Abstract:
BACKGROUND:The role of laparoscopic surgery in the treatment of various upper and lower gastrointestinal disorders is still under investigation. However, a variety of laparoscopic procedures may be applied in the treatment of inflammatory bowel disease (IBD). PATIENTS AND METHODS:We present our initial results of laparoscopic and laparoscopic-assisted management of IBD in 72 consecutive patients (37 women and 35 men; mean age 36 years, range 20 to 79). The indications for surgery included: terminal ileitis in 29 patients, mucosal ulcerative colitis in 23 patients, Crohn's colitis in 11 patients, severe perianal Crohn's disease in 4 patients, duodenal Crohn's disease in 3 patients, Crohn's rectovaginal fistula in 1 patient, and rectourethral fistula in 1 patient. The procedures performed included: total abdominal colectomy (TAC) in 30 patients (22 with total proctocolectomy with ileoanal reservoir, 6 with TAC with ileorectal anastomosis, and 2 with TAC with end ileostomy), ileocolic resection in 30 patients, diverting loop ileostomy in 6 patients, closure of an end ileostomy as an ileorectal anastomosis in 3 patients who already underwent a TAC with end ileostomy, and duodenal bypass gastrojejunostomy in 3 patients. RESULTS:There were 16 complications in 13 (18%) patients: 3 enterotomies, 4 episodes of bleeding, 3 pelvic abscesses, 2 intestinal obstructions, 2 prolonged ileus, 1 anastomotic leak, and 1 efferent loop obstruction after gastrojejunostomy. However, only 3 patients required laparotomy for morbidity, and there was no mortality. In 7 (10%) patients, the laparoscopic procedure was converted to a laparotomy due to a large inflammatory mass with fistula in 4 patients, bleeding in 2 patients, and an enterotomy in 1 patient. The mean operating time was 2.9 hours (range 0.7 to 6) and the mean length of hospital stay was 6.5 days (range 3 to 19). When compared with ileocolic resection, total colectomy was associated with higher morbidity (30% versus 10%, P < 0.05) and longer hospitalization (8.7 days [range 4 to 19] versus 5.2 days [range 3 to 7], respectively; P < 0.05). CONCLUSIONS:According to this initial experience, laparoscopic surgery is a versatile and effective modality in the surgical management of inflammatory bowel disease in selected patients. However, laparoscopic total colectomy is associated with higher morbidity when compared with ileocolic resection.
journal_name
Am J Surgjournal_title
American journal of surgeryauthors
Reissman P,Salky BA,Pfeifer J,Edye M,Jagelman DG,Wexner SDdoi
10.1016/s0002-9610(99)80072-5subject
Has Abstractpub_date
1996-01-01 00:00:00pages
47-50; discussion 50-1issue
1eissn
0002-9610issn
1879-1883pii
S0002961099800725journal_volume
171pub_type
杂志文章abstract:BACKGROUND:In about 30% of patients, chronic pancreatitis leads to an inflammatory enlargement of the pancreatic head with subsequent obstruction of the pancreatic duct, common bile duct, and duodenum. METHODS:In a prospective, randomized controlled trial, we compared duodenum-preserving pancreatic head resection (DPP...
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/s0002-9610(99)80111-1
更新日期:1995-01-01 00:00:00
abstract:BACKGROUND:To establish feasibility, reliability and validity of a newly designed basic surgical training (BST) assessment form. METHODS:The assessment form was evaluated among trainees on the South-east Scotland BST rotation over 18 months. Feasibility was indicated by response rate. Reliability was determined using ...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/s0002-9610(01)00647-x
更新日期:2001-07-01 00:00:00
abstract::Schatzki's ring is a distinct anatomical entity associated with hiatal hernia; however, its significance is unclear. Thirty-two patients with a radiologically demonstrated Schatzki's ring were compared with 32 patients with hiatal hernia and no Schatzki's ring. Schatzki's ring was confirmed on endoscopy in 59 percent ...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/0002-9610(89)90193-1
更新日期:1989-12-01 00:00:00
abstract:BACKGROUND:Circumportal pancreas is a rare congenital pancreatic anomaly. The aim of this study was to clarify the clinical characteristics of patients with circumportal pancreases undergoing pancreatectomy. METHODS:The medical records of 508 patients who underwent pancreatectomy were retrospectively reviewed. The pre...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/j.amjsurg.2016.11.018
更新日期:2017-08-01 00:00:00
abstract::The purpose of this research was to assess reliability and construct validity of the objective structured clinical examination (OSCE) for evaluating the clinical skills of surgical residents. Reliability refers to precision of the examination and construct validity to the degree to which the examination can discrimina...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/s0002-9610(06)80029-2
更新日期:1990-09-01 00:00:00
abstract::Maximal anal pressures have been measured after proctoscopy in 145 patients with hemorrhoids, 48 patients with anal fissure, and 78 asymptomatic control subjects. Anal pressures in patients with hemorrhoids (106 +/- 40 cm H2O) and anal fissure (130 +/- 43 cm H2O) were very significantly higher than those of controls (...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/0002-9610(77)90445-7
更新日期:1977-11-01 00:00:00
abstract:BACKGROUND:The aim of this study was to characterize patients readmitted following inpatient general surgery procedures. We hypothesized that a decreased length of stay would increase risk for readmission. METHODS:We utilized our institutional National Surgical Quality Improvement Project database from 2006 to 2011. T...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/j.amjsurg.2013.10.022
更新日期:2014-04-01 00:00:00
abstract::Feeding gastrostomy and jejunostomy provide effective access for long-term enteral nutrition. Traditional operative techniques for the performance of these procedures requires laparotomy and often, general anesthesia. This report describes our experience with two relatively new methods, percutaneous endoscopic gastros...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/s0002-9610(85)80017-9
更新日期:1985-01-01 00:00:00
abstract::Twenty-five patients were treated for retained, recurrent, or primary common duct stones by permanent drainage of the biliary tract with external choledochoduodenostomy. Twenty-one patients had common duct stones which became evident two to fifty years after the initial biliary tract procedure and which may represent ...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/0002-9610(79)90136-3
更新日期:1979-02-01 00:00:00
abstract::The charts of 81 patients who underwent skull base surgery between 1982 and 1993 were reviewed retrospectively. Data relative to demographic aspects, clinical stage, previous treatment, surgical approach, type of reconstruction, histology, extent of disease, complications, and follow-up were analyzed. The craniofacial...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/s0002-9610(05)80106-0
更新日期:1994-11-01 00:00:00
abstract::Knowledge of venous, capillary, and arterial blood flow in microgravity is required to modify hemostatic techniques for control of bleeding in traumatic injuries or surgical procedures in space. To simulate human arterial, venous, and capillary bleeding, fresh whole bovine blood was injected by two operators at calcul...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/s0002-9610(05)80368-x
更新日期:1992-08-01 00:00:00
abstract::Appendicitis in preschool children is not uncommon. A duration of greater than 40 hours usually implied perforation. The most common findings were abdominal pain, tenderness, temperature elevation and vomiting. In the presence of perforation or abscess formation, appendectomy followed by copious wound irrigation, absc...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/0002-9610(80)90265-2
更新日期:1980-02-01 00:00:00
abstract:BACKGROUND:Data concerning the long-term efficacy of laparoscopic sleeve gastrectomy in the treatment of morbid obesity remain scarce. In this retrospective, the authors present 5-year follow-up of 30 patients having undergone laparoscopic sleeve gastrectomy. METHODS:Since 2004, 30 patients underwent laparoscopic slee...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/j.amjsurg.2014.04.006
更新日期:2015-02-01 00:00:00
abstract:BACKGROUND:Obesity is a risk factor for many comorbid conditions that increase the cost of health care. We sought to examine the effect of obesity on surgical complications and cost in a group of patients undergoing intestinal surgery. METHODS:Using the Veterans Affairs Surgical Quality Improvement Program (VASQIP), w...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/j.amjsurg.2012.01.013
更新日期:2012-10-01 00:00:00
abstract:BACKGROUND:Contaminated abdominal wall fascial defects present a challenging problem. The use of human acellular dermal matrix (AlloDerm; LifeCell Corp., Branchburg, NJ) provides a novel method of primary closure of abdominal wall defects in this setting. The aim of the current study was to determine what factors predi...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/j.amjsurg.2006.08.017
更新日期:2006-11-01 00:00:00
abstract::We have confirmed earlier findings that treatment with allopurinol offers some protection to the kidney from ischemic damage caused by total interruption of renal circulation. With this evidence, a clinical trial is warranted, particularly when periods of warm ischemia are unavoidable. ...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/0002-9610(76)90171-9
更新日期:1976-06-01 00:00:00
abstract:BACKGROUND:The objective of this study was to compare middle authorships between male and female general surgeons in the United States. METHODS:A stratified random sample of American College of Surgeons general surgery fellows was identified. Relevant author demographic, affiliation, and publication metrics were colle...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/j.amjsurg.2020.04.025
更新日期:2020-12-01 00:00:00
abstract::Seven patients who had typical and persistent symptoms of gallbladder disease but repeatedly normal oral cholecystograms were seen in an 18 month period. Ultrasound examination of the gallbladder was diagnostic of cholelithiasis in all seven patients. Six patients were found to have gallstones at operation, and the se...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/0002-9610(79)90339-8
更新日期:1979-11-01 00:00:00
abstract::Over a ten year period, four patients with inflammation or perforation of non-Meckelian, small intestinal diverticula were treated on the surgical services of Bellevue Hospital. This entity remains uncommon but may be increasing in incidence. The patients presented with a short history of severe abdominal pain, usuall...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/0002-9610(76)90364-0
更新日期:1976-11-01 00:00:00
abstract:BACKGROUND:Colonic inertia (CI) is a disturbance of colonic motility characterized by severe constipation and abdominal pain. This study was conducted to assess the results of total abdominal colectomy (TAC) in the management of CI. METHODS:A retrospective chart review of 55 patients who underwent TAC for CI was condu...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/s0002-9610(01)00820-0
更新日期:2001-12-01 00:00:00
abstract:BACKGROUND:Epithelioid sarcoma is a rare sarcoma with a high local recurrence rate that frequently metastasizes to lymph nodes. We reviewed our experience with adjuvant therapy in patients with this disease. METHODS:Between 1990 and 2003, we treated 11 patients with epithelioid sarcoma. Patient, tumor, and treatment c...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/j.amjsurg.2007.07.029
更新日期:2008-09-01 00:00:00
abstract:BACKGROUND:Despite blood-conservation techniques, hemorrhage during burn excision remains substantial. It is difficult to predict the blood loss that will occur per operation and how many units the patient will require during surgery. This may result in high cross-match-to-transfusion ratios (CMTRs). METHODS:A retrosp...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/j.amjsurg.2004.11.030
更新日期:2005-03-01 00:00:00
abstract:BACKGROUND:Despite significant advantages to patients, less than 5% of all colorectal surgeries for cancer are performed laparoscopically. A minimally invasive colorectal cancer program was created in our Veterans' Affairs hospital with the intent of increasing access and improving quality of patient care while maintai...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/j.amjsurg.2009.07.016
更新日期:2009-11-01 00:00:00
abstract:BACKGROUND:The successful excision of a renal cell carcinoma (RCC) invading the inferior vena cava (IVC) remains a technical intraoperative challenge and requires a careful preoperative surgical management planning. Although a radical operation remains the mainstay of the therapy for RCC, the optimal management of the ...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/s0002-9610(02)00782-1
更新日期:2002-03-01 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:BACKGROUND:Management of patients with thoracic empyema ranges from tube thoracostomy drainage, with or without fibrinolytics, to operative intervention, with the optimal intervention remaining uncertain. Streptococcus milleri, typically a benign bacterium colonizing the oropharynx, has recently been reported as a pote...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/j.amjsurg.2006.08.050
更新日期:2006-12-01 00:00:00
abstract::Massive doses of methylprednisolone were given to dogs prior to severe, lethal, hemorrhagic shock. An untreated group of dogs subjected to hemorrhagic shock served as controls. No persistent significant differences were seen in cardiac output, mean arterial blood pressure, superior mesenteric artery flow, and survival...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/0002-9610(75)90394-3
更新日期:1975-09-01 00:00:00
abstract:BACKGROUND:The aim of this study was to analyze the associations between the degree of postoperative leukocytosis and major morbidity after elective distal pancreatectomy with splenectomy (DPS). METHODS:Retrospective review of patients undergoing DPS for pancreatic diseases (2013-2016). Receiver operating characterist...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/j.amjsurg.2019.12.004
更新日期:2020-08-01 00:00:00
abstract::To assess the usefulness of ultrasound and ultrasound-guided fine-needle aspiration cytology in detecting occult cervical lymph node metastases, 107 patients with squamous cell carcinoma of the head and neck, who underwent 132 elective neck dissections, had preoperative ultrasound examination. During the assessment of...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/0002-9610(91)90149-8
更新日期:1991-10-01 00:00:00
abstract:BACKGROUND:Although several methods of repair of extremity venous injuries have been shown to be efficacious, patency rates have varied significantly from center to center. METHODS:A retrospective review was made of treatment outcomes of adult and pediatric patients with major venous injuries of the lower extremity. ...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/j.amjsurg.2003.08.006
更新日期:2003-12-01 00:00:00