Abstract:
OBJECTIVE:Comparison of short- and long-term effects after laparoscopic Heller myotomy (LHM) and endoscopic balloon dilation (EBD) considering the need for retreatment. BACKGROUND:Previously published studies have indicated that LHM is the most effective treatment for Achalasia. In contrast to that a recent randomized trial found EBD equivalent to LHM 2 years after initial treatment. METHODS:A search in Medline, PubMed, and Cochrane Central Register of Controlled Trials was conducted for prospective studies on interventional achalasia therapy with predefined exclusion criteria. Data on success rates after the initial and repeated treatment were extracted. An adjusted network meta-analysis and meta-regression analysis was used, combined with a head-to-head comparison, for follow-up at 12, 24, and 60 months. RESULTS:Sixteen studies including results of 590 LHM and EBD patients were identified. Odds ratio (OR) was 2.20 at 12 months (95% confidence interval: 1.18-4.09; P = 0.01); 5.06 at 24 months (2.61-9.80; P < 0.00001) and 29.83 at 60 months (3.96-224.68; P = 0.001). LHM was also significantly superior for all time points when therapy included re-treatments [OR = 4.83 (1.87-12.50), 19.61 (5.34-71.95), and 17.90 (2.17-147.98); P ≤ 0.01 for all comparisons) Complication rates were not significantly different. Meta-regression analysis showed that amount of dilations had a significant impact on treatment effects (P = 0.009). Every dilation (up to 3) improved treatment effect by 11.9% (2.8%-21.8%). CONCLUSIONS:In this network meta-analysis, LHM demonstrated superior short- and long-term efficacy and should be considered first-line treatment of esophageal achalasia.
journal_name
Ann Surgjournal_title
Annals of surgeryauthors
Schoenberg MB,Marx S,Kersten JF,Rösch T,Belle S,Kähler G,Vassiliou MC,Lüth S,von Renteln Ddoi
10.1097/SLA.0000000000000212subject
Has Abstractpub_date
2013-12-01 00:00:00pages
943-52issue
6eissn
0003-4932issn
1528-1140pii
00000658-201312000-00014journal_volume
258pub_type
杂志文章,meta分析abstract:OBJECTIVE:The authors evaluated the morbidity, mortality, and quality of life after pancreatic debridement for necrosis and compared these values to those for quality of life after elective medical and surgical management for chronic pancreatitis. SUMMARY BACKGROUND DATA:Quality of life after pancreatic debridement fo...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-199606000-00005
更新日期:1996-06-01 00:00:00
abstract:OBJECTIVE:To assess the feasibility of developing a simulated ward environment in which to assess the ward-based care of surgical patients by clinicians of varying levels of experience (construct validation). BACKGROUND:Increasing evidence points to the importance of the postoperative or ward-based phase of surgical c...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/SLA.0b013e318288e1d4
更新日期:2014-02-01 00:00:00
abstract:OBJECTIVE:To report survival, functional, and quality-of-life (QoL) outcomes after extended radical resection for advanced pelvic tumors with en bloc sciatic or femoral nerve resection. BACKGROUND:Advanced pelvic tumors involving the sciatic or femoral nerve have traditionally been considered inoperable. Small studies...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/SLA.0000000000003390
更新日期:2019-06-07 00:00:00
abstract:OBJECTIVE:The aim of this study was to analyze the health care costs and savings associated with quality improvement (QI) interventions initiated and implemented utilizing NSQIP. BACKGROUND:Five acute care facilities of Alberta Health Services (AHS) adopted NSQIP in 2015 for a pilot project. METHODS:The cost-savings ...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/SLA.0000000000002708
更新日期:2019-05-01 00:00:00
abstract::Little information has been reported on the metabolic characteristics of the totally pancreatectomized patient or the efficacy of medical management after radical pancreatic surgery. The prospective evaluation of 49 such patients, with 31% followed for 48 or more months, forms the basis of this report. The major immed...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-199108000-00007
更新日期:1991-08-01 00:00:00
abstract::Primary hyperparathyroidism was studied in a well-defined geriatric population of 1129 individuals during a three-month interval. Primary hyperparathyroidism was diagnosed in 1.5%. The diagnosis was based on a morphologic and biochemic basis. From clinical material consisting of 400 patients treated surgically for pri...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-198302000-00003
更新日期:1983-02-01 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
abstract:OBJECTIVES:To develop a risk prediction model for serious complications after bariatric surgery. BACKGROUND:Despite evidence for improved safety with bariatric surgery, serious complications remain a concern for patients, providers and payers. There is little population-level data on which risk factors can be used to ...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/SLA.0b013e318230058c
更新日期:2011-10-01 00:00:00
abstract:OBJECTIVE:Generation and maintenance of pain in chronic pancreatitis (CP) have been shown to be partially attributable to neuroimmune interactions, which involve neuropeptides such as substance P (SP). So far, expression of SP receptors NK-2R, NK-3R, the SP-encoding gene preprotachykinin A (PPT-A), and the SP degradati...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/SLA.0b013e318070d56e
更新日期:2007-11-01 00:00:00
abstract:OBJECTIVE:Determine whether absorbable or nonabsorbable mesh in repair of large hiatus hernias reduces the risk of recurrence, compared with suture repair. BACKGROUND:Repair of large hiatus hernia is associated with radiological recurrence rates of up to 30%, and to improve outcomes mesh repair has been recommended. P...
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.0000000000000842
更新日期:2015-02-01 00:00:00
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
更新日期:2020-12-01 00:00:00
abstract:OBJECTIVE:To assess the evolution of visceral transplantation in the milieu of surgical technical modifications, new immunosuppressive protocols, and other management strategies. SUMMARY BACKGROUND DATA:With the clinical feasibility of intestinal and multivisceral transplantation in 1990, multifaceted innovative tacti...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/SLA.0b013e3181b67725
更新日期:2009-10-01 00:00:00
abstract::This study was conducted to elucidate plasma cholecystokinin (CCK) and pancreatic polypeptide (PP) response after pancreatoduodenectomy and to compare response of CCK and PP in patients who had pancreatoduodenectomy with Billroth I and Billroth II type of reconstruction. Basal levels of plasma CCK were significantly l...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-198708000-00006
更新日期:1987-08-01 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:INTRODUCTION:Radiation therapy is increasingly used as adjuvant treatment of many childhood and adult malignancies. Radiation-induced sarcoma is a well recognized if uncommon event. The objective of this study is to determine the prevalence and long-term outcome for patients who develop radiation-induced sarcomas. MET...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/01.sla.0000128686.51815.8b
更新日期:2004-06-01 00:00:00
abstract:OBJECTIVE AND BACKGROUND:Ventricular assist devices (VADs) have been used for temporary circulatory support pending transplantation or recovery of the native heart. Outcome in 38 patients treated at the authors' institution with VADs pending transplantation was analyzed to provide information relevant to the future use...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-199706000-00007
更新日期:1997-06-01 00:00:00
abstract:OBJECTIVE:Few studies have evaluated long-term outcomes after orthotopic liver transplantation (OLT). This work analyzes the experience of nearly 2 decades by the same team in a single center. Outcomes of OLT and factors affecting survival were analyzed. METHODS:Retrospective analysis of 3200 consecutive OLTs that wer...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/01.sla.0000164077.77912.98
更新日期:2005-06-01 00:00:00
abstract:OBJECTIVE:To evaluate the correlation between the morphologic nuclear features and clinicopathologic parameters in patients with advanced gastric cancer. SUMMARY BACKGROUND DATA:Nuclear profiles have been reported as useful prognostic predictors in various cancers. Data from computerized morphometries are objective an...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-199901000-00007
更新日期:1999-01-01 00:00:00
abstract:OBJECTIVE:To investigate the existence of a pathway between intraluminal products and the muscularis leukocytic infiltrate. SUMMARY BACKGROUND DATA:Mild intestinal manipulation or lipopolysaccharide initiates an intense inflammatory response within the intestinal muscularis, resulting in paralytic ileus. A major poten...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-200201000-00005
更新日期:2002-01-01 00:00:00
abstract::The case records of the Connecticut Tumor Registry were reviewed from 1952-1982. There were 37 cases of adenoid cystic carcinoma of the breast (ACC) from a total of 40,350 invasive breast tumors. Patient survival, complications, and pathologic sections were reviewed. Only 14 of 27 surgical pathology slides available f...
journal_title:Annals of surgery
pub_type: 杂志文章,评审
doi:10.1097/00000658-198703000-00013
更新日期:1987-03-01 00:00:00
abstract:BACKGROUND/OBJECTIVE:The National Surgical Quality Improvement Program (NSQIP) has demonstrated quality improvement in the VA and pilot study of 14 academic institutions. The objective was to show that American College of Surgeons (ACS)-NSQIP helps all enrolled hospitals. METHODS:ACS-NSQIP data was used to evaluate im...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/SLA.0b013e3181b4148f
更新日期:2009-09-01 00:00:00
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
更新日期:1998-08-01 00:00:00
abstract:OBJECTIVE:To determine the effects of recombinant human insulin-like growth factor-1 (IGF-1) complexed with its principal binding protein, IGFBP-3, on skeletal muscle metabolism in severely burned children. SUMMARY BACKGROUND DATA:Severe burns are associated with a persistent hypermetabolic response characterized by h...
journal_title:Annals of surgery
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1097/00000658-199905000-00014
更新日期:1999-05-01 00:00:00
abstract:OBJECTIVE:To evaluate the use of herpes simplex viral (HSV) amplicon vectors for production of tumor vaccines and to determine if such vaccines expressing combinations of immunostimulatory agents may be effective in the treatment of experimental liver cancer. METHODS:A hepatic metastatic tumor model using CT-26 colore...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-200209000-00010
更新日期:2002-09-01 00:00:00
abstract:OBJECTIVE:To review the physiologic effects of carbon dioxide (CO2) pneumoperitoneum in the morbidly obese. SUMMARY BACKGROUND DATA:The number of laparoscopic bariatric operations performed in the United States has increased dramatically over the past several years. Laparoscopic bariatric surgery requires abdominal in...
journal_title:Annals of surgery
pub_type: 杂志文章,评审
doi:10.1097/01.sla.0000151791.93571.70
更新日期:2005-02-01 00:00:00
abstract::A case report and review of the literature regarding multiple primary melanomas, and a discussion of the histologic differentiation between cutaneous primary melanomas and dermal metastases are presented. This report concerns a patient who, following wide surgical resection of a 1.3 mm thick primary melanoma with sate...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-198102000-00021
更新日期:1981-02-01 00:00:00
abstract:BACKGROUND:Fine-needle aspiration (FNA) is currently the primary diagnostic procedure in diagnosing thyroid malignancy and guides surgeons on patient selection for thyroidectomy for thyroid nodules. Diagnostic sensitivity is reported to be approximately 80%; however, patients with negative FNA results do not necessaril...
journal_title:Annals of surgery
pub_type: 杂志文章,评审
doi:10.1097/SLA.0b013e3180f61adc
更新日期:2007-11-01 00:00:00
abstract::Despite recommended preoperative preparation with alpha-adrenergic blockers, severe hemodynamic instability may occur during operations to resect pheochromocytoma. We combined the alpha-blocker phenoxybenzamine with the tyrosine hydroxylase inhibitor metyrosine in an attempt to better manage the hypertension of patien...
journal_title:Annals of surgery
pub_type: 临床试验,杂志文章
doi:10.1097/00000658-199011000-00010
更新日期:1990-11-01 00:00:00
abstract::We analyzed the course of 186 patients with external gastrointestinal fistulas treated at the University of California Medical Center, San Francisco from 1968 to 1977. There were 82 patients in the earlier group (1968-1971) and 104 patients in the later group (1972-1977). The groups differed in that 35% of patients in...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-197810000-00003
更新日期:1978-10-01 00:00:00
abstract:OBJECTIVE:To review the literature with regard to outcome of surgical management for hilar cholangiocarcinoma (Klatskin tumor). BACKGROUND:Hilar cholangiocarcinoma is a rare tumor with a poor prognosis. Surgical resection provides the only possibility for cure. Advances in hepatobiliary imaging and surgical strategies...
journal_title:Annals of surgery
pub_type: 杂志文章,评审
doi:10.1097/SLA.0b013e3181afe0ab
更新日期:2009-08-01 00:00:00