Abstract:
Purpose:Anastomotic leakage is a major surgical complication following esophagectomy and gastric pull-up. Specific risk factors such as celiac trunk (TC) stenosis and high calcification score of the aorta have been identified, but no data are available on their relative prognostic values. This retrospective study aimed to compare and evaluate calcification score versus stenosis quantification with regards to prognostic impact on anastomotic leakage. Patients and methods:Preoperative contrast-enhanced computed tomography scans of 164 consecutive patients with primary esophageal cancer were evaluated by two radiologists to apply a calcification score (0-3 scale) assessing the aorta, the celiac axis and the right and left postceliac arteries. Concurrently, the presence and degree of stenosis of TC and superior mesenteric artery were recorded for stenosis quantification. Results:Anastomotic leakage was noted in 14/164 patients and 12/14 showed stenosis of TC (n=11). The presence of TC stenosis was found to have a significant impact on anastomotic healing (p=0.004). The odds ratio for the prediction of anastomotic leakage by the degree of stenosis was 1.04 (95% CI, 1.02-1.07). Ten of 14 patients had aortic calcification scores of 1 or 2, but calcification scores of the aorta, the celiac axis and the right and left postceliac arteries did not correlate with the corresponding TC stenosis values and showed no influence on patient outcome as defined by the occurrence of anastomotic insufficiency (p=0.565, 0.855, 0.518 and 1.000, respectively). Inter-reader reliability of computed tomography analysis and absolute agreement on calcium scoring was mostly over 90%. No significant differences in preoperative comorbidities and patient characteristics were found between those with and without anastomotic leakage. Conclusion:Measurement of TC stenosis in preoperative contrast-enhanced computed tomography scans proved to be more reliable than calcification scores in predicting anastomotic leakage and should, therefore, be used in the risk assessment of patients undergoing esophagectomy and gastric pull-up.
journal_name
Ther Clin Risk Managjournal_title
Therapeutics and clinical risk managementauthors
Chang DH,Brinkmann S,Smith L,Becker I,Schroeder W,Hoelscher AH,Haneder S,Maintz D,Spiro JEdoi
10.2147/TCRM.S157352subject
Has Abstractpub_date
2018-04-17 00:00:00pages
721-727eissn
1176-6336issn
1178-203Xpii
tcrm-14-721journal_volume
14pub_type
杂志文章abstract:Background:Hyperparathyroidism is a frequent endocrine disorder with variable clinical manifestations and outcomes. We aimed to evaluate clinical presentations, management and outcomes of hyperparathyroidism. Methods:A retrospective study was conducted to include all patients presented with hyperparathyroidism between...
journal_title:Therapeutics and clinical risk management
pub_type: 杂志文章
doi:10.2147/TCRM.S160896
更新日期:2018-07-31 00:00:00
abstract::Parkinson's disease (PD) is a progressive neurodegenerative, dopamine deficiency disorder. The main therapeutic strategies for PD treatment relies on dopamine precursors (levodopa), inhibition of dopamine metabolism (monoamine oxidase [MAO] B and catechol-O-methyl transferase inhibitors), and dopamine receptor agonist...
journal_title:Therapeutics and clinical risk management
pub_type: 杂志文章
doi:
更新日期:2007-06-01 00:00:00
abstract::[This corrects the article on p. 741 in vol. 14, PMID: 29719401.]. ...
journal_title:Therapeutics and clinical risk management
pub_type: 已发布勘误
doi:10.2147/TCRM.S177217
更新日期:2018-06-26 00:00:00
abstract::Treatment of HIV-1 infection has produced dramatic success for many patients. Nevertheless, viral resistance continues to limit the efficacy of currently available agents in many patients. The CCR5 antagonists are a new class of antiretroviral agents that target a necessary coreceptor for viral entry of many strains o...
journal_title:Therapeutics and clinical risk management
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doi:10.2147/tcrm.s1997
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journal_title:Therapeutics and clinical risk management
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pub_type: 杂志文章,评审
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journal_title:Therapeutics and clinical risk management
pub_type: 杂志文章
doi:10.2147/TCRM.S37785
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journal_title:Therapeutics and clinical risk management
pub_type: 杂志文章,评审
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journal_title:Therapeutics and clinical risk management
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更新日期:2010-10-21 00:00:00
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journal_title:Therapeutics and clinical risk management
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doi:10.2147/TCRM.S41131
更新日期:2013-01-01 00:00:00
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journal_title:Therapeutics and clinical risk management
pub_type: 杂志文章
doi:10.2147/TCRM.S78124
更新日期:2015-02-16 00:00:00
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journal_title:Therapeutics and clinical risk management
pub_type: 杂志文章
doi:10.2147/TCRM.S202454
更新日期:2019-06-11 00:00:00
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journal_title:Therapeutics and clinical risk management
pub_type: 杂志文章
doi:10.2147/TCRM.S199630
更新日期:2019-06-04 00:00:00
abstract::[This corrects the article on p. 19 in vol. 12, PMID: 26730198.]. ...
journal_title:Therapeutics and clinical risk management
pub_type: 已发布勘误
doi:10.2147/TCRM.S105169
更新日期:2016-03-10 00:00:00
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journal_title:Therapeutics and clinical risk management
pub_type: 杂志文章
doi:10.2147/tcrm.1.2.107.62910
更新日期:2005-06-01 00:00:00
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journal_title:Therapeutics and clinical risk management
pub_type:
doi:10.2147/TCRM.S99987
更新日期:2016-05-11 00:00:00
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journal_title:Therapeutics and clinical risk management
pub_type: 杂志文章
doi:10.2147/TCRM.S241216
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journal_title:Therapeutics and clinical risk management
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journal_title:Therapeutics and clinical risk management
pub_type: 杂志文章,评审
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journal_title:Therapeutics and clinical risk management
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doi:10.2147/tcrm.s821
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journal_title:Therapeutics and clinical risk management
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doi:10.2147/tcrm.s1265
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journal_title:Therapeutics and clinical risk management
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更新日期:2018-12-05 00:00:00
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journal_title:Therapeutics and clinical risk management
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更新日期:2020-04-17 00:00:00
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journal_title:Therapeutics and clinical risk management
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更新日期:2015-02-27 00:00:00
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journal_title:Therapeutics and clinical risk management
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更新日期:2020-05-19 00:00:00
abstract:AIM:To compare the long-term survival outcomes of radiofrequency ablation and liver resection for single very early/early stage hepatocellular carcinoma (HCC). METHODS:The Cochrane Library (Issue 3, 2015), Embase (1974 to March 15, 2015), PubMed (1950 to March 15, 2015), Web of Science (1900 to March 15, 2015), and Ch...
journal_title:Therapeutics and clinical risk management
pub_type: 杂志文章,评审
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更新日期:2016-02-23 00:00:00
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journal_title:Therapeutics and clinical risk management
pub_type: 杂志文章
doi:10.2147/tcrm.s4029
更新日期:2009-02-01 00:00:00
abstract::The antiresorptive drug elcatonin (ECT) is known to relieve pain in postmenopausal women with osteoporosis. A prospective open-labeled trial was conducted to compare the effects of short-term combined treatment with alendronate (ALN) and ECT on bone mineral density (BMD) and bone turnover with those of single treatmen...
journal_title:Therapeutics and clinical risk management
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doi:10.2147/tcrm.s5982
更新日期:2009-06-01 00:00:00
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journal_title:Therapeutics and clinical risk management
pub_type:
doi:10.2147/TCRM.S147056
更新日期:2017-09-05 00:00:00