Abstract:
OBJECTIVE:This study aimed at: (1) documenting the evolution of surgical results of esophagectomy in a high-volume center, (2) identifying predictive factors of pulmonary complications and mortality, and (3) examining whether preoperative chemoradiation therapy would complicate postoperative recovery. SUMMARY BACKGROUND DATA:Pulmonary complications and mortality rate after esophagectomy remain substantial, and factors responsible have not been adequately studied. Neoadjuvant chemoradiation is widely used; it is hypothesized that this may lead to adverse postoperative outcome. METHODS:Prospectively collected data were used to analyze outcome in 421 patients with intrathoracic squamous cell esophageal cancer who underwent resection. Logistic regression analyses determined independent predictors of pulmonary complications and death. Two time periods were compared: period I (January 1990 to June 1995) and period II (July 1995 to December 2001). In the later period, neoadjuvant chemoradiation therapy was introduced. RESULTS:Transthoracic resections were carried out in 83% of patients. Neoadjuvant chemoradiation was given to 42% of patients in period II. Major pulmonary complications occurred in 15.9%, and were primarily responsible for 55% of hospital deaths. Thirty-day and hospital mortality rates were 1.4% and 4.8%, respectively. Logistic regression analysis identified age, operation duration, and proximal tumor location as risk factors for pulmonary complications, whereas advanced age and higher blood loss were predictive of mortality. Chemoradiation did not lead to worse outcome. When period I and II were compared, hospital mortality rate reduced from 7.8% to 1.1%, P = 0.001, with correspondingly less blood loss (median blood loss was 700 ml (range: 200-2700 (period I) and 450 ml (range: 100-7000) (period II), P < 0.01). CONCLUSION:A 1.1% mortality rate was achieved in the last 6 years of the study period. Preoperative chemoradiation did not result in worse outcome. Reduction in mortality rate correlated with decreased blood loss.
journal_name
Ann Surgjournal_title
Annals of surgeryauthors
Law S,Wong KH,Kwok KF,Chu KM,Wong Jdoi
10.1097/01.sla.0000143123.24556.1csubject
Has Abstractpub_date
2004-11-01 00:00:00pages
791-800issue
5eissn
0003-4932issn
1528-1140pii
00000658-200411000-00010journal_volume
240pub_type
杂志文章abstract:OBJECTIVE AND BACKGROUND:Watch-and-wait approach in rectal cancer relies on the identification of a clinical complete response (CR) after neoadjuvant (chemo)radiotherapy. This is mainly performed by rectal examination, magnetic resonance imaging, and endoscopy. Endoscopy has been less well studied, and the objective of...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/SLA.0000000000003718
更新日期:2019-12-09 00:00:00
abstract:OBJECTIVE:To examine the surgical and pathologic findings of 15 patients who had initially unresectable hepatocellular carcinoma (HCC) and received preoperative systemic chemoimmunotherapy and sequential resection. SUMMARY BACKGROUND DATA:More than 80% of patients with HCC present for treatment at an unresectable stag...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-200102000-00013
更新日期:2001-02-01 00:00:00
abstract:OBJECTIVE:The authors review the results and outcomes of esophagectomy (prophylactic esophagectomy) for patients with Barrett's esophagus and high-grade epithelial dysplasia (HGD). SUMMARY BACKGROUND DATA:The role of prophylactic esophagectomy for Barrett's esophagus with HGD is controversial, with some authors recomm...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-199607000-00010
更新日期:1996-07-01 00:00:00
abstract::External pneumatic calf compression is effective but imperfect for antithrombotic prophylaxis in surgical patients. In preliminary studies, sequential filling of multisegmented leggings with graded pressure decreasing from ankle to knee increased venous flow velocity and wall shear stress, decreased residual venous vo...
journal_title:Annals of surgery
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1097/00000658-198711000-00014
更新日期:1987-11-01 00:00:00
abstract:OBJECTIVE:The purpose of this study was to create a technical skills assessment toolbox for 35 basic and advanced skills/procedures that comprise the American College of Surgeons (ACS)/Association of Program Directors in Surgery (APDS) surgical skills curriculum and to provide a critical appraisal of the included tools...
journal_title:Annals of surgery
pub_type: 杂志文章,评审
doi:10.1097/SLA.0000000000000520
更新日期:2015-02-01 00:00:00
abstract:OBJECTIVE:To determine prospectively the immunologic response and adverse clinical events in surgical patients exposed to bovine thrombin during cardiac surgical procedures. SUMMARY BACKGROUND DATA:Topical bovine thrombin is used extensively as a hemostatic agent during cardiovascular surgery. Antibodies developing af...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-200101000-00014
更新日期:2001-01-01 00:00:00
abstract::Five days after thyroidectomy (Tx) or sham-Tx in young male Sprague-Dawley rats, sepsis was induced by cecal ligation and puncture (CLP). Control animals underwent laparotomy and manipulation of the cecum without ligation or puncture. Sixteen hours after CLP or laparotomy, protein synthesis and degradation were measur...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-198707000-00003
更新日期:1987-07-01 00:00:00
abstract:OBJECTIVE:Our objective was to compare outcomes of a restrictive to a liberal red cell transfusion strategy in 20% or more total body surface area (TBSA) burn patients. We hypothesized that the restrictive group would have less blood stream infection (BSI), organ dysfunction, and mortality. BACKGROUND:Patients with ma...
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.0000000000002408
更新日期:2017-10-01 00:00:00
abstract:OBJECTIVE:The aim of this study was to perform a systematic review and meta-analysis to assess the accuracy of different surgical axillary staging procedures compared with ALND. SUMMARY OF BACKGROUND DATA:Optimal axillary staging after neoadjuvant systemic therapy (NST) in node-positive breast cancer is an area of con...
journal_title:Annals of surgery
pub_type: 杂志文章,meta分析
doi:10.1097/SLA.0000000000003075
更新日期:2019-03-01 00:00:00
abstract:OBJECTIVE:To compare actual 90-day hospital costs between elective open and laparoscopic colon and rectal cancer resection in a daily practice multicenter setting stratified for operative risk. BACKGROUND:Laparoscopic resection has developed as a commonly accepted surgical procedure for colorectal cancer. There are co...
journal_title:Annals of surgery
pub_type: 杂志文章,多中心研究
doi:10.1097/SLA.0000000000002000
更新日期:2017-12-01 00:00:00
abstract::In 79 patients in whom distal small vessel bypass with autogenous vein was used for revascularization because of gangrene, gangrenous ulceration or rest pain, 14 had femoroperoneal bypasses. Femorotibial or femoroperoneal bypasses were performed in those patients in whom no popliteal runoff was present on pre-operativ...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-197502000-00010
更新日期:1975-02-01 00:00:00
abstract:OBJECTIVE:The authors evaluated the morbidity, mortality, and quality of life after pancreatic debridement for necrosis and compared these values to those for quality of life after elective medical and surgical management for chronic pancreatitis. SUMMARY BACKGROUND DATA:Quality of life after pancreatic debridement fo...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-199606000-00005
更新日期:1996-06-01 00:00:00
abstract:OBJECTIVE:To examine factors influencing surgical research and assess the current state of training future surgical scientists. SUMMARY BACKGROUND DATA:The number of surgeons actively engaged in research seems to be decreasing. Training future surgical scientists to increase these numbers depends on a variety of facto...
journal_title:Annals of surgery
pub_type: 杂志文章,评审
doi:10.1097/SLA.0b013e318163d27d
更新日期:2008-05-01 00:00:00
abstract:OBJECTIVE:To determine whether ischemic preconditioning protects the human liver against a subsequent period of ischemia in patients undergoing hemihepatectomy, and to identify possible underlying protective mechanisms of ischemic preconditioning, such as inhibition of hepatocellular apoptosis. SUMMARY BACKGROUND DATA...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-200008000-00001
更新日期:2000-08-01 00:00:00
abstract::This study sought to minimize juxta-anastomotic neointimal hyperplasia (JNIH) following the use of polytetrafluorethylene (PTFE) conduits. PTFE anastomoses to canine carotid arteries (noncuff grafts) were compared with grafts with vein cuffs interposed proximally and distally between the graft and native artery. This ...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-198806000-00011
更新日期:1988-06-01 00:00:00
abstract:OBJECTIVE:To identify patient characteristics associated with the development of local recurrence and the effect of local recurrence on subsequent morbidity and mortality in patients with intermediate- to high-grade extremity soft tissue sarcomas. SUMMARY BACKGROUND DATA:Numerous studies on extremity soft tissue sarco...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/01.SLA.0000048448.56448.70
更新日期:2003-02-01 00:00:00
abstract:BACKGROUND:Despite antiviral treatment has been shown to reduce hepatocellular carcinoma (HCC) recurrence after curative treatment for hepatitis B virus (HBV)-related HCC in patients with high preoperative HBV-DNA levels, it is still unclear whether antiviral therapy is useful in reducing recurrence in patients with lo...
journal_title:Annals of surgery
pub_type: 杂志文章,随机对照试验
doi:10.1097/SLA.0000000000002727
更新日期:2018-12-01 00:00:00
abstract:OBJECTIVE:We report on a new side-to-side isoperistaltic strictureplasty (SSIS), the Michelassi II or end-to-side-to-side-to-end strictureplasty, performed with discontinuous bowel loops. SUMMARY BACKGROUND DATA:The SSIS Michelassi strictureplasty was described a quarter of a century ago to avoid massive bowel resecti...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/SLA.0000000000003430
更新日期:2020-01-01 00:00:00
abstract:OBJECTIVE:A prospective consecutive study was planned to evaluate the postpancreaticoduodenectomy (PD) oral intake tolerance. The occurrence of delayed gastric emptying (DGE), as defined by the International Study Group of Pancreatic Surgery (ISGPS), and the amount of dietary intake were analyzed. The risk factors for ...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/SLA.0b013e3181a63c4c
更新日期:2009-06-01 00:00:00
abstract:OBJECTIVE:To investigate the use of coffee, caffeinated drinks, and caffeine tablets for pharmacological cognitive enhancement (CE) among surgeons. BACKGROUND:Surgeons have demanding workloads, and the resulting fatigue and concentration deficits can lead to medical errors. Some surgeons use substances that promote wa...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/SLA.0000000000000830
更新日期:2015-06-01 00:00:00
abstract:OBJECTIVE:Based on development of stem cell technology, newborn tissue, even undergoing cryopreservation, possesses promising potential as a donor source in the field of organ transplantation. However, the precise regeneration processes remains unclear. This study was designed to investigate the regenerative potential ...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/01.sla.0000168089.64630.94
更新日期:2005-07-01 00:00:00
abstract:OBJECTIVE:To determine which mammographically guided breast biopsy technique is the most efficient in making a diagnosis in women with suspicious mammograms. SUMMARY BACKGROUND DATA:Mammographically guided biopsy techniques include stereotactic 14-gauge core-needle biopsy (SC bx), stereotactic 11-gauge suction-assiste...
journal_title:Annals of surgery
pub_type: 临床试验,杂志文章
doi:10.1097/00000658-199905000-00004
更新日期:1999-05-01 00:00:00
abstract:OBJECTIVE:To compare the outcomes of bilateral subtotal (BST) versus total thyroidectomy (TT) for benign bilateral thyroid disease (BBTD). BACKGROUND:The extent of thyroid resection in benign goiter is controversial. Potential advantages of TT over BST may include: one-stage removal of incidental thyroid cancer, and a...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/SLA.0b013e3182360118
更新日期:2011-11-01 00:00:00
abstract::In 1974 total colectomy and ileoanal straight endorectal pull-through (ERPT) were first used at our institution for the definitive management of total colonic Hirschsprung's disease in infants and children. Early success with this operation encouraged us to use this procedure in children and adults with ulcerative col...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-199009000-00002
更新日期:1990-09-01 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:OBJECTIVES:Aggressive human melanomas express, C-X-C chemokine receptor 4 (CXCR4), the receptor for the chemokine, stromal cell-derived factor-1alpha (SDF-1α). The CXCR4-SDF-1α axis has been postulated to increase melanoma invasiveness. We discovered that SDF-1α specifically upregulates E-selectin on endothelial cells,...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/SLA.0b013e31822a72dc
更新日期:2011-09-01 00:00:00
abstract:OBJECTIVE:To determine if the extent of lymphadenectomy (number of recovered lymph nodes) was associated with long-term outcome in patients operated on for stage B and C colon cancer. SUMMARY BACKGROUND DATA:Lymphatic spreading is the main prognostic indicator in colon cancer patients, although the optimal extent of l...
journal_title:Annals of surgery
pub_type: 杂志文章,多中心研究
doi:10.1097/00000658-200204000-00002
更新日期:2002-04-01 00:00:00
abstract::Seventy-five consecutive patients who sustained injuries to the duodenum were admitted to our hospital over a nine-year period. Nineteen blunt injuries and 56 penetrating injuries were encountered. Blunt injuries were usually the result of motor vehicle accidents and steering wheel impact was frequently implicated. Pe...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-198006000-00006
更新日期:1980-06-01 00:00:00
abstract::Two hundred thirty-four patients with extensive ulcerative colitis from the city of Göteborg, Sweden have been followed up and the cumulative risk of development of cancer of the large bowel was estimated. These patients constitute all persons in this region who developed an extensive ulcerative colitis between 1951 a...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-197812000-00018
更新日期:1978-12-01 00:00:00
abstract::Tissue reaction to sutures was studied in 666 specimens obtained from patients from one day to 23 years after operation. Reaction to catgut depends on the stage of absorption and is mainly histocytic in type. Nonabsorbable sutures are encapsulated by a rim of connective tissue, while near the suture histocytes, giant ...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-197502000-00003
更新日期:1975-02-01 00:00:00