Risk and location of cancer in patients with preoperative colitis-associated dysplasia undergoing proctocolectomy.

Abstract:

OBJECTIVE:To evaluate the influence of preoperative dysplasia grade, appearance, and site on risk and location of cancer in patients with colitis. BACKGROUND:The ability to predict the presence and location of cancer in colitis patients with dysplasia is essential to facilitate recommendations regarding the necessity and type of surgery. METHODS:Ulcerative and indeterminate colitis patients who underwent proctocolectomy for dysplasia were retrospectively selected. Patient characteristics and findings at colonoscopic surveillance were associated with findings on the surgical specimen by regression analysis. RESULTS:From 1984 to 2007, 348 proctocolectomy specimens with preoperative dysplasia showed cancer in 51 (15%) and dysplasia in 172 (49%) cases. Patients with preoperative high-grade dysplasia (HGD) had cancer in 29% compared with 3% in low-grade dysplasia (LGD) (P < 0.001). Patients with preoperative dysplasia-associated lesion/mass (DALM) had cancer in 25% compared with 8% in flat dysplasia (P < 0.001). In LGD with DALM, the risk of cancer was not significantly higher than in flat LGD (7% vs 2%, P = 0.3), but risk of cancer or HGD was higher with a threefold increase (29% vs 9%, P = 0.015). On multivariate analysis, HGD, DALM, and disease duration were independent risk factors for postoperative cancer. In patients with isolated colonic dysplasia above the sigmoid level, postoperative rectal involvement was limited. CONCLUSIONS:Risk of cancer for patients with HGD or DALM is substantial. Despite low risk of cancer in patients with flat LGD, threshold for surgery should be low given the high prevalence of postoperative pathologic findings. Only in selected cases, colonoscopic surveillance after discussion of associated risks may be acceptable, provided high patient compliance can be assured. Surgery should be considered in all other cases, because it is the only modality that can eliminate the risk of cancer. The location of preoperative dysplasia may allow for the clarification of the need for proctectomy especially in the poor risk surgical patient.

journal_name

Ann Surg

journal_title

Annals of surgery

authors

Kiran RP,Ahmed Ali U,Nisar PJ,Khoury W,Gu J,Shen B,Remzi FH,Hammel JP,Lavery IC,Fazio VW,Goldblum JR

doi

10.1097/SLA.0b013e31828e7417

subject

Has Abstract

pub_date

2014-02-01 00:00:00

pages

302-9

issue

2

eissn

0003-4932

issn

1528-1140

journal_volume

259

pub_type

杂志文章
  • Hypertonic saline resuscitation of hemorrhagic shock diminishes neutrophil rolling and adherence to endothelium and reduces in vivo vascular leakage.

    abstract:OBJECTIVE:To evaluate the in vivo effects of hypertonic saline (HTS) resuscitation on the interactions of endothelial cells (ECs) and polymorphonuclear neutrophils (PMNs) and vascular permeability after hemorrhagic shock. SUMMARY BACKGROUND DATA:The PMN has been implicated in the pathogenesis of EC damage and organ in...

    journal_title:Annals of surgery

    pub_type: 杂志文章

    doi:10.1097/00000658-200211000-00014

    authors: Pascual JL,Ferri LE,Seely AJ,Campisi G,Chaudhury P,Giannias B,Evans DC,Razek T,Michel RP,Christou NV

    更新日期:2002-11-01 00:00:00

  • Differential clinical workloads among faculty at a major academic health center.

    abstract:OBJECTIVE:The authors analyzed patient care (1981-1995) and financial data (1991-1996) to determine if differential workloads existed at a major academic health center. SUMMARY BACKGROUND DATA:Academic health centers differ markedly from community-based medical centers, but they are required to compete with others who...

    journal_title:Annals of surgery

    pub_type: 杂志文章

    doi:10.1097/00000658-199709000-00013

    authors: Zelenock GB,Stanley JC,More RA,Greenfield LJ,Shanley CJ,Jacobs LA

    更新日期:1997-09-01 00:00:00

  • Soft tissue sarcomas.

    abstract::One hundred fifty-five adult patients with "operable" soft part sarcomas including rhabdomyosarcoma, liposarcoma, leiomyosarcoma and fibrosarcoma of the trunk and extremities are reviewed. Local recurrences of 93% and 60% occurred after local and wide excisions of the primary tumor. In this series of patients, amputat...

    journal_title:Annals of surgery

    pub_type: 杂志文章

    doi:10.1097/00000658-197506000-00007

    authors: Gerner RE,Moore GE,Pickren JW

    更新日期:1975-06-01 00:00:00

  • Nationwide Procedural Trends for Renal Trauma Management.

    abstract:OBJECTIVE:To characterize national trends in procedural management of renal trauma. BACKGROUND:Management of renal trauma has evolved to favor a more conservative approach. For patients requiring intervention, there is a paucity of information to characterize the nature of procedural therapy administered. METHODS:A r...

    journal_title:Annals of surgery

    pub_type: 杂志文章

    doi:10.1097/SLA.0000000000002475

    authors: Colaco M,Navarrete RA,MacDonald SM,Stitzel JD,Terlecki RP

    更新日期:2019-02-01 00:00:00

  • Long-term Results of a Randomized Double-blinded Prospective Trial of a Lightweight (Ultrapro) Versus a Heavyweight Mesh (Prolene) in Laparoscopic Total Extraperitoneal Inguinal Hernia Repair (TULP-trial).

    abstract:OBJECTIVE:The aim of the randomized clinical trial was to compare the 2 years of clinical outcomes of a lightweight (Ultrapro) vs a heavyweight (Prolene) mesh for laparoscopic total extraperitoneal (TEP) inguinal hernia repair. BACKGROUND:Lightweight meshes reduce postoperative pain and stiffness in open anterior ingu...

    journal_title:Annals of surgery

    pub_type: 杂志文章,随机对照试验

    doi:10.1097/SLA.0000000000001579

    authors: Burgmans JP,Voorbrood CE,Simmermacher RK,Schouten N,Smakman N,Clevers G,Davids PH,Verleisdonk EM,Hamaker ME,Lange JF,van Dalen T

    更新日期:2016-05-01 00:00:00

  • Adrenalectomy for Secondary Malignancy: Patients, Outcomes, and Indications.

    abstract:OBJECTIVE:The goal of this study was to examine a multi-institutional experience with adrenal metastases to describe survival outcomes and identify subpopulations who benefit from adrenal metastasectomy. BACKGROUND:Adrenalectomy for metastatic disease is well-described, although indications and outcomes are incomplete...

    journal_title:Annals of surgery

    pub_type: 杂志文章

    doi:10.1097/SLA.0000000000003876

    authors: Wachtel H,Roses RE,Kuo LE,Lindeman BM,Nehs MA,Tavakkoli A,Parangi S,Hodin RA,Fraker DL,James BC,Carr AA,Wang TS,Solórzano CC,Lubitz CC

    更新日期:2020-05-18 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

  • Alvimopan, a novel, peripherally acting mu opioid antagonist: results of a multicenter, randomized, double-blind, placebo-controlled, phase III trial of major abdominal surgery and postoperative ileus.

    abstract:OBJECTIVE:To demonstrate that alvimopan (6 or 12 mg) accelerates recovery of gastrointestinal (GI) function in patients undergoing laparotomy for bowel resection or radical hysterectomy. SUMMARY BACKGROUND DATA:Postoperative ileus (POI) following laparotomy may increase morbidity and extend hospitalization. Opioids ca...

    journal_title:Annals of surgery

    pub_type: 临床试验,杂志文章,meta分析,随机对照试验

    doi:10.1097/01.sla.0000141158.27977.66

    authors: Wolff BG,Michelassi F,Gerkin TM,Techner L,Gabriel K,Du W,Wallin BA,Alvimopan Postoperative Ileus Study Group.

    更新日期:2004-10-01 00:00:00

  • A statewide, population-based time-series analysis of the outcome of ruptured abdominal aortic aneurysm.

    abstract:OBJECTIVES:The purpose of this study was to perform the first statewide, population-based, time-series analysis of the frequency of ruptured abdominal aortic aneurysm (RAAA), to determine the outcomes of RAAA, and to assess the association of patient, physician, and hospital factors with survival after RAAA. The hypoth...

    journal_title:Annals of surgery

    pub_type: 杂志文章

    doi:10.1097/00000658-199605000-00005

    authors: Rutledge R,Oller DW,Meyer AA,Johnson GJ Jr

    更新日期:1996-05-01 00:00:00

  • Restoration of normal distensive characteristics of the esophagogastric junction after fundoplication.

    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

    authors: Pandolfino JE,Curry J,Shi G,Joehl RJ,Brasseur JG,Kahrilas PJ

    更新日期:2005-07-01 00:00:00

  • Duodenum-preserving resection of the head of the pancreas in chronic pancreatitis. A prospective, randomized trial.

    abstract:OBJECTIVE:Two techniques of duodenum-preserving resection of the head of the pancreas were compared in a prospective, randomized trial. The technical feasibility and effects on quality of life were assessed. SUMMARY BACKGROUND DATA:Drainage and resection are the principles of surgery in chronic pancreatitis. The techn...

    journal_title:Annals of surgery

    pub_type: 临床试验,杂志文章,随机对照试验

    doi:10.1097/00000658-199504000-00004

    authors: Izbicki JR,Bloechle C,Knoefel WT,Kuechler T,Binmoeller KF,Broelsch CE

    更新日期:1995-04-01 00:00:00

  • Effect of Esophageal Cancer Surgeon Volume on Management and Mortality From Emergency Upper Gastrointestinal Conditions: Population-based Cohort Study.

    abstract:OBJECTIVE:To study the influence of esophageal cancer surgeon volume upon mortality from upper gastrointestinal emergencies. BACKGROUND:Volume-outcome relationships led to the centralization of esophageal cancer surgery. METHODS:Hospital Episode Statistics data were used to identify patients admitted to hospitals wit...

    journal_title:Annals of surgery

    pub_type: 杂志文章

    doi:10.1097/SLA.0000000000002387

    authors: Markar SR,Mackenzie H,Askari A,Faiz O,Hanna GB

    更新日期:2017-11-01 00:00:00

  • Biologic determinants of tumor growth in healing wounds.

    abstract::The morphologic characteristics of a scar may render it an "immunologically privileged site" providing fertile ground for tumor occurrence and growth. We sought to extend this concept and to determine the effect of different stages of wound healing on tumor occurrence. Syngeneic strain-2 guinea pigs and a methylcholan...

    journal_title:Annals of surgery

    pub_type: 杂志文章

    doi:10.1097/00000658-197902000-00009

    authors: Pendergrast WJ Jr,Futrell JW

    更新日期:1979-02-01 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

    doi:10.1097/00000658-199208000-00010

    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

  • Pylorus Resection Does Not Reduce Delayed Gastric Emptying After Partial Pancreatoduodenectomy: A Blinded Randomized Controlled Trial (PROPP Study, DRKS00004191).

    abstract:OBJECTIVES:The aim of this study was to investigate the effect of pylorus resection on postoperative delayed gastric emptying (DGE) after partial pancreatoduodenectomy (PD). BACKGROUND:PD is the standard treatment for tumors of the pancreatic head. Preservation of the pylorus has been widely accepted as standard proce...

    journal_title:Annals of surgery

    pub_type: 杂志文章,随机对照试验

    doi:10.1097/SLA.0000000000002480

    authors: Hackert T,Probst P,Knebel P,Doerr-Harim C,Bruckner T,Klaiber U,Werner J,Schneider L,Michalski CW,Strobel O,Ulrich A,Diener MK,Büchler MW

    更新日期:2018-06-01 00:00:00

  • Choledochal cyst in the adult.

    abstract:OBJECTIVE:The authors examined the natural history of choledochal cysts in adults treated surgically. BACKGROUND:An initial diagnosis of choledochal cyst is uncommon in adults. The recommended treatment is excision, rather than bypass, to achieve effective biliary drainage and because of the risk of cancer. METHODS:A...

    journal_title:Annals of surgery

    pub_type: 杂志文章

    doi:10.1097/00000658-199508000-00004

    authors: Stain SC,Guthrie CR,Yellin AE,Donovan AJ

    更新日期:1995-08-01 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

  • Laparoscopic liver resection for malignant liver tumors: preliminary results of a multicenter European study.

    abstract:OBJECTIVE:To assess the feasibility, safety, and outcome of laparoscopic liver resection for malignant liver tumors. SUMMARY BACKGROUND DATA:The precise role of laparoscopy in resection of liver malignancies (hepatocellular carcinoma [HCC] and liver metastases) remains controversial despite an increasing number of pub...

    journal_title:Annals of surgery

    pub_type: 杂志文章,多中心研究

    doi:10.1097/00000658-200207000-00014

    authors: Gigot JF,Glineur D,Santiago Azagra J,Goergen M,Ceuterick M,Morino M,Etienne J,Marescaux J,Mutter D,van Krunckelsven L,Descottes B,Valleix D,Lachachi F,Bertrand C,Mansvelt B,Hubens G,Saey JP,Schockmel R,Hepatobiliary a

    更新日期:2002-07-01 00:00:00

  • Hyperthermic pelvic perfusion with tumor necrosis factor-α for locally advanced cancers: encouraging results of a phase II study.

    abstract:PURPOSE:To assess the efficacy of isolated pelvic perfusion (IPP) with tumor necrosis factor (TNF)-α and melphalan in patients with locally advanced cancers in the pelvic and groin area requiring mutilating surgery. METHODS:A total of 27 patients were enrolled (carcinoma, n = 17; sarcoma/melanoma, n = 4; and endocrine...

    journal_title:Annals of surgery

    pub_type: 杂志文章

    doi:10.1097/SLA.0b013e318242ebe7

    authors: Bonvalot S,de Baere T,Mendiboure J,Paci A,Farace F,Drouard-Troalen L,Bonnet L,Hakime A,Bonniaud G,Raynard B,Israel P,Le Cesne A,Eggermont AM,Laplanche A,Muret J

    更新日期:2012-02-01 00:00:00

  • Acute hand burns in children: management and long-term outcome based on a 10-year experience with 698 injured hands.

    abstract:OBJECTIVE:To document long-term results associated with an coordinated plan of care for acutely burned hands in children. SUMMARY AND BACKGROUND DATA:Optimal hand function is a crucial component of a high-quality survival after burn injury. This can be achieved only with a coordinated approach to the injuries. Long-te...

    journal_title:Annals of surgery

    pub_type: 杂志文章

    doi:10.1097/00000658-199904000-00016

    authors: Sheridan RL,Baryza MJ,Pessina MA,O'Neill KM,Cipullo HM,Donelan MB,Ryan CM,Schulz JT,Schnitzer JJ,Tompkins RG

    更新日期:1999-04-01 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

  • Laparoscopic resection does not adversely affect early survival curves in patients undergoing surgery for colorectal adenocarcinoma.

    abstract:OBJECTIVE:To determine the survival curves for laparoscopic resection (LR) of colorectal cancer. SUMMARY BACKGROUND DATA:Laparoscopic resection for cure of colorectal cancer is controversial, and survival curves have not been determined. METHODS:A prospective database of 177 consecutive LRs of colorectal cancers perf...

    journal_title:Annals of surgery

    pub_type: 临床试验,杂志文章

    doi:10.1097/00000658-199904000-00006

    authors: Poulin EC,Mamazza J,Schlachta CM,Grégoire R,Roy N

    更新日期:1999-04-01 00:00:00

  • Have outcomes of incisional hernia repair improved with time? A population-based analysis.

    abstract:OBJECTIVE:To determine if certain outcomes of incisional hernia repair have improved in recent eras. SUMMARY BACKGROUND DATA:Technological developments have been reported to improve outcomes in the repair of abdominal wall incisional hernias. METHODS:This retrospective, population-based cohort study was conducted usi...

    journal_title:Annals of surgery

    pub_type: 杂志文章

    doi:10.1097/00000658-200301000-00018

    authors: Flum DR,Horvath K,Koepsell T

    更新日期:2003-01-01 00:00:00

  • Desmoid-type fibromatosis and pregnancy: a multi-institutional analysis of recurrence and obstetric risk.

    abstract:BACKGROUND:Many women who present with desmoid-type fibromatosis (DF) have had a recent pregnancy. Long-term data about disease behavior during and after pregnancy are lacking. OBJECTIVE:To investigate the possible relationship between DF and pregnancy. PATIENTS AND METHODS:A cohort of women with DF and pregnancy was...

    journal_title:Annals of surgery

    pub_type: 杂志文章,多中心研究

    doi:10.1097/SLA.0000000000000224

    authors: Fiore M,Coppola S,Cannell AJ,Colombo C,Bertagnolli MM,George S,Le Cesne A,Gladdy RA,Casali PG,Swallow CJ,Gronchi A,Bonvalot S,Raut CP

    更新日期:2014-05-01 00:00:00

  • General surgery in patients on maintenance hemodialysis.

    abstract::A review of the experience with 66 patients on chronic hemodialysis who underwent 67 major surgical procedures is presented. There were 58 general surgical procedures, and nine major cardiovascular procedures including four emergency cardiac valve replacements. The preoperative, intraoperative and postoperative manage...

    journal_title:Annals of surgery

    pub_type: 杂志文章

    doi:10.1097/00000658-197406000-00008

    authors: Haimov M,Glabman S,Schupak E,Neff M,Burrows L

    更新日期:1974-06-01 00:00:00

  • Prevalence, Management and Outcomes Related to Preoperative Medical Orders for life Sustaining Treatment (MOLST) in an Adult Surgical Population.

    abstract:OBJECTIVE:To determine prevalence of documented preoperative code status discussions and post-operative outcomes (specifically mortality, readmission and discharge disposition) of patients with completed Medical Orders for Life-Sustaining Treatments (MOLST) forms before surgery. SUMMARY OF BACKGROUND DATA:A MOLST form...

    journal_title:Annals of surgery

    pub_type: 杂志文章

    doi:10.1097/SLA.0000000000004675

    authors: Tanious M,Lindvall C,Cooper Z,Tukan N,Peters S,Streid J,Fields K,Bader A

    更新日期:2020-12-18 00:00:00

  • Predictive index for long-term survival after retransplantation of the liver in adult recipients: analysis of a 26-year experience in a single center.

    abstract:OBJECTIVE:To develop a prognostic scoring system for risk stratification of patients with hepatic graft failure (GF) undergoing retransplants of the liver (ReLT) and improve patient selection. SUMMARY OF BACKGROUND DATA:Retransplantation of the liver remains controversial because of inferior outcomes compared with the...

    journal_title:Annals of surgery

    pub_type: 杂志文章

    doi:10.1097/SLA.0b013e31822c5878

    authors: Hong JC,Kaldas FM,Kositamongkol P,Petrowsky H,Farmer DG,Markovic D,Hiatt JR,Busuttil RW

    更新日期:2011-09-01 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

  • Gene expression signature of the gross morphology in hepatocellular carcinoma.

    abstract:OBJECTIVE:To evaluate the gene expression signature of hepatocellular carcinoma (HCC) in relation to the gross morphology. BACKGROUND:Eggel's nodular type of HCC is morphologically subclassified into the single nodular (SN) type, the single nodular type with extranodular growth (SNEG), and the confluent multinodular (...

    journal_title:Annals of surgery

    pub_type: 杂志文章

    doi:10.1097/SLA.0b013e3181f9bc00

    authors: Murakata A,Tanaka S,Mogushi K,Yasen M,Noguchi N,Irie T,Kudo A,Nakamura N,Tanaka H,Arii S

    更新日期:2011-01-01 00:00:00

  • Splenic injury during resection for esophageal cancer: risk factors and consequences.

    abstract:OBJECTIVE:Esophageal cancer surgery carries a risk of splenic injury, which may require splenectomy, but predictors of such events remain uncertain. Moreover, the hypothesis that incidental splenectomy carries a worse prognosis deserves attention. DESIGN:A population-based, nationwide cohort study was conducted on 167...

    journal_title:Annals of surgery

    pub_type: 杂志文章

    doi:10.1097/SLA.0000000000000650

    authors: Derogar M,Sadr-Azodi O,Lagergren P,Lagergren J

    更新日期:2015-01-01 00:00:00