Effect of resection margins on the recurrence of Crohn's disease in the small bowel. A randomized controlled trial.

Abstract:

OBJECTIVE:The authors assess the effect of surgical margin width on recurrence rates after intestinal resection of Crohn's Disease (CD). BACKGROUND:The optimal width of margins when resecting DC of the small bowel is controversial. Most studies have been retrospective and have had conflicting results. METHODS:Patients undergoing ileocolic resection for CD (N = 152) were randomly assigned to two groups in which the proximal line of resection was 2 cm (limited resection) or 12 cm (extended resection) from the macroscopically involved area. Patients also were classified by whether the margin of resection was microscopically normal (category 1), contained nonspecific changes (category 2), were suggestive but not diagnostic for CD (category 3), or were diagnostic for CD (category 4). Recurrence was defined as reoperation for recurrent preanastomotic disease. RESULTS:Data were collected on 131 patients. Median follow-up time was 55.7 months. Disease recurred in 29 patients: 25% of patients in the limited resection group and 18% of patients in the extended resection group. In the 90 patients in category 1 with normal tissue, recurrence occurred in 16, whereas in the 41 patients with some degree of microscopic involvement, recurrence occurred in 13. Recurrence rates were 36% in category 2, 39% in category 3, and 21% in category 4. No group differences were statistically at the 0.01 level. CONCLUSION:Recurrence of CD is unaffected by the width of the margin of resection from macroscopically involved bowel. Recurrence rates also do not increase when microscopic CD is present at the resection margins. Therefore, extensive resection margins are unnecessary.

journal_name

Ann Surg

journal_title

Annals of surgery

authors

Fazio VW,Marchetti F,Church M,Goldblum JR,Lavery C,Hull TL,Milsom JW,Strong SA,Oakley JR,Secic M

doi

10.1097/00000658-199610000-00014

subject

Has Abstract

pub_date

1996-10-01 00:00:00

pages

563-71; discussion 571-3

issue

4

eissn

0003-4932

issn

1528-1140

journal_volume

224

pub_type

临床试验,杂志文章,随机对照试验
  • Michelassi II Strictureplasty for Crohn's Disease: A New Side-to-Side Isoperistaltic Strictureplasty With Discontinuous Bowel Loops.

    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

    authors: Mege D,Michelassi F

    更新日期:2020-01-01 00:00:00

  • Is ambulatory laparoscopic Roux-en-Y gastric bypass associated with higher adverse events?

    abstract:OBJECTIVE:To determine the impact of length of stay upon 30-day outcomes. BACKGROUND:It has been recommended the goal length of stay (LOS) after laparoscopic Roux-en-Y gastric bypass (LRYGB) should be 1 day to improve resource utilization. This study's aim was to assess LRYGB outcomes by LOS. METHODS:Data were obtain...

    journal_title:Annals of surgery

    pub_type: 杂志文章

    doi:10.1097/SLA.0000000000000227

    authors: Morton JM,Winegar D,Blackstone R,Wolfe B

    更新日期:2014-02-01 00:00:00

  • The long-term outcome of Billroth I partial gastrectomy for benign gastric ulcer.

    abstract::A study was done of 144 patients undergoing Billroth I partial gastrectomy for benign gastric ulcer. At a mean follow-up of 9.4 years, 95 patients were alive. Of 79 patients reviewed, 84% had an excellent or good result on clinical (Visick) grading. Five cases of proven recurrent ulceration were found; two of these pa...

    journal_title:Annals of surgery

    pub_type: 杂志文章

    doi:10.1097/00000658-198202000-00012

    authors: Thomas WE,Thompson MH,Williamson RC

    更新日期:1982-02-01 00:00:00

  • The inhibition of aldose reductase attenuates hepatic ischemia-reperfusion injury through reducing inflammatory response.

    abstract:OBJECTIVE:We aim to investigate the role of aldose reductase (AR) in hepatic ischemia-reperfusion injury (IRI) of normal and fatty livers and to explore the underlying mechanisms. BACKGROUND:Hepatic IRI is a typical inflammatory response during liver surgery. It contributes to liver graft failure or nonfunction after ...

    journal_title:Annals of surgery

    pub_type: 杂志文章

    doi:10.1097/SLA.0000000000000429

    authors: Li CX,Ng KT,Shao Y,Liu XB,Ling CC,Ma YY,Geng W,Qi X,Cheng Q,Chung SK,Lo CM,Man K

    更新日期:2014-08-01 00:00:00

  • Survival and function of hepatocytes on a novel three-dimensional synthetic biodegradable polymer scaffold with an intrinsic network of channels.

    abstract:OBJECTIVE:To evaluate the survival and function of hepatocytes (HCs) on a novel three-dimensional (3D) synthetic biodegradable polymer scaffold with an intrinsic network of interconnected channels under continuous flow conditions. SUMMARY BACKGROUND DATA:The authors' laboratory has investigated HC transplantation usin...

    journal_title:Annals of surgery

    pub_type: 杂志文章

    doi:10.1097/00000658-199807000-00002

    authors: Kim SS,Utsunomiya H,Koski JA,Wu BM,Cima MJ,Sohn J,Mukai K,Griffith LG,Vacanti JP

    更新日期:1998-07-01 00:00:00

  • Surgical strategy for hilar cholangiocarcinoma of the left-side predominance: current role of left trisectionectomy.

    abstract:OBJECTIVE:To evaluate recent surgical strategy for hilar cholangiocarcinoma (HC) of the left-side predominance. BACKGROUND:When employing left hemihepatectomy (LH) for HC, vasculobiliary anatomy of the right liver often makes it difficult to achieve a tumor-free margin of the right posterior sectional bile duct (RPSBD...

    journal_title:Annals of surgery

    pub_type: 杂志文章

    doi:10.1097/SLA.0000000000000584

    authors: Hosokawa I,Shimizu H,Yoshidome H,Ohtsuka M,Kato A,Yoshitomi H,Miyazaki M

    更新日期:2014-06-01 00:00:00

  • Impact of statistical approaches for handling missing data on trauma center quality.

    abstract:OBJECTIVE:To determine whether imputed data can be used to produce unbiased hospital quality measures. BACKGROUND:Different methods for handling missing data may influence which hospitals are designated as quality outliers. METHODS:Monte-Carlo simulation study based on 63,020 patients with no missing data in 68 hospi...

    journal_title:Annals of surgery

    pub_type: 杂志文章

    doi:10.1097/SLA.0b013e31818e544b

    authors: Glance LG,Osler TM,Mukamel DB,Meredith W,Dick AW

    更新日期:2009-01-01 00:00:00

  • Long-term survival after pancreatoduodenectomy for pancreatic adenocarcinoma: is cure possible?

    abstract:OBJECTIVE:To determine long-term survival after pancreatoduodenectomy for pancreatic ductal adenocarcinoma and to identify clinical factors associated with long-term survival. SUMMARY BACKGROUND DATA:The prognosis for long-term survival even after potentially curative resection for pancreatic adenocarcinoma is thought...

    journal_title:Annals of surgery

    pub_type: 杂志文章

    doi:10.1097/SLA.0b013e3181613142

    authors: Schnelldorfer T,Ware AL,Sarr MG,Smyrk TC,Zhang L,Qin R,Gullerud RE,Donohue JH,Nagorney DM,Farnell MB

    更新日期:2008-03-01 00:00:00

  • Prognostic significance of DNA replication errors in young patients with colorectal cancer.

    abstract:OBJECTIVE:To determine the DNA replication error (RER) status in young patients with colorectal cancer (CRC), and to compare the clinical and pathologic characteristics of RER-positive and RER-negative cases. SUMMARY BACKGROUND DATA:Recent studies suggest that patients with RER-positive CRC have an improved prognosis....

    journal_title:Annals of surgery

    pub_type: 杂志文章

    doi:10.1097/00000658-199801000-00008

    authors: Lukish JR,Muro K,DeNobile J,Katz R,Williams J,Cruess DF,Drucker W,Kirsch I,Hamilton SR

    更新日期:1998-01-01 00:00:00

  • Comparative Effectiveness and Risks of Bowel Preparation Before Elective Colorectal Surgery.

    abstract:OBJECTIVE:The objective of this study was to determine the relationship between bowel preparation and surgical site infections (SSIs), and also other postoperative complications, after elective colorectal surgery. BACKGROUND:SSI is a major source of postoperative morbidity/costs after colorectal surgery. The value of ...

    journal_title:Annals of surgery

    pub_type: 杂志文章

    doi:10.1097/SLA.0000000000002159

    authors: Koller SE,Bauer KW,Egleston BL,Smith R,Philp MM,Ross HM,Esnaola NF

    更新日期:2018-04-01 00:00:00

  • Hyperparathyroidism associated with the enlargement of two or three parathyroid glands.

    abstract::Eighty-five (23%) of 375 patients undergoing surgery for primary hyperparathyroidism were found to have enlargement (greater than 50 mg) of two or three parathyroid glands. Of 76 patients followed from 12 to 140 months after surgery, eight (10.5%) developed hypercalcemia at 1, 4, 45, 64, 74, 79, 84, and 133 months. In...

    journal_title:Annals of surgery

    pub_type: 杂志文章

    doi:10.1097/00000658-198511000-00001

    authors: Wells SA Jr,Leight GS,Hensley M,Dilley WG

    更新日期:1985-11-01 00:00:00

  • The impact of neural invasion severity in gastrointestinal malignancies: a clinicopathological study.

    abstract:OBJECTIVES:Because neural invasion (NI) is still inconsistently reported and not well characterized within gastrointestinal malignancies (GIMs), our aim was to determine the exact prevalence and severity of NI and to elucidate the true impact of NI on patient's prognosis. BACKGROUND:The union internationale contre le ...

    journal_title:Annals of surgery

    pub_type: 杂志文章

    doi:10.1097/SLA.0000000000000968

    authors: Liebl F,Demir IE,Mayer K,Schuster T,DʼHaese JG,Becker K,Langer R,Bergmann F,Wang K,Rosenberg R,Novotny AR,Feith M,Reim D,Friess H,Ceyhan GO

    更新日期:2014-11-01 00:00:00

  • Pathologic complete response of primary tumor following preoperative chemoradiotherapy for locally advanced rectal cancer: long-term outcomes and prognostic significance of pathologic nodal status (KROG 09-01).

    abstract:OBJECTIVE:To investigate long-term outcomes of locally advanced rectal cancer (LARC) patients with postchemoradiotherapy (post-CRT) pathologic complete response of primary tumor (ypT0) and determine prognostic significance of post-CRT pathologic nodal (ypN) status. BACKGROUND:LARC patients with post-CRT pathologic com...

    journal_title:Annals of surgery

    pub_type: 杂志文章

    doi:10.1097/SLA.0b013e3181f3f1b1

    authors: Yeo SG,Kim DY,Kim TH,Chang HJ,Oh JH,Park W,Choi DH,Nam H,Kim JS,Cho MJ,Kim JH,Park JH,Kang MK,Koom WS,Kim JS,Nam TK,Chie EK,Kim JS,Lee KJ

    更新日期:2010-12-01 00:00:00

  • Blunt intestinal trauma. A modern-day review.

    abstract::During the 5-year period from January 1978 through December 1982, 196 patients with blunt trauma to the small bowel, colon, or mesentery were treated at the Maryland Institute for Emergency Medical Services Systems (MIEMSS) Shock Trauma Center. More than 80% of these patients were the victims of motor vehicle accident...

    journal_title:Annals of surgery

    pub_type: 杂志文章

    doi:10.1097/00000658-198502000-00011

    authors: Dauterive AH,Flancbaum L,Cox EF

    更新日期:1985-02-01 00:00:00

  • Lack of preoperative enteral nutrition reduces gut-associated lymphoid cell numbers in colon cancer patients: a possible mechanism underlying increased postoperative infectious complications during parenteral nutrition.

    abstract:OBJECTIVE:To examine preoperative dietary influences on gut-associated lymphoid tissue (GALT) cell number in the context of postoperative infectious complications. BACKGROUND:There is little clinical evidence regarding whether nutritional routes affect GALT size and/or phenotype. The influence of GALT atrophy on clini...

    journal_title:Annals of surgery

    pub_type: 杂志文章

    doi:10.1097/SLA.0b013e31827a0e05

    authors: Okamoto K,Fukatsu K,Hashiguchi Y,Ueno H,Shinto E,Moriya T,Saitoh D,Yamamoto J,Hase K

    更新日期:2013-12-01 00:00:00

  • Going the Extra Mile: Improved Survival for Pancreatic Cancer Patients Traveling to High-volume Centers.

    abstract:OBJECTIVE:This study compares outcomes following pancreaticoduodenectomy (PD) for patients treated at local, low-volume centers and those traveling to high-volume centers. BACKGROUND:Although outcomes for PD are superior at high-volume institutions, not all patients live in proximity to major medical centers. Theoreti...

    journal_title:Annals of surgery

    pub_type: 杂志文章

    doi:10.1097/SLA.0000000000001924

    authors: Lidsky ME,Sun Z,Nussbaum DP,Adam MA,Speicher PJ,Blazer DG 3rd

    更新日期:2017-08-01 00:00:00

  • Subareolar versus peritumoral injection for location of the sentinel lymph node.

    abstract:BACKGROUND:Sentinel lymph node (SLN) biopsy is fast becoming the standard for testing lymph node involvement in many institutions. However, questions remain as to the best method of injection. The authors hypothesized that a subareolar injection of material would drain to the same lymph node as a peritumoral injection,...

    journal_title:Annals of surgery

    pub_type: 临床试验,杂志文章

    doi:10.1097/00000658-199906000-00013

    authors: Klimberg VS,Rubio IT,Henry R,Cowan C,Colvert M,Korourian S

    更新日期:1999-06-01 00:00:00

  • Use of extended criteria livers decreases wait time for liver transplantation without adversely impacting posttransplant survival.

    abstract:INTRODUCTION:The use of extended criteria donors (ECDs) could minimize shortage of suitable donor livers for transplantation. In 3 years, the aggressive use of ECD livers has reduced the wait list at our center from 257 to 30 patients with a median wait time of 18 days without using living donors. This study compares t...

    journal_title:Annals of surgery

    pub_type: 杂志文章

    doi:10.1097/01.sla.0000234896.18207.fa

    authors: Tector AJ,Mangus RS,Chestovich P,Vianna R,Fridell JA,Milgrom ML,Sanders C,Kwo PY

    更新日期:2006-09-01 00:00:00

  • Twenty-five-year follow-up for liver resection: the personal series of Dr. Joseph G. Fortner.

    abstract:BACKGROUND:Liver resection is performed for many types of malignancies. Few reports document actual long-term survival. METHODS:Long-term follow-up of a series of 548 liver resections performed between 1970 and 1992 was performed and is presented. RESULTS:All patients were followed for at least 15 years after surgery...

    journal_title:Annals of surgery

    pub_type: 杂志文章

    doi:10.1097/SLA.0b013e3181b59491

    authors: Fortner JG,Fong Y

    更新日期:2009-12-01 00:00:00

  • How Much Weight Loss is Required for Cardiovascular Benefits? Insights From a Metabolic Surgery Matched-cohort Study.

    abstract:OBJECTIVE:The aim of this study was to determine the minimum amount of weight loss required to see a reduction in major adverse cardiovascular events (MACE). BACKGROUND:Although obesity is an established risk factor for morbidity and mortality, the minimum amount of weight loss to have a meaningful impact on cardiovas...

    journal_title:Annals of surgery

    pub_type: 杂志文章

    doi:10.1097/SLA.0000000000004369

    authors: Aminian A,Zajichek A,Tu C,Wolski KE,Brethauer SA,Schauer PR,Kattan MW,Nissen SE

    更新日期:2020-10-01 00:00:00

  • A prospective pathologic analysis using whole-mount sections of rectal cancer following preoperative combined modality therapy: implications for sphincter preservation.

    abstract:OBJECTIVE:The aims of this study were to use a comprehensive whole-mount pathologic analysis to characterize microscopic patterns of residual disease, as well as circumferential and distal resection margins, in rectal cancer treated with preoperative CMT; and to identify clinicopathologic factors associated with residu...

    journal_title:Annals of surgery

    pub_type: 杂志文章

    doi:10.1097/01.sla.0000232540.82364.43

    authors: Guillem JG,Chessin DB,Shia J,Suriawinata A,Riedel E,Moore HG,Minsky BD,Wong WD

    更新日期:2007-01-01 00:00:00

  • Total parathyroidectomy with forearm autograft for secondary hyperparathyroidism in chronic renal failure.

    abstract::One hundred twenty-eight patients with chronic renal failure and secondary hyperparathyroidism underwent total parathyroidectomy with forearm autograft. Postoperative clinical improvement was remarkable. In all cases, the grafted tissue functioned well, and reimplantation of the cryopreserved parathyroid tissues was u...

    journal_title:Annals of surgery

    pub_type: 杂志文章

    doi:10.1097/00000658-198811000-00016

    authors: Takagi H,Tominaga Y,Tanaka Y,Uchida K,Orihara A,Yamada N,Kawai M,Hayashi S,Taira N,Kano T

    更新日期:1988-11-01 00:00:00

  • Surgical aspects of sclerosing cholangitis. Results in 178 patients.

    abstract::Of 178 patients with sclerosing cholangitis treated since 1950, 88 patients had associated inflammatory bowel disease, 72 had no such history, and 18 had iatrogenic injury or stone disease. A total of 233 biliary operations were performed, with a 75% rate of temporary improvement after initial operation. Subsequent op...

    journal_title:Annals of surgery

    pub_type: 杂志文章

    doi:10.1097/00000658-199010000-00017

    authors: Martin FM,Rossi RL,Nugent FW,Scholz FJ,Jenkins RL,Lewis WD,Gagner M,Foley E,Braasch JW

    更新日期:1990-10-01 00:00:00

  • Significance of Examined Lymph Node Number in Accurate Staging and Long-term Survival in Resected Stage I-II Pancreatic Cancer-More is Better? A Large International Population-based Cohort Study.

    abstract:OBJECTIVE:This large international cohort study aimed to investigate the associations of examined lymph node (ELN) number with accurate staging and long-term survival in pancreatic adenocarcinoma (PaC) and to robustly determine the minimal and optimal ELN thresholds. SUMMARY BACKGROUND DATA:ELN number is an important ...

    journal_title:Annals of surgery

    pub_type: 杂志文章

    doi:10.1097/SLA.0000000000003558

    authors: Huang L,Jansen L,Balavarca Y,van der Geest L,Lemmens V,Groot Koerkamp B,van Santvoort HC,Grützmann R,Besselink MG,Schrotz-King P,Brenner H

    更新日期:2019-08-13 00:00:00

  • Administration of balanced or BCAA-enriched amino acid solution in septic rats. Effects on protein synthesis in the liver.

    abstract::Total hepatic protein synthesis was measured in vivo with a flooding-dose technique, and the production of total secreted proteins, albumin, complement component C3, and seromucoid fraction was measured in perfused livers of septic rats that received one of three different solutions infused intravenously; Group 1 rece...

    journal_title:Annals of surgery

    pub_type: 杂志文章

    doi:10.1097/00000658-198812000-00007

    authors: Pedersen P,Li SJ,Hasselgren PO,LaFrance R,Fischer JE

    更新日期:1988-12-01 00:00:00

  • Effect of intravenous hyperalimentation on established delayed hypersensitivity in the cancer patient.

    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

    authors: Copeland EM,Fadyen BV Jr,Dudrick SJ

    更新日期:1976-07-01 00:00:00

  • The cost of not wearing seat belts. A comparison of outcome in 3396 patients.

    abstract::Data from the North Carolina Trauma Registry were analyzed to determine the effect of seat belt usage on outcome in motor vehicle accidents. Of 6237 persons involved in motor vehicle accidents, data on seat belt usage were available for 3396. Of these, 1916 were not and 1480 were wearing seat belts. The mean hospital ...

    journal_title:Annals of surgery

    pub_type: 杂志文章

    doi:10.1097/00000658-199302000-00005

    authors: Rutledge R,Lalor A,Oller D,Hansen A,Thomason M,Meredith W,Foil MB,Baker C

    更新日期:1993-02-01 00:00:00

  • Prolonged partial venoarterial bypass: physiologic, biochemical, and hematologic responses.

    abstract::Prolonged veno arterial extracorporeal bypass (50-80% of cardiac output) was evaluated in normal, unanesthetized sheep. The evaluation protocol included serial measurements of hemodynamics, pulmonary and renal function, serum enzymes to detect organ damage, and detailed studies of coagulation and platelets. Blood expo...

    journal_title:Annals of surgery

    pub_type: 杂志文章

    doi:10.1097/00000658-197412000-00010

    authors: Bartlett RH,Fong SW,Burns NE,Gazzaniga AB

    更新日期:1974-12-01 00:00:00

  • Total pancreatectomy with preservation of the duodenum and pylorus for chronic pancreatitis.

    abstract::In an effort to minimize the nutritional complications that follow resection of the pancreas for severe chronic pancreatitis, the authors have performed a duodenum-preserving total pancreatectomy in eight patients for severe unremitting pain requiring large doses of opiate analgesia. Good relief of pain was obtained i...

    journal_title:Annals of surgery

    pub_type: 杂志文章

    doi:10.1097/00000658-199111000-00007

    authors: Easter DW,Cuschieri A

    更新日期:1991-11-01 00:00:00

  • Activating KRAS mutations and overexpression of epidermal growth factor receptor as independent predictors in metastatic colorectal cancer patients treated with cetuximab.

    abstract:OBJECTIVE:Cetuximab, a monoclonal antibody targeting epidermal growth factor receptor (EGFR), has been proven to be efficient in metastatic colorectal cancer (mCRC); however, the therapeutic response is variable and markers predictive of response are urgently required. This study was conducted to determinate the predic...

    journal_title:Annals of surgery

    pub_type: 杂志文章

    doi:10.1097/SLA.0b013e3181bc9d96

    authors: Yen LC,Uen YH,Wu DC,Lu CY,Yu FJ,Wu IC,Lin SR,Wang JY

    更新日期:2010-02-01 00:00:00