Abstract:
BACKGROUND:Surgery for Crohn's disease is not intended for cure, but rather to relieve symptoms and treat complications. Perioperative morbidity, the fear of creating short bowel syndrome, and the tendency of the disease to recur convinced many physicians to refer their Crohn's patients for surgery only when life-threatening complications occur. METHODS:This is a retrospective analysis of 47 patients operated on for Crohn's disease between 1989 and 1994. Twenty-six patients were operated on for "classic" indications ("classic" group) and the other 21 were operated on to improve their quality of life ("quality" group). RESULTS:There was no operative or postoperative mortality during a mean follow-up period of 50 (27 to 84) months. All major postoperative complications occurred only in patients operated on for the classic indications (four abscesses, two fistulas, one wound dehiscence, and two small bowel obstructions). During the follow-up period, a total of 13 patients (50%) in the classic group and only 5 patients (24%) in the quality group required reintroduction of medical therapy or additional operations for exacerbations and complications of Crohn's disease. CONCLUSIONS:Our data suggest that surgical intervention intended to improve the quality of life for Crohn's disease patients is safe and effective for carefully selected patients. It does improve quality of life, may prevent life-threatening complications, and offers a lower recurrence rate following surgery.
journal_name
Am J Surgjournal_title
American journal of surgeryauthors
Nissan A,Zamir O,Spira RM,Seror D,Alweiss T,Beglaibter N,Eliakim R,Rachmilewitz D,Freund HRdoi
10.1016/s0002-9610(97)00102-5subject
Has Abstractpub_date
1997-09-01 00:00:00pages
339-41issue
3eissn
0002-9610issn
1879-1883pii
S0002961097001025journal_volume
174pub_type
杂志文章abstract:BACKGROUND:The relationship between hospital volume and patient outcomes remains controversial for rectal cancer. METHODS:This is a population-based database study. Patients treated with surgery for a stage I to III rectal adenocarcinoma from 2003 to 2009 were identified. High-volume hospitals (HVH) were those centers...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/j.amjsurg.2016.07.007
更新日期:2017-02-01 00:00:00
abstract:BACKGROUND:Few patients with priapism require inpatient management unless they are refractory to intracavernosal therapy. Their risk factors and outcomes are poorly characterized. METHODS:This is a retrospective analysis of the Nationwide Inpatient Sample (1998-2006). Priapism patients were identified and analyzed ove...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/j.amjsurg.2010.03.017
更新日期:2011-04-01 00:00:00
abstract:BACKGROUND:The laparoscopic approach to surgical diseases of the foregut is rapidly gaining acceptance. These new approaches, however, pit the unwary surgeon against potentially devastating complications. PATIENTS AND METHODS:Based on a retrospective review of 153 consecutive laparoscopic foregut surgeries performed a...
journal_title:American journal of surgery
pub_type: 临床试验,杂志文章
doi:10.1016/S0002-9610(99)80206-2
更新日期:1995-05-01 00:00:00
abstract::Fifty-two patients with ulcerative colitis and colorectal cancer undergoing colectomy at the Mount Sinai Hospital between 1973 and 1988 were studied retrospectively to determine the correlation of age, sex, duration of colitis, tumor location, number of cancers, tumor differentiation, colloid content, presence of sign...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/s0002-9610(05)80638-5
更新日期:1992-07-01 00:00:00
abstract:BACKGROUND:The multimodality addition of preoperative gabapentin, acetaminophen, and celecoxib (GAC) and postoperative TENS has been recommended to diminish narcotics. We predict that GAC-TENS implementation will reduce recovery room time, improve pain control, reduce narcotic refills, and demonstrate usefulness of TEN...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/j.amjsurg.2018.01.070
更新日期:2018-05-01 00:00:00
abstract::Early diagnosis of esophageal perforation is critical. The importance of performing sufficient surgery at the first procedure whenever possible is emphasized. If early primary closure cannot be achieved, then the initial therapeutic method of choice is resection or diversion followed by reconstruction. Drainage of the...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/0002-9610(80)90379-7
更新日期:1980-06-01 00:00:00
abstract::The lower extremity complications of 100 consecutive patients who required the placement of an intra-aortic balloon pump (IABP) during a 3-year period were studied. Indications for the IABP included hypotension during cardiac catheterization (33%) or coronary angioplasty (13%), hemodynamic instability after open heart...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/s0002-9610(05)81192-4
更新日期:1992-11-01 00:00:00
abstract:BACKGROUND:Luminal pressure may injure the gut mucosa in obstruction, ileus, or inflammatory bowel disease. METHODS:We formed Roux-en-Y anastomoses in 19 mice, creating proximal and defunctionalized partially obstructed limbs and a distal limb to vary luminal pressure and flow. We induced mucosal ulcers by serosal ace...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/j.amjsurg.2008.07.016
更新日期:2008-11-01 00:00:00
abstract::The wire introducer method is a satisfactory technique for management of central venous catheters if bacteriologic monitoring of the removed catheter is used to determine whether the introduced catheter should be allowed to remain. The data indicate that when central venous catheters become infected, they do so throug...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/0002-9610(81)90327-5
更新日期:1981-12-01 00:00:00
abstract:BACKGROUND:Peritoneal macrophages play an important role in the immune response after abdominal operations. The stress response after these operations has been associated with impaired phagocytosis by peritoneal macrophages. This study examined the influence of minimally invasive techniques and preoperative corticoster...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/j.amjsurg.2008.07.023
更新日期:2008-12-01 00:00:00
abstract:BACKGROUND:Despite recent increased indications for infrapopliteal prosthetic bypass grafts with complementary arteriovenous fistulas, objective documentation of improved perfusion to the foot is lacking. In addition, the value of post operative noninvasive testing in the prediction of bypass success remains unclear. ...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/s0002-9610(99)80264-5
更新日期:1995-08-01 00:00:00
abstract:OBJECTIVE:Arterial base deficit (BD) is a commonly used marker of injury severity and endpoint of resuscitation but requires an arterial puncture and blood gas analysis. Serum bicarbonate (HCO3) is routinely obtained as part of the chemistry panel on most admissions. We hypothesized that serum HCO3 strongly correlates ...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/j.amjsurg.2005.08.024
更新日期:2005-12-01 00:00:00
abstract:BACKGROUND:Adhesion formation, which results from mechanical peritoneal damage, tissue ischemia, or the presence of foreign materials, is a complicated process. The formation of adhesions is associated with inflammatory response and extracellular matrix deposition in response to injury. Although the pathophysiology of ...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/j.amjsurg.2015.05.037
更新日期:2016-06-01 00:00:00
abstract:BACKGROUND:The radial forearm free flap has become a workhorse flap in head and neck reconstruction. Its lack of bulk, ease of dissection, vascularity, and malleability are among its many advantages. PATIENTS AND METHODS:A review of 157 radial forearm free flaps performed in 155 patients between March 1988 and June 19...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/s0002-9610(05)80096-0
更新日期:1994-11-01 00:00:00
abstract::The effects of cyclosporin A on the regenerating liver were studied in rats after partial hepatectomy and were compared with those of conventional immunosuppressants such as methylprednisolone and azathioprine. In Group I, a standard hepatectomy removing two thirds of the organ was performed. In Group II, an oral dose...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/s0002-9610(88)80705-0
更新日期:1988-02-01 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:Emergency surgical airway is a low frequency, high risk clinical scenario. Implementing a simulation-based curriculum may bridge the gap in surgical training and address quality assurance/performance improvement (QAPI) needs. METHODS:We designed and implemented an Advanced Surgical Airway Curriculum (ASAC) ...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/j.amjsurg.2018.09.026
更新日期:2019-03-01 00:00:00
abstract:BACKGROUND:The purpose of this study was to describe the incidence and clinical/pathologic characteristics of papillary thyroid microcarcinoma (PMC) in a community hospital setting and to evaluate the frequency and characteristics of these lesions when unsuspected preoperatively. METHODS:A total of 723 patients underw...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/j.amjsurg.2010.12.008
更新日期:2012-02-01 00:00:00
abstract::The accuracy of operative cholangiograms can be increased by radiomanometry. This study identified 17 patients among 198 studied whose choledocholiths would have likely been missed by routine cholangiography. These are almost invariably small stones the fate of which would be conjectural if left behind. In the present...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/0002-9610(77)90305-1
更新日期:1977-12-01 00:00:00
abstract:BACKGROUND:Incision and drainage of perianal sepsis has appreciable success in the immunocompetent population, but outcomes after incision and drainage in the immunosuppressed population are unknown. METHODS:13,666 patients (n = 930 immunosuppressed) undergoing incision and drainage of perianal sepsis between 2011 and...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/j.amjsurg.2019.01.036
更新日期:2019-09-01 00:00:00
abstract::Measurement of arterial and liver tissue oxygen tension (PO2) in animals subjected to hemorrhagic shock demonstrates a significant (p less than 0.001) decrease in tissue PO2 while PaO2 remains essentially unchanged. In fact, marked increase in PaO2 fail to increase tissue PO2 to control levels, demonstrating that the ...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/0002-9610(77)90020-4
更新日期:1977-05-01 00:00:00
abstract:BACKGROUND:The authors determined the radiological misdiagnosis rate of primary epiploic appendagitis (PEA) and its impact on patient management and hospital resource use. METHODS:A total of 660 computed tomography scans performed for clinically suspected diverticulitis (348 cases) or appendicitis (312 cases) were rev...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/s0002-9610(98)00103-2
更新日期:1998-07-01 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::Massive venous thromboses of the extremities, although uncommon, are responsible for many of the long-term sequelae associated with venous disease. The charts of all patients with a diagnosis of iliofemoral venous thrombosis or subclavian vein thrombosis over a 6-year period were reviewed. There were 59 patients with ...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/0002-9610(89)90361-9
更新日期:1989-08-01 00:00:00
abstract::Only 3 per cent of all melanomas arise in the mucosa of the head and neck region. Melanomas of mucosal origin in this series differed from their cutaneous counterpart in that size of the primary lesion did not influence prognosis. Regional lymph node metastases were infrequent and did not seem to influence prognosis. ...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/0002-9610(77)90393-2
更新日期:1977-10-01 00:00:00
abstract::The results of the present study emphasize the importance of minimizing the time delay between a significant elevation in CEA and a second-look operation. Equally important are the frequency of serial determinations, a thorough understanding of the limitations of the assay, and careful evaluation of the clinical condi...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/0002-9610(79)90137-5
更新日期:1979-02-01 00:00:00
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 cholecystecto...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/S0002-9610(97)89608-0
更新日期:1996-05-01 00:00:00
abstract:BACKGROUND:The Trauma Evaluation and Management (TEAM) module orients medical students to the initial assessment of an injured patient. At the Medical College of Wisconsin, a course based on expanded TEAM (eTEAM) was developed for junior medical students. This study determined whether eTEAM improved the ability to perf...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/j.amjsurg.2005.08.033
更新日期:2006-02-01 00:00:00
abstract:OBJECTIVE:The purpose of our study is to further clarify the incidence of ductal carcinoma in situ (DCIS) patients that are upstaged upon final pathology and/or have metastatic disease in the axilla. METHODS:All patients were diagnosed with DCIS or DCIS with microinvasion (DCISm) on their diagnostic biopsy and receive...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/j.amjsurg.2005.06.011
更新日期:2005-10-01 00:00:00
abstract::Long-term results of postanal repair are poor. Many patients with neuropathic incontinence have evidence of anterior pelvic floor weakness. A more comprehensive surgical repair has therefore been developed that involves postanal repair, anterior levatorplasty, and external sphincter plication. Primary total pelvic flo...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/0002-9610(92)90018-m
更新日期:1992-03-01 00:00:00