Abstract:
OBJECTIVE:To assess our outcomes after minimally invasive esophagectomy (MIE). SUMMARY BACKGROUND DATA:Esophagectomy has traditionally been performed by open methods. Results from most series include mortality rates in excess of 5% and hospital stays frequently greater than 10 days. MIE has the potential to improve these results, but only a few small series have been reported. This report summarizes our experience of 222 cases. METHODS:From 1996 to 2002, MIE was performed in 222 patients. Indications for operation included high-grade dysplasia (n = 47) and cancer (n = 175). Neoadjuvant chemotherapy was used in 78 (35.1%) and radiation in 36 (16.2%). Initially, a laparoscopic transhiatal approach was used (n = 8), but subsequently our approach evolved to include thoracoscopic mobilization (n = 214). RESULTS:There were 186 men and 36 women. Median age was 66.5 years (range, 39-89). Nonemergent conversion to open procedure was required in 16 patients (7.2%). MIE was successfully completed in 206 (92.8%) patients. The median intensive care unit stay was 1 day (range, 1-30); hospital stay was 7 days (range, 3-75). Operative mortality was 1.4% (n = 3). Anastomotic leak rate was 11.7% (n = 26). At a mean follow-up of 19 months (range, 1-68), quality of life scores were similar to preoperative values and population norms. Stage specific survival was similar to open series. CONCLUSIONS:MIE offers results as good as or better than open operation in our center with extensive minimally invasive and open experience. In this single institution experience, we observed a lower mortality rate (1.4%) and shorter hospital stay (7 days) than most open series. Given these results, we are now developing an intergroup trial (ECOG 2202) to assess MIE in a multicenter setting.
journal_name
Ann Surgjournal_title
Annals of surgeryauthors
Luketich JD,Alvelo-Rivera M,Buenaventura PO,Christie NA,McCaughan JS,Litle VR,Schauer PR,Close JM,Fernando HCdoi
10.1097/01.sla.0000089858.40725.68subject
Has Abstractpub_date
2003-10-01 00:00:00pages
486-94; discussion 494-5issue
4eissn
0003-4932issn
1528-1140pii
00000658-200310000-00004journal_volume
238pub_type
杂志文章abstract:OBJECTIVE:To determine whether bariatric surgery is associated with a lower risk of cancer. BACKGROUND:Obesity is strongly associated with many types of cancer. Few studies have examined the relationship between bariatric surgery and cancer risk. METHODS:We conducted a retrospective cohort study of patients undergoin...
journal_title:Annals of surgery
pub_type: 杂志文章,多中心研究
doi:10.1097/SLA.0000000000002525
更新日期:2019-01-01 00:00:00
abstract:OBJECTIVE:To define and test "Textbook Outcome" (TO)-a composite measure for healthcare quality-among Medicare patients undergoing hepatopancreatic resections. Hospital variation in TO and Medicare payments were analyzed. BACKGROUND:Composite measures of quality may be superior to individual measures for the analysis ...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/SLA.0000000000003105
更新日期:2020-06-01 00:00:00
abstract::CLINICAL AND LABORATORY STUDIES OF AFP PRODUCING HEPATOMAS DEMONSTRATED THAT: 1) serum AFP levels correlated directly with tumor growth; 2) circulating AFP could be cleared by passive administration of an. excess of anti-AFP; and 3) highly specific anti-AFP functioned as a carrier to localize diagnostic and possibly t...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-197410000-00025
更新日期:1974-10-01 00:00:00
abstract:OBJECTIVE:The aim of this study was to determine the contribution of the hepatic artery, gastroduodenal artery, and portal vein to the microvascular blood flow in the common bile duct (CBD). BACKGROUND:Biliary complications are a common cause of graft loss after liver transplantation. The occurrence is, partly, attrib...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/SLA.0b013e31824714d0
更新日期:2012-03-01 00:00:00
abstract:OBJECTIVE:To explore the impact of short-term surgical missions (STMs) on medical practice in Guatemala as perceived by Guatemalan and foreign physicians. SUMMARY BACKGROUND DATA:STMs send physicians from high-income countries to low and middle-income countries to address unmet surgical needs. Although participation a...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/SLA.0000000000003292
更新日期:2019-04-18 00:00:00
abstract::Twenty-three selected patients presenting with massive bleeding from peptic ulcers underwent emergency parietal cell vagotomy (PCV). Nineteen patients had a duodenal ulcer, two a prepyloric ulcer, and one a gastric ulcer. The patients were studied retrospectively with regard to postoperative mortality and morbidity, e...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-198711000-00005
更新日期:1987-11-01 00:00:00
abstract::The relationship between two variables may be mathematically coupled if either one or both variables are derived and/or calculated, and this can lead to erroneous results and invalid conclusions. The purpose of this report is to identify four types of mathematic coupling of data. Type 1 coupling involves directional c...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-198103000-00008
更新日期:1981-03-01 00:00:00
abstract::One hundred fifty-five adult patients with "operable" soft part sarcomas including rhabdomyosarcoma, liposarcoma, leiomyosarcoma and fibrosarcoma of the trunk and extremities are reviewed. Local recurrences of 93% and 60% occurred after local and wide excisions of the primary tumor. In this series of patients, amputat...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-197506000-00007
更新日期:1975-06-01 00:00:00
abstract:OBJECTIVE:To determine the significance of the extent of mesorectal tumor invasion as a prognostic factor for T3 rectal cancer patients. SUMMARY BACKGROUND DATA:There is controversy as to which primary lesion characteristics, other than regional lymph node involvement, in T3 rectal cancer are reliable prognostic facto...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/01.sla.0000205627.05769.08
更新日期:2006-04-01 00:00:00
abstract:OBJECTIVE:Because continuity of care (CC) is a necessary component of resident education, this analysis was done to understand what keeps CC between residents and patients low and how it can be most effectively improved. BACKGROUND:Many authors lament low CC between residents and patients, especially in the era of dut...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/SLA.0b013e3182468dcf
更新日期:2012-04-01 00:00:00
abstract:OBJECTIVE:To evaluate the effect of preoperative transarterial chemoembolization (TACE) for resectable large hepatocellular carcinoma (HCC). SUMMARY BACKGROUND DATA:Resection of HCC is potentially curative, but local recurrence is very common. There is currently no effective neoadjuvant or adjuvant therapy. METHODS:F...
journal_title:Annals of surgery
pub_type: 杂志文章,随机对照试验
doi:10.1097/SLA.0b013e3181961c16
更新日期:2009-02-01 00:00:00
abstract:OBJECTIVE:To assess the impact of a laparoscopic approach on female fecundity in ileoanal pouch surgery. BACKGROUND:Restorative proctocolectomy with ileal pouch anal anastomosis (IPAA) is associated with tubal factor infertility in female patients. Different studies showed less adhesion formation after laparoscopic co...
journal_title:Annals of surgery
pub_type: 临床试验,杂志文章
doi:10.1097/SLA.0b013e318250caa9
更新日期:2012-12-01 00:00:00
abstract:BACKGROUND:EVAR for abdominal aortic aneurysm has an initial survival advantage over OR, but more frequent complications increase costs and long-term aneurysm-related mortality. Randomized controlled trials of EVAR versus OR have shown EVAR is not cost-effective over a patient's lifetime. However, in the EVAR-1 trial, ...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/SLA.0000000000003625
更新日期:2019-10-07 00:00:00
abstract:OBJECTIVE:The aim of this study was to determine whether parastomal hernia (PSH) rate can be reduced by using synthetic mesh in the sublay position when constructing permanent end colostomy. The secondary aim was to investigate possible side-effects of the mesh. BACKGROUND:Prevention of PSH is important as it often ca...
journal_title:Annals of surgery
pub_type: 杂志文章,多中心研究,随机对照试验
doi:10.1097/SLA.0000000000002542
更新日期:2019-03-01 00:00:00
abstract::Spectral analysis was used to examine 257 carotid arteries in 227 patients who had undergone carotid endarterectomy at 1, 3, 6, and 12 months after surgery and annually thereafter. Routine intraoperative completion angiography ensured that the operations were technically satisfactory. Postoperative restenoses were ide...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-198407000-00013
更新日期:1984-07-01 00:00:00
abstract::Although patients with bronchial and ovarian carcinoid tumors can develop the carcinoid syndrome (diarrhea and/or flushing) in the absence of hepatic metastasis, it is believed that development of the carcinoid syndrome in patients with carcinoid tumors of gastrointestinal origin occurs only after the patient has hepa...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-198207000-00008
更新日期:1982-07-01 00:00:00
abstract:OBJECTIVE:The authors addressed whether a repeat hepatic operation is warranted in patients with recurrent isolated hepatic metastases. Are the results as good after second operation as after first hepatic operation? SUMMARY BACKGROUND DATA:Five-year survival after initial hepatic operation for colorectal metastases i...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-199606000-00015
更新日期:1996-06-01 00:00:00
abstract:INTRODUCTION:There is a documented association between critically ill patients who are in refractory shock and adrenal insufficiency. The underlying pathophysiology may be related to ischemia, necrosis, reperfusion, or resuscitative dilution. We hypothesize this blunted adrenal response is due to ischemia and necrosis ...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/01.sla.0000216759.36819.1b
更新日期:2006-05-01 00:00:00
abstract:OBJECTIVE:This single-institution review examined the incidence of biliary stricture formation after pancreaticoduodenectomy (PD) for benign and malignant periampullary disease. BACKGROUND:The incidence and course of stricture of the hepaticojejunostomy have not been documented after PD. METHODS:Between January 1995 ...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/01.sla.0000216285.07069.fc
更新日期:2006-05-01 00:00:00
abstract:OBJECTIVE:To assess the significance of axillary lymph node status and tumor size for predicting locoregional recurrence (LRR) and overall survival after mastectomy for breast cancer and to discuss the utility of postmastectomy radiation therapy. SUMMARY BACKGROUND DATA:Patients with locally advanced breast cancer req...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/01.SLA.0000065289.06765.71
更新日期:2003-05-01 00:00:00
abstract:BACKGROUND:The efficacy of irrigating the peritoneal cavity during appendectomy for perforated appendicitis has been debated extensively. To date, prospective comparative data are lacking. Therefore, we conducted a prospective, randomized trial comparing peritoneal irrigation to suction alone during laparoscopic append...
journal_title:Annals of surgery
pub_type: 杂志文章,随机对照试验
doi:10.1097/SLA.0b013e31826a91e5
更新日期:2012-10-01 00:00:00
abstract::Desmoid tumors are locally invasive, nonmetastasizing fibrous tumors most frequently seen in patients with familial polyposis coli (FPC). Of 325 patients with FPC treated at the Cleveland Clinic, 29 (8.9%) were found to have a total of 36 desmoid tumors. These tumors occur in young patients (mean age: 29.8 years), par...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-198607000-00014
更新日期:1986-07-01 00:00:00
abstract::The effects of severe infection on luminal transport of amino acids and glucose by the small intestine were investigated. Studies were done in endotoxin-treated rats and in septic patients who underwent resection of otherwise normal small bowel. In rats the kinetics of the brush border glutamine transporter and the gl...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-199105000-00004
更新日期:1991-05-01 00:00:00
abstract:OBJECTIVE:To determine the therapeutic effects of dietary supplementation on Clostridium difficile infection (CDI). BACKGROUND:With limited treatment options, the rise of C. difficile-associated disease has spurred on the search for novel therapies. Recent data define a role for the aryl hydrocarbon receptor (AHR) and...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/SLA.0000000000001830
更新日期:2017-06-01 00:00:00
abstract::This study explores whether fetal allograft survival is age dependent and organ specific. Fetal rat tissue (renal, gonadal, hepatic) from the third trimester of gestation (days 15-21) was transplanted into 306 outbred adult rats for 10-30 days. Grafts were studied by morphometric and histologic analysis. Ten days afte...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-198610000-00008
更新日期:1986-10-01 00:00:00
abstract:OBJECTIVE:The aim of this study was to show the safety and feasibility of single-port laparoscopic surgery (SPLS) by comparing its short-term outcomes with those following conventional laparoscopic surgery. SUMMARY BACKGROUND DATA:Single-port laparoscopic surgery maximizes the advantages of laparoscopic surgery, and t...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/SLA.0b013e318237826b
更新日期:2011-12-01 00:00:00
abstract:OBJECTIVE:To evaluate whether the type of on-site care a trauma patient receives affects outcome. SUMMARY BACKGROUND DATA:The controversy regarding the prehospital care of trauma patients between Advanced Life Support (ALS) and Basic Life Support (BLS) is ongoing. Due to this unresolved controversy, as well as histori...
journal_title:Annals of surgery
pub_type: 杂志文章,多中心研究
doi:10.1097/01.SLA.0000048374.46952.10
更新日期:2003-02-01 00:00:00
abstract:BACKGROUND:A recent revision of the American Joint Committee on Cancer (AJCC) staging for gallbladder cancer (6th Edition) involved some major changes. Most notably, T2N0M0 tumors were moved from stage II to stage IB; T3N1M0 disease was moved from stage III to stage IIB; and T4NxM0 (x = any) tumors were moved from stag...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/01.sla.0000219737.81943.4e
更新日期:2006-06-01 00:00:00
abstract:OBJECTIVE:To determine whether black patients have higher odds of readmission than white patients after major surgery, and to ascertain whether these disparities are related to where black patients receive care. BACKGROUND:Racial disparities are known to exist for many aspects of surgical care. However, it is unknown ...
journal_title:Annals of surgery
pub_type: 杂志文章,多中心研究
doi:10.1097/SLA.0000000000000326
更新日期:2014-06-01 00:00:00
abstract:OBJECTIVE:To examine preoperative dietary influences on gut-associated lymphoid tissue (GALT) cell number in the context of postoperative infectious complications. BACKGROUND:There is little clinical evidence regarding whether nutritional routes affect GALT size and/or phenotype. The influence of GALT atrophy on clini...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/SLA.0b013e31827a0e05
更新日期:2013-12-01 00:00:00