Abstract:
:The factors contributing to the development of esophageal mucosal injury in gastroesophageal reflux disease (GERD) are unclear. The lower esophageal sphincter, esophageal acid and acid/alkaline exposure, and the presence of excessive duodenogastric reflux (DGR) was evaluated in 205 consecutive patients with GERD and various degrees of mucosal injury (no mucosal injury, n = 92; esophagitis, n = 66; stricture, n = 19; Barrett's esophagus, n = 28). Manometry and 24-hour esophageal pH monitoring showed that the prevalence and severity of esophageal mucosal injury was higher in patients with a mechanically defective lower esophageal sphincter (p less than 0.01) or increased esophageal acid/alkaline exposure (p less than 0.01) as compared with those with a normal sphincter or only increased esophageal acid exposure. Complications of GERD were particularly frequent and severe in patients who had a combination of a defective sphincter and increased esophageal acid/alkaline exposure (p less than 0.01). Combined esophageal and gastric pH monitoring showed that esophageal alkaline exposure was increased only in GERD patients with DGR (p less than 0.05) and that DGR was more frequent in GERD patients with a stricture or Barrett's esophagus. A mechanically defective lower esophageal sphincter and reflux of acid gastric juice contaminated with duodenal contents therefore appear to be the most important determinants for the development of mucosal injury in GERD. This explains why some patients fail medical therapy and supports the surgical reconstruction of the defective sphincter as the most effective therapy.
journal_name
Ann Surgjournal_title
Annals of surgeryauthors
Stein HJ,Barlow AP,DeMeester TR,Hinder RAdoi
10.1097/00000658-199207000-00006subject
Has Abstractpub_date
1992-07-01 00:00:00pages
35-43issue
1eissn
0003-4932issn
1528-1140journal_volume
216pub_type
杂志文章abstract:OBJECTIVE:We compared the incidence of appendicitis or appendectomy across the world and evaluated temporal trends. SUMMARY BACKGROUND DATA:Population-based studies reported the incidence of appendicitis. METHODS:We searched MEDLINE and EMBASE databases for population-based studies reporting the incidence of appendic...
journal_title:Annals of surgery
pub_type: 杂志文章,meta分析,评审
doi:10.1097/SLA.0000000000002188
更新日期:2017-08-01 00:00:00
abstract:OBJECTIVE:To identify factors that have contributed to reduced rates of death and complications after esophageal resection in a 17-year period at a tertiary referral center. SUMMARY BACKGROUND DATA:There has been an evolving refinement in surgical technique and perioperative management of patients undergoing esophagea...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-200103000-00006
更新日期:2001-03-01 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::The induction of donor-specific tolerance could prevent the side effects of immunosuppression while improving allograft survival. Male adult Buffalo (RT1b) rats underwent an intrathymic (IT), portal venous (PV), intrasplenic (IS), or subcutaneous (SQ) injection of 25 x 10(6) major histocompatibility complex (MHC) mism...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-199210000-00003
更新日期:1992-10-01 00:00:00
abstract:BACKGROUND:Controversy exists on the use of mesh in the repair of paraesophageal hernias (PEH). This debate centers around the type of mesh used, its value in preventing recurrence, its short- and long-term complications, and the consequences of those complications compared with primary repair. Decision analysis is a m...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/SLA.0b013e3182822c8c
更新日期:2013-04-01 00:00:00
abstract:OBJECTIVES:To evaluate the results of a vertical rectus abdominis myocutaneus (VRAM) flap after abdomino-perineal resection (APR) for anal cancer (AC). BACKGROUND DATA:APR is the only curative treatment for AC that recurs or persists after radiochemotherapy. To obtain a clear surgical margin, APR frequently includes a...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/SLA.0b013e3181bce334
更新日期:2009-11-01 00:00:00
abstract::The effects of two levels of protein intake on protein metabolism in six severely burned adult patients were studied (means of 70% BSA burned). A crossover experimental design enabled the authors to study each patient at the end of two three-day dietary regimens. All diets were isocaloric and provided approximately 25...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-198302000-00007
更新日期:1983-02-01 00:00:00
abstract:OBJECTIVES:Surgical simulation has been shown to enhance the training of general surgery residents. Since catheter-based techniques have become an important part of the vascular surgeon's armamentarium, we explored whether simulation might impact the acquisition of catheter skills by surgical residents. METHODS:Twenty...
journal_title:Annals of surgery
pub_type: 杂志文章,随机对照试验
doi:10.1097/01.sla.0000234932.88487.75
更新日期:2006-09-01 00:00:00
abstract:OBJECTIVE:To assess existing measures of pathologic response to neoadjuvant therapy in esophageal and junctional cancer, and to recommend an optimum classification. BACKGROUND:Multimodal therapy is increasingly the standard of care for locally advanced esophageal cancer. Numerous measures of pathologic response have b...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/SLA.0b013e3182a66588
更新日期:2013-11-01 00:00:00
abstract:OBJECTIVE:A randomized controlled trial was conducted to clarify the effectiveness of intraoperative blood salvage in reducing blood loss. BACKGROUND:Although reduction of central venous pressure (CVP) is thought to decrease blood loss during liver resection, no consistently effective and safe method for obtaining the...
journal_title:Annals of surgery
pub_type: 杂志文章,随机对照试验
doi:10.1097/01.sla.0000255562.60215.3b
更新日期:2007-05-01 00:00:00
abstract:OBJECTIVE:The authors analyzed the frequency and character of postoperative complications after splenectomy in patients with hematologic malignancies, and correlated these findings with preoperative conditions that could have predicted their outcome. SUMMARY BACKGROUND DATA:Splenectomy is performed for hematologic mal...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-199603000-00010
更新日期:1996-03-01 00:00:00
abstract:OBJECTIVE:To assess surgical aspects in the treatment of children with unilateral Wilms tumor based on data from the Cooperative Tumor Study SIOP 93-01 of the German Society of Pediatric Hematology and Oncology. SUMMARY BACKGROUND DATA:Although multiple international study trials exist for the treatment of nephroblast...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/SLA.0b013e31819ed92b
更新日期:2009-04-01 00:00:00
abstract:BACKGROUND:Postcholecystectomy complex bile duct injuries involving the hilar confluence, which are often associated with vascular injuries and liver atrophy, remain a considerable surgical challenge. The aim of this study is to report our experience of major hepatectomy with long-term outcome in these patients. METHO...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/SLA.0b013e31817b65f2
更新日期:2008-07-01 00:00:00
abstract::From January 1982 to June 1986, 444 patients had localization of 500 nonpalpable mammographically suspicious lesions using the Kopans hook wire technique. Four hundred ninety-nine biopsies were performed in 443 patients. Cancer was identified in 12% of the biopsies performed for a suspicious mass or density and in 20%...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-198705000-00010
更新日期:1987-05-01 00:00:00
abstract::As a continuation of work from this laboratory on anticholinesterase induced pancreatitis, a study of the relationship between reduced serum cholinesterase activity and changes in pancreatic intraductal pressure was undertaken. Pharmakokinetic studies in three dogs revealed rapid reduction in serum cholinesterase acti...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-197907000-00002
更新日期:1979-07-01 00:00:00
abstract::During a 10-year period, 94 surgical resections for adenocarcinoma of the cardia (75 "curative" and 19 palliative) were performed using three primary approaches: Group I (46 curative, 14 palliative), esophagogastrectomy performed through a left thoracotomy or left thoraco-abdominal incision; Group II (17 curative, 4 p...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-198202000-00004
更新日期:1982-02-01 00:00:00
abstract::Thirty-one infants less than a year of age underwent surgery for correction of pernicious gastroesophageal reflux. Severe growth retardation from persistent vomiting was the single most important indication for surgery (25 patients). Recurrent aspiration penumonitis was another serious sequella of reflux and necessita...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-197410000-00013
更新日期:1974-10-01 00:00:00
abstract:OBJECTIVE:To achieve consensus on the best practices in the management of ventral hernias (VH). BACKGROUND:Management patterns for VH are heterogeneous, often with little supporting evidence or correlation with existing evidence. METHODS:A systematic review identified the highest level of evidence available for each ...
journal_title:Annals of surgery
pub_type: 共识发展会议,杂志文章
doi:10.1097/SLA.0000000000001701
更新日期:2017-01-01 00:00:00
abstract:OBJECTIVE:Prehospital intravenous (IV) fluid administration is common in trauma patients, although little evidence supports this practice. We hypothesized that trauma patients who received prehospital IV fluids have higher mortality than trauma patients who did not receive IV fluids in the prehospital setting. METHODS...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/SLA.0b013e318207c24f
更新日期:2011-02-01 00:00:00
abstract::In order to determine which factors most influence late survival after the coronary bypass procedure, a review was made of the initial experience of one surgeon who performed 792 operations between 1968 and 1972. The initial 250 patients were compared with the subsequent 542 patients. The two groups were of similar ag...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-197806000-00013
更新日期:1978-06-01 00:00:00
abstract::The prognostic and postoperative monitoring capabilities of the CEA assay were compared to pathological staging of the operative specimens, clinical followup including endoscopy, radiology and scanning techniques, as well as DNCB skin testing and laboratory enzyme determinations (alkaline phosphatase and transaminase)...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-197601000-00002
更新日期:1976-01-01 00:00:00
abstract::Inclusion of vagotomy and pyloroplasty in the surgical treatment of gastroesophageal reflux associated with hiatal hernia has long been controversial. To evaluate the morbidity of vagotomy in the treatment of reflux esophagitis, a retrospective study of 311 patients treated by the Hill posterior gastropexy technique o...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-197606000-00003
更新日期:1976-06-01 00:00:00
abstract::Glutaraldehyde treated human umbilical veins (Dardik Biograft) were used to bypass short segments of the femoral artery in 15 dogs and were compared to autogenous jugular veins placed in the contralateral femoral artery of each animal. All 15 autogenous jugular veins remained patent for the four month period of observ...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-197808000-00005
更新日期:1978-08-01 00:00:00
abstract:OBJECTIVE:To develop a model of established respiratory immunity against Pseudomonas aeruginosa pneumonia and to investigate the effects of route and type of nutrition on this immunity. SUMMARY BACKGROUND DATA:Diet influences the ability of gut-associated lymphoid tissue (GALT) to maintain mucosal immunity. Complex en...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-199902000-00016
更新日期:1999-02-01 00:00:00
abstract::A cross-over design study was used to examine the metabolic consequences of enteral feeding for 48 to 96 hours with either a branched-chain amino acid (BCAA)-enriched (44% BCAA) or a conventional egg protein formulation in 12 severely burned adult patients. A stable isotope labeled leucine (L-1-13C-leucine) tracer app...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-198804000-00009
更新日期:1988-04-01 00:00:00
abstract::Fetus-in-fetu is an unusual cause of retroperitoneal abdominal mass in infants, which most likely arises from inclusion of a monozygotic, diamniotic twin. This entity is distinguished from teratoma by its embryological origin, its unusual location in the retroperitoneal space, its invariable benignity, and by the pres...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-197407000-00011
更新日期:1974-07-01 00:00:00
abstract::Little information has been reported on the metabolic characteristics of the totally pancreatectomized patient or the efficacy of medical management after radical pancreatic surgery. The prospective evaluation of 49 such patients, with 31% followed for 48 or more months, forms the basis of this report. The major immed...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-199108000-00007
更新日期:1991-08-01 00:00:00
abstract::As a consequence of an experience with 175 patients undergoing reoperation for persistent or recurrent hyperparathyroidism, the authors have evolved an approach to management. The emphasis is on the confirmation of the diagnosis; the critical evaluation of invasive and noninvasive localization tests, techniques of int...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:
更新日期:1985-01-01 00:00:00
abstract:BACKGROUND:Surgery is the criterion standard for the treatment of severe burns and of late sequels after ingestion of corrosive agents, but long-term outcome is unknown. METHODS:Patients who underwent surgery between 1987 and 2006, for the treatment of severe caustic burns (group I, n = 268) or of late sequels (group ...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/SLA.0b013e3182583fb2
更新日期:2012-12-01 00:00:00
abstract:OBJECTIVE:This article describes a preliminary work on virtual reality applied to liver surgery and discusses the repercussions of assisted surgical strategy and surgical simulation on tomorrow's surgery. SUMMARY BACKGROUND DATA:Liver surgery is considered difficult because of the complexity and variability of the org...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-199811000-00001
更新日期:1998-11-01 00:00:00