Abstract:
OBJECTIVE:The authors determined the incidence of complications in 133 patients who had undergone staging laparotomy with splenectomy before treatment for Hodgkin's disease (stages I-IV). METHODS AND MATERIALS:Medical records were reviewed, and the patients or their relatives were interviewed. Median follow-up after laparotomy was 15.7 years (range = 2.5-28 years). RESULTS:Ten episodes of overwhelming postsplenectomy infection (OPSI) were documented in nine patients (6.8%). None of 25 patients who received pneumococcal vaccine before splenectomy developed OPSI. Patients with advanced (stages III-IV) or recurrent Hodgkin's disease were at higher risk of OPSI than those with early disease, and those who received combined modality oncologic therapy were at greater risk than those receiving less intensive treatment. Surgical complications included small bowel obstruction in 13 patients (9.8%), necessitating repeat laparotomy in 9 patients (6.8%), atelectasis in 17 patients, abscess in 3 patients, and 1 wound dehiscence. No deaths occurred as a result of surgical complications. Causes of death in the 29 patients who died included Hodgkin's disease (12 patients), acute treatment-related morbidity (1 patient), leukemia (5 patients), bone marrow failure (3 patients), solid malignancy (2 patients), intercurrent disease (4 patients), unknown causes (1 patient), and OPSI (1 patient). CONCLUSION:With presplenectomy pneumococcal vaccination and modern surgical techniques, the long-term risks of laparotomy with splenectomy are acceptable if knowledge of the pathologic extent of abdominal Hodgkin's disease would alter treatment regimens.
journal_name
Ann Surgjournal_title
Annals of surgeryauthors
Jockovich M,Mendenhall NP,Sombeck MD,Talbert JL,Copeland EM 3rd,Bland KIdoi
10.1097/00000658-199406000-00004subject
Has Abstractpub_date
1994-06-01 00:00:00pages
615-21; discussion 621-4issue
6eissn
0003-4932issn
1528-1140journal_volume
219pub_type
杂志文章,评审abstract:BACKGROUND:Sentinel lymph node (SLN) biopsy is fast becoming the standard for testing lymph node involvement in many institutions. However, questions remain as to the best method of injection. The authors hypothesized that a subareolar injection of material would drain to the same lymph node as a peritumoral injection,...
journal_title:Annals of surgery
pub_type: 临床试验,杂志文章
doi:10.1097/00000658-199906000-00013
更新日期:1999-06-01 00:00:00
abstract::Of 178 patients with sclerosing cholangitis treated since 1950, 88 patients had associated inflammatory bowel disease, 72 had no such history, and 18 had iatrogenic injury or stone disease. A total of 233 biliary operations were performed, with a 75% rate of temporary improvement after initial operation. Subsequent op...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-199010000-00017
更新日期:1990-10-01 00:00:00
abstract:OBJECTIVE:To evaluate the epidemiology of Clostridium difficile colitis (CDC) in a subset of patients admitted specifically to a surgical service. SUMMARY BACKGROUND DATA:CDC is an increasingly prevalent nosocomial infection that can prolong hospitalization and adversely affect patient outcome. Although this disease h...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-199802000-00021
更新日期:1998-02-01 00:00:00
abstract:OBJECTIVE:To determine whether the rates of death and complications of carotid endarterectomy (CE) were different in the octogenarian population than in patients younger than age 80. SUMMARY BACKGROUND DATA:The utility of CE depends on the ability of the surgeon and hospital to attain low rates of death and complicati...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-200006000-00001
更新日期:2000-06-01 00:00:00
abstract:OBJECTIVE:To develop a model for the identification of individuals at risk for carotid stenosis (CS) that could be useful in a clinical setting when trying to decide whether screening is worthwhile. BACKGROUND:Evidence that aggressive medical therapy and life style changes reduce the risk of stroke in individuals with...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/SLA.0b013e31827b9761
更新日期:2013-06-01 00:00:00
abstract:OBJECTIVE:The aim of this study was to assess how thermal ablation of colorectal liver metastases affects the outgrowth of micrometastases in the transition zone (TZ) between ablated tissue and the unaffected reference zone (RZ) in 2 different murine models. BACKGROUND:Thermal destruction therapies of nonresectable co...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/SLA.0b013e3181a38ef5
更新日期:2009-05-01 00:00:00
abstract:OBJECTIVE:The impact of co-morbid conditions on early and late clinical outcomes after endovascular treatment of abdominal aortic aneurysm (AAA) was assessed in concurrent cohorts of patients stratified with respect to risk for intervention. SUMMARY BACKGROUND DATA:As a minimally invasive strategy for the treatment of...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-200206000-00011
更新日期:2002-06-01 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:BACKGROUND:Chest computed tomography (CT) screening of patients with blunt trauma for thoracic aortic injury is controversial. This study was undertaken to determine whether CT could exclude aortic injury and be used to select patients for aortography. METHODS:Computed tomography and aortography were used to evaluate ...
journal_title:Annals of surgery
pub_type: 临床试验,杂志文章
doi:10.1097/00000658-199411000-00015
更新日期:1994-11-01 00:00:00
abstract::Seven patients with a mean burn size of 69.6% total body-surface area underwent skin grafting with autologous cultured epidermis. They were compared with a historical group of 18 controls, with a mean burn size of 60%, who underwent grafting with conventional meshed split-thickness autograft. There were no statistical...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-199006000-00005
更新日期:1990-06-01 00:00:00
abstract::Between 1968 and 1984 liver resection with curative attempt was performed in 22 patients with hilar cholangiocarcinoma. Right lobectomy was performed in 4 patients, extended right lobectomy in 7, left lobectomy in 8, and excision of the median segment segment of the left lobe (segment IV) in 3. Bilio-enteric continuit...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-198802000-00002
更新日期:1988-02-01 00:00:00
abstract::Clinical pulmonary embolic disease was categorized into four classes according to hemodynamic and respiratory effects of the occlusion at the time of diagnosis. A new approach to management of massive embolization (Class III and IV) by transvenous catheter embolectomy was attempted in ten patients with initial success...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-197410000-00011
更新日期:1974-10-01 00:00:00
abstract:OBJECTIVES:We sought association of genetic variants in the renin-angiotensin system (RAS) and vitamin D system with acute pancreatitis (AP) development and severity. BACKGROUND:The endocrine RAS is involved in circulatory homeostasis through the pressor action of angiotensin II at its AT1 receptor. However, local RAS...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/SLA.0000000000000655
更新日期:2015-01-01 00:00:00
abstract:OBJECTIVE:To establish reliable standards for surgical application to elderly patients 75 years old or older with gastric or colorectal cancer with special reference to the postoperative recovery of activities of daily living (ADL) and quality of life (QOL). SUMMARY BACKGROUND DATA:ADL and QOL are important outcomes o...
journal_title:Annals of surgery
pub_type: 杂志文章,多中心研究
doi:10.1097/SLA.0b013e3180caa3fb
更新日期:2007-08-01 00:00:00
abstract:OBJECTIVE:To review the literature with regard to outcome of surgical management for hilar cholangiocarcinoma (Klatskin tumor). BACKGROUND:Hilar cholangiocarcinoma is a rare tumor with a poor prognosis. Surgical resection provides the only possibility for cure. Advances in hepatobiliary imaging and surgical strategies...
journal_title:Annals of surgery
pub_type: 杂志文章,评审
doi:10.1097/SLA.0b013e3181afe0ab
更新日期:2009-08-01 00:00:00
abstract:OBJECTIVE:We examined management strategies, overall survival (OS), and progression-free survival (PFS) among patients with PMNSGCTs undergoing resection and multidisciplinary management at a high-volume institution. SUMMARY OF BACKGROUND DATA:Outcomes after resection of PMNSGCTs are not well-characterized, with limit...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/SLA.0000000000003754
更新日期:2020-01-21 00:00:00
abstract:OBJECTIVE:To review the methodology employed in surgical mortality studies to control for potential confounders. SUMMARY BACKGROUND DATA:Nationwide hospital data are increasingly used to investigate surgical outcomes. However, poor data granularity and coding inaccuracies may lead to flawed findings. METHODS:We condu...
journal_title:Annals of surgery
pub_type: 杂志文章,评审
doi:10.1097/SLA.0000000000002119
更新日期:2017-06-01 00:00:00
abstract::Three hundred seventeen carotid endarterectomies performed on 240 consecutive patients in four Charleston hospitals were reviewed. The overall incidence of stroke was 10.7% and the mortality 3.2%. From these 317 operations a standardized series of 253 operations performed on neurologically stable patients was analyzed...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-197706000-00010
更新日期:1977-06-01 00:00:00
abstract::Infected (mycotic) aortic aneurysms are infrequent and, without surgical intervention, usually lead to uncontrolled sepsis or catastrophic hemorrhage. Symptoms are frequently absent or non-specific during the early stages, and a high index of suspicion is essential to make the diagnosis. Surgery performed after ruptur...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-199205000-00005
更新日期:1992-05-01 00:00:00
abstract::To determine the significance of proteolysis and delayed freezing of tumor samples on estrogen receptor levels, values from 19 of 31 biopsy specimens were compared with that in remaining tumor at the completion of mastectomy. There was a 15-100% decrease in receptor content. Time-decay studies on selected postmastecto...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-198105000-00003
更新日期:1981-05-01 00:00:00
abstract:OBJECTIVE:To test the hypothesis that higher hospital volume decreases endoscopic and surgical re-intervention rates after antireflux surgery. BACKGROUND:Antireflux surgery for gastro-esophageal reflux disease is followed by varying rates of re-interventions. Whether hospital volume influences re-intervention rates is...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/SLA.0000000000003776
更新日期:2020-01-06 00:00:00
abstract::One hundred fifty-five adult patients with "operable" soft part sarcomas including rhabdomyosarcoma, liposarcoma, leiomyosarcoma and fibrosarcoma of the trunk and extremities are reviewed. Local recurrences of 93% and 60% occurred after local and wide excisions of the primary tumor. In this series of patients, amputat...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-197506000-00007
更新日期:1975-06-01 00:00:00
abstract:OBJECTIVE:To evaluate discrepancies between trial registry entries and final reports of randomized controlled trials (RCTs) published in major general surgical journals. BACKGROUND:Health care decisions are based on published results in peer-reviewed journals. Mandatory trial registration was introduced to increase tr...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/SLA.0b013e318283cf7f
更新日期:2013-06-01 00:00:00
abstract::This study evaluated a possible protective and therapeutic effect of moderate hypothermia in the treatment of severe hemorrhagic shock. A modified Wiggers shock preparation was used. Normothermic dogs (Group I, N = 6) were maintained at normal body temperature throughout hemorrhagic shock and resuscitation. In Group I...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-198804000-00015
更新日期:1988-04-01 00:00:00
abstract::Cadaver kidneys remain a scarce resource, yet single pediatric donor kidneys are underutilized at some centers. Between 1967 and 1984, 133 single pediatric and 318 adult donor cadaver transplants were performed. Patient and graft survival, renal function, and complications in adult recipients grouped by donor age were...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-198608000-00011
更新日期:1986-08-01 00:00:00
abstract::A prospective study of factors predisposing to infection in badly injured patients has disclosed: the dominant roles of two specific parameters: monocyte antigen presenting capacity, and opsonic capacity of diluted serum; the potential value of further assessment of: the predictive value of plots of activated T-cells/...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:
更新日期:1986-09-01 00:00:00
abstract::Twelve prognostic features of melanoma were examined in a series of 185 patients with nodal metastases (Stage II), who underwent surgical treatment at our institution during the past 20 years. Forty-four per cent of the patients presented with synchronous nodal metastases (substage IIA), 44% of the patients had delaye...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-198103000-00023
更新日期:1981-03-01 00:00:00
abstract:OBJECTIVE:To analyze the histopathological indicators significantly associated with surgical outcome and the pattern of recurrence in the setting of preoperative gemcitabine-based chemoradiation therapy (CRT) and subsequent pancreatectomy. BACKGROUND:Clinicopathological assessment of the resected specimen is an indisp...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/SLA.0b013e31823d813c
更新日期:2012-01-01 00:00:00
abstract::The importance of prostacyclin (PGI2) and thromboxane (Tx) medication of depressed cardiac performance during abdominal aortic aneurysm operative surgery was studied by contrasting the effects of 650 mg aspirin administered 12 hours before operation to that of a placebo. In 11 patients who received a placebo, the stab...
journal_title:Annals of surgery
pub_type: 临床试验,杂志文章
doi:10.1097/00000658-198111000-00008
更新日期:1981-11-01 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