Abstract:
BACKGROUND:Traditional chemotherapy agents adversely affect wound healing and need to be held prior to or after surgery. Immune checkpoint inhibitors (ICIs) and targeted agents are now standard of care for the several treatment cancers. We hypothesize that ICI and targeted therapy do not have similar adverse effects on perioperative outcomes. METHODS:We performed a review of melanoma patients undergoing surgery at an academic hospital between 2011 and 2019. All patients received ICI or targeted therapy ≤ 60 days prior to surgery, including palliative procedures. Preoperative performance status was assessed using Eastern Cooperative Oncology Group score and American Society of Anesthesiologists Classification System. Thirty-day complications were classified by Clavien-Dindo grade. No statistical comparisons were performed. RESULTS:Of 63 patients included in the analysis, 29 (46%) patients received ICI and 34 (54%) received targeted therapy with median of 14 days (IQR 5-27 days) between the last preoperative dose and day of surgery (ICI, median 18 days [IQR 13-34.5]; targeted therapy, median 7 days [IQR 3-22.25]). There were no perioperative mortalities. Among patients treated with ICI, 22 patients (76%) had no complications. Four patients had wound infections (2 readmitted), 1 had reoperation (hematoma) and 2 readmitted for other reasons (fever; volvulus). Among patients treated with targeted therapy, 25 patients (74%) had no complications. Seven patients had wound infections (none readmitted), 1 had reoperation (flap failure) and 1 had dehiscence (not treated). CONCLUSIONS:Patients undergoing treatment with ICI or targeted therapies can safely undergo surgery without substantially increased risk of serious intraoperative and postoperative complications.
journal_name
World J Surgjournal_title
World journal of surgeryauthors
Sun J,Kirichenko DA,Chung JL,Carr MJ,Eroglu Z,Khushalani NI,Markowitz J,Messina JL,Sondak VK,Zager JS,Patel SYdoi
10.1007/s00268-019-05314-2subject
Has Abstractpub_date
2020-04-01 00:00:00pages
1283-1293issue
4eissn
0364-2313issn
1432-2323pii
10.1007/s00268-019-05314-2journal_volume
44pub_type
杂志文章,评审abstract:BACKGROUND:The technical complexity of pancreatic resection has made it a specialized procedure performed in high-volume centers. It has been shown that patients operated on in high-volume pancreatobiliary centers have fewer complications and better survival. The purpose of this study was to share our experience with a...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/s00268-014-2644-6
更新日期:2014-10-01 00:00:00
abstract::Gastric emptying times and symptoms were recorded in 18 patients after total gastrectomy and either a 15-cm J-pouch (n = 10) or a standard esophagojejunal anastomosis (n = 8). A solid test meal labeled with 99mTc was used to compare the emptying times. The postoperative symptoms and nutritional status were also assess...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/BF01659117
更新日期:1993-09-01 00:00:00
abstract:BACKGROUND:The aim of this study was to compare the influence of either general (GA) or local (LA) anesthesia on the postoperative neurocognitive outcome in patients undergoing carotid endarterectomy (CEA) in a randomized study. Therefore, we performed a subgroup analysis of the multicenter GALA study. METHODS:A total...
journal_title:World journal of surgery
pub_type: 杂志文章,多中心研究,随机对照试验
doi:10.1007/s00268-009-0047-x
更新日期:2009-07-01 00:00:00
abstract:BACKGROUND:Complications following esophagectomy are a significant source of morbidity. The aim of this study was to investigate the utility of the neutrophil:lymphocyte ratio (NLR) in the early identification of complications following esophagectomy, as compared to other routinely available parameters. METHODS:We per...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/s00268-016-3427-z
更新日期:2016-06-01 00:00:00
abstract:INTRODUCTION:Parathyroid cysts are rare but clinically significant lesions. They can be functional, mistaken for a thyroid cyst, and/or managed nonoperatively on occasion. METHODS:We identified seven patients (1 male, 6 females) with the diagnosis of parathyroid cyst from 1998 to 2003. RESULTS:Altogether, 33% of the ...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/s00268-005-0748-8
更新日期:2007-01-01 00:00:00
abstract::Patients with short bowel syndrome (SBS) receiving total parenteral nutrition (TPN) have a high incidence of catheter-related sepsis, one of its major complications. The aim of this study was to correlate the length of remaining small bowel (RSB) with septic episodes related to the central venous catheter in a group o...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/s002680010274
更新日期:2000-12-01 00:00:00
abstract::Duodenal leiomyomas are rare neoplasms and when present are usually asymptomatic. There are, however, isolated case reports of such leiomyomas giving rise to complications including gastrointestinal hemorrhage and obstruction. The purpose of this study was to review the surgical experience with duodenal leiomyomas at ...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/s002680020083
更新日期:2001-05-01 00:00:00
abstract::Over the past three decades Canada has developed an exemplary system of universal health care. However, current financial constraints threaten to undermine the very foundation of the system that represents Canada's respect for social justice. The first of these two articles (Part 1) discusses the unique characteristic...
journal_title:World journal of surgery
pub_type: 杂志文章,评审
doi:10.1007/BF00298897
更新日期:1994-09-01 00:00:00
abstract::A new technique for ligating vessels and similar structures that offers more security is described. The aim of the study was to test whether this hypothesis was correct. Six different types of knots, including the one described in this article were compared by a strength-testing study. The knots were tied on a silicon...
journal_title:World journal of surgery
pub_type: 杂志文章,评审
doi:10.1007/s00268-005-7675-6
更新日期:2005-10-01 00:00:00
abstract::Calcium oxalate is a major component of renal stones, and its urinary concentration plays an important role in stone formation. Even a small increase in urinary oxalate has a significant impact on calcium oxalate saturation. Although primary hyperoxaluria is relatively uncommon, patients with calcium oxalate stones ha...
journal_title:World journal of surgery
pub_type: 杂志文章,评审
doi:10.1007/s002680010193
更新日期:2000-10-01 00:00:00
abstract::Open gastric surgery in elderly patients is associated with higher morbidity and mortality rates than those reported among younger individuals. Therefore, minimally invasive surgery may have a larger impact on the elderly compared to the younger age group. The objective of this study was to evaluate the experience of ...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/s00268-005-0208-5
更新日期:2005-12-01 00:00:00
abstract:BACKGROUND:There are few established metrics to define surgical capacity in resource-limited settings. Previous work hypothesizes that the relative frequency of cesarean sections (CS) at a hospital, expressed as a proportion of total operative procedures (%CS), may serve as a proxy measure of surgical capacity. We atte...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/s00268-012-1629-6
更新日期:2012-09-01 00:00:00
abstract:BACKGROUND:The splintering of general surgery into subspecialties in the past decade has brought into question the relevance of a continued emphasis on traditional general surgical training. With the majority of trainees now expressing a preference to subspecialise early, this study sought to identify if the requiremen...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/s00268-014-2890-7
更新日期:2015-02-01 00:00:00
abstract:BACKGROUND:Understanding the lymphatic drainage route in gastric cancer is crucial for complete lymph node retrieval from sites susceptible to metastasis. However, the lymphatic stream of the stomach is complex and remains incompletely characterized. METHODS:Patients with small (<4 cm) serosa-negative gastric cancer w...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/s00268-009-9985-6
更新日期:2009-06-01 00:00:00
abstract::The value of surgical resection for patients with chronic pancreatitis has been debated on account of persistent symptoms and the morbidity of the operative procedure, both immediate and delayed. This paper explores the consequence of pancreatoduodenectomy in 175 patients with chronic pancreatitis who were operated on...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/s00268-003-7239-6
更新日期:2003-11-01 00:00:00
abstract::The well-known poor prognosis of proximal bile duct cancer is due to its unfortunate anatomical location and its late diagnosis. Successful tumor resection, which is considered to be optimal treatment, depends on many factors. Eighty-eight patients suffering from proximal bile duct cancer underwent surgical exploratio...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/s00268-003-6656-x
更新日期:2003-06-01 00:00:00
abstract::Acute biliary pancreatitis is a serious complication of biliary calculous disease and is associated with significant morbidity and mortality. The role of endoscopic retrograde cholangiopancreatography (ERCP) in the management of acute biliary pancreatitis has been the focus of discussion in recent years. In addition, ...
journal_title:World journal of surgery
pub_type: 临床试验,杂志文章
doi:10.1007/s002689900207
更新日期:1997-02-01 00:00:00
abstract:BACKGROUND:Beginning in 2004, a standardized medial-to-lateral approach was adopted in laparoscopic colorectal resection (LapCR) in our institution. The present study aimed to compare the outcomes of patients operated on by this approach with those who were operated on prior to the adoption of this technique. METHODS:...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/s00268-009-0173-5
更新日期:2009-10-01 00:00:00
abstract::There has been a long, unresolved debate regarding the operation of choice for well differentiated carcinoma of the thyroid. We therefore analyzed the feasibility, scope, sample size, and length of follow-up required to determine the optimal operation for papillary thyroid carcinoma. A statistical approach was used to...
journal_title:World journal of surgery
pub_type: 杂志文章,评审
doi:10.1007/s002689900016
更新日期:1996-01-01 00:00:00
abstract::The objective of this study was to assess the validity and responsiveness of a new quality of life instrument, the Patient Generated Index (PGI), in patients with rectal cancer. Thirty-three patients with rectal cancer were administered the PGI, the European Organisation for Research and Treatment of Cancer (EORTC) Qu...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/s00268-002-6360-2
更新日期:2002-11-01 00:00:00
abstract::In spite of recent therapeutic advances, severe overt secondary hyperparathyroidism due to chronic renal failure necessitates parathyroidectomy and recurrent hyperparathyroidism is one of the most significant problems in this patient population. In the present study, the incidence of recurrent hyperparathyroidism was ...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/BF02067331
更新日期:1992-07-01 00:00:00
abstract::The goals of operative treatment of primary hyperparathyroidism are (1) cure; (2) minimal invasion; and (3) cost-effectiveness. The optimal strategy is controversial. Retrospective review of was undertaken 66 previously unoperated patients having minimal-incision, full-neck exploration by one surgeon over 29 months. A...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/s002680010238
更新日期:2000-11-01 00:00:00
abstract:BACKGROUND:Primary hyperaldosteronism (PHA) is a cause of secondary arterial hypertension potentially curable by laparoscopic unilateral adrenalectomy. We describe the follow-up of these patients according to their medical or surgical treatment. METHODS:We report a retrospective single-center study of 91 patients with...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/s00268-014-2461-y
更新日期:2014-07-01 00:00:00
abstract::Recent collective reviews have outlined when and how surgeons should treat patients with bile duct injuries after laparoscopic cholecystectomy (LC). However, little is described about other injuries combined with bile duct injuries, for example, hepatic arterial injury and secondary biliary cirrhosis. Fifteen patients...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/s00268-001-0120-6
更新日期:2001-10-01 00:00:00
abstract:BACKGROUND:We reported phonatory recovery in the majority of 88 patients after recurrent laryngeal nerve (RLN) reconstruction. Here we analyzed factors that might influence the recovery, in a larger patient series. METHODS:At Kuma Hospital, 449 patients (354 females and 95 males) underwent RLN reconstruction with dire...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/s00268-016-3634-7
更新日期:2016-12-01 00:00:00
abstract::Distinguishing cellular follicular adenomas (FA) from minimally invasive follicular carcinomas (FC) continues to plague even experienced thyroid pathologists. DNA ploidy analysis has been promoted as a means of making this differentiation; however, the finding of DNA aneuploidy in FA has caused concern that they may d...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/BF01658504
更新日期:1990-05-01 00:00:00
abstract:BACKGROUND:The aim of this study was to analyze the prognostic factors associated with long-term outcome after liver resection for colorectal metastases. The retrospective analysis included 297 liver resections for colorectal metastases. METHODS:The variables considered included disease stage, differentiation grade, s...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/s00268-007-9285-y
更新日期:2008-01-01 00:00:00
abstract::This study was conducted retrospectively to examine the efficacy of Traverso reconstruction compared with Billroth I reconstruction after pylorus-preserving pancreaticoduodenectomy, in the prevention of several complications. Pylorus-preserving pancreaticoduodenectomy is an aggressive surgery, and insufficiency of the...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/s00268-005-7697-0
更新日期:2005-07-01 00:00:00
abstract:BACKGROUND:The majority of small bowel obstructions (SBO) are the result of adhesions caused by a previous abdominal operation. On rare occasions, adhesional SBO occurs in the absence of such an operation. Our objective was to describe the management, findings, and outcomes of unexplained adhesional SBO (UA-SBO) and ex...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/s00268-009-0200-6
更新日期:2009-11-01 00:00:00
abstract::The aim of this study was to investigate the collagen matrix in recurrent inguinal hernias. Total ribonucleic acid (RNA) was extracted from skin fibroblasts of three groups (control group I = healthy skin; control group II = plain skin scar; recurrent inguinal hernia group = skin of recurrent inguinal hernias; each n ...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/s00268-001-0239-5
更新日期:2002-04-01 00:00:00