Repeat hepatectomy for colorectal liver metastases.

Abstract:

OBJECTIVE:The authors assess the long-term results of repeat hepatectomies for recurrent metastases of colorectal cancer and determine the factors that can predict survival. SUMMARY BACKGROUND DATA:Safer techniques of hepatic resection have allowed surgeons to consider repeat hepatectomy for colorectal metastases in an increasing number of patients. However, higher operative bleeding and increased morbidity have been reported after repeat hepatectomies, and the long-term benefit of these procedures needs to be evaluated. STUDY POPULATION:Sixty-four patients from a group of 243 patients resected for colorectal liver metastases were submitted to 83 repeat hepatectomies (64 second, 15 third, and 4 fourth hepatectomies). Combined extrahepatic surgery was performed in 21 (25%) of these 83 repeat hepatectomies. RESULTS:There was no intraoperative or postoperative mortality. Operative bleeding was not significantly increased in repeat hepatectomies as compared to first resections. Morbidity and duration of hospital stay were comparable to first hepatectomies. Overall and disease-free survival after a second hepatectomy were 60% and 42%, respectively, at 3 years and 41% and 26%, respectively, at 5 years. Factors of prognostic value on univariate analysis included the curative nature of first and second hepatectomies (p = 0.04 and p = 0.002, respectively), an interval between the two procedures of more than 1 year (p = 0.003), the number of recurrent tumors (p = 0.002), serum carcinoembryonic antigen levels (p = 0.03), and the presence of extrahepatic disease (p = 0.03). Only the curative nature of the second hepatectomy and an interval of more than 1 year between the two procedures were independently related to survival on multivariate analysis. CONCLUSIONS:Repeat hepatectomies can provide long-term survival rates similar to those of first hepatectomies, with no mortality and comparable morbidity. Combined extrahepatic surgery can be required to achieve tumor eradication. Repeat hepatectomies appear worthwhile when potentially curative.

journal_name

Ann Surg

journal_title

Annals of surgery

authors

Adam R,Bismuth H,Castaing D,Waechter F,Navarro F,Abascal A,Majno P,Engerran L

doi

10.1097/00000658-199701000-00006

subject

Has Abstract

pub_date

1997-01-01 00:00:00

pages

51-60; discussion 60-2

issue

1

eissn

0003-4932

issn

1528-1140

journal_volume

225

pub_type

杂志文章
  • Effect of intravascular volume expansion on renal function during prolonged CO2 pneumoperitoneum.

    abstract:OBJECTIVE:To evaluate whether intravascular volume expansion would improve renal blood flow and function during prolonged CO2 pneumoperitoneum. SUMMARY BACKGROUND DATA:Although laparoscopic living donor nephrectomies have a considerably reduced risk of complications for the donors, significant concerns exist regarding...

    journal_title:Annals of surgery

    pub_type: 杂志文章

    doi:10.1097/00000658-200002000-00007

    authors: London ET,Ho HS,Neuhaus AM,Wolfe BM,Rudich SM,Perez RV

    更新日期:2000-02-01 00:00:00

  • Adenocarcinoma of the esophagus.

    abstract::Adenocarcinoma involving the distal esophagus usually is far advanced when the patient is first seen. Adenocarcinoma differs from squamous carcinoma of the esophagus since it is relatively unresponsive to radiation therapy or chemotherapy. Adenocarcinoma of the esophagus resembles gastric cancer in its tendency to for...

    journal_title:Annals of surgery

    pub_type: 杂志文章

    doi:10.1097/00000658-198705000-00015

    authors: Mahoney JL,Condon RE

    更新日期:1987-05-01 00:00:00

  • Studies on the possible role of thyroid hormone in altered muscle protein turnover during sepsis.

    abstract::Five days after thyroidectomy (Tx) or sham-Tx in young male Sprague-Dawley rats, sepsis was induced by cecal ligation and puncture (CLP). Control animals underwent laparotomy and manipulation of the cecum without ligation or puncture. Sixteen hours after CLP or laparotomy, protein synthesis and degradation were measur...

    journal_title:Annals of surgery

    pub_type: 杂志文章

    doi:10.1097/00000658-198707000-00003

    authors: Hasselgren PO,Chen IW,James JH,Sperling M,Warner BW,Fischer JE

    更新日期:1987-07-01 00:00:00

  • Subclassification of Microscopic Vascular Invasion in Hepatocellular Carcinoma.

    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

    authors: Kang I,Jang M,Lee JG,Han DH,Joo DJ,Kim KS,Kim MS,Choi JS,Kim SI,Park YN,Choi GH

    更新日期:2020-01-14 00:00:00

  • Hyperthermic pelvic perfusion with tumor necrosis factor-α for locally advanced cancers: encouraging results of a phase II study.

    abstract:PURPOSE:To assess the efficacy of isolated pelvic perfusion (IPP) with tumor necrosis factor (TNF)-α and melphalan in patients with locally advanced cancers in the pelvic and groin area requiring mutilating surgery. METHODS:A total of 27 patients were enrolled (carcinoma, n = 17; sarcoma/melanoma, n = 4; and endocrine...

    journal_title:Annals of surgery

    pub_type: 杂志文章

    doi:10.1097/SLA.0b013e318242ebe7

    authors: Bonvalot S,de Baere T,Mendiboure J,Paci A,Farace F,Drouard-Troalen L,Bonnet L,Hakime A,Bonniaud G,Raynard B,Israel P,Le Cesne A,Eggermont AM,Laplanche A,Muret J

    更新日期:2012-02-01 00:00:00

  • The impact of prophylactic total gastrectomy on health-related quality of life: a prospective cohort study.

    abstract:BACKGROUND:The advice to individuals with identified CDH1 mutations is generally to undertake prophylactic total gastrectomy (PTG). This study evaluated the effect of PTG on health-related quality of life (HRQL) in asymptomatic individuals with identified CDH1 mutations at high risk for gastric cancer. METHODS:Individ...

    journal_title:Annals of surgery

    pub_type: 杂志文章,多中心研究

    doi:10.1097/SLA.0000000000000446

    authors: Worster E,Liu X,Richardson S,Hardwick RH,Dwerryhouse S,Caldas C,Fitzgerald RC

    更新日期:2014-07-01 00:00:00

  • Vasodilator prostaglandins (PG) prevent renal damage after ischemia.

    abstract::Thromboxane (Tx) synthase but not cyclo-oxygenase inhibitors prevent acute tubular necrosis (ATN) after renal ischemia, a phenomenon believed to be due to stimulation of the endogenous production of vasodilating prostaglandins (PG). This study directly tests that vasodilating PG protect against the consequences of ren...

    journal_title:Annals of surgery

    pub_type: 杂志文章

    doi:10.1097/00000658-198702000-00015

    authors: Kaufman RP Jr,Anner H,Kobzik L,Valeri CR,Shepro D,Hechtman HB

    更新日期:1987-02-01 00:00:00

  • Effect of optimization of hemodynamics on fibrinolytic activity and antithrombotic efficacy of external pneumatic calf compression.

    abstract::External pneumatic calf compression is effective but imperfect for antithrombotic prophylaxis in surgical patients. In preliminary studies, sequential filling of multisegmented leggings with graded pressure decreasing from ankle to knee increased venous flow velocity and wall shear stress, decreased residual venous vo...

    journal_title:Annals of surgery

    pub_type: 临床试验,杂志文章,随机对照试验

    doi:10.1097/00000658-198711000-00014

    authors: Salzman EW,McManama GP,Shapiro AH,Robertson LK,Donovan AS,Blume HW,Sweeney J,Kamm RD,Johnson MC,Black PM

    更新日期:1987-11-01 00:00:00

  • Laser surgery in exsanguinating liver injury.

    abstract::Thirty-two conditioned 15-18 kg dogs underwent laparotomy, heparinization, left lateral hepatic lobe injury and subsequent partial left lateral hepatic lobectomy. The hemostatic capabilities of the surgical scalpel combined with suture ligatures and stay sutures, the Bovie, and the CO2 laser were compared. The CO2 las...

    journal_title:Annals of surgery

    pub_type: 杂志文章

    doi:10.1097/00000658-197501000-00016

    authors: Fidler JP,Hoefer RW,Polanyi TG,Bredemeier HC,Siler VE,Altemeier WA

    更新日期:1975-01-01 00:00:00

  • Mental Skills in Surgery: Lessons Learned from Virtuosos, Olympians, and Navy Seals.

    abstract:OBJECTIVE:The present study investigated the role of mental skills in surgery through the unique lens of current surgeons who had previously served as Olympic athletes, elite musicians, or expert military personnel. BACKGROUND:Recent work has demonstrated great potential for mental skills training in surgery. However,...

    journal_title:Annals of surgery

    pub_type: 杂志文章

    doi:10.1097/SLA.0000000000003573

    authors: Deshauer S,McQueen S,Hammond Mobilio M,Mutabdzic D,Moulton CE

    更新日期:2019-08-28 00:00:00

  • Causes of short-term mortality after appendectomy: a population-based case-controlled study.

    abstract:OBJECTIVE:This case control study is a detailed analysis of the causes of death and the risk factors of short-term mortality after appendectomy. SUMMARY BACKGROUND DATA:Although death is a rare event after appendectomy, we found a 7-fold excess mortality after appendectomy overall and a 9-fold excess mortality after n...

    journal_title:Annals of surgery

    pub_type: 杂志文章

    doi:10.1097/SLA.0b013e31821ad9c4

    authors: Andersson MN,Andersson RE

    更新日期:2011-07-01 00:00:00

  • Histologic Subtype Defines the Risk and Kinetics of Recurrence and Death for Primary Extremity/Truncal Liposarcoma.

    abstract:OBJECTIVE:We sought to define the prognostic significance of histologic subtype for extremity/truncal liposarcoma (LPS). BACKGROUND:LPS, the most common sarcoma, is comprised of 5 histologic subtypes. Despite their distinct behaviors, LPS outcomes are frequently reported as a single entity. METHODS:We analyzed data o...

    journal_title:Annals of surgery

    pub_type: 杂志文章

    doi:10.1097/SLA.0000000000003453

    authors: Bartlett EK,Curtin CE,Seier K,Qin LX,Hameed M,Yoon SS,Crago AM,Brennan MF,Singer S

    更新日期:2019-07-05 00:00:00

  • Morbidity and mortality after pelvic exenteration for colorectal adenocarcinoma.

    abstract::A retrospective analysis was made of the complications from pelvic exenterations performed over the past 30 years for colorectal adenocarcinoma at the Roswell Park Cancer Institute. Seventy-five patients underwent exenteration, 51 for primary disease (PD) and 24 for recurrent disease (RD). Both total and posterior exe...

    journal_title:Annals of surgery

    pub_type: 杂志文章

    doi:10.1097/00000658-199201000-00009

    authors: Hafner GH,Herrera L,Petrelli NJ

    更新日期:1992-01-01 00:00:00

  • Trainee Involvement in Ivor Lewis Esophagectomy Does Not Negatively Impact Outcomes.

    abstract:OBJECTIVE:The aim of the present study was to determine whether trainee involvement in esophageal cancer resection is associated with adverse patient outcomes. BACKGROUND:Operative experience for surgical trainees is under threat. A number of factors have been implicated in this leading to fewer hours for training. Es...

    journal_title:Annals of surgery

    pub_type: 杂志文章

    doi:10.1097/SLA.0000000000002047

    authors: Phillips AW,Dent B,Navidi M,Immanuel A,Griffin SM

    更新日期:2018-01-01 00:00:00

  • Ileal pouch-anal anastomosis for chronic ulcerative colitis. Long-term results.

    abstract::The aim of this study was to determine the long-term outcome among 390 patients with ulcerative colitis who underwent ileal J pouch-anal anastomosis and whether patient or operative factors influenced results. The combined operative morbidity rate for the pouch-anal anastomosis and the subsequent closure of the tempor...

    journal_title:Annals of surgery

    pub_type: 杂志文章

    doi:10.1097/00000658-198710000-00011

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

    更新日期:1987-10-01 00:00:00

  • Integrative marker analysis allows risk assessment for metastasis in stage II colon cancer.

    abstract:OBJECTIVES:Individualized risk assessment in patients with UICC stage II colon cancer based on a panel of molecular genetic alterations. BACKGROUND:Risk assessment in patients with colon cancer and localized disease (UICC stage II) is not sufficiently reliable. Development of metachronous metastasis is assumed to be g...

    journal_title:Annals of surgery

    pub_type: 杂志文章

    doi:10.1097/SLA.0b013e318272de87

    authors: Nitsche U,Rosenberg R,Balmert A,Schuster T,Slotta-Huspenina J,Herrmann P,Bader FG,Friess H,Schlag PM,Stein U,Janssen KP

    更新日期:2012-11-01 00:00:00

  • Preoperative and long-term cardiac risk assessment. Predictive value of 23 clinical descriptors, 7 multivariate scoring systems, and quantitative dipyridamole imaging in 360 patients.

    abstract::A total of 360 patients underwent preoperative cardiac risk assessment using 23 clinical parameters, seven multivariate clinical scoring systems, and quantitative dipyridamole-thallium imaging to predict postoperative and long-term myocardial infarction and cardiac death after noncardiac surgery. There were 30 postope...

    journal_title:Annals of surgery

    pub_type: 杂志文章

    doi:10.1097/00000658-199208000-00010

    authors: Lette J,Waters D,Bernier H,Champagne P,Lassonde J,Picard M,Cerino M,Nattel S,Boucher Y,Heyen F

    更新日期:1992-08-01 00:00:00

  • Management of secondary peritonitis.

    abstract:OBJECTIVE:The authors review current definition, classification, scoring, microbiology, inflammatory response, and goals of management of secondary peritonitis. SUMMARY BACKGROUND DATA:Despite improved diagnostic modalities, potent antibiotics, modern intensive care, and aggressive surgical treatment, up to one third ...

    journal_title:Annals of surgery

    pub_type: 杂志文章,评审

    doi:10.1097/00000658-199607000-00003

    authors: Wittmann DH,Schein M,Condon RE

    更新日期:1996-07-01 00:00:00

  • Carotid endarterectomy: neurologic complications as related to surgical techniques.

    abstract::Three hundred seventeen carotid endarterectomies performed on 240 consecutive patients in four Charleston hospitals were reviewed. The overall incidence of stroke was 10.7% and the mortality 3.2%. From these 317 operations a standardized series of 253 operations performed on neurologically stable patients was analyzed...

    journal_title:Annals of surgery

    pub_type: 杂志文章

    doi:10.1097/00000658-197706000-00010

    authors: Prioleau WH Jr,Alken AF,Hairston P

    更新日期:1977-06-01 00:00:00

  • Paradigm shift in the management of gastroesophageal reflux disease.

    abstract:OBJECTIVE:To compare the short-term results of the radiofrequency treatment of the gastroesophageal junction known as the Stretta procedure versus laparoscopic fundoplication (LF) in patients with gastroesophageal reflux disease (GERD). SUMMARY BACKGROUND DATA:The Stretta procedure has been shown to be safe, well tole...

    journal_title:Annals of surgery

    pub_type: 临床试验,杂志文章

    doi:10.1097/01.SLA.0000064358.25509.36

    authors: Richards WO,Houston HL,Torquati A,Khaitan L,Holzman MD,Sharp KW

    更新日期:2003-05-01 00:00:00

  • The role of tumor necrosis factor and nitric oxide in the acute cardiovascular response to endotoxin.

    abstract:OBJECTIVE:This study was designed to examine the differential effects of tumor necrosis factor (TNF) and nitric oxide on the acute cardiovascular changes that occur in response to endotoxemia. SUMMARY BACKGROUND DATA:Recent studies have suggested that some, if not all, of the cardiovascular effects of TNF are mediated...

    journal_title:Annals of surgery

    pub_type: 杂志文章

    doi:10.1097/00000658-199601000-00009

    authors: Fahey TJ 3rd,Yoshioka T,Shires GT,Fantini GA

    更新日期:1996-01-01 00:00:00

  • Partial versus total portacaval shunt in alcoholic cirrhosis. Results of a prospective, randomized clinical trial.

    abstract:OBJECTIVE:Results of the first prospective randomized clinical trial comparing partial and total portacaval shunt for variceal hemorrhage are reported. SUMMARY BACKGROUND DATA:Total portacaval shunts produce subnormal portal pressures, completely diverting hepatic portal flow. Partial shunts maintain higher pressures ...

    journal_title:Annals of surgery

    pub_type: 临床试验,杂志文章,随机对照试验

    doi:10.1097/00000658-199404000-00005

    authors: Sarfeh IJ,Rypins EB

    更新日期:1994-04-01 00:00:00

  • Is surgical resection superior to transplantation in the treatment of hepatocellular carcinoma?

    abstract:OBJECTIVE:To compare outcomes for patients with hepatocellular carcinoma (HCC) treated with either liver resection or transplantation. METHODS:A retrospective, single-institution analysis of 413 HCC patients from 1999 to 2009. RESULTS:A total of 413 patients with HCC underwent surgical resection (n = 106) and transpl...

    journal_title:Annals of surgery

    pub_type: 杂志文章

    doi:10.1097/SLA.0b013e31822ca66f

    authors: Koniaris LG,Levi DM,Pedroso FE,Franceschi D,Tzakis AG,Santamaria-Barria JA,Tang J,Anderson M,Misra S,Solomon NL,Jin X,DiPasco PJ,Byrne MM,Zimmers TA

    更新日期:2011-09-01 00:00:00

  • Response of protein and urea kinetics in burn patients to different levels of protein intake.

    abstract::The effects of two levels of protein intake on protein metabolism in six severely burned adult patients were studied (means of 70% BSA burned). A crossover experimental design enabled the authors to study each patient at the end of two three-day dietary regimens. All diets were isocaloric and provided approximately 25...

    journal_title:Annals of surgery

    pub_type: 杂志文章

    doi:10.1097/00000658-198302000-00007

    authors: Wolfe RR,Goodenough RD,Burke JF,Wolfe MH

    更新日期:1983-02-01 00:00:00

  • Reversal of mortality for congenital diaphragmatic hernia with ECMO.

    abstract::Extracorporeal Membrane Oxygenation (ECMO) has been available to neonates with respiratory failure at the University of Michigan School of Medicine since June 1981. In order to evaluate the impact of this type of pulmonary support, a retrospective analysis of 50 neonates with posterolateral congenital diaphragmatic he...

    journal_title:Annals of surgery

    pub_type: 杂志文章,评审

    doi:10.1097/00000658-198902000-00014

    authors: Heiss K,Manning P,Oldham KT,Coran AG,Polley TZ Jr,Wesley JR,Bartlett RH

    更新日期:1989-02-01 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

  • Tumor progression while on chemotherapy: a contraindication to liver resection for multiple colorectal metastases?

    abstract:OBJECTIVE:To evaluate the influence of the response to preoperative chemotherapy, especially tumor progression, on the outcome following resection of multiple colorectal liver metastases (CRM). SUMMARY BACKGROUND DATA:Hepatic resection is the only treatment that currently offers a chance of long-term survival, althoug...

    journal_title:Annals of surgery

    pub_type: 杂志文章

    doi:10.1097/01.sla.0000145964.08365.01

    authors: Adam R,Pascal G,Castaing D,Azoulay D,Delvart V,Paule B,Levi F,Bismuth H

    更新日期:2004-12-01 00:00:00

  • The core competencies of James Marion Sims, MD.

    abstract::The concept of core competencies in graduate medical education was introduced by the Accreditation Council for Graduate Medical Education of the American Medical Association to semiquantitatively assess the professional performance of students, residents, practitioners, and faculty. Many aspects of the career of J. Ma...

    journal_title:Annals of surgery

    pub_type: 传,历史文章,杂志文章

    doi:10.1097/SLA.0b013e318249ce3b

    authors: Straughn JM Jr,Gandy RE,Rodning CB

    更新日期:2012-07-01 00:00:00

  • Preventing Parastomal Hernia Using a Modified Sugarbaker Technique With Composite Mesh During Laparoscopic Abdominoperineal Resection: A Randomized Controlled Trial.

    abstract:OBJECTIVE:The aim of this study was to assess the reduction in the incidence of parastomal hernia (PH) after placement of prophylactic synthetic mesh using a modified Sugarbaker technique when a permanent end-colostomy is needed. SUMMARY OF BACKGROUND DATA:Prevention of PH formation is crucial given the high prevalenc...

    journal_title:Annals of surgery

    pub_type: 杂志文章,多中心研究,随机对照试验

    doi:10.1097/SLA.0000000000001684

    authors: López-Cano M,Serra-Aracil X,Mora L,Sánchez-García JL,Jiménez-Gómez LM,Martí M,Vallribera F,Fraccalvieri D,Serracant A,Kreisler E,Biondo S,Espín E,Navarro-Soto S,Armengol-Carrasco M

    更新日期:2016-12-01 00:00:00

  • Minimally invasive esophagectomy: outcomes in 222 patients.

    abstract:OBJECTIVE:To assess our outcomes after minimally invasive esophagectomy (MIE). SUMMARY BACKGROUND DATA:Esophagectomy has traditionally been performed by open methods. Results from most series include mortality rates in excess of 5% and hospital stays frequently greater than 10 days. MIE has the potential to improve th...

    journal_title:Annals of surgery

    pub_type: 杂志文章

    doi:10.1097/01.sla.0000089858.40725.68

    authors: Luketich JD,Alvelo-Rivera M,Buenaventura PO,Christie NA,McCaughan JS,Litle VR,Schauer PR,Close JM,Fernando HC

    更新日期:2003-10-01 00:00:00