Surgery annual最新文献

Fractures of the Distal Radius 桡骨远端骨折

Surgery annual Pub Date : 1996-01-01 DOI: 10.1007/978-1-4684-0478-4

D. Fernandez, J. Jupiter

引用次数: 207

Nutrition and Immune Function 营养与免疫功能

Surgery annual Pub Date : 1995-01-25 DOI: 10.1201/9781482277722-13

Torosian

引用次数: 1

Three-dimensional manometric imaging of the lower esophageal sphincter. 食管下括约肌三维测压成像。

Surgery annual Pub Date : 1995-01-01

H J Stein, P F Crookes, T R DeMeester

{"title":"Three-dimensional manometric imaging of the lower esophageal sphincter.","authors":"H J Stein, P F Crookes, T R DeMeester","doi":"","DOIUrl":"","url":null,"abstract":"The lower esophageal sphincter provides a pressure barrier between the negative intrathoracic and positive intra-abdominal pressure environment. The resistance of the lower esophageal sphincter to reflux of gastric juice is determined by the integrated effects of radial pressures exerted over the entire length of the sphincter. This can be best quantitated by manometry with radially oriented pressure transducers and calculation of the SPVV (ie, the volume of the 3D sphincter pressure image). Validation studies have shown that the SPVV is superior to standard parameters of sphincter strength (ie, sphincter resting pressure, overall length, and abdominal length) and improves the identification of patients that will benefit from an anti-reflux procedure. This is particularly so in patients with subtle sphincter defects and patients with increased esophageal acid exposure and no mucosal injury on endoscopy. In addition, asymmetry of the sphincter that may contribute to incompetence of the cardia can only be detected by 3D manometric sphincter imaging. The effect of an anti-reflux procedure in controlling reflux is dependent on restoration of the defective 3D sphincter pressure image. Failure to do so is associated with recurrent or persistent reflux. 3D sphincter imaging can also illustrate the severely asymmetric and hypertensive sphincter in patients with achalasia and the effect of myotomy with or without a concomitant anti-reflux procedure on the sphincter pressure profile.","PeriodicalId":76570,"journal":{"name":"Surgery annual","volume":"27 ","pages":"199-214"},"PeriodicalIF":0.0,"publicationDate":"1995-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"18603044","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Gastroesophageal reflux in children. 儿童胃食管反流

Surgery annual Pub Date : 1995-01-01

C E Bagwell

{"title":"Gastroesophageal reflux in children.","authors":"C E Bagwell","doi":"","DOIUrl":"","url":null,"abstract":"Whereas all of these surgical modifications and new approaches are somewhat preliminary and have yet to achieve widespread clinical application, they illustrate an awareness of shortcomings in the present operative management of reflux as well as a gradual disenchantment with complications seen in many children, especially the neurologically impaired. However, the final analysis of surgical treatment for these children should not be viewed in an overly pessimistic light. Strategies for management of gastroesophageal reflux remain multifaceted, and operative intervention has a laudable role in the relief of symptoms for many afflicted children. However, the child's presentation and symptomatology should be predominant in planning therapy, operative or otherwise. It is the goal of this review to point out several points in this respect: 1. The diagnosis of gastroesophageal reflux may be difficult to pinpoint. 2. Multiple tests for reflux may offer conflicting results. 3. Clinical presentations associated with reflux do respond to treatment, which may include operative intervention. 4. The risks of anti-reflux procedures are greater than have been previously recognized, especially in the chronically ill and neurologically impaired child. 5. New approaches offer some promise to lower the risks of complications inherent in operative treatment of pathologic gastroesophageal reflux. 6. The best management plan for surgical treatment of reflux in children is evolving with less of a conviction for \"prophylactic\" fundoplication procedures, especially in the neurologically impaired child, and there is a recognition that underlying motility disorders may require modification of the operative approach or even the decision to operate. It is only through an awareness of the significant benefits as well as the considerable risks of operative treatment that the contemporary surgeon can best serve the interests of a child with gastroesophageal reflux. It is hoped that these guidelines will be helpful in this regard.","PeriodicalId":76570,"journal":{"name":"Surgery annual","volume":"27 ","pages":"133-63"},"PeriodicalIF":0.0,"publicationDate":"1995-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"18603040","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Carotid endarterectomy. Management of transient ischemic attack and asymptomatic carotid stenosis. 颈动脉内膜切除手术。短暂性脑缺血发作和无症状颈动脉狭窄的处理。

Surgery annual Pub Date : 1995-01-01

R Barry, S P Grobler, C J Nel

引用次数: 0

Pelvic fracture hemorrhage. Current strategies in diagnosis and management. 骨盆骨折出血。当前的诊断和管理策略。

Surgery annual Pub Date : 1995-01-01

J J Berger, L D Britt

引用次数: 0

Rectovaginal fistula. 直肠阴道瘘。

Surgery annual Pub Date : 1995-01-01

R D Fry, I J Kodner