Abstract:
:During a five-year period, 34 patients had persistence or recurrence of abnormal hemodynamic measurements in limbs after arterial reconstruction depsite graft patency documented by arteriography. Initial operations included aortofemoral (four), femorofemoral (ten), femoropopliteal (18), and femorotibial (two) bypass. Immediate postoperative hemodynamic failure was documented in seven patients by a mean ankle/brachial systolic pressure index increase of only 0.05 +/- 0.04 following the initial reconstruction. The remaining 27 patients had delayed hemodynamic failure; mean increase in ankle pressure was only 0.06 +/- 0.05 from the preoperative period until time of detection of failure (average duration 2.5 years). In all 34 patients, arteriography demonstrated patency of the initial graft. In conjunction with the vascular laboratory examination, arteriography identified the cause of hemodynamic failure to be inadequate inflow in 10 patients, poor outflow in 16, combined inflow and outflow obstruction in one, and graft stenosis in seven. Unrecognized stenosis in areas proximal (two patients) and distal (three patients) to the bypass emphasized the importance of complete biplanar arteriography before initial operation. Reoperation was successful in correcting hemodynamic failure in 26 patients (76.5%) with a mean increase in ankle index of 0.41 +/- 0.15. Operation was technically not feasible in four patients and was not performed in another four patients because of concomitant medical problems. In two of these patients, progression to graft thrombosis was documented. The results of this study suggest that early objective recognition of an anatomically patent but hemodynamically failed graft is possible by frequent noninvasive testing. Prompt investigation by arteriography defines the cause and location of failure, and reoperation restores normal limb hemodynamics. Most important, reoperation permits salvage of the majority of these patent grafts prior to ultimate failure from thrombosis.
journal_name
Ann Surgjournal_title
Annals of surgeryauthors
O'Mara CS,Flinn WR,Johnson ND,Bergan JJ,Yao JSdoi
10.1097/00000658-198104000-00012subject
Has Abstractpub_date
1981-04-01 00:00:00pages
467-76issue
4eissn
0003-4932issn
1528-1140journal_volume
193pub_type
杂志文章abstract:OBJECTIVE:This multicenter study sought to evaluate the accuracy of the American College of Surgeons National Surgical Quality Improvement Program's (ACS-NSQIP) surgical risk calculator for predicting outcomes after pancreatoduodenectomy (PD) and to determine whether incorporating other factors improves its predictive ...
journal_title:Annals of surgery
pub_type: 杂志文章,多中心研究
doi:10.1097/SLA.0000000000001796
更新日期:2017-05-01 00:00:00
abstract:OBJECTIVE:The objective of this study is to determine the characteristics and frequency of intraoperative safety threats and resilience supports using a human factors measurement tool. BACKGROUND:Human factors analysis can provide insight into how system elements contribute to intraoperative adverse events. Empiric ev...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/SLA.0000000000003616
更新日期:2019-10-04 00:00:00
abstract::During the 5-year period from January 1978 through December 1982, 196 patients with blunt trauma to the small bowel, colon, or mesentery were treated at the Maryland Institute for Emergency Medical Services Systems (MIEMSS) Shock Trauma Center. More than 80% of these patients were the victims of motor vehicle accident...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-198502000-00011
更新日期:1985-02-01 00:00:00
abstract:OBJECTIVE:To compare the modified Rossetti fundoplication with the classic Nissen. SUMMARY BACKGROUND DATA:The traditional surgical treatment of gastroesophageal reflux in children has been the classic Nissen fundoplication, defined by liver mobilization, crural repair, takedown of short gastric vessels, and floppy wr...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-199906000-00003
更新日期:1999-06-01 00:00:00
abstract:OBJECTIVE:To determine the impact of length of stay upon 30-day outcomes. BACKGROUND:It has been recommended the goal length of stay (LOS) after laparoscopic Roux-en-Y gastric bypass (LRYGB) should be 1 day to improve resource utilization. This study's aim was to assess LRYGB outcomes by LOS. METHODS:Data were obtain...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/SLA.0000000000000227
更新日期:2014-02-01 00:00:00
abstract::A retrospective analysis was made of the complications from pelvic exenterations performed over the past 30 years for colorectal adenocarcinoma at the Roswell Park Cancer Institute. Seventy-five patients underwent exenteration, 51 for primary disease (PD) and 24 for recurrent disease (RD). Both total and posterior exe...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-199201000-00009
更新日期:1992-01-01 00:00:00
abstract::Desmoid tumors are locally invasive, nonmetastasizing fibrous tumors most frequently seen in patients with familial polyposis coli (FPC). Of 325 patients with FPC treated at the Cleveland Clinic, 29 (8.9%) were found to have a total of 36 desmoid tumors. These tumors occur in young patients (mean age: 29.8 years), par...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-198607000-00014
更新日期:1986-07-01 00:00:00
abstract:OBJECTIVE:To assess the impact of the 80-hour resident workweek restrictions on surgical residents and attending surgeons. SUMMARY BACKGROUND DATA:The ACGME mandated resident duty hour restrictions have required a major workforce restructuring. The impact of these changes needs to be critically evaluated for both the ...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/01.sla.0000220042.48310.66
更新日期:2006-06-01 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::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::From 1969 to 1985, 129 patients with combined pancreatoduodenal injuries were treated at one urban trauma center. A total of 104 patients (80.6%) had penetrating wounds, and multiple visceral and vascular injuries were usually associated with the pancreatoduodenal injury. Primary repair or resection of one or both org...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-198706000-00009
更新日期:1987-06-01 00:00:00
abstract:OBJECTIVES:The aim of this systematic review was to assess the impact of surgical safety checklists on the quality of teamwork and communication in the operating room (OR). BACKGROUND:Safety checklists have been shown to impact positively on patient morbidity and mortality following surgery, but it is unclear whether ...
journal_title:Annals of surgery
pub_type: 杂志文章,评审
doi:10.1097/SLA.0000000000000206
更新日期:2013-12-01 00:00:00
abstract:OBJECTIVE:This study was designed to determine whether the volume and type of fluid administered for pancreaticoduodenectomy impacts postoperative outcomes. BACKGROUND:Three percent hypertonic saline (HYS) has been suggested as a means of reducing the volume of fluid required to sustain tissue perfusion in the periope...
journal_title:Annals of surgery
pub_type: 杂志文章,随机对照试验
doi:10.1097/SLA.0000000000000872
更新日期:2014-09-01 00:00:00
abstract::A cross-over design study was used to examine the metabolic consequences of enteral feeding for 48 to 96 hours with either a branched-chain amino acid (BCAA)-enriched (44% BCAA) or a conventional egg protein formulation in 12 severely burned adult patients. A stable isotope labeled leucine (L-1-13C-leucine) tracer app...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-198804000-00009
更新日期:1988-04-01 00:00:00
abstract:OBJECTIVE:To evaluate the efficacy of a novel 2-stage treatment with reductive surgery plus percutaneous isolated hepatic perfusion (PIHP) for multiple hepatocellular carcinoma (HCC), which was previously unresectable. SUMMARY BACKGROUND DATA:Surgical resection is the treatment of choice for HCC, but the majority of p...
journal_title:Annals of surgery
pub_type: 临床试验,杂志文章
doi:10.1097/01.sla.0000103133.03688.3d
更新日期:2004-01-01 00:00:00
abstract:OBJECTIVE:To test the total burden of complications in the early postoperative period after liver transplantation (LT) between donation after circulatory death (DCD) and donation after brain death (DBD) grafts with the novel Comprehensive Complication Index (CCI). BACKGROUND:LT is complex surgery and the increasing us...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/SLA.0000000000002419
更新日期:2017-11-01 00:00:00
abstract::Fetus-in-fetu is an unusual cause of retroperitoneal abdominal mass in infants, which most likely arises from inclusion of a monozygotic, diamniotic twin. This entity is distinguished from teratoma by its embryological origin, its unusual location in the retroperitoneal space, its invariable benignity, and by the pres...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-197407000-00011
更新日期:1974-07-01 00:00:00
abstract:OBJECTIVES:We aimed to examine the association between total number of resected nodes and survival in patients after esophagectomy with and without nCRT. BACKGROUND:Most studies concerning the potentially positive effect of extended lymphadenectomy on survival have been performed in patients who underwent surgery alon...
journal_title:Annals of surgery
pub_type: 杂志文章,随机对照试验
doi:10.1097/SLA.0000000000000965
更新日期:2014-11-01 00:00:00
abstract:OBJECTIVE:This study was intended to identify prognostic biomarkers for lymph node (LN)-positive locoregional esophageal squamous cell carcinoma (ESCC) patients. SUMMARY OF BACKGROUND DATA:Surgery is a major treatment for LN-positive locoregional ESCC patients in China. However, patient outcomes are poor and heterogen...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/SLA.0000000000003369
更新日期:2019-04-30 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:"Rediscovered" in 1976, transhiatal esophagectomy (THE) has been applicable in most situations requiring esophageal resection and reconstruction. The objective of this study was to review the authors' 30-year experience with THE and changing trends in its use. METHODS:Using the authors' prospective Esophagec...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/SLA.0b013e31814697f2
更新日期:2007-09-01 00:00:00
abstract:OBJECTIVE:To describe the incidence and risk factors for mortality and morbidity in patients with cirrhosis undergoing elective or emergent abdominal surgeries. BACKGROUND:Postoperative morbidity and mortality are higher in patients with cirrhosis; variation by surgical procedure type and cirrhosis severity remain unc...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/SLA.0000000000003674
更新日期:2019-10-23 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::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::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::In construction of the eosphagojejunostomy after total gastrectomy, the EEA stapled (US Surgical Corporation, Norwalk, CT) and the two-layer interrupted 3-0 Dexon anastomoses are compared concerning the radiological appearance, breaking strength, circulation, and collagen concentration. Thirty female pigs were used. A...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-198604000-00017
更新日期:1986-04-01 00:00:00
abstract:OBJECTIVE:This study was conducted to evaluate those factors associated with popliteal artery injury that influence amputation, with emphasis placed on those that the surgeon can control. SUMMARY BACKGROUND DATA:Generally accepted factors impacting amputation after popliteal artery injury include blunt trauma, prolong...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-199705000-00009
更新日期:1997-05-01 00:00:00
abstract:OBJECTIVE:This article outlines the formation of the Australian and New Zealand Audit of Surgical Mortality (ANZASM) and describes its objectives, governance, functioning and challenges. BACKGROUND:A nationwide audit of surgical mortality provides an overview of the leading causes of death in patients who require surg...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/SLA.0000000000000581
更新日期:2015-02-01 00:00:00
abstract:BACKGROUND AND OBJECTIVE:The opioid epidemic has stimulated initiatives to reduce the number of unnecessary narcotic prescriptions. We adopted an opt-in prescription system for patients undergoing ambulatory cervical endocrine surgery (CES). We hypothesized that empowering patients to decide whether or not to receive n...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/SLA.0000000000003443
更新日期:2019-07-06 00:00:00
abstract::The aim of this study was to define the post-traumatic changes in body fluid compartments and to evaluate the effect of plasma colloid osmotic pressure (COP) on the partitioning of body fluid between these compartments. Forty-two measurements of plasma volume (green dye), extracellular volume (bromine), and total body...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-198909000-00015
更新日期:1989-09-01 00:00:00