Abstract:
BACKGROUND:Surgical enteral access prior to multimodality treatment for esophageal cancer is controversial as dysphagia is often used for feeding tube referral. We hypothesized that enteral access before neoadjuvant chemoradiation for esophageal cancer provides no benefit compared to that placed during definitive esophagectomy. METHODS:Patients undergoing esophagectomy for esophageal malignancy from 2007 - 2014 were retrospectively identified. Clinicopathologic factors were recorded including preoperative enteral access, weight change, nutritional laboratory works, and perioperative complications. RESULTS:Of 156 identified patients, 99 (63.5%) received neoadjuvant chemoradiation and comprised the study cohort. Fifty (50.5%) underwent enteral access (gastrostomy [14], jejunostomy [32], other [4]; "Access Group") prior to chemoradiation followed by esophagectomy and were compared to 49 "No-Access" patients who underwent enteral access during esophagectomy. Clinicopathologic variables were similar between cohorts. The Access and No-Access cohorts had similar reported dysphagia (86% vs 75.5%, respectively; P = .2) and mean preesophagectomy serum albumin (3.9 vs 4 gm/dL, respectively; P = .2). Weight loss ± 6-month periesophagectomy was similar between access versus No-Access cohorts (-11.2% vs -15.4%, respectively; P = .1). Weight loss during this period was likewise similar for patients with dysphagia in the Access (-11%) versus No-Access group (-15.2%, P = .1). No difference in complication rates was noted between Access (64%) and No-Access groups (51%, P = .2). CONCLUSION:Despite healthcare provider bias, there seems to be no nutritional or perioperative benefit for enteral access before neoadjuvant chemoradiation for esophageal malignancy. Patients with esophageal malignancy should therefore proceed to appropriate neoadjuvant and surgical therapy with enteral access performed during definitive resection or reserved for those with frank obstruction on endoscopy.
journal_name
Surgeryjournal_title
Surgeryauthors
Jenkins TK,Lopez AN,Sarosi GA,Ben-David K,Thomas RMdoi
10.1016/j.surg.2017.09.046subject
Has Abstractpub_date
2018-04-01 00:00:00pages
770-776issue
4eissn
0039-6060issn
1532-7361pii
S0039-6060(17)30694-3journal_volume
163pub_type
杂志文章相关文献
SURGERY文献大全abstract::Patients with chronic renal failure and total diversion of the lower urinary tract have been considered poor transplant candidates, and post-transplant urinary diversion, i.e., Bricker loop, has been thought to be necessary. Our experience with nine patients clearly indicates that these patients are actually excellent...
journal_title:Surgery
pub_type: 杂志文章
doi:
更新日期:1976-03-01 00:00:00
abstract::Two patients were treated for asymptomatic aneurysms of the inferior mesenteric artery during reconstructive operation for infrarenal aortic disease. These lesions were discovered incidentally during arteriographic study in one case and during operation in the second case. Including these two patients, the number of r...
journal_title:Surgery
pub_type: 杂志文章
doi:
更新日期:1985-02-01 00:00:00
abstract::Between 1978 and 1985, 88 patients underwent insertion of the Greenfield vena cava filter. In 21 of the 88 patients (23.9%) the filter was inserted prophylactically. Sixteen of the 21 prophylactic insertions were performed before total joint replacement in patients with a history of venous thromboembolism. Operative m...
journal_title:Surgery
pub_type: 杂志文章
doi:
更新日期:1988-01-01 00:00:00
abstract:BACKGROUND:The aim of this study was to evaluate the incidence of complications in the upper limbs as a new event after radial artery (RA) harvesting for coronary artery bypass grafting (CABG). METHODS:From June 1997 to August 2001, the RA graft was used in 271 patients who underwent cardiac surgery at our department....
journal_title:Surgery
pub_type: 杂志文章
doi:10.1067/msy.2003.43
更新日期:2003-03-01 00:00:00
abstract:BACKGROUND:Patients undergoing ventral hernia repair (VHR) are at risk of an inadvertent enterotomy during surgery. Inadvertent enterotomies potentially contaminate the surgical field presenting a management dilemma for the surgeon. The aim of our study was to define the incidence and risk factors for a recognized inad...
journal_title:Surgery
pub_type: 杂志文章
doi:10.1016/j.surg.2018.04.003
更新日期:2018-08-01 00:00:00
abstract::The unexpected finding of hyperamylasemia in a patient with isolated head injury prompted a study of amylase levels in patients with various degrees of cranial trauma. None of seven patients with isolated maxillofacial trauma had hyperamylasemia. This group was studied to discount injury to salivary glands as a source...
journal_title:Surgery
pub_type: 杂志文章
doi:
更新日期:1983-08-01 00:00:00
abstract::The optimal stimulus which produced the maximum increase in blood velocity in the femoral vein during compression of the lower limb with a sequential compression device (six chambers) was determined using Doppler ultrasound in 10 normal limbs. Pressures of 35, 30, and 20 mm Hg at the ankle, calf, and thigh, respective...
journal_title:Surgery
pub_type: 临床试验,杂志文章,随机对照试验
doi:
更新日期:1980-01-01 00:00:00
abstract::The aims of this study were to determine whether ectopic pacemakers are present after meals in the Roux limbs of dogs after vagotomy and Roux gastrectomy, whether these pacemakers slow gastric emptying of liquids or solids, and whether abolishing the pacemakers with electric pacing might speed any slow emptying that o...
journal_title:Surgery
pub_type: 杂志文章
doi:
更新日期:1989-11-01 00:00:00
abstract:BACKGROUND:We sought to compare the impact of sequential and contemporaneous revascularizations of portal vein and hepatic artery on biliary complications in patients undergoing liver transplantation. METHODS:We reviewed 184 patients who underwent liver transplantation in our center, and categorized them into differen...
journal_title:Surgery
pub_type: 杂志文章
doi:10.1016/j.surg.2013.06.056
更新日期:2014-01-01 00:00:00
abstract:BACKGROUND:The number of dendritic cells (DC) in the local tumor environment correlates with patient survival in numerous tumors. The relationship of DC infiltration in the tumor microenvironment and prognosis was examined in patients with pancreatic adenocarcinoma. METHODS:Forty-seven pancreatectomy specimens with a ...
journal_title:Surgery
pub_type: 杂志文章
doi:10.1067/msy.2002.119937
更新日期:2002-02-01 00:00:00
abstract:BACKGROUND:We determined the effect of infusing the iron chelator deferoxamine complexed to hetastarch on the degree of lung dysfunction and systemic abnormalities produced by a severe smoke exposure. METHODS:Adult sheep were given a smoke exposure under anesthesia that produced a peak carboxyhemoglobin between 40% an...
journal_title:Surgery
pub_type: 杂志文章
doi:10.1016/s0039-6060(96)80121-8
更新日期:1996-03-01 00:00:00
abstract::A 73-year-old woman developed temporal balding and "hoarseness" over a 3-year interval. Investigation including extensive endocrinologic screening, abdominal computed tomography scanning, pelvic ultrasonography, iodocholesterol (NP-59) adrenal scanning, and selective retrograde venous sampling revealed only an elevate...
journal_title:Surgery
pub_type: 杂志文章
doi:
更新日期:1983-12-01 00:00:00
abstract::Direct measurement of the femoral artery pressure before operation has been used to predict the postoperative change in ankle and toe pressure in 102 limbs (83 patients) that underwent aortoiliac surgery for the treatment of atherosclerotic occlusion or stenosis affecting both the aortoiliac and femoral artery segment...
journal_title:Surgery
pub_type: 杂志文章
doi:
更新日期:1982-07-01 00:00:00
abstract:BACKGROUND:Stress adaptation requires interactions between the hypothalamic-pituitary-adrenal axis, the sympathetic nervous system, and a family of intracellular stress response proteins termed heat shock proteins (HSPs). These HSPs are present in every living organism and are selectively induced in the adrenal cortex ...
journal_title:Surgery
pub_type: 杂志文章
doi:
更新日期:1994-05-01 00:00:00
abstract::To compare estrogen and progesterone receptor values between biopsy and mastectomy specimens, we prospectively studied 29 patients with breast cancer treated by incisional biopsy followed by mastectomy. The average tumor size was 5.4 +/- 0.5 cm and the mean age was 57.6 +/- 3.0 years. Nine patients were premenopausal ...
journal_title:Surgery
pub_type: 杂志文章
doi:
更新日期:1985-10-01 00:00:00
abstract:BACKGROUND:Gastric cancer is an aggressive disease, and overall changes in incidence rates have been noted. There are conflicting data on whether young patients have worse outcomes than older patients; the roles of tumor biology and access to care are critical to answering this question. Our objectives were to explore ...
journal_title:Surgery
pub_type: 杂志文章
doi:10.1016/j.surg.2013.05.017
更新日期:2013-09-01 00:00:00
abstract:BACKGROUND:Little is known about the clinical significance and risk factors for incomplete liver restoration after partial hepatectomy, which is defined by a liver volume restoration of less than 100% of the original volume. METHODS:We retrospectively analyzed patients who underwent hepatic resection for liver tumors ...
journal_title:Surgery
pub_type: 杂志文章
doi:10.1016/j.surg.2020.02.022
更新日期:2020-07-01 00:00:00
abstract:BACKGROUND:The aim of this study was to investigate the genotype-phenotype relationship of pancreatic neuroendocrine tumors in patients with multiple endocrine neoplasia type 1 treated at our institution. METHODS:We conducted a retrospective chart review of all patients with multiple endocrine neoplasia type 1 treated...
journal_title:Surgery
pub_type: 杂志文章
doi:10.1016/j.surg.2017.04.044
更新日期:2018-01-01 00:00:00
abstract::We investigated the effects of infusion of somatostatin (200 and 500 ng/kg/min) on central hemodynamics and renal blood flow measured with radioactive microspheres. At the lower dose infusion rate somatostatin did not alter any hemodynamic parameter, but at 500 ng/kg/min somatostatin caused minor transient bradycardia...
journal_title:Surgery
pub_type: 杂志文章
doi:
更新日期:1985-03-01 00:00:00
abstract:INTRODUCTION:Policies that mandate colorectal screening coverage by private insurers are associated with increased use of screening procedures. We seek to understand whether such mandates have improved access to care and short-term operative outcomes for patients undergoing operations of the colon and rectum (OCR). ME...
journal_title:Surgery
pub_type: 杂志文章
doi:10.1016/j.surg.2013.04.037
更新日期:2013-08-01 00:00:00
abstract:BACKGROUND:Patients with primary mediastinal lymphomas frequently present with a residual mass after completion of first-line therapy. Although a positron emission tomography scan is usually recommended, it fails to distinguish between persistent lymphoma and inflammation. Although percutaneous biopsy may have a high d...
journal_title:Surgery
pub_type: 杂志文章
doi:10.1016/j.surg.2018.05.039
更新日期:2018-10-01 00:00:00
abstract::Hygroma renalis is an unusual benign tumor of the kidney. Only 24 cases have been reported previously in the world literature; 22 of these patients underwent nephrectomy. Two sisters, with the first known occurrence in siblings, are discussed and the world literature is reviewed. Our first patient underwent nephrectom...
journal_title:Surgery
pub_type: 杂志文章,评审
doi:
更新日期:1992-03-01 00:00:00
abstract::One hundred thirty-three patients with familial adenomatous polyposis undergoing colectomy and ileorectal anastomosis have been reviewed for the occurrence of cancer in the rectal stump. Ten patients developed rectal cancer (Actuarial survivorship rate of 88% for those patients free of rectal cancer at 20 years). Pote...
journal_title:Surgery
pub_type: 杂志文章
doi:
更新日期:1987-01-01 00:00:00
abstract::Perirectal and perineal infections represent a life-threatening complication of hematologic diseases associated with granulocytopenia. Early and aggressive surgical management is essential. This should include hemodynamic support and monitoring, broad-spectrum antibiotics, wide surgical debridement, and a totally dive...
journal_title:Surgery
pub_type: 杂志文章
doi:
更新日期:1986-11-01 00:00:00
abstract::Fourteen infants with extensive short-bowel syndrome (SBS) were treated from 1978 through 1987 at the Children's Hospital, Columbus, Ohio. Extensive SBS was defined as a residual jejunoileum that was 25% or less than the normal expected length for each infant's gestational age. The cause of the SBS included gastroschi...
journal_title:Surgery
pub_type: 杂志文章
doi:
更新日期:1989-02-01 00:00:00
abstract::Arteriosclerotic aneurysm of the innominate artery is an unusual lesion. A review of the literature has revealed many approaches to this problem in the past, but the mortality rate has remained significant and serious complications have been frequent. Computerized axial tomography and noninvasive cerebrovascular metho...
journal_title:Surgery
pub_type: 杂志文章
doi:
更新日期:1979-05-01 00:00:00
abstract::Primary aortocolic fistulas are a rare but lethal complication of aortic or iliac aneurysms. A case of fistula between a nonaneurysmal aortic bifurcation and sigmoid colon caused by an ingested chicken bone is presented. This cause of rectal bleeding, which has never been described, might have been suspected after car...
journal_title:Surgery
pub_type: 杂志文章
doi:
更新日期:1988-04-01 00:00:00
abstract::A 30-channel pulsed Doppler vessel imaging system (MAVIS, GEC Medical, Middlesex, England), was used to obtain images and maximal Doppler velocity time waveforms in the diagnosis of stenosis of the origin of the profunda femoris artery (PFA) and in the detection of structural changes within Dacron arterial grafts. In ...
journal_title:Surgery
pub_type: 杂志文章
doi:
更新日期:1979-12-01 00:00:00
abstract::To explain the incidence and significance of mitral and aortic valve calcification and calcific deposits in the myocardium, a prospective echocardiographic study was performed with 21 consecutive patients who had primary hyperparathyroidism (PHP) and with 21 age- and sex-matched control subjects with normocalcemia. Ca...
journal_title:Surgery
pub_type: 杂志文章
doi:
更新日期:1990-12-01 00:00:00
abstract::Between 1969 and 1976, 174 patients were treated surgically for simultaneous carotid and coronary atherosclerosis. In 59 patients, staged carotid endarterectomy was performed a few days to 6 months prior to myocardial revascularization. Severe (more than 60% stenosis) coronary atherosclerosis affected a single vessel ...
journal_title:Surgery
pub_type: 杂志文章
doi:
更新日期:1978-12-01 00:00:00