Abstract：
BACKGROUND:Many cases of acute adhesive small-bowel obstruction (SBO) can be successfully treated with intestinal tube decompression. There is considerable controversy, however, regarding whether a short nasogastric tube (NGT) or a long nasointestinal tube (LT) is the best method of intestinal tube decompression. PATIENTS AND METHODS:A prospective, randomized trial was conducted to compare NGT and LT decompression with respect to the success of nonoperative treatment and morbidity of surgical intervention in 55 patients with acute adhesive SBO. RESULTS:Twenty-eight patients were managed with NGT and 27 with LT. There were 44 cases of partial SBO (23 NGT, 21 LT) and 11 cases of complete SBO (5 NGT, 6 LT). Twenty-one patients ultimately required operation, including 13 managed with NGT (46%) and 8 with LT (30%) (P = 0.16). The mean period between admission and operation was 60 hours in the NGT group versus 65 hours in the LT group. At operation, 3 patients in the NGT group had ischemic bowel that required resection. Postoperative complications occurred in 23% of patients treated with NGT versus 38% of patients treated with LT (P = 0.89). Postoperative ileus averaged 6.1 days for NGT patients versus 4.6 days for LT patients (P = 0.44). There were no deaths. CONCLUSIONS:Patients with adhesive SBO can safely be given a trial of tube decompression upon hospital admission. There was no advantage of one type of tube over the other in patients with adhesive SBO.
journal_name
Am J Surgjournal_title
American journal of surgeryauthors
Fleshner PR,Siegman MG,Slater GI,Brolin RE,Chandler JC,Aufses AH Jrdoi
10.1016/s0002-9610(99)80305-5subject
Has Abstractpub_date
1995-10-01 00:00:00pages
366-70issue
4eissn
0002-9610issn
1879-1883pii
S0002-9610(99)80305-5journal_volume
170pub_type
临床试验,杂志文章,随机对照试验abstract：:Significant arterial trauma can result from femoral arterial cannulation for cardiopulmonary bypass or intraaortic balloon pumping. Threat of imminent loss of limb or suture line disruption requires prompt surgical intervention. Delayed appearance of claudication, characteristically at 1 to 2 weeks postoperatively, is...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/0002-9610(80)90026-4
更新日期：1980-08-01 00:00:00
abstract：BACKGROUND:Retroperitoneal vascular injury remains one of the most frequent causes of death following abdominal trauma. A risk analysis of the association between potential outcome predictors and mortality following abdominal aorta and inferior vena cava injuries was performed. METHODS:Eighty-nine patients sustaining ...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/S0002-9610(96)00231-0
更新日期：1996-11-01 00:00:00
abstract：BACKGROUND:To prevent hepatic failure after major hepatectomy, it is important to assess preoperative factors related to liver failure. METHODS:We examined 80 patients who underwent right-sided hepatectomy. Hyperbilirubinemia, uncontrolled ascites, and prolonged postoperative hospital stay were defined as liver failur...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/j.amjsurg.2012.12.013
更新日期：2013-09-01 00:00:00
abstract：:It has been shown that truncal vagotomy with pyloroplasty (TVP), but not highly selective vagotomy (HSV), delays the onset, decreases the extent, and changes the pattern of gallbladder emptying. The aim of the present study was to investigate any alterations in gallbladder emptying after a variety of antiulcer gastric...
journal_title：American journal of surgery
pub_type： 临床试验,杂志文章
doi：10.1016/s0002-9610(05)80160-6
更新日期：1994-10-01 00:00:00
abstract：:The lecture activity of neurology and neurosurgery faculty at allopathic medical schools during the academic years 1985-1986 through 1987-1988 was surveyed. Lectures were categorized into three combinations for analysis: first- and second-year basic science, first- and second-year clinical, and third- and fourth-year ...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/0002-9610(94)90213-5
更新日期：1994-03-01 00:00:00
abstract：:During a fourteen year period, diagnostic peritoneal lavage was 98.5 per cent accurate in determining the presence or absence of blunt intraabdominal injuries among 2,586 patients. Of these, 69.4 per cent had a negative lavage and 29.2 per cent a positive lavage. Six patients (0.2 per cent) had a false-positive lavage...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/0002-9610(78)90339-2
更新日期：1978-12-01 00:00:00
abstract：BACKGROUND:The purpose of this study was to investigate the reliability and validity of a performance assessment of communication, professionalism, and surgical skills competencies for surgery residents. METHODS:Fourteen residents from the general surgery program of the University of Calgary were assessed in 7 surgica...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/j.amjsurg.2010.07.045
更新日期：2011-10-01 00:00:00
abstract：BACKGROUND:Following appendectomy, management is often guided by surgeon determination of whether the appendicitis is uncomplicated or complicated. Our objectives were to determine the incidence of discordance between intraoperative and pathological findings and determine effect on outcomes. METHODS:We performed a ret...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/j.amjsurg.2019.05.004
更新日期：2020-01-01 00:00:00
abstract：:A technic of esophagogastrostomy is described for constructing an end-to-side, back-to-front anastomosis using stapling devices. Twelve consecutive cases are reported with no deaths and no anastomotic leaks. ...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/0002-9610(78)90305-7
更新日期：1978-09-01 00:00:00
abstract：:With the purpose of facilitating liver biopsy during upper abdominal procedures, an adaptation of the percutaneous one-second needle biopsy technic is proposed. A simple device, consisting of a three-way deviator, allows the utilization of the standard needles for percutaneous biopsy. The entire procedure requires fro...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/0002-9610(77)90551-7
更新日期：1977-03-01 00:00:00
abstract：:A discussion of congenital arteriovenous malformation of the head and neck based on five patients followed from three to twenty years is presented. Definition of the lesion and its progression as followed by angiography is described. The poor response to surgery is ascribed to the ischemic nature of the area of involv...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/0002-9610(78)90255-6
更新日期：1978-10-01 00:00:00
abstract：:Five hundred twenty-six patients who underwent carotid endarterectomy were separated by reviewing those 81 (15%) patients with an occluded contralateral carotid artery and those 445 (85%) with nonocclusion. The population characteristics and surgical indications were similar between the occluded and nonoccluded groups...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/s0002-9610(05)81050-5
更新日期：1993-08-01 00:00:00
abstract：:The portal-superior mesenteric vein (PV/SMV) is occasionally involved by a microscopic level of cancer invasion from pancreatic cancer even when it seems to be intact by a macroscopic inspection during surgery. Therefore, contact endoscopy, with which a high-magnification image of the methylene blue-stained PV/SMV wal...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/j.amjsurg.2009.03.009
更新日期：2009-11-01 00:00:00
abstract：BACKGROUND:Little is known about the role of percutaneous revascularization of the profunda femoral artery (PFA) in patients with amputation stump ischemia who are at risk of hip disarticulation. METHODS:We identified 4 patients who were treated for persistent amputation stump ischemia by PFA percutaneous revasculariz...
journal_title：American journal of surgery
pub_type： 杂志文章,评审
doi：10.1016/j.amjsurg.2012.07.001
更新日期：2012-11-01 00:00:00
abstract：:By means of intragastric instillation of meat extract, two groups of duodenal ulcer patients were identified--antral responders and antral nonresponders. Antral response was abolished ater vagotomy and drainage or vagotomy-antrectomy. The differentiation would allow for selective surgery for duodenal ulcer patients. ...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/0002-9610(77)90355-5
更新日期：1977-08-01 00:00:00
abstract：BACKGROUND:The progress and development of stapling devices has been remarkable. They have become indispensable for gastrointestinal diseases and are increasingly utilized in laparoscopic operations. Liver surgery applications for this technique are continuing to emerge, and in this study, we introduced the use of stap...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/j.amjsurg.2003.11.005
更新日期：2004-02-01 00:00:00
abstract：:A seven day old dehydrated male infant was found to have acute ischemia of the leg due to acute thrombotic occlusion of an external iliac, common and superficial femoral, and popliteal arteries. Early thrombectomy and arterioplasty resulted in complete remission of ischemia. Our success with direct vascular surgery pr...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/0002-9610(75)90254-8
更新日期：1975-03-01 00:00:00
abstract：:A new break-away needle for subclavian catheter insertion has been described. This needle functions exactly as the usual 14 gauge needle, but it can be completely removed from the catheter while leaving the integral Luer adaptor intact. ...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/0002-9610(84)90210-1
更新日期：1984-06-01 00:00:00
abstract：:1. A review of the immediate and long-term results of prophylactic carotid endarterectomy for asymptomatic lesions of 78 carotid arteries in 72 patients between 1961 and 1976 is presented. 2. The inhospital operative mortality was zero. Two patients experienced postoperative transient neurologic deficit with complete ...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/0002-9610(79)90375-1
更新日期：1979-08-01 00:00:00
abstract：:One hundred thirty-four patients suspected of having pancreas cancer successfully underwent gray scale ultrasound examination of the pancreas. The prospective ultrasound findings were correlated with the final diagnoses, laparotomy findings, and pathology findings. Fifty-four patients had pancreas cancer, confirmed by...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/0002-9610(78)90313-6
更新日期：1978-11-01 00:00:00
abstract：:Limb ischemia due to blunt trauma, dissecting hematoma, and cardiac dysfunction jeopardizes limbs and lives more than is generally appreciated. Delay in diagnosis after blunt trauma led to major amputation in 21 percent of our patients. Current principles avoid those hazards. Five patients presented with acute limb is...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/0002-9610(82)90513-x
更新日期：1982-08-01 00:00:00
abstract：BACKGROUND:Despite recent increased indications for infrapopliteal prosthetic bypass grafts with complementary arteriovenous fistulas, objective documentation of improved perfusion to the foot is lacking. In addition, the value of post operative noninvasive testing in the prediction of bypass success remains unclear. ...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/s0002-9610(99)80264-5
更新日期：1995-08-01 00:00:00
abstract：BACKGROUND:An ideal treatment method for the widely prevalent pilonidal sinus disease is not yet available. The most commonly practiced technique is simple closure following resection of the effected tissue. However, high recurrence rates in some series have led to the search for other methods. One of these methods is ...
journal_title：American journal of surgery
pub_type： 杂志文章,随机对照试验
doi：10.1016/j.amjsurg.2008.12.030
更新日期：2010-02-01 00:00:00
abstract：BACKGROUND:The presence of an "open abdomen" after a trauma laparotomy can complicate the nutritional management of injured patients. METHODS:The medical records of patients admitted to an American College of Surgeons-verified level 1 trauma center were evaluated. The timing of nutritional support was noted. The metho...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/j.amjsurg.2009.08.033
更新日期：2010-03-01 00:00:00
abstract：:During the thirty-three years from 1941 through 1973, forty-two children with ovarian teratomas were seen. The most common complaint was that of abdominal pain and the most common physical finding was palpable lower abdominal mass. Thirty-seven patients had ovarian teratomas with nature tissues only. Of these, two pat...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/0002-9610(76)90349-4
更新日期：1976-11-01 00:00:00
abstract：BACKGROUND:Local custom, rather than evidence-based medicine, dictates how a surgeon closes abdominal wounds. Closures might be more secure if grounded on statistical data. MATERIALS AND METHODS:A meta-analysis of 12,249 patients with abdominal wound closures was made. Infections, hernias, and dehiscences were compare...
journal_title：American journal of surgery
pub_type： 杂志文章,meta分析
doi：10.1016/s0002-9610(98)00277-3
更新日期：1998-12-01 00:00:00
abstract：:Silver biopsies of the common bile duct were obtained from 15 patients with clinical and surgical evidence of cholangitis. The most pronounced histologic changes were edema, congestion, and marked mucous gland hypertrophy and hyperplasia. No ulceration, intramural abscess, or areas of necrosis were found. Clinical cho...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/0002-9610(79)90089-8
更新日期：1979-06-01 00:00:00
abstract：:The dose response curves for acid and pepsin output to increasing intravenous doses of pentagastrin (0.01, 0.02, 2, 8, and 16 micrograms/kg per hour) were determined in six male patients with duodenal ulcer and six with type 1 corporeal gastric ulcer before and 3 to 6 months after selective proximal vagotomy and excis...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/0002-9610(85)90433-7
更新日期：1985-11-01 00:00:00
abstract：BACKGROUND:Studies of gender disparity in surgical training have yielded conflicting results. We hypothesize that there is no influence of gender on resident self-evaluation Milestone (SEM) scores and those assigned by the Clinical Competency Committee (CCC). METHODS:42 residents (25 male & 17 female) and faculty comp...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/j.amjsurg.2020.12.020
更新日期：2020-12-13 00:00:00
abstract：BACKGROUND:In this study, we explore surgical resident communication with simulated patient surrogates (SPs), in an Objective Structured Clinical Examination (OSCE). METHODS:We use discourse analysis (DA), a qualitative approach to analyzing language, to evaluate our residents' interactions with simulated patient surr...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/j.amjsurg.2017.10.041
更新日期：2018-02-01 00:00:00
