Thoracic duct in patients with multiple organ failure: no major route of bacterial translocation.

Abstract:

OBJECTIVE:To determine whether translocation of bacteria or endotoxin occurred into the thoracic duct in patients with multiple organ failure (MOF). SUMMARY BACKGROUND DATA:Translocation of bacteria or endotoxin has been proposed as a causative factor for MOF in patients without an infectious focus, although it has rarely been demonstrated in patients at risk for MOF. Most studies have investigated the hematogenic route of translocation, but it has been argued that lymphatic translocation of bacteria or endotoxin by the thoracic duct is the major route of translocation. METHODS:The thoracic duct was drained for 5 days in patients with MOF caused either by generalized fecal peritonitis (n = 4) or by an event without clinical and microbiologic evidence of infection (n = 4). Patients without MOF who were undergoing a transthoracic esophageal resection served as controls. In lymph and blood, concentrations of endotoxin, proinflammatory cytokines, and antiinflammatory cytokines were measured. RESULTS:Endotoxin concentrations in lymph and blood of patients with MOF ranged from 39 to 63 units per liter and were not significantly different from concentrations in patients without MOF. The quantity of endotoxin transported by the thoracic duct in the study group was small. In patients with MOF, low levels of proinflammatory cytokines and high levels of antagonists of these cytokines were found. CONCLUSION:This study provides evidence that translocation (especially of endotoxin) occurs into the thoracic duct. However, these data do not support the concept that the thoracic duct is a major route of bacterial translocation in patients with MOF.

journal_name

Ann Surg

journal_title

Annals of surgery

authors

Lemaire LC,van Lanschot JB,Stoutenbeek CP,van Deventer SJ,Dankert J,Oosting H,Gouma DJ

doi

10.1097/00000658-199901000-00017

subject

Has Abstract

pub_date

1999-01-01 00:00:00

pages

128-36

issue

1

eissn

0003-4932

issn

1528-1140

journal_volume

229

pub_type

杂志文章
  • Long-term prognosis after operation for adhesive small bowel obstruction.

    abstract:AIM OF STUDY:The objective of this study was to determine the pattern of recurrence after one or more episodes of adhesive small bowel obstruction (ASBO) during a follow-up period of up to 40 years. Furthermore, we wanted to analyze possible factors with an influence on the recurrence rate and to study the magnitude of...

    journal_title:Annals of surgery

    pub_type: 杂志文章

    doi:10.1097/01.sla.0000132988.50122.de

    authors: Fevang BT,Fevang J,Lie SA,Søreide O,Svanes K,Viste A

    更新日期:2004-08-01 00:00:00

  • Recurrent versus residual carotid stenosis. Incidence detected by Doppler ultrasound.

    abstract::A sterile Doppler probe was used for intraoperative monitoring of the integrity of carotid endarterectomy of 125 vessels of 107 patients. Our objective was to reduce the contribution of residual carotid lesions to recurrent stenosis, which was evaluated by Doppler spectrum analysis in the early (less than 3 months, 66...

    journal_title:Annals of surgery

    pub_type: 杂志文章

    doi:10.1097/00000658-198606000-00010

    authors: Barnes RW,Nix ML,Wingo JP,Nichols BT

    更新日期:1986-06-01 00:00:00

  • Duodenal injury. Analysis of common misconceptions in diagnosis and treatment.

    abstract::Seventy-five consecutive patients who sustained injuries to the duodenum were admitted to our hospital over a nine-year period. Nineteen blunt injuries and 56 penetrating injuries were encountered. Blunt injuries were usually the result of motor vehicle accidents and steering wheel impact was frequently implicated. Pe...

    journal_title:Annals of surgery

    pub_type: 杂志文章

    doi:10.1097/00000658-198006000-00006

    authors: Flint LM Jr,McCoy M,Richardson JD,Polk HC Jr

    更新日期:1980-06-01 00:00:00

  • Prognostic evaluation of stage B colon cancer patients is improved by an adequate lymphadenectomy: results of a secondary analysis of a large scale adjuvant trial.

    abstract:OBJECTIVE:To determine if the extent of lymphadenectomy (number of recovered lymph nodes) was associated with long-term outcome in patients operated on for stage B and C colon cancer. SUMMARY BACKGROUND DATA:Lymphatic spreading is the main prognostic indicator in colon cancer patients, although the optimal extent of l...

    journal_title:Annals of surgery

    pub_type: 杂志文章,多中心研究

    doi:10.1097/00000658-200204000-00002

    authors: Prandi M,Lionetto R,Bini A,Francioni G,Accarpio G,Anfossi A,Ballario E,Becchi G,Bonilauri S,Carobbi A,Cavaliere P,Garcea D,Giuliani L,Morziani E,Mosca F,Mussa A,Pasqualini M,Poddie D,Tonetti F,Zardo L,Rosso R

    更新日期:2002-04-01 00:00:00

  • Comparison of surgical outcomes between teaching and nonteaching hospitals in the Department of Veterans Affairs.

    abstract:OBJECTIVE:To determine whether the investment in postgraduate education and training places patients at risk for worse outcomes and higher costs than if medical and surgical care was delivered in nonteaching settings. SUMMARY BACKGROUND DATA:The Veterans Health Administration (VA) plays a major role in the training of...

    journal_title:Annals of surgery

    pub_type: 杂志文章

    doi:10.1097/00000658-200109000-00011

    authors: Khuri SF,Najjar SF,Daley J,Krasnicka B,Hossain M,Henderson WG,Aust JB,Bass B,Bishop MJ,Demakis J,DePalma R,Fabri PJ,Fink A,Gibbs J,Grover F,Hammermeister K,McDonald G,Neumayer L,Roswell RH,Spencer J,Turnage RH,V

    更新日期:2001-09-01 00:00:00

  • Outcomes After Multidisciplinary Management of Primary Mediastinal Germ Cell Tumors.

    abstract:OBJECTIVE:We examined management strategies, overall survival (OS), and progression-free survival (PFS) among patients with PMNSGCTs undergoing resection and multidisciplinary management at a high-volume institution. SUMMARY OF BACKGROUND DATA:Outcomes after resection of PMNSGCTs are not well-characterized, with limit...

    journal_title:Annals of surgery

    pub_type: 杂志文章

    doi:10.1097/SLA.0000000000003754

    authors: Caso R,Jones GD,Bains MS,Hsu M,Tan KS,Feldman DR,Funt SA,Reuter VE,Bosl GJ,McHugh D,Huang J,Molena D,Amar D,Fischer G,Rusch VW,Jones DR

    更新日期:2020-01-21 00:00:00

  • Impact of a clinical pathway for elective infrarenal aortic reconstructions.

    abstract:OBJECTIVE:To determine the impact of a clinical pathway for elective infrarenal aortic reconstruction on outcome, resource utilization, and cost in a university medical center. SUMMARY BACKGROUND DATA:Clinical pathways have been reported to control costs, reduce resource utilization, and maintain or improve the qualit...

    journal_title:Annals of surgery

    pub_type: 杂志文章

    doi:10.1097/00000658-199805000-00009

    authors: Huber TS,Carlton LM,Harward TR,Russin MM,Phillips PT,Nalli BJ,Flynn TC,Seeger JM

    更新日期:1998-05-01 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

  • Improvement in treatment results and long-term survival of patients with esophageal cancer: impact of chemoradiation and change in treatment strategy.

    abstract:OBJECTIVE:To identify prognostic factors and reasons for improved survival over time in patients with esophageal cancer. SUMMARY BACKGROUND DATA:Management strategies for esophageal cancer have evolved with time. The impact of chemoradiation in the overall treatment results has not been adequately studied. METHODS:Fr...

    journal_title:Annals of surgery

    pub_type: 杂志文章

    doi:10.1097/01.sla.0000086545.45918.ee

    authors: Law S,Kwong DL,Kwok KF,Wong KH,Chu KM,Sham JS,Wong J

    更新日期:2003-09-01 00:00:00

  • Carotid Artery Reactivity Predicts Events in Peripheral Arterial Disease Patients.

    abstract:OBJECTIVE:Patients with peripheral arterial disease (PAD) have increased risk on future cerebro- and cardiovascular events. Our aim was to examine whether carotid artery reactivity (CAR; a novel, simple procedure to examine endothelial function) predicts cardiovascular events in PAD patients. BACKGROUND:Increased risk...

    journal_title:Annals of surgery

    pub_type: 杂志文章

    doi:10.1097/SLA.0000000000002558

    authors: van Mil ACCM,Pouwels S,Wilbrink J,Warlé MC,Thijssen DHJ

    更新日期:2019-04-01 00:00:00

  • Twenty-three-year follow-up of separated ischiopagus tetrapus conjoined twins.

    abstract::This paper presents a 23-year follow-up of the separation of ischiopagus tetrapus conjoined twins reported in Annals of Surgery in December 1966. One twin died of septicemia at age 2 years after bilateral pelvic osteotomies for the treatment of her marked pelvic diastasis. The surviving twin has done reasonably well, ...

    journal_title:Annals of surgery

    pub_type: 杂志文章,评审

    doi:10.1097/00000658-198911000-00017

    authors: Hoyle RM,Thomas CG Jr

    更新日期:1989-11-01 00:00:00

  • Association of adult celiac disease with surgical abdominal pain: a case-control study in patients referred to secondary care.

    abstract:BACKGROUND:Acute abdominal pain is the most common indication for surgical admission. Nonspecific abdominal pain (NSAP) may account for up to 40% of cases. There has been no published prospective study in which adult patients presenting with acute abdominal pain are investigated for celiac disease. AIMS:We aimed to as...

    journal_title:Annals of surgery

    pub_type: 杂志文章

    doi:10.1097/01.sla.0000171301.35513.cf

    authors: Sanders DS,Hopper AD,Azmy IA,Rahman N,Hurlstone DP,Leeds JS,George RR,Bhala N

    更新日期:2005-08-01 00:00:00

  • Registration rates, adequacy of registration, and a comparison of registered and published primary outcomes in randomized controlled trials published in surgery journals.

    abstract:OBJECTIVE:To determine the proportion of registered trials published in the surgical literature, to compare, in registered trials, the primary outcomes registered with those published and to determine whether outcome-reporting bias favored significant primary outcomes. BACKGROUND:Trial protocol registration before pat...

    journal_title:Annals of surgery

    pub_type: 杂志文章

    doi:10.1097/SLA.0b013e318299d00b

    authors: Killeen S,Sourallous P,Hunter IA,Hartley JE,Grady HL

    更新日期:2014-01-01 00:00:00

  • The Importance of Registries in the Postmarketing Surveillance of Surgical Meshes.

    abstract:OBJECTIVE:To assess the role of registries in the postmarketing surveillance of surgical meshes. BACKGROUND:To date, surgical meshes are classified as group II medical devices. Class II devices do not require premarket clearance by clinical studies. Ethicon initiated a voluntary market withdrawal of Physiomesh for lap...

    journal_title:Annals of surgery

    pub_type: 杂志文章,多中心研究

    doi:10.1097/SLA.0000000000002326

    authors: Köckerling F,Simon T,Hukauf M,Hellinger A,Fortelny R,Reinpold W,Bittner R

    更新日期:2018-12-01 00:00:00

  • Parathyroid re-exploration. A clinical and pathological study of 112 cases.

    abstract::In a series of 112 patients who underwent reoperation for primary hyperparathyroidism at the Massachusetts General Hospital between 1930 and 1975, all but 10 were treated successfully. Seventy-five initial explorations had been performed elsewhere, and 37 in our hospital. A total of 110 diseased parathyroids were unco...

    journal_title:Annals of surgery

    pub_type: 杂志文章

    doi:10.1097/00000658-197708000-00004

    authors: Wang CA

    更新日期:1977-08-01 00:00:00

  • Lymphoma of the breast.

    abstract::Thirteen patients with lymphoma of the breast are presented. In addition, 163 previously reported cases of lymphoma of the breast are reviewed. Complete staging was performed on all patients. No patient had a diagnosis of lymphoma prior to breast biopsy. The histologic findings were diffuse histiocytic lymphoma (DHL) ...

    journal_title:Annals of surgery

    pub_type: 杂志文章

    doi:10.1097/00000658-198112000-00015

    authors: Schouten JT,Weese JL,Carbone PP

    更新日期:1981-12-01 00:00:00

  • Macrophage elimination increases bacterial translocation and gut-origin septicemia but attenuates symptoms and mortality rate in a model of systemic inflammation.

    abstract:OBJECTIVE:The central question tested in this study was whether dichloromethylene-diphosphonate (CL2MDP) liposome-mediated elimination of hepatic and splenic macrophages would influence zymosan-induced bacterial translocation and the zymosan-induced generalized inflammatory response. SUMMARY BACKGROUND DATA:Both an un...

    journal_title:Annals of surgery

    pub_type: 杂志文章

    doi:10.1097/00000658-199312000-00014

    authors: Nieuwenhuijzen GA,Haskel Y,Lu Q,Berg RD,van Rooijen N,Goris RJ,Deitch EA

    更新日期:1993-12-01 00:00:00

  • Prophylactic revascularization of the gut.

    abstract::Reconstitution of the mesenteric vascular circulation, in our experience, is advisable when advanced occlusive disease is noted on the preoperative arteriogram of patients selected for aortoiliofemoral, renal artery, or aortic aneurysm surgery. A lateral aortogram is mandatory, and the presence of an anastomotic meand...

    journal_title:Annals of surgery

    pub_type: 杂志文章

    doi:10.1097/00000658-197910000-00011

    authors: Connolly JE,Kwaan JH

    更新日期:1979-10-01 00:00:00

  • Is there still a glass ceiling for women in academic surgery?

    abstract::Despite the dramatically increased entry of women into general surgery and surgical subspecialties, traditionally male-dominated fields, there remains a gross under-representation of women in the leadership positions of these departments. Women begin their careers with fewer academic resources and tend to progress thr...

    journal_title:Annals of surgery

    pub_type: 杂志文章,评审

    doi:10.1097/SLA.0b013e3182111120

    authors: Zhuge Y,Kaufman J,Simeone DM,Chen H,Velazquez OC

    更新日期:2011-04-01 00:00:00

  • Embryonic Origin of Primary Colon Cancer Predicts Pathologic Response and Survival in Patients Undergoing Resection for Colon Cancer Liver Metastases.

    abstract:BACKGROUND:The aim of this study was to determine the prognostic value of embryonic origin in patients undergoing resection after chemotherapy for colon cancer liver metastases (CCLM). METHODS:We identified 725 patients with primary colon cancer and known RAS mutation status who underwent hepatic resection after preop...

    journal_title:Annals of surgery

    pub_type: 杂志文章

    doi:10.1097/SLA.0000000000002087

    authors: Yamashita S,Brudvik KW,Kopetz SE,Maru D,Clarke CN,Passot G,Conrad C,Chun YS,Aloia TA,Vauthey JN

    更新日期:2018-03-01 00:00:00

  • Modified technique of obturator bypass in failed or infected grafts.

    abstract::The obturator bypass graft operation can be performed in a moderately simplified manner by a technique that allows extension of indications for the procedure beyond situations in which sepsis is present in the groin. Long-term analysis of the results of the cases available for study indicates that the procedure may ve...

    journal_title:Annals of surgery

    pub_type: 杂志文章

    doi:10.1097/00000658-198303000-00015

    authors: Pearce WH,Ricco JB,Yao JS,Flinn WR,Bergan JJ

    更新日期:1983-03-01 00:00:00

  • Gastrointestinal adaptation following small bowel bypass for obesity.

    abstract::Small intestinal morphologic and biochemical changes were studied following jejuno-ileal bypass for obesity after body weight stabilization had occurred. Four patients underwent biopsy of in-continuity and bypassed jejunal and ileal segments of the small intestine 11 to 22 months after the bypass operation. Microscopi...

    journal_title:Annals of surgery

    pub_type: 杂志文章

    doi:10.1097/00000658-197706000-00005

    authors: Dudrick SJ,Daly JM,Castro G,Akhtar M

    更新日期:1977-06-01 00:00:00

  • Desmoid-type fibromatosis and pregnancy: a multi-institutional analysis of recurrence and obstetric risk.

    abstract:BACKGROUND:Many women who present with desmoid-type fibromatosis (DF) have had a recent pregnancy. Long-term data about disease behavior during and after pregnancy are lacking. OBJECTIVE:To investigate the possible relationship between DF and pregnancy. PATIENTS AND METHODS:A cohort of women with DF and pregnancy was...

    journal_title:Annals of surgery

    pub_type: 杂志文章,多中心研究

    doi:10.1097/SLA.0000000000000224

    authors: Fiore M,Coppola S,Cannell AJ,Colombo C,Bertagnolli MM,George S,Le Cesne A,Gladdy RA,Casali PG,Swallow CJ,Gronchi A,Bonvalot S,Raut CP

    更新日期:2014-05-01 00:00:00

  • Significantly increased pregnancy rates after laparoscopic restorative proctocolectomy: a cross-sectional study.

    abstract:OBJECTIVE:To assess the impact of a laparoscopic approach on female fecundity in ileoanal pouch surgery. BACKGROUND:Restorative proctocolectomy with ileal pouch anal anastomosis (IPAA) is associated with tubal factor infertility in female patients. Different studies showed less adhesion formation after laparoscopic co...

    journal_title:Annals of surgery

    pub_type: 临床试验,杂志文章

    doi:10.1097/SLA.0b013e318250caa9

    authors: Bartels SA,DʼHoore A,Cuesta MA,Bensdorp AJ,Lucas C,Bemelman WA

    更新日期:2012-12-01 00:00:00

  • A clinicopathologic study of sex cases.

    abstract::Six patients with surgically treated Menetrier's disease are presented. Diffuse or focal cystic hyperplasia of mucous secreting epithelium of the fundus with antral sparing characterized the stomachs in all of these cases. In most instances the disorder was found during evaluation of non-specific complaints of pain, n...

    journal_title:Annals of surgery

    pub_type: 杂志文章

    doi:10.1097/00000658-197704000-00015

    authors: Davis JM,Gray GF,Thorbjarnarson B

    更新日期:1977-04-01 00:00:00

  • Conversion for Unfavorable Intraoperative Events Results in Significantly Worse Outcomes During Laparoscopic Liver Resection: Lessons Learned From a Multicenter Review of 2861 Cases.

    abstract:OBJECTIVE:To investigate the risk factors for conversion during laparoscopic liver resection and its effect on patient outcome in a large cohort of patients. Additional analysis of outcomes in patients who required conversion for unfavorable intraoperative findings and conversion for unfavorable intraoperative events w...

    journal_title:Annals of surgery

    pub_type: 杂志文章,多中心研究

    doi:10.1097/SLA.0000000000002332

    authors: Halls MC,Cipriani F,Berardi G,Barkhatov L,Lainas P,Alzoubi M,D'Hondt M,Rotellar F,Dagher I,Aldrighetti L,Troisi RI,Edwin B,Abu Hilal M

    更新日期:2018-12-01 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

  • Post-traumatic parotid fistulae and sialoceles. A prospective study of conservative management in 51 cases.

    abstract::The management of parotid sialoceles and fistulae have been unsatisfactory in the past, and numerous methods of treatment with varying success and morbidity have been described. The present prospective study reports results of conservative therapy in 51 patients over a 3-year period. In 50 patients, the injury healed ...

    journal_title:Annals of surgery

    pub_type: 杂志文章

    doi:10.1097/00000658-198901000-00015

    authors: Parekh D,Glezerson G,Stewart M,Esser J,Lawson HH

    更新日期:1989-01-01 00:00:00

  • Weight Loss, Satiety, and the Postprandial Gut Hormone Response After Esophagectomy: A Prospective Study.

    abstract:OBJECTIVE:To prospectively characterize changes in body weight, satiety, and postprandial gut hormone profiles following esophagectomy. BACKGROUND:With improved oncologic outcomes in esophageal cancer, there is an increasing focus on functional status and health-related quality of life in survivorship. Early satiety a...

    journal_title:Annals of surgery

    pub_type: 杂志文章

    doi:10.1097/SLA.0000000000001918

    authors: Elliott JA,Docherty NG,Eckhardt HG,Doyle SL,Guinan EM,Ravi N,Reynolds JV,Roux CWL

    更新日期:2017-07-01 00:00:00

  • Endovascular repair of abdominal aortic aneurysms: risk stratified outcomes.

    abstract:OBJECTIVE:The impact of co-morbid conditions on early and late clinical outcomes after endovascular treatment of abdominal aortic aneurysm (AAA) was assessed in concurrent cohorts of patients stratified with respect to risk for intervention. SUMMARY BACKGROUND DATA:As a minimally invasive strategy for the treatment of...

    journal_title:Annals of surgery

    pub_type: 杂志文章

    doi:10.1097/00000658-200206000-00011

    authors: Chaikof EL,Lin PH,Brinkman WT,Dodson TF,Weiss VJ,Lumsden AB,Terramani TT,Najibi S,Bush RL,Salam AA,Smith RB 3rd

    更新日期:2002-06-01 00:00:00