Abstract:
BACKGROUND:The prediction of postoperative liver function remains a largely subjective practice based on CT volumetric analysis. However, future liver volume after a hepatectomy is not the only factor that contributes to postoperative liver function and outcomes. STUDY DESIGN:In this prospective trial, 185 consecutive patients who underwent liver operations between 2014 and 2015 were studied. Volumetric and functional rates of remnant liver were measured using technetium 99m-galactosyl human serum albumin single-photon emission computed tomography/CT fusion imaging to evaluate post-hepatectomy remnant liver function. Remnant indocyanine green clearance rate using galactosyl (KGSA) (KGSA × functional rate) was used to predict future remnant liver function. Hepatectomy was considered safe for patients with remnant KGSA values ≥0.05, and the primary end point was to determine the accuracy and reliability of this criteria. The prediction of the 90-day major complication and mortality rates was assessed. RESULTS:Median hospital stay was 9 days and median ICU stay was 1 day, with only 1 in-hospital death (90-day mortality rate 0.5%). Overall morbidity rate evaluated according to the Clavien-Dindo classification was 9%. For post-hepatectomy liver failure definitions, the International Study Group of Liver Surgery definition was fulfilled in 14 patients (8%), with the majority being grade B (50%), compared with 2 patients (1%) fulfilling the "50-50" criteria, and 0 patients (0%) fulfilling the PeakBili >7 criteria. CONCLUSIONS:Results of this study showed that remnant KGSA provided information that allowed us to predict remnant liver function. This information will be important for surgeons when deciding on a treatment plan for patients with liver diseases. (ClinicalTrials.gov ID: NCT02013895).
journal_name
J Am Coll Surgjournal_title
Journal of the American College of Surgeonsauthors
Okabayashi T,Shima Y,Morita S,Shimada Y,Sumiyoshi T,Sui K,Iwata J,Iiyama Tdoi
10.1016/j.jamcollsurg.2017.08.021subject
Has Abstractpub_date
2017-12-01 00:00:00pages
789-797issue
6eissn
1072-7515issn
1879-1190pii
S1072-7515(17)31926-9journal_volume
225pub_type
临床试验,杂志文章abstract:BACKGROUND:Adenosine, a metabolite of adenosine triphosphate degradation during ischemia, is reported to attenuate ischemia and reperfusion injury in several tissues. Dipyridamole is a nucleoside transport inhibitor that augments endogenous adenosine. In this study, we tested whether dipyridamole would attenuate hepati...
journal_title:Journal of the American College of Surgeons
pub_type: 杂志文章
doi:10.1016/j.jamcollsurg.2003.12.002
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abstract:BACKGROUND:Axillary nodal status is an important prognostic predictor in patients with breast cancer. This study evaluated the sensitivity and specificity of ultrasound-guided core biopsy (Ax US-CB) at detecting axillary nodal metastases in patients with primary breast cancer, thereby determining how often sentinel lym...
journal_title:Journal of the American College of Surgeons
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abstract:BACKGROUND:The role of portosystemic shunt (PSS) in children with portal hypertension has changed because of acceptance of liver transplantation and endoscopic hemostasis. We report our experience with PSS, mainly the distal splenorenal shunt, to define its role in the management of variceal bleeding. STUDY DESIGN:Fro...
journal_title:Journal of the American College of Surgeons
pub_type: 杂志文章
doi:10.1016/j.jamcollsurg.2004.03.024
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abstract:BACKGROUND:Trauma services are increasingly providing emergency surgery care by creating "acute care surgery" teams. We compared two periods at a Level I trauma center to determine if trauma service coverage would negatively impact timely management of acute appendicitis. STUDY DESIGN:All patients admitted through the...
journal_title:Journal of the American College of Surgeons
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abstract:BACKGROUND:The incidence of thyroid cancer in patients treated operatively for thyroid disease has been historically low (<5%). Previous series have not specifically addressed cancer rates in both euthyroid and hyperthyroid patients. This study examined cancer frequency in patients referred for removal of benign thyroi...
journal_title:Journal of the American College of Surgeons
pub_type: 杂志文章,多中心研究
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abstract:BACKGROUND:The concept of hemodilution after blood loss and crystalloid infusion is a surgical maxim that remains unproven in humans. We sought to quantify the effect of hemodilution after crystalloid administration in voluntary blood donors as a model for acute hemorrhage. STUDY DESIGN:A prospective, randomized contr...
journal_title:Journal of the American College of Surgeons
pub_type: 杂志文章,随机对照试验
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abstract:BACKGROUND:Interleukin-6 (IL-6) plays a central role in the acute phase of inflammation after surgical injury. The serum concentration of IL-6 increases during an operation. The mechanisms of this increase in the serum IL-6 level, however, has not yet been fully clarified. STUDY DESIGN:To determine the possibility of ...
journal_title:Journal of the American College of Surgeons
pub_type: 杂志文章
doi:
更新日期:1994-09-01 00:00:00
abstract:BACKGROUND:Immediate breast reconstruction with autologous tissue can re-create a breast mound that closely resembles the native breast in shape and consistency. Results are limited by scarring and color differences between flap and native breast skin. This study reviews all patients undergoing complete skin-sparing ma...
journal_title:Journal of the American College of Surgeons
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abstract:BACKGROUND:Identifying iatrogenic injuries using existing data sources is important for improved transparency in the occurrence of intraoperative events. There is evidence that procedure codes are reliably recorded in claims data. The objective of this study was to assess whether concurrent splenic procedure codes in p...
journal_title:Journal of the American College of Surgeons
pub_type: 杂志文章
doi:10.1016/j.jamcollsurg.2014.02.029
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journal_title:Journal of the American College of Surgeons
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更新日期:2016-04-01 00:00:00
abstract:BACKGROUND:Falls from a height are a major cause of morbidity and hospital cost. Spinal injury is frequently associated with falls from height, but reliable predictive factors have not been identified. Diagnostic evaluation of the spine is complex and debated. Our objective was to characterize spinal injury after falls...
journal_title:Journal of the American College of Surgeons
pub_type: 杂志文章
doi:10.1016/j.jamcollsurg.2006.07.002
更新日期:2006-11-01 00:00:00
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journal_title:Journal of the American College of Surgeons
pub_type: 杂志文章
doi:10.1016/j.jamcollsurg.2012.03.023
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abstract:BACKGROUND:The choice between breast-conserving surgery and modified radical mastectomy in the treatment of women with early stage breast cancer in the Department of Defense Healthcare System may be influenced by demographic factors. STUDY DESIGN:The Department of Defense Automated Central Tumor Registry (ACTUR) was q...
journal_title:Journal of the American College of Surgeons
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更新日期:2001-03-01 00:00:00
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journal_title:Journal of the American College of Surgeons
pub_type: 杂志文章
doi:10.1016/j.jamcollsurg.2017.12.054
更新日期:2018-07-01 00:00:00
abstract:BACKGROUND:Laparoscopic operative procedures have decreased postoperative pain and the length of hospitalization. In addition, evidence supports a physiologic benefit from laparoscopic surgery. By analyzing several parameters of peritoneal macrophage function, we report a comparison of the magnitude of postoperative st...
journal_title:Journal of the American College of Surgeons
pub_type: 杂志文章
doi:
更新日期:1997-04-01 00:00:00
abstract:BACKGROUND:Many published accounts of clinical trials report no differences between the treatment arms, while being underpowered to find differences. This study determined how the authors of these reports interpreted their findings. STUDY DESIGN:We examined 54 reports of surgical trials chosen randomly from a database...
journal_title:Journal of the American College of Surgeons
pub_type: 杂志文章
doi:10.1016/j.jamcollsurg.2012.09.015
更新日期:2013-01-01 00:00:00
abstract:BACKGROUND:The role of C-Jun N-terminal Kinase (c-Jun Kinase) in apoptosis is unclear. It is likely that c-Jun Kinase activation is cell type and stimulus dependent. c-Jun Kinase promotes tumor necrosis factor (TNF)-alpha mediated apoptosis in nuclear factor (NF)-KB deficient cells. Minimal NF-KB expression may be enou...
journal_title:Journal of the American College of Surgeons
pub_type: 杂志文章
doi:10.1016/j.jamcollsurg.2007.01.029
更新日期:2007-05-01 00:00:00
abstract:BACKGROUND:Oxandrolone, an anabolic agent, has been administered for 1 year post burn with beneficial effects in pediatric patients. However, the long-lasting effects of this treatment have not been studied. This single-center prospective trial determined the long-term effects of 1 year of oxandrolone administration in...
journal_title:Journal of the American College of Surgeons
pub_type: 杂志文章,随机对照试验
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journal_title:Journal of the American College of Surgeons
pub_type: 杂志文章
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journal_title:Journal of the American College of Surgeons
pub_type: 杂志文章,多中心研究
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journal_title:Journal of the American College of Surgeons
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journal_title:Journal of the American College of Surgeons
pub_type: 杂志文章
doi:10.1016/j.jamcollsurg.2003.12.001
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journal_title:Journal of the American College of Surgeons
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journal_title:Journal of the American College of Surgeons
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journal_title:Journal of the American College of Surgeons
pub_type: 杂志文章
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journal_title:Journal of the American College of Surgeons
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journal_title:Journal of the American College of Surgeons
pub_type: 杂志文章
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journal_title:Journal of the American College of Surgeons
pub_type: 杂志文章
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abstract::A nationwide survey of patterns of care for carcinoma of the breast was conducted by the Commission on Cancer of the American College of Surgeons. Information regarding patient history, diagnostic tests, treatment, survival and disease status was obtained for 17,295 patients treated during 1983 and 24,356 patients tre...
journal_title:Journal of the American College of Surgeons
pub_type: 杂志文章
doi:
更新日期:1994-03-01 00:00:00