Meckel's diverticulum--a high-risk region for malignancy in the ileum. Insights from a population-based epidemiological study and implications in surgical management.


BACKGROUND:Surgical management of incidental Meckel's diverticulum(MD) is a highly debated controversial issue that has never been discussed from the oncological standpoint. OBJECTIVE:To describe the epidemiology and risk of Meckel's diverticulum cancer (MDC) and compare it with other ileal malignancies. METHODS:Data were obtained from 163 cases of MDC and 6214 cases of non-Meckelian ileal cancer, between 1973 and 2006, from the Surveillance, Epidemiology, and End Results database. RESULTS:Mean annual incidence was 1.44 (± 1.12) per 10 million population,with a 5-fold increase in the last few decades. Incidence increases with age,with a mean age at diagnosis of 60.6 (±15.1) years. Adjusted risk of cancer in the MD was at least 70 times higher than any other ileal site. Disease was localized in 67% at presentation and malignant carcinoids constituted the major histologic type (77%). One-third of patients have had lifetime occurrence of other malignancies and in 13% of these patients, MDC was the first malignancy. Median tumor size was 7 mm. Median overall survival was 173 months (95% confidence interval [CI], 124-221 months), with 1- and 5-year relative survival rates of 85.8% (95% CI, 76.9%-91.4%) and 75.8% (95%CI, 64.9%-83.8%), respectively. Cox proportional hazards model revealed that age, histologic type, and metastatic disease were independent factors affecting survival. CONCLUSIONS:MD is a "hot-spot" or high-risk area for cancer in the ileum.With risk that increases with age and high possibility of curative resection with negligible operative mortality, incidental MD is best treated with resection.


Ann Surg


Annals of surgery


Thirunavukarasu P,Sathaiah M,Sukumar S,Bartels CJ,Zeh H 3rd,Lee KK,Bartlett DL




Has Abstract


2011-02-01 00:00:00












  • Normoxic wound fluid contains high levels of vascular endothelial growth factor.

    abstract:OBJECTIVE:To examine the temporal integration of vascular endothelial growth factor (VEGF), which has been shown to be present in wound fluid, with the putatively related processes of wound fluid oxygen content, wound angiogenesis, and granulation tissue formation. SUMMARY BACKGROUND DATA:During cutaneous wound repair...

    journal_title:Annals of surgery

    pub_type: 杂志文章


    authors: Howdieshell TR,Riegner C,Gupta V,Callaway D,Grembowicz K,Sathyanarayana,McNeil PL

    更新日期:1998-11-01 00:00:00

  • Minimally invasive esophagectomy: outcomes in 222 patients.

    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 th...

    journal_title:Annals of surgery

    pub_type: 杂志文章


    authors: Luketich JD,Alvelo-Rivera M,Buenaventura PO,Christie NA,McCaughan JS,Litle VR,Schauer PR,Close JM,Fernando HC

    更新日期:2003-10-01 00:00:00

  • Prevention of biliary lesions that may occur during radiofrequency ablation of the liver: study on the pig.

    abstract:OBJECTIVE:To prevent bile duct injury by using a cold 5% glucose isotonic solution cooling in the bile ducts when radiofrequency (RF) is performed in a porcine model. SUMMARY BACKGROUND DATA:Complications that may arise during liver RF ablation include biliary stenosis and abscesses. METHODS:The RITA 1500 generator w...

    journal_title:Annals of surgery

    pub_type: 杂志文章


    authors: Marchal F,Elias D,Rauch P,Zarnegar R,Leroux A,Stines J,Verhaeghe JL,Guillemin F,Carteaux JP,Villemot JP

    更新日期:2006-01-01 00:00:00

  • The choice of primary repair or mesh repair for paraesophageal hernia: a decision analysis based on utility scores.

    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


    authors: Obeid NM,Velanovich V

    更新日期:2013-04-01 00:00:00

  • A randomized trial of hemithyroidectomy versus Dunhill for the surgical management of asymmetrical multinodular goiter.

    abstract:OBJECTIVE:To assess the immediate and long-term clinical results of 2 different surgical procedures for the treatment of asymmetrical multinodular goiter (AMG). BACKGROUND:Half of the patients presenting with a single benign thyroid nodule have contralateral subclinical disease. There is a controversy whether these pa...

    journal_title:Annals of surgery

    pub_type: 杂志文章,多中心研究,随机对照试验


    authors: Sancho JJ,Prieto R,Dueñas JP,Ribera C,Ripollés J,Larrad A,Sitges-Serra A

    更新日期:2012-11-01 00:00:00

  • Comparison of amputation with limb-sparing operations for adult soft tissue sarcoma of the extremity.

    abstract::The use of amputation in extremity soft tissue sarcoma has been decreasing at Memorial Sloan-Kettering Cancer Center (MSKCC) over the last 15 years. In an attempt to define the efficacy and future role of amputation in extremity soft tissue sarcoma, a prospective sarcoma database compiled at MSKCC from July 1982 to Ja...

    journal_title:Annals of surgery

    pub_type: 杂志文章


    authors: Williard WC,Hajdu SI,Casper ES,Brennan MF

    更新日期:1992-03-01 00:00:00

  • Cavernous hemangioma of the liver. A single institution report of 16 resections.

    abstract::Over the past 27 years cavernous hemangioma of the liver has been diagnosed in 12 nonoperated patients and in 16 patients who had resection of the lesion at Strong Memorial Hospital. In almost all patients the diagnosis was suggested by an imaging procedure. In the 12 nonoperated patients the average size of the tumor...

    journal_title:Annals of surgery

    pub_type: 杂志文章


    authors: Schwartz SI,Husser WC

    更新日期:1987-05-01 00:00:00

  • Impact of pancreatic head resection on direct medical costs in patients with chronic pancreatitis.

    abstract:OBJECTIVE:To quantitate disease-specific hospital-based medical costs in 34 patients with chronic pancreatitis before and after treatment by either duodenal-preserving pancreatic head resection (DPPHR) or pylorus-preserving pancreaticoduodenectomy (PPPD). SUMMARY BACKGROUND DATA:Pancreatic head resection in selected p...

    journal_title:Annals of surgery

    pub_type: 杂志文章


    authors: Howard TJ,Jones JW,Sherman S,Fogel E,Lehman GA

    更新日期:2001-11-01 00:00:00

  • Middle aortic syndrome. Effectiveness and durability of complex arterial revascularization techniques.

    abstract::Middle aortic syndrome typically occurs as severe hypertension in young patients who have weak or absent femoral pulses and an abdominal bruit. It results from a diffuse narrowing of the distal thoracic and abdominal aorta, commonly involving the visceral and renal arteries. The clinical presentation, angiographic ass...

    journal_title:Annals of surgery

    pub_type: 杂志文章


    authors: Messina LM,Reilly LM,Goldstone J,Ehrenfeld WK,Ferrell LD,Stoney RJ

    更新日期:1986-09-01 00:00:00

  • Endoscopic harvesting device type and outcomes in patients undergoing coronary artery bypass surgery.

    abstract:OBJECTIVE:To evaluate angiographic and clinical outcomes associated with open and closed dissection tunnel endoscopic vein harvesting (EVH) devices. BACKGROUND:A previous PREVENT-IV (PRoject of Ex-vivo Vein graft ENgineering via Transfection IV) analysis reported that EVH for coronary artery bypass graft surgery was a...

    journal_title:Annals of surgery

    pub_type: 杂志文章,多中心研究,随机对照试验


    authors: van Diepen S,Brennan JM,Hafley GE,Reyes EM,Allen KB,Ferguson TB,Peterson ED,Williams JB,Gibson CM,Mack MJ,Kouchoukos NT,Alexander JH,Lopes RD

    更新日期:2014-08-01 00:00:00

  • Laparoscopy decreases postoperative complication rates after abdominal colectomy: results from the national surgical quality improvement program.

    abstract:OBJECTIVE:Compare outcomes of non-emergent laparoscopic to open colon surgery. BACKGROUND:Laparoscopy has revolutionized much of gastrointestinal surgery. Colon and rectal surgery has seen drastic changes with many of the abdominal operations being performed laparoscopically. However, data comparing recovery and compl...

    journal_title:Annals of surgery

    pub_type: 杂志文章


    authors: Kennedy GD,Heise C,Rajamanickam V,Harms B,Foley EF

    更新日期:2009-04-01 00:00:00

  • Pancreatic Cancer Surgery: The New R-status Counts.

    abstract:OBJECTIVE:To assess the relevance of resection margin status for survival outcome after resection and adjuvant therapy for pancreatic cancer. BACKGROUND:The definitions for R0 and R1 margin status after resection for pancreatic cancer are controversial. The strict definition of R0 requiring a 1 mm tumor-free margin is...

    journal_title:Annals of surgery

    pub_type: 杂志文章


    authors: Strobel O,Hank T,Hinz U,Bergmann F,Schneider L,Springfeld C,Jäger D,Schirmacher P,Hackert T,Büchler MW

    更新日期:2017-03-01 00:00:00

  • Surgical Complications in a Multicenter Randomized Trial Comparing Preoperative Chemoradiotherapy and Immediate Surgery in Patients With Resectable and Borderline Resectable Pancreatic Cancer (PREOPANC Trial).

    abstract:OBJECTIVES:To investigate the effect of preoperative chemoradiotherapy on surgical complications in patients after pancreatic resection for (borderline-)resectable pancreatic cancer. SUMMARY OF BACKGROUND DATA:Preoperative chemoradiotherapy is increasingly used in patients with (borderline-)resectable pancreatic cance...

    journal_title:Annals of surgery

    pub_type: 杂志文章


    authors: van Dongen JC,Suker M,Versteijne E,Bonsing BA,Mieog JSD,de Vos-Geelen J,van der Harst E,Patijn GA,de Hingh IH,Festen S,Ten Tije AJ,Busch OR,Besselink MG,van Tienhoven G,Groot Koerkamp B,van Eijck CHJ,Dutch Pancreatic Canc

    更新日期:2020-11-12 00:00:00

  • Pancreatogastrostomy Versus Pancreatojejunostomy for RECOnstruction After PANCreatoduodenectomy (RECOPANC, DRKS 00000767): Perioperative and Long-term Results of a Multicenter Randomized Controlled Trial.

    abstract:OBJECTIVES:To assess pancreatic fistula rate and secondary endpoints after pancreatogastrostomy (PG) versus pancreatojejunostomy (PJ) for reconstruction in pancreatoduodenectomy in the setting of a multicenter randomized controlled trial. BACKGROUND:PJ and PG are established methods for reconstruction in pancreatoduod...

    journal_title:Annals of surgery

    pub_type: 杂志文章,多中心研究,随机对照试验


    authors: Keck T,Wellner UF,Bahra M,Klein F,Sick O,Niedergethmann M,Wilhelm TJ,Farkas SA,Börner T,Bruns C,Kleespies A,Kleeff J,Mihaljevic AL,Uhl W,Chromik A,Fendrich V,Heeger K,Padberg W,Hecker A,Neumann UP,Junge K,Kalff

    更新日期:2016-03-01 00:00:00

  • Troponin Elevation After Colorectal Surgery: Significance and Management.

    abstract:OBJECTIVE:The aim of this study is to identify the association between early postoperative troponin elevations and outcomes after major colorectal surgery. BACKGROUND:Myocardial infarction is the leading cause of death after noncardiac surgery. Most postoperative myocardial infarctions are clinically silent, and asymp...

    journal_title:Annals of surgery

    pub_type: 杂志文章


    authors: Gorgun E,Lan BY,Aydinli HH,Reed GW,Menon V,Sessler DI,Stocchi L,Remzi FH

    更新日期:2016-10-01 00:00:00

  • Caustic burns and carcinoma of the esophagus.

    abstract::A history of caustic injury was obtained in 12 of 846 patients with squamous cell carcinoma of the esophagus. The average age was 52.8 years; the interval from injury to development of carcinoma was 45.8 years. Nine of the 12 carcinomas were in the midthoracic segment. Resection was possible in nine patients, with two...

    journal_title:Annals of surgery

    pub_type: 杂志文章


    authors: Hopkins RA,Postlethwait RW

    更新日期:1981-08-01 00:00:00

  • Predictive Value of Endoscopic Features for a Complete Response After Chemoradiotherapy for Rectal Cancer.

    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


    authors: van der Sande ME,Maas M,Melenhorst J,Breukink SO,van Leerdam ME,Beets GL

    更新日期:2019-12-09 00:00:00

  • Experience with a modified Witzel gastrostomy without gastropexy.

    abstract::The records of 161 adult patients who underwent a modification of the Witzel gastrostomy without gastropexy at Ellis Fischel State Cancer Hospital, Columbia, Missouri, between 1977 and 1980, are reviewed in detail and form the basis of this report. Six of these patients had gastrostomies on two different occasions. Th...

    journal_title:Annals of surgery

    pub_type: 杂志文章


    authors: Johnston WD,Lopez MJ,Kraybill WG,Bricker EM

    更新日期:1982-06-01 00:00:00

  • Hemodynamic consequences of femoral arteriovenous bovine shunts.

    abstract::Seventeen patients with femoral arteriovenous bovine shunts (FAVBS) were evaluated to delineate the cardiovascular consequences of the procedure. The resting cardiac index (CI), as estimated by echocardiography, was increased in 8 patients (47%). Twelve of the 17 patients (71%) had more than a 20% reduction in CI afte...

    journal_title:Annals of surgery

    pub_type: 杂志文章


    authors: Fee HJ Jr,Levisman JA,Dickmeyer JP,Golding AL

    更新日期:1976-07-01 00:00:00

  • Isolated tumor cells are frequently detectable in the peritoneal cavity of gastric and colorectal cancer patients and serve as a new prognostic marker.

    abstract:OBJECTIVE:To evaluate the prognostic significance of isolated tumor cells detected by a panel of various monoclonal antibodies. SUMMARY BACKGROUND DATA:Previously, we showed by using immunocytology that cancer cells are frequently found in bone marrow and peritoneal cavity samples of gastrointestinal cancer patients. ...

    journal_title:Annals of surgery

    pub_type: 杂志文章


    authors: Schott A,Vogel I,Krueger U,Kalthoff H,Schreiber HW,Schmiegel W,Henne-Bruns D,Kremer B,Juhl H

    更新日期:1998-03-01 00:00:00

  • Tacrolimus and Single Intraoperative High-dose of Anti-T-lymphocyte Globulins Versus Tacrolimus Monotherapy in Adult Liver Transplantation: One-year Results of an Investigator-driven Randomized Controlled Trial.

    abstract:OBJECTIVE:The aim of the study is to evaluate whether intra-operative induction with anti-lymphocytic serum (ALS) is superior to no induction in adult liver transplantation (LT). BACKGROUND:The efficacy of ALS induction remains inconclusive in LT, because of poorly designed trials. METHODS:A randomized controlled tri...

    journal_title:Annals of surgery

    pub_type: 杂志文章,随机对照试验


    authors: Iesari S,Ackenine K,Foguenne M,De Reyck C,Komuta M,Bonaccorsi Riani E,Ciccarelli O,Coubeau L,Lai Q,Gianello P,Lerut J

    更新日期:2018-11-01 00:00:00

  • Critical operative management of small bowel obstruction.

    abstract::The records of 238 patients with the diagnosis of small bowel obstruction at the University of Illinois Hospital from 1967 through the spring of 1976 were reviewed. Mortality, intra-operative management, and clinical findings were evaluated. Previous reports list a mortality of gangrenous small bowel obstruction, seco...

    journal_title:Annals of surgery

    pub_type: 杂志文章


    authors: Stewardson RH,Bombeck CT,Nyhus LM

    更新日期:1978-02-01 00:00:00

  • Host defense against opportunist microorganisms following trauma. II. Changes in complement and immunoglobulins in patients with abdominal trauma and in septic patients without trauma.

    abstract::Total hemolytic complement (CH50), conversion of C3 by inulin and cobra venom factor (CoVF), and immunochemical levels of Clq, C4, C2, C3, C5, factor B, properdin, C3b inactivator (KAF), and immunoglobulins (Igs) G, A, and M were measured in the sera of ten patients with abdominal trauma and ten medical patients with ...

    journal_title:Annals of surgery

    pub_type: 杂志文章


    authors: Bjornson AB,Altemeier WA,Bjornson HS

    更新日期:1978-07-01 00:00:00

  • The influence of injury severity on complication rates after primary closure or colostomy for penetrating colon trauma.

    abstract::The management of penetrating colon injury has been frequently debated in the literature, yet few reports have evaluated primary closure versus diverting colostomy in similarly injured patients. Diverting colostomy is the standard of care when mucosal penetration is present, but primary closure in civilian practice ha...

    journal_title:Annals of surgery

    pub_type: 杂志文章


    authors: Nelken N,Lewis F

    更新日期:1989-04-01 00:00:00

  • Exclusion of nonisolated splenic vein in distal splenorenal shunt for prevention of portal malcirculation.

    abstract::In an attempt to prevent portoprival malcirculation after distal splenorenal shunt (DSRS), a splenic hilar renal shunt (HRS) with proximal flush ligation of splenic vein was designed. To accomplish this procedure, two methods were compared: HRS alone (Group A) and HRS plus proximal flush ligation of the splenic vein (...

    journal_title:Annals of surgery

    pub_type: 杂志文章


    authors: Inokuchi K,Beppu K,Koyanagi N,Nagamine K,Hashizume M,Sugimachi K

    更新日期:1984-12-01 00:00:00

  • Indications and outcome of pelvic exenteration for locally advanced primary and recurrent rectal cancer.

    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


    authors: Bhangu A,Ali SM,Brown G,Nicholls RJ,Tekkis P

    更新日期:2014-02-01 00:00:00

  • Main pancreatic ductal anatomy can direct choice of modality for treating pancreatic pseudocysts (surgery versus percutaneous drainage).

    abstract:OBJECTIVE:To test the hypothesis that pancreatic ductal anatomy may predict the likely success of percutaneous drainage of pseudocysts of the pancreas. SUMMARY BACKGROUND DATA:Various modalities are currently applied to pseudocysts, with little or no data to aid in the choice of management strategy. Pancreatic ductal ...

    journal_title:Annals of surgery

    pub_type: 杂志文章


    authors: Nealon WH,Walser E

    更新日期:2002-06-01 00:00:00

  • Early cholecystectomy for acute cholecystitis: a prospective randomized study.

    abstract::A randomized clinical trial was undertaken to compare early and delayed cholecystectomy for acute cholecystitis. Patients entering early (n = 83) or delayed (n = 82) surgery groups were comparable with regard to prerandomization data. One patient in the early group and five in the delayed group refused surgery (p < 0....

    journal_title:Annals of surgery

    pub_type: 临床试验,杂志文章,随机对照试验


    authors: Järvinen HJ,Hästbacka J

    更新日期:1980-04-01 00:00:00

  • Surgical aspects in the treatment of patients with unilateral wilms tumor: a report from the SIOP 93-01/German Society of Pediatric Oncology and Hematology.

    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


    authors: Fuchs J,Kienecker K,Furtwängler R,Warmann SW,Bürger D,Thürhoff JW,Hager J,Graf N

    更新日期:2009-04-01 00:00:00

  • Medullary thyroid carcinoma: relationship of method of diagnosis to pathologic staging.

    abstract::Medullary thyroid carcinoma (MTC) develops in virtually all patients affected with multiple endocrine neoplasia type II (MEN II), a disease inherited as an autosomal dominant trait. The thyroid tumor cells secrete calcitonin (CT) and the detection of elevated plasma levels (>300 pg/ml) of this hormone in MEN II kindre...

    journal_title:Annals of surgery

    pub_type: 杂志文章


    authors: Wells SA Jr,Baylin SB,Gann DS,Farrell RE,Dilley WG,Preissig SH,Linehan WM,Cooper CW

    更新日期:1978-09-01 00:00:00