Abstract：
BACKGROUND:In the western literature, controversy exists regarding the operative management of carcinoma of the stomach. Still debated are the extent of gastric resection, the role of splenectomy, and the significance of lymphadenectomy. STUDY DESIGN:We performed a retrospective study of 646 consecutive patients who underwent curative gastrectomy for carcinoma of the stomach from 1950 to 1989. A multivariate analysis of nine clinicopathologic and treatment-related variables, including type of gastrectomy, splenectomy, and extent of lymphadenectomy was done to assess the relative influence of these variables on survival. RESULTS:The following variables emerged as independent predictors of death: serosal involvement, distant lymph node metastases, and total gastrectomy. Splenectomy and lymphadenectomy were not related to prognosis. However, a separate analysis on defined subsets of patients revealed that radical lymphadenectomy (removal of N2 nodes) provided a survival benefit in patients with T1-2 N0-1 disease. CONCLUSIONS:These findings suggest that although prognosis of carcinoma of the stomach is mainly determined by the stage of disease at time of operation, the choice of the surgeon can affect survival. Total gastrectomy should be avoided when it is not necessary for proximal tumor location. Subtotal gastrectomy in distally located tumors seems to be the best option. Radical lymph node dissection should be performed when nodal involvement is expected to be limited or absent.
journal_name
J Am Coll Surgjournal_title
Journal of the American College of Surgeonsauthors
Stipa S,Di Giorgio A,Ferri M,Botti Csubject
Has Abstractpub_date
1994-11-01 00:00:00pages
567-72issue
5eissn
1072-7515issn
1879-1190journal_volume
179pub_type
杂志文章abstract：BACKGROUND:Most studies comparing surgical results of laparoscopic procedures for gastric cancer with open gastrectomies have been conducted based on limited experience. We aimed to compare laparoscopy-assisted distal gastrectomy (LADG) and conventional open distal gastrectomy (ODG) after a protracted learning experien...
journal_title：Journal of the American College of Surgeons
pub_type： 杂志文章
doi：10.1016/j.jamcollsurg.2006.02.028
更新日期：2006-06-01 00:00:00
abstract：BACKGROUND:Poor access to adequate health care coverage is associated with poor outcomes for many chronic medical conditions. We hypothesized that insurance coverage is also associated with mortality after gunshot trauma. STUDY DESIGN:The trauma records for gunshot victims and their insurance status were reviewed at o...
journal_title：Journal of the American College of Surgeons
pub_type： 杂志文章
doi：10.1016/j.jamcollsurg.2009.12.002
更新日期：2010-03-01 00:00:00
abstract：BACKGROUND:In 1991, a National Institutes of Health Consensus Panel stated that preoperative localization for primary hyperparathyroidism is not cost effective. Since then, the sestamibi scan has been applied to parathyroid disease with excellent results, even allowing unilateral exploration under local anesthesia. ST...
journal_title：Journal of the American College of Surgeons
pub_type： 杂志文章,meta分析
doi：10.1016/s1072-7515(98)00016-7
更新日期：1998-03-01 00:00:00
abstract：BACKGROUND:To gain additional insight into the impact of fatigue on surgery resident proficiency, we set out to quantify its impact on behavioral and neurophysiologic measures. STUDY DESIGN:Simulations were first created using a visio-haptic joystick attached to a surgical instrument (tool) that allows realistic inter...
journal_title：Journal of the American College of Surgeons
pub_type： 杂志文章
doi：10.1016/j.jamcollsurg.2011.03.028
更新日期：2011-07-01 00:00:00
abstract：BACKGROUND:Efforts to improve surgical outcomes have traditionally focused on improving preoperative patient selection and reducing the risk of postoperative medical complications. Strategies to optimize surgical technique have been less well studied. We sought to assess the relation between complications related to su...
journal_title：Journal of the American College of Surgeons
pub_type： 杂志文章
doi：10.1016/j.jamcollsurg.2003.08.007
更新日期：2004-01-01 00:00:00
abstract：BACKGROUND:There has been a recent focus on sex-based disparities within the field of academic surgery. However, the proportion of female surgeons conducting NIH-funded research is unknown. STUDY DESIGN:The NIH RePORTER (Research Portfolio Online Reporting Tools Expenditures and Results) was queried for R01 grants fro...
journal_title：Journal of the American College of Surgeons
pub_type： 杂志文章
doi：10.1016/j.jamcollsurg.2020.06.013
更新日期：2020-10-01 00:00:00
abstract：BACKGROUND:Thyroglossal duct remnants are the most common midline neck masses in childhood but can be found in adults and the elderly. Sistrunk's procedure, with dissection of the tract and removal of the hyoid bone, is accepted as the main operation of choice. STUDY DESIGN:Fifty-five patients were treated from Januar...
journal_title：Journal of the American College of Surgeons
pub_type： 杂志文章
doi：10.1016/s1072-7515(01)01171-1
更新日期：2002-03-01 00:00:00
abstract：BACKGROUND:Hospital readmission is a significant contributor to increasing health care use related to caring for older trauma patients. This study was undertaken with the following aims: determine the proportion of older adult trauma patients who experience unplanned readmission, as well as risk factors for these readm...
journal_title：Journal of the American College of Surgeons
pub_type： 杂志文章
doi：10.1016/j.jamcollsurg.2014.11.012
更新日期：2015-03-01 00:00:00
abstract：BACKGROUND:Neuroendocrine tumors commonly metastasize to the liver. Although surgical resection is considered a treatment option for patients with localized metastases confined to the liver, the longterm survival benefit of liver resection has not been clearly demonstrated. We examined the survival of patients undergoi...
journal_title：Journal of the American College of Surgeons
pub_type： 杂志文章
doi：10.1016/s1072-7515(98)00099-4
更新日期：1998-07-01 00:00:00
abstract：BACKGROUND:The majority of patients with gallbladder cancer (GBC) have advanced disease at the time of diagnosis and are unresectable. Longterm survival is usually seen in a subset of patients with early GBC (EGBC)-cancer confined to the mucosa (pT1a) and muscularis (pT1b). Management guidelines of EGBC are not yet def...
journal_title：Journal of the American College of Surgeons
pub_type： 杂志文章
doi：10.1016/s1072-7515(01)01136-x
更新日期：2002-02-01 00:00:00
abstract：BACKGROUND:Multiple reports have demonstrated pancreatic cancer patients undergoing surgery have superior outcomes at high-volume hospitals. This study noted trends in access to high-volume centers for pancreatic resection and identified gaps in improving access. STUDY DESIGN:We performed a retrospective analysis of t...
journal_title：Journal of the American College of Surgeons
pub_type： 杂志文章
doi：10.1016/j.jamcollsurg.2009.09.011
更新日期：2009-12-01 00:00:00
abstract：BACKGROUND:Pancreaticoduodenectomy (PD) is a complex general surgical procedure originally associated with significant perioperative morbidity and mortality. Multiple studies have now shown that this operation can be performed quite safely at high-volume institutions that develop a particular expertise. Critical pathwa...
journal_title：Journal of the American College of Surgeons
pub_type： 杂志文章
doi：10.1016/j.jamcollsurg.2007.01.057
更新日期：2007-05-01 00:00:00
abstract：BACKGROUND:Colonic Crohn's disease can be treated surgically by total colonic resection or by segmental colonic resection. The aim of this study was to analyze the outcomes of patients treated by segmental colectomy for colonic Crohn's disease. STUDY DESIGN:Among 413 patients undergoing operations for Crohn's disease,...
journal_title：Journal of the American College of Surgeons
pub_type： 杂志文章
doi：10.1016/s1072-7515(02)01122-5
更新日期：2002-04-01 00:00:00
abstract：BACKGROUND:Autologous transfusion (AT) has long been considered unsafe in major oncologic operations due to a theoretic risk of spreading metastatic disease, however, few data support this assumption. STUDY DESIGN:We conducted a retrospective analysis of 147 patients who underwent partial hepatectomy for colorectal ca...
journal_title：Journal of the American College of Surgeons
pub_type： 杂志文章
doi：10.1016/j.jamcollsurg.2018.10.020
更新日期：2019-06-01 00:00:00
abstract：BACKGROUND:In changing our technique to performing needle localization breast biopsies (NLBB) using local anesthesia in an outpatient setting, we investigated whether or not our complication rates with local anesthesia were acceptable when compared with complications from a cohort of biopsies of the breast performed fo...
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:Health care reform goals involve more cost-effective methods of delivering health care. The cost-effectiveness of axillary ultrasound-guided core needle biopsy (AUS-CNB) was compared with sentinel lymph node biopsy (SLNB) when evaluating the status of the axilla in operable invasive breast cancer. STUDY DES...
journal_title：Journal of the American College of Surgeons
pub_type： 杂志文章
doi：10.1016/j.jamcollsurg.2014.12.033
更新日期：2015-04-01 00:00:00
abstract：BACKGROUND:Thyroid surgery is performed using general anesthesia by the majority of surgeons in current practice. This study was conducted to analyze the utility and safety of local anesthesia for thyroid surgery. STUDY DESIGN:Prospective data were collected for 1,025 consecutive patients undergoing thyroidectomy usin...
journal_title：Journal of the American College of Surgeons
pub_type： 杂志文章
doi：10.1016/j.jamcollsurg.2005.04.034
更新日期：2005-09-01 00:00:00
abstract：BACKGROUND:Triage decision correctness for children in motor vehicle crashes can be affected by occult injuries. There is a need to develop a transfer score (TS) metric for children that can help quantify the likelihood that an injury is present that would require transfer to a trauma center (TC) from a non-TC, and imp...
journal_title：Journal of the American College of Surgeons
pub_type： 杂志文章
doi：10.1016/j.jamcollsurg.2017.09.018
更新日期：2018-01-01 00:00:00
abstract：BACKGROUND:Percutaneous endoscopic gastrostomy (PEG) by the "push" technique avoids peri-catheter infection, repeated insertion of the endoscope, potential esophageal injury from the catheter, and the possible need for another endoscopy for catheter removal associated with the "pull" technique. In small infants, howeve...
journal_title：Journal of the American College of Surgeons
pub_type： 杂志文章
doi：
更新日期：1996-03-01 00:00:00
abstract：BACKGROUND:Small bowel obstruction (SBO) represents roughly 15% of admissions by general surgeons. Management of SBO relies heavily on provider judgment, including decisions on how long to try nonsurgical management and whether to use a laparoscopic or open approach when surgery is needed. Given the subjective nature o...
journal_title：Journal of the American College of Surgeons
pub_type： 杂志文章
doi：10.1016/j.jamcollsurg.2017.11.006
更新日期：2018-06-01 00:00:00
abstract：BACKGROUND:To determine prospectively if simulator-based laparoscopic training could improve laparoscopic skills of gynecology residents. STUDY DESIGN:Twenty-six gynecology residents were enrolled in a laparoscopy training curriculum involving didactics, self-paced learning modules, and graded simulator-based laparosc...
journal_title：Journal of the American College of Surgeons
pub_type： 杂志文章
doi：10.1016/j.jamcollsurg.2007.08.005
更新日期：2008-02-01 00:00:00
abstract：BACKGROUND:Palliative surgery for advanced cancer patients involves complex decision making. Surgeons with a cancer-focused practice were surveyed to determine the extent to which palliative surgery was currently practiced, to identify ethical dilemmas and barriers they faced in performing palliative surgery, and to ev...
journal_title：Journal of the American College of Surgeons
pub_type： 杂志文章
doi：10.1016/s1072-7515(02)01306-6
更新日期：2002-09-01 00:00:00
abstract：BACKGROUND:An association between frailty and mortality exists; we hypothesized this is secondary to failure to rescue (F2R). STUDY DESIGN:Data were obtained from the NSQIP (2005 to 2012) for patients undergoing thoracoabdominal operations. Using the Modified Frailty Index, patients were classified as not (0 points), ...
journal_title：Journal of the American College of Surgeons
pub_type： 杂志文章
doi：10.1016/j.jamcollsurg.2017.12.055
更新日期：2018-06-01 00:00:00
abstract：BACKGROUND:Some patients require major leg amputation after lower-extremity prosthetic bypass for graft occlusion or failure of wound healing, despite a patent graft. Amputation above or below the knee was hypothesized to increase susceptibility to prosthetic graft infection in the ipsilateral extremity. STUDY DESIGN:...
journal_title：Journal of the American College of Surgeons
pub_type： 杂志文章
doi：10.1016/j.jamcollsurg.2009.01.001
更新日期：2009-04-01 00:00:00
abstract：BACKGROUND:Technetium 99m-sestamibi imaging might be the best method to localize abnormal parathyroid glands. No studies to date have compared preoperative imaging and intraoperative gamma probe localization in patients with primary hyperparathyroidism. STUDY DESIGN:This prospective study included 20 arbitrarily selec...
journal_title：Journal of the American College of Surgeons
pub_type： 杂志文章
doi：10.1016/s1072-7515(02)01178-x
更新日期：2002-07-01 00:00:00
abstract：BACKGROUND:In laparoscopic operations for rectal carcinoma, only a few multicenter studies of a large number of patients have examined the impact of conversion on outcomes and determined risk factors for conversion. This study was designed to evaluate short-term outcomes and risk factors for conversion to open operatio...
journal_title：Journal of the American College of Surgeons
pub_type： 杂志文章,多中心研究
doi：10.1016/j.jamcollsurg.2008.12.002
更新日期：2009-03-01 00:00:00
abstract：BACKGROUND:Retained surgical items (RSI) continue to occur. Large RSI studies are few due to low RSI frequency in single institutions and the medicolegal implications. Consequently, RSI risks are not fully defined, with discrepancies persisting among published studies. The goals of this study were to better define risk...
journal_title：Journal of the American College of Surgeons
pub_type： 杂志文章,多中心研究
doi：10.1016/j.jamcollsurg.2012.08.026
更新日期：2013-01-01 00:00:00
abstract：BACKGROUND:A new proprietary negative pressure wound device has been developed to apply negative pressure therapy to closed wounds (closed-NPWT). We postulated that closed-NPWT management of contaminated and dirty wounds would lead to faster wound healing and no significant difference in wound complications. STUDY DES...
journal_title：Journal of the American College of Surgeons
pub_type： 杂志文章,随机对照试验
doi：10.1016/j.jamcollsurg.2017.12.008
更新日期：2018-04-01 00:00:00
abstract：BACKGROUND:We compared the rates of stroke, death, and/or MI between men and women, stratified by symptomatic status and procedure type (carotid endarterectomy [CEA] or carotid artery stent [CAS]). STUDY DESIGN:Using the Nationwide Inpatient Sample, crude and propensity-matched rates of the composite end point of stro...
journal_title：Journal of the American College of Surgeons
pub_type： 杂志文章,多中心研究
doi：10.1016/j.jamcollsurg.2019.02.054
更新日期：2019-07-01 00:00:00
abstract：BACKGROUND:Near infrared autofluorescence (NIRAF) can guide intraoperative parathyroid gland (PG) identification. NIRAF detection devices typically rely on imaging and fiber probe-based approaches. Imaging modalities provide NIRAF pictures on adjacent display monitors, and fiber probe-based systems measure tissue NIRAF...
journal_title：Journal of the American College of Surgeons
pub_type： 杂志文章
doi：10.1016/j.jamcollsurg.2019.09.003
更新日期：2019-12-01 00:00:00
