Abstract:
OBJECTIVE:"Rediscovered" in 1976, transhiatal esophagectomy (THE) has been applicable in most situations requiring esophageal resection and reconstruction. The objective of this study was to review the authors' 30-year experience with THE and changing trends in its use. METHODS:Using the authors' prospective Esophagectomy Database, this single institution experience with THE was analyzed retrospectively. RESULTS:Two thousand and seven THEs were performed-1063 (previously reported) between 1976 and 1998 (group I) and 944 from 1998 to 2006 (group II), 24% for benign disease, 76%, cancer. THE was possible in 98%. Stomach was the esophageal substitute in 97%. Comparing outcomes between group I and group II, statistically significant differences (P < 0.001) were observed in hospital mortality (4% vs. 1%); adenocarcinoma histology (69% vs. 86%); use of neoadjuvant chemoradiation (28% vs. 52%); mean blood loss (677 vs. 368 mL); anastomotic leak (14% vs. 9%); and discharge within 10 days (52% vs. 78%). Major complications remain infrequent: wound infection/dehiscence, 3%, atelectasis/pneumonia, 2%, intrathoracic hemorrhage, recurrent laryngeal nerve paralysis, chylothorax, and tracheal laceration, <1% each. Late functional results have been good or excellent in 73%. Aggressive preoperative conditioning, avoiding the ICU, improved pain management, and early ambulation reduce length of stay, with 50% in group II discharged within 1 week. CONCLUSION:THE refinements have reduced the historic morbidity and mortality of esophageal resection. This largest reported THE experience reinforces the value of consistent technique and a clinical pathway in managing these high acuity esophageal patients.
journal_name
Ann Surgjournal_title
Annals of surgeryauthors
Orringer MB,Marshall B,Chang AC,Lee J,Pickens A,Lau CLdoi
10.1097/SLA.0b013e31814697f2subject
Has Abstractpub_date
2007-09-01 00:00:00pages
363-72; discussion 372-4issue
3eissn
0003-4932issn
1528-1140pii
00000658-200709000-00003journal_volume
246pub_type
杂志文章abstract:OBJECTIVE:The aim of this study was to determine characteristics of the most cited publications in the history of the American Surgical Association (ASA). SUMMARY BACKGROUND DATA:The Annals of Surgery has served as the journal of record for the ASA since 1928, with a special issue each year dedicated to papers present...
journal_title:Annals of surgery
pub_type: 历史文章,杂志文章
doi:10.1097/SLA.0000000000003633
更新日期:2020-04-01 00:00:00
abstract::The pattern of failure was studied in 1012 patients with resected Stage I or II non-small-cell carcinoma of the lung. Initial intrathoracic failure (41%) was more common than initial extrathoracic failure (34%) even though a complete resection was the intent in all patients. The most frequent sites of initial failure ...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-198701000-00012
更新日期:1987-01-01 00:00:00
abstract:OBJECTIVE:This study aims to review the operative results and oncological outcomes of anterior resection for rectal and rectosigmoid cancer. Comparison was made between patients with total mesorectal excision (TME) for mid and distal cancer and partial mesorectal excision (PME) for proximal cancer, when a 4- to 5-cm me...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/01.sla.0000133185.23514.32
更新日期:2004-08-01 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:BACKGROUND:Experience with minimal access, transoral/transmural endoscopic drainage/debridement of walled-off pancreatic necrosis (WOPN) after necrotizing pancreatitis is limited. We sought to determine outcome using this technique. METHODS:Retrospective analysis. RESULTS:From 1998 to 2006, 53 patients underwent tran...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/01.sla.0000254366.19366.69
更新日期:2007-06-01 00:00:00
abstract::The effect of reperfusion following hemorrhagic shock on splanchnic prostanoid release was studied. Anesthetized male rats were bled to a mean arterial blood pressure of 30 mmHg for 30 minutes and either killed or treated with shed blood for 60 minutes and then killed. The superior mesenteric arterial bed was cannulat...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-199012000-00006
更新日期:1990-12-01 00:00:00
abstract:OBJECTIVE:To study the mechanical characteristics of the esophagogastric junction (EGJ) of postfundoplication patients and compare them with previously reported data on normal subjects and GERD patients. METHODS:Eight normal subjects, 9 GERD patients, and 8 fundoplication patients were studied with concurrent manometr...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/01.sla.0000167868.44211.f0
更新日期:2005-07-01 00:00:00
abstract:OBJECTIVE:To investigate which perioperative treatment, ie, laparoscopic or open surgery combined with fast track (FT) or standard care, is the optimal approach for patients undergoing segmental resection for colon cancer. SUMMARY BACKGROUND DATA:Important developments in elective colorectal surgery are the introducti...
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.0b013e31821fd1ce
更新日期:2011-12-01 00:00:00
abstract::Data are presented on the clinical application of radionuclide imaging to evaluate changes in cadaver transplant function in the immediate postoperative period. The method uses orthoiodohippuric acid (hippuran) administered IV, with scintillation imaging, and curve analysis by a digital computer. An initial study is a...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-197505000-00013
更新日期:1975-05-01 00:00:00
abstract:OBJECTIVE:To compare the clinical outcome of simultaneous bilateral endoscopic totally extraperitoneal inguinal hernioplasty (TEP) using fibrin sealant (FS) and mechanical stapling for prosthetic mesh fixation. SUMMARY BACKGROUND DATA:Similar efficacy of FS and mechanical stapling for mesh fixation has been demonstrat...
journal_title:Annals of surgery
pub_type: 杂志文章,随机对照试验
doi:10.1097/01.sla.0000186440.02977.de
更新日期:2005-11-01 00:00:00
abstract:OBJECTIVE:To understand whether racial disparities in surgery for lower-extremity arterial disease are minimized by high-quality providers, or instead, differential treatment of otherwise similar patients pervades all settings. SUMMARY BACKGROUND DATA:Black patients are substantially more likely than whites to undergo...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/SLA.0b013e3181b41d53
更新日期:2009-09-01 00:00:00
abstract:OBJECTIVE:The current study investigates activation of the nutritional anti-inflammatory pathway by lipid-rich nutrition. BACKGROUND:Enteral nutrition activates humoral and neural pathways to regulate food intake and sustain energy balance. Recently, we demonstrated that enteral nutrition and in particular lipid-rich ...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/SLA.0b013e3181dae411
更新日期:2010-08-01 00:00:00
abstract:OBJECTIVE:To determine if addition of the S-nitrosylating agent ethyl nitrite (ENO) to the preservation solution can improve perfusion parameters in pumped human kidneys. BACKGROUND:A significant percentage of actively stored kidneys experience elevations in resistance and decreases in flow rate during the ex vivo sto...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/SLA.0000000000003702
更新日期:2019-12-05 00:00:00
abstract::We studied a series of 26 cases of carcinoma of the ampulla of Vater. There were 24 adenocarcinomas and two neuroendocrine tumors. Histologically the carcinomas could be divided into tumors arising from periampullary duodenal mucosa and those arising within the ampulla. True ampullary tumors had a significantly better...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-198908000-00006
更新日期:1989-08-01 00:00:00
abstract:OBJECTIVE:To examine treatment trends in invasive lobular carcinoma (ILC) over the last 15 years and, in particular, to compare rates of recurrence and disease-free survival associated with breast conservation therapy compared with mastectomy. SUMMARY BACKGROUND DATA:The biologic characteristics of ILC make it difficu...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/01.sla.0000171306.74366.22
更新日期:2005-08-01 00:00:00
abstract:BACKGROUND:The risk of metastatic spread among patients with early-stage pancreatic neuroendocrine tumors has not been well established. The authors sought to evaluate whether the new TNM staging systems proposed by the American Joint Committee on Cancer (AJCC) and European Neuroendocrine Tumor Society (ENETS) are prog...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/SLA.0b013e31824e6108
更新日期:2012-08-01 00:00:00
abstract:OBJECTIVE:To assess the impact of the 80-hour resident workweek restrictions on surgical residents and attending surgeons. SUMMARY BACKGROUND DATA:The ACGME mandated resident duty hour restrictions have required a major workforce restructuring. The impact of these changes needs to be critically evaluated for both the ...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/01.sla.0000220042.48310.66
更新日期:2006-06-01 00:00:00
abstract:OBJECTIVE:To analyze the clinical course, treatment, complications, outcome, and quality of life (QOL) in patients with perineal/perianal rhabdomyosarcoma (PRMS) treated within the CWS-86, -91, -96, and -2002P trials. BACKGROUND:Although multiple international study trials exist for the treatment of rhabdomyosarcoma, ...
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.0b013e3182a6f320
更新日期:2014-06-01 00:00:00
abstract::An ileosigmoid fistula complicating Crohn's disease of the small bowel has been considered a perplexing entity, but in practice does not pose a serious operative problem. The presence of such a fistula does not signify that the sigmoid colon is a primary site of Crohn's disease. The operative treatment of this entity ...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-198209000-00015
更新日期:1982-09-01 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
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:OBJECTIVE:To assess a new bloodless technique using radiofrequency energy for segmental liver resection of hepatic tumors. SUMMARY BACKGROUND DATA:Liver resection remains a formidable surgical procedure; safe performance requires a high level of training and skill. Intraoperative blood loss during liver resection rema...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-200211000-00004
更新日期:2002-11-01 00:00:00
abstract::Previous studies have demonstrated that Na(+)-dependent brush border glutamine transport is diminished in septic patients. To examine the potential regulation of this decreased transport by endotoxin, cytokines, or glucocorticoids, the human intestinal Caco-2 cell line was studied in vitro. Na(+)-dependent glutamine t...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-199205000-00017
更新日期:1992-05-01 00:00:00
abstract:OBJECTIVE:Evaluate the value of cytology relative to imaging features in risk assessment for malignancy as defined in the Sendai Guidelines. BACKGROUND:The Sendai Guidelines list symptoms, cyst size >30 mm, dilated main pancreatic duct (MPD) >6 mm, mural nodule (MN) and "positive" cytology as high risk stigmata for ma...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/SLA.0b013e3182383118
更新日期:2011-12-01 00:00:00
abstract::Pancreas divisum is an anatomic duct variant, which may predispose to pancreatitis. Most patients are managed conservatively, but some patients justify attempts to improve drainage. The correct surgical approach is not yet established, and there has been no series published concerning pancreatic resection in this cont...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-198411000-00006
更新日期:1984-11-01 00:00:00
abstract:SUMMARY BACKGROUND DATA:During the past five decades, significant improvements have been made in the diagnosis and treatment of thoracic outlet syndrome (TOS) secondary to sports activities, breast implants, or median sternotomy. METHODS, RESULTS, AND CONCLUSIONS:Of more than 15,000 patients evaluated for TOS, 3914 un...
journal_title:Annals of surgery
pub_type: 杂志文章,评审
doi:10.1097/00000658-199810000-00017
更新日期:1998-10-01 00:00:00
abstract::The effect of intrajejunal infusion of a fat solution on pentagastrin-stimulated (0.5 microgram/kg-hr) gastric acid secretion was studied in five duodenal ulcer patients before and three to five months after truncal vagotomy. Preoperatively mean acid output was reduced from 41 +/- 5.2 meq H+/hr to 15.4 +/- 1.3 meq H+/...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-197711000-00005
更新日期:1977-11-01 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 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 compare three options for the elective treatment of portal hypertension during a 10-year period. METHODS:Patients included in the trial were 18 to 76 years old, had a history of bleeding portal hypertension, and had undergone no prior treatment. Treatment options were beta-blockers (propranolol), scleroth...
journal_title:Annals of surgery
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1097/00000658-200008000-00011
更新日期:2000-08-01 00:00:00