Morbidity and mortality in 1,174 patients undergoing hepatic parenchymal transection using a stapler device.

Abstract:

BACKGROUND:Transection of liver parenchyma using staplers is now commonly performed. Large studies are needed to assess the usefulness of the technique as well as perioperative outcomes. METHODS:This is a retrospective study of a prospectively maintained database. A total of 1,174 patients undergoing liver resections in routine surgical practice, using a stapler device at MD Anderson Cancer Center between January 1, 1994 and November 10, 2011 were evaluated. RESULTS:There were 900 major resections (3 segments or more) (77 %) and 274 minor resections (<3 segments or wedge resections) (23 %). A vast majority, 1,133 (96.5 %), were indicated for an underlying malignancy (24 % primary liver or gall bladder and 72.5 % metastatic) compared with benign disease, 41 (3.5 %), with the most common indication being metastatic colorectal cancer 584 (49.7 %). Of the total 1,174 patients 128 (10.9 %) had a prior liver resection. Median OR time and blood loss was 206 min and 300 mL, respectively, with 11 % of patients requiring transfusion in the perioperative or postoperative period. Overall morbidity and mortality rate was 14 and 3.2 %, respectively, with a median hospital stay of 7 days (interquartile range [IQR], 4 days). Multivariate logistic regression demonstrated blood loss and extent of liver resection to be independent predictors of adverse outcome. A total of 13 instances (1.1 %) of misfired staplers were noted and were associated with higher blood loss (p < 0.001) and mortality (15 vs. 3.1 %, p = 0.013). CONCLUSIONS:Use of stapler device for hepatic resection is safe and effective, but rare instances of a misfired stapler device are associated with an adverse outcome.

journal_name

Ann Surg Oncol

authors

Raoof M,Aloia TA,Vauthey JN,Curley SA

doi

10.1245/s10434-013-3331-9

subject

Has Abstract

pub_date

2014-03-01 00:00:00

pages

995-1001

issue

3

eissn

1068-9265

issn

1534-4681

journal_volume

21

pub_type

杂志文章
  • Metastasectomy for Tumor-Infiltrating Lymphocytes: An Emerging Operative Indication in Surgical Oncology.

    abstract::Adoptive cell transfer (ACT) of tumor-infiltrating lymphocytes (TILs) is an emerging immunotherapy for metastatic cancer. Surgeons play a central role in ACT treatments by performing resection of tumors from which TILs are isolated. It is important that surgeons have familiarity with this emerging treatment method bec...

    journal_title:Annals of surgical oncology

    pub_type: 杂志文章

    doi:10.1245/s10434-017-6266-8

    authors: Crompton JG,Klemen N,Kammula US

    更新日期:2018-02-01 00:00:00

  • A multicenter phase I dose escalation trial to evaluate safety and tolerability of intra-arterial temozolomide for patients with advanced extremity melanoma using normothermic isolated limb infusion.

    abstract:BACKGROUND:L-phenylalanine mustard (LPAM) has been the standard for use in regional chemotherapy (RC) for unresectable in-transit melanoma. Preclinical data demonstrated that regional temozolomide (TMZ) may be more effective. METHODS:Patients with AJCC Stage IIIB or IIIC extremity melanoma who failed previous LPAM-bas...

    journal_title:Annals of surgical oncology

    pub_type: 杂志文章,多中心研究

    doi:10.1245/s10434-014-3887-z

    authors: Beasley GM,Speicher P,Augustine CK,Dolber PC,Peterson BL,Sharma K,Mosca PJ,Royal R,Ross M,Zager JS,Tyler DS

    更新日期:2015-01-01 00:00:00

  • Implications of a postoperative rehabilitation program on quality of life in women with primary breast cancer treated with sentinel lymph node biopsy or complete axillary lymph node dissection.

    abstract:BACKGROUND:The aim of this clinical study was to evaluate quality of life (QoL) in early-stage breast cancer patients and to investigate the effects of a comprehensive rehabilitation program comparing women undergoing sentinel node biopsy (SNB) versus complete axillary lymph node dissection (ALND). QoL was assessed wit...

    journal_title:Annals of surgical oncology

    pub_type: 杂志文章,随机对照试验

    doi:10.1245/s10434-008-0161-2

    authors: Pinto e Silva MP,Sarian LO,Morais SS,Pace do Amaral MT,Freire de Oliveira MM,Derchain S

    更新日期:2008-12-01 00:00:00

  • Secretory carcinoma of the male breast.

    abstract:BACKGROUND:Secretory carcinoma is a distinctive and rare variant of breast carcinoma with a favorable prognosis because these tumors usually behave in an indolent manner. The occurrence of this type of breast cancer in males was studied. METHODS:An extensive literature survey concerning secretory breast cancer in male...

    journal_title:Annals of surgical oncology

    pub_type: 杂志文章,评审

    doi:10.1007/BF02574482

    authors: de Bree E,Askoxylakis J,Giannikaki E,Chroniaris N,Sanidas E,Tsiftsis DD

    更新日期:2002-08-01 00:00:00

  • Arteriolovenular shunting critically determines shutdown of microcirculation upon cryotherapy in tumor-bearing rat liver.

    abstract:BACKGROUND:Tissue destruction by cryosurgery not only is mediated by direct cell damage, but also involves secondary mechanisms, such as ischemia due to shutdown of the microcirculation. Clinicians favor repetitive cryoapplication, although there is no proven evidence for a more effective tumor eradication. METHODS:Th...

    journal_title:Annals of surgical oncology

    pub_type: 杂志文章

    doi:10.1245/ASO.2005.04.014

    authors: Richter S,Pistorius G,Seidel R,Feifel G,Schilling MK,Vollmar B,Menger MD

    更新日期:2005-04-01 00:00:00

  • Iliosacral resections of pelvic malignant tumors and reconstruction with nonvascular bilateral fibular autografts.

    abstract:BACKGROUND:Iliosacral resection of pelvic malignant tumors and subsequent reconstruction have tested the ingenuity of orthopedic oncologists because of the difficulty of oncological wide resection and the complex biomechanics of the sacroiliac joint render reconstruction challenging. This study compared the functional ...

    journal_title:Annals of surgical oncology

    pub_type: 杂志文章

    doi:10.1245/s10434-012-2339-x

    authors: Wang J,Tang Q,Xie X,Yin J,Zhao Z,Li Z,Zou C,Huang G,Shen J

    更新日期:2012-12-01 00:00:00

  • Association Between Waiting Time from Diagnosis to Treatment and Survival in Patients with Curable Gastric Cancer: A Population-Based Study in the Netherlands.

    abstract:BACKGROUND:In the Netherlands, a maximum waiting time from diagnosis to treatment (WT) of 5 weeks is recommended for curative cancer treatment. This study aimed to evaluate the association between WT and overall survival (OS) in patients undergoing gastrectomy for cancer. METHODS:This nationwide study included data fr...

    journal_title:Annals of surgical oncology

    pub_type: 杂志文章

    doi:10.1245/s10434-017-5820-8

    authors: Brenkman HJF,Visser E,van Rossum PSN,Siesling S,van Hillegersberg R,Ruurda JP

    更新日期:2017-07-01 00:00:00

  • Electrochemotherapy in the Treatment of Cutaneous Metastases from Breast Cancer: A Multicenter Cohort Analysis.

    abstract:BACKGROUND:The management of breast cancer (BC) skin metastases represents a therapeutic challenge. Electrochemotherapy (ECT) combines the administration of bleomycin with temporary permeabilization induced by locally administered electric pulses. Preliminary experience with ECT in BC patients is encouraging. METHODS:...

    journal_title:Annals of surgical oncology

    pub_type: 杂志文章,多中心研究

    doi:10.1245/s10434-015-4779-6

    authors: Cabula C,Campana LG,Grilz G,Galuppo S,Bussone R,De Meo L,Bonadies A,Curatolo P,De Laurentiis M,Renne M,Valpione S,Fabrizio T,Solari N,Guida M,Santoriello A,D'Aiuto M,Agresti R

    更新日期:2015-12-01 00:00:00

  • Neoadjuvant chemoradiotherapy affects the indications for lateral pelvic node dissection in mid/low rectal cancer with clinically suspected lateral node involvement: a multicenter retrospective cohort study.

    abstract:BACKGROUND:Although lateral pelvic node dissection (LPND) is recommended for rectal cancer with clinically metastatic lateral pelvic lymph nodes (LPNs), LPNs may respond to neoadjuvant chemoradiotherapy (nCRT). Our aim was to determine the optimal indication for LPND after nCRT for mid/low rectal cancer. METHODS:Of 2,...

    journal_title:Annals of surgical oncology

    pub_type: 杂志文章,多中心研究

    doi:10.1245/s10434-014-3559-z

    authors: Oh HK,Kang SB,Lee SM,Lee SY,Ihn MH,Kim DW,Park JH,Kim YH,Lee KH,Kim JS,Kim JW,Kim JH,Chang TY,Park SC,Sohn DK,Oh JH,Park JW,Ryoo SB,Jeong SY,Park KJ

    更新日期:2014-07-01 00:00:00

  • Cytoreductive Surgery Plus Hyperthermic Intraperitoneal Chemotherapy for Patients with Peritoneal Metastases from Endometrial Cancer.

    abstract:BACKGROUND:More information is needed for selection of patients with peritoneal metastases from endometrial cancer (EC) to undergo cytoreductive surgery (CRS) plus hyperthermic intraperitoneal chemotherapy (HIPEC). METHODS:This study analyzed clinical, pathologic, and treatment data for patients with peritoneal metast...

    journal_title:Annals of surgical oncology

    pub_type: 杂志文章,多中心研究

    doi:10.1245/s10434-017-6307-3

    authors: Cornali T,Sammartino P,Kopanakis N,Christopoulou A,Framarino Dei Malatesta M,Efstathiou E,Spagnoli A,Ciardi A,Biacchi D,Spiliotis J

    更新日期:2018-03-01 00:00:00

  • Shear wave elastography in evaluation of cervical lymph node metastasis of papillary thyroid carcinoma: elasticity index as a prognostic implication.

    abstract:PURPOSE:The aim of this study was to evaluate the usefulness of shear wave elastography (SWE) for predicting cervical lymph node (LN) metastasis and the prognostic implication of SWE as histopathologic factors of papillary thyroid carcinoma (PTC). METHODS:Eighty-four LNs of 66 patients with PTC underwent B-mode ultras...

    journal_title:Annals of surgical oncology

    pub_type: 杂志文章

    doi:10.1245/s10434-014-3627-4

    authors: Jung WS,Kim JA,Son EJ,Youk JH,Park CS

    更新日期:2015-01-01 00:00:00

  • Ratio between positive lymph nodes and total excised axillary lymph nodes as an independent prognostic factor for overall survival in patients with nonmetastatic lymph node-positive breast cancer.

    abstract:BACKGROUND:The status of the axillary lymph nodes in nonmetastatic lymph node-positive breast cancer (BC) patients remains the single most important determinant of overall survival (OS). Although the absolute number of nodes involved with cancer is important for prognosis, the role of the total number of excised nodes ...

    journal_title:Annals of surgical oncology

    pub_type: 临床试验,杂志文章

    doi:10.1245/s10434-009-0653-8

    authors: Hatoum HA,Jamali FR,El-Saghir NS,Musallam KM,Seoud M,Dimassi H,Abbas J,Khalife M,Boulos FI,Tawil AN,Geara FB,Salem Z,Shamseddine AA,Al-Feghali K,Shamseddine AI

    更新日期:2009-12-01 00:00:00

  • Clinicopathological Features and Outcomes in Individuals with Breast Cancer and ATM, CHEK2, or PALB2 Mutations.

    abstract:INTRODUCTION:The moderate-penetrance germline mutations ATM, CHEK2, and PALB2 are implicated in an increased risk of the development of breast cancer. Whether these mutations provide clinical utility to guide treatment strategies and prognosis remains unknown. METHODS:A retrospective case-control study from a tertiary...

    journal_title:Annals of surgical oncology

    pub_type: 杂志文章

    doi:10.1245/s10434-020-09158-2

    authors: Bergstrom C,Pence C,Berg J,Partain N,Sadeghi N,Mauer C,Pirzadeh-Miller S,Gao A,Li H,Unni N,Syed S

    更新日期:2020-09-29 00:00:00

  • Prognostic value of cytokeratin-positive bone marrow cells of gastric cancer patients.

    abstract:BACKGROUND:Epithelial cells in the bone marrow of patients with gastric cancer suggest tumor dissemination; however, their prognostic implications are controversial. We prospectively evaluated the correlation of bone marrow findings, recurrence rate, and disease-free survival after long-term follow-up. METHODS:Bone ma...

    journal_title:Annals of surgical oncology

    pub_type: 杂志文章

    doi:10.1245/s10434-006-9039-3

    authors: Gretschel S,Schick C,Schneider U,Estevez-Schwarz L,Bembenek A,Schlag PM

    更新日期:2007-02-01 00:00:00

  • Morbidity and mortality associated with gastrectomy for gastric cancer.

    abstract:BACKGROUND:Surgery alone is often inadequate for advanced-stage gastric cancer. Surgical complications may delay adjuvant therapy. Understanding these complications is needed for multidisciplinary planning. MATERIAL AND METHODS:The American College of Surgeons National Surgical Quality Improvement Program (ACS NSQIP) ...

    journal_title:Annals of surgical oncology

    pub_type: 杂志文章,多中心研究

    doi:10.1245/s10434-014-3664-z

    authors: Papenfuss WA,Kukar M,Oxenberg J,Attwood K,Nurkin S,Malhotra U,Wilkinson NW

    更新日期:2014-09-01 00:00:00

  • Trends in the surgical treatment of gastric adenocarcinoma.

    abstract:BACKGROUND:In past decade, the treatment of gastric adenocarcinoma has evolved as a result of the publication of two seminal randomized controlled trials. We aimed to examine treatment trends for resectable gastric cancer (stage I-III) using the National Cancer Data Base (NCDB). Our hypothesis was that the use of chemo...

    journal_title:Annals of surgical oncology

    pub_type: 杂志文章

    doi:10.1245/s10434-013-3314-x

    authors: Raigani S,Hardacre JM,Kim J,Ammori JB

    更新日期:2014-02-01 00:00:00

  • Prognostic index for extremity soft tissue sarcomas with isolated local recurrence.

    abstract:BACKGROUND:Local recurrence occurs in 10% to 20% of patients with extremity soft tissue sarcomas despite optimal treatment. The association of local recurrence with subsequent survival is controversial and conflicting. There is a need for a staging system to predict outcome in this subset of patients and also to plan o...

    journal_title:Annals of surgical oncology

    pub_type: 杂志文章

    doi:10.1007/s10434-001-0278-z

    authors: Ramanathan RC,A'Hern R,Fisher C,Thomas JM

    更新日期:2001-05-01 00:00:00

  • Hiatal Hernia After Open versus Minimally Invasive Esophagectomy: A Systematic Review and Meta-analysis.

    abstract::Hiatal hernia (HH) is an infrequent yet potentially life-threatening complication after esophagectomy. Several studies have reported the incidence of this complication after both open and minimally invasive esophagectomy (MIE). This meta-analysis aimed to determine the pooled incidence of HH after both types of esopha...

    journal_title:Annals of surgical oncology

    pub_type: 杂志文章,meta分析,评审

    doi:10.1245/s10434-016-5155-x

    authors: Oor JE,Wiezer MJ,Hazebroek EJ

    更新日期:2016-08-01 00:00:00

  • Prophylactic lymphadenectomy of neck level II in clinically node-positive papillary thyroid carcinoma.

    abstract:BACKGROUND:The purpose of this study was to examine the frequency, pattern, and predictive factors associated with occult level II lymph node (LN) metastases in papillary thyroid carcinoma (PTC) patients with clinically metastatic lymph nodes in the lateral neck (level III, IV, and/or V) by preoperative ultrasonography...

    journal_title:Annals of surgical oncology

    pub_type: 杂志文章

    doi:10.1245/s10434-010-0958-7

    authors: Koo BS,Seo ST,Lee GH,Kim JM,Choi EC,Lim YC

    更新日期:2010-06-01 00:00:00

  • Treatment of Inguinal Lymph Node Metastases in Patients with Rectal Adenocarcinoma.

    abstract:BACKGROUND:Inguinal lymph node metastases (ILNM) from rectal adenocarcinoma are rare and staged as systemic disease. This study aimed to provide insight into the treatment and prognosis of ILNM from rectal adenocarcinoma. METHODS:All patients with a diagnosis of synchronous or metachronous ILNM from rectal adenocarcin...

    journal_title:Annals of surgical oncology

    pub_type: 杂志文章

    doi:10.1245/s10434-019-07191-4

    authors: Hagemans JAW,Rothbarth J,van Bogerijen GHW,van Meerten E,Nuyttens JJME,Verhoef C,Burger JWA

    更新日期:2019-04-01 00:00:00

  • Prognostic and Predictive Value of the Peritoneal Cancer Index in Primary Advanced Epithelial Ovarian Cancer Patients After Complete Cytoreductive Surgery: Study of Tumor Bank Ovarian Cancer.

    abstract:PURPOSE:The peritoneal cancer index (PCI) is used to refer gastrointestinal malignancy patients to either palliative or curative management of their peritoneal carcinomatosis. The aim of this retrospective study was to evaluate the prognostic value of the PCI in patients with primary advanced epithelial ovarian cancer ...

    journal_title:Annals of surgical oncology

    pub_type: 杂志文章

    doi:10.1245/s10434-014-4329-7

    authors: Gasimli K,Braicu EI,Richter R,Chekerov R,Sehouli J

    更新日期:2015-08-01 00:00:00

  • High Expression of the Mitophagy-Related Protein Pink1 is Associated with a Poor Response to Chemotherapy and a Poor Prognosis for Patients Treated with Neoadjuvant Chemotherapy for Esophageal Squamous Cell Carcinoma.

    abstract:BACKGROUND:Autophagy plays a major role in cellular homeostasis and is implicated in cancer progression. Damaged mitochondria are scavenged and eliminated by mitochondrial autophagy, referred to as mitophagy, which can promote cancer cell survival. This study investigated the expression and effects of the autophagy-rel...

    journal_title:Annals of surgical oncology

    pub_type: 杂志文章

    doi:10.1245/s10434-017-6096-8

    authors: Yamashita K,Miyata H,Makino T,Masuike Y,Furukawa H,Tanaka K,Miyazaki Y,Takahashi T,Kurokawa Y,Yamasaki M,Nakajima K,Takiguchi S,Morii E,Mori M,Doki Y

    更新日期:2017-12-01 00:00:00

  • Validation of lymphatic mapping in colorectal cancer: in vivo, ex vivo, and laparoscopic techniques.

    abstract:BACKGROUND:The use of lymphatic mapping (LM) is being investigated to improve the staging of colorectal cancer (CRC) and thereby identify patients who might benefit from adjuvant chemotherapy. This study evaluated in vivo, laparoscopic, and ex vivo approaches for the ultrastaging of CRC. METHODS:Seventy-five CRC patie...

    journal_title:Annals of surgical oncology

    pub_type: 杂志文章

    doi:10.1007/s10434-001-0150-1

    authors: Wood TF,Saha S,Morton DL,Tsioulias GJ,Rangel D,Hutchinson W Jr,Foshag LJ,Bilchik AJ

    更新日期:2001-03-01 00:00:00

  • Population-Based Study on Risk Factors for Tumor-Positive Resection Margins in Patients with Gastric Cancer.

    abstract:BACKGROUND:Radical gastrectomy is the cornerstone of the treatment of locally advanced gastric cancer. This study was designed to evaluate factors associated with a tumor-positive resection margin after gastrectomy and to evaluate the influence of hospital volume. METHODS:In this Dutch cohort study, patients with junc...

    journal_title:Annals of surgical oncology

    pub_type: 杂志文章

    doi:10.1245/s10434-019-07381-0

    authors: van der Werf LR,Cords C,Arntz I,Belt EJT,Cherepanin IM,Coene PLO,van der Harst E,Heisterkamp J,Langenhoff BS,Lamme B,van Berge Henegouwen MI,Lagarde SM,Wijnhoven BPL

    更新日期:2019-07-01 00:00:00

  • Epidermal growth factor-containing fibulin-like extracellular matrix protein 1, EFEMP1, a novel tumor-suppressor gene detected in hepatocellular carcinoma using double combination array analysis.

    abstract:BACKGROUND:Although hepatocellular carcinoma (HCC) is one of the commonest cancers worldwide, the underlying molecular mechanisms contributing to hepatocarcinogenesis are still not clear. METHODS:In this study, we performed double array analysis, consisting of both expression profiling and karyotyping analysis using s...

    journal_title:Annals of surgical oncology

    pub_type: 杂志文章

    doi:10.1245/s10434-009-0790-0

    authors: Nomoto S,Kanda M,Okamura Y,Nishikawa Y,Qiyong L,Fujii T,Sugimoto H,Takeda S,Nakao A

    更新日期:2010-03-01 00:00:00

  • Effect of Extending the Original CROSS Criteria on Tumor Response to Neoadjuvant Chemoradiotherapy in Esophageal Cancer Patients: A National Multicenter Cohort Analysis.

    abstract:BACKGROUND:Extending the original criteria of the Chemoradiotherapy for Oesophageal Cancer followed by Surgery Study (CROSS) in daily practice may increase the treatment outcome of esophageal cancer (EC) patients. This retrospective national cohort study assessed the impact on the pathologic complete response (pCR) rat...

    journal_title:Annals of surgical oncology

    pub_type: 杂志文章

    doi:10.1245/s10434-020-09372-y

    authors: Wang HH,de Heer EC,Hulshoff JB,Kats-Ugurlu G,Burgerhof JGM,van Etten B,Plukker JTM,Hospers GAP,Dutch Upper Gastrointestinal Cancer Audit (DUCA) Group.

    更新日期:2020-11-28 00:00:00

  • Age as a prognostic factor in patients with localized melanoma and regional metastases.

    abstract:BACKGROUND:We postulated that the worse prognosis of melanoma with advancing age reflected more aggressive tumor biology and that in younger patients the prognosis would be more favorable. MATERIALS AND METHODS:The expanded AJCC melanoma staging database contained 11,088 patients with complete data for analysis, inclu...

    journal_title:Annals of surgical oncology

    pub_type: 杂志文章,多中心研究

    doi:10.1245/s10434-013-3100-9

    authors: Balch CM,Soong SJ,Gershenwald JE,Thompson JF,Coit DG,Atkins MB,Ding S,Cochran AJ,Eggermont AM,Flaherty KT,Gimotty PA,Johnson TM,Kirkwood JM,Leong SP,McMasters KM,Mihm MC Jr,Morton DL,Ross MI,Sondak VK

    更新日期:2013-11-01 00:00:00

  • Assessing medical students' and surgery residents' clinical competence in problem solving in surgical oncology.

    abstract:BACKGROUND:We sought to determine the competence of medical students and surgery residents in evaluating clinical problems (using both real and simulated patients) in surgical oncology. METHODS:Forty-five third-year medical students, 23 first postgraduate year (PGY-1) residents, and seven second postgraduate year (PGY...

    journal_title:Annals of surgical oncology

    pub_type: 杂志文章

    doi:10.1007/BF02303525

    authors: Sloan DA,Donnelly MB,Schwartz RW,Munch LC,Wells MD,Johnson SB,Strodel WE

    更新日期:1994-05-01 00:00:00

  • Isolated Limb Perfusion for Melanoma is Safe and Effective in Elderly Patients.

    abstract:BACKGROUND:Data on isolated limb perfusion (ILP) in elderly melanoma patients are scarce. We aimed to evaluate the efficacy and safety of ILP in our institutional cohort of melanoma patients. METHODS:We performed retrospective analysis of stage IIIB/C melanoma patients who underwent ILP for melanoma in-transit metasta...

    journal_title:Annals of surgical oncology

    pub_type: 杂志文章

    doi:10.1245/s10434-017-5803-9

    authors: Madu MF,Deken MM,van der Hage JA,Jóźwiak K,Wouters MWJM,van Akkooi ACJ

    更新日期:2017-07-01 00:00:00

  • Long-Term Outcomes of Local Excision Following Neoadjuvant Chemoradiotherapy for Locally Advanced Rectal Cancer.

    abstract:BACKGROUND:Local excision might represent an alternative to total mesorectal excision for patients with locally advanced rectal cancer who achieve a major or complete clinical response after neoadjuvant chemoradiotherapy. METHODS:Between August 2005 and July 2011, 63 patients with mid-low rectal adenocarcinoma who had...

    journal_title:Annals of surgical oncology

    pub_type: 杂志文章

    doi:10.1245/s10434-020-09243-6

    authors: D'Alimonte L,Bao QR,Spolverato G,Capelli G,Del Bianco P,Albertoni L,De Paoli A,Guerrieri M,Mantello G,Gambacorta MA,Canzonieri V,Valentini V,Coco C,Pucciarelli S

    更新日期:2020-10-30 00:00:00