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


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 exenteration between 2006 and 2011 were identified from a prospectively maintained database. The main endpoints were 3-year disease-free survival (DFS) and local recurrence-free survival (LRFS). RESULTS:Of 100 exenterative operations, 55 were for LAP cancer and 45 for RRC. Exenteration of 1 pelvic compartment was required in 30 cases, 2 compartments in 49 cases, and 3 of 4 compartments in 21 cases. R0, R1, and R2 resections were achieved in 78, 15, and 7 cases, respectively. R0 rates were significantly higher in LAP cancer than in RRC (91% vs 62%, P = 0.001). Three-year DFS for R0, R1, and R2 resections was 67%, 49%, and 0%, respectively (P < 0.001). For R0 resections only, DFS in LAP cancer was 76% and 57% in RRC (P = 0.212). On multivariate analysis, a positive resection margin (hazard ratio, 4.04; P < 0.001) and positive lymph node staging (hazard ratio, 2.43; P = 0.022) were significant predictors of reduced DFS. Three-year LRFS for R0 resection was 86% for LAP cancer and 84% for RRC (P = 0.817). On multivariate analysis, only a positive resection margin was a significant predictor of reduced LRFS (hazard ratio, 5.48; P = 0.002). CONCLUSIONS:Resection margin status is more important than primary or recurrent cancer in predicting long-term outcome.


Ann Surg


Annals of surgery


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




Has Abstract


2014-02-01 00:00:00












  • The effect of jejunoileal bypass on bile composition and the formation of billiary calculi.

    abstract::In our series of 101 patients with small bowel bypass for morbid obesity, nine developed biliary calculi postoperatively during a mean follow-up of 29.6 months. The development of gallstones depends in part on biliary cholesterol saturation and on the zeta potential of bile. In eight consecutive patients, the lithogen...

    journal_title:Annals of surgery

    pub_type: 杂志文章


    authors: Wise L,Stein T

    更新日期:1978-01-01 00:00:00

  • Is ambulatory laparoscopic Roux-en-Y gastric bypass associated with higher adverse events?

    abstract:OBJECTIVE:To determine the impact of length of stay upon 30-day outcomes. BACKGROUND:It has been recommended the goal length of stay (LOS) after laparoscopic Roux-en-Y gastric bypass (LRYGB) should be 1 day to improve resource utilization. This study's aim was to assess LRYGB outcomes by LOS. METHODS:Data were obtain...

    journal_title:Annals of surgery

    pub_type: 杂志文章


    authors: Morton JM,Winegar D,Blackstone R,Wolfe B

    更新日期:2014-02-01 00:00:00

  • Appendectomy by residents is safe and not associated with a higher incidence of complications: a retrospective cohort study.

    abstract:OBJECTIVE:The purpose of this retrospective cohort study was to investigate whether current practice where residents perform appendectomies affects quality of care. Therefore, we investigated whether there was a difference in incidence of complications and mortality in appendectomies performed by surgeons (S), supervis...

    journal_title:Annals of surgery

    pub_type: 杂志文章


    authors: Graat LJ,Bosma E,Roukema JA,Heisterkamp J

    更新日期:2012-04-01 00:00:00

  • Appraisal of laparoscopic cholecystectomy.

    abstract::This paper reports the experience of three general surgeons performing 304 laparoscopic cholecystectomies in three private hospitals between October 1989 and November 1990. Laparoscopic cholecystectomy boasts two major advantages over the conventional procedure: the remarkable reduction in postoperative pain and econo...

    journal_title:Annals of surgery

    pub_type: 杂志文章


    authors: Graves HA Jr,Ballinger JF,Anderson WJ

    更新日期:1991-06-01 00:00:00

  • Effect of resection margins on the recurrence of Crohn's disease in the small bowel. A randomized controlled trial.

    abstract:OBJECTIVE:The authors assess the effect of surgical margin width on recurrence rates after intestinal resection of Crohn's Disease (CD). BACKGROUND:The optimal width of margins when resecting DC of the small bowel is controversial. Most studies have been retrospective and have had conflicting results. METHODS:Patient...

    journal_title:Annals of surgery

    pub_type: 临床试验,杂志文章,随机对照试验


    authors: Fazio VW,Marchetti F,Church M,Goldblum JR,Lavery C,Hull TL,Milsom JW,Strong SA,Oakley JR,Secic M

    更新日期:1996-10-01 00:00:00

  • Popliteal artery trauma. Systemic anticoagulation and intraoperative thrombolysis improves limb salvage.

    abstract:OBJECTIVE:This study was conducted to evaluate those factors associated with popliteal artery injury that influence amputation, with emphasis placed on those that the surgeon can control. SUMMARY BACKGROUND DATA:Generally accepted factors impacting amputation after popliteal artery injury include blunt trauma, prolong...

    journal_title:Annals of surgery

    pub_type: 杂志文章


    authors: Melton SM,Croce MA,Patton JH Jr,Pritchard FE,Minard G,Kudsk KA,Fabian TC

    更新日期:1997-05-01 00:00:00

  • Adults with Ewing's sarcoma/primitive neuroectodermal tumor: adverse effect of older age and primary extraosseous disease on outcome.

    abstract:OBJECTIVE:To assess outcome and prognostic factors for survival of adults with Ewing's sarcoma/primitive neuroectodermal tumor (PNET). BACKGROUND:Ewing's sarcoma/PNET is a disease of childhood rarely seen in adults. Accordingly, there is a relative paucity of published literature pertaining to outcome for adults with ...

    journal_title:Annals of surgery

    pub_type: 临床试验,杂志文章


    authors: Baldini EH,Demetri GD,Fletcher CD,Foran J,Marcus KC,Singer S

    更新日期:1999-07-01 00:00:00

  • Surgical management of carcinoma of the junction of the main hepatic ducts.

    abstract::Twenty-six patients are reviewed who had primary carcinomas involving the junction of the hepatic ducts. The majority had had an initial procedure of palliative biliary diversion elsewhere and were referred for further treatment. In three cases, en bloc resection of the tumor with total hepatectomy and orthotopic live...

    journal_title:Annals of surgery

    pub_type: 杂志文章


    authors: Fortner JG,Kallum BO,Kim DK

    更新日期:1976-07-01 00:00:00

  • Hepatic abscess in patients with chronic granulomatous disease.

    abstract:OBJECTIVE:To evaluate the clinical presentation, diagnostic procedures, and surgical management of hepatic abscesses in patients with chronic granulomatous disease (CGD). SUMMARY BACKGROUND DATA:Chronic granulomatous disease is a rare inherited primary immunodeficiency in which phagocytes cannot destroy catalase-posit...

    journal_title:Annals of surgery

    pub_type: 杂志文章


    authors: Lublin M,Bartlett DL,Danforth DN,Kauffman H,Gallin JI,Malech HL,Shawker T,Choyke P,Kleiner DE,Schwartzentruber DJ,Chang R,DeCarlo ES,Holland SM

    更新日期:2002-03-01 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


    authors: Bernstein EF,Chan EL

    更新日期:1984-09-01 00:00:00

  • A multivariate analysis of preoperative risk factors in patients with common bile duct stones. Implications for treatment.

    abstract::A multivariate analysis of 30 preoperative risk factors was undertaken in 248 patients who underwent surgery alone for common bile duct (CBD) stones and in 190 patients who had endoscopic sphincterotomy (ES), 77 of whom subsequently also had surgery. Independently significant risk factors in those undergoing surgery w...

    journal_title:Annals of surgery

    pub_type: 杂志文章


    authors: Neoptolemos JP,Shaw DE,Carr-Locke DL

    更新日期:1989-02-01 00:00:00

  • Simulation improves resident performance in catheter-based intervention: results of a randomized, controlled study.

    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


    authors: Chaer RA,Derubertis BG,Lin SC,Bush HL,Karwowski JK,Birk D,Morrissey NJ,Faries PL,McKinsey JF,Kent KC

    更新日期:2006-09-01 00:00:00

  • Recurrent versus residual carotid stenosis. Incidence detected by Doppler ultrasound.

    abstract::A sterile Doppler probe was used for intraoperative monitoring of the integrity of carotid endarterectomy of 125 vessels of 107 patients. Our objective was to reduce the contribution of residual carotid lesions to recurrent stenosis, which was evaluated by Doppler spectrum analysis in the early (less than 3 months, 66...

    journal_title:Annals of surgery

    pub_type: 杂志文章


    authors: Barnes RW,Nix ML,Wingo JP,Nichols BT

    更新日期:1986-06-01 00:00:00

  • Stat 6-dependent induction of myeloid derived suppressor cells after physical injury regulates nitric oxide response to endotoxin.

    abstract:OBJECTIVE:To delineate the role of T-helper 2 (Th2) cytokines in the induction of trauma induced myeloid suppressor cells (TIMSC) and the regulation of nitric oxide production. BACKGROUND:Trauma induces myeloid cells that express CD11b+/Gr1+ and arginase 1 and exhibit an immune suppressing activity. This article explo...

    journal_title:Annals of surgery

    pub_type: 杂志文章


    authors: Munera V,Popovic PJ,Bryk J,Pribis J,Caba D,Matta BM,Zenati M,Ochoa JB

    更新日期:2010-01-01 00:00:00

  • Preoperative and long-term cardiac risk assessment. Predictive value of 23 clinical descriptors, 7 multivariate scoring systems, and quantitative dipyridamole imaging in 360 patients.

    abstract::A total of 360 patients underwent preoperative cardiac risk assessment using 23 clinical parameters, seven multivariate clinical scoring systems, and quantitative dipyridamole-thallium imaging to predict postoperative and long-term myocardial infarction and cardiac death after noncardiac surgery. There were 30 postope...

    journal_title:Annals of surgery

    pub_type: 杂志文章


    authors: Lette J,Waters D,Bernier H,Champagne P,Lassonde J,Picard M,Cerino M,Nattel S,Boucher Y,Heyen F

    更新日期:1992-08-01 00:00:00

  • Experimental comparison of the thrombogenicity of fibrin and PTFE flow surfaces.

    abstract::Two types of 4 mm ID prostheses were studied in the carotid arteries of the dog. These were noncrimped polypropylene-supported filamentous velour knitted Dacron (PPSFV) and expanded polytetrafluoroethylene (e-PTFE, Gore-Tex). Thrombus-"Free" Surface TFS) areas and patency rates were determined at the end of the implan...

    journal_title:Annals of surgery

    pub_type: 杂志文章


    authors: Kenny DA,Berger K,Walker MW,Robel SB,Boguslavsky L,Ray LI,Lischko MM,Sauvage LR

    更新日期:1980-03-01 00:00:00

  • A systematic proactive risk assessment of hazards in surgical wards: a quantitative study.

    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


    authors: Anderson O,Brodie A,Vincent CA,Hanna GB

    更新日期:2012-06-01 00:00:00

  • Gastrointestinal hemorrhage from adhesion-related mesenteric varices.

    abstract::As a result of this retrospective analysis of hemorrhage from a porta-systemic venous shunt occurring within the small intestine, we believe that the early diagnosis of the syndrome is strongly suggested by the presence of varices in unusual locations demonstrated by the venous phase of mesenteric arteriography. In al...

    journal_title:Annals of surgery

    pub_type: 杂志文章


    authors: Moncure AC,Waltman AC,Vandersalm TJ,Linton RR,Levine FH,Abbott WM

    更新日期:1976-01-01 00:00:00

  • A stapling instrument for end-to-end inverting anastomoses in the gastrointestinal tract.

    abstract::A stapling instrument is described for end-to-end inverting anastomoses applicable principally to low rectal anastomosis or esophagogastric or esophagojejunal anastomosis. The instrument creates an inverting anastomosis held by a double staggered row of stainless steel wire staples creating an anastomosis 21.2 mm inte...

    journal_title:Annals of surgery

    pub_type: 杂志文章


    authors: Ravitch MM,Steichen FM

    更新日期:1979-06-01 00:00:00

  • Cultured epidermis for the coverage of massive burn wounds. A single center experience.

    abstract::Seven patients with a mean burn size of 69.6% total body-surface area underwent skin grafting with autologous cultured epidermis. They were compared with a historical group of 18 controls, with a mean burn size of 60%, who underwent grafting with conventional meshed split-thickness autograft. There were no statistical...

    journal_title:Annals of surgery

    pub_type: 杂志文章


    authors: Munster AM,Weiner SH,Spence RJ

    更新日期:1990-06-01 00:00:00

  • Prolonged partial venoarterial bypass: physiologic, biochemical, and hematologic responses.

    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


    authors: Bartlett RH,Fong SW,Burns NE,Gazzaniga AB

    更新日期:1974-12-01 00:00:00

  • Should perioperative supplemental oxygen be routinely recommended for surgery patients? A Bayesian meta-analysis.

    abstract:OBJECTIVE:The purpose of this study is to use updated data and Bayesian methods to evaluate the effectiveness of hyperoxia to reduce surgical site infections (SSIs) and/or mortality in both colorectal and all surgery patients. Because few trials assessed potential harms of hyperoxia, hazards were not included. BACKGRO...

    journal_title:Annals of surgery

    pub_type: 杂志文章,meta分析


    authors: Kao LS,Millas SG,Pedroza C,Tyson JE,Lally KP

    更新日期:2012-12-01 00:00:00

  • Somatostatin receptor gene therapy combined with targeted therapy with radiolabeled octreotide: a new treatment for liver metastases.

    abstract:OBJECTIVE:To evaluate the effect of peptide receptor radionuclide therapy (PRRT) on somatostatin receptor (SSR)-transfected colon carcinoma cells in a rat liver metastases model. SUMMARY BACKGROUND DATA:Previously the authors have shown highly effective therapy with PRRT of SSR-positive tumors. This treatment is SSR-m...

    journal_title:Annals of surgery

    pub_type: 杂志文章


    authors: Mearadji A,Breeman W,Hofland L,van Koetsveld P,Marquet R,Jeekel J,Krenning E,van Eijck C

    更新日期:2002-12-01 00:00:00

  • Variability in Patterns of Recurrence After Resection of Primary Retroperitoneal Sarcoma (RPS): A Report on 1007 Patients From the Multi-institutional Collaborative RPS Working Group.

    abstract:BACKGROUND:Retroperitoneal sarcomas (RPS) are rare tumors composed of several well defined histologic subtypes. The aim of this study was to analyze patterns of recurrence and treatment variations in a large population of patients, treated at reference centers. METHODS:All consecutive patients with primary RPS treated...

    journal_title:Annals of surgery

    pub_type: 杂志文章,多中心研究


    authors: Gronchi A,Strauss DC,Miceli R,Bonvalot S,Swallow CJ,Hohenberger P,Van Coevorden F,Rutkowski P,Callegaro D,Hayes AJ,Honoré C,Fairweather M,Cannell A,Jakob J,Haas RL,Szacht M,Fiore M,Casali PG,Pollock RE,Raut CP

    更新日期:2016-05-01 00:00:00

  • Intestinal Oxygenation and Survival After Surgery for Necrotizing Enterocolitis: An Observational Cohort Study.

    abstract:OBJECTIVE:To assess whether regional intestinal oxygen saturation (rintSO2) and regional cerebral oxygen saturation (rcSO2) measurements aid in estimating survival of preterm infants after surgery for NEC. SUMMARY OF BACKGROUND DATA:Predicting survival after surgery for NEC is difficult yet of the utmost importance fo...

    journal_title:Annals of surgery

    pub_type: 杂志文章


    authors: Kuik SJ,van der Heide M,Bruggink JLM,Bos AF,Verhagen AAE,Kooi EMW,Hulscher JBF

    更新日期:2020-04-20 00:00:00

  • Effect of postdischarge morbidity and mortality on comparisons of hospital surgical quality.

    abstract:BACKGROUND:Hospitals increasingly rely on surgical quality assessment programs that require considerable resources to capture outcomes after hospital discharge. However, it is unclear whether capturing postdischarge complications and deaths is important. Our objectives were (1) to determine the frequency of postdischar...

    journal_title:Annals of surgery

    pub_type: 杂志文章


    authors: Bilimoria KY,Cohen ME,Ingraham AM,Bentrem DJ,Richards K,Hall BL,Ko CY

    更新日期:2010-07-01 00:00:00

  • Early postoperative small bowel obstruction.

    abstract::The hospital records of 41 patients with a diagnosis of early postoperative small bowel obstruction were reviewed in an attempt to identify criteria which could be used to separate those patients who would require an operation to resolve their obstruction, from those who would resolve with nonoperative therapy. The us...

    journal_title:Annals of surgery

    pub_type: 杂志文章


    authors: Quatromoni JC,Rosoff L Sr,Halls JM,Yellin AE

    更新日期:1980-01-01 00:00:00

  • Chronic respiratory symptoms and occult gastroesophageal reflux. A prospective clinical study and results of surgical therapy.

    abstract::Seventy-seven patients with a primary complaint of persistent cough, wheezing, and/or recurrent pneumonia were evaluated for the presence of occult gastroesophageal reflux disease. Fifty-four patients (70%) had increased esophageal acid exposure on 24-hour pH monitoring of the distal esophagus. In 28% of these patient...

    journal_title:Annals of surgery

    pub_type: 杂志文章


    authors: DeMeester TR,Bonavina L,Iascone C,Courtney JV,Skinner DB

    更新日期:1990-03-01 00:00:00

  • Acute Kidney Injury in Burn Patients: Clinically Significant Over the Initial Hospitalization and 1 Year After Injury: An Original Retrospective Cohort Study.

    abstract:OBJECTIVE:To examine the development of acute kidney injury (AKI) after burn injury as an independent risk factor for increased morbidity and mortality over initial hospitalization and 1-year follow-up. BACKGROUND:Variability in fluid resuscitation and difficulty recognizing early sepsis are major barriers to preventi...

    journal_title:Annals of surgery

    pub_type: 杂志文章


    authors: Thalji SZ,Kothari AN,Kuo PC,Mosier MJ

    更新日期:2017-08-01 00:00:00

  • Enteral contrast in the computed tomography diagnosis of appendicitis: comparative effectiveness in a prospective surgical cohort.

    abstract:OBJECTIVE:Our goal was to perform a comparative effectiveness study of intravenous (IV)-only versus IV + enteral contrast in computed tomographic (CT) scans performed for patients undergoing appendectomy across a diverse group of hospitals. BACKGROUND:Small randomized trials from tertiary centers suggest that enteral ...

    journal_title:Annals of surgery

    pub_type: 杂志文章,多中心研究


    authors: Drake FT,Alfonso R,Bhargava P,Cuevas C,Dighe MK,Florence MG,Johnson MG,Jurkovich GJ,Steele SR,Symons RG,Thirlby RC,Flum DR,Writing Group for SCOAP-CERTAIN.

    更新日期:2014-08-01 00:00:00