Abstract：
BACKGROUND:Retroperitoneal vascular injury remains one of the most frequent causes of death following abdominal trauma. A risk analysis of the association between potential outcome predictors and mortality following abdominal aorta and inferior vena cava injuries was performed. METHODS:Eighty-nine patients sustaining abdominal aortic or inferior vena cava injury were concurrently evaluated for a 10-year period and retrospectively reviewed. A multiple logistic regression model evaluated the following variables:presence of shock on admission, base deficit (< -10 or > or = -10), classification by the organ injury scale (OIS), blood transfusion, crystalloid infusion, total infusion volume, associated injuries, site of injury, and presence of retroperitoneal tamponade. RESULTS:Overall mortality for all injuries was 57%. Excluding all death on arrival (DOA) patients, the mortality rate decreased to 45.7%. Death following abdominal aortic injuries was significantly associated with free bleeding in the peritoneal cavity, acidosis, and an injury in the suprarenal location (OIS > 4). For inferior vena cava injuries and combined abdominal aortic and inferior vena cava injuries, death was associated with free bleeding, the suprarenal location (OIS = 4), and the presence of shock on admission as well. CONCLUSIONS:Despite advances in transport and resuscitation, mortality of aortic and vena cava injuries remains unchanged. Shock on admission, bleeding without retroperitoneal tamponade, acidosis, and the suprarenal location each play a significant role in mortality. Immediate identification associated with a rapid surgical approach are the only factors that may improve survival of such devastating injuries.
journal_name
Am J Surgjournal_title
American journal of surgeryauthors
Coimbra R,Hoyt D,Winchell R,Simons R,Fortlage D,Garcia Jdoi
10.1016/S0002-9610(96)00231-0subject
Has Abstractpub_date
1996-11-01 00:00:00pages
541-4; discussion 545issue
5eissn
0002-9610issn
1879-1883pii
S0002-9610(96)00231-0journal_volume
172pub_type
杂志文章abstract：:Mediastinal tracheostomy has been associated with high morbidity and mortality, often due to skin necrosis, with resultant exposure of the great vessels and subsequent hemorrhage. During a 4 year period, 11 patients underwent mediastinal tracheostomy. Reconstruction included the use of a pectoralis major musculocutane...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/0002-9610(84)90377-5
更新日期：1984-10-01 00:00:00
abstract：BACKGROUND:This study evaluated the outcomes of the first 5 years of sentinel node biopsy (SNB) in British Columbia (BC), Canada, 1996 to 2001. METHODS:There were 547 SNB procedures for breast cancer performed by 29 surgeons at 12 hospitals in BC between October 1996 and July 2001. Identification, accuracy, and false-...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/s0002-9610(02)01215-1
更新日期：2003-02-01 00:00:00
abstract：BACKGROUND:In this study, we explore surgical resident communication with simulated patient surrogates (SPs), in an Objective Structured Clinical Examination (OSCE). METHODS:We use discourse analysis (DA), a qualitative approach to analyzing language, to evaluate our residents' interactions with simulated patient surr...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/j.amjsurg.2017.10.041
更新日期：2018-02-01 00:00:00
abstract：BACKGROUND:Current recommendations using Hounsfield units (HU) ≤ 10 to identify adrenal adenomas on unenhanced computed tomography (CT) miss 10-40% of benign adenomas. We sought to determine if changing HU threshold and adding absolute percent contrast washout (APW) criteria would identify adrenal adenomas better than ...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/j.amjsurg.2020.04.021
更新日期：2020-10-01 00:00:00
abstract：:Prehospital and emergency room recordings of hemodynamic vital signs frequently play a major role in the evaluation and treatment of trauma victims. Guidelines for resuscitation and treatment are affected by absolute cutoffs in hemodynamic parameters. To determine the sensitivity of various strata of systolic blood pr...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/0002-9610(89)90649-1
更新日期：1989-05-01 00:00:00
abstract：BACKGROUND:This is a retrospective study analyzing data of normocalcemic patients with enlarged parathyroid glands discovered during thyroid surgery and comparing it with data of patients operated on for proved primary hyperparathyroidism. METHODS:The records of patients with enlarged parathyroid glands (group 1) and ...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/j.amjsurg.2007.01.033
更新日期：2008-01-01 00:00:00
abstract：BACKGROUND:Changes in surgical training have raised concerns about residents' operative exposure and preparedness for independent practice. One way of addressing this concern is by optimizing teaching and feedback in the operating room (OR). The objective of this study was to perform a systematic review on perioperativ...
journal_title：American journal of surgery
pub_type： 杂志文章,评审
doi：10.1016/j.amjsurg.2016.12.014
更新日期：2017-07-01 00:00:00
abstract：BACKGROUND:Trovafloxacin, a broad-spectrum fourth-generation quinolone with gram-positive and gram-negative aerobic and anaerobic bacterial activity, is available in oral and intravenous formulations. The objective of this prospective, multicenter, double-blind, randomized study was to compare the efficacy of trovaflox...
journal_title：American journal of surgery
pub_type： 临床试验,杂志文章,多中心研究,随机对照试验
doi：10.1016/s0002-9610(98)00223-2
更新日期：1998-12-01 00:00:00
abstract：:Pretreatment staging and posttreatment follow-up of the breast cancer patient consists of physical examination of the breasts and regional node-bearing areas, routine laboratory studies, chest radiography, and bilateral mammography. For palpable tumors, mammography is used to determine tumor size and to identify nonpa...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/0002-9610(89)90539-4
更新日期：1989-02-01 00:00:00
abstract：:Between July 1973 and October 1984, we performed proctectomy either as part of a primary proctocolectomy or as a secondary staged procedure in 388 patients with ulcerative colitis and in 39 patients with Crohn's disease. The proctectomies were performed using a two-team synchronous approach. An intersphincteric or per...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/0002-9610(86)90026-7
更新日期：1986-01-01 00:00:00
abstract：BACKGROUND:A nonintrusive e-mail reminder incorporating teaching tips and manuscripts was developed to supplement resident-as-teacher curricula. METHODS:Ten high-yield manuscripts and 10 teaching tips exemplifying the themes of mentorship or role modeling, teaching methods, adult learning theory, feedback, and the res...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/j.amjsurg.2016.05.004
更新日期：2017-01-01 00:00:00
abstract：:Fistula-in-ano is a common surgical problem. Various materials have been used to perform the seton technique in the treatment of fistula-in-ano. In this study, a novel material, a self-locking cable tie, was used regardless of the fistula type. Seventeen consecutive patients with anal fistula underwent surgery with th...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/j.amjsurg.2006.06.048
更新日期：2007-06-01 00:00:00
abstract：:Despite intensive investigation, the pathogenesis of postinjury multiple organ failure (MOF) remains elusive. Laboratory and clinical research strongly implicate that the gastrointestinal tract plays a pivotal role. Shock with resulting gut hypoperfusion appears to be one important inciting event. While early studies ...
journal_title：American journal of surgery
pub_type： 杂志文章,评审
doi：10.1016/s0002-9610(99)00231-7
更新日期：1999-12-01 00:00:00
abstract：BACKGROUND:The extent of tissue loss amenable to primary healing after revascularization is unknown. Salvage of limbs with large soft-tissue defects with exposed tendon, joint, or bone lies beyond the limits of conventional techniques. We report our results using free tissue transfer as an adjunct to lower extremity va...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/s0002-9610(97)00175-x
更新日期：1997-12-01 00:00:00
abstract：:Eighty-two femoropopliteal reconstructions were performed on sixty-six consecutive patients. Of seventeen late failures, thirteen were secondarily reconstructed. Clinical and angiographic studies demonstrated the reasons for failure in all patients except one. Seven patients were improved and six unimproved by reopera...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/0002-9610(78)90107-1
更新日期：1978-02-01 00:00:00
abstract：:The lifetime risk for developing thin (< or =1 mm) melanoma continues to increase steadily. Although generally associated with an excellent prognosis, it also has a proven capacity to metastasize. There has been increasing interest in using sentinel lymph node biopsy to improve staging for thin melanoma. However, it i...
journal_title：American journal of surgery
pub_type： 杂志文章,评审
doi：10.1016/j.amjsurg.2005.05.011
更新日期：2005-08-01 00:00:00
abstract：:A case is reported of hypercalcemia persisting for seven years after kidney transplantation, with normocalcemia being achieved after subtotal parathyriodectomy. The finding of post-transplantation hyperparathyroidism of this extreme duration, in association with several other reports of hyperparathyroidism persisting ...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/0002-9610(76)90296-8
更新日期：1976-07-01 00:00:00
abstract：:Substitution of segments of traumatized or diseased ureter has been attempted often with little success. The ideal ureteral subsitute has yet to be found, and experiments with the newer biologically inert prosthetic materials such as the bovine carotid artery heterograft are warranted. ...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/0002-9610(76)90010-6
更新日期：1976-05-01 00:00:00
abstract：BACKGROUND:Bioethics education has been recommended as a formal component of surgical residency training. The best method for teaching bioethics to residents is unclear. We compared the effectiveness of a standardized patient (SP)-based seminar to a traditional seminar format for teaching bioethics to surgical resident...
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/j.amjsurg.2004.08.066
更新日期：2005-04-01 00:00:00
abstract：:Significant arterial trauma can result from femoral arterial cannulation for cardiopulmonary bypass or intraaortic balloon pumping. Threat of imminent loss of limb or suture line disruption requires prompt surgical intervention. Delayed appearance of claudication, characteristically at 1 to 2 weeks postoperatively, is...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/0002-9610(80)90026-4
更新日期：1980-08-01 00:00:00
abstract：:Twenty-five patients were identified with non-pituitary, nonadrenal ACTH-secreting tumors (bronchial carcinoid, bronchial small cell carcinoma, pancreatic islet cell carcinoma, medullary thyroid carcinoma, thymic carcinoids, metastatic adenocarcinoma, and pancreatic cystadenoma). Clinical features were weakness, hyper...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/s0002-9610(85)80085-4
更新日期：1985-02-01 00:00:00
abstract：BACKGROUND:While vascular patency and overall viability of the gut can be evaluated perioperatively, damage to the mucosal barrier can hardly be judged in the perioperative setting and, moreover, will probably determine the clinical course. METHODS:In 19 consecutive cases with intestinal ischemia, the clinical course ...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/s0002-9610(97)00048-2
更新日期：1997-07-01 00:00:00
abstract：:Feeding gastrostomy can be troublesome, inconvenient and painful to the patient, especially if the catheter is redundant, thereby causing deformity of the opening ad leakage of gastric juice and food around the tube. A skin level permanent feeding gastrostomy was fashioned in four patients with neurologic disease. The...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/0002-9610(81)90205-1
更新日期：1981-03-01 00:00:00
abstract：BACKGROUND:Laparoscopic colorectal surgery remains one of the most challenging techniques to learn. METHODS:The authors collected studies that have compared hand-assisted laparoscopic surgery (HALS) and open surgery for the treatment of colorectal disease over the past 17 years. Data of interest for HALS and open surg...
journal_title：American journal of surgery
pub_type： 杂志文章,meta分析,评审
doi：10.1016/j.amjsurg.2013.04.013
更新日期：2014-01-01 00:00:00
abstract：:The effects of epinephrine on the vascular perfusion of solitary Walker tumors implanted in the liver were studied in Sprague-Dawley rats. Colored silicone rubber (Microfil) solutions were injected into the arterial and portal circulations in each animal, and specimens were studied under a stereomicroscope. Internal v...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/0002-9610(80)90044-6
更新日期：1980-11-01 00:00:00
abstract：BACKGROUND:The aim of this study was to determine whether acute histologic inflammatory activity at the rectal margin predicts postoperative complications in children with ulcerative colitis following ileal pouch-anal anastomoses (IPAA). METHODS:Patients who underwent IPAA following previous total abdominal colectomy ...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/j.amjsurg.2020.02.054
更新日期：2020-04-01 00:00:00
abstract：BACKGROUND:In the surgical management of lower gastrointestinal tract peritonitis (LGTP), drainage of the peritoneal cavity is often recommended. The objective of the study was to evaluate the impact of drainage of the abdominal cavity during management of LGTP. METHODS:From January 2009 to January 2012, patients unde...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/j.amjsurg.2016.09.031
更新日期：2017-07-01 00:00:00
abstract：:The purpose of this experimental study was to test the potential value of heat welding to cut the ends of knotted surgical sutures. This heat process resulted in knot security in a coated polyglactin suture with fewer throws than those needed for the same suture with knotted ends cut by scissors. Results of mechanical...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/0002-9610(85)90069-8
更新日期：1985-09-01 00:00:00
abstract：BACKGROUND:Aging of the population necessitates consideration of the increasing number of older adults requiring emergency care. The objective of this study was to compare outcomes and presentation of octogenarian and/or nonagenarian emergency general surgery (EGS) patients with younger adults. METHODS:Based on a stan...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/j.amjsurg.2016.01.021
更新日期：2016-08-01 00:00:00
abstract：:The presence of cholelithiasis, steatorrhea, diabetes mellitus, and a pancreatic tumor initiated a diagnostic workup for somatostatinoma in a 43 year old black woman. The hypothesis of somatostatinoma was supported by a high level of plasma-like immunoreactivity and secretory granules resembling D-cell granules by ele...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/0002-9610(83)90309-4
更新日期：1983-11-01 00:00:00
