Abstract:
BACKGROUND:Gastroesophageal reflux is frequently associated with abnormal motility in the body of the esophagus. Concern for dysphagia has led surgeons to perform less competent procedures in this group, or to avoid surgery altogether. The current study was undertaken to evaluate our experience with the laparoscopic Hill repair in patients with reflux-associated abnormal motility. METHODS:A retrospective review of 338 laparoscopic Hill repairs was performed; 253 patients had adequate information for analysis, and 8 patients were excluded because of hypertensive motility. The remaining 245 patients were divided into group I (175) with normal esophageal body peristalsis, group IIA (37) with moderate dysmotility, and group IIB (33) with severe dysmotility. All patients underwent standard laparoscopic Hill repair. Follow-up included postoperative manometry and 24-hour pH studies and interview by an independent physician. Dilation for dysphagia was performed when necessary. Statistical analysis was performed using the F test. RESULTS:Mean follow-up was 11.0 months (range 1 to 41). Early dysphagia (<3 months) occurred in 4.0% of group I patients and 12.9% of group II patients. Late dysphagia (>3 months) occurred in 1.1% of group I patients and 1.4% of group II patients. Postoperative motility returned to normal in 43% of group IIB patients studied. Twenty-four hour pH evaluation showed fractional pH <4 an average of 4.8% in group I (median 2.1%) and 6.4% in group II (median 4.0%; P = 0.57). Patient rating of results was good to excellent in 91.0% with no statistical difference between the two groups. No patient required reoperation for dysphagia. CONCLUSION:The laparoscopic Hill repair can be safely performed in patients with reflux-associated dysmotility, with excellent results. Even severely disordered motility will return to normal in a high percentage of cases. Manometric control of the repair and secure distal fixation of the gastroesophageal junction are advantages. Abnormal motility may be an indication for, rather than a contraindication to, laparoscopic Hill repair.
journal_name
Am J Surgjournal_title
American journal of surgeryauthors
Aye RW,Mazza DE,Hill LDdoi
10.1016/S0002-9610(96)00062-1subject
Has Abstractpub_date
1997-05-01 00:00:00pages
379-82issue
5eissn
0002-9610issn
1879-1883pii
S0002-9610(96)00062-1journal_volume
173pub_type
杂志文章abstract::For 173 patients undergoing major leg amputations, the operative mortality was 13 per cent. The ratio of below-knee (BK) to above-knee (AK) amputations was approximately unity. Of the 150 patients who survived amputation, 93 were given prostheses. Amoung the latter group, 76 per cent of the unilateral AK amputees and ...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/0002-9610(77)90133-7
更新日期:1977-04-01 00:00:00
abstract:BACKGROUND:The aim of this study was to calculate and analyze the cost of treatment for stage IV pressure ulcers. METHODS:A retrospective chart analysis of patients with stage IV pressure ulcers was conducted. Hospital records and treatment outcomes of these patients were followed up for a maximum of 29 months and ana...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/j.amjsurg.2009.12.021
更新日期:2010-10-01 00:00:00
abstract:BACKGROUND:Residents are more likely to learn from educational experiences when properly prepared from the start of instruction and expectations are clear and consistent. The purpose of this study was to examine what first year residents need to know and be able to perform before starting their rotation in the intensiv...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/s0002-9610(96)00029-3
更新日期:1996-06-01 00:00:00
abstract::Compared with total parenteral nutrition, enteral feeding via jejunostomy reduces septic complications in patients with severe trauma. However, violation of the bowel with insertion of a jejunostomy tube may increase the risk of intra-abdominal abscess (IAA), particularly if no simultaneous gastrointestinal tract inju...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/s0002-9610(05)80680-4
更新日期:1993-12-01 00:00:00
abstract:BACKGROUND:Acute diverticulitis of the right colon is a rare condition with a higher incidence in Oriental populations than in Occidental populations. PATIENTS AND METHODS:A retrospective review was conducted between 1982 and 1993 on 22 surgically treated Chinese patients (14 men, 8 women; mean age 47 years) with docu...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/S0002-9610(97)89559-1
更新日期:1996-02-01 00:00:00
abstract::Three hundred eight patients underwent parotidectomy for a benign parotid tumor between 1948 and 1979. Two hundred seventy-four had operation for primary tumor, and 34, for recurrent tumor. Ninety-eight percent of those with primary tumors had superficial or total parotidectomy, and 2 percent had local excision with a...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/0002-9610(86)90321-1
更新日期:1986-10-01 00:00:00
abstract::One hundred seventeen patients with threatened limb loss were evaluated. Seventy-three of these patients underwent vascular reconstruction. Diabetics had a significantly higher incidence of ischemic ulceration and gangrene when compared with nondiabetics. Nondiabetics typically presented with rest pain. The outcome of...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/s0002-9610(88)80534-8
更新日期:1988-12-01 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:Tracheostomal recurrence after total laryngectomy for laryngeal carcinoma has a poor prognosis. The independent risk factors of tracheostomal recurrence are, however, not well documented. METHODS:This is a multivariate analysis of the risk factors of tracheostomal recurrence after total laryngectomy for 322...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/S0002-9610(96)00162-6
更新日期:1996-09-01 00:00:00
abstract::This investigation was designed to study the effects of home health care (HHC) on patients who have been hospitalized with peripheral vascular disease. For a patient to have HHC, the patient had to have a defined wound, educational needs, or both. Sixty patients, 30 with HHC and 30 without, were contacted approximatel...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/s0002-9610(05)80302-2
更新日期:1990-08-01 00:00:00
abstract::(1) Carcinoma of the lip occurs predominantly in men in their seventh and eighth decades of life. (2) Epidermoid carcinoma is the most common malignant lip tumor. (3) Metastases to cervical lymph nodes are uncommon. (4) Elective neck dissection is not indicated. (5) Therapeutic radical neck dissection can benefit the ...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/0002-9610(79)90427-6
更新日期:1979-10-01 00:00:00
abstract::A 5 year experience of 248 patients with isolated penetrating lower chest injury was reviewed. Twenty-two (15 percent) of the stab wounds and 46 (46 percent) of the gunshot wounds caused associated intraabdominal injury. Among those taken to the operating room for laparotomy, physical examination proved misleading in ...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/0002-9610(80)90104-x
更新日期:1980-12-01 00:00:00
abstract::A 78-year-old healthy woman with no previous surgeries or history of trauma presented with a painful abdominal mass for 1 day. The computed tomography (CT) scan of the abdomen demonstrated a partial herniation and strangulation of the cecum (Richter's hernia) between the internal and external oblique muscles through t...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/j.amjsurg.2006.02.028
更新日期:2007-01-01 00:00:00
abstract:BACKGROUND:Many surgeons continue to use prosthetic arteriovenous grafts for dialysis access despite the clear superiority of native arteriovenous fistulas. This study was undertaken to review our experience with elevated brachial-basilic fistulas as an alternative to prosthetic grafts in patients lacking veins suitabl...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/s0002-9610(99)00102-6
更新日期:1999-06-01 00:00:00
abstract:BACKGROUND:Surgery is a vital component of a comprehensive health system, but there are often personnel limitations in resource constrained areas. Zambia provides post graduate surgical training through two systems to help address this shortage. However, no studies have analyzed surgical trainees' perceptions of these ...
journal_title:American journal of surgery
pub_type: 杂志文章,多中心研究
doi:10.1016/j.amjsurg.2017.07.023
更新日期:2018-04-01 00:00:00
abstract::As discussed by Urschel [13], 50 to 70 percent of patients with symptoms of thoracic outlet syndrome may be treated conservatively by nonsurgical methods. Patients who still have symptoms after years of such therapy are referred to us for surgical treatment. Failure to obtain symptomatic relief after scalenotomy alone...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/0002-9610(80)90351-7
更新日期:1980-05-01 00:00:00
abstract:BACKGROUND:Currently, there is significant variability in the development, implementation and overarching goals of video review for assessment of surgical performance. METHODS:This paper evaluates the current methods in which video review is used for evaluation of surgical performance and identifies which processes ar...
journal_title:American journal of surgery
pub_type: 杂志文章,评审
doi:10.1016/j.amjsurg.2020.06.027
更新日期:2021-01-01 00:00:00
abstract:BACKGROUND:Most patients with primary hyperparathyroidism undergo localization prior to operation with variable success. Therefore, in this study we investigated the safety of parathyroidectomy without imaging. METHODS:A prospective database of 2057 surgical patients with primary hyperparathyroidism from 2001 to 2019 ...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/j.amjsurg.2020.04.029
更新日期:2020-09-01 00:00:00
abstract:PURPOSE:This study aimed to determine one-year outcomes and the impact of various factors on the need for readmission and reoperation following abdominoperineal resection (APR). METHOD:A multivariate logistic regression analysis was conducted to determine predictors of readmission and/or reoperation within one year of...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/j.amjsurg.2018.08.021
更新日期:2019-07-01 00:00:00
abstract:BACKGROUND:Several anecdotal papers suggest that laparoscopic cholecystectomy can be done safely in pregnant patients, but few patients are reported and other patients such as those who underwent laparoscopic appendectomy are often included. A larger series would help clarify the situation. METHODS:The Connecticut Lap...
journal_title:American journal of surgery
pub_type: 临床试验,杂志文章,多中心研究
doi:10.1016/s0002-9610(99)00007-0
更新日期:1999-03-01 00:00:00
abstract::Four hundred seventy-eight patients with hand burns (786 hands) were treated at the burn service of the Massachusetts General Hospital. Long-term evaluation showed that early incision and immediate autografting of deep second degree, mixed second and third degree, and third degree full-thickness hand burns resulted in...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/s0002-9610(85)80049-0
更新日期:1985-04-01 00:00:00
abstract::During a 2 year period, 83 patients with gastric motility problems were evaluated using radionuclide imaging. The patients presented with epigastric distress, postprandial fullness, pain, nausea, vomiting, and diarrhea; signs and symptoms suggestive of either gastroparesis or gastric outlet obstruction. Upper gastroin...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/0002-9610(83)90351-3
更新日期:1983-12-01 00:00:00
abstract::The management of the failing myocardium was primarily empirical for centuries, until Withering introduced foxglove (digitalis) in 1785 as an effective medication. Gradually, the medical treatment included, besides digitalis preparations, the use of diuretics to reduce excessive sodium and water retention; limiting sa...
journal_title:American journal of surgery
pub_type: 历史文章,杂志文章
doi:10.1016/0002-9610(84)90186-7
更新日期:1984-06-01 00:00:00
abstract::Two courses of triple-agent chemotherapy were given to 47 patients with advanced head and neck cancer. All but one patient with a nasopharyngeal carcinoma had resectable stage III and IV squamous cell carcinoma. Eighty-eight percent of the patients responded to the chemotherapy with a 50 percent or greater decrease in...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/0002-9610(82)90417-2
更新日期:1982-10-01 00:00:00
abstract::Small intestinal epithelium digests and absorbs nutrients. Crypt stem cell transplantation can generate neomucosa with normal morphology, but the digestive and absorptive capacities of this neomucosa are unknown. This study evaluates stem cell induced neomucosal brush border digestive enzyme activity and nutrient tran...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/s0002-9610(99)80119-6
更新日期:1995-01-01 00:00:00
abstract:BACKGROUND:Current literature does not define ideal qualities of surgical mentors. We sought to define mentoring qualities desired by medical students in attending and resident surgeons. METHODS:We conducted a survey asking third-year medical students to identify the best attending surgeon and resident surgeon mentors...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/j.amjsurg.2003.12.053
更新日期:2004-06-01 00:00:00
abstract::Breast symptoms of pain, tenderness, and engorgement correlate with objective findings of nodularity on physical examination. Like all other factors for breast disease, they are not a single determinant of diagnosis, as shown by the 3 X 3 contingency table, but they are a useful addition to our understanding. From the...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/0002-9610(85)90135-7
更新日期:1985-08-01 00:00:00
abstract:BACKGROUND:We examined and compared APP versus surgical resident perceptions of the role of APPs in surgical subspecialty teams. METHODS:Residents/first year surgical critical care fellows and inpatient service-specific APPs responded to a survey that examined perceptions about the APP-resident/fellow relationship. St...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/j.amjsurg.2018.10.014
更新日期:2019-06-01 00:00:00
abstract::The relationship between platelet count and aggregability was serially evaluated after splenectomy in patients with normosplenism and hypersplenism, and the results were compared with those found in patients undergoing only upper abdominal surgery. The preoperative count and aggregability of platelets were significant...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/0002-9610(78)90242-8
更新日期:1978-08-01 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