Abstract：
BACKGROUND:Improvements in outcomes after pancreatoduodenectomy (PD) have permitted more complex resections. Complete extirpation at PD may require multivisceral resection (MVR-PD); however, descriptions of morbidity of MVR-PD are limited to small, single-institution series. METHODS:The National Surgical Quality Improvement Project database (2005-2011) was used to compare 30-day postoperative morbidity of PD with MVR-PD. Concurrent resection of colon, small bowel, stomach, kidney, or adrenal gland defined MVR-PD. RESULTS:Of 9,927 PDs, MVR-PD was performed in 273 patients (3%). MVR included colon (58%), small bowel (30%), and gastric (12%) resections. Preoperative comorbidities were similar between groups. Pancreatic, duodenal, or periampullary cancer was present in 75% of patients. Mortality (8.8% vs 2.9%) and major morbidity (56.8% vs 30.8%) were much greater for MVR-PD versus PD alone (P < .001). MVR-PD patients also experienced greater rates of wound, pulmonary, cardiac, thromboembolic, renal, and septic complications. On multivariable regression, MVR was an independent predictor of death (odds ratio [OR], 3.4; P < .001), overall morbidity (OR, 3.01; P < .001), major morbidity (OR, 3.21; P < .001), and minor morbidity (OR, 1.65; P = .03). Among patients undergoing PD+MVR, colectomy was an independent predictor of increased overall morbidity (OR, 1.96; P = .03) and major morbidity (OR, 1.90; P = .02). CONCLUSION:Margin-negative resection may require MVRs at the time of PD. MVR at is associated with 3-fold mortality and substantial morbidity after adjusting for comorbidities. Colectomy independently predicted major morbidity. At PD, the morbidity of MVR should be approached with caution when attempting margin-negative resection.
journal_name
Surgeryjournal_title
Surgeryauthors
Bhayani NH,Enomoto LM,James BC,Ortenzi G,Kaifi JT,Kimchi ET,Staveley-O'Carroll KF,Gusani NJdoi
10.1016/j.surg.2013.12.020subject
Has Abstractpub_date
2014-03-01 00:00:00pages
567-74issue
3eissn
0039-6060issn
1532-7361pii
S0039-6060(13)00639-9journal_volume
155pub_type
杂志文章相关文献
SURGERY文献大全abstract：BACKGROUND:Cytotoxic lymphocytes (CTLs) are an important component of immune function, involved in antigen recognition and resistance to viral infection. Burn injury suppresses cell-mediated immunity, induces allograft tolerance, and increases the risk of viral infection, but the mechanisms are not well understood. Thi...
journal_title：Surgery
pub_type： 杂志文章
doi：10.1016/s0039-6060(05)80354-x
更新日期：1995-08-01 00:00:00
abstract：BACKGROUND:Dynamic musculoplasty is increasingly being used to replace severely damaged muscle. Electrical stimulation induces a change in muscle composition from type II to type I muscle fibers. The aim of this study was to assess the optimal time to start stimulation and the beneficial effect of a vascular delay. ME...
journal_title：Surgery
pub_type： 杂志文章
doi：10.1016/s0039-6060(97)90310-x
更新日期：1997-04-01 00:00:00
abstract：CONTEXT:The rate and the extent of bone remineralization at cancellous versus cortical sites after treatment of hyperthyroidism is unclear. Few studies have examined the effect of operative management of hyperthyroidism on recovery of bone mass. OBJECTIVE:To evaluate prospectively the bone mineral density (BMD), bone ...
journal_title：Surgery
pub_type： 杂志文章
doi：10.1016/j.surg.2015.10.002
更新日期：2016-03-01 00:00:00
abstract：:Forty-seven patients with 50 clinically occult injuries of major arteries were studied prospectively to determine the natural history of these lesions and the safety of nonoperative management. Penetrating trauma was the predominant mechanism and lower extremity arteries were most commonly involved. The morphology of ...
journal_title：Surgery
pub_type： 杂志文章
doi：
更新日期：1991-01-01 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:Recent trends toward regionalization of complex surgical procedures may increase the risk for care fragmentation during readmissions. Conflicting conclusions have been reported regarding risk factors and consequences of nonindex readmissions (ie, readmission to a separate hospital than the one where surgery ...
journal_title：Surgery
pub_type： 杂志文章,meta分析
doi：10.1016/j.surg.2018.08.021
更新日期：2019-03-01 00:00:00
abstract：:The proliferative defects observed in phagocytic stem cells after major thermal injuries may be caused by an inadequate production of colony-stimulating factors (CSFs), a family of hemopoietic cytokines necessary for the production and function of granulocytes and monocytes. In this study a biologic response modifier ...
journal_title：Surgery
pub_type： 杂志文章
doi：
更新日期：1992-04-01 00:00:00
abstract：:Twenty Dacron grafts (10 crimped and 10 noncrimped) were studied with light microscopy, scanning electron microscopy, and transmission electron microscopy (TEM) 1 to 10 months after insertion into the canine thoracoabdominal aorta. Fibroblast-derived pseudointima maintained a smooth luminal lining that approximated th...
journal_title：Surgery
pub_type： 杂志文章
doi：
更新日期：1983-11-01 00:00:00
abstract：BACKGROUND:Pancreatoduodenectomy is the standard treatment for pathologies of the pancreatic head and is performed routinely worldwide. The aim of the study was to analyze this procedure in terms of extent of surgery, technical difficulty, and clinical outcomes and thereby provide a standardized surgical categorization...
journal_title：Surgery
pub_type： 杂志文章
doi：10.1016/j.surg.2020.11.030
更新日期：2020-12-29 00:00:00
abstract：BACKGROUND:Activated nuclear factor-kappaB (NF-kappaB) is associated reportedly with the pathogenesis of numerous malignancies. This study investigated whether a common insertion (ins)/deletion (del) polymorphism (-94 ins/del ATTG) in the NFKB1 promoter is associated with susceptibility to gastric cancer and its tumor ...
journal_title：Surgery
pub_type： 杂志文章
doi：10.1016/j.surg.2008.11.001
更新日期：2009-03-01 00:00:00
abstract：:Forty-five patients with varying biliary pathology were injected with one gram of intramuscular cefazolin sodium prior to surgery. Serum, gallbladder bile, and common duct bile levels were measured. The type of biliary disease did not influence serum levels (mean, 29 mug per milliliter) which reached a peak one hour a...
journal_title：Surgery
pub_type： 杂志文章
doi：
更新日期：1977-04-01 00:00:00
abstract：BACKGROUND:The aim of this study was to clarify whether the types of portal vein (PV) occlusion during hepatectomy affect the long-term outcome in patients with hepatocellular carcinoma (HCC). METHODS:Eighty-six patients who had undergone curative hepatic resection for HCC were divided on the basis of the type of PV o...
journal_title：Surgery
pub_type： 杂志文章
doi：10.1016/j.surg.2005.02.008
更新日期：2005-06-01 00:00:00
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 an...
journal_title：Surgery
pub_type： 杂志文章
doi：10.1016/j.surg.2015.02.026
更新日期：2015-09-01 00:00:00
abstract：BACKGROUND:Interaction of the CD11/CD18 complex on polymorphonuclear neutrophils (PMNs) and intercellular adhesion molecule (ICAM)-1 on endothelium is a critical event in PMN-mediated tissue injury. In addition, increased expression of ICAM-1 on type I pneumocytes has been identified in a variety of pulmonary disorders...
journal_title：Surgery
pub_type： 杂志文章
doi：10.1016/s0039-6060(05)80320-4
更新日期：1995-08-01 00:00:00
abstract：:The term big data has been popularized over the past decade and is often used to refer to data sets that are too large or complex to be analyzed by traditional means. Although the term has been utilized for some time in business and engineering, the concept of big data is relatively new to medicine. The reception from...
journal_title：Surgery
pub_type： 杂志文章
doi：10.1016/j.surg.2018.06.022
更新日期：2018-10-01 00:00:00
abstract：BACKGROUND:Postoperative ileus, a transient impairment of bowel motility initiated by intestinal inflammation, is common after an abdominal operation and leads to increased hospital stays and costs. Hydrogen has potent anti-inflammatory and antioxidant properties and potential therapeutic value. Solubilized hydrogen ma...
journal_title：Surgery
pub_type： 杂志文章
doi：10.1016/j.surg.2016.05.026
更新日期：2016-09-01 00:00:00
abstract：BACKGROUND:The aim of this study was to determine if nonoperative, noninterventional expectant management of pancreatic pseudocysts is warranted in selected patients. METHODS:From 1980 to 1985, 114 patients with the diagnosis of pancreatic pseudocyst were evaluated. RESULTS:Forty-six patients underwent primary operat...
journal_title：Surgery
pub_type： 杂志文章
doi：
更新日期：1992-02-01 00:00:00
abstract：BACKGROUND:Although various suture techniques for murine pancreas transplantation have been described, severe limitations have limited their widespread use. We therefore designed a surgical model for cervical heterotopic pancreas transplantation using a cuff technique. METHODS:C57BL6 mice were used as donor and recipi...
journal_title：Surgery
pub_type： 杂志文章
doi：10.1016/j.surg.2006.07.037
更新日期：2007-05-01 00:00:00
abstract：:Thyroglossal cysts are common developmental abnormalities of the thyroid gland. The malignant form of these cysts, however, is extremely rare, with fewer than 100 cases reported since 1915. Here we add 10 cases of malignant thyroglossal cysts, nine women and one man, encountered at M.D. Anderson Cancer Center, based o...
journal_title：Surgery
pub_type： 杂志文章
doi：
更新日期：1991-12-01 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：BACKGROUND:Autotransplanted parathyroid tissue is capable of inducing neovascularization in vivo, restoring calcium homeostasis with regulatory control. The mechanisms of parathyroid-induced neovascularization remain to be determined. Using an unique three-dimensional in vitro model, we tested the ability of parathyroi...
journal_title：Surgery
pub_type： 杂志文章
doi：10.1016/s0039-6060(96)80060-2
更新日期：1996-12-01 00:00:00
abstract：BACKGROUND:The purpose of this study was to review our 15-year experience in the treatment of blunt splenic injury in adults. Our hypothesis was that the implementation of a change in practice, with stress on splenic preservation and splenic artery embolization for the management of splenic injury, would result in impr...
journal_title：Surgery
pub_type： 杂志文章
doi：10.1016/j.surg.2006.07.005
更新日期：2006-10-01 00:00:00
abstract：BACKGROUND:Coronary artery bypass grafting surgery has an increased risk of adverse events in obese patients. This increased risk might be explained in part by an increased intra-abdominal pressure and the development of intra-abdominal hypertension. Therefore, the objective of this study was to investigate the correla...
journal_title：Surgery
pub_type： 杂志文章
doi：10.1016/j.surg.2019.05.038
更新日期：2019-12-01 00:00:00
abstract：BACKGROUND:Surgical residents have traditionally been evaluated by ward evaluations and multiple-choice testing; overall resident performance has seldom been objectively evaluated. We developed a comprehensive evaluation program for senior residents. The purpose of this study was to determine whether the several differ...
journal_title：Surgery
pub_type： 杂志文章
doi：
更新日期：1994-10-01 00:00:00
abstract：BACKGROUND:Medullary carcinoma of the thyroid gland (MCT) is a disease commonly associated with regional metastases. Apart from surgical resection, there are limited therapeutic options for such patients. Given the variable and often prolonged survival of such patients, the benefit of surgical resection is difficult to...
journal_title：Surgery
pub_type： 杂志文章
doi：
更新日期：1993-12-01 00:00:00
abstract：:The object of this article is to assess the value of human serum albumin (HSA) in the initial resuscitation of hypotensive trauma victims. Thirty-six patients (mean age = 30 years) in shock from trauma who underwent laparotomies were randomly assigned to either Ringer's lactate solution (RL) resuscitation or 4% HSA in...
journal_title：Surgery
pub_type： 临床试验,杂志文章,随机对照试验
doi：
更新日期：1981-04-01 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:Alternative methods for abdominal wall closure may be necessary after emergency laparotomy. The purpose of this study was to determine the morbidity and outcome of emergency fascial closure with polypropylene mesh. METHODS:A retrospective review was performed of all patients undergoing emergency fascial clo...
journal_title：Surgery
pub_type： 杂志文章,评审
doi：10.1016/s0039-6060(05)80043-1
更新日期：1995-10-01 00:00:00
abstract：BACKGROUND:Vocal cord paralysis is associated with extrathyroidal invasive malignancy. This study was performed to analyze the presentation of patients with invasive thyroid malignancy and to determine the preoperative symptomatic and radiographic correlates of vocal cord paralysis. METHODS:In a group of 365 consecuti...
journal_title：Surgery
pub_type： 杂志文章
doi：10.1016/j.surg.2005.08.009
更新日期：2006-03-01 00:00:00
abstract：BACKGROUND:General, health-related quality-of-life questionnaires and recovery-specific questionnaires have been used to measure recovery in surgical patients. The aim of this study was to evaluate the clinimetric properties of 3 recovery instruments and to examine whether recovery-specific instruments are useful. MET...
journal_title：Surgery
pub_type： 杂志文章
doi：10.1016/j.surg.2008.03.027
更新日期：2008-07-01 00:00:00
