Abstract:
:We evaluated clinical and vascular laboratory data on 126 patients with below-knee or forefoot amputation. Vascular laboratory examination included Doppler systolic blood pressure and arterial wave form analysis using the segmental plethysmograph. Fifty-four patients had below-knee amputation. A calf systolic pressure greater than 70 torr was associated with 97% (33/34) success (p less than 0.005), an ankle systolic pressure greater than 30 torr yielded 91% (39/43) success (p less than 0.025), and an ankle systolic pressure greater than zero yielded an 87% success (p less than 0.005). In the absence of each of the above criteria, the predictive value of a negative test was only 32%, 40%, and 52%, respectively. The presence of a popliteal pulse was associated with 97% success (p less than 0.025); however, 88% of those with an absent popliteal pulse also achieved successful healing of below-the-knee amputations. Prior vascular reconstructive surgery was detrimental to healing of below-knee amputations. with 33% failure rate (p less than 0.025). For the 72 forefoot amputations, an ankle systolic pressure greater than 70 torr yielded a 65% success (p less than 0.025). The sensitivity of an ankle systolic pressure greater than 70 torr was 80% (32/40) and an ankle systolic greater than 35 yielded a sensitivity of 95% (38/40). The specificity was low for both of these reference values. Clinical and vascular laboratory criteria can identify patients who will have a successful below-knee amputation; however, because of the high false negative rate, patients should not be denied below-knee amputation solely on the basis of Doppler systolic pressure. Vascular laboratory criteria for predicting healing of forefoot amputations are also limited by the high rate of false positive and false negative results.
journal_name
Ann Surgjournal_title
Annals of surgeryauthors
Nicholas GG,Myers JL,DeMuth WE Jrdoi
10.1097/00000658-198204000-00014subject
Has Abstractpub_date
1982-04-01 00:00:00pages
469-73issue
4eissn
0003-4932issn
1528-1140journal_volume
195pub_type
杂志文章abstract:OBJECTIVE:This study was designed to determine if resection of positive regional nodes in patients with breast cancer provided a group of cured patients. SUMMARY BACKGROUND DATA:Previous studies of long-term follow-up of patients with breast cancer have demonstrated that 30% of patients with positive nodes may be aliv...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-199309000-00006
更新日期:1993-09-01 00:00:00
abstract::Gallbladder contraction in response to a fatty meal is thought to be caused by release of cholecystokinin (CCK). We have previously demonstrated a close correlation between circulating concentrations of CCK and contraction of the gallbladder in normal humans and in gallstone patients. Recent studies in animals, howeve...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-198506000-00002
更新日期:1985-06-01 00:00:00
abstract:OBJECTIVE:This prospective observational study was designed to assess Pediatric Quality of Life (PedsQL) after surgical treatment for congenital diaphragmatic hernia (CDH), esophageal atresia/tracheoesophageal fistula (EA/TEF), Hirschsprung disease (HD), gastroschisis (GAS), omphalocele (OMP), and necrotizing enterocol...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/SLA.0000000000002918
更新日期:2018-09-01 00:00:00
abstract:BACKGROUND:Aortic elasticity creates a cushion that protects the heart from pressure injury, and a recoil that helps perfuse the coronary arteries. TEVAR has become first-line therapy for many aortic pathologies including trauma, but stent-grafts stiffen the aorta and likely increase LV afterload. OBJECTIVE:Test the h...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/SLA.0000000000003768
更新日期:2020-01-03 00:00:00
abstract:OBJECTIVE:The purpose of this retrospective cohort study was to investigate whether current practice where residents perform appendectomies affects quality of care. Therefore, we investigated whether there was a difference in incidence of complications and mortality in appendectomies performed by surgeons (S), supervis...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/SLA.0b013e318248bdb5
更新日期:2012-04-01 00:00:00
abstract:OBJECTIVE:To evaluate the efficacy of mesh fixation with fibrin sealant (FS) in laparoscopic preperitoneal inguinal hernia repair and to compare it with stapled fixation. SUMMARY BACKGROUND DATA:Laparoscopic hernia repair involves the fixation of the prosthetic mesh in the preperitoneal space with staples to avoid dis...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-200101000-00004
更新日期:2001-01-01 00:00:00
abstract:OBJECTIVE:To assess surgical aspects in the treatment of children with unilateral Wilms tumor based on data from the Cooperative Tumor Study SIOP 93-01 of the German Society of Pediatric Hematology and Oncology. SUMMARY BACKGROUND DATA:Although multiple international study trials exist for the treatment of nephroblast...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/SLA.0b013e31819ed92b
更新日期:2009-04-01 00:00:00
abstract::Intestinal ischemia-reperfusion is a common clinical event associated with both clinical and experimental distant organ injury. In particular, the pulmonary microvasculature appears to be susceptible to injury resulting from systemic inflammatory mediator activation. This study was designed to evaluate the hypothesis ...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-199301000-00009
更新日期:1993-01-01 00:00:00
abstract::Verapamil administered before treatment, but not after treatment, had a beneficial effect on a 90-minute warm ischemia-reperfusion rat liver injury model. The possible activation of proteases converting the xanthine dehydrogenase to xanthine oxidase, the significant mitochondrial calcium loading during the ischemic pe...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-199102000-00008
更新日期:1991-02-01 00:00:00
abstract:OBJECTIVE:To investigate differences in the quality, confidence, and consistency of intraoperative surgical decision making (DM) and using functional neuroimaging expose decision systems that operators use. SUMMARY BACKGROUND DATA:Novices are hypothesized to use conscious analysis (effortful DM) leading to activation ...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/SLA.0000000000001651
更新日期:2017-02-01 00:00:00
abstract:OBJECTIVE AND BACKGROUND:Local and distant disease recurrence are frequently observed following pancreatic cancer resection, but an improved understanding of resection margin assessment is required to aid tailored therapies. METHODS:Analyses were carried out to assess the association between clinical characteristics a...
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.0000000000002557
更新日期:2019-03-01 00:00:00
abstract::A study of 103 cases of acute occlusion of the superior mesenteric artery is presented. The relation of site of occlusion to etiology, extent of infarction, and survival following resection and revascularization is described. Included is an analysis of the technical factors contributing to successful revascularization...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-197812000-00003
更新日期:1978-12-01 00:00:00
abstract:OBJECTIVES:The aim of this study was to investigate the effect of pylorus resection on postoperative delayed gastric emptying (DGE) after partial pancreatoduodenectomy (PD). BACKGROUND:PD is the standard treatment for tumors of the pancreatic head. Preservation of the pylorus has been widely accepted as standard proce...
journal_title:Annals of surgery
pub_type: 杂志文章,随机对照试验
doi:10.1097/SLA.0000000000002480
更新日期:2018-06-01 00:00:00
abstract:OBJECTIVE:To compare the clinical, microbiological, and therapeutic features of nonpostoperative nosocomial intra-abdominal infections (non-PostopNAI) with community-acquired intra-abdominal infections (CAI). SUMMARY BACKGROUND DATA:Prospective (June 2000 through January 2001) consecutive case series analysis of patie...
journal_title:Annals of surgery
pub_type: 杂志文章,多中心研究
doi:10.1097/01.sla.0000114214.68169.e9
更新日期:2004-03-01 00:00:00
abstract:OBJECTIVE:The objective of this prospective, nonrandomized study was to evaluate the immediate and long-term results of first-line chemotherapy and possible surgery in locally advanced, presumably T4 squamous cell esophageal cancer. SUMMARY BACKGROUND DATA:Locally advanced esophageal cancer is rarely operable and has ...
journal_title:Annals of surgery
pub_type: 临床试验,杂志文章
doi:10.1097/00000658-199712000-00008
更新日期:1997-12-01 00:00:00
abstract:OBJECTIVE:To determine if certain outcomes of incisional hernia repair have improved in recent eras. SUMMARY BACKGROUND DATA:Technological developments have been reported to improve outcomes in the repair of abdominal wall incisional hernias. METHODS:This retrospective, population-based cohort study was conducted usi...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-200301000-00018
更新日期:2003-01-01 00:00:00
abstract::Fifteen patients who had a prior portasystemic shunt underwent orthotopic liver transplantation. Shunt types were portacaval in six patients, H-graft mesocaval in six, distal splenorenal in two, and proximal splenorenal in one. Mean blood loss and hospital stay were highest in the portacaval group. Retransplants (two ...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-198901000-00008
更新日期:1989-01-01 00:00:00
abstract:OBJECTIVE:To determine the disease-free survival (DFS) and recurrence after the treatment of patients with rectal cancer with open (OPEN) or laparoscopic (LAP) resection. BACKGROUND:This randomized clinical trial (ACOSOG [Alliance] Z6051), performed between 2008 and 2013, compared LAP and OPEN resection of stage II/II...
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.0000000000003002
更新日期:2019-04-01 00:00:00
abstract::The obturator bypass graft operation can be performed in a moderately simplified manner by a technique that allows extension of indications for the procedure beyond situations in which sepsis is present in the groin. Long-term analysis of the results of the cases available for study indicates that the procedure may ve...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-198303000-00015
更新日期:1983-03-01 00:00:00
abstract:OBJECTIVES:The aim of the study was to evaluate and study the full spectrum of swallowing dysfunction and long-term disease-specific outcomes in adults with surgically corrected esophageal atresia/tracheaesophageal fistula (EA/TEF). BACKGROUND:Long-term outcomes for adults who underwent EA/TEF repair because infants a...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/SLA.0000000000001978
更新日期:2017-08-01 00:00:00
abstract::Abdominal aortic aneurysmectomy is being performed with progressively lower operative mortality and morbidity. Three hundred thirty seven patients have had elective aneurysm repair since 1954. Factors affecting mortality and morbidity in the last 108 cases are analyzed. Seventy-four per cent of patients had pre-existi...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-197505000-00020
更新日期:1975-05-01 00:00:00
abstract:OBJECTIVE:The authors determined whether radioligand binding of neuropeptide Y (NPY) to hypothalamus taken from nonanorectic and anorectic tumor-bearing rats was altered as compared with similar tissue taken from freely-feeding and food-restricted control rats. SUMMARY BACKGROUND DATA:Previous results indicate that tu...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-199505000-00016
更新日期:1995-05-01 00:00:00
abstract::Glutaraldehyde treated human umbilical veins (Dardik Biograft) were used to bypass short segments of the femoral artery in 15 dogs and were compared to autogenous jugular veins placed in the contralateral femoral artery of each animal. All 15 autogenous jugular veins remained patent for the four month period of observ...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-197808000-00005
更新日期:1978-08-01 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:OBJECTIVE:The current study was undertaken to determine long-term results of aortic valve replacement (AVR) in the elderly, to ascertain predictors of poor outcome, and to assess quality of life. SUMMARY BACKGROUND DATA:Aortic valve replacement is the procedure of choice for elderly patients with aortic valve disease....
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-199706000-00017
更新日期:1997-06-01 00:00:00
abstract::In a prospective study of 103 patients with carcinoid tumors consecutively referred for medical treatment, the most common sites of the primary tumors were the ileum (73%), bronchi (7%), and jejunum (4%). All patients had local metastases, and 96 (93%) also had liver metastases. The most common initial symptoms were d...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-198708000-00001
更新日期:1987-08-01 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::As a consequence of an experience with 175 patients undergoing reoperation for persistent or recurrent hyperparathyroidism, the authors have evolved an approach to management. The emphasis is on the confirmation of the diagnosis; the critical evaluation of invasive and noninvasive localization tests, techniques of int...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:
更新日期:1985-01-01 00:00:00
abstract::In our series of 101 patients with small bowel bypass for morbid obesity, nine developed biliary calculi postoperatively during a mean follow-up of 29.6 months. The development of gallstones depends in part on biliary cholesterol saturation and on the zeta potential of bile. In eight consecutive patients, the lithogen...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-197801000-00011
更新日期:1978-01-01 00:00:00
abstract:OBJECTIVE:The aim of the study was to determine the prognostic impact of co-existence of APC and PIK3CA mutations in patients undergoing preoperative chemotherapy and resection for colorectal liver metastases (CLM). BACKGROUND:Co-occurring genetic events have been shown to drive carcinogenesis in multiple malignancies...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/SLA.0000000000002245
更新日期:2020-12-01 00:00:00