Abstract:
:Several recent reviews have suggested that aggressive surgical intervention can reduce morbidity and mortality associated with intra-abdominal crises in AIDS patients. We reviewed our experience with 57 AIDS patients with 63 emergent laparotomies performed at 4 hospitals affiliated with the University of California in San Francisco. Fifty-five patients (96%) were homosexual men. Thirty-nine (68%) had been treated for an opportunistic infection. Indications for exploration included right lower quadrant pain consistent with appendicitis in 24 patients (38%), visceral perforation or obstruction in 11 (17%), right upper quadrant pain in 9 (14%), diffuse peritonitis in 8 (13%), and uncontrollable hemorrhage in 8 (13%). Perioperative mortality was 12% (7/57). Fifteen patients (26%) suffered major complications including pneumonia, sepsis, multi-organ failure, and intra-abdominal abscess. Forty-five of 50 survivors (90%) were receiving some type of chronic antimicrobial or antineoplastic chemotherapy, compared to only 2 of the 7 patients who died (28.6%) (P < 0.001). Lack of ongoing prophylactic treatment for AIDS-related disease, active opportunistic infections, Walter Reed VI classification, and ongoing sepsis at the time of exploration were noted to be associated with increased morbidity and mortality.
journal_name
Am J Surgjournal_title
American journal of surgeryauthors
Whitney TM,Brunel W,Russell TR,Bossart KJ,Schecter WPdoi
10.1016/s0002-9610(05)80194-1subject
Has Abstractpub_date
1994-09-01 00:00:00pages
239-43issue
3eissn
0002-9610issn
1879-1883pii
S0002-9610(05)80194-1journal_volume
168pub_type
杂志文章abstract::Our thirteen year experience with villous adenomas of the colon and rectum, embracing 264 patients, is reported. The average age of patients was sixty-two years with an almost equal sex distribution. Seventy-two per cent of the lesions occurred in the rectum and rectosigmoid and the most frequent symptoms were rectal ...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/0002-9610(75)90430-4
更新日期:1975-12-01 00:00:00
abstract:BACKGROUND:Our aim was to determinate the prognostic value of neutrophil-lymphocyte ratio (NLR) and platelet-lymphocyte ratio (PLR) in primary operable patients with non-small cell lung cancer (NSCLC). METHODS:Six hundred seventy-eight NSCLC patients were enrolled in this study. The prognostic significance of both mar...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/j.amjsurg.2015.03.022
更新日期:2015-09-01 00:00:00
abstract:BACKGROUND:We investigated whether or not interleukin-8 (IL-8) and granulocyte elastase (GE) can be associated with pulmonary complication after esophagectomy (the most common cause of postoperative death). METHODS:We measured serial changes in the IL-8 concentration and GE activity in the plasma and bronchoalveolar l...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/s0002-9610(00)00558-4
更新日期:2001-02-01 00:00:00
abstract:BACKGROUND:This prospective study was performed to ascertain the added benefit of lymphoscintigraphy to a standard method of intraoperative lymphatic mapping and sentinel node biopsy for breast cancer. METHODS:Patients with invasive breast cancer were injected with 99mTc sulfur colloid prior to sentinel node biopsy; p...
journal_title:American journal of surgery
pub_type: 临床试验,杂志文章
doi:10.1016/s0002-9610(99)00088-4
更新日期:1999-06-01 00:00:00
abstract::Three patients who underwent 95 percent removal of the pancreas for chronic pancreatitis with autotransplantation of the body and tail of the gland to the femoral area are described. The follow-up periods are 18, 6, and 2 months. Pain lessened in all patients and none required exogenous insulin. Patency of the graft w...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/0002-9610(83)90036-3
更新日期:1983-04-01 00:00:00
abstract:BACKGROUND:We describe the presentation, diagnostic pathway, and management of 28 patients with benign retroperitoneal schwannomas. METHODS:A prospectively kept soft-tissue tumor database was reviewed to identify patients who presented to the Royal Marsden Hospital with retroperitoneal schwannomas. RESULTS:From 2001 ...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/j.amjsurg.2010.06.036
更新日期:2011-08-01 00:00:00
abstract::DVT involving the lower extremities is a frequent (25-40 percent of patients) complication of major thoracic, abdominal, and pelvic surgery in patients beyond the age of 40 years. Herein, we have reported a recently completed large prospective, randomized multicenter investigation of the prophylaxis of postoperative D...
journal_title:American journal of surgery
pub_type: 临床试验,杂志文章,随机对照试验
doi:
更新日期:1985-10-08 00:00:00
abstract:BACKGROUND:Virtual reality simulators provide an effective learning environment and are widely used. This study evaluated the Endoscopic Sinus Surgery Simulator (ES3; Lockheed Martin) as a tool for anatomic education. METHODS:Two medical student groups (experimental, n = 8; control, n = 7) studied paranasal sinus anat...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/j.amjsurg.2007.06.026
更新日期:2008-07-01 00:00:00
abstract:BACKGROUND:The prognostic significance of tumor location in breast cancer remains unclear. To better understand this relationship, we evaluated the Department of Defense tumor registry. METHODS:Patients with infiltrating ductal adenocarcinoma or lobular carcinoma over a 10-year period were identified and analyzed. RE...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/j.amjsurg.2007.12.039
更新日期:2008-05-01 00:00:00
abstract::A review of 143 patients with 144 feeding jejunostomies was carried out. In the 129 patients in whom catheters were utilized, only 48 (45 percent) had no complications. Seventy-one patients (55 percent) suffered one or more catheter-related complications. Ten of these complications were life-threatening or fatal, incl...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/s0002-9610(88)80267-8
更新日期:1988-01-01 00:00:00
abstract::One hundred thirty-six patients meeting our criteria for one or more of eight clinical conditions were prospectively observed for the development of the adult respiratory distress syndrome. A high risk population was identified, including those with sepsis syndrome (38 percent), documented aspiration of gastric conten...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/0002-9610(82)90612-2
更新日期:1982-07-01 00:00:00
abstract:BACKGROUND:Although increasingly administered to patients with pancreatic ductal adenocarcinoma, the role of preoperative therapy for patients with distal cholangiocarcinoma is undefined. METHODS:All patients with distal cholangiocarcinoma who underwent pancreatoduodenectomy between 1999 and 2014 were retrospectively ...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/j.amjsurg.2018.08.024
更新日期:2019-07-01 00:00:00
abstract:BACKGROUND:Predicting length of stay (LOS) is difficult for trauma and emergency general surgery (TEGS) patients. Our aim was to determine the accuracy of LOS predictions by TEGS team members and the NSQIP Risk Calculator and the patient factors associated with inaccurate predictions. METHODS:LOS for 200 TEGS patients...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/j.amjsurg.2020.01.055
更新日期:2020-09-01 00:00:00
abstract::Most series dealing with external gastrointestinal fistulas cover experience of many years and include a heterogeneous sample of fistulas. We present our experience with 117 cases of postoperative external alimentary tract fistulas treated since 1980. Only fistulas caused by anastomotic leaks and operative injury to b...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/0002-9610(91)91107-t
更新日期:1991-04-01 00:00:00
abstract:BACKGROUND:We previously reported on a pilot trauma multidisciplinary crisis resource course titled S.T.A.R.T.T. (Simulated Trauma and Resuscitative Team Training). Here, we study the course's evolution. METHODS:Satisfaction was evaluated by postcourse survey. Trauma teams were evaluated using the Ottawa global rating...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/j.amjsurg.2015.07.024
更新日期:2016-07-01 00:00:00
abstract::A technique for the repair of inguinal hernias in elderly patients with weak abdominal muscles has been presented. It consists of the overlapping of the flaps of the aponeurosis of the external oblique muscle according to the method previously proposed by Andrews. To date, the technique has given good results, even in...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/0002-9610(83)90419-1
更新日期:1983-09-01 00:00:00
abstract:BACKGROUND:Transduodenal sphincterotomy (TS) has fallen into disuse since endoscopists developed techniques to treat sphincter problems nonsurgically. However, some patients experience recurrent sphincter strictures after endoscopic sphincterotomy (ES), with the ampulla endoscopically inaccessible, and pancreas divisum...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/j.amjsurg.2009.08.048
更新日期:2010-08-01 00:00:00
abstract:BACKGROUND:Acellular dermal matrix (ADM) represents a promising new fascial substitute for repairing abdominal wall defects. METHODS:We retrospectively studied 63 patients who underwent fascial reconstruction with ADM and analyzed risk factors for recurrence and infectious wound complications. RESULTS:Postoperative w...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/j.amjsurg.2007.11.019
更新日期:2009-01-01 00:00:00
abstract:OBJECTIVE:We aimed to identify potential variables predictive of a resident achieving faculty future entrustment as a way to enhance attending surgeons' planning of teaching in the operating room leading to improved resident operative autonomy in practice. METHODS:We reviewed 273 resident performance evaluations from ...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/j.amjsurg.2021.01.020
更新日期:2021-01-19 00:00:00
abstract:BACKGROUND:This study defines the entity of the hypertensive lower esophageal sphincter (HLES) and its treatment, including surgical implications. METHODS:Esophageal manometry was performed on 1,300 patients. Of these, 53 (4%) had HLES with resting pressure > 26.5 mm Hg, defined as the upper limit of normal resting LE...
journal_title:American journal of surgery
pub_type: 临床试验,杂志文章
doi:10.1016/S0002-9610(96)00219-X
更新日期:1996-11-01 00:00:00
abstract:BACKGROUND:Hepatic portal venous gas is an unusual entity associated with a variety of abdominal catastrophes. There is usually a grave prognosis when hepatic portal venous gas is associated with ischemic bowel disease. We reported a 57-year-old man with hepatic portal venous gas associated with extensive infarction of...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/j.amjsurg.2004.09.014
更新日期:2005-04-01 00:00:00
abstract:BACKGROUND:Current standard of care dictates that central venous catheter (CVC) insertion should be followed by an immediate chest radiograph to confirm appropriate position and rule out complications. We hypothesized that a subset of monitored intensive care unit patients exists that is at low risk for complications a...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/s0002-9610(00)00498-0
更新日期:2000-12-01 00:00:00
abstract:BACKGROUND:Training surgeons in vital decision-making skills remains unstructured. We aimed to map a process of care from the perspective of surgical decision making and test whether it could be deconstructed into an accessible format for trainees. METHODS:Semistructured interviews were conducted with 10 experienced s...
journal_title:American journal of surgery
pub_type: 杂志文章,多中心研究
doi:10.1016/j.amjsurg.2007.02.016
更新日期:2008-05-01 00:00:00
abstract::In a random double-blind trial monitored by 125I-fibrinogen leg scan, impedance plethysmography, and contrast phleobograms if impedance became abnormal, hydroxycholoroquine was shown to be no more effective than placebo for prevention of venous thrombosis after total hip replacement. Subsequently, the combination of h...
journal_title:American journal of surgery
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1016/0002-9610(77)90125-8
更新日期:1977-04-01 00:00:00
abstract:PURPOSE:Stoma closure has been associated with a high rate of surgical site infection (SSI) and the optimal skin closure method is still controversial. The aim of this study was to compare the short-term and long-term outcomes between the conventional linear closure (CC) and the persestring closure (PC) using propensit...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/j.amjsurg.2017.09.031
更新日期:2018-01-01 00:00:00
abstract:BACKGROUND:Transluminal balloon angioplasty offers advantages to patch angioplasty. We evaluated the primary patency of thrombosed hemodialysis grafts that had undergone balloon angioplasty versus patch angioplasty as a salvage method. METHODS:We reviewed our experience with 22 consecutive intraoperative balloon angio...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/s0002-9610(97)90072-6
更新日期:1997-08-01 00:00:00
abstract::Between 1960 and 1990, a total of 998 patients were treated at the Sydney Melanoma Unit for cutaneous melanoma of the head and neck. There were 595 male and 403 female patients, with a median age of 53 years. The most common primary lesion site was the face (47%), followed by the neck (29%), scalp (14%), and ear (10%)...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/0002-9610(91)90138-4
更新日期:1991-10-01 00:00:00
abstract::Experience with fifty-three femorofemoral grafts performed as the initial operation for iliac occlusive disease over a ten year period is reviewed. There was one operative death (2 per cent). There were two early and three late graft failures, for a five year cumulative graft patency rate of 80 per cent. Of the twenty...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/0002-9610(78)90224-6
更新日期:1978-08-01 00:00:00
abstract::Parastomal hernia repair remains a significant surgical challenge. Recurrence after standard "keyhole" or primary suture repair is common. We adopted and modified a new technique using a construct shaped like an inverted top hat. We review our experience over the last six years in the first 30 patients (31 consecutive...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/j.amjsurg.2018.02.018
更新日期:2018-09-01 00:00:00
abstract::The histopathology, clinical features, treatment, and results are reported in twenty-nine patients with thymoma. Benign and malignant thymomas are differentiated by their invasive characteristics. Surgical excision is recommended for benign lesions. Surgical excision and postoperative irradiation are recommended for m...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/0002-9610(78)90199-x
更新日期:1978-07-01 00:00:00