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 Surgjournal_title
Annals of surgeryauthors
Robertson CS,Chung SC,Woods SD,Griffin SM,Raimes SA,Lau JT,Li AKdoi
10.1097/00000658-199408000-00009subject
Has Abstractpub_date
1994-08-01 00:00:00pages
176-82issue
2eissn
0003-4932issn
1528-1140journal_volume
220pub_type
临床试验,杂志文章,随机对照试验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
更新日期:2004-11-01 00:00:00
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
更新日期:2000-02-01 00:00:00
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
更新日期:2019-09-01 00:00:00
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
更新日期:2020-05-01 00:00:00
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
更新日期:2010-09-01 00:00:00
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
更新日期:1978-09-01 00:00:00
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
更新日期:2020-08-01 00:00:00
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
更新日期:2020-11-13 00:00:00
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
更新日期:1991-12-01 00:00:00
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
更新日期:1985-03-01 00:00:00
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
更新日期:2021-02-01 00:00:00
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
更新日期:1999-08-01 00:00:00
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
更新日期:2020-10-19 00:00:00
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
更新日期:1998-12-01 00:00:00
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
更新日期:2016-06-01 00:00:00
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
更新日期:2020-09-15 00:00:00
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
更新日期:1977-07-01 00:00:00
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
更新日期:1992-05-01 00:00:00
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
更新日期:1989-09-01 00:00:00
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
更新日期:2020-07-09 00:00:00
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
更新日期:2011-12-01 00:00:00
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
更新日期:2013-04-01 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: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
更新日期:2009-02-01 00:00:00
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
更新日期:1997-03-01 00:00:00
abstract:OBJECTIVE:This study determined the association between proximal gastrointestinal (GI) colonization and the development of intensive care unit (ICU)-acquired infection and multiple organ failure (MOF) in a population of critically ill surgical patients. SUMMARY BACKGROUND DATA:ICU-acquired infection in association wit...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-199308000-00001
更新日期:1993-08-01 00:00:00
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
更新日期:2004-05-01 00:00:00
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
更新日期:2013-09-01 00:00:00
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
更新日期:2005-10-01 00:00:00
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
更新日期:1987-08-01 00:00:00