Abstract:
OBJECTIVE:The aim of this study was to report the long-term results of percutaneous isolated liver chemoperfusion with hepatic venous isolation and charcoal hemoperfusion (HVI-CHP) in patients with multiple advanced hepatocellular carcinoma (HCC). SUMMARY BACKGROUND DATA:The results of conventional chemotherapy including regional and systemic chemotherapy in patients with HCC remain dismal, and long-term survivors after treatment are rare among patients with multiple advanced HCC. In an effort to improve this situation, we previously developed a novel system of percutaneous isolated liver chemoperfusion with HVI-CHP. METHODS:Doxorubicin (60 to 150 mg/m2) was administered via the hepatic artery, under conditions of extracorporeal drug elimination by HVI-CHP in 28 consecutive patients with advanced HCC (39 total treatments). Hepatic venous isolation and charcoal hemoperfusion was accomplished mainly by the single catheter technique using a newly developed 4-lumen-balloon catheter, which was used to isolate and capture total hepatic venous outflow and, at the same time, to direct the filtered blood to the right atrium. RESULTS:Complete remission was achieved in five patients, of which four received repeated treatments (two or three times). Although 1 of 5 patients with complete remission died of pulmonary metastases at 8 months, the other 4 remain healthy and free of disease at 20, 24, 27, and 42 months after the first treatment. Partial responses were observed in 12 patients. Duration of response in responders (complete and partial) with repeated treatments was significantly longer than that with a single treatment (p = 0.01). The overall survival rate by the Kaplan-Meier method was 39.7% at 5 years. The treatments were well-tolerated, and the primary side effects were mild to moderate chemical hepatitis and reversible myelosuppression. CONCLUSIONS:The results suggest that percutaneous isolated liver chemoperfusion with HVI-CHP is an effective palliative treatment in the majority of patients and yields long-term complete remission in some patients with multiple advanced HCC.
journal_name
Ann Surgjournal_title
Annals of surgeryauthors
Ku Y,Iwasaki T,Fukumoto T,Tominaga M,Muramatsu S,Kusunoki N,Sugimoto T,Suzuki Y,Kuroda Y,Saitoh Y,Sako M,Matsumoto S,Hirota S,Obara Hdoi
10.1097/00000658-199804000-00012subject
Has Abstractpub_date
1998-04-01 00:00:00pages
519-26issue
4eissn
0003-4932issn
1528-1140journal_volume
227pub_type
杂志文章abstract:OBJECTIVE:To assess a new bloodless technique using radiofrequency energy for segmental liver resection of hepatic tumors. SUMMARY BACKGROUND DATA:Liver resection remains a formidable surgical procedure; safe performance requires a high level of training and skill. Intraoperative blood loss during liver resection rema...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-200211000-00004
更新日期:2002-11-01 00:00:00
abstract::The incidence of renovascular hypertension in the transplanted kidney is reported to range between 5 and 15%. A review of 391 consecutive renal transplant patients revealed 16 patients (5.4%) with hypertension secondary to partial obstruction of renal arterial blood flow. The clinical course of this group of patients ...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-198011000-00010
更新日期:1980-11-01 00:00:00
abstract:OBJECTIVE:Research evaluating fatigue-induced skills decline has focused on acute sleep deprivation rather than the effects of circadian desynchronization associated with multiple shifts. As a result, the number of consecutive night shifts that residents can safely be on duty without detrimental effects to their techni...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/SLA.0b013e3181661a99
更新日期:2008-03-01 00:00:00
abstract:BACKGROUND:Experience with minimal access, transoral/transmural endoscopic drainage/debridement of walled-off pancreatic necrosis (WOPN) after necrotizing pancreatitis is limited. We sought to determine outcome using this technique. METHODS:Retrospective analysis. RESULTS:From 1998 to 2006, 53 patients underwent tran...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/01.sla.0000254366.19366.69
更新日期:2007-06-01 00:00:00
abstract:OBJECTIVE:The authors determine the reliability, validity, and usefulness of the Objective Structured Clinical Examination (OSCE) in the evaluation of surgical residents. SUMMARY BACKGROUND DATA:Interest is increasing in using the OSCE as a measurement of clinical competence and as a certification tool. However, conce...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-199512000-00007
更新日期:1995-12-01 00:00:00
abstract:BACKGROUND:Over the past 2 decades, there has been an increase in opioid use and subsequently, opioid deaths. The amount of opioid prescribed to surgical patients has also increased. The aim of this systematic review was to determine postdischarge opioid consumption in surgical patients compared with the amount of opio...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/SLA.0000000000002591
更新日期:2018-06-01 00:00:00
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 identify and prioritize hazards in surgical wards and recommend interventions. BACKGROUND:Retrospective and prospective studies report the frequency and severity of surgical adverse events, but not in sufficient detail to allow interventions to be recommended in surgical wards. METHODS:Seventy hours of o...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/SLA.0b013e31824f5f36
更新日期:2012-06-01 00:00:00
abstract:OBJECTIVE:The aim of this study was to analyze the health care costs and savings associated with quality improvement (QI) interventions initiated and implemented utilizing NSQIP. BACKGROUND:Five acute care facilities of Alberta Health Services (AHS) adopted NSQIP in 2015 for a pilot project. METHODS:The cost-savings ...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/SLA.0000000000002708
更新日期:2019-05-01 00:00:00
abstract::Glutaraldehyde treated human umbilical veins (Dardik Biograft) were used to bypass short segments of the femoral artery in 15 dogs and were compared to autogenous jugular veins placed in the contralateral femoral artery of each animal. All 15 autogenous jugular veins remained patent for the four month period of observ...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-197808000-00005
更新日期:1978-08-01 00:00:00
abstract:OBJECTIVE:To study risk factors for early and late death after heart transplantation in the current era. SUMMARY BACKGROUND DATA:The current cardiac transplant population differs from earlier periods in that an increasing number of sicker patients, such as those with ventricular assist device (LVAD) support, prior car...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-200009000-00002
更新日期:2000-09-01 00:00:00
abstract:OBJECTIVE:To compare three options for the elective treatment of portal hypertension during a 10-year period. METHODS:Patients included in the trial were 18 to 76 years old, had a history of bleeding portal hypertension, and had undergone no prior treatment. Treatment options were beta-blockers (propranolol), scleroth...
journal_title:Annals of surgery
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1097/00000658-200008000-00011
更新日期:2000-08-01 00:00:00
abstract::: There is growing interest in global surgery among US academic surgical departments. As academic global surgery is a relatively new field, departments may have minimal experience in evaluation of faculty contributions and how they integrate into the existing academic paradigm for promotion and tenure. The American Su...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/SLA.0000000000003480
更新日期:2020-02-01 00:00:00
abstract:OBJECTIVE:To critically review the theoretical and actual risks and benefits of accelerated partial breast irradiation (APBI) after breast-conserving surgery. SUMMARY BACKGROUND DATA:Because of rapid evolution of radiation therapy techniques related to brachytherapy and three-dimensional conformal radiation therapy, A...
journal_title:Annals of surgery
pub_type: 杂志文章,评审
doi:10.1097/01.sla.0000114219.71899.13
更新日期:2004-03-01 00:00:00
abstract:OBJECTIVE:To define the natural history of, and treatment strategy for, blunt traumatic internal carotid artery (ICA) pseudoaneurysms. BACKGROUND:The natural history and management of traumatic ICA pseudoaneurysms is controversial. METHODS:We retrospectively identified all traumatic ICA pseudoaneurysms diagnosed on h...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/SLA.0000000000001158
更新日期:2016-04-01 00:00:00
abstract:OBJECTIVE:This study aims to evaluate whether graduates of integrated vascular surgery residency (IVSR) programs achieve similar surgical outcomes in clinical practice as compared to graduates of vascular surgery fellowships (VSF). SUMMARY BACKGROUND DATA:Early sub-specialization through IVSR programs decreases the to...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/SLA.0000000000004706
更新日期:2020-12-18 00:00:00
abstract::Low mortality rates for elective surgical treatment of abdominal aortic aneurysms justify an aggressive approach in most patients. However, in high-risk patients with small aneurysms and no symptoms, the decision to operate remains a delicate balance of risk and benefit. Our observations include 99 high-risk patients ...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-198409000-00003
更新日期:1984-09-01 00:00:00
abstract:OBJECTIVE:To test the hypothesis that higher hospital volume decreases endoscopic and surgical re-intervention rates after antireflux surgery. BACKGROUND:Antireflux surgery for gastro-esophageal reflux disease is followed by varying rates of re-interventions. Whether hospital volume influences re-intervention rates is...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/SLA.0000000000003776
更新日期:2020-01-06 00:00:00
abstract:OBJECTIVE:To assess the feasibility, safety, and outcome of laparoscopic liver resection for malignant liver tumors. SUMMARY BACKGROUND DATA:The precise role of laparoscopy in resection of liver malignancies (hepatocellular carcinoma [HCC] and liver metastases) remains controversial despite an increasing number of pub...
journal_title:Annals of surgery
pub_type: 杂志文章,多中心研究
doi:10.1097/00000658-200207000-00014
更新日期:2002-07-01 00:00:00
abstract::Twenty-six patients are reviewed who had primary carcinomas involving the junction of the hepatic ducts. The majority had had an initial procedure of palliative biliary diversion elsewhere and were referred for further treatment. In three cases, en bloc resection of the tumor with total hepatectomy and orthotopic live...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-197607000-00012
更新日期:1976-07-01 00:00:00
abstract:OBJECTIVE:By comparing cohorts in 2 exclusive time frames, the factors that affected the surgical outcomes of patients with hepatocellular carcinoma (HCC) are presented. SUMMARY BACKGROUND DATA:Reportedly, survival results of patients with HCC who underwent hepatectomy have improved in recent years. However, the major...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/01.sla.0000217921.28563.55
更新日期:2006-08-01 00:00:00
abstract:OBJECTIVE:The aim of this study was to investigate tumor recurrence after liver transplantation for hepatocellular carcinoma (HCC), with and without hypothermic oxygenated liver perfusion (HOPE) before transplantation. PATIENTS AND METHODS:We analyzed all liver recipients with HCC, transplanted between January 2012 an...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/SLA.0000000000004258
更新日期:2020-11-01 00:00:00
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
更新日期:2019-08-13 00:00:00
abstract:OBJECTIVE:Influence of sacral nerve modulation (SNM) on cerebral somatosensory evoked potentials (SEP) was determined in patients with incontinence and constipation. BACKGROUND:Selection of patients with incontinence and constipation for SNM could be improved. METHODS:The latency (ms) of SEP induced by pudendal nerve...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/SLA.0b013e3182196ff4
更新日期:2011-07-01 00:00:00
abstract:OBJECTIVE:The primary aim of this study was to delineate the role of computed tomography (CT) in patients undergoing NOM for AGSW. BACKGROUND:Nonoperative management (NOM) of abdominal gunshot wounds (AGSWs) remains controversial. METHODS:This prospective study included all patients with abdominal gunshot injuries ad...
journal_title:Annals of surgery
pub_type: 临床试验,杂志文章
doi:10.1097/SLA.0000000000000879
更新日期:2015-04-01 00:00:00
abstract::Primary hyperparathyroidism was studied in a well-defined geriatric population of 1129 individuals during a three-month interval. Primary hyperparathyroidism was diagnosed in 1.5%. The diagnosis was based on a morphologic and biochemic basis. From clinical material consisting of 400 patients treated surgically for pri...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-198302000-00003
更新日期:1983-02-01 00:00:00
abstract:OBJECTIVE:Our goal was to perform a comparative effectiveness study of intravenous (IV)-only versus IV + enteral contrast in computed tomographic (CT) scans performed for patients undergoing appendectomy across a diverse group of hospitals. BACKGROUND:Small randomized trials from tertiary centers suggest that enteral ...
journal_title:Annals of surgery
pub_type: 杂志文章,多中心研究
doi:10.1097/SLA.0000000000000272
更新日期:2014-08-01 00:00:00
abstract:OBJECTIVE:Our objective was to analyze factors predicting outcomes after a total pancreatectomy and islet autotransplantation (TP-IAT). BACKGROUND:Chronic pancreatitis (CP) is increasingly treated by a TP-IAT. Postoperative outcomes are generally favorable, but a minority of patients fare poorly. METHODS:In our singl...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/SLA.0000000000001453
更新日期:2015-10-01 00:00:00
abstract::Between June 1977 and November 1981, 26 children and adults with ulcerative colitis have undergone a total colectomy, an endorectal dissection of the rectal mucosa, and an ileoanostomy. A combined abdominoperineal approach was used to perform the operation, and the mucosal-submucosal rectal tube was dissected out inta...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:
更新日期:1983-01-01 00:00:00
abstract:OBJECTIVE:To report on the long-term follow-up of a randomized clinical trial comparing pancreatic head resection according to Beger and limited pancreatic head excision combined with longitudinal pancreatico-jejunostomy according to Frey for surgical treatment of chronic pancreatitis. SUMMARY BACKGROUND DATA:Resectio...
journal_title:Annals of surgery
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1097/01.sla.0000157268.78543.03
更新日期:2005-04-01 00:00:00