Abstract:
:Although pancreatectomy is still performed in a few patients with pancreatic cancer, and nearly all patients who develop pancreatic cancer eventually die of their disease, significant improvements have been made recently. Pancreatectomy is now safer, with major morbidity (hemorrhage, pancreatic anastomotic leak, intraabdominal sepsis) occurring in only about 20% and operative mortality of less than 5%. Two (seemingly subtle) issues cannot be overemphasized when someone carefully studies the literature: (1) There is a crucial difference between actuarial and actual survival, with the former generally being higher whereas the latter is true; and (2) careful re-review of pathologic specimens (especially in long-term survivors) initially diagnosed as pancreatic cancer, preferably by an independent pathologist before publishing long-term results is essential. (Erroneous inclusion of patients with nonductal carcinoma substantially and artificially increases survival.) After curative resection, 5-year actual survival is realistically about 10% with median survivals of 12 to 18 months. In certain subgroups with favorable pathologic characteristics (neoplasms <2 cm without nodal or perineural invasion) the prognosis appears to be significantly better, with the 5-year survival about 20%. The recent improvements in postoperative morbidity and mortality and long-term outcome (resulting also in decreased cost of care of such patients) have occurred typically in centers with an invested interest in and proven record with pancreatic surgery. Further improvements in survival should be sought at the areas of earlier diagnosis and novel treatments designed to prevent locoregional recurrences; the role of extended resections must be determined by prospective, randomized trials.
journal_name
World J Surgjournal_title
World journal of surgeryauthors
Tsiotos GG,Farnell MB,Sarr MGdoi
10.1007/s002689900599keywords:
subject
Has Abstractpub_date
1999-09-01 00:00:00pages
913-9issue
9eissn
0364-2313issn
1432-2323pii
5324journal_volume
23pub_type
杂志文章abstract:BACKGROUND:The goal of this study was to evaluate the outcome of patients who had the Nuss procedure for repair of pectus excavatum. METHODS:Thirty-nine patients (26 male, 13 female) of 61 (63.9%) who had bar removal after the Nuss procedure agreed to participate in an interview. All patients and their parents were as...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/s00268-011-1111-x
更新日期:2011-07-01 00:00:00
abstract:BACKGROUND:Liver transplantation for biliary atresia is indicated whenever a Kasai portoenterostomy is considered unfeasible. However, the timing of liver transplantation in biliary atresia has not been precisely defined. Excessive shortening of hepatocellular telomeres may occur in patients with biliary atresia, and t...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/s00268-012-1453-z
更新日期:2012-04-01 00:00:00
abstract::Herniographic examinations were performed on more than 4,000 patients. The method was found to be of great value in patients with obscure symptoms in the groin or pelvis. Herniography shows not only hernial sacs but also the general condition and tissue strength of the inguinal part of the abdominal wall. The differen...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/BF01658871
更新日期:1989-09-01 00:00:00
abstract:BACKGROUND:The open abdomen (OA) is commonly utilized as a technique during damage control laparotomy (DCL). We propose that a selected group of these OA patients can be extubated prior to abdominal closure to decrease ventilator days and risk of pneumonia. METHODS:A retrospective chart review was performed at a Level...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/s00268-018-4610-1
更新日期:2018-10-01 00:00:00
abstract:: ...
journal_title:World journal of surgery
pub_type: 评论,信件
doi:10.1007/s00268-018-4704-9
更新日期:2019-03-01 00:00:00
abstract:BACKGROUND:With the progressive use of new diagnostic techniques, the management of penetrating abdominal stab wounds is changing. Most studies have been conducted in well-equipped trauma centers in developed countries, and there is a paucity of reports from general teaching hospitals with limited resources. We reviewe...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/s00268-013-1931-y
更新日期:2013-05-01 00:00:00
abstract:BACKGROUND:Intra-abdominal adhesions constitute between 49% and 74% of the causes of small bowel obstruction. Traditionally, laparotomy and open adhesiolysis have been the treatment for patients who have failed conservative measures or when clinical and physiologic derangements suggest toxemia and/or ischemia. With the...
journal_title:World journal of surgery
pub_type: 杂志文章,评审
doi:10.1007/s00268-005-7778-0
更新日期:2006-04-01 00:00:00
abstract:BACKGROUND:Acute appendicitis is the most common reason for abdominal surgery in young adults and children. Open appendectomy is still the treatment often chosen because it is simple, safe, and effective. Our aim was to study whether cosmetic results of appendectomy wounds are better after using continuous absorbable i...
journal_title:World journal of surgery
pub_type: 杂志文章,随机对照试验
doi:10.1007/s00268-013-2396-8
更新日期:2014-05-01 00:00:00
abstract:BACKGROUND:Thoracoscopic repair of esophageal atresia is considered to be one of the more advanced pediatric surgical procedures, and it undoubtedly has a learning curve. This is a single-center study that was designed to determine the learning curve of thoracoscopic repair of esophageal atresia. METHODS:The study inv...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/s00268-012-1651-8
更新日期:2012-09-01 00:00:00
abstract:BACKGROUND:Emerging evidences have gradually revealed the skeletal muscle attenuation (MA) was not only reflected the accumulation of lipids in skeletal muscle but also associated with physiological and pathological states. The aim of this study was to evaluate the impact of MA on the prognosis of pancreatic cancer pat...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/s00268-015-3205-3
更新日期:2015-12-01 00:00:00
abstract::Numerous clinicopathologic factors have been reported to have prognostic significance for gastrointestinal cancer. Many problems, however, confront the surgeon assessing the extent of disease and the clinical and molecular pathologist distinguishing differences in tumor differentiation, behavior, and defining importan...
journal_title:World journal of surgery
pub_type: 杂志文章,评审
doi:10.1007/BF00308623
更新日期:1995-03-01 00:00:00
abstract::In the original article, Mehreen K. Bhettani's last name and Mubarik Rehman's first name are misspelled. ...
journal_title:World journal of surgery
pub_type: 杂志文章,已发布勘误
doi:10.1007/s00268-019-05334-y
更新日期:2020-06-01 00:00:00
abstract:BACKGROUND:Medullary thyroid carcinoma (MTC) accounts only for 1.4% of all thyroid malignancies in Japan. Since 1996, we have performed hemithyroidectomy, instead of total thyroidectomy, for sporadic nonhereditary MTC when the primary lesion is located in only one lobe. Regarding lymph node dissection, modified radical...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/s00268-008-9795-2
更新日期:2009-01-01 00:00:00
abstract:BACKGROUND:Postoperative outcome prediction in elderly is based on preoperative physical status but its predictive value is uncertain. The goal was to evaluate the value of risk assessment performed perioperatively in predicting outcome in case of admission to an intensive care unit (ICU). METHODS:A total of 108 posts...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/s00268-020-05742-5
更新日期:2020-12-01 00:00:00
abstract:BACKGROUND:Hernia is especially prevalent in developing countries where the population is obliged to undertake strenuous work in order to survive, and International Cooperation Programmes are helping to solve this problem. However, the quality of surgical interventions is unknown. The objective of the present study was...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/s00268-012-1768-9
更新日期:2012-12-01 00:00:00
abstract::This retrospective study reports our experience managing 78 patients with adenocarcinoma of the esophagus and gastroesophageal junction operated between January 1982 and December 1996. Altogether 18 patients presented with stage I and II disease, and 60 patients had stage III and IV disease at presentation; 56 patient...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/pl00013179
更新日期:1999-03-01 00:00:00
abstract:BACKGROUND:Inguinal hernia repair is the most common elective procedure in general surgery. Therefore, the number of patients having complications related to inguinal hernia surgery is relatively large. The aim of this study was to compare complication profiles of inguinal open mesh (OM) hernioplasties with open non-me...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/s00268-015-3028-2
更新日期:2015-08-01 00:00:00
abstract::The effects of splenectomy in 41 patients managed from 1982 to 1995 at Sher-i-Kashmir Institute of Medical Sciences, Srinagar (Jammu and Kashmir), India, were studied. Immune thrombocytopenic purpura (ITP) was the main indication for therapeutic splenectomy among all the hematologic disorders. The mean age was 30 year...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/s002689910017
更新日期:2000-01-01 00:00:00
abstract:INTRODUCTION:Covid-19 has had a significant impact on all aspects of health care. We aimed to characterise the trends in emergency general surgery at a district general hospital in Scotland. METHODS:A prospective cohort study was performed from 23/03/20 to 07/05/20. All emergency general surgery patients were included...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/s00268-020-05760-3
更新日期:2020-11-01 00:00:00
abstract:BACKGROUND:Medullary thyroid carcinoma (MTC) originates from calcitonin-producing cells of the thyroid. In 2009, we published our first report on the biological characteristics and prognosis of 118 MTC patients. Herein, we enrolled a larger number of patients with longer follow-up periods to further study the biologica...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/s00268-018-4738-z
更新日期:2018-12-01 00:00:00
abstract:BACKGROUND:Recently, diagnostic criteria for malnutrition have been proposed by the European Society for Clinical Nutrition and Metabolism (ESPEN). This study aimed to investigate the utility of the ESPEN malnutrition criteria as a predictor for major complications following hepatectomy and pancreatectomy. METHODS:Dat...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/s00268-020-05767-w
更新日期:2021-01-01 00:00:00
abstract:BACKGROUND:Insertion of a nasogastric tube (NGT) in an anesthetized, paralyzed, and intubated patient is difficult, and many methods have been proposed to aid in the procedure. We present a simple insertion technique. METHODS:A silicone NGT was made rigid by filling it with distilled water and freezing it. Patients we...
journal_title:World journal of surgery
pub_type: 杂志文章,随机对照试验
doi:10.1007/s00268-009-0144-x
更新日期:2009-09-01 00:00:00
abstract:BACKGROUND:Surgery is increasingly recognized as a means to reduce the morbidity and mortality of disabling impairments in resource-limited environments. We sought to estimate the burden of surgically correctable disabling impairments and the cost-effectiveness of their treatment among children in a large refugee camp....
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/s00268-012-1899-z
更新日期:2013-07-01 00:00:00
abstract:BACKGROUND:The aims of this study were to investigate predictive factors for microscopic portal venous invasion (mPVI) in hepatocellular carcinoma (HCC) and whether anatomical liver resection (ALR) was useful in such cases. METHODS:We analyzed 852 patients with HCC without macroscopic portal venous invasion who were t...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/s00268-017-3964-0
更新日期:2017-08-01 00:00:00
abstract:PURPOSE:The prognosis for stage III melanoma patients is mixed, and there is need for new prognostic factors to be incorporated into a revision of melanoma TNM staging. We analyzed the possible role of the timing of lymph node involvement as an important prognostic factor. METHODS:Among 249 melanoma patients who under...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/s00268-008-9895-z
更新日期:2009-03-01 00:00:00
abstract:BACKGROUND:Enhanced Recovery After Surgery (ERAS®) Society guidelines integrate evidence-based practices into multimodal care pathways that have improved outcomes in multiple adult surgical specialties. There are currently no pediatric ERAS® Society guidelines. We created an ERAS® guideline designed to enhance quality ...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/s00268-020-05530-1
更新日期:2020-08-01 00:00:00
abstract::The combination of conventional traumatic injuries and radiation exposure has synergistic consequences, the full extent of which may take days to weeks to become apparent. Our understanding of such is derived from a variety of laboratory and clinical scenarios involving both therapeutic and accidental exposures. When ...
journal_title:World journal of surgery
pub_type: 杂志文章,评审
doi:10.1007/BF02066992
更新日期:1992-09-01 00:00:00
abstract::One hundred years ago, Edoardo Bassini said: "L'ernia é una malattia meccanica." Before that, Ambroise Paré (1598) and Joseph-Pierre Desault (1798) asserted the mechanical nature of strangulation. Beside strangulation, the most serious of all complications even today, I have studied huge hernias, which are natural com...
journal_title:World journal of surgery
pub_type: 杂志文章,评审
doi:10.1007/BF01658869
更新日期:1989-09-01 00:00:00
abstract::Mesosigmoidoplasty is a nonresective procedure for nongangrenous sigmoid volvulus. It aims to correct the main pathogenetic factor of this condition, the narrow but long mesosigmoid. Although it had been demonstrated by intraoperative measurements that this has indeed achieved its purpose, recurrent volvulus has been ...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/s00268-003-7010-z
更新日期:2003-12-01 00:00:00
abstract:BACKGROUND:We analyzed perioperative platelet counts as a potential clinical marker for survival after transthoracic en bloc resection for esophageal cancer. Recent data described preoperative thrombocytosis in malignancies to be associated with poor prognosis. METHODS:A retrospective analysis from a prospective datab...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/s00268-010-0707-x
更新日期:2010-11-01 00:00:00