Abstract：
BACKGROUND:This 17-year review was undertaken to examine clinical outcomes and the changing trends in resource utilization for lower extremity bypass grafts performed in a managed care setting. PATIENTS AND METHODS:Between 1979 and 1995, 338 bypasses in 276 patients (199 men, 77 women; 62% diabetics) were carried out for limb salvage. Autogenous vein bypasses (AVB) were performed in 324 (96%) of the cases, which included 150 (43%) femoropopliteal (FP) and 174 (57%) femoro-tibial (FT) bypasses. There were 32 secondary AVB reconstructions included in the study group. RESULTS:The 30-day mortality rate was 2.2% and patient survival was 46% and 21% at 5 and 10 years. At 1 and 5 years, primary patency rates for the AVB were 87% and 79% for FP; 80% and 67% for FT AVB, whereas the limb salvage rates at those intervals were 96% and 94% for FP; 87% and 77% for FT, respectively. Despite an average annual inflation rate of 8%, significant reductions in hospital charges were noted during the study period. These were made possible by decreasing lengths of hospital stay, the development and application of guidelines and protocols for the management of leg ischemia, and the implementation of angioscopy for improving the surgical technique for in situ AVB. CONCLUSIONS:High-quality outcomes for lower extremity AVB are possible in a managed care setting with demonstrated improvements in the efficiency of resource utilization.
journal_name
Am J Surgjournal_title
American journal of surgeryauthors
Maini BS,Orr RK,O'Mara P,Hendershott Tdoi
10.1016/S0002-9610(96)00130-4subject
Has Abstractpub_date
1996-08-01 00:00:00pages
113-6; discussion 117issue
2eissn
0002-9610issn
1879-1883pii
S0002-9610(96)00130-4journal_volume
172pub_type
杂志文章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：BACKGROUND:Human immunodeficiency virus (HIV), hepatitis B (HBV), and hepatitis C (HCV) infections are transmitted by blood exposure. Surgeons have been concerned about the risks of blood exposure in the operating room as a potential source of occupational infections from these viruses. The actual risk and frequency of...
journal_title：American journal of surgery
pub_type： 杂志文章,评审
doi：10.1016/j.amjsurg.2005.05.021
更新日期：2005-08-01 00:00:00
abstract：:Performing a timely fasciotomy for compartment syndrome prevents ischemic injury to muscles and nerves. Fasciotomy entails incision of the overlying skin and investing fascia of the compartment, relieving pressure and enhancing tissue perfusion. Delayed primary closure is ideal, but because of skin edge retraction, th...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/0002-9610(94)90130-9
更新日期：1994-04-01 00:00:00
abstract：BACKGROUND:Laparoscopic deroofing has been shown to produce good patient satisfaction and to have results similar to those of open surgical techniques. We evaluated the feasibility and efficacy of laparoscopic deroofing using an argon beam coagulator (ABC) in the patients with nonparasitic liver cysts. METHODS:Laparos...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/s0002-9610(02)01361-2
更新日期：2003-03-01 00:00:00
abstract：:Specific circulating serum proteins may reflect unique properties governing the growth and progression of head and neck cancers. One hundred three previously untreated patients with squamous cell carcinoma of the head and neck were prospectively evaluated for serum IgA, IgG, and IgM and C1q-binding macromolecules. Imm...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/s0002-9610(05)80560-4
更新日期：1990-10-01 00:00:00
abstract：BACKGROUND:Spigelian hernias are rare defects of the abdominal wall usually appearing between the abdominal muscles, lateral to the rectus abdominis and through a debilitated Spigelian aponeurosis. Recently, mesh repair has been introduced for the treatment of these types of hernias and different approaches have been p...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/j.amjsurg.2006.04.016
更新日期：2007-01-01 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：:The social, economic and political challenges accompanying our rapidly transforming global health environments have created unique social challenges that demand cross-sector solutions. Four cross-sector partnerships are reviewed with a special focus on sector roles, change management, phases of partnership development...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/s0002-9610(02)01143-1
更新日期：2003-01-01 00:00:00
abstract：:Experience with seven cases of pancreatic abscess is reviewed. All patients were treated with radical pancreatic debridement, large sump drainage with postoperative irrigation, gastrointestinal defunctionalization, antibiotic therapy and nutritional support. One patient died, for a mortality rate of 14 percent. We fee...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/0002-9610(81)90307-x
更新日期：1981-12-01 00:00:00
abstract：:Experience with 37 patients with adult colovesical fistula over the past 19 years is reviewed. Specific guidelines for treatment of adult colovesical fistula are influenced by the location and cause of the fistula, the patient's general condition, the presence of a pelvic abscess and the presence of colonic obstructio...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/0002-9610(80)90421-3
更新日期：1980-07-01 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:Although neoadjuvant chemotherapy is increasingly used for breast cancer, if a patient has a complete clinical response, it is often difficult for the surgeon to know exactly where and how much breast tissue to remove. METHODS:A method is described where the edges of the tumor are tattooed prior to chemothe...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/j.amjsurg.2007.07.009
更新日期：2007-10-01 00:00:00
abstract：BACKGROUND:The Centers for Disease Control and Prevention reported that surgical site infections (SSIs) create a significant hospital burden. To date, few multi-institutional studies have been performed to evaluate the risk factors for SSIs in mastectomy patients. METHODS:By using the American College of Surgeons' Nat...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/j.amjsurg.2012.05.007
更新日期：2013-02-01 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:Immunosuppressed patients have an increased risk of developing anal cancer, but little data exists regarding outcomes of this population. METHODS:A retrospective review of anal cancer patients at a single academic institution from 2006 to 2017 was performed. RESULTS:19 (14%) of 136 anal cancer patients wer...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/j.amjsurg.2019.08.011
更新日期：2020-01-01 00:00:00
abstract：BACKGROUND:Patients with recurrent pelvic malignancy have few treatment options, and surgery is fraught with complications. We sought to characterize the relationship between radiographic pelvic volume and postoperative complications after pelvic salvage surgery. METHODS:A retrospective chart review of all patients un...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/j.amjsurg.2014.08.015
更新日期：2014-12-01 00:00:00
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...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/s0002-9610(05)80194-1
更新日期：1994-09-01 00:00:00
abstract：BACKGROUND:Several recent studies have suggested that Braun enteroenterostomy (BEE) during conventional pancreatoduodenectomy might decrease delayed gastric emptying (DGE). However, the advantages and disadvantages of performing BEE during pylorus-preserving pancreatoduodenectomy (PPPD) remain controversial. METHODS:T...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/j.amjsurg.2014.05.007
更新日期：2015-02-01 00:00:00
abstract：:This study has summarized our results with popliteal-tibial in situ saphenous vein bypass in 26 patients, 25 of whom were diabetic, over a 2 year period. Both above- and below-knee popliteal inflow sites were used for bypass of limb-threatening ischemia. Distal calf or pedal outflow sites were required in all but two ...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/0002-9610(87)90191-7
更新日期：1987-08-01 00:00:00
abstract：:The records of more than 1,000 patients who underwent colonoscopy were reviewed. The study group consisted of 55 of these 1,000 patients who had persistent unexplained bleeding per rectum and negative radiographic examinations. Colonoscopy was helpful in defining the site of bleeding in approximately 50 per cent of th...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/0002-9610(79)90332-5
更新日期：1979-11-01 00:00:00
abstract：BACKGROUND:Approximately 30% to 50% of appendicitis in children is already perforated at presentation. The optimal management of these children remains controversial. METHODS:Ninety-six children (aged 2 to 16 years) were treated for perforated appendicitis. Seventy-one underwent immediate appendectomy and drainage of ...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/j.amjsurg.2003.08.027
更新日期：2003-12-01 00:00:00
abstract：BACKGROUND:When learning multiple tasks, blocked or random training schedules may be used. We assessed the effects of blocked and random schedules on the acquisition and retention of laparoscopic skills. METHODS:Thirty-six laparoscopic novices were randomized to practice laparoscopic tasks using blocked, random, or no...
journal_title：American journal of surgery
pub_type： 杂志文章,随机对照试验
doi：10.1016/j.amjsurg.2014.08.038
更新日期：2015-01-01 00:00:00
abstract：:Between 1968 and 1979, 183 patients with invasive epidermoid cancer of the anal canal were treated at Institut Curie. There was 156 women, 27 men with a mean age of 67 +/- 11 years (range 40 to 85 years). The initial height of the tumor was less than 4 cm (65 patients), 4 to 6 cm (98 patients), and more than 6 cm (20 ...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/0002-9610(84)90032-1
更新日期：1984-01-01 00:00:00
abstract：:In a prospective, randomized trial, selective proximal vagotomy with complete ulcer excision was compared with partial gastrectomy with gastroduodenostomy for the treatment of primary corporeal gastric ulcer in 30 patients. The results were evaluated by clinical follow-up examinations at regular intervals, endoscopy, ...
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(83)90300-8
更新日期：1983-11-01 00:00:00
abstract：BACKGROUND:To evaluate if laparoscopic adrenalectomy (LA) has changed the indications for adrenalectomy. METHODS:Retrospective analysis of patients with adrenal lesions referred from 1992 to 2004. Patients were divided into 2 groups, those before and those after the introduction of LA. RESULTS:One hundred eighty pati...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/j.amjsurg.2005.02.003
更新日期：2005-05-01 00:00:00
abstract：:The records of patients treated for upper gastrointestinal bleeding from 1974 through 1978 were reviewed. Five percent of this group (69 patients) had bleeding due to the Mallory-Weiss syndrome. Only 36 percent of patients had a correct admitting diagnosis. Esophagogastroscopy proved the most reliable diagnostic tool,...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/0002-9610(81)90425-6
更新日期：1981-11-01 00:00:00
abstract：BACKGROUND:The anastomotic leak and stricture formation after esophagectomy and cervical esophagogastric anastomosis deny patients with esophageal carcinoma the benefits of surgery. The present study was designed to ascertain whether a wide cross-sectional area at the site of anastomosis leads to lesser anastomotic com...
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(01)00616-x
更新日期：2001-06-01 00:00:00
abstract：BACKGROUND:We reviewed Nissen fundoplications performed in a single practice from January 1989 to March 1997, encompassing our transition from open to laparoscopic procedures. Because all operations were done by two surgeons in the same two hospitals, the study is well controlled for comparisons. METHODS:Records of 27...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/S0002-9610(98)00049-X
更新日期：1998-05-01 00:00:00
abstract：:Aspiration of foreign bodies in children can lead to illness and even death if not recognized and treated promptly. Seventy-six patients were referred to our hospital for suspected foreign body aspiration. The following is a retrospective review of their diagnosis and treatment. There was no foreign body found at bron...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/0002-9610(89)90208-0
更新日期：1989-12-01 00:00:00
abstract：:Percentage and levels of circulating T-lymphocytes were studied in forty-six patients with squamous cell carcinoma of the head and neck before and/or after treatment and compared with control values obtained in fifty-one healthy volunteers. Mean percentages of circulating T-cells and mean T-cell levels in cancer patie...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/0002-9610(75)90481-x
更新日期：1975-10-01 00:00:00
