Abstract:
BACKGROUND:Perihilar cholangiocarcinoma is usually unresectable at the time of diagnosis. Only few patients are candidates for a potential curative treatment. For those patients, prognosis is strongly related to negative resection margin and lymph node status. Thus, a certain benchmark of lymph node count is necessary to secure relevant lymph node recovery and to avoid understaging. However, the required minimum number of retrieved lymph nodes remains unclear for perihilar cholangiocarcinoma. The 7th American Joint Committee on Cancer tumor, nodes, metastases edition increased the requirement for the histologic examination of lymph nodes in perihilar cholangiocarcinoma patients from 3 to 15. The applicability of such recommendation appears difficult and questionable. Therefore, the purpose of this systematic review is to evaluate the number of retrieved lymph nodes for staging of patients undergoing surgery for perihilar cholangiocarcinoma. METHODS:The MEDLINE, EMBASE, and The Cochrane Library databases were systematically screened up to December 2014. All studies reporting the number of lymph node count in perihilar cholangiocarcinoma were included and assessed for eligibility. RESULTS:A total of 725 abstracts were screened and 20 studies were included for analysis, comprising almost 4,000 patients. The cumulative median lymph node count was 7 (2 to 24). A median lymph node count greater than or equal to 15 was reported in 9% of perihilar cholangiocarcinoma patients and could only be achieved in extended lymphadenectomy. Subgroup analysis revealed a median lymph node count of 7 (range 7 to 9), which was associated with the detection of most lymph node positive patients and showed the lowest risk for understaging patients. Lymph node count greater than or equal to 15 did not increase detection rate of lymph node positive patients. CONCLUSIONS:This systematic analysis suggests that lymph node count greater than or equal to 7 is adequate for prognostic staging, while lymph node count greater than or equal to 15 does not improve detection of patients with positive lymph nodes.
journal_name
Am J Surgjournal_title
American journal of surgeryauthors
Kambakamba P,Linecker M,Slankamenac K,DeOliveira MLdoi
10.1016/j.amjsurg.2015.05.015subject
Has Abstractpub_date
2015-10-01 00:00:00pages
694-701issue
4eissn
0002-9610issn
1879-1883pii
S0002-9610(15)00366-9journal_volume
210pub_type
杂志文章,评审abstract::The effects of ranitidine, a new H2-receptor antagonist, on liver regeneration were investigated using a protocol described previously. The animals in Group I had standard two-thirds hepatectomy. In Group II, the rats received an 8 mg/kg intramuscular dose of ranitidine immediately and 24 and 48 hours after two-thirds...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/s0002-9610(85)80074-x
更新日期:1985-02-01 00:00:00
abstract:BACKGROUND:Experience with laparoscopic procedures and recent advances in laparoscopic devices have created an evolving interest in the application of these techniques to liver resection. However, laparoscopic liver resection has not been widely developed and anatomical segmental liver resection is not currently perfor...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/j.amjsurg.2007.10.027
更新日期:2008-10-01 00:00:00
abstract:BACKGROUND:Prospective evaluation of the percutaneous tracheostomy by the guide wire dilating forceps (GWDF) technique. METHODS:In 50 selected patients percutaneous tracheostomy with fiberscopic control was performed and evaluated. RESULTS:Most percutaneous tracheostomies were performed without any adverse effect. No...
journal_title:American journal of surgery
pub_type: 临床试验,杂志文章
doi:10.1016/s0002-9610(99)00049-5
更新日期:1999-04-01 00:00:00
abstract:PURPOSE:To describe the current practice and opinions held by surgeons performing colorectal surgery in Washington regarding laparoscopic colorectal surgery. METHODS:After attempting to identify all surgeons with hospital privileges in colorectal surgery in Washington, a survey was sent to 303 surgeons. The survey ask...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/s0002-9610(03)00112-0
更新日期:2003-07-01 00:00:00
abstract:BACKGROUND:Peritoneal macrophages play an important role in the immune response after abdominal operations. The stress response after these operations has been associated with impaired phagocytosis by peritoneal macrophages. This study examined the influence of minimally invasive techniques and preoperative corticoster...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/j.amjsurg.2008.07.023
更新日期:2008-12-01 00:00:00
abstract::We devised a new technique to increase the safety of pancreaticojejunostomy in patients with an extended operation for pancreatic cancer. This new pancreaticojejunostomy was created by end-to-side anastomosis with four layers about 7 cm distal to the jejunal stump. The cut surface of the pancreas was placed on the ser...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/s0002-9610(05)80524-0
更新日期:1993-02-01 00:00:00
abstract::The difficulties created by an unsuccessful initial operation can usually be avoided by choosing experienced surgeons, identifying four glands, and selectively excising grossly abnormal parathyroid tissue. Patients with multiple endocrine adenomatosis or familial hyperparathyroidism should have a subtotal parathyroide...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/0002-9610(82)90412-3
更新日期:1982-10-01 00:00:00
abstract::We present a patient with pseudo-Meigs syndrome (PMS) secondary to sigmoid colon cancer metastasis to the ovary with elevated serum levels of carcinoembryonic antigen, CA19-9, and CA-125 who showed a marked change in pleural effusion before and after surgery. We have to consider PMS associated with colon cancer in pat...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/j.amjsurg.2010.09.007
更新日期:2012-01-01 00:00:00
abstract:BACKGROUND:The frequency of 90-day, postdischarge deaths and readmissions in Medicare patients undergoing elective surgical procedures has not been well studied. METHODS:The Medicare MedPar database for 2009 to 2010 was used to develop inpatient risk-adjusted, postoperative length-of-stay (RApoLOS) prediction models f...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/j.amjsurg.2013.09.007
更新日期:2014-03-01 00:00:00
abstract::Experience with 37 patients with adult colovesical fistula over the past 19 years is reviewed. Specific guidelines for treatment of adult colovesical fistula are influenced by the location and cause of the fistula, the patient's general condition, the presence of a pelvic abscess and the presence of colonic obstructio...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/0002-9610(80)90421-3
更新日期:1980-07-01 00:00:00
abstract::The lower esophageal high pressure zone (HPZ) was characterized manometrically and reflux status determined in eight male rhesus monkeys. The studies were repeated six weeks and six months after 50 per cent distal small bowel resection. At the same time fasting serum gastrin and gastric inhibitory polypeptide values w...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/0002-9610(77)90002-2
更新日期:1977-05-01 00:00:00
abstract::The correlation between serum amylase and pancreatic amylase secretion was studied in two patients. Both patients underwent sphincterotomy, and the pancreatic duct was cannulated with a polyethylene tube. The tube was left in place for 15 to 21 days. The rate of amylase secretion over 7 days was studied in response to...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/0002-9610(82)90178-7
更新日期:1982-05-01 00:00:00
abstract:BACKGROUND:Since 1977, we have studied preoperative treatments using 5-fluorouracil (5-FU) suppositories alone or in combination with radiation to reduce local recurrence and improve survival of patients with rectal cancer. PATIENTS AND METHODS:We developed a novel preoperative therapy combining radiation, intralumina...
journal_title:American journal of surgery
pub_type: 临床试验,杂志文章
doi:10.1016/S0002-9610(97)89639-0
更新日期:1996-03-01 00:00:00
abstract::In an effort to assess the impact of enhanced macrophage function in acute pancreatitis, mice were subjected to a choline-deficient diet supplemented by ethionine to induce necrotizing pancreatitis. Treatment with the macrophage stimulant glucan resulted in improved survival rates (58 percent versus 14 percent) and ma...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/0002-9610(87)90197-8
更新日期:1987-01-01 00:00:00
abstract::It has been shown that truncal vagotomy with pyloroplasty (TVP), but not highly selective vagotomy (HSV), delays the onset, decreases the extent, and changes the pattern of gallbladder emptying. The aim of the present study was to investigate any alterations in gallbladder emptying after a variety of antiulcer gastric...
journal_title:American journal of surgery
pub_type: 临床试验,杂志文章
doi:10.1016/s0002-9610(05)80160-6
更新日期:1994-10-01 00:00:00
abstract:INTRODUCTION:There is little consensus of quality measurements for restorative proctocolectomy with ileal pouch-anal anastomosis(RPC-IPAA) performed for ulcerative colitis(UC). The National Surgical Quality Improvement Program(NSQIP) cannot accurately classify RPC-IPAA staged approaches. We formed an IBD-surgery regist...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/j.amjsurg.2020.05.035
更新日期:2021-01-01 00:00:00
abstract::Of six healthy laboratory workers with no history of illness caused by Pseudomonas aeruginosa, four exhibited positive skin responses at 24 hours, strong inhibition of leukocyte migration, and marked stimulation of blastogenesis of peripheral lymphocytes when exposed to a "cocktail" of three phenol-killed strains of P...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/0002-9610(77)90160-x
更新日期:1977-06-01 00:00:00
abstract::Nine cases of microemboli of arterial origin to the upper extremity are reported. The source of emboli in five of these cases was in the subclavian artery compressed by osseous anomalies in the thoracic outlet. Three aneurysms, one in a subclavian vein graft and two traumatic false aneurysms in the hand, were also not...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/0002-9610(77)90296-3
更新日期:1977-07-01 00:00:00
abstract::This study is a retrospective review of 18 patients treated from 1964 to 1990 with inguinal lymph node metastases from rectal adenocarcinoma. Statistical analyses were performed to determine the effects of sex, disease-free interval, extent of inguinal lymph node metastases, and the presence of extranodal disease upon...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/s0002-9610(05)80204-1
更新日期:1994-09-01 00:00:00
abstract::Schatzki's ring is a distinct anatomical entity associated with hiatal hernia; however, its significance is unclear. Thirty-two patients with a radiologically demonstrated Schatzki's ring were compared with 32 patients with hiatal hernia and no Schatzki's ring. Schatzki's ring was confirmed on endoscopy in 59 percent ...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/0002-9610(89)90193-1
更新日期:1989-12-01 00:00:00
abstract::The obturator hernia is rare, accounting for only 0.05% of all hernias and 0.2% of all small-bowel obstructions requiring laparotomy at our institution. Typically, there is a delay in diagnosis and surgical intervention, despite the presence of a bowel obstruction. A laparotomy is needed, not a preoperative diagnosis....
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/s0002-9610(99)80256-6
更新日期:1995-07-01 00:00:00
abstract:BACKGROUND:Many women with breast cancer recurrence previously treated with breast-conservation therapy desire repeat lumpectomies. We hypothesized that women undergoing mastectomy for breast cancer recurrence would show superior survival. METHODS:Patients who previously received breast-conservation therapy diagnosed ...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/j.amjsurg.2008.06.018
更新日期:2008-10-01 00:00:00
abstract::A new break-away needle for subclavian catheter insertion has been described. This needle functions exactly as the usual 14 gauge needle, but it can be completely removed from the catheter while leaving the integral Luer adaptor intact. ...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/0002-9610(84)90210-1
更新日期:1984-06-01 00:00:00
abstract:BACKGROUND:This study analyzed presentation and management of hemorrhage after pancreaticoduodenectomy (PD) to determine the respective role of surgery and embolization. METHODS:From January 1992 to March 2005, 411 patients underwent PD and were analyzed with regard to postoperative hemorrhage. RESULTS:Hemorrhage occ...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/j.amjsurg.2006.08.088
更新日期:2007-07-01 00:00:00
abstract::The application of systems analysis and flow charting technics to abdominal incision and closure allow a complete display of objectives and alternatives. A route of alternatives has been chosen and supported by the best available principles in the surgical literature. The choices include an unconventional large bite m...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/0002-9610(76)90160-4
更新日期:1976-04-01 00:00:00
abstract:BACKGROUND:We examined and compared APP versus surgical resident perceptions of the role of APPs in surgical subspecialty teams. METHODS:Residents/first year surgical critical care fellows and inpatient service-specific APPs responded to a survey that examined perceptions about the APP-resident/fellow relationship. St...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/j.amjsurg.2018.10.014
更新日期:2019-06-01 00:00:00
abstract:BACKGROUND:Trauma readmissions have been well studied but little data exists regarding Emergency Department (ED) utilization following an injury. This study was performed to determine the factors associated with a return to the ED after trauma. METHODS:A retrospective review of all adult trauma patients evaluated betw...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/j.amjsurg.2019.10.046
更新日期:2020-07-01 00:00:00
abstract:BACKGROUND:Following appendectomy, management is often guided by surgeon determination of whether the appendicitis is uncomplicated or complicated. Our objectives were to determine the incidence of discordance between intraoperative and pathological findings and determine effect on outcomes. METHODS:We performed a ret...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/j.amjsurg.2019.05.004
更新日期:2020-01-01 00:00:00
abstract:BACKGROUND:In this study, we explore surgical resident communication with simulated patient surrogates (SPs), in an Objective Structured Clinical Examination (OSCE). METHODS:We use discourse analysis (DA), a qualitative approach to analyzing language, to evaluate our residents' interactions with simulated patient surr...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/j.amjsurg.2017.10.041
更新日期:2018-02-01 00:00:00
abstract:BACKGROUND:This study was designed to compare short-term laparoscopic total gastrectomy (LTG) with open total gastrectomy (OTG) outcomes in gastric cancer. METHODS:Seventy patients who underwent total gastrectomy via LTG or OTG were included. All cases were matched for stage, age, and sex by means of statistically gen...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/j.amjsurg.2012.11.011
更新日期:2013-09-01 00:00:00