efficiency of 2 image guidance modalities, perfect augmented reality (AR) and side-by-side unregistered image guidance (IG), against a no guidance control (NG), when performing a simulated laparoscopic cholecystectomy (LC). BACKGROUND:Image guidance using AR offers the potentia...
journal_title:Annals of surgery
pub_type: 杂志文章,随机对照试验
doi:10.1097/SLA.0000000000002793
更新日期:2019-02-01 00:00:00
abstract:OBJECTIVE:To investigate the use of coffee, caffeinated drinks, and caffeine tablets for pharmacological cognitive enhancement (CE) among surgeons. BACKGROUND:Surgeons have demanding workloads, and the resulting fatigue and concentration deficits can lead to medical errors. Some surgeons use substances that promote wa...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/SLA.0000000000000830
更新日期:2015-06-01 00:00:00
abstract:OBJECTIVE:To investigate the roles and underlying mechanism of an inflammatory mediator-lipocalin-2 (Lcn2) in small-for-size fatty graft liver injury. BACKGROUND:Understanding of the distinct mechanism regulating small-for-size fatty liver graft injury will be crucial to prevent marginal graft failure during living do...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/SLA.0000000000000427
更新日期:2014-12-01 00:00:00
abstract::Prolonged veno arterial extracorporeal bypass (50-80% of cardiac output) was evaluated in normal, unanesthetized sheep. The evaluation protocol included serial measurements of hemodynamics, pulmonary and renal function, serum enzymes to detect organ damage, and detailed studies of coagulation and platelets. Blood expo...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-197412000-00010
更新日期:1974-12-01 00:00:00
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:OBJECTIVE:To study risk factors for early and late death after heart transplantation in the current era. SUMMARY BACKGROUND DATA:The current cardiac transplant population differs from earlier periods in that an increasing number of sicker patients, such as those with ventricular assist device (LVAD) support, prior car...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-200009000-00002
更新日期:2000-09-01 00:00:00
abstract:OBJECTIVE:The current study investigates activation of the nutritional anti-inflammatory pathway by lipid-rich nutrition. BACKGROUND:Enteral nutrition activates humoral and neural pathways to regulate food intake and sustain energy balance. Recently, we demonstrated that enteral nutrition and in particular lipid-rich ...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/SLA.0b013e3181dae411
更新日期:2010-08-01 00:00:00
abstract:OBJECTIVE:We aimed to determine the unbiased mortality rates for pancreatic surgery procedures at the national level through a comprehensive analysis of every inpatient case in Germany. SUMMARY OF BACKGROUND DATA:Several studies have proclaimed a general improvement of perioperative outcomes following pancreatic surge...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/SLA.0000000000001693
更新日期:2016-12-01 00:00:00
abstract:OBJECTIVE/BACKGROUND:There is a high risk of relapse in stage IIIB/IIIC melanoma. The utility of 2-[fluorine-18]-fluoro-2-deoxy-D-glucose positron emission tomography integrated with computed tomography (FDG-PET/CT) in these patients to evaluate response to treatment or for surveillance after treatment is currently not...
journal_title:Annals of surgery
pub_type: 杂志文章,多中心研究
doi:10.1097/SLA.0b013e318256d1f5
更新日期:2012-08-01 00:00:00
abstract:OBJECTIVE:To summarize the long-term efficacy and safety of tacrolimus in orthotopic liver transplant (OLT) recipients, as well as to examine the factors that influence long-term morbidity and mortality rates. BACKGROUND:Tacrolimus (FK506, Prograf) was introduced as primary immunosuppression for primary liver transpla...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-199909000-00016
更新日期:1999-09-01 00:00:00
abstract::A review of the experience with 66 patients on chronic hemodialysis who underwent 67 major surgical procedures is presented. There were 58 general surgical procedures, and nine major cardiovascular procedures including four emergency cardiac valve replacements. The preoperative, intraoperative and postoperative manage...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-197406000-00008
更新日期:1974-06-01 00:00:00
abstract:OBJECTIVE:To isolate heat exposure as a cause of cognitive impairment and increased subjective workload in burns surgical teams. SUMMARY BACKGROUND DATA:Raising ambient temperature of the operating room can improve burns patient outcomes, but risks increased cognitive impairment and workload of surgical team members. ...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/SLA.0000000000004598
更新日期:2020-11-13 00:00:00
abstract::Transplantation of the intrathoracic inferior vena cava into the abdominal inferior vena cava of the recipient was performed in inbred rat strains of the following combinations: Syngeneic F344 leads to F344, RT-1-identical allogeneic LEW leads to F344, and RT-1-different allogeneic CAP leads to F344. In the RT-1-diffe...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-198103000-00006
更新日期:1981-03-01 00:00:00
abstract:OBJECTIVE:The authors analyzed patient care (1981-1995) and financial data (1991-1996) to determine if differential workloads existed at a major academic health center. SUMMARY BACKGROUND DATA:Academic health centers differ markedly from community-based medical centers, but they are required to compete with others who...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-199709000-00013
更新日期:1997-09-01 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::Adenocarcinoma involving the distal esophagus usually is far advanced when the patient is first seen. Adenocarcinoma differs from squamous carcinoma of the esophagus since it is relatively unresponsive to radiation therapy or chemotherapy. Adenocarcinoma of the esophagus resembles gastric cancer in its tendency to for...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-198705000-00015
更新日期:1987-05-01 00:00:00
abstract:OBJECTIVES:Medicaid and Uninsured populations are a significant focus of current healthcare reform. We hypothesized that outcomes following major surgical operations in the United States is dependent on primary payer status. METHODS:From 2003 to 2007, 893,658 major surgical operations were evaluated using the Nationwi...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/SLA.0b013e3181e8fd75
更新日期:2010-09-01 00:00:00
abstract:OBJECTIVE:This study aims to review the operative results and oncological outcomes of anterior resection for rectal and rectosigmoid cancer. Comparison was made between patients with total mesorectal excision (TME) for mid and distal cancer and partial mesorectal excision (PME) for proximal cancer, when a 4- to 5-cm me...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/01.sla.0000133185.23514.32
更新日期:2004-08-01 00:00:00
abstract::Twelve children underwent elective laparoscopic cholecystectomy for symptomatic cholelithiasis during a 10-month period in one institution. The operative technique that has been described for adults was modified because of the smaller dimensions of pediatric patients. These modifications are discussed in this report, ...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-199202000-00015
更新日期:1992-02-01 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::A patient is reported whose symptoms and clinical features were interpreted as pulmonary embolism. However, the ultimate diagnosis was malignant fibrous histiocytoma of the pulmonary artery, which was made evident at operation. Although extremely rare in the early medical literature, primary sarcoma of the pulmonary a...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-198702000-00017
更新日期:1987-02-01 00:00:00
abstract:OBJECTIVE:The COVID-19 pandemic requires to conscientiously weigh "timely surgical intervention" for colorectal cancer against efforts to conserve hospital resources and protect patients and health care providers. SUMMARY BACKGROUND DATA:Professional societies provided ad-hoc guidance at the outset of the COVID-19 pan...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/SLA.0000000000004029
更新日期:2020-08-01 00:00:00
abstract:OBJECTIVE:To evaluate the impact of subtotal (SG) versus total (TG) gastrectomy on the oncologic outcome of patients with cancer of the distal stomach from 28 Italian institutions. SUMMARY BACKGROUND DATA:There is controversy over whether SG and TG have a different impact on the 5-year survival probability of patients...
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:10.1097/00000658-199908000-00006
更新日期:1999-08-01 00:00:00
abstract:OBJECTIVE:To examine the prevalence of BRAF mutation among thyroid cancer histologic subtypes and determine the association of BRAF mutation with indicators of poor prognosis for papillary thyroid cancer and patient outcome. SUMMARY BACKGROUND DATA:The appropriate extent of surgical treatment, adjuvant therapy and fol...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/SLA.0b013e318148563d
更新日期:2007-09-01 00:00:00
abstract:OBJECTIVE:To determine the optimal management of symptomatic non-parasitic liver cysts. SUMMARY BACKGROUND DATA:Management options for symptomatic nonparasitic liver cysts lack substantiation through comparative studies with respect to safety and long-term effectiveness. METHODS:A retrospective review of the surgical...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-199808000-00004
更新日期:1998-08-01 00:00:00
abstract:OBJECTIVE:To study the effects of autologous platelet-rich fibrin (PRF) versus human albumin on incisional wound breaking strength and subcutaneous collagen deposition in patients undergoing laparoscopic cholecystectomy in a randomized trial. SUMMARY BACKGROUND DATA:Platelet peptidic growth factors may stimulate colla...
journal_title:Annals of surgery
pub_type: 杂志文章,随机对照试验
doi:10.1097/SLA.0b013e3181d3548c
更新日期:2010-05-01 00:00:00
abstract::The abilities of polymorphonuclear leukocytes (PMN) and pulmonary alveolar macrophages (PAM), to demonstrate chemotaxis, phagocytosis, and superoxide release after bile duct ligation in the rat were investigated to determine the effect of cholestasis on nonspecific cellular immune mechanisms. Chemotactic response to C...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-198711000-00004
更新日期:1987-11-01 00:00:00
abstract::Continuous epidural anesthesia offers special advantages for patients with vascular disease. In 193 patients who had this technique employed for aortofemoral arteriography, profound pain relief was provided and the accompanying vasodilation produced superior demonstration of collateral and small distal vessels. Eleven...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-198206000-00015
更新日期:1982-06-01 00:00:00