Digestive Surgery最新文献_第10页

Association between Surgical Patient Selection and Hospital Variation in Failure to Cure in Esophageal Cancer Surgery: A Nationwide Cohort Study. 食管癌手术患者选择与医院治疗失败之间的关系:一项全国性队列研究。

IF 2.7 3区医学

Digestive Surgery Pub Date : 2022-01-01 DOI: 10.1159/000524999

Daan M Voeten, Pauline A J Vissers, Rob H A Verhoeven, Richard van Hillegersberg, Mark Ivo Van Berge Henegouwen

{"title":"Association between Surgical Patient Selection and Hospital Variation in Failure to Cure in Esophageal Cancer Surgery: A Nationwide Cohort Study.","authors":"Daan M Voeten, Pauline A J Vissers, Rob H A Verhoeven, Richard van Hillegersberg, Mark Ivo Van Berge Henegouwen","doi":"10.1159/000524999","DOIUrl":"https://doi.org/10.1159/000524999","url":null,"abstract":"Introduction: Failure to cure describes: (1) nonresectional (\"open-close\") surgery, (2) non-radical surgery (R1-R2), and/or (3) postoperative mortality. This study aimed to investigate whether hospitals offering surgery to a large proportion of patients have higher failure-to-cure rates than hospitals operating fewer patients.Methods: From the Netherlands Cancer Registry, all cT1-cT4a/cTx-any cN-cM0 esophageal cancer patients diagnosed in 2015-2018 were included. For each center, the expected (E) proportion of patients undergoing surgery was established and divided by the observed (O) proportion. Hospitals were categorized into three groups: (1) hospitals treating relatively many patients with surgery, (2) average hospitals, and (3) hospitals treating relatively few patients with surgery. Multilevel multivariable regression investigated the association between these hospital groups and failure to cure.Results: Some 3,437 (53.2%) of 6,457 patients underwent surgery, ranging from 45 to 64% among 16 hospitals. The failure-to-cure rate was 15.0% (hospital variation [4.6-23.7%]). After categorizing, 1,003 patients underwent surgery in hospitals with low surgery rates (O/E ratio <0.94/corrected percentage <50%), 1,297 patients in average hospitals, and 1,137 patients in hospitals treating many patients surgically (O/E ratio >1.01/corrected percentage >54%). Failure-to-cure rates were 16.8%, 12.2%, and 14.0%, respectively. This was nonsignificant in multilevel analyses (aOR: 0.63, 95% CI: 0.38-1.05; aOR: 0.76, 95% CI: 0.46-1.24).Discussion/conclusion: Failure-to-cure rates were similar in hospitals with a high surgery rate and hospitals with a low rate. Increasing the proportion of patients undergoing a resection may offer more patients, a chance for cure.","PeriodicalId":11241,"journal":{"name":"Digestive Surgery","volume":null,"pages":null},"PeriodicalIF":2.7,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10570472","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

EDS Society News. EDS社会新闻。

IF 2.7 3区医学

Digestive Surgery Pub Date : 2022-01-01 DOI: 10.1159/000528742

引用次数: 0

Front & Back Matter 正面和背面事项

IF 2.7 3区医学

Digestive Surgery Pub Date : 2022-01-01 DOI: 10.1159/000521822

S. Paiella

引用次数: 0

Contents Vol. 38, 2021 目录2021年第38卷

IF 2.7 3区医学

Digestive Surgery Pub Date : 2022-01-01 DOI: 10.1159/000521224

S. Paiella

引用次数: 0

Management Strategy for Gallbladder Polypoid Lesions: Results of a 5-Year Single-Center Cohort Study. 胆囊息肉病的治疗策略:一项5年单中心队列研究的结果。

IF 2.7 3区医学

Digestive Surgery Pub Date : 2022-01-01 DOI: 10.1159/000529221

Feng Tian, Yu-Xin Ma, Yi-Fan Liu, Wei Liu, Tao Hong, Xiao-Dong He, Qiang Qu

{"title":"Management Strategy for Gallbladder Polypoid Lesions: Results of a 5-Year Single-Center Cohort Study.","authors":"Feng Tian, Yu-Xin Ma, Yi-Fan Liu, Wei Liu, Tao Hong, Xiao-Dong He, Qiang Qu","doi":"10.1159/000529221","DOIUrl":"https://doi.org/10.1159/000529221","url":null,"abstract":"Introduction: Controversy remains about the classification, differential diagnosis, and treatment strategy for gallbladder polypoid lesions (GPLs). This study sought to explore the individualized treatment strategy for GPLs.Methods: We retrospectively studied 642 consecutive patients with GPLs from January 2015 to May 2020. Univariate and multivariable analyses were performed to explore the potential risk factors for neoplastic polyps. The outcome of laparoscopic gallbladder-preserving polypectomy (GPP) was evaluated and compared with that of laparoscopic cholecystectomy (LC).Results: Of 642 enrolled patients, 572 underwent LC, and 70 underwent GPP. Pathologically, the majority of GPLs were cholesterol polyps (68.4%), followed by adenomyomatosis (19.9%), benign adenoma (7.3%), adenocarcinoma (3.6%), and rare pathological types (0.8%). Additionally, 66.3% (379/572) of the LC cases were classified as non-neoplastic, and 33.7% (193/572) neoplastic polyps. Multivariate analysis demonstrated that single polyps (OR 1.956, 95% CI: 1.121-3.412; p = 0.018), polyps located at the gallbladder fundus (OR 4.326, 95% CI: 2.179-8.591; p < 0.001), polyps not less than 14 mm (OR 2.833, 95% CI: 1.614-4.973; p < 0.001), and polyps with a broad base (OR 4.173, 95% CI: 1.743-9.990; p = 0.001) were independent risk factors for neoplastic polyps. The 5-year prospective results after GPP showed that the 1-year and 3-year polyp recurrence rates were 13.2% and 23.4%, respectively.Conclusion: The majority of GPLs are cholesterol or other benign lesions without malignant potential. LC is the main treatment procedure for GPLs with a high neoplastic risk. GPP is potentially feasible and could be an alternative management strategy for a group of GPLs patients who meet the selection criteria.","PeriodicalId":11241,"journal":{"name":"Digestive Surgery","volume":null,"pages":null},"PeriodicalIF":2.7,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9367267","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Safety and Efficacy of Laparoscopic Surgery versus Open Surgery in Elderly Patients with Colon Cancer: A Propensity Score Matching Cohort Study. 老年结肠癌患者腹腔镜手术与开放手术的安全性和有效性:一项倾向评分匹配队列研究

IF 2.7 3区医学

Digestive Surgery Pub Date : 2022-01-01 DOI: 10.1159/000529223

Chao Wang, Lin Gan, Kewei Jiang, Zhidong Gao, Yingjiang Ye

{"title":"Safety and Efficacy of Laparoscopic Surgery versus Open Surgery in Elderly Patients with Colon Cancer: A Propensity Score Matching Cohort Study.","authors":"Chao Wang, Lin Gan, Kewei Jiang, Zhidong Gao, Yingjiang Ye","doi":"10.1159/000529223","DOIUrl":"https://doi.org/10.1159/000529223","url":null,"abstract":"Introduction: The safety of laparoscopic surgery (LS) and its effect on survival have not been sufficiently assessed in elderly colon cancer patients.Methods: Clinicopathologic data of patients aged ≥75 years who underwent colectomy for primary colon cancer, between January 2018 and June 2021, were reviewed. Patients were divided into the LS and open surgery (OS) groups according to the intention-to-treat principle and were compared using propensity score matching. The primary outcomes were differences in surgical safety and 3-year survival.Results: There were 98 patients with a median age of 82 years and 85 patients with a median age of 80 years assigned to the OS and LS groups, respectively. Propensity score matching revealed that LS did not prolong the operative time (190 vs. 180 min, p = 0.209) and was linked to less intraoperative blood loss (50 vs. 100 mL, p = 0.039) and shorter postoperative hospital stay (8 vs. 10 days, p = 0.005), compared to OS. In addition, LS was not accompanied by more stress response when the variations exhibited in laboratory tests and the Barthel index pre- and postsurgery were considered. There were no significant differences in the adjusted 3-year overall survival (86.0% vs. 81.2%, p = 0.795) and disease-free survival (86.6% vs. 87.9%, p = 0.356) between the groups.Conclusion: LS enhanced postoperative recovery without increasing surgical risks, compared to OS, in colon cancer patients aged ≥75 years. Furthermore, no significant differences in the 3-year adjusted survival were observed between the groups.","PeriodicalId":11241,"journal":{"name":"Digestive Surgery","volume":null,"pages":null},"PeriodicalIF":2.7,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9367268","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Hybrid Laparo-Endoscopic Resection of Submucosal Cardial Tumors Assisted by Flexible Articulated Instruments. 柔性关节器械辅助下的混合腹腔镜内镜下心脏粘膜下肿瘤切除术。

IF 2.7 3区医学

Digestive Surgery Pub Date : 2022-01-01 DOI: 10.1159/000527026

Federico Llanos, Matias Turchi, Mauricio Ramirez, Franco Badaloni, Fabio Nachman, Alejandro Nieponice

引用次数: 0

Handling of Hilar Vasculature in Living Donor Right Hepatectomy Using Extrahepatic Glissonean Approach. 肝外格利索内入路对活体右肝切除术肝门血管的处理。

IF 2.7 3区医学

Digestive Surgery Pub Date : 2022-01-01 Epub Date: 2021-12-06 DOI: 10.1159/000521240

Naokazu Chiba, Motohide Shimazu, Shigeto Ochiai, Takahiro Gunji, Toshimichi Kobayashi, Toru Sano, Koichi Tomita, Shigeyuki Kawachi

{"title":"Handling of Hilar Vasculature in Living Donor Right Hepatectomy Using Extrahepatic Glissonean Approach.","authors":"Naokazu Chiba, Motohide Shimazu, Shigeto Ochiai, Takahiro Gunji, Toshimichi Kobayashi, Toru Sano, Koichi Tomita, Shigeyuki Kawachi","doi":"10.1159/000521240","DOIUrl":"https://doi.org/10.1159/000521240","url":null,"abstract":"Donor hepatectomy is one of the most important procedures in LDLT because it affects the safety of donors and the outcome of the recipients. We standardized a method of securing the important vessels at the hepatic hilum while advancing the dissection toward the central direction. This research introduces our technique of handling hilar vasculature in living donor hepatectomy, using the extrahepatic Glissonean approach, and discusses its efficacy. At first, after the extrahepatic right Glissonean approach, the resected hepatic artery and portal vein are secured on the same line as with the secured Glisson. The resected hepatic artery and portal vein are followed in the central direction, and the surrounding area is dissected. The dissection is continued up to the main brunch of the hepatic artery and portal vein. The bile duct can be secured by subtracting the hepatic artery and portal vein from the tape that secured the Glissonean pedicle. The bile duct, hepatic artery, and the portal vein are dissected in this order, before dissecting the right hepatic vein, completing the surgery. This method of dissection approaching the extrahepatic Glisson carried out toward the central direction suggests to acquire minimal tissue removal and to shorten operative time. This could result in adequate perfusion to the remaining liver and donor safety, taken together effective results on the recipient.","PeriodicalId":11241,"journal":{"name":"Digestive Surgery","volume":null,"pages":null},"PeriodicalIF":2.7,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39697361","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Surgical Resection Is Preferred in Selected Solitary Hepatocellular Carcinoma with Portal Vein Tumor Thrombosis. 选择性单发肝细胞癌合并门静脉肿瘤血栓，首选手术切除。

IF 2.7 3区医学

Digestive Surgery Pub Date : 2022-01-01 Epub Date: 2022-01-11 DOI: 10.1159/000521827

Jaehun Yang, Jong Man Kim, Jinsoo Rhu, Gyu-Seong Choi, Choon Hyuck David Kwon, Jae-Won Joh

{"title":"Surgical Resection Is Preferred in Selected Solitary Hepatocellular Carcinoma with Portal Vein Tumor Thrombosis.","authors":"Jaehun Yang, Jong Man Kim, Jinsoo Rhu, Gyu-Seong Choi, Choon Hyuck David Kwon, Jae-Won Joh","doi":"10.1159/000521827","DOIUrl":"https://doi.org/10.1159/000521827","url":null,"abstract":"Introduction: Sorafenib is the standard care for hepatocellular carcinoma (HCC) patients with portal vein tumor thrombosis (PVTT), though it offers limited survival. This study was designed to compare clinical outcomes between liver resection (surgery) and transarterial chemoembolization plus radiotherapy (TACE-RT) as the initial treatment modality for resectable treatment-naïve solitary HCC combined with subsegmental (Vp1), segmental (Vp2), and lobar (Vp3) PVTT.Methods: From the institutional HCC registry, we identified 116 patients diagnosed with resectable treatment-naïve HCC with Vp1-Vp3 PVTT based on radiologic images who received surgery (n = 44) or TACE-RT (n = 72) as a primary treatment between 2010 and 2015. A propensity score matching (PSM) model was created.Results: The TACE-RT group had a higher tumor burden (tumor size, extent, and markers) than the surgery group. Cumulative patient survival curve in the surgery group was significantly higher than that in the TACE-RT group before and after PSM. Liver function was relatively well preserved in the surgery group compared with the TACE-RT group. TACE-RT group, male, increased alkaline phosphatase, and increased platelet count were predisposing factors for patient death in resectable treatment-naïve solitary HCC with PVTT.Discussion/conclusion: The present study suggests that surgery is considered as an initial treatment in selectively resectable treatment-naïve solitary HCC with Vp1-Vp3 PVTT.","PeriodicalId":11241,"journal":{"name":"Digestive Surgery","volume":null,"pages":null},"PeriodicalIF":2.7,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39811103","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 2

Front & Back Matter 正面和背面

IF 2.7 3区医学

Digestive Surgery Pub Date : 2021-09-01 DOI: 10.1159/000519733

D. O’Toole

引用次数: 0