A prospective randomized trial comparing R1 subtotal gastrectomy with R3 total gastrectomy for antral cancer.

Abstract:

OBJECTIVE:The authors determined if more radical surgery with extended lymphadenectomy improves the results of gastrectomy in patients with adenocarcinoma of the gastric antrum. SUMMARY BACKGROUND DATA:The overall survival in patients with gastric cancer is disappointing. Improved survival has been reported by Japanese authors. Whether this is because of a higher number of early gastric cancers in the Japanese series, different biologic behavior in Asians, or the adoption of radical surgery with lymphadenectomy remains unclear. METHODS:R1 subtotal gastrectomy with omentectomy and R3 total gastrectomy (omentectomy, splenectomy, distal pancreatectomy, lymphatic clearance of the celiac axis, and skeletonization of vessels in the porta hepatis) were evaluated in a prospective, randomized comparison. RESULTS:Fifty-five patients were randomized--25 to the R1 group and 30 to the R3 group. The two groups were comparable for age, sex, tumor size, TNM stage, and length of follow-up. The R3 group had a longer operating time (140 vs. 260 min; p < 0.05), a greater transfusion requirement (0 vs. 2 units, p < 0.05) and a longer hospital stay (8 vs. 16 days; p < 0.05) (medians; Mann-Whitney U test). The only postoperative death was in the R3 group and was caused by intra-abdominal sepsis. Fourteen patients in the R3 group developed left subphrenic abscesses. There were no major complications in the R1 group. Overall survival was significantly better in the R1 group (median survival estimated by Kaplan-Meier method, 1511 vs. 922 days, p < 0.05, log-rank test). CONCLUSIONS:R3 total gastrectomy can be performed with a low mortality, but it has a high morbidity because of intra-abdominal sepsis. The data do not support the routine use of R3 total gastrectomy for treatment of patients with antral cancer.

journal_name

Ann Surg

journal_title

Annals of surgery

authors

Robertson CS,Chung SC,Woods SD,Griffin SM,Raimes SA,Lau JT,Li AK

doi

10.1097/00000658-199408000-00009

subject

Has Abstract

pub_date

1994-08-01 00:00:00

pages

176-82

issue

2

eissn

0003-4932

issn

1528-1140

journal_volume

220

pub_type

临床试验,杂志文章,随机对照试验
  • Lymphedema after complete axillary node dissection for melanoma: assessment using a new, objective definition.

    abstract:OBJECTIVES:The objectives of this study were to define appropriate criteria for assessing the presence of lymphedema, and to report the prevalence and risk factors for development of upper limb lymphedema after level I-III axillary dissection for melanoma. SUMMARY BACKGROUND DATA:The lack of a consistent and reliable ...

    journal_title:Annals of surgery

    pub_type: 杂志文章

    doi:10.1097/01.sla.0000143271.32568.2b

    authors: Starritt EC,Joseph D,McKinnon JG,Lo SK,de Wilt JH,Thompson JF

    更新日期:2004-11-01 00:00:00

  • Decreased surgical risks of pancreas transplantation in the modern era.

    abstract:OBJECTIVE:To document the decreased incidence of surgical complications after pancreas transplantation in recent times. SUMMARY BACKGROUND DATA:Compared with other abdominal transplants, pancreas transplants have historically had the highest incidence of surgical complications. However, over the past few years, the au...

    journal_title:Annals of surgery

    pub_type: 杂志文章

    doi:10.1097/00000658-200002000-00017

    authors: Humar A,Kandaswamy R,Granger D,Gruessner RW,Gruessner AC,Sutherland DE

    更新日期:2000-02-01 00:00:00

  • Can We Predict Incisional Hernia?: Development of a Surgery-specific Decision-Support Interface.

    abstract:OBJECTIVE:The aim of this study was to identify procedure-specific risk factors independently associated with incisional hernia (IH) and demonstrate the feasibility of preoperative risk stratification through the use of an IH risk calculator app and decision-support interface. SUMMARY BACKGROUND DATA:IH occurs after 1...

    journal_title:Annals of surgery

    pub_type: 杂志文章

    doi:10.1097/SLA.0000000000003472

    authors: Basta MN,Kozak GM,Broach RB,Messa CA 4th,Rhemtulla I,DeMatteo RP,Serletti JM,Fischer JP

    更新日期:2019-09-01 00:00:00

  • Open Versus Fenestrated Endovascular Repair of Complex Abdominal Aortic Aneurysms.

    abstract:OBJECTIVE:To compare outcomes of fenestrated (FEVAR) and open repairs of complex abdominal aortic aneurysms (cAAA). BACKGROUND:FEVAR has emerged as an alternative to open surgery for treating cAAA, but direct comparisons are limited. METHODS:We studied all repairs of intact or symptomatic cAAA in the Vascular Quality...

    journal_title:Annals of surgery

    pub_type: 杂志文章,多中心研究

    doi:10.1097/SLA.0000000000003094

    authors: O'Donnell TFX,Boitano LT,Deery SE,Schermerhorn ML,Schanzer A,Beck AW,Green RM,Takayama H,Patel VI

    更新日期:2020-05-01 00:00:00

  • Primary payer status affects mortality for major surgical operations.

    abstract:OBJECTIVES:Medicaid and Uninsured populations are a significant focus of current healthcare reform. We hypothesized that outcomes following major surgical operations in the United States is dependent on primary payer status. METHODS:From 2003 to 2007, 893,658 major surgical operations were evaluated using the Nationwi...

    journal_title:Annals of surgery

    pub_type: 杂志文章

    doi:10.1097/SLA.0b013e3181e8fd75

    authors: LaPar DJ,Bhamidipati CM,Mery CM,Stukenborg GJ,Jones DR,Schirmer BD,Kron IL,Ailawadi G

    更新日期:2010-09-01 00:00:00

  • Medullary thyroid carcinoma: relationship of method of diagnosis to pathologic staging.

    abstract::Medullary thyroid carcinoma (MTC) develops in virtually all patients affected with multiple endocrine neoplasia type II (MEN II), a disease inherited as an autosomal dominant trait. The thyroid tumor cells secrete calcitonin (CT) and the detection of elevated plasma levels (>300 pg/ml) of this hormone in MEN II kindre...

    journal_title:Annals of surgery

    pub_type: 杂志文章

    doi:10.1097/00000658-197809000-00013

    authors: Wells SA Jr,Baylin SB,Gann DS,Farrell RE,Dilley WG,Preissig SH,Linehan WM,Cooper CW

    更新日期:1978-09-01 00:00:00

  • Management Considerations for the Surgical Treatment of Colorectal Cancer During the Global Covid-19 Pandemic.

    abstract:OBJECTIVE:The COVID-19 pandemic requires to conscientiously weigh "timely surgical intervention" for colorectal cancer against efforts to conserve hospital resources and protect patients and health care providers. SUMMARY BACKGROUND DATA:Professional societies provided ad-hoc guidance at the outset of the COVID-19 pan...

    journal_title:Annals of surgery

    pub_type: 杂志文章

    doi:10.1097/SLA.0000000000004029

    authors: O'Leary MP,Choong KC,Thornblade LW,Fakih MG,Fong Y,Kaiser AM

    更新日期:2020-08-01 00:00:00

  • An Experimental Simulation of Heat Effects on Cognition and Workload of Surgical Team Members.

    abstract:OBJECTIVE:To isolate heat exposure as a cause of cognitive impairment and increased subjective workload in burns surgical teams. SUMMARY BACKGROUND DATA:Raising ambient temperature of the operating room can improve burns patient outcomes, but risks increased cognitive impairment and workload of surgical team members. ...

    journal_title:Annals of surgery

    pub_type: 杂志文章

    doi:10.1097/SLA.0000000000004598

    authors: Ward MK,Yam CMH,Palejwala Z,Wallman K,Taggart SM,Wood FM,Parker SK

    更新日期:2020-11-13 00:00:00

  • Experience with 100 consecutive simultaneous kidney-pancreas transplants with bladder drainage.

    abstract::From December 1985 to December 1989, 100 consecutive simultaneous pancreas-kidney (SPK) transplants were performed at the University of Wisconsin Hospital and Clinics. Bladder drainage technique was used for all grafts. One- and three-year patient survival was 93% and 90%; kidney survival, 90% and 85%; and pancreas su...

    journal_title:Annals of surgery

    pub_type: 杂志文章

    doi:10.1097/00000658-199112000-00010

    authors: Sollinger HW,Knechtle SJ,Reed A,D'Alessandro AM,Kalayoglu M,Belzer FO,Pirsch J

    更新日期:1991-12-01 00:00:00

  • Effects of superoxide dismutase and allopurinol on the survival of acute island skin flaps.

    abstract::We have demonstrated previously that oxygen-derived free radicals are important mediators of tissue injury following ischemia (total venous occlusion) and reperfusion in small (3 cm X 6 cm) island skin flaps in rats. In this study, we evaluated extension of this concept to regional ischemia in large (8 cm X 8 cm) acut...

    journal_title:Annals of surgery

    pub_type: 杂志文章

    doi:10.1097/00000658-198503000-00018

    authors: Im MJ,Manson PN,Bulkley GB,Hoopes JE

    更新日期:1985-03-01 00:00:00

  • Factors Predicting Response, Perioperative Outcomes, and Survival Following Total Neoadjuvant Therapy for Borderline/Locally Advanced Pancreatic Cancer.

    abstract:OBJECTIVE:To identify predictive factors associated with operative morbidity, mortality, and survival outcomes in patients with borderline resectable (BR) or locally advanced (LA) pancreatic ductal adenocarcinoma (PDAC) undergoing total neoadjuvant therapy (TNT). BACKGROUND:The optimal preoperative treatment sequencin...

    journal_title:Annals of surgery

    pub_type: 杂志文章

    doi:10.1097/SLA.0000000000003284

    authors: Truty MJ,Kendrick ML,Nagorney DM,Smoot RL,Cleary SP,Graham RP,Goenka AH,Hallemeier CL,Haddock MG,Harmsen WS,Mahipal A,McWilliams RR,Halfdanarson TR,Grothey AF

    更新日期:2021-02-01 00:00:00

  • Subtotal versus total gastrectomy for gastric cancer: five-year survival rates in a multicenter randomized Italian trial. Italian Gastrointestinal Tumor Study Group.

    abstract:OBJECTIVE:To evaluate the impact of subtotal (SG) versus total (TG) gastrectomy on the oncologic outcome of patients with cancer of the distal stomach from 28 Italian institutions. SUMMARY BACKGROUND DATA:There is controversy over whether SG and TG have a different impact on the 5-year survival probability of patients...

    journal_title:Annals of surgery

    pub_type: 临床试验,杂志文章,多中心研究,随机对照试验

    doi:10.1097/00000658-199908000-00006

    authors: Bozzetti F,Marubini E,Bonfanti G,Miceli R,Piano C,Gennari L

    更新日期:1999-08-01 00:00:00

  • Prospective Phase II Trials Validate the Effect of Neoadjuvant Chemotherapy on Pattern of Recurrence in Pancreatic Adenocarcinoma.

    abstract:OBJECTIVE:The objective of this study was to characterize the patterns of first recurrence after curative-intent resection for pancreatic adenocarcinoma (PDAC). SUMMARY BACKGROUND DATA:We evaluated the first site of recurrence after neoadjuvant treatment as locoregional (LR) or distant metastasis (DM). To validate our...

    journal_title:Annals of surgery

    pub_type: 杂志文章

    doi:10.1097/SLA.0000000000004585

    authors: Chawla A,Qadan M,Castillo CF,Wo JY,Allen JN,Clark JW,Murphy JE,Catalano OA,Ryan DP,Ting DT,Deshpande V,Weekes CD,Parikh A,Lillemoe KD,Hong TS,Ferrone CR

    更新日期:2020-10-19 00:00:00

  • Cytology of peritoneal lavage performed during staging laparoscopy for gastrointestinal malignancies: is it useful?

    abstract:OBJECTIVE:To evaluate the potential benefit of cytology of the peritoneal lavage obtained during diagnostic laparoscopy for staging gastrointestinal (GI) malignancies. SUMMARY BACKGROUND DATA:Peritoneal lavage is a simple procedure that can be performed during laparotomy for GI tumors. Tumor cells in the lavage fluid ...

    journal_title:Annals of surgery

    pub_type: 杂志文章

    doi:10.1097/00000658-199812000-00002

    authors: Nieveen van Dijkum EJ,Sturm PD,de Wit LT,Offerhaus J,Obertop H,Gouma DJ

    更新日期:1998-12-01 00:00:00

  • Weekday of Esophageal Cancer Surgery and Its Relation to Prognosis.

    abstract:OBJECTIVE:To assess whether weekday of surgery influences long-term survival in esophageal cancer. BACKGROUND:Increased 30-day mortality rates have been reported in patients undergoing elective surgery later compared with earlier in the week. METHODS:This population-based cohort study included 98% of all esophageal c...

    journal_title:Annals of surgery

    pub_type: 杂志文章

    doi:10.1097/SLA.0000000000001324

    authors: Lagergren J,Mattsson F,Lagergren P

    更新日期:2016-06-01 00:00:00

  • TransCarotid Revascularization with Dynamic Flow reversal versus Carotid Endarterectomy in the Vascular Quality Initiative Surveillance Project.

    abstract:OBJECTIVE:To compare the outcomes of TransCarotid Artery Revascularization with flow reversal (TCAR) to the gold standard carotid endarterectomy (CEA) using data from the Society for Vascular Surgery Vascular Quality Initiative TCAR Surveillance Project. SUMMARY BACKGROUND DATA:TCAR is a novel minimally invasive proce...

    journal_title:Annals of surgery

    pub_type: 杂志文章

    doi:10.1097/SLA.0000000000004496

    authors: Malas MB,Dakour-Aridi H,Kashyap VS,Eldrup-Jorgensen J,Wang GJ,Motaganahalli RL,Cronenwett JL,Schermerhorn ML

    更新日期:2020-09-15 00:00:00

  • Biostatistical basis of elective node dissection for malignant melanoma.

    abstract::During the years 1954 through 1964, 259 individuals with primary malignant melanoma had an elective node dissection. Microscopic metastases were found in 15% of these patients. The presence of only a microscopic focus of involvement gave a 10-year cure rate of 67%; metastasis larger than a microscopic focus in a singl...

    journal_title:Annals of surgery

    pub_type: 杂志文章

    doi:10.1097/00000658-197707000-00014

    authors: Fortner JG,Woodruff J,Schottenfeld D,Maclean B

    更新日期:1977-07-01 00:00:00

  • Cytokine modulation of Na(+)-dependent glutamine transport across the brush border membrane of monolayers of human intestinal Caco-2 cells.

    abstract::Previous studies have demonstrated that Na(+)-dependent brush border glutamine transport is diminished in septic patients. To examine the potential regulation of this decreased transport by endotoxin, cytokines, or glucocorticoids, the human intestinal Caco-2 cell line was studied in vitro. Na(+)-dependent glutamine t...

    journal_title:Annals of surgery

    pub_type: 杂志文章

    doi:10.1097/00000658-199205000-00017

    authors: Souba WW,Copeland EM

    更新日期:1992-05-01 00:00:00

  • Ileal pouch-anal anastomosis: comparison of results in familial adenomatous polyposis and chronic ulcerative colitis.

    abstract::The aim of this study was to compare the immediate postoperative results and the long-term outcome of ileal pouch-anal anastomosis in 94 patients with familial adenomatous polyposis to those in 758 patients with ulcerative colitis. Two colitis patients died after operation (0.3%), but no polyposis patients died. Overa...

    journal_title:Annals of surgery

    pub_type: 杂志文章

    doi:10.1097/00000658-198909000-00002

    authors: Dozois RR,Kelly KA,Welling DR,Gordon H,Beart RW Jr,Wolff BG,Pemberton JH,Ilstrup DM

    更新日期:1989-09-01 00:00:00

  • Transferability of Liver Transplantation Experience to Complex Liver Resection for Locally Advanced Hepatobiliary Malignancy - Lessons Learnt From 3 Decades of Single Center Experience.

    abstract:OBJECTIVE:To study the impact of LT experience on the outcome of CLR for locally advanced hepatobiliary malignancy SUMMARY OF BACKGROUND DATA:: Despite evolution in LT knowledge and surgical techniques in the past decades, there is yet data to evaluate the significance of LT experience in performing CLR. METHODS:Posto...

    journal_title:Annals of surgery

    pub_type: 杂志文章

    doi:10.1097/SLA.0000000000004227

    authors: Chan ACY,Chok KSH,Dai J,Tsang SHY,Cheung TT,Poon R,Fan ST,Lo CM

    更新日期:2020-07-09 00:00:00

  • Cytology adds value to imaging studies for risk assessment of malignancy in pancreatic mucinous cysts.

    abstract:OBJECTIVE:Evaluate the value of cytology relative to imaging features in risk assessment for malignancy as defined in the Sendai Guidelines. BACKGROUND:The Sendai Guidelines list symptoms, cyst size >30 mm, dilated main pancreatic duct (MPD) >6 mm, mural nodule (MN) and "positive" cytology as high risk stigmata for ma...

    journal_title:Annals of surgery

    pub_type: 杂志文章

    doi:10.1097/SLA.0b013e3182383118

    authors: Genevay M,Mino-Kenudson M,Yaeger K,Konstantinidis IT,Ferrone CR,Thayer S,Castillo CF,Sahani D,Bounds B,Forcione D,Brugge WR,Pitman MB

    更新日期:2011-12-01 00:00:00

  • Alterations in gut hormones after laparoscopic sleeve gastrectomy: a prospective clinical and laboratory investigational study.

    abstract:OBJECTIVE:To evaluate the effect of laparoscopic sleeve gastrectomy (LSG) on fasting and meal-stimulated release of the gut hormones ghrelin, pancreatic polypeptide (PP), peptide-YY (PYY), glucagon-like peptide-1 (GLP-1), and amylin and of the adipocytokine leptin. BACKGROUND:Mounting evidence suggests that the mechan...

    journal_title:Annals of surgery

    pub_type: 杂志文章

    doi:10.1097/SLA.0b013e31826e1846

    authors: Dimitriadis E,Daskalakis M,Kampa M,Peppe A,Papadakis JA,Melissas J

    更新日期:2013-04-01 00:00:00

  • Pathogenesis of paralytic ileus: intestinal manipulation opens a transient pathway between the intestinal lumen and the leukocytic infiltrate of the jejunal muscularis.

    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

    authors: Schwarz NT,Beer-Stolz D,Simmons RL,Bauer AJ

    更新日期:2002-01-01 00:00:00

  • Mucosal damage in the esophageal remnant after esophagectomy and gastric transposition.

    abstract:OBJECTIVE:To assess development of mucosal damage in the esophageal remnant in regard to the level of the esophagogastrostomy reconstruction either in a right chest or in a left neck position. SUMMARY BACKGROUND DATA:Esophagectomy with gastric interposition creates an in vivo human model of pathologic esophageal reflu...

    journal_title:Annals of surgery

    pub_type: 杂志文章

    doi:10.1097/SLA.0b013e31818eec06

    authors: D'Journo XB,Martin J,Rakovich G,Brigand C,Gaboury L,Ferraro P,Duranceau A

    更新日期:2009-02-01 00:00:00

  • Pancreatic reg gene expression is inhibited during cellular differentiation.

    abstract:BACKGROUND AND OBJECTIVE:Factors that control pancreatic regenerating (reg I) gene expression are unknown, but it is believed that its expression may correspond with cellular differentiation. The authors recently demonstrated that reg I is expressed in AR42J, a rat acinar cell line whose state of differentiation can be...

    journal_title:Annals of surgery

    pub_type: 杂志文章

    doi:10.1097/00000658-199703000-00013

    authors: Zenilman ME,Magnuson TH,Perfetti R,Chen J,Shuldiner AR

    更新日期:1997-03-01 00:00:00

  • The gastrointestinal tract. The "undrained abscess" of multiple organ failure.

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    journal_title:Annals of surgery

    pub_type: 杂志文章

    doi:10.1097/00000658-199308000-00001

    authors: Marshall JC,Christou NV,Meakins JL

    更新日期:1993-08-01 00:00:00

  • Prospective, randomized, multicenter, controlled trial of a bioartificial liver in treating acute liver failure.

    abstract:OBJECTIVE:The HepatAssist liver support system is an extracorporeal porcine hepatocyte-based bioartificial liver (BAL). The safety and efficacy of the BAL were evaluated in a prospective, randomized, controlled, multicenter trial in patients with severe acute liver failure. SUMMARY BACKGROUND DATA:In experimental anim...

    journal_title:Annals of surgery

    pub_type: 临床试验,杂志文章,多中心研究,随机对照试验

    doi:10.1097/01.sla.0000124298.74199.e5

    authors: Demetriou AA,Brown RS Jr,Busuttil RW,Fair J,McGuire BM,Rosenthal P,Am Esch JS 2nd,Lerut J,Nyberg SL,Salizzoni M,Fagan EA,de Hemptinne B,Broelsch CE,Muraca M,Salmeron JM,Rabkin JM,Metselaar HJ,Pratt D,De La Mata M,Mc

    更新日期:2004-05-01 00:00:00

  • The comparative effectiveness of surgeons over interventionalists in endovascular repairs of abdominal aortic aneurysm.

    abstract:OBJECTIVE:Comparative effectiveness research has mostly been focused on comparison of treatment techniques. The goal of the present study was to extend the research to physician specialty. BACKGROUND:Both surgeons and interventionalists (cardiologists and radiologists) are involved in endovascular repairs (EVAR) of ao...

    journal_title:Annals of surgery

    pub_type: 杂志文章

    doi:10.1097/SLA.0b013e3182a196b5

    authors: McCutcheon BA,Talamini MA,Chang DC,Rose JA,Bandyk DF,Wilson SE

    更新日期:2013-09-01 00:00:00

  • Sentinel node skills verification and surgeon performance: data from a multicenter clinical trial for early-stage breast cancer.

    abstract:OBJECTIVE:Marked variations in sentinel lymph node dissection (SLND) technique have been identified, and definitive qualifications for SLND performance remain controversial. Based on previous reports and expert opinion, we predicted that 20 to 30 cases of SLND with axillary lymph node dissection (ALND) would enable sur...

    journal_title:Annals of surgery

    pub_type: 临床试验,杂志文章,多中心研究

    doi:10.1097/01.sla.0000184210.68646.77

    authors: Posther KE,McCall LM,Blumencranz PW,Burak WE Jr,Beitsch PD,Hansen NM,Morrow M,Wilke LG,Herndon JE 2nd,Hunt KK,Giuliano AE

    更新日期:2005-10-01 00:00:00

  • The comparative influence of prophylactic antibiotics on the prothrombin response to warfarin in the postoperative prosthetic cardiac valve patient. Cefamandole, cefazolin, vancomycin.

    abstract::A prospective randomized trial was conducted comparing the effect of three antibiotics: cefamandole (CM), cefazolin (CZ), and vancomycin (V), used as prophylaxis for prosthetic valve surgery, on the prothrombin (PT) response to warfarin (W) on the third day of anticoagulant therapy. Twenty patients, with normal preope...

    journal_title:Annals of surgery

    pub_type: 临床试验,杂志文章,随机对照试验

    doi:10.1097/00000658-198708000-00007

    authors: Angaran DM,Dias VC,Arom KV,Northrup WF,Kersten TG,Lindsay WG,Nicoloff DM

    更新日期:1987-08-01 00:00:00