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

Abstract:

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.

journal_name

Ann Surg

journal_title

Annals of surgery

authors

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

doi

10.1097/SLA.0b013e3181ef488d

subject

Has Abstract

pub_date

2011-02-01 00:00:00

pages

223-30

issue

2

eissn

0003-4932

issn

1528-1140

journal_volume

253

pub_type

杂志文章
  • Immune RNA therapy for renal cell carcinoma: survival and immunologic monitoring.

    abstract::Twenty patients with metastatic renal cell carcinoma and nine patients with minimal residual disease (MRD) but at high risk for recurrence following nephrectomy received weekly four milligram intradermal injections of purified RNA extracted from lymphoid organs of sheep immunized with human renal cell carcinoma. Eight...

    journal_title:Annals of surgery

    pub_type: 杂志文章

    doi:10.1097/00000658-197710000-00007

    authors: Ramming KP,deKernion JB

    更新日期:1977-10-01 00:00:00

  • Abdominal aortic aneurysm in high-risk patients. Outcome of selective management based on size and expansion rate.

    abstract::Low mortality rates for elective surgical treatment of abdominal aortic aneurysms justify an aggressive approach in most patients. However, in high-risk patients with small aneurysms and no symptoms, the decision to operate remains a delicate balance of risk and benefit. Our observations include 99 high-risk patients ...

    journal_title:Annals of surgery

    pub_type: 杂志文章

    doi:10.1097/00000658-198409000-00003

    authors: Bernstein EF,Chan EL

    更新日期:1984-09-01 00:00:00

  • Aspirin and dipyridamole decrease intimal hyperplasia in experimental vein grafts.

    abstract::Release from platelets of a factor mitogenic for smooth muscle cells is a postulated mechanism for the pathogenesis of vascular intimal hyperplasia. In this study the effect of antiplatelet therapy was evaluated. Aspirin (165 mg twice daily) and dipyridamole (25 mg twice daily) were administered to six rhesus monkeys ...

    journal_title:Annals of surgery

    pub_type: 杂志文章

    doi:10.1097/00000658-198002000-00018

    authors: McCann RL,Hagen PO,Fuchs JC

    更新日期:1980-02-01 00:00:00

  • Comparative Effectiveness and Risks of Bowel Preparation Before Elective Colorectal Surgery.

    abstract:OBJECTIVE:The objective of this study was to determine the relationship between bowel preparation and surgical site infections (SSIs), and also other postoperative complications, after elective colorectal surgery. BACKGROUND:SSI is a major source of postoperative morbidity/costs after colorectal surgery. The value of ...

    journal_title:Annals of surgery

    pub_type: 杂志文章

    doi:10.1097/SLA.0000000000002159

    authors: Koller SE,Bauer KW,Egleston BL,Smith R,Philp MM,Ross HM,Esnaola NF

    更新日期:2018-04-01 00:00:00

  • Randomized Trial of Laparoscopic Nissen vs. Anterior 180 Degree Partial Fundoplication - Late Clinical Outcomes at 15-20 years.

    abstract:OBJECTIVE:To determine very late clinical outcomes at up to 20 years follow-up from a randomized controlled trial of Nissen vs. anterior 180-degree partial fundoplication. SUMMARY BACKGROUND DATA:Nissen fundoplication for gastroesophageal reflux can be followed by troublesome side effects. To address this, partial fun...

    journal_title:Annals of surgery

    pub_type: 杂志文章

    doi:10.1097/SLA.0000000000004643

    authors: Rudolph-Stringer V,Bright T,Irvine T,Thompson SK,Devitt PG,Game PA,Jamieson GG,Watson DI

    更新日期:2020-11-18 00:00:00

  • Genetic polymorphisms and the risk of infection following esophagectomy. positive association with TNF-alpha gene -308 genotype.

    abstract:OBJECTIVE:To examine the association of single nucleotide polymorphisms (SNPs) in inflammation-related genes in the development of infections following esophagectomy. SUMMARY BACKGROUND DATA:Genetic polymorphisms for immunoregulatory cytokines may explain individual variation in response to trauma. Esophagectomy is as...

    journal_title:Annals of surgery

    pub_type: 杂志文章,多中心研究

    doi:10.1097/01.sla.0000259389.09161.49

    authors: Azim K,McManus R,Brophy K,Ryan A,Kelleher D,Reynolds JV

    更新日期:2007-07-01 00:00:00

  • Circulating Tumor Cell Phenotype Predicts Recurrence and Survival in Pancreatic Adenocarcinoma.

    abstract:OBJECTIVE:We assessed circulating tumor cells (CTCs) with epithelial and mesenchymal phenotypes as a potential prognostic biomarker for patients with pancreatic adenocarcinoma (PDAC). BACKGROUND:PDAC is the fourth leading cause of cancer death in the United States. There is an urgent need to develop biomarkers that pr...

    journal_title:Annals of surgery

    pub_type: 杂志文章

    doi:10.1097/SLA.0000000000001600

    authors: Poruk KE,Valero V 3rd,Saunders T,Blackford AL,Griffin JF,Poling J,Hruban RH,Anders RA,Herman J,Zheng L,Rasheed ZA,Laheru DA,Ahuja N,Weiss MJ,Cameron JL,Goggins M,Iacobuzio-Donahue CA,Wood LD,Wolfgang CL

    更新日期:2016-12-01 00:00:00

  • Incidence and Risk Factors of Postoperative Mortality and Morbidity After Elective Versus Emergent Abdominal Surgery in a National Sample of 8193 Patients With Cirrhosis.

    abstract:OBJECTIVE:To describe the incidence and risk factors for mortality and morbidity in patients with cirrhosis undergoing elective or emergent abdominal surgeries. BACKGROUND:Postoperative morbidity and mortality are higher in patients with cirrhosis; variation by surgical procedure type and cirrhosis severity remain unc...

    journal_title:Annals of surgery

    pub_type: 杂志文章

    doi:10.1097/SLA.0000000000003674

    authors: Johnson KM,Newman KL,Green PK,Berry K,Cornia PB,Wu P,Beste LA,Itani K,Harris AHS,Kamath PS,Ioannou GN

    更新日期:2019-10-23 00:00:00

  • Permanent Pancreatic Duct Occlusion With Neoprene-based Glue Injection After Pancreatoduodenectomy at High Risk of Pancreatic Fistula: A Prospective Clinical Study.

    abstract:OBJECTIVE:The aim of this study was to assess safety and efficacy of pancreatic duct occlusion (PDO) with neoprene-based glue in selected patients undergoing pancreatoduodenectomy (PD) at high risk of postoperative pancreatic fistula (POPF). BACKGROUND DATA:PD is the reference standard approach for tumors of the pancr...

    journal_title:Annals of surgery

    pub_type: 临床试验,杂志文章

    doi:10.1097/SLA.0000000000003514

    authors: Mazzaferro V,Virdis M,Sposito C,Cotsoglou C,Droz Dit Busset M,Bongini M,Flores M,Prinzi N,Coppa J

    更新日期:2019-11-01 00:00:00

  • The Carbon Footprint of Surgical Operations: A Systematic Review.

    abstract:OF BACKGROUND DATA AND OBJECTIVES:Operating theatres are typically the most resource-intensive area of a hospital, 3-6 times more energy-intensive than the rest of the hospital and a major contributor of waste. The primary objective of this systematic review was to evaluate existing literature calculating the carbon fo...

    journal_title:Annals of surgery

    pub_type: 杂志文章

    doi:10.1097/SLA.0000000000003951

    authors: Rizan C,Steinbach I,Nicholson R,Lillywhite R,Reed M,Bhutta MF

    更新日期:2020-12-01 00:00:00

  • Human umbilical veins and autogenous veins as canine arterial bypass grafts.

    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

    authors: Oblath RW,Buckley FO Jr,Donnelly WA,Green RM,Deweese JA

    更新日期:1978-08-01 00:00:00

  • Gastroesophageal reflux: prevalence in adults older than 28 years after correction of esophageal atresia.

    abstract:OBJECTIVE:To study the incidence of gastroesophageal reflux (GER)related complications after correction of esophageal atresia (EA). SUMMARY BACKGROUND DATA:The association of EA and GER in children is well known. However, little is known about the prevalence of GER and its potential complications in adults who have un...

    journal_title:Annals of surgery

    pub_type: 杂志文章

    doi:10.1097/01.sla.0000094303.07910.05

    authors: Deurloo JA,Ekkelkamp S,Bartelsman JF,Ten Kate FJ,Schoorl M,Heij HA,Aronson DC

    更新日期:2003-11-01 00:00:00

  • Influence of pentobarbital and chloralose on metabolic and hemodynamic changes in liver ischemia.

    abstract::Hemodynamic and metabolic consequences of a 90-minute period of liver ischemia followed by 120 minutes of reperfusion were studied in rats that were awake during most of the experiment and in rats anesthetized with either pentobarbital (40 mg/kg body weight) or chloralose (30 mg/kg X hour) during the complete length o...

    journal_title:Annals of surgery

    pub_type: 杂志文章

    doi:10.1097/00000658-199007000-00004

    authors: Nordström G,Winsö O,Biber B,Hasselgren PO

    更新日期:1990-07-01 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

    doi:10.1097/00000658-197607000-00017

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

    更新日期:1976-07-01 00:00:00

  • Management of secondary peritonitis.

    abstract:OBJECTIVE:The authors review current definition, classification, scoring, microbiology, inflammatory response, and goals of management of secondary peritonitis. SUMMARY BACKGROUND DATA:Despite improved diagnostic modalities, potent antibiotics, modern intensive care, and aggressive surgical treatment, up to one third ...

    journal_title:Annals of surgery

    pub_type: 杂志文章,评审

    doi:10.1097/00000658-199607000-00003

    authors: Wittmann DH,Schein M,Condon RE

    更新日期:1996-07-01 00:00:00

  • TransCarotid Revascularization with Dynamic Flow reversal versus Carotid Endarterectomy in the Vascular Quality Initiative Surveillance Project.

    abstract:OBJECTIVE:To compare the outcomes of TransCarotid Artery Revascularization with flow reversal (TCAR) to the gold standard carotid endarterectomy (CEA) using data from the Society for Vascular Surgery Vascular Quality Initiative TCAR Surveillance Project. SUMMARY BACKGROUND DATA:TCAR is a novel minimally invasive proce...

    journal_title:Annals of surgery

    pub_type: 杂志文章

    doi:10.1097/SLA.0000000000004496

    authors: Malas MB,Dakour-Aridi H,Kashyap VS,Eldrup-Jorgensen J,Wang GJ,Motaganahalli RL,Cronenwett JL,Schermerhorn ML

    更新日期:2020-09-15 00:00:00

  • Thoracic duct in patients with multiple organ failure: no major route of bacterial translocation.

    abstract:OBJECTIVE:To determine whether translocation of bacteria or endotoxin occurred into the thoracic duct in patients with multiple organ failure (MOF). SUMMARY BACKGROUND DATA:Translocation of bacteria or endotoxin has been proposed as a causative factor for MOF in patients without an infectious focus, although it has ra...

    journal_title:Annals of surgery

    pub_type: 杂志文章

    doi:10.1097/00000658-199901000-00017

    authors: Lemaire LC,van Lanschot JB,Stoutenbeek CP,van Deventer SJ,Dankert J,Oosting H,Gouma DJ

    更新日期:1999-01-01 00:00:00

  • "Sideways": results of repair of biliary injuries using a policy of side-to-side hepatico-jejunostomy.

    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

    authors: Winslow ER,Fialkowski EA,Linehan DC,Hawkins WG,Picus DD,Strasberg SM

    更新日期:2009-03-01 00:00:00

  • Interleukin 12 secretion enhances antitumor efficacy of oncolytic herpes simplex viral therapy for colorectal cancer.

    abstract:OBJECTIVE:To assess the strategy of combining oncolytic herpes simplex virus (HSV) therapy with immunomodulatory therapy as treatment for experimental colon cancer. The oncolytic HSV recombinant NV1023 and the interleukin 12 (IL-12)-secreting oncolytic NV1042 virus were evaluated in vitro and in vivo with respect to an...

    journal_title:Annals of surgery

    pub_type: 杂志文章

    doi:10.1097/00000658-200106000-00012

    authors: Bennett JJ,Malhotra S,Wong RJ,Delman K,Zager J,St-Louis M,Johnson P,Fong Y

    更新日期:2001-06-01 00:00:00

  • Tailoring the management of nonparasitic liver cysts.

    abstract:OBJECTIVE:To determine the optimal management of symptomatic non-parasitic liver cysts. SUMMARY BACKGROUND DATA:Management options for symptomatic nonparasitic liver cysts lack substantiation through comparative studies with respect to safety and long-term effectiveness. METHODS:A retrospective review of the surgical...

    journal_title:Annals of surgery

    pub_type: 杂志文章

    doi:10.1097/00000658-199808000-00004

    authors: Martin IJ,McKinley AJ,Currie EJ,Holmes P,Garden OJ

    更新日期:1998-08-01 00:00:00

  • The advantages of 131I-orthoiodohippurate scintiphotography in the management of patients after renal transplantation.

    abstract::Renal scintiphotography with (131)I-hippurate was the primary diagnostic procedure in evaluating renal failure and complications in over 500 transplant patients. This diagnostic test has become our principal method of evaluation and followup of renal transplants, especially in the early post-transplant period. It has ...

    journal_title:Annals of surgery

    pub_type: 杂志文章

    doi:10.1097/00000658-197409000-00014

    authors: Salvatierra O Jr,Powell MR,Price DC,Kountz SL,Belzer FO

    更新日期:1974-09-01 00:00:00

  • A four-year experience with splenectomy versus splenorrhaphy.

    abstract::From 1980 to 1984, 326 patients requiring splenectomy or splenorrhaphy were treated at one urban trauma center. Splenic injuries were graded in severity from one to five at the time of celiotomy. Splenorrhaphy was attempted in all patients, except when the spleen was shattered or avulsed or when multiple injuries were...

    journal_title:Annals of surgery

    pub_type: 杂志文章

    doi:10.1097/00000658-198505000-00005

    authors: Feliciano DV,Bitondo CG,Mattox KL,Rumisek JD,Burch JM,Jordan GL Jr

    更新日期:1985-05-01 00:00:00

  • Recovery of fasted and fed gastrointestinal motility after open versus laparoscopic cholecystectomy in dogs.

    abstract:OBJECTIVE:The authors investigate the recovery of gastrointestinal motility in the fed and fasted state after laparoscopic and open cholecystectomy. SUMMARY BACKGROUND DATA:Clinical recovery after laparoscopic cholecystectomy is known to be more rapid than after conventional open cholecystectomy. However, the actual e...

    journal_title:Annals of surgery

    pub_type: 杂志文章

    doi:10.1097/00000658-199604000-00010

    authors: Hotokezaka M,Combs MJ,Mentis EP,Schirmer BD

    更新日期:1996-04-01 00:00:00

  • Changing paradigm in the management of hepatocellular carcinoma improves the survival benefit of early detection by screening.

    abstract:OBJECTIVE:To evaluate the impact of improved surgical management of hepatocellular carcinoma (HCC) on the survival of patients with screened HCC. SUMMARY BACKGROUND DATA:It is unclear whether the advent of new treatment modalities such as liver transplantation and radiofrequency ablation (RFA) in recent years have imp...

    journal_title:Annals of surgery

    pub_type: 杂志文章

    doi:10.1097/SLA.0b013e31816a747a

    authors: Chan AC,Poon RT,Ng KK,Lo CM,Fan ST,Wong J

    更新日期:2008-04-01 00:00:00

  • Narcotic Free Cervical Endocrine Surgery: A Shift in Paradigm.

    abstract:BACKGROUND AND OBJECTIVE:The opioid epidemic has stimulated initiatives to reduce the number of unnecessary narcotic prescriptions. We adopted an opt-in prescription system for patients undergoing ambulatory cervical endocrine surgery (CES). We hypothesized that empowering patients to decide whether or not to receive n...

    journal_title:Annals of surgery

    pub_type: 杂志文章

    doi:10.1097/SLA.0000000000003443

    authors: Ruffolo LI,Jackson KM,Juviler P,Kaur R,Chennell T,Glover DM,Linehan DC,Moalem J

    更新日期:2019-07-06 00:00:00

  • Prognostic value of preoperative clinical staging assessed by computed tomography in resectable gastric cancer patients: a viewpoint in the era of preoperative treatment.

    abstract:BACKGROUND:In the era of pre- or perioperative therapy for gastric cancer, clinical staging before treatment appears to be increasingly important for prognosis, yet there are no data on the subject for resectable gastric cancer patients. OBJECTIVES:To evaluate the prognostic role of preoperative locoregional staging i...

    journal_title:Annals of surgery

    pub_type: 杂志文章

    doi:10.1097/SLA.0b013e3181ca69a7

    authors: Park SR,Kim MJ,Ryu KW,Lee JH,Lee JS,Nam BH,Choi IJ,Kim YW

    更新日期:2010-03-01 00:00:00

  • Malignant fibrous histiocytoma of the pulmonary artery.

    abstract::A patient is reported whose symptoms and clinical features were interpreted as pulmonary embolism. However, the ultimate diagnosis was malignant fibrous histiocytoma of the pulmonary artery, which was made evident at operation. Although extremely rare in the early medical literature, primary sarcoma of the pulmonary a...

    journal_title:Annals of surgery

    pub_type: 杂志文章

    doi:10.1097/00000658-198702000-00017

    authors: Van Damme H,Vaneerdeweg W,Schoofs E

    更新日期:1987-02-01 00:00:00

  • Effect of moderate hypothermia in the treatment of canine hemorrhagic shock.

    abstract::This study evaluated a possible protective and therapeutic effect of moderate hypothermia in the treatment of severe hemorrhagic shock. A modified Wiggers shock preparation was used. Normothermic dogs (Group I, N = 6) were maintained at normal body temperature throughout hemorrhagic shock and resuscitation. In Group I...

    journal_title:Annals of surgery

    pub_type: 杂志文章

    doi:10.1097/00000658-198804000-00015

    authors: Meyer DM,Horton JW

    更新日期:1988-04-01 00:00:00

  • Mild hypothermia provides significant protection against ischemia/reperfusion injury in livers of obese and lean rats.

    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

    authors: Choi S,Noh J,Hirose R,Ferell L,Bedolli M,Roberts JP,Niemann CU

    更新日期:2005-03-01 00:00:00

  • True Short Esophagus in Gastro-esophageal Reflux Disease: Old Controversies With New Perspectives.

    abstract::MINI: In cases of true short esophagus diagnosed intraoperatively with an endoscopic-laparoscopic method, Collis-Nissen and stomach around stomach fundoplication procedures achieved similar results. The notion that the gastric fundus must be wrapped around a conveniently long segment of the tubular esophagus to obtain...

    journal_title:Annals of surgery

    pub_type: 杂志文章

    doi:10.1097/SLA.0000000000003582

    authors: Lugaresi M,Mattioli B,Daddi N,Bassi F,Pilotti V,Ferruzzi L,Mattioli S

    更新日期:2019-09-03 00:00:00