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101.
Oswens Siu Hung Lo Wai Lun Law Hok Kwok Choi Yee Man Lee Judy Wai Chu Ho Chi Leung Seto 《Langenbeck's archives of surgery / Deutsche Gesellschaft fur Chirurgie》2007,392(2):173-178
OBJECTIVES: The study aimed to review the etiologies of patients who underwent surgery for small bowel obstruction (SBO) and to evaluate the risk factors affecting the early postoperative outcomes. MATERIALS AND METHODS: A case series of 430 patients (252 men) with a mean age of 64.5 years, who underwent 437 operations for SBO, were retrospectively reviewed. RESULTS: Peritoneal adhesions and hernia were the most common causes of SBO, contributing 42.3 and 26.8% of all cases, respectively. Strangulation occurred in 27.7% and caused nonviable bowel in 13.0% of obstructing episodes. Old age (age >/= 70 years), female patient, nonadhesive obstruction, and hernia were the independent significant factors associated with bowel strangulation. The 30-day mortality was 6.5%, and the median postoperative hospital stay was 8 days. Old age, the presence of premorbid pulmonary disease, and malignant obstruction were the independent factors associated with operative mortality. The overall complication rate was 35.5%, and old age was the only significant factor associated with postoperative complications. CONCLUSIONS: Surgery for SBO is still associated with significant mortality and morbidity. As old age is significantly associated with an increased incidence of strangulation, operative mortality, and complications, this group of patients should be managed with extra cautions to avoid unfavorable outcome of surgery. 相似文献
102.
Stefan Ockert Hardy Schumacher Dittmar Böckler Katrin Malcherek Jochen Hansmann Jens Allenberg 《Langenbeck's archives of surgery / Deutsche Gesellschaft fur Chirurgie》2007,392(6):725-730
Background and aims Since the introduction of endovascular aortic aneurysm repair (EVAR) for aortic aneurysms, the number of juxtarenal aortic
aneurysms (JRA) has been growing steadily due to selection bias (neck morphology for EVAR). This case-match study compares
the perioperative outcome and midterm results of suprarenally clamped JRA with infrarenal aortic aneurysms (AAA).
Methods From 1997 to 2004, patients who received open surgery with suprarenal clamping for JRA were included in the study and compared
to matched patients with infrarenal clamping (AAA). Measurements analyzed were the in-hospital mortality and morbidity. Midterm
results were obtained through clinical investigation and magnetic resonance angiography imaging.
Results Thirty-five patients (mean age, 68.4 years; 30 male and 5 female) received suprarenal cross-clamping for JRA. The overall
in-hospital mortality for JRA and for the controls (AAA) with elective aortic repair was 4.5% (6.1% JRA; 3% AAA, p = 0.058). The morbidity of JRA was elevated according to the rate of pulmonary complications (p = 0.021) and the need for re-operation (p = 0.019). The mean follow-up time was 2.3 years (range, 8–96 months). At follow-up, 28 patients (80%) from the JRA group
and 29 patients from the AAA group (82.9%) were alive.
Conclusion Open aortic surgery for JRA with the need for suprarenal cross-clamping shows a slightly elevated in-hospital mortality rate
without statistical significance and equal midterm mortality results in comparison with infrarenally clamped aortic aneurysms. 相似文献
103.
Udo Lorenz Marianne Abele-Horn Dieter Bussen Arnulf Thiede 《Langenbeck's archives of surgery / Deutsche Gesellschaft fur Chirurgie》2007,392(6):761-765
Background To our best knowledge, Panton–Valentine leucocidin (PVL)-positive methicillin-sensitive Staphylococcus aureus (MSSA) has not been described yet as cause for severe pyomyositis.
Case report We present a 23-year-old apparently healthy male patient without any typical predisposing findings who developed severe pyomyositis
secondary to an operated pilonidal cyst. In the follow-up, the patient showed signs of immunocompromisation. The causative
agent for purulent infection of multiple muscles was a MSSA strain harbouring PVL toxin.
Results In the reported case, aggressive antibiotic and surgical treatment with additional application of immunoglobulins has lead
to recovery from the disease without relapse.
Conclusions PVL-positive S. aureus are associated with skin diseases, multiple abscesses and often complicated by severe sepsis and necrotising pneumonia. Under
such circumstances, the mortality rate can reach up to 75%. In addition, the PVL toxin can cause immunocompromisation and
might be therefore involved in the aetiology of pyomyositis. Aggressive antibiotic and surgical treatment with additional
application of immunoglobulins is recommended for treatment. 相似文献
104.
Usha Chinappen-Horsley Glen M Blake Ignac Fogelman Tim D Spector 《BMC musculoskeletal disorders》2007,8(1):113
Background
Skeletal ratios and bone lengths are widely used in anthropology and forensic pathology and hip axis length is a useful predictor of fracture. The aim of this study was to show that skeletal ratios, such as length of femur to height, could be accurately measured from a DXA (dual energy X-ray absorptiometry) image. 相似文献105.
Stefano Di Domenico Giulio Bovio Maximiliano Gelli Ferruccio Ravazzoni Enzo Andorno Damiano Cottalasso Umberto Valente 《BMC surgery》2007,7(1):18
Background
Liver transplantation in presence of diffuse portal vein thrombosis is possible by using caval blood as portal inflow, through cavo-portal transposition. However, clinical results are heterogeneous and experimental studies are needed, but similar hemodynamic conditions are difficult to obtain, especially in small animals. Herein we describe a new simple model of cavo-portal transposition in rat. 相似文献106.
Background
Health service policy in the United Kingdom emphasises the importance of self-care by patients with chronic conditions. Written information for patients about their condition is seen as an important aid to help patients look after themselves. From a discourse analysis perspective written texts such as patient information leaflets do not simply describe the reality of a medical condition and its management but by drawing on some sorts of knowledge and evidence rather than others help construct the reality of that condition. This study explored patient information leaflets on osteoarthritis (OA) to see how OA was constructed and to consider the implications for self-care. 相似文献107.
108.
Ulrik Sartipy Anders Albåge Per Insulander Dan Lindblom 《Journal of interventional cardiac electrophysiology》2007,19(3):171-178
This article presents a review on the efficacy of surgical ventricular restoration and direct surgery for ventricular tachycardia
in patients with left ventricular aneurysm or dilated ischemic cardiomyopathy. The procedure includes a non-electrophysiologically
guided subtotal endocardiectomy and cryoablation in addition to endoventricular patch plasty of the left ventricle. Coronary
artery bypass surgery and mitral valve repair are performed concomitantly as needed. In our experience, this procedure yielded
a 90% success rate in terms of freedom from spontaneous ventricular tachycardia, with an early mortality rate of 3.8%. A practical
guide to the pre- and postoperative management of these patients is provided.
Electronic supplementary material The online version of this article (doi: ) contains supplementary material, which is available to authorized users. 相似文献
109.
Javairiah Fatima Scott G. Houghton Michael G. Sarr 《Journal of gastrointestinal surgery》2007,11(8):1052-1056
Small bowel transplantation (SBT) is associated with poorly understood enteric dysfunction. The study of SBT in mice is hindered
by the technical difficulty of orthotopic SBT in the mouse. Our aim was to develop an easy preparation of extrinsic denervation
of the entire jejunoileum in mice as a model of orthotopic SBT. All neurolymphatic tissues accompanying the superior mesenteric
artery (SMA) and vein (SMV) were ligated just distal to the middle colic vessels. The SMA and SMV were then stripped of investing
adventitia, and the mesentery to jejunum and colon were transected radially. Jejunum and colon were not transected and reanastomosed.
To confirm extrinsic denervation 1, 3, and 6 months later, segments of small bowel were stained for protein gene product 9.5
(PGP9.5) and tyrosine hydroxylase (TH). Tyrosine hydroxylase immunoreactive intensity was then quantified using a semiquantitative
analysis. Immunohistochemical fluorescence showed persistence of PGP9.5 immunoreactivity confirming enteric nerves in jejunoileum;
however, there was no TH immunoreactivity in jejunoileum in denervated mice despite the expected preservation of TH immunoreactivity
in the still-innervated duodenum at 1 month. At 3 months, sparse immunoreactivity for TH was present, and by 6 months, reinnervation
of TH-containing nerves appeared similar to controls. Quantification of intensity at each time-point further confirmed this
trend. This technique in the mouse accomplishes a complete extrinsic denervation of jejunoileum early postoperatively (1 and
3 months); reinnervation occurs by 6 months. This is an easily learned murine model of orthotopic SBT.
Presented at the American Gastroenterological Association during Digestive Disease Week in Los Angeles, CA, as a poster presentation
on May 23 2006. Abstract published in GastroenterologyE 2006; 130:A604. 相似文献
110.
Marcelo W. Hinojosa Zuri A. Murrell Viken R. Konyalian Steven Mills Ninh T. Nguyen Michael J. Stamos 《Journal of gastrointestinal surgery》2007,11(11):1423-1430
Few studies have examined outcomes of laparoscopic and open sigmoid colectomy performed at US academic centers. Using ICD-9
diagnosis and procedural codes, data was obtained from the University HealthSystem Consortium (UHC) Clinical Database of 10,603
patients who underwent laparoscopic or open sigmoid colectomy for benign and malignant disease between 2003–2006. A total
of 1,092 patients (10.3%) underwent laparoscopic sigmoid colectomy. Laparoscopic sigmoid colectomy was associated with a significantly
shorter length of stay (5.4 vs 7.4 days), lower overall complication rate (19.7 vs 26.0%), lower 30-day readmission rate (3.4
vs 4.6), and a lower hospital cost ($13,814 vs $15,626). When a subset analysis of malignant and benign groups was performed,
a significantly shorter length of stay in both the malignant laparoscopic group (6.4 ± 6.4 vs 7.8 ± 6.6 days) and in the benign
laparoscopic groups (5.1 ± 3.5 vs 7.2 ± 7.6) exists. A lower wound complication rate (2.1 vs 5.5%, malignant and 4.0 vs 6.1,
benign) is also evident. Laparoscopic sigmoid colectomy was associated with a shorter length of stay, less complications,
and a lower 30-day readmission rate. The shorter length of stay and wound infection rate maintain significance when comparing
laparoscopic vs open sigmoid resections for malignant and benign disease.
Presented at the 48th annual meeting of the Society for Surgery of the Alimentary Tract at Digestive Disease Weak, Washington,
DC, May 21st 2007.
The information contained in this article was based on the Clinical Data Base provided by the University HealthSystem Consortium. 相似文献