Abstract:
BACKGROUND:Laparoscopic splenectomy (LS) has been used to treat a variety of splenic disorders. However, there have been few direct comparisons of this approach with open splenectomy (OS). METHODS:Results and outcomes were compared retrospectively in 46 consecutive patients treated by laparoscopic (n = 26) or open splenectomy (n = 20) from January 1990 through March 1996. The two groups were similar in age, sex, and American Society of Anesthesiology classification. Splenectomy was performed for a variety of indications, and the majority of patients in both groups had normal or near-normal size spleens. All data are expressed as mean +/- standard deviation. RESULTS:Laparoscopic splenectomy was successfully completed in all 26 attempted cases. Operative times were significantly longer for LS (202 +/- 55 minutes) than for OS (134 +/- 43 minutes) (P < 0.001); however, operative times in the last 13 LS cases (176 +/- 48 minutes) averaged 51 minutes less than in the first 13 cases (227 +/- 51 minutes). Estimated operative blood loss was less for LS (222 +/- 280 mL) than for OS (376 +/- 500 mL) (P = not significant). A mean of 2.0 units of red blood cells was transfused in 4 (15%) of 26 patients during LS vs 1.0 unit transfused in 2 (10%) of 20 patients who had OS (P = NS). Patients who underwent LS required significantly less parenteral pain medications, had a more rapid return to regular diet, and were discharged sooner than patients who had OS. Complication rates were similar in the two groups. CONCLUSIONS:These results suggest that LS is technically safe and has several advantages over OS. Laparoscopic splenectomy should become the procedure of choice for the removal of normal and near-normal size spleens.
journal_name
Am J Surgjournal_title
American journal of surgeryauthors
Brunt LM,Langer JC,Quasebarth MA,Whitman EDdoi
10.1016/s0002-9610(96)00241-3subject
Has Abstractpub_date
1996-11-01 00:00:00pages
596-9; discussion 599-601issue
5eissn
0002-9610issn
1879-1883pii
S0002961096002413journal_volume
172pub_type
杂志文章abstract::A quantitative endotoxin assay was applied in this study of endotoxin transport from the infected abdomen. In rats with fecal peritonitis, extremely high concentrations were found in thoracic duct lymph (approximately 400 times higher than those found in arterial and portal vein plasma). Taking flow rates into account...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/0002-9610(86)90098-x
更新日期:1986-04-01 00:00:00
abstract::We studied the effect of high caloric parenteral nutrition on the rate of gastric emptying of solid food. The linear pattern of gastric emptying was not altered by parenteral nutrition, but the gastric emptying rate was consistently slowed. The degree of slowing of gastric emptying while on parenteral nutrition correl...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/0002-9610(79)90338-6
更新日期:1979-11-01 00:00:00
abstract::We attempted to determine the incidence and significance of cytomegalovirus infection and the effect of immunoglobulin G infusions on specific cytomegalovirus titers in burn patients. On admission, 48 percent of a group of 120 patients (mean burn size 28.5 percent of the total body surface area) were seronegative, inc...
journal_title:American journal of surgery
pub_type: 临床试验,杂志文章
doi:10.1016/s0002-9610(88)80718-9
更新日期:1988-02-01 00:00:00
abstract::The surgical management of an infectious and fistulous wound with a pharyngoesophageal tumor is one of the greatest challenges for head and neck and plastic surgeons. The free jejunal transfer has been the standard technique for pharyngoesophageal reconstruction, and the free omental flap has been one of the most reli...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/s0002-9610(00)00392-5
更新日期:2000-06-01 00:00:00
abstract:BACKGROUND:Few data exist regarding surveillance for multiple primary melanoma (MPM) in elderly patients or whether the incidence and risk factors are the same as for younger patients. Thus, we studied the frequency and characteristics of MPM in the elderly melanoma patients. METHODS:From our prospective melanoma regi...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/j.amjsurg.2015.05.023
更新日期:2016-01-01 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::Normal volunteers and patients were studied to determine the relative importance of NMTT and patient risk factors in the production of hypoprothrombinemia. The normal volunteers demonstrated in vivo NMTT production, but the order of magnitude (cefoperazone, moxalactam, and cefotetan in descending order) was different ...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/s0002-9610(88)80210-1
更新日期:1988-05-31 00:00:00
abstract:BACKGROUND:Vacuum Assisted Closure (VAC; Kinetic Concepts, Inc., San Antonio, TX) has been used to successfully treat a variety of complex wounds. This technique was investigated for use in managing Fournier's gangrene following initial debridement. METHODS:Ten patients with Fournier's gangrene were treated in this st...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/j.amjsurg.2008.04.018
更新日期:2009-05-01 00:00:00
abstract::Axillary node dissection was performed in 212 patients with malignant melanoma. For 212 initial dissections plus 49 repeat procedures (261 operations), wound infection occurred in 25 (10%) and arm edema in 10 (4%), with other complications being infrequent. The arm edema resolved promptly and completely six (2%) patie...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/0002-9610(91)90069-p
更新日期:1991-09-01 00:00:00
abstract:BACKGROUND:Hepatocellular carcinoma (HCC) occur in livers with injury-remodeling, accomplished by enzymes called matrix metalloproteinases (MMP). Metastasis involves basement membrane invasion also caused by MMP activity. Alterations in MMP expression and their endogenous inhibitor (TIMP) may factor in HCC metastasis. ...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/s0002-9610(02)00833-4
更新日期:2002-05-01 00:00:00
abstract:BACKGROUND:Establishment of an instant, reproducible, and reliable rat model of a refined 3-cuff technique for performing orthotopic intestinal transplantation is reported, and the surgical skills required to perform modified surgical procedure are discussed. METHODS:A retrospective analysis was used to study 270 rat ...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/j.amjsurg.2008.07.057
更新日期:2009-07-01 00:00:00
abstract::Abdominal angina that is characterized by postprandial pain, and often associated with weight loss, is a well-recognized symptom complex of mesenteric artery insufficiency (mesenteric territory symptoms). In the past 5 years, we have observed six patients with atypical symptoms who had mesenteric artery occlusion comb...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/s0002-9610(05)81061-x
更新日期:1993-08-01 00:00:00
abstract:BACKGROUND:Postoperative pain management with a continuous preperitoneal infusion (CPI) for locoregional anesthesia has been shown to have improved postoperative outcomes. This is the first direct comparison of CPI versus epidural infusion (EPI), both in conjunction with systemic analgesia. METHODS:A retrospective rev...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/j.amjsurg.2011.05.016
更新日期:2011-12-01 00:00:00
abstract::Of six healthy laboratory workers with no history of illness caused by Pseudomonas aeruginosa, four exhibited positive skin responses at 24 hours, strong inhibition of leukocyte migration, and marked stimulation of blastogenesis of peripheral lymphocytes when exposed to a "cocktail" of three phenol-killed strains of P...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/0002-9610(77)90160-x
更新日期:1977-06-01 00:00:00
abstract::1. Approximately 40,000 cases of cancer of the head and neck (excluding skin) are diagnosed each year. 2. Approximately 20,000 of these cases and 30,000 cases of skin cancer are treated by 366 head and neck cancer surgeons. 3. Ninety per cent of the cases are treated by 63 per cent of the surgeons. 4. Fifty-eight per ...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/0002-9610(75)90239-1
更新日期:1975-03-01 00:00:00
abstract::A mock disaster at Orange County's John Wayne Airport provided a basis for examining correct triage of patients and their arrival time for definitive care. The ability to triage critically injured patients in a timely fashion was found to be only slightly better than chance routing. For most of the seriously and criti...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/0002-9610(85)90070-4
更新日期:1985-09-01 00:00:00
abstract:BACKGROUND:A clear understanding of simulation-based curricula in use at American College of Surgeons Accredited Education Institutes (ACS-AEIs) is lacking. METHODS:A 25-question online survey was sent to ACS-AEIs. RESULTS:The response rate approached 60%. The most frequent specialties to use the ACS-AEIs are general...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/j.amjsurg.2016.08.011
更新日期:2017-04-01 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::Abdominal muscular contractions may have a protective influence against the development of indirect inguinal hernia. A portion of the transversus abdominus muscles acts on the internal inguinal rings and produces a closure mechanism during voluntary abdominal muscular activity. It follows, therefore, that injury or in...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/0002-9610(82)90108-8
更新日期:1982-03-01 00:00:00
abstract::The effects of the intravenous bolus administration of famotidine versus the administration of Mylanta II liquid every 2 hours on the pH of the gastric antrum, body, and fundus for 24 hours were compared in 10 critically ill patients admitted to the intensive care unit with isolated cranial trauma. Patients received 3...
journal_title:American journal of surgery
pub_type: 临床试验,杂志文章
doi:10.1016/s0002-9610(05)80667-1
更新日期:1993-12-01 00:00:00
abstract::This study prospectively compared the following tests for their accuracy in amputation level selection: transcutaneous oxygen, transcutaneous carbon dioxide, transcutaneous oxygen-to-transcutaneous carbon dioxide, foot-to-chest transcutaneous oxygen, intradermal xenon-133, ankle-brachial index, and absolute popliteal ...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/0002-9610(87)90174-7
更新日期:1987-08-01 00:00:00
abstract:BACKGROUND:The survival of patients with metastatic melanoma is poor. The response rates for chemotherapy and immunotherapy have been low, with no real improvement in survival. We reviewed the results of surgical resection. METHODS:We performed a retrospective review of the medical records of all patients who underwen...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/S0002-9610(98)00041-5
更新日期:1998-05-01 00:00:00
abstract:BACKGROUND:Short bowel syndrome, secondary to a variety of causes, can be lethal in infancy and childhood. Isoperistaltic bowel lengthening, performed by longitudinal division of dilated small bowel with end-to-end anastomosis, has shown early promise but long-term outcome is unknown. METHODS:Sixteen infants and child...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/s0002-9610(99)00218-4
更新日期:1999-12-01 00:00:00
abstract:BACKGROUND:Surgery is an environment in which being an expert requires the ability to manage the unexpected. This feature has necessitated a shift in surgical decision-making research. The present study explores the processes by which surgeons assess and respond to nonroutine challenges in the operating room. METHODS:...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/j.amjsurg.2012.10.005
更新日期:2013-02-01 00:00:00
abstract:BACKGROUND:It was hypothesized that splenectomy following trauma results in hypercoagulability. METHODS:A prospective, nonrandomized, single-center study was performed to evaluate coagulation parameters in trauma patients with splenic injury. RESULTS:Patients with splenectomy (n = 30) and nonoperative management (n =...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/j.amjsurg.2010.01.015
更新日期:2010-05-01 00:00:00
abstract::Static and dynamic forces exerted on 6-0 polypropylene suture material after carotid arteriotomy were measured in 22 adult mongrel dogs. Force was measured in 11 normotensive animals (Group I) before and 6 weeks after carotid artery repair. Force was measured in the remaining animals during normotension and induced hy...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/0002-9610(89)90618-1
更新日期:1987-09-01 00:00:00
abstract::Dissatisfaction with time-consuming double layer anastomoses in intestinal surgery and with occasionally questionable stapled anastomoses prompted a review of available techniques for hand sewn suture lines. Single layer anastomoses have been used extensively and their integrity and safety have often been questioned. ...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/s0002-9610(85)80189-6
更新日期:1985-06-01 00:00:00
abstract:BACKGROUND:Chronic pain is a severe complication of mesh-based inguinal hernia repair. Its perceived risk varies widely in the literature. The current objectives are to review the incidence, severity, and consequences of chronic pain and its etiologies. DATA SOURCES:A multi-database systematic search was conducted for...
journal_title:American journal of surgery
pub_type: 杂志文章,评审
doi:10.1016/j.amjsurg.2007.02.012
更新日期:2007-09-01 00:00:00
abstract:BACKGROUND:The aims of this study were to compare the effectiveness of percutaneous drainage between pyogenic hepatic abscesses with and those without biliary communication and to evaluate the role of endoscopic biliary stent placement in the treatment of communicating abscesses. METHODS:Sixty-one patients with hepati...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/s0002-9610(01)00869-8
更新日期:2002-02-01 00:00:00
abstract:BACKGROUND:Penetrating injuries of the subclavian artery occurs infrequently but represent a surgical challenge. We reviewed our experience with penetrating injury of the subclavian artery and identify factors that influenced morbidity and mortality. METHODS:A retrospective review was performed on 54 consecutive patie...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/s0002-9610(03)00070-9
更新日期:2003-06-01 00:00:00