Abstract:
BACKGROUND:Some, but not all, studies using registry data have suggested a small but significant long-term survival advantage following a curative surgical resection of gastric cancer at hospitals where the volume of such surgeries is high. However, because such data may be significantly influenced by the impact of postoperative mortality, and may be imbalanced for factors important to survival, the true nature of this relationship remains uncertain. METHODS:We conducted a nested volume-outcome study in a sample of 448 surgical survivors with stage IB through IV (M0) gastric and gastroesophageal junction adenocarcinoma, previously randomized to adjuvant chemoradiation after surgery or surgery alone, to measure the effect of hospital surgical volume, as assessed by Medicare claims data, on overall survival and gastric cancer recurrence. RESULTS:In this selected sample of postoperative survivors, hospital surgical volume was not predictive of overall survival (P = 0.46) or disease-free survival (P = 0.43) at a median follow-up of 8.9 years. However, patients who underwent either a D1 or D2 dissection at a high- or moderate-volume center experienced an adjusted hazard ratio of 0.80 (95% CI, 0.53-1.20) for overall survival and 0.78 (95% CI, 0.53-1.14) for disease-free survival compared with those patients resected at a low-volume hospital; these results were not statistically significant. When a D0 resection was performed, hospital procedure volume showed no impact on survival. CONCLUSIONS:Excluding the impact of perioperative mortality by utilizing prospectively recorded data from a large postoperative adjuvant trial, hospital procedure volume had no overall effect on long-term gastric cancer survival. The potential benefit of moderate- to high-volume centers for patients who underwent a D1 or D2 dissection requires confirmation in larger studies.
journal_name
Ann Surgjournal_title
Annals of surgeryauthors
Enzinger PC,Benedetti JK,Meyerhardt JA,McCoy S,Hundahl SA,Macdonald JS,Fuchs CSdoi
10.1097/01.sla.0000245469.35088.42subject
Has Abstractpub_date
2007-03-01 00:00:00pages
426-34issue
3eissn
0003-4932issn
1528-1140pii
00000658-200703000-00014journal_volume
245pub_type
杂志文章,随机对照试验abstract:OBJECTIVE:To assess ischemia and reperfusion (I/R) injury in a hemihepatectomy model in pigs after prolonged continuous or intermittent vascular inflow occlusion in the liver. SUMMARY BACKGROUND DATA:Massive intraoperative blood loss during liver resections can be prevented by temporary vascular inflow occlusion, cons...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-199903000-00011
更新日期:1999-03-01 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:This study determined the association between proximal gastrointestinal (GI) colonization and the development of intensive care unit (ICU)-acquired infection and multiple organ failure (MOF) in a population of critically ill surgical patients. SUMMARY BACKGROUND DATA:ICU-acquired infection in association wit...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-199308000-00001
更新日期:1993-08-01 00:00:00
abstract:OBJECTIVE:To identify and prioritize hazards in surgical wards and recommend interventions. BACKGROUND:Retrospective and prospective studies report the frequency and severity of surgical adverse events, but not in sufficient detail to allow interventions to be recommended in surgical wards. METHODS:Seventy hours of o...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/SLA.0b013e31824f5f36
更新日期:2012-06-01 00:00:00
abstract::A clinical program in liver transplantation was begun at UCLA in 1984 after a period of laboratory investigation. The first 100 orthotopic liver transplants (OLT) were performed in 83 patients (43 adults and 40 children) between February 1, 1984 and November 1, 1986. Donors and recipients were matched only for size an...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-198710000-00001
更新日期:1987-10-01 00:00:00
abstract:OBJECTIVE:The aim of this study was to compare patient outcomes between International Medical Graduate (IMG) versus US medical graduate (USMG) surgeons. SUMMARY BACKGROUND DATA:One in 7 surgeons practicing in the US graduated from a foreign medical school. However, it remains unknown whether patient outcomes differ be...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/SLA.0000000000003736
更新日期:2019-12-10 00:00:00
abstract::Reconstitution of the mesenteric vascular circulation, in our experience, is advisable when advanced occlusive disease is noted on the preoperative arteriogram of patients selected for aortoiliofemoral, renal artery, or aortic aneurysm surgery. A lateral aortogram is mandatory, and the presence of an anastomotic meand...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-197910000-00011
更新日期:1979-10-01 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:BACKGROUND:Aortic elasticity creates a cushion that protects the heart from pressure injury, and a recoil that helps perfuse the coronary arteries. TEVAR has become first-line therapy for many aortic pathologies including trauma, but stent-grafts stiffen the aorta and likely increase LV afterload. OBJECTIVE:Test the h...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/SLA.0000000000003768
更新日期:2020-01-03 00:00:00
abstract:OBJECTIVE:To determine the impact of tumor characteristics and treatment approach on (1) local recurrence, (2) scoliosis development and (3) patient-reported quality of life in children with sarcoma of the chest wall. SUMMARY BACKGROUND DATA:Children with chest wall sarcoma require multimodal therapy including chemoth...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/SLA.0000000000004579
更新日期:2020-11-04 00:00:00
abstract:OBJECTIVE:The authors determined the incidence of complications in 133 patients who had undergone staging laparotomy with splenectomy before treatment for Hodgkin's disease (stages I-IV). METHODS AND MATERIALS:Medical records were reviewed, and the patients or their relatives were interviewed. Median follow-up after l...
journal_title:Annals of surgery
pub_type: 杂志文章,评审
doi:10.1097/00000658-199406000-00004
更新日期:1994-06-01 00:00:00
abstract:INTRODUCTION:The use of extended criteria donors (ECDs) could minimize shortage of suitable donor livers for transplantation. In 3 years, the aggressive use of ECD livers has reduced the wait list at our center from 257 to 30 patients with a median wait time of 18 days without using living donors. This study compares t...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/01.sla.0000234896.18207.fa
更新日期:2006-09-01 00:00:00
abstract:OBJECTIVE:To evaluate the long-term outcome of aggressive surgery incorporating hepatic resection and systematic nodal dissection for advanced carcinoma involving the hepatic hilus. SUMMARY BACKGROUND DATA:Few long-term results are available regarding radical surgery incorporating major hepatectomy and nodal dissectio...
journal_title:Annals of surgery
pub_type: 杂志文章,评审
doi:10.1097/00000658-199911000-00008
更新日期:1999-11-01 00:00:00
abstract:OBJECTIVE:To evaluate the effect of anesthesia induced mild systemic hypothermia on hepatic injury in lean and obese rats during warm ischemia. SUMMARY BACKGROUND DATA:Hepatic warm ischemia during surgery remains a significant problem, particularly in organs with presumed baseline dysfunction. METHODS:The left and me...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/01.sla.0000154259.73060.f1
更新日期:2005-03-01 00:00:00
abstract::Adenocarcinoma involving the distal esophagus usually is far advanced when the patient is first seen. Adenocarcinoma differs from squamous carcinoma of the esophagus since it is relatively unresponsive to radiation therapy or chemotherapy. Adenocarcinoma of the esophagus resembles gastric cancer in its tendency to for...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-198705000-00015
更新日期:1987-05-01 00:00:00
abstract::Traumatic injuries to the upper abdominal vasculature pose difficult management problems related to both exposure and associated injuries. Among those injuries that are more difficult to manage are those involving the portal vein. While occurring rarely, portal vein injuries require specific therapeutic considerations...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-197505000-00003
更新日期:1975-05-01 00:00:00
abstract:BACKGROUND:The Hepp-Couinaud technique describes side-to-side HJ to the main left hepatic duct but a side-to-side approach is not consistently used when repairing other ducts. Compared with end-to-side repairs, side-to-side anastomoses require less dissection, theoretically preserving blood supply to the bile ducts, an...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/SLA.0b013e31819a6b2e
更新日期:2009-03-01 00:00:00
abstract::The myocardial effects of protamine, with and without heparin, were documented in this investigation. Isolated rabbit hearts (n = 30) were retrograde perfused with Krebs-Ringers bicarbonate solution aerated with 95% O2/5% CO2 through the aortic root (37 C, 80 mmHg). Developed left ventricular blood pressure, heart rat...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-199010000-00001
更新日期:1990-10-01 00:00:00
abstract:OBJECTIVE:The outcome of pelvic exenteration was compared in patients with locally advanced primary (LAP) cancer and recurrent rectal cancer (RRC). BACKGROUND:There are few reports comparing the results of pelvic exenteration for primary advanced rectal cancer and RRC. METHODS:Consecutive patients undergoing pelvic e...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/SLA.0b013e31828a0d22
更新日期:2014-02-01 00:00:00
abstract:BACKGROUND/OBJECTIVE:The National Surgical Quality Improvement Program (NSQIP) has demonstrated quality improvement in the VA and pilot study of 14 academic institutions. The objective was to show that American College of Surgeons (ACS)-NSQIP helps all enrolled hospitals. METHODS:ACS-NSQIP data was used to evaluate im...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/SLA.0b013e3181b4148f
更新日期:2009-09-01 00:00:00
abstract::We reviewed 37 consecutive, hemodynamically stable patients (16 adults, 21 children) who had splenic injuries diagnosed by computed tomography (CT) scan to compare the CT evaluation with operative assessment of injury and eventual treatment. Computed tomographic scans and operative findings were graded by a splenic in...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-199005000-00009
更新日期:1990-05-01 00:00:00
abstract::In the absence of a prospective randomized study of patients treated conservatively or with thymectomy, a computer-assisted retrospective matches study was devised. Of 563 patients treated for myasthenia gravis without thymoma up to 1965, 104 had thymectomy. With computer assistance, each surgical patient was matched ...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-197610000-00008
更新日期:1976-10-01 00:00:00
abstract::The present work was performed to clarify the effects of epidermal growth factor (EGF) on the growth of human breast cancer and carcinoma of the esophagus. Human breast cancer MX-1, UM-1, and esophageal cancer ES-4 were transplanted to the subcutaneous tissue of nude mice. Human EGF (2 micrograms) was injected locally...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:
更新日期:1990-03-01 00:00:00
abstract::Prolonged veno arterial extracorporeal bypass (50-80% of cardiac output) was evaluated in normal, unanesthetized sheep. The evaluation protocol included serial measurements of hemodynamics, pulmonary and renal function, serum enzymes to detect organ damage, and detailed studies of coagulation and platelets. Blood expo...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-197412000-00010
更新日期:1974-12-01 00:00:00
abstract:OBJECTIVE:To analyze the challenges encountered during surgical quality improvement interventions, and explain the relative success of different intervention strategies. SUMMARY BACKGROUND DATA:Understanding why and how interventions work is vital for developing improvement science. The S3 Program of studies tested wh...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/SLA.0000000000001583
更新日期:2016-12-01 00:00:00
abstract:OBJECTIVE:To analyze outcomes after open small-incision surgery (minilaparotomy) and laparoscopic surgery for gallstone disease in general surgical practice. METHODS:This study was a randomized, single-blind, multicenter trial comparing laparoscopic cholecystectomy (LC) to minilaparotomy cholecystectomy (MC). Both ele...
journal_title:Annals of surgery
pub_type: 临床试验,杂志文章,多中心研究,随机对照试验
doi:10.1097/00000658-200112000-00005
更新日期:2001-12-01 00:00:00
abstract:OBJECTIVE:To determine the role of the microvascular endothelium in the regulation of regenerating liver mass after partial hepatectomy. SUMMARY BACKGROUND DATA:Angiogenesis is critical for both pathologic and physiologic processes. The ability of certain tissues, such as the liver, kidney, and spleen, to regenerate a...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/01.SLA.0000059986.96051.EA
更新日期:2003-04-01 00:00:00
abstract::Circular, full-thickness dermal burn- and freeze-produced wounds were produced in rats to compare the difference in healing between the two types of thermal injuries. Contraction did not occur in wounds (n = 30) caused by freezing, while burn wounds (n = 30) contracted to less than one-third of original size by 21 day...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-198002000-00019
更新日期:1980-02-01 00:00:00
abstract::In a study of wound healing at high altitude, subcutaneously implanted PTFE tubes were used to stimulate and measure accumulation of wound hydroxyproline (an index of collagen) in 26 patients who had appendectomy and in 38 patients who had cholecystectomy. Patient age, length of surgery, and postoperative recovery see...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-198703000-00006
更新日期:1987-03-01 00:00:00
abstract:OBJECTIVE:To determine the factors that may predict music-induced relaxation in friends and family of patients in the emergency department. BACKGROUND:It remains unclear to date which demographic and experiential factors predict the effectiveness of music-induced relaxation. Furthermore, in-hospital stressors for frie...
journal_title:Annals of surgery
pub_type: 杂志文章,随机对照试验
doi:10.1097/SLA.0b013e31828ee1da
更新日期:2013-05-01 00:00:00