Abstract:
OBJECTIVE:To prospectively characterize changes in body weight, satiety, and postprandial gut hormone profiles following esophagectomy. BACKGROUND:With improved oncologic outcomes in esophageal cancer, there is an increasing focus on functional status and health-related quality of life in survivorship. Early satiety and weight loss are common after esophagectomy, but the pathophysiology of these phenomena remains poorly understood. METHODS:In this prospective study, consecutive patients undergoing esophagectomy with gastric conduit reconstruction were studied preoperatively and at 10 days, 6 weeks, and 3 months postoperatively. Glucagon-like peptide 1 (GLP-1) immunoreactivity of plasma collected immediately before and at 15, 30, 60, 90, 120, 150, and 180 minutes after a standardized 400-kcal mixed meal was determined. Gastrointestinal symptom scores were computed using European Organization for Research and Treatment of Cancer questionnaires. RESULTS:Body weight loss at 6 weeks and 3 months postoperatively among 13 patients undergoing esophagectomy was 11.1 ± 2.3% (P < 0.001) and 16.3 ± 2.2% (P < 0.0001), respectively. Early satiety (P = 0.043), gastrointestinal pain and discomfort (P = 0.01), altered taste (P= 0.006), and diarrhea (P= 0.038) scores increased at 3 months postoperatively. Area under the curve for the satiety gut hormone GLP-1 was significantly increased from 10 days postoperatively (2.4 ± 0.2-fold increase, P < 0.01), and GLP-1 peak increased 3.8 ± 0.6-, 4.7 ± 0.8-, and 4.4 ± 0.5-fold at 10 days, 6 weeks, and 3 months postoperatively (all P < 0.0001). Three months postoperatively, GLP-1 area under the curve was associated with early satiety (P = 0.0002, R = 0.74), eating symptoms (P = 0.007, R = 0.54), and trouble enjoying meals (P = 0.0004, R = 0.73). CONCLUSIONS:After esophagectomy, patients demonstrate an exaggerated postprandial satiety gut hormone response, which may mediate postoperative changes in satiety, body weight, and gastrointestinal quality of life.
journal_name
Ann Surgjournal_title
Annals of surgeryauthors
Elliott JA,Docherty NG,Eckhardt HG,Doyle SL,Guinan EM,Ravi N,Reynolds JV,Roux CWLdoi
10.1097/SLA.0000000000001918subject
Has Abstractpub_date
2017-07-01 00:00:00pages
82-90issue
1eissn
0003-4932issn
1528-1140journal_volume
266pub_type
杂志文章abstract:OBJECTIVE:This article describes a preliminary work on virtual reality applied to liver surgery and discusses the repercussions of assisted surgical strategy and surgical simulation on tomorrow's surgery. SUMMARY BACKGROUND DATA:Liver surgery is considered difficult because of the complexity and variability of the org...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-199811000-00001
更新日期:1998-11-01 00:00:00
abstract:BACKGROUND:We conducted a study using an intravenous (i.v.) infusion of iloprost in the treatment of venous ulcers to verify whether the association of i.v. iloprost + local therapy + elastic compression has a favorable effect when compared with traditional treatment with local therapy and elastic compression. STUDY D...
journal_title:Annals of surgery
pub_type: 杂志文章,随机对照试验
doi:10.1097/SLA.0b013e3180caa44c
更新日期:2007-11-01 00:00:00
abstract:OBJECTIVE:To evaluate perioperative statin treatment, to explore the rapidly increasing body of literature on the pleiotropic effects of statins, and to suggest a rational strategy of perioperative risk reduction. SUMMARY OF BACKGROUND DATA:Vascular, cerebrovascular, and cardiovascular complications are all too common...
journal_title:Annals of surgery
pub_type: 杂志文章,评审
doi:10.1097/SLA.0b013e3181492c0d
更新日期:2008-01-01 00:00:00
abstract:OBJECTIVE:To evaluate the preoperative relationships of hypertension and diabetes mellitus in severe obesity and the effects of gastric bypass (GBP)-induced weight loss. SUMMARY BACKGROUND DATA:Severe obesity is associated with multiple comorbidities, particularly hypertension and type 2 diabetes mellitus, that may af...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/01.SLA.0000071560.76194.11
更新日期:2003-06-01 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 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 ...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/SLA.0b013e31828e7417
更新日期:2014-02-01 00:00:00
abstract::The pattern of failure was studied in 1012 patients with resected Stage I or II non-small-cell carcinoma of the lung. Initial intrathoracic failure (41%) was more common than initial extrathoracic failure (34%) even though a complete resection was the intent in all patients. The most frequent sites of initial failure ...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-198701000-00012
更新日期:1987-01-01 00:00:00
abstract:OBJECTIVE:This investigation aimed at exploring the prospects of a cure for persistent medullary thyroid cancer (MTC) stratified by basal calcitonin levels before reoperation and the number of lymph node metastases previously removed at outside facilities. BACKGROUND:There is no evidence-based information supporting t...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/SLA.0b013e31826bc239
更新日期:2013-04-01 00:00:00
abstract:OBJECTIVE:The objective of this study is to determine the characteristics and frequency of intraoperative safety threats and resilience supports using a human factors measurement tool. BACKGROUND:Human factors analysis can provide insight into how system elements contribute to intraoperative adverse events. Empiric ev...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/SLA.0000000000003616
更新日期:2019-10-04 00:00:00
abstract:OBJECTIVE:To examine factors influencing surgical research and assess the current state of training future surgical scientists. SUMMARY BACKGROUND DATA:The number of surgeons actively engaged in research seems to be decreasing. Training future surgical scientists to increase these numbers depends on a variety of facto...
journal_title:Annals of surgery
pub_type: 杂志文章,评审
doi:10.1097/SLA.0b013e318163d27d
更新日期:2008-05-01 00:00:00
abstract:OBJECTIVE:To evaluate whether the type of on-site care a trauma patient receives affects outcome. SUMMARY BACKGROUND DATA:The controversy regarding the prehospital care of trauma patients between Advanced Life Support (ALS) and Basic Life Support (BLS) is ongoing. Due to this unresolved controversy, as well as histori...
journal_title:Annals of surgery
pub_type: 杂志文章,多中心研究
doi:10.1097/01.SLA.0000048374.46952.10
更新日期:2003-02-01 00:00:00
abstract:OBJECTIVE:To review the Department of Veteran Affairs (VA) and the Society of Thoracic Surgeons (STS) national databases over the past 10 years to evaluate their relative similarities and differences, to appraise their use as quality improvement tools, and to assess their potential to facilitate improvements in quality...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-200110000-00006
更新日期:2001-10-01 00:00:00
abstract:OBJECTIVE:To assess the distant metastatic potential of duodeno-pancreatic neuroendocrine tumors (DP-NETs) in patients with MEN1, according to functional status and size. SUMMARY BACKGROUND DATA:DP-NETs, with their numerous lesions and endocrine secretion-related symptoms, continue to be a medical challenge; unfortuna...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/SLA.0000000000003162
更新日期:2020-12-01 00:00:00
abstract:OBJECTIVES:This study aimed to compare long-term survival following minimally invasive esophagectomy (MIE) versus open esophagectomy (OE) for esophageal cancer using a nationwide propensity-score matched cohort. SUMMARY BACKGROUND DATA:MIE provides lower postoperative morbidity and mortality, and similar short-term on...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/SLA.0000000000004708
更新日期:2020-12-23 00:00:00
abstract::A clinical program in liver transplantation was begun at UCLA in 1984 after a period of laboratory investigation. The first 100 orthotopic liver transplants (OLT) were performed in 83 patients (43 adults and 40 children) between February 1, 1984 and November 1, 1986. Donors and recipients were matched only for size an...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-198710000-00001
更新日期:1987-10-01 00:00:00
abstract:OBJECTIVE:To compare duodenal-jejunal bypass (DJB) with standard medical care in nonobese patients with type 2 diabetes and evaluate surgically induced endocrine and metabolic changes. METHODS:Eighteen patients submitted to a DJB procedure met the following criteria: overweight, diabetes diagnosis less than 15 years, ...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/SLA.0b013e3182592c62
更新日期:2012-07-01 00:00:00
abstract:OBJECTIVE:This study investigated the current state of fecal and urinary continence in an extensive group of adults after operative correction for high anorectal malformations and how they cope with their incontinence. SUMMARY BACKGROUND DATA:Normal fecal continence is hardly to be expected after correction for high a...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-199308000-00012
更新日期:1993-08-01 00:00:00
abstract:OBJECTIVE:To determine the optimum excision margin and nodal management for patients with primary cutaneous melanomas 2.01- to 4.00-mm thick (T3 melanomas). BACKGROUND:Currently available evidence does not reliably define the minimum safe excision margin and best nodal management for patients with primary cutaneous T3...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/SLA.0000000000000792
更新日期:2014-12-01 00:00:00
abstract::Twelve children underwent elective laparoscopic cholecystectomy for symptomatic cholelithiasis during a 10-month period in one institution. The operative technique that has been described for adults was modified because of the smaller dimensions of pediatric patients. These modifications are discussed in this report, ...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-199202000-00015
更新日期:1992-02-01 00:00:00
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
更新日期:1997-09-01 00:00:00
abstract:OBJECTIVE:To identify prognostic factors and reasons for improved survival over time in patients with esophageal cancer. SUMMARY BACKGROUND DATA:Management strategies for esophageal cancer have evolved with time. The impact of chemoradiation in the overall treatment results has not been adequately studied. METHODS:Fr...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/01.sla.0000086545.45918.ee
更新日期:2003-09-01 00:00:00
abstract:OBJECTIVE:To perform a systematic review of economic evaluations of enhanced recovery pathways (ERP) for colorectal surgery. BACKGROUND:Although there is extensive literature investigating the clinical effectiveness of ERP, little is known regarding its cost-effectiveness. METHODS:A systematic literature search ident...
journal_title:Annals of surgery
pub_type: 杂志文章,评审
doi:10.1097/SLA.0b013e318295fef8
更新日期:2014-04-01 00:00:00
abstract:BACKGROUND AND AIM:Immunomodulating nutrition is supposed to reduce the number of complications and lengthen of hospital stay during the postoperative period in patients after major gastrointestinal surgery. The aim of the study was to assess the clinical effect of immunostimulatory enteral and parenteral nutrition in ...
journal_title:Annals of surgery
pub_type: 杂志文章,随机对照试验
doi:10.1097/SLA.0b013e318180a3c1
更新日期:2008-08-01 00:00:00
abstract:OBJECTIVE:To evaluate the potential of postischemic intravenous infusion of the endogenous antioxidant glutathione (GSH) to protect the liver from reperfusion injury following prolonged warm ischemia. BACKGROUND DATA:The release of reactive oxygen species (ROS) by activated Kupffer cells (KC) and leukocytes causes rep...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/01.sla.0000110321.64275.95
更新日期:2004-02-01 00:00:00
abstract:OBJECTIVE:This study was undertaken to define the incidence and etiology of small bowel obstruction (SBO) after nephrectomy for Wilms' tumor. SUMMARY BACKGROUND DATA:Intestinal obstruction is one of the most common postoperative complications after nephrectomy for nephroblastoma. However, few reports have evaluated ri...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-199321850-00011
更新日期:1993-11-01 00:00:00
abstract:OBJECTIVE:The study objectives were to analyze the impact of the number of lymph nodes (LNs) reported as resected (NLNr) and the number of LNs invaded (NLNi) on the prognosis of esophageal cancer (EC) after neoadjuvant chemoradiotherapy. BACKGROUND:Pathological LN status is a major disease prognostic factor and marker...
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.0000000000000991
更新日期:2015-05-01 00:00:00
abstract:OBJECTIVE:To investigate the roles and underlying mechanism of an inflammatory mediator-lipocalin-2 (Lcn2) in small-for-size fatty graft liver injury. BACKGROUND:Understanding of the distinct mechanism regulating small-for-size fatty liver graft injury will be crucial to prevent marginal graft failure during living do...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/SLA.0000000000000427
更新日期:2014-12-01 00:00:00
abstract:OBJECTIVE:To investigate Fas and FasL expression in pancreatic tissues and cultured pancreatic cancer cell lines, and to assess the ability of anti-Fas antibodies to induce apoptosis. SUMMARY BACKGROUND DATA:Activation of the Fas receptor by Fas-ligand (FasL) results in apoptosis, and dysregulation of this pathway may...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-200003000-00010
更新日期:2000-03-01 00:00:00
abstract:OBJECTIVE:To determine the clinical features, natural history, and role of surgery for gastrointestinal manifestations of the multiple endocrine neoplasia type 2 (MEN 2) syndromes. SUMMARY BACKGROUND DATA:The MEN 2 syndromes are characterized by medullary thyroid carcinoma and other endocrinopathies. In addition, some...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-200205000-00006
更新日期:2002-05-01 00:00:00
abstract::Spectral analysis was used to examine 257 carotid arteries in 227 patients who had undergone carotid endarterectomy at 1, 3, 6, and 12 months after surgery and annually thereafter. Routine intraoperative completion angiography ensured that the operations were technically satisfactory. Postoperative restenoses were ide...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-198407000-00013
更新日期:1984-07-01 00:00:00