Abstract:
OBJECTIVE:Our experience with omental flap transposition in the treatment of deep sternal wound infections is reviewed here with an emphasis on efficacy, risk factors for in-hospital mortality rates, and long-term results. SUMMARY BACKGROUND DATA:Even with improvements in muscle and omental flap transposition, the timing of closure and the surgical strategy are controversial. METHODS:Forty-four consecutive patients with deep sternal wound infections were treated using the omental flap transposition from 1985 through 1994. The strategies included debridement with delayed omental flap transposition or single-stage management, which consisted of debridement of the sternal wound and omental flap transposition. Methicillin-resistant Staphylococcus aureus was cultured from more than 50% of the wounds. A logistic regression analysis was used to identify the predictors of in-hospital death after omental flap transposition. RESULTS:There were seven (16%) in-hospital deaths. Univariate analysis demonstrated that hemodialysis and ventilatory support at the time of omental flap transposition were significantly associated with in-hospital mortality rates (p = 0.0023 and p = 0.0075, respectively). Thirty-seven patients whose wounds healed well were discharged from the hospital. Two patients with cultures positive for methicillin-resistant Staphylococcus aureus had recurrent sternal infections. Patients without positive methicillin-resistant Staphylococcus aureus cultures had good long-term results after reconstructive surgery. CONCLUSIONS:Transposition of an omental flap is a reliable option in the treatment of deep sternal wound infections, unless the patients require ventilatory support or hemodialysis at the time of transposition.
journal_name
Ann Surgjournal_title
Annals of surgeryauthors
Yasuura K,Okamoto H,Morita S,Ogawa Y,Sawazaki M,Seki A,Masumoto H,Matsuura A,Maseki T,Torii Sdoi
10.1097/00000658-199803000-00019subject
Has Abstractpub_date
1998-03-01 00:00:00pages
455-9issue
3eissn
0003-4932issn
1528-1140journal_volume
227pub_type
杂志文章abstract::A prospective study was performed on 358 patients to examine the diagnosis, management, and natural history of fish bone ingestion. All patients admitted with the complaint had a thorough oral examination. Flexible endoscopy under local pharyngeal anesthesia would be performed on patients with negative findings. Of 11...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-199004000-00012
更新日期:1990-04-01 00:00:00
abstract:OBJECTIVE:Comparative analyses of survival and funding statistics in cancers with high mortality were performed to quantify discrepancies and identify areas for intervention. BACKGROUND:Discrepancies in research funding may contribute to stagnant survival rates in pancreatic ductal adenocarcinoma (PDAC). METHODS:The ...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/SLA.0000000000003042
更新日期:2020-02-01 00:00:00
abstract:OBJECTIVE:The aim of this study was to investigate the incidence of parastomal hernias (PSHs) after end-colostomy formation using a polypropylene mesh in a randomized controlled trial versus conventional colostomy formation. BACKGROUND:A PSH is the most frequent complication after stoma formation. Symptoms may range f...
journal_title:Annals of surgery
pub_type: 杂志文章,随机对照试验
doi:10.1097/SLA.0000000000001903
更新日期:2017-04-01 00:00:00
abstract:OBJECTIVE:To determine if addition of the S-nitrosylating agent ethyl nitrite (ENO) to the preservation solution can improve perfusion parameters in pumped human kidneys. BACKGROUND:A significant percentage of actively stored kidneys experience elevations in resistance and decreases in flow rate during the ex vivo sto...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/SLA.0000000000003702
更新日期:2019-12-05 00:00:00
abstract::Between June 1977 and November 1981, 26 children and adults with ulcerative colitis have undergone a total colectomy, an endorectal dissection of the rectal mucosa, and an ileoanostomy. A combined abdominoperineal approach was used to perform the operation, and the mucosal-submucosal rectal tube was dissected out inta...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:
更新日期:1983-01-01 00:00:00
abstract:OBJECTIVE:To define and test "Textbook Outcome" (TO)-a composite measure for healthcare quality-among Medicare patients undergoing hepatopancreatic resections. Hospital variation in TO and Medicare payments were analyzed. BACKGROUND:Composite measures of quality may be superior to individual measures for the analysis ...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/SLA.0000000000003105
更新日期:2020-06-01 00:00:00
abstract:BACKGROUND:Patients frequently voice concerns regarding wait times for cancer treatment; however, little is known about the length of wait times from diagnosis to surgery in the United States. Our objectives were (1) to assess changes in wait times over the past decade and (2) to identify patient, tumor, and hospital f...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/SLA.0b013e318211cc0f
更新日期:2011-04-01 00:00:00
abstract::The influence of deep vein thrombosis on intramuscular pressure was evaluated in 22 patients by means of the wick technique. Intramuscular pressure was measured in the anterior tibial and the deep posterior compartments in both legs before and during treatment. The intramuscular pressure was significantly (p less than...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-198304000-00013
更新日期:1983-04-01 00:00:00
abstract:OBJECTIVE:This study aims at improving diagnosis of intestinal ischemia, by measuring plasma and urinary fatty acid binding protein (FABP) levels. METHODS:Fifty consecutive patients suspected of intestinal ischemia were included and blood and urine were sampled at time of suspicion. Plasma and urinary concentrations o...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/SLA.0b013e318207a767
更新日期:2011-02-01 00:00:00
abstract:OBJECTIVE:We sought to determine whether a data-driven scheduling approach improves Operative Suite (OS) efficiency. BACKGROUND:Although efficient use of the OS is a critical determinant of access to health care services, OS scheduling methodologies are simplistic and do not account for all the available characteristi...
journal_title:Annals of surgery
pub_type: 杂志文章,随机对照试验
doi:10.1097/SLA.0000000000002763
更新日期:2019-12-01 00:00:00
abstract:OBJECTIVE:To compare outcomes of fenestrated (FEVAR) and open repairs of complex abdominal aortic aneurysms (cAAA). BACKGROUND:FEVAR has emerged as an alternative to open surgery for treating cAAA, but direct comparisons are limited. METHODS:We studied all repairs of intact or symptomatic cAAA in the Vascular Quality...
journal_title:Annals of surgery
pub_type: 杂志文章,多中心研究
doi:10.1097/SLA.0000000000003094
更新日期:2020-05-01 00:00:00
abstract::Twenty patients with metastatic renal cell carcinoma and nine patients with minimal residual disease (MRD) but at high risk for recurrence following nephrectomy received weekly four milligram intradermal injections of purified RNA extracted from lymphoid organs of sheep immunized with human renal cell carcinoma. Eight...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-197710000-00007
更新日期:1977-10-01 00:00:00
abstract:BACKGROUND:Retrospective single-center studies have shown that diffusion-weighted magnetic resonance imaging (DWI) is promising for identification of patients with rectal cancer with a complete tumor response after neoadjuvant chemoradiotherapy (CRT), using certain volumetric thresholds. OBJECTIVE:This study aims to v...
journal_title:Annals of surgery
pub_type: 杂志文章,多中心研究
doi:10.1097/SLA.0000000000000909
更新日期:2015-12-01 00:00:00
abstract:OBJECTIVES:To determine pathologic features associated with recurrence and survival in patients with lymph node-negative gastric adenocarcinoma. STUDY DESIGN:Multi-institutional retrospective analysis. BACKGROUND:Lymph node status is among the most important predictors of recurrence after gastrectomy for gastric aden...
journal_title:Annals of surgery
pub_type: 杂志文章,多中心研究
doi:10.1097/SLA.0000000000001084
更新日期:2015-12-01 00:00:00
abstract::The relationship of transcutaneous oxygen tension (PtcO2) to arterial oxygen tension (PaO2), pulmonary shunt (Qsp/Qt), mixed venous oxygen tension (PVO2), and O2 delivery was determined in patients with respiratory failure in order to explore the possible usefulness of PtcO2 to titrate the level of positive end expira...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-198102000-00014
更新日期:1981-02-01 00:00:00
abstract::Pressures in the Oddi sphincter and common bile duct were determined before, immediately after and several weeks after endoscopic papillotomy. Fifteen patients were included in the study. Significant decreases in Oddi sphincter and common bile duct pressures were found and the decrease in Oddi sphincter pressure was t...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-197908000-00009
更新日期:1979-08-01 00:00:00
abstract::Cyclosporine has been used as primary immunosuppression in renal allograft recipients in our unit for the past decade. The overall clinical experience and long-term effects of the agent are reviewed. There were 461 consecutive recipients of kidney grafts; 379 received grafts from cadaver donors (CAD) and 82 from livin...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-199107000-00007
更新日期:1991-07-01 00:00:00
abstract:OBJECTIVE:To determine the proportion of registered trials published in the surgical literature, to compare, in registered trials, the primary outcomes registered with those published and to determine whether outcome-reporting bias favored significant primary outcomes. BACKGROUND:Trial protocol registration before pat...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/SLA.0b013e318299d00b
更新日期:2014-01-01 00:00:00
abstract:BACKGROUND:Pancreatic ductal adenocarcinoma (PDA) is a devastating disease that killed nearly 38,000 people in the United States this past year. OBJECTIVE:Treatment of PDA typically includes surgery and/or chemotherapy with gemcitabine. No reliable biomarker exists for prognosis or response to chemotherapy. Two previo...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/SLA.0b013e3181f1fd44
更新日期:2010-09-01 00:00:00
abstract::This is the first reported case of mumps hemorrhagic pancreatitis in a child, documented at operation, and by rising mumps titers and complicated by a pseudocyst. In severe cases when surgery is indicated, drainage of the lesser sac usually prevents pseudocyst formation. If a pseudocyst occurs, drainage is required to...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-197407000-00012
更新日期:1974-07-01 00:00:00
abstract:OBJECTIVE:There were 2 objectives: first, to investigate how many patients were excluded from surgery on the basis of the radiological extent of the peritoneal carcinomatosis (PC) or the clinical examination; and second, to develop a score based primarily on serum tumor markers (STMs) that could predict short cancer-sp...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/SLA.0b013e318254f281
更新日期:2012-12-01 00:00:00
abstract:OBJECTIVE:To validate the global features of postoperative adverse outcomes for surgical patients with schizophrenia. BACKGROUND:Patients with schizophrenia were known to have a higher risk of complications during hospitalization. Quality of care has become the key factor in reducing their potential mortality afterwar...
journal_title:Annals of surgery
pub_type: 杂志文章,多中心研究
doi:10.1097/SLA.0b013e31827b9b25
更新日期:2013-03-01 00:00:00
abstract:OBJECTIVE:To review the current concepts in the mediastinal staging of nonsmall cell lung cancer (NSCLC), evaluating traditional and modern staging modalities. SUMMARY BACKGROUND DATA:Staging of NSCLC includes the assessment of mediastinal lymph nodes. Traditionally, computed tomography (CT) and mediastinoscopy are us...
journal_title:Annals of surgery
pub_type: 杂志文章,评审
doi:10.1097/01.SLA.0000081086.37779.1a
更新日期:2003-08-01 00:00:00
abstract::The current performance and applicability of elective hepatic resection represents an impressive evolution. From removal of tumor-bearing, ill-defined portions of the liver, which is always threatened by the inability to control bleeding, surgery of the liver has progressed to hemostatically controlled dissection of a...
journal_title:Annals of surgery
pub_type: 杂志文章,评审
doi:10.1097/00000658-199001000-00001
更新日期:1990-01-01 00:00:00
abstract:OBJECTIVE:The aim of this study is to assess CT-PET and endoscopic assessment postneoadjuvant chemoradiotherapy (nCRT) in predicting complete pathologic response (pCR) in locally advanced esophageal cancer (LAEC). DESIGN:A prospective cohort study. BACKGROUND:nCRT is increasingly standard of care in LAEC, with pCR a ...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/SLA.0000000000001902
更新日期:2016-11-01 00:00:00
abstract:OBJECTIVE:To identify the outcomes and risks of split-liver transplantation (SLT) for two adult recipients to determine the feasibility of more widespread use of this procedure to increase the graft pool for adults. SUMMARY BACKGROUND DATA:The shortage of cadaver liver grafts for adults is increasing. Using livers fro...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-200104000-00013
更新日期:2001-04-01 00:00:00
abstract::After attaching appropriate monitoring devices enabling the measurement of the slope of the left ventricular function curve, left atrial pressure, mean aortic pressure, peak left ventricular pressure, and tension time index, three groups of ten dogs were subjected to varying periods of hemorrhagic shock until a slope ...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-197501000-00025
更新日期:1975-01-01 00:00:00
abstract::We analyzed the course of 186 patients with external gastrointestinal fistulas treated at the University of California Medical Center, San Francisco from 1968 to 1977. There were 82 patients in the earlier group (1968-1971) and 104 patients in the later group (1972-1977). The groups differed in that 35% of patients in...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-197810000-00003
更新日期:1978-10-01 00:00:00
abstract:OBJECTIVE:To evaluate the association between anesthetic management before and after graft reperfusion and early graft regeneration in living donor liver transplantation (LDLT). BACKGROUND:Sufficient graft regeneration is essential for the success of LDLT. Diverse signals start to trigger liver regeneration immediatel...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/SLA.0000000000001526
更新日期:2016-12-01 00:00:00
abstract::From 1980 to 1984, 326 patients requiring splenectomy or splenorrhaphy were treated at one urban trauma center. Splenic injuries were graded in severity from one to five at the time of celiotomy. Splenorrhaphy was attempted in all patients, except when the spleen was shattered or avulsed or when multiple injuries were...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-198505000-00005
更新日期:1985-05-01 00:00:00