Abstract:
:This retrospective study in 79 surgically treated patients with a proximal bile duct carcinoma revealed 12 patients with a median age of 59.5 years (range 21-73 years) who survived more than 5 years. These 12 patients were analyzed to identify specific patient characteristics for long-term survival. Fifteen patients died from postoperative complications and were excluded from this survival analysis. In relation with preoperative Bismuth classification, there were 3 (20%) long-term survivors of 15 patients with type I tumors and 9 (35%) long-term survivors of 26 patients with type II tumors. In the group of type III and IV tumors, there were no long-term survivors. Concerning the type of resection, 9 of 51 (18%) patients had long-term survival after local resection and 3 of 13 (23%) patients after local resection combined with hemihepatectomy. Complete tumor-free surgical specimen margins were found in only 4 of 64 cases (6%), among which only one patient survived more than 5 years. Negative proximal bile duct margins, absence of multifocality, and diploid tumors showed a significant correlation with long-term survival. There was no significant correlation between long-term survival and postoperative radiotherapy. Of the 12 long-term survivors, 5 died after 5 years: 2 had developed metastases and 1 a local recurrence; the other 2 died of a metastasis of an ovarian adenocarcinoma and cachexia, respectively. The remaining seven patients were still alive at the completion of this study. The mean survival of the 64 patients analyzed in this study (in which hospital mortality was excluded) was 33.7 months, with a median survival of 18.8 months. In conclusion, the preoperative Bismuth classification of the tumor, absence of multifocality, diploid-type tumors, and negative proximal bile duct margins at histopathologic examination were the only significant prognostic factors for long-term survival.
journal_name
World J Surgjournal_title
World journal of surgeryauthors
Gerhards MF,van Gulik TM,Bosma A,ten Hoopen-Neumann H,Verbeek PC,Gonzalez Gonzalez D,de Wit LT,Gouma DJdoi
10.1007/s002689900571subject
Has Abstractpub_date
1999-01-01 00:00:00pages
91-6issue
1eissn
0364-2313issn
1432-2323journal_volume
23pub_type
杂志文章abstract::Axillary dissection in patients with breast cancer is associated with significant morbidity. Because 85% of the patients with a cancer < or = 1 cm have negative axillary nodal status, axillary dissection in these patients is only a staging procedure. A study of the sentinel lymph node (SLN) biopsy has been developed t...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/s00268-001-0272-4
更新日期:2002-05-01 00:00:00
abstract::Thoracic and thoracoabdominal penetrating wounds are frequently encountered in urban medical centers in the United States. This study was undertaken to determine the clinical characteristics and in hospital outcome of these injuries. This was a longitudinal, nonblinded study using the established standard of care of p...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/BF03215862
更新日期:2001-09-01 00:00:00
abstract:BACKGROUND:The 6th edition TNM staging (TNM-6) for hepatocellular carcinoma (HCC) has been recommended. However, its superiority, in contrast to the previous 5th edition (TNM-5), has not been fully recognized. Besides, tumor differentiation was not included. The current study was designed to compare the value of these ...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/s00268-008-9615-8
更新日期:2008-08-01 00:00:00
abstract::Abdominal infections are treated by resuscitation, abdominal drainage, control of the source of infection, and antimicrobial agents. Ideally, antimicrobial therapy is active against expected pathogens, safe and effective in clinical trials, inexpensive, and unlikely to promote drug resistance. Numerous single-agent an...
journal_title:World journal of surgery
pub_type: 杂志文章,评审
doi:10.1007/s002689900363
更新日期:1998-02-01 00:00:00
abstract:BACKGROUND:There is emerging evidence indicating that distractions in the operating room (OR) are prevalent. Studies have shown a negative impact of distractions, but they have been conducted mostly with residents in simulated environments. We tested the hypothesis that intraoperative distractions are associated with d...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/s00268-013-2315-z
更新日期:2014-04-01 00:00:00
abstract::Among 26 patients with gallbladder carcinoma, 11 resected cases were studied retrospectively with respect to the preoperative imaging techniques and the operative procedures employed. Ultrasonography, endoscopic ultrasonography, and computed tomography were valuable in detecting gallbladder carcinoma preoperatively wh...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/BF01658723
更新日期:1991-05-01 00:00:00
abstract:BACKGROUND:In 2002, the UICC/AJCC TNM classification for papillary thyroid carcinoma was revised. In this study, we examined the validity of this classification system by investigating the predictors of disease-free survival (DFS) and cause-specific survival (CSS) in patients. METHODS:We examined various clinicopathol...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/s00268-006-0455-0
更新日期:2007-04-01 00:00:00
abstract:INTRODUCTION:Hypoxic stress is a feature of rapidly growing thyroid tumours. Cancer progression is thought to be driven by a small population of tumour cells possessing stem cell properties. Hypoxia-inducible factors (HIFs) are important mediators of hypoxia. Both HIF-1alpha and HIF-2alpha have been reported to be expr...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/s00268-017-4331-x
更新日期:2018-02-01 00:00:00
abstract::Sixty-one patients who were diagnosed with mucosal gastric cancer have been successfully treated with two laparoscopic techniques at our institute from March 1992 to March 1997. One is laparoscopic wedge resection of the stomach using a lesion-lifting method for lesions of the anterior wall, the lesser curvature, and ...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/pl00013167
更新日期:1999-02-01 00:00:00
abstract::The development of laparoscopic surgery has provided minimally invasive surgeons with advanced laparoscopic instrumentation and high definition imaging. The resulting surgical expertise and technology has now been extended to gastric endoluminal surgery. Laboratory and clinical investigations have been initiated for v...
journal_title:World journal of surgery
pub_type: 杂志文章,评审
doi:10.1007/pl00012311
更新日期:1999-04-01 00:00:00
abstract::During the course of tumor progression the differentiated morphologic and functional characteristics of differentiated thyroid carcinomas (DTC) disappear. This corresponds to more aggressive growth, metastatic spread, and loss of iodine uptake. Experimental data give strong evidence that differentiated functions of io...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/s002689900436
更新日期:1998-06-01 00:00:00
abstract:BACKGROUND:Total thyroidectomy is now accepted worldwide as the standard surgical procedure for the management of benign bilateral nodular thyroid disease. Hypocalcemia is the most common complication of that procedure and a variety of strategies for diagnosing and managing post-thyroidectomy hypocalcemia have been adv...
journal_title:World journal of surgery
pub_type: 杂志文章,评审
doi:10.1007/s00268-008-9545-5
更新日期:2008-07-01 00:00:00
abstract::Since the pathogenesis of endocrine ophthalmopathy is unclear, there has been little agreement on the treatment of the disease. The influence of thyroid surgery on endocrine ophthalmopathy is controversial. To evaluate the effect of thyroid surgery on the course of the disease, we developed a special ophthalmopathy in...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/BF01658552
更新日期:1990-05-01 00:00:00
abstract::The aim of this study was to investigate the effects of various surgical modalities directed at the cavity of hydatid cysts in patients with occult intrabiliary rupture. In this respect, 324 patients with hydatid cyst of the liver operated on during 1983-2003 were analyzed; among them, 39 patients with occult intrabil...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/s00268-004-7571-5
更新日期:2005-02-01 00:00:00
abstract::Subtotal esophagectomy still is the major treatment for early Barrett's carcinoma. The inevitable loss of the gastric reservoir leaves an unresolved functional problem. Distal esophageal resection combined with a short jejunal interposition might be a safe alternative with the advantage of better functional results. I...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/s00268-003-7203-5
更新日期:2003-09-01 00:00:00
abstract::Dukes' classification is a useful staging system in patients with colorectal cancer. The aim of this study was to present clinicopathologic characteristics and survival of patients with gastric cancer based on Dukes' classification. A total of 273 patients with gastric cancer curatively treated by radical gastrectomy ...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/pl00012338
更新日期:1999-05-01 00:00:00
abstract:BACKGROUND:Distal splenorenal shunt and coronary caval shunt are commonly used for selective decompression of esophagogastric varices, but they may not solve severe hypersplenism and their application may be hampered by the presence of splenic venous thrombosis or a left gastric vein (LGV) situated deeply behind the pa...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/s00268-018-4796-2
更新日期:2019-02-01 00:00:00
abstract::Secretin is a stimulator of both endocrine and exocrine secretions of the pancreas, and we aimed to evaluate its effects on splanchnic blood flow in rats with a microsphere technique. Anesthetized rats were infused with secretin (0.5 or 2.0 micrograms/kg body weight/hr) for 10 minutes. Some animals were normoglycemic,...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/s00268-001-0037-0
更新日期:2001-07-01 00:00:00
abstract:OBJECTIVE:The aim of the study was to describe the perioperative and long-term results of carotid endarterectomy (CEA) in patients aged 60 or less and compare them to patients of more advanced age in a retrospective single-centre case-control study. METHODS:From January 1996 to December 2014, 5893 consecutive CEAs wer...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/s00268-017-4133-1
更新日期:2018-01-01 00:00:00
abstract:BACKGROUND:Idiopathic thrombocytopenic purpura (ITP) is an autoimmune disorder for which appropriate diagnostic treatments are uncertain. The response to splenectomy varies from 60% to 90%, and the remaining patients relapse and require further treatment. Therefore, it is important to predict the outcome of splenectomy...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/s00268-005-7964-0
更新日期:2006-04-01 00:00:00
abstract:BACKGROUND:The long-term course after peptic ulcer perforation is unclear, but because the ulcer population is generally older and has concomitant disease, the long-term prognosis may be expected to be poor. METHODS:In a study based on prospective data collection, all patients with peptic ulcer perforation treated at ...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/s00268-007-9370-2
更新日期:2008-03-01 00:00:00
abstract:BACKGROUND:The objective of the cross-sectional study reported here was to compare the quality of life of patients with an appropriate stoma site and with that of patients with an inappropriate stoma site. MATERIALS AND METHODS:Two groups of patients with permanent intestinal stomas were assessed, 174 patients with ap...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/s00268-009-0275-0
更新日期:2010-01-01 00:00:00
abstract::The previous finding of an increased risk of premature death in a consecutive series of 896 patients operated on for primary hyperparathyroidism between 1953 and 1982 [1] raised the question of the role that surgery plays in relation to the risk of death. In the present study, undertaken to examine that issue, 3 facto...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/BF01658740
更新日期:1991-05-01 00:00:00
abstract:BACKGROUND:The aim of the present study was to evaluate the efficacy of 10 % sucralfate ointment in the reduction of acute postoperative pain after open hemorrhoidectomy. METHODS:A total of 48 patients (24 men and 24 women) between 20 and 70 years of age who underwent open hemorrhoidectomy were included in this prospe...
journal_title:World journal of surgery
pub_type: 杂志文章,随机对照试验
doi:10.1007/s00268-012-1805-8
更新日期:2013-01-01 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::Axillary clearance in node-negative breast cancer patients is performed only for staging and prognostic purposes. The sentinel node concept may provide an alternative conservative approach for these patients. This paper reports on the learning experience with lymphatic mapping involving the use of patent blue dye for ...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/s002689910054
更新日期:2000-03-01 00:00:00
abstract::Knowledge of how factors related to esophageal cancer resection affect long-term quality of life after surgery is scarce, and no population-based studies are available. Therefore, we conducted a Swedish nationwide, prospective, population-based study of how esophageal surgery-related factors influence quality of life ...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/s00268-005-7887-9
更新日期:2005-07-01 00:00:00
abstract:BACKGROUND:Approximately half of trauma patients develop post-traumatic depression. It is suggested that beta-blockade impairs trauma memory recollection, reducing depressive symptoms. This study investigates the effect of early beta-blockade on depression following severe traumatic injuries in patients without signifi...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/s00268-017-3935-5
更新日期:2017-07-01 00:00:00
abstract:BACKGROUND:Intraoperative parathyroid hormone assay (IOPTH) has been suggested to have value in predicting the development of postoperative hypoparathyroidism after thyroid surgery. IOPTH has been validated in identification of patients at risk of postoperative hypocalcemia requiring early onset of calcium supplementat...
journal_title:World journal of surgery
pub_type: 杂志文章,随机对照试验
doi:10.1007/s00268-007-9405-8
更新日期:2008-05-01 00:00:00
abstract:BACKGROUND:The treatment of acute limb ischemia (ALI) has barely changed over the last years. However, the progressive implementation of anticoagulants, antiplatelet agents or statins within the population might have modified the profile and prognosis of patients suffering an ALI. The aim of this study was to evaluate ...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/s00268-018-4511-3
更新日期:2018-08-01 00:00:00