Abstract:
OBJECTIVE:This study aimed to identify risk factors for recurrence after pancreatic resection for intraductal papillary mucinous neoplasm (IPMN). SUMMARY BACKGROUND DATA:Long-term follow-up data on recurrence after surgical resection for IPMN are currently lacking. Previous studies have presented mixed results on the role of margin status in risk of recurrence after surgical resection. METHODS:A total of 126 patients that underwent resection for noninvasive IPMN were followed for a median of 9.5 years. Dedicated pathological and radiological reviews were performed to correlate clinical and pathological features (including detailed pathological features of the parenchymal margin) with recurrence after surgical resection. In addition, in a subset of 32 patients with positive margins, we determined the relationship between the margin and original IPMN using driver gene mutations identified by next-generation sequencing. RESULTS:Family history of pancreatic cancer and high-grade IPMN was identified as risk factors for recurrence in both uni- and multivariate analysis (adjusted hazard ratio 3.05 and 1.88, respectively). Although positive margin was not significantly associated with recurrence in our cohort, the size and grade of the dysplastic focus at the margin were significantly correlated with recurrence in margin-positive patients. Genetic analyses showed that the neoplastic epithelium at the margin was independent from the original IPMN in at least 9 of 32 cases (28%). The majority of recurrences (74%) occurred after 3 years, and a significant minority (32%) occurred after 5 years. CONCLUSION:Sustained postoperative surveillance for all patients is indicated, particularly those with risk factors such has family history and high-grade dysplasia.
journal_name
Ann Surgjournal_title
Annals of surgeryauthors
Pflüger MJ,Griffin JF,Hackeng WM,Kawamoto S,Yu J,Chianchiano P,Shin E,Lionheart G,Tsai HL,Wang H,Rezaee N,Burkhart RA,Cameron JL,Thompson ED,Wolfgang CL,He J,Brosens LAA,Wood LDdoi
10.1097/SLA.0000000000004427subject
Has Abstractpub_date
2020-11-17 00:00:00eissn
0003-4932issn
1528-1140pub_type
杂志文章abstract::Prior experience with the rare combination of horseshoe kidney and significant atherosclerotic vascular disease suggests difficulty in intraoperative management, often requiring division of the renal isthmus or sacrifice of some renal tissue. Seven patients have been managed successfully over the past ten years at The...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-197807000-00012
更新日期:1978-07-01 00:00:00
abstract::Five dogs prepared with Heidenhain pouches received infusions of saline, GIP and VIP before and after a standard meat meal. Blood samples were obtained under basal conditions and at subsequent intervals for measurement of gastrin, insulin, GIP and VIP by radioimmunoassay. GIP and VIP infusions had no effect on basal l...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-197607000-00016
更新日期:1976-07-01 00:00:00
abstract:OBJECTIVE:To determine the optimal management of symptomatic non-parasitic liver cysts. SUMMARY BACKGROUND DATA:Management options for symptomatic nonparasitic liver cysts lack substantiation through comparative studies with respect to safety and long-term effectiveness. METHODS:A retrospective review of the surgical...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-199808000-00004
更新日期:1998-08-01 00:00:00
abstract:OBJECTIVE:To investigate adverse event free admissions as a potential, patient-centered indicator aligned directly with the goal of patient safety-freedom from harm. BACKGROUND:Preventable adverse event rates in healthcare could be further reduced. These are generally measured separately, one adverse event at a time. ...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/SLA.0000000000001792
更新日期:2017-05-01 00:00:00
abstract::A case report and review of the literature regarding multiple primary melanomas, and a discussion of the histologic differentiation between cutaneous primary melanomas and dermal metastases are presented. This report concerns a patient who, following wide surgical resection of a 1.3 mm thick primary melanoma with sate...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-198102000-00021
更新日期:1981-02-01 00:00:00
abstract:OBJECTIVE:We developed and validated a nomogram predicting the likelihood of occult lymph node metastases in surgically resectable esophageal cancers. BACKGROUND:Patients with esophageal cancer with positive lymph nodes benefit from neoadjuvant therapy, but limitations in current clinical staging techniques mean nodal...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/SLA.0000000000003450
更新日期:2019-07-03 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::The prognostic and postoperative monitoring capabilities of the CEA assay were compared to pathological staging of the operative specimens, clinical followup including endoscopy, radiology and scanning techniques, as well as DNCB skin testing and laboratory enzyme determinations (alkaline phosphatase and transaminase)...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-197601000-00002
更新日期:1976-01-01 00:00:00
abstract:OBJECTIVE:To assess the accuracy of physical examination, ultrasonography, and mammography in predicting residual size of breast tumors following neoadjuvant chemotherapy. BACKGROUND:Neoadjuvant chemotherapy is an accepted part of the management of stage II and III breast cancer. Accurate prediction of residual pathol...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/01.sla.0000197714.14318.6f
更新日期:2006-02-01 00:00:00
abstract:OBJECTIVES:To develop, validate, and implement a competency assessment tool (CAT) for technical surgical performance in the context of a summative assessment process for the National Training Programme in Laparoscopic Colorectal Surgery (NTP). BACKGROUND:The NTP is an educational initiative by the National Cancer Acti...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/SLA.0b013e318275b72a
更新日期:2013-03-01 00:00:00
abstract:OBJECTIVE:FN present a management quandary as they are often benign but may also be aggressive TC. Consensus recommendations have historically advised thyroidectomy for definitive diagnosis. Although MT have robust benefit in hypothetical cost analyses, under current management guidelines a real-time study of their cli...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/SLA.0000000000004130
更新日期:2020-10-01 00:00:00
abstract:OBJECTIVE:We report on a new side-to-side isoperistaltic strictureplasty (SSIS), the Michelassi II or end-to-side-to-side-to-end strictureplasty, performed with discontinuous bowel loops. SUMMARY BACKGROUND DATA:The SSIS Michelassi strictureplasty was described a quarter of a century ago to avoid massive bowel resecti...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/SLA.0000000000003430
更新日期:2020-01-01 00:00:00
abstract:OBJECTIVE:To investigate the pattern of nodal metastasis, morbidity, recurrence rates of papillary thyroid carcinoma (PTC), and parathyroid hormone (PTH) responses following neck dissection (ND) plus total thyroidectomy (TT). SUMMARY BACKGROUND DATA:While hypoparathyroidism develops after TT plus ND, little is known o...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/01.sla.0000250451.59685.67
更新日期:2007-04-01 00:00:00
abstract::Twenty-two patients developed one or more aortoenteric fistulae following aortic reconstruction with a dacron graft. Endoscopy was performed on 11 of these patients on 17 occasions and a preoperative diagnosis was made in eight patients. Fistulous communication was most common between the aorta and duodenum (60%), and...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-198203000-00011
更新日期:1982-03-01 00:00:00
abstract::Inclusion of vagotomy and pyloroplasty in the surgical treatment of gastroesophageal reflux associated with hiatal hernia has long been controversial. To evaluate the morbidity of vagotomy in the treatment of reflux esophagitis, a retrospective study of 311 patients treated by the Hill posterior gastropexy technique o...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-197606000-00003
更新日期:1976-06-01 00:00:00
abstract:OBJECTIVE:To investigate whether subclassification of microscopic vascular invasion (MiVI) affects the long-term outcome after curative surgical resection or liver transplantation (LT) in patients with hepatocellular carcinoma (HCC). SUMMARY OF BACKGROUND DATA:The most important factor for TNM staging in HCC is MiVI, ...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/SLA.0000000000003781
更新日期:2020-01-14 00:00:00
abstract::The problem of lead poisoning from bullets has been investigated by surgically implanting discs of lead, each enriched in a different natural isotope, into the tissue of two mongrel dogs and monitoring by mass spectrometry the release of the lead into each animal's blood over the course of 3 years. Lead placed in the ...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-198611000-00014
更新日期:1986-11-01 00:00:00
abstract:OBJECTIVE:Minimally invasive techniques have expanded the donor pool for living kidney donation. We changed our approach to single-port donor nephrectomy in 2009 and have compared outcomes with traditional multiple-port laparoscopic donor nephrectomy. BACKGROUND:The development of minimally invasive surgical technique...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/SLA.0b013e318262ddd6
更新日期:2013-03-01 00:00:00
abstract:OBJECTIVE:The aim of this study was to evaluate the role of surgical transgastric necrosectomy (TGN) for walled-off pancreatic necrosis (WON) in selected patients. BACKGROUND:WON is a common consequence of severe pancreatitis and typically occurs 3 to 5 weeks after the onset of acute pancreatitis. When symptomatic, it...
journal_title:Annals of surgery
pub_type: 杂志文章,多中心研究
doi:10.1097/SLA.0000000000003048
更新日期:2020-01-01 00:00:00
abstract::To determine if visceral blood flow was altered by thermal injury, effective renal blood flow (ERBF) was measured by para-aminohippurate clearance in five control subjects and 13 nonbacteremic burn patients (mean burn size: 50% total body surface, range: 24.5-83.5) 6-25 days after burn injury. Splanchnic blood flow (S...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-198101000-00018
更新日期:1981-01-01 00:00:00
abstract::From 1979 to 1983, 1726 carotid endarterectomies were performed at the Cleveland Clinic. During this period, 39 men (mean age, 60 years) and 22 women (mean age, 63 years) required 65 reoperations (3.8%) for correction of recurrent carotid stenosis occurring 3 to 194 months (mean, 42 months) after previous endarterecto...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-198507000-00004
更新日期:1985-07-01 00:00:00
abstract:OBJECTIVE:To investigate the existence of a pathway between intraluminal products and the muscularis leukocytic infiltrate. SUMMARY BACKGROUND DATA:Mild intestinal manipulation or lipopolysaccharide initiates an intense inflammatory response within the intestinal muscularis, resulting in paralytic ileus. A major poten...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-200201000-00005
更新日期:2002-01-01 00:00:00
abstract:BACKGROUND:The American Academy of Pediatrics has established guidelines for optimal, age-appropriate child occupant restraint. While optimal restraint has been shown to reduce the risk of injuries overall, its effect on specific types of injuries, in particular abdominal injuries, has not been demonstrated. METHODS:C...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/01.sla.0000103068.51037.20
更新日期:2004-01-01 00:00:00
abstract::Because hospitalization is a key factor in controlling health care costs and because fee-for-service remains the predominant mode of physician payment, a study was undertaken of the hospitalization experiences of open panel fee-for-service health maintenance organizations (IPA-HMOs) and Foundations for Medical Care (F...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-197709000-00017
更新日期:1977-09-01 00:00:00
abstract::To determine the significance of proteolysis and delayed freezing of tumor samples on estrogen receptor levels, values from 19 of 31 biopsy specimens were compared with that in remaining tumor at the completion of mastectomy. There was a 15-100% decrease in receptor content. Time-decay studies on selected postmastecto...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-198105000-00003
更新日期:1981-05-01 00:00:00
abstract:OBJECTIVE:The purpose of this study was to examine the effects of radiofrequency ablation (RFA) on tumor growth and growth factor expression in a murine model. BACKGROUND:Surgical excision remains the only potentially curative therapy for hepatic malignancies. Tumor growth in the remaining liver may be accelerated aft...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/01.sla.0000261319.51744.59
更新日期:2007-05-01 00:00:00
abstract:OBJECTIVE:Computed tomographic angiography (CTA) by 16-channel multidetector scanner is increasingly replacing conventional digital subtraction angiography (DSA) for diagnosing or excluding blunt carotid/vertebral injuries (BCVI). To date there has been only 1 study in which all patients received both examinations. Tha...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/SLA.0b013e3181568cab
更新日期:2007-10-01 00:00:00
abstract:OBJECTIVE:To analyze the utility of quick intraoperative parathyroid hormone (PTH) measurement in the surgical management of primary hyperparathyroidism. BACKGROUND DATA:The use of intraoperative PTH monitoring is well established in the surgery of primary hyperparathyroidism. However, some false-negative predictions ...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/01.sla.0000145927.29265.8a
更新日期:2004-12-01 00:00:00
abstract::Forty-seven cancer patients were selected for study based on their candidacy for hyperalimentation. Each patient received selected skin test antigens intradermally in the forearm prior to the initiation of hyperalimentation, and at 7-day intervals throughout treatment with either chemotherapy, radiation therapy or sur...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-197607000-00010
更新日期:1976-07-01 00:00:00
abstract::Of 531 patients admitted to the Duke Coronary Care Unit with unstable angina (UA) from June 1981 to September 1982, 100 had persistent angina despite optimal medical therapy of nitrates, propranolol, and nifedipine. At catheterization, 70% of the refractory patients had left main (LM) or three-vessel disease (TVD), 68...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-198410000-00007
更新日期:1984-10-01 00:00:00