Abstract:
INTRODUCTION:A diverting stoma is often performed at the time of low anterior resection (LAR) for rectal cancer after neoadjuvant chemoradiation (nCRT) to protect the anastomosis. The aim of this study was to compare surgical outcomes in large cohorts of mid-high rectal cancer patients undergoing LAR after nCRT with and without a diverting stoma. METHODS:Patients undergoing LAR for rectal cancer (ICD-9 diagnosis code 154.1) after nCRT were identified from the American College of Surgeons National Surgical Quality Improvement Program database records from 2005 to 2012. Using Current Procedural Terminology (CPT) codes for LAR for mid-high rectal tumors, patients were stratified into diverting stoma (CPT: 44146, 44208) or no diverting stoma (CPT: 44145, 44207) cohorts. Emergency resection, stage IV disease, and permanent end colostomy patients were excluded. RESULTS:We included 1,406 patients in the analysis. All patients received nCRT; 607 (43%) received a diverting stoma and 799 (57%) were not diverted. The diverted group was more likely to have a higher body mass index (28.3 vs 27.4 kg/m(2); P = .02) and hypertension (46% vs 39%; P = .002). Otherwise, the group demographics and comorbidities were comparable. Overall morbidity was 28% for the entire cohort with no differences in deep organ space infection, sepsis and septic shock, unplanned reoperation, duration of stay, or overall mortality between the groups. CONCLUSION:Diverting stoma does not decrease mortality or infectious complications in mid-high rectal cancer patients undergoing LAR after nCRT. The decision to construct a protective stoma should not be driven solely on the receipt of nCRT.
journal_name
Surgeryjournal_title
Surgeryauthors
Messaris E,Connelly TM,Kulaylat AN,Miller J,Gusani NJ,Ortenzi G,Wong J,Bhayani Ndoi
10.1016/j.surg.2015.02.026subject
Has Abstractpub_date
2015-09-01 00:00:00pages
686-91issue
3eissn
0039-6060issn
1532-7361pii
S0039-6060(15)00323-2journal_volume
158pub_type
杂志文章相关文献
SURGERY文献大全abstract:INTRODUCTION:Routine, whole-body computed tomography imaging (PAN-SCAN) has been shown to identify unexpected injuries and alter the management of patients presenting with blunt trauma. We sought to characterize the changes in practice over time and the utility of PAN-SCAN imaging in elderly patients who fall and requi...
journal_title:Surgery
pub_type: 杂志文章
doi:10.1016/j.surg.2013.07.015
更新日期:2013-10-01 00:00:00
abstract:BACKGROUND:Intestinal barrier failure during acute pancreatitis (AP) is associated with translocation of luminal bacteria, resulting in infectious complications. We examined the effects of multispecies probiotics on the intestinal barrier impairment in a murine model of AP. METHODS:Mice were injected with cerulein to ...
journal_title:Surgery
pub_type: 杂志文章
doi:10.1016/j.surg.2008.09.011
更新日期:2009-02-01 00:00:00
abstract::In 337 limbs (208 patients) with primary varicose veins, Doppler ultrasound was used to detect reverse flow in the saphenous veins caused by manual compression of the calf. According to the extent of reverse flow in the saphenous trunks, varicosities of the long saphenous vein were classified into five types and the s...
journal_title:Surgery
pub_type: 杂志文章
doi:
更新日期:1988-06-01 00:00:00
abstract:BACKGROUND:The benefit of removing the splenic lymph nodes in patients with proximal gastric cancer has been controversial. The purpose of our study was to investigate the importance of performing a splenic hilar lymph node dissection without splenectomy in patients undergoing total gastrectomy for gastric cancer. MET...
journal_title:Surgery
pub_type: 杂志文章
doi:10.1016/j.surg.2020.07.053
更新日期:2021-02-01 00:00:00
abstract:BACKGROUND:Despite nationwide campaigns to increase the use of helmets among pediatric cyclists, many children continue to be injured while riding without a helmet. To determine where programs and policies intended to promote helmet use should be directed, we surveyed a large national dataset to identify variables asso...
journal_title:Surgery
pub_type: 杂志文章
doi:10.1016/j.surg.2015.02.025
更新日期:2015-08-01 00:00:00
abstract::Lipopolysaccharide increases intestinal mucosal permeability to hydrophilic compounds such as chromium 51-labeled edetate (51Cr-EDTA). We sought to determine whether this phenomenon is partly mediated by lipopolysaccharide-induced mesenteric hypoperfusion. We assessed permeability in an isolated segment of ileum by me...
journal_title:Surgery
pub_type: 杂志文章
doi:
更新日期:1991-08-01 00:00:00
abstract::The recent surge in enthusiasm for laparoscopic surgery has created concern that abdominal insufflation with carbon dioxide produces a respiratory acidosis. This may be because of both transperitoneal gas absorption and impaired ventilation with increased dead space from elevated intraabdominal pressure. To examine th...
journal_title:Surgery
pub_type: 杂志文章
doi:
更新日期:1993-05-01 00:00:00
abstract:BACKGROUND:Major postoperative complications are associated with a substantial increase in hospital costs. Trauma patients are known to have a higher rate of complications than the general surgery population. We used the National Surgical Quality Improvement Program (NSQIP) methodology to evaluate hospital costs, durat...
journal_title:Surgery
pub_type: 杂志文章
doi:10.1016/j.surg.2008.05.003
更新日期:2008-08-01 00:00:00
abstract::Twenty dogs underwent 15 minutes of normothermic ischemic arrest and 30 minutes of reperfusion while on cardiopulmonary bypass. In 10 control dogs, the reperfusate blood was not modified. In 10 other dogs, the aorta was reclamped and the heart reperfused for 5 minutes with blood containing L-glutamate (0.026M). We mea...
journal_title:Surgery
pub_type: 杂志文章
doi:
更新日期:1980-11-01 00:00:00
abstract:BACKGROUND:The experience at Loyola University Chicago was retrospectively reviewed to evaluate survival and functional outcome after single lung transplantation (SLT) and bilateral lung transplantation (BLT). METHODS:Ninety patients underwent lung transplantation at Loyola University Chicago between April 1990 and De...
journal_title:Surgery
pub_type: 杂志文章
doi:
更新日期:1994-10-01 00:00:00
abstract::It is possible that in the future, lasers will replace electrocautery in gastrointestinal surgical procedures. Few studies exist that compare the tissue effects of electrocautery with newer laser modalities. In this study, the tissue effects of electrocautery, noncontact Nd:YAG, contact Nd:YAG, and CO2 lasers were stu...
journal_title:Surgery
pub_type: 杂志文章
doi:
更新日期:1987-06-01 00:00:00
abstract::Little is known about the response of surface cells and glandular cells of the gastric mucosa to various injurious agents. This study examines the effects of bile acid and salicylate on oxygen consumption and membraneolysis of isolated gastric mucosal surface cells and compares these responses to those of cells consti...
journal_title:Surgery
pub_type: 杂志文章
doi:
更新日期:1983-05-01 00:00:00
abstract::Since 1966, 29 patients with recurrent carotid artery stenosis have been encountered. The mean (+/- SEM) internal between initial carotid endarterectomy and secondary presentation was 67.5 +/- 9.2 months (range 6 to 180 months). There was a disproportionate number of women with recurrent stenosis. The mean age at init...
journal_title:Surgery
pub_type: 杂志文章
doi:
更新日期:1983-02-01 00:00:00
abstract:INTRODUCTION:Although frequently used as an adjunct to cytology in patients with differentiated thyroid cancers, interpretation of thyroglobulin washout remains unclear. We aim to compare the utility of different analytic tools to develop recommendations for use in post-total thyroidectomy follow-up. METHODS:This is a...
journal_title:Surgery
pub_type: 杂志文章
doi:10.1016/j.surg.2019.05.083
更新日期:2020-01-01 00:00:00
abstract:BACKGROUND:The reconstruction of outflow is a crucial step in living donor liver transplantation. This study describes a suitable technique that uses synthetic vascular conduits in presence of multiple draining veins of right lobe of liver and the outcome of the recipients to evaluate safety of using multiple synthetic...
journal_title:Surgery
pub_type: 杂志文章
doi:10.1016/j.surg.2015.03.018
更新日期:2015-11-01 00:00:00
abstract:BACKGROUND:The aims of the present study were to confirm the consumption coagulopathy of disseminated intravascular coagulation with the fibrinolytic phenotype at an early phase of trauma and to test the hypothesis that thrombin-activatable fibrinolysis inhibitor, neutrophil elastase, and plasmin contribute to the incr...
journal_title:Surgery
pub_type: 杂志文章
doi:10.1016/j.surg.2010.06.010
更新日期:2011-02-01 00:00:00
abstract::Endorectal ileoanal anastomosis with proximal interposition of an ileal reservoir was evaluated experimentally in dogs as an approach to retain sphincteric control of defecation after proctocolectomy. Two months after the operative procedure, eight animals with a reservoir had four to eight semisolid stools per day an...
journal_title:Surgery
pub_type: 杂志文章
doi:
更新日期:1982-03-01 00:00:00
abstract:BACKGROUND:Retroperitoneal sarcomas are rare tumors that can be locally aggressive with high rates of recurrence. Given that data on survival in patients with retroperitoneal sarcomas are conflicting, we sought to use a nationwide cancer database to identify factors associated with survival in patients with retroperito...
journal_title:Surgery
pub_type: 杂志文章
doi:10.1016/j.surg.2016.05.041
更新日期:2016-12-01 00:00:00
abstract::Abnormalities of the immune response are commonly observed after surgery. In many cases, they are part of a physiologic rather than of a pathologic response to trauma. In this study we show that after elective surgery in otherwise healthy subjects the B cell compartment is deeply affected, as documented by the appeara...
journal_title:Surgery
pub_type: 杂志文章
doi:
更新日期:1988-05-01 00:00:00
abstract:BACKGROUND:Mechanical anastomosis has been claimed to reduce the rate of leakage compared with manual anastomosis. No randomized trials have been performed to date to prove this specifically in esophagogastric anastomosis. METHODS:One hundred fifty-four patients, 139 men and 15 women ranging in age from 36 to 83 years...
journal_title:Surgery
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1016/s0039-6060(96)80066-3
更新日期:1996-09-01 00:00:00
abstract::A dominant belief throughout the last half of the 1970s was that operative rates in the United States continued to show steady increases. This strongly suggested that an excessive number of operations were being performed. Unsubstantiated statements regarding surgical rates have been accepted at face value, and little...
journal_title:Surgery
pub_type: 杂志文章
doi:
更新日期:1981-02-01 00:00:00
abstract:BACKGROUND:Sudden massive release of serotonin, histamine, kallikrein, and bradykinin is postulated to cause an intraoperative carcinoid crisis. The exact roles of each of these possible agents, however, remain unknown. Optimal treatment will require an improved understanding of the pathophysiology of the carcinoid cri...
journal_title:Surgery
pub_type: 杂志文章
doi:10.1016/j.surg.2018.04.093
更新日期:2019-01-01 00:00:00
abstract:BACKGROUND:Difficult cephalad exposure during carotid endarterectomy in patients with high plaque (HP) may lead to increased incidence of complications after carotid endarterectomy. We report on our experience of carotid endarterectomy in patients with HP. METHODS:This is a retrospective review of 1,233 consecutive pa...
journal_title:Surgery
pub_type: 杂志文章,多中心研究
doi:10.1016/j.surg.2019.06.017
更新日期:2019-10-01 00:00:00
abstract:BACKGROUND:Although preoperative administration of high-dose glucocorticoid may lead to improved recovery after operative procedures, this regimen has not been examined in patients undergoing abdominal wall reconstruction for repair of large ventral hernias. The aim of the current trial was to examine the effects of pr...
journal_title:Surgery
pub_type: 杂志文章,随机对照试验
doi:10.1016/j.surg.2019.12.007
更新日期:2020-04-01 00:00:00
abstract:BACKGROUND:Obese patients can develop a large lower abdominal panniculus (worsened by significant weight loss). Patients with advanced chronic kidney disease (CKD) affected by this obesity-related sequela are not infrequently declined for kidney transplantation because of the high risk for serious wound-healing complic...
journal_title:Surgery
pub_type: 杂志文章
doi:10.1016/j.surg.2015.12.001
更新日期:2016-06-01 00:00:00
abstract:BACKGROUND:Encapsulated follicular variant of papillary thyroid carcinoma has recently been reclassified as noninvasive follicular thyroid neoplasm with papillary-like nuclear features on the basis of its highly indolent behavior, as proposed by an international group of experienced thyroid pathologists. METHODS:All p...
journal_title:Surgery
pub_type: 杂志文章,多中心研究
doi:10.1016/j.surg.2018.04.089
更新日期:2019-01-01 00:00:00
abstract:BACKGROUND:The aim of this study was to establish the clinical and pathologic aspects of 3 atypical lipomatous lesions in the region of the adrenal gland. METHODS:Three young Chinese patients (ages 18, 18, and 37 years) were seen for nonspecific back pain. Radiologic examination revealed a lipomatous lesion in the reg...
journal_title:Surgery
pub_type: 杂志文章
doi:10.1067/msy.1999.98924
更新日期:1999-07-01 00:00:00
abstract:BACKGROUND:Only annual mammography and physical examination are recommended for the post-treatment surveillance of early stage breast cancer. METHODS:We used Texas Cancer Registry-Medicare linked data (2001-2007) to identify physician visits and use of mammography, magnetic resonance imaging (MRI), computed tomography...
journal_title:Surgery
pub_type: 杂志文章
doi:10.1016/j.surg.2013.04.004
更新日期:2013-08-01 00:00:00
abstract::We examined whether L-arginine is a substrate for nitric oxide (NO) production by peripheral blood mononuclear cells (MNC) in vitro. Minimal extracellular arginine (0.04 mmol/L) is required for maximal lymphocyte proliferation after phytohemagglutinin stimulation. In the absence of arginine, proliferation was 41% of n...
journal_title:Surgery
pub_type: 杂志文章
doi:
更新日期:1991-08-01 00:00:00
abstract:BACKGROUND:While roughly half of adrenocortical carcinomas are functional, whether functional status impacts outcomes remains controversial. We compared presentation and survival for functional and nonfunctional neoplasms. METHODS:Adult patients presented with adrenocortical carcinomas at the Mayo Clinic were included...
journal_title:Surgery
pub_type: 杂志文章
doi:10.1016/j.surg.2019.04.066
更新日期:2020-01-01 00:00:00