Abstract：
BACKGROUND:The purpose of this paper is to review the experience of a community surgeon performing laparoscopic antireflux procedures (LAP). The experience has been difficult and at times unsettling, and underscores the need for advanced laparoscopic expertise not normally obtained performing laparoscopic cholecystectomies. METHODS:Sixty-one consecutive patients underwent attempted LAP. The preoperative evaluation is reviewed, and the length of operative times, conversion rates, complications, and patient satisfaction is discussed. RESULTS:Four patients were converted to an open procedure, and two more patients required later reoperation for dysphagia. While the operative times are shorter now, the technical difficulty in performing the procedure does not seem to be appreciatively decreasing. No deaths or esophageal perforations occurred; however, there were a large number of patients with varying degrees of troubling dysphagia that did not require reoperation but frequently required endoscopic gastroduodenoscopy (EGD) dilatation. No recurrence of reflux has been documented in the short 2-year follow-up period. CONCLUSIONS:LAP is still the most difficult procedure that I perform, and the learning curve is at least 60 cases. Patient satisfaction is quite good as only three have mild "heartburn." Dysphagia is a significant problem that has led to takedown of several short gastric vessels to obtain looser fundoplications around larger and larger bougies. Appropriate patient preoperative selection is paramount and the antireflux procedure should be tailored to the individual patient. Major complications have been reported elsewhere, but have not been seen in this review.
journal_name
Am J Surgjournal_title
American journal of surgeryauthors
Harris SCdoi
10.1016/S0002-9610(97)89608-0subject
Has Abstractpub_date
1996-05-01 00:00:00pages
482-4issue
5eissn
0002-9610issn
1879-1883pii
S0002-9610(97)89608-0journal_volume
171pub_type
杂志文章abstract：BACKGROUND:Little is known about care coordination and communication with outpatient endocrine surgery patients. This study evaluated phone calls between office nurses and surgical patients to identify common issues addressed and their effect on patient care. METHODS:Qualitative analysis of preoperative and postoperat...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/j.amjsurg.2015.11.008
更新日期：2016-03-01 00:00:00
abstract：:The accepted approach to patients with intermittent calf claudication is nonoperative unless the symptoms are truly incapacitating, in which case arteriography and either percutaneous angioplasty or operation is indicated. Arteriography is considered a preoperative procedure. However, with improvements in percutaneous...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/s0002-9610(05)80300-9
更新日期：1990-08-01 00:00:00
abstract：BACKGROUND:The purpose of this study was to evaluate the impact of computed tomographic (CT) scans of the abdomen on clinical outcomes and costs in young male patients presenting with suspected appendicitis. METHODS:Discharge data from the University HealthSystem Consortium was accessed for all male patients between 1...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/j.amjsurg.2012.05.024
更新日期：2012-12-01 00:00:00
abstract：BACKGROUND:Robotic surgery is increasingly adopted into surgical practice, but it remains unclear what level of robotic training general surgery residents receive. The purpose of our study was to assess the variation in robotic surgery training amongst general surgery residency programs in the United States. METHODS:A...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/j.amjsurg.2018.11.006
更新日期：2019-02-01 00:00:00
abstract：:Vertical banded gastroplasty creates a channel by two applications of the TA-90 stapler from an end-to-end anastomosis window above the crow's foot to the angle of His, against a 32 F. tube along the lesser curvature. The caudad end of the channel is restricted by a 5 cm collar. Thirty-one obese patients more than 45 ...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/s0002-9610(88)80125-9
更新日期：1988-03-01 00:00:00
abstract：PURPOSE:To perform a satisfaction/quality-of-life (QOL) survey of patients undergoing MammoSite brachytherapy (MBT; Hologic, Inc, Marlborough, MA). METHODS:We asked patients 15 questions regarding treatment decision-making, and experience on-therapy/post-treatment. RESULTS:A total of 52 patients responded (median fol...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/j.amjsurg.2008.06.014
更新日期：2008-10-01 00:00:00
abstract：:The survival of 103 patients operated on for advanced carcinoma of the stomach other than the cardia was assessed. The median duration of survival for patients subjected to palliative partial gastrectomy, total gastrectomy, gastrojejunostomy, and biopsy only was 24, 22, 11, and 10 weeks, respectively. All of these pat...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/0002-9610(82)90051-4
更新日期：1982-06-01 00:00:00
abstract：:Ileal water and electrolyte absorption exceed jejunal absorption in both the basal and meal-stimulated states. The purposes of these experiments were to determine: (1) if luminal bile acids alter basal or meal-stimulated intestinal absorption, and (2) if there is site specificity or meal stimulation of intestinal bile...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/s0002-9610(05)80792-5
更新日期：1993-06-01 00:00:00
abstract：INTRODUCTION:Medical students applying for general surgery residencies often require a letter of recommendation (LOR) from the Surgical Chair. However, LORs may reveal gender and ethnic bias. This study examines the presence of implicit bias in general surgery resident selection by evaluating chair LORs. METHODS:A ret...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/j.amjsurg.2020.08.010
更新日期：2020-08-15 00:00:00
abstract：:We report our experience with 65 patients with congenital duodenal obstruction, 36 with intrinsic and 29 with extrinsic lesions. Seventeen patients had trisomy 21 syndrome. Eight pregnancies were complicated by polyhydramnios. The diagnostic features encountered, the operative procedures used, and the postoperative ma...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/0002-9610(79)90305-2
更新日期：1979-12-01 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：:Patients who had undergone inguinal herniorrhaphy with local, general, or spinal anesthesia were surveyed for satisfaction with the anesthesia. A review of complications was carried out for these same patients to determine comparative rates in the three anesthesia groups. Patients were stratified by age and concomitan...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/0002-9610(87)90154-1
更新日期：1987-06-01 00:00:00
abstract：BACKGROUND:Professionalism and ethics are Accreditation Council for Graduate Medical Education (ACGME) core competencies, but there is little evidence regarding the effectiveness of ethics education. METHODS:General surgery residents at the University of Pittsburgh completed questionnaires measuring attitudes and know...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/j.amjsurg.2010.08.002
更新日期：2010-11-01 00:00:00
abstract：PURPOSE:To provide an algorithm for the management of hepatic cysts through an analysis of our series over 16 years. METHOD:We reviewed the surgical management and outcome of patients with hepatic cysts between 1984 and 2000 at a single institution. Data were collected by chart review, telephone interview, and follow-...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/s0002-9610(01)00611-0
更新日期：2001-05-01 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：:Recent developments in protein and genetic engineering methods have allowed the production of antibody-derived molecules that have important potential as therapeutic agents. Although monoclonal antibodies of murine origin have been used for therapeutic purposes, limitations due to anti-antibody responses and suboptima...
journal_title：American journal of surgery
pub_type： 杂志文章,评审
doi：10.1016/s0002-9610(05)80653-1
更新日期：1992-07-01 00:00:00
abstract：:Multiple organ failure (MOF) emerged 30 years ago and became our research focus. Over the years, we have proposed a series of cartoons that rallied multidisciplinary translational research teams around common themes to generate "win-win" hypotheses that when tested (right or wrong) have advanced our understanding of M...
journal_title：American journal of surgery
pub_type：
doi：10.1016/j.amjsurg.2010.05.009
更新日期：2010-12-01 00:00:00
abstract：:The salient clinical and pathological features of verrucous carcinoma, as first described by Ackerman in 1948, are reviewed. Two case reports are presented. The first concerns a personal experience with a patient who had five surgical procedures for multifocal oral verrucous carcinoma and remains alive and well 28 yea...
journal_title：American journal of surgery
pub_type： 传,历史文章,杂志文章
doi：10.1016/s0002-9610(98)00232-3
更新日期：1998-11-01 00:00:00
abstract：:The results of surgical treatment for chronic pancreatitis at our clinic and in the eight leading institutions of Japan were reviewed in a total of 328 cases. Abdominal pain disappeared or was alleviated in about 90 percent of the patients who survived more than 6 months after operation. There was no significant diffe...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/0002-9610(81)90338-x
更新日期：1981-09-01 00:00:00
abstract：BACKGROUND:We hypothesized that intravenous methylene blue will facilitate adrenal gland identification and resection during laparoscopic adrenalectomy. METHODS:Five mini-Hanford pigs were anesthetized and monitored per an approved Internal Review Board protocol. Timing of color changes in the adrenals was recorded af...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/j.amjsurg.2003.07.011
更新日期：2003-11-01 00:00:00
abstract：BACKGROUND:Many trauma surgeons and trauma centers use routine exploration of Gerota's fascia (GE) for renal gunshot wounds (RGSW). The purpose of this study was to assess whether RGSW can be selectively explored for patients who undergo exploratory laparotomy. METHODS:Retrospective 10-year review of all patients who ...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/j.amjsurg.2015.09.023
更新日期：2016-04-01 00:00:00
abstract：:Ten cases of giant lung abscess were treated by one-stage closed tube drainage after initial medical therapy. Sepsis or hemorrhage was relieved in all patients. There were no operative deaths, serious complications, or late recurrences. Three patients have subsequently died from bronchogenic cancer. ...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/0002-9610(78)90213-1
更新日期：1978-07-01 00:00:00
abstract：BACKGROUND:Accurate assessment is imperative for learning, feedback and progression. The aim of this study was to examine whether surgeons can accurately self-assess their technical and nontechnical skills compared with expert faculty members' assessments. METHODS:Twenty-five surgeons performed a laparoscopic cholecys...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/j.amjsurg.2011.01.024
更新日期：2011-10-01 00:00:00
abstract：BACKGROUND:Work-related injuries (WRIs) represent a significant economic and logistical burden to healthcare systems. METHODS:All patients with severe WRIs (Injury Severity Score [ISS] ≥ 12) (1995 to 2013) were compared with patients with non-WRIs using standard methodology (P < .05). RESULTS:A total of 1,270 (8.5%) ...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/j.amjsurg.2015.01.023
更新日期：2015-09-01 00:00:00
abstract：:A retrospective review of 58 rare breast neoplasms encountered at the British Columbia Cancer Agency between 1972 and 1992 was undertaken. There were 38 cystosarcoma phyllodes tumors, 6 carcinosarcomas, and 14 other sarcomas. Initial management involved total mastectomy in 37 cases, wide excision in 14, and excision b...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/0002-9610(94)90238-0
更新日期：1994-05-01 00:00:00
abstract：PURPOSE:The Integrated Procedural Performance Instrument (IPPI) consists of clinical scenarios in which bench-top models are positioned to simulated patients. Trainees are required to perform technical skills while engaging with the patient. The purpose of this study was to determine whether an IPPI format examination ...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/j.amjsurg.2008.08.011
更新日期：2009-01-01 00:00:00
abstract：:From these data and data from the literature, our recommended treatment for well-differentiated cancer is as follows: For papillary cancer, resection should be adequate to encompass the entire tumor, which in most cases would be complete lobectomy and possibly isthmusectomy. Prophylactic neck dissection is of no value...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/0002-9610(81)90378-0
更新日期：1981-10-01 00:00:00
abstract：BACKGROUND:Survival in breast cancer maybe more accurately predicted by a scoring system based on the biologic characteristics of the tumor such as diameter, number of involved nodes, and hormone receptor status than by conventional staging. METHODS:Medical records of 419 patients with a diagnosis of breast cancer fro...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/s0002-9610(03)00283-6
更新日期：2003-10-01 00:00:00
abstract：BACKGROUND:Recent literature suggests that peritoneal drainage (PD) is not helpful after elective pancreatectomy and may be detrimental. Data specific to distal pancreatectomy (DP) have not received prior evaluation. METHODS:We performed a retrospective review of patients who underwent DP. Factors examined included po...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/j.amjsurg.2012.02.005
更新日期：2012-10-01 00:00:00
abstract：:Twenty-two cirrhotic patients who underwent hepatic resection from July 1989 to March 1991 at Vancouver General Hospital were analyzed prospectively in order to determine whether there was any preoperative evaluation of liver function that would help identify those patients who would not survive hepatic resection. Pat...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/0002-9610(92)90400-l
更新日期：1992-05-01 00:00:00
