Digestive Surgery最新文献_第6页

High Preoperative Platelet to Lymphocyte Ratio Is Associated with a Greater Risk of Postoperative Complications and Hematogenous Recurrences in Esophageal Squamous Cell Carcinoma Patients Receiving Neoadjuvant Treatment. 在接受新辅助治疗的食管鳞状细胞癌患者中，术前血小板与淋巴细胞比例高与术后并发症和血液复发的高风险相关。

IF 2.7 3区医学

Digestive Surgery Pub Date : 2023-01-01 DOI: 10.1159/000530018

Masahiro Sasahara, Mitsuro Kanda, Dai Shimizu, Hideki Takami, Yoshikuni Inokawa, Norifumi Hattori, Masamichi Hayashi, Chie Tanaka, Michitaka Fujiwara, Goro Nakayama, Yasuhiro Kodera

{"title":"High Preoperative Platelet to Lymphocyte Ratio Is Associated with a Greater Risk of Postoperative Complications and Hematogenous Recurrences in Esophageal Squamous Cell Carcinoma Patients Receiving Neoadjuvant Treatment.","authors":"Masahiro Sasahara, Mitsuro Kanda, Dai Shimizu, Hideki Takami, Yoshikuni Inokawa, Norifumi Hattori, Masamichi Hayashi, Chie Tanaka, Michitaka Fujiwara, Goro Nakayama, Yasuhiro Kodera","doi":"10.1159/000530018","DOIUrl":"https://doi.org/10.1159/000530018","url":null,"abstract":"Introduction: Neoadjuvant treatment is currently the gold standard for advanced esophageal squamous cell carcinoma (ESCC). Several studies have examined the value of blood count-based indexes for predicting short- and long-term outcomes after esophagectomy for ESCC, but the relative predictive value of pretreatment, preoperative, and postoperative indexes has not yet been examined.Methods: This study included 320 patients with thoracic ESCC who underwent subtotal esophagectomy after neoadjuvant chemotherapy or chemoradiotherapy at our institution. A total of 19 candidate blood parameters were measured before neoadjuvant treatment as well as preoperatively and postoperatively. The ability of the parameters to predict postoperative complications, overall survival (OS), and relapse-free survival (RFS) was assessed using receiver operating characteristic (ROC) curve analysis and Cox regression analysis.Results: ROC curve analysis indicated that preoperative platelet to lymphocyte ratio (PLR) had the best predictive value with an optimal cutoff value of 166. Patients with high preoperative PLR (≥166) had significantly shorter OS and RFS and significantly higher incidences of hematogenous recurrence and postoperative pneumonia compared with patients with low preoperative PLR (<166). In multivariate analysis, high preoperative PLR and high preoperative serum carcinoembryonic antigen level were independent predictors of poor prognosis.Conclusion: Preoperative PLR is a good predictor of short- and long-term prognosis in patients with advanced ESCC who receive neoadjuvant treatment followed by radical resection.","PeriodicalId":11241,"journal":{"name":"Digestive Surgery","volume":"40 1-2","pages":"48-57"},"PeriodicalIF":2.7,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9830104","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

Identifying Risk Factors of Complications following Total Gastrectomy for Gastric Cancer: Comparison between Splenectomy and Spleen-Preserving Surgery - A Supplementary Analysis of JCOG0110. 胃癌全胃切除术后并发症的危险因素分析:脾切除术与保脾手术的比较——JCOG0110的补充分析

IF 2.7 3区医学

Digestive Surgery Pub Date : 2023-01-01 DOI: 10.1159/000531192

Seiji Ito, Takeshi Sano, Junki Mizusawa, Masanori Tokunaga, Tadayoshi Hashimoto, Hiroshi Imamura, Shin Teshima, Koei Nihei, Makoto Yamada, Yasuhiro Choda, Kazuhiro Imamura, Shinji Hato, Masanori Terashima, Mitsuru Sasako

{"title":"Identifying Risk Factors of Complications following Total Gastrectomy for Gastric Cancer: Comparison between Splenectomy and Spleen-Preserving Surgery - A Supplementary Analysis of JCOG0110.","authors":"Seiji Ito, Takeshi Sano, Junki Mizusawa, Masanori Tokunaga, Tadayoshi Hashimoto, Hiroshi Imamura, Shin Teshima, Koei Nihei, Makoto Yamada, Yasuhiro Choda, Kazuhiro Imamura, Shinji Hato, Masanori Terashima, Mitsuru Sasako","doi":"10.1159/000531192","DOIUrl":"https://doi.org/10.1159/000531192","url":null,"abstract":"Introduction: Splenectomy for proximal gastric cancer was found to offer no survival benefit in a randomized trial clarifying the role of splenectomy (JCOG0110 study). Although many studies have explored risk factors for morbidities following total gastrectomy, none have assessed the risk factors for postoperative complications in spleen-preserving total gastrectomy.Methods: Using data from 505 patients enrolled in a previous randomized trial, risk factors for postoperative complications were identified by multivariable logistic regression analysis. Then, the risk factors were assessed separately between splenectomy and spleen-preserving total gastrectomy.Results: Postoperative complications were identified in 119 patients (23.6%) and were more common following splenectomy than following spleen-preserving surgery (30.7% and 16.1%, respectively, p < 0.01). Multivariable analysis revealed that age ≥65 years (p = 0.032), body mass index ≥25 (p = 0.003), and blood loss ≥350 (p = 0.019) were independent risk factors for postoperative complications in the entire cohort. Among them, only body mass index was a significant independent risk factor for complications in both spleen preservation (p = 0.047) and splenectomy groups (p = 0.017).Conclusion: Risk factors for postoperative complications were essentially the same between splenectomy and spleen preservation. Being overweight increased the risk of postoperative complications.","PeriodicalId":11241,"journal":{"name":"Digestive Surgery","volume":"40 3-4","pages":"114-120"},"PeriodicalIF":2.7,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10209119","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

Updating the Predictive Models for Mortality and Morbidity after Low Anterior Resection Based on the National Clinical Database. 基于国家临床数据库的前低位切除术后死亡率和发病率预测模型的更新。

IF 2.7 3区医学

Digestive Surgery Pub Date : 2023-01-01 DOI: 10.1159/000531370

Kazushige Kawai, Shinya Hirakawa, Hisateru Tachimori, Taro Oshikiri, Hiroaki Miyata, Yoshihiro Kakeji, Yuko Kitagawa

{"title":"Updating the Predictive Models for Mortality and Morbidity after Low Anterior Resection Based on the National Clinical Database.","authors":"Kazushige Kawai, Shinya Hirakawa, Hisateru Tachimori, Taro Oshikiri, Hiroaki Miyata, Yoshihiro Kakeji, Yuko Kitagawa","doi":"10.1159/000531370","DOIUrl":"https://doi.org/10.1159/000531370","url":null,"abstract":"Introduction: We previously developed risk models for mortality and morbidity after low anterior resection using a nationwide Japanese database. However, the milieu of low anterior resection in Japan has undergone drastic changes since then. This study aimed to construct risk models for 6 short-term postoperative outcomes after low anterior resection, i.e., in-hospital mortality, 30-day mortality, anastomotic leakage, surgical site infection except for anastomotic leakage, overall postoperative complication rate, and 30-day reoperation rate.Methods: This study enrolled 120,912 patients registered with the National Clinical Database, who underwent low anterior resection between 2014 and 2019. Multiple logistic regression analyses were performed to generate predictive models of mortality and morbidity using preoperative information, including the TNM stage.Results: We developed new risk prediction models for the overall postoperative complication and 30-day reoperation rates for low anterior resection, which were absent from the previous version. The concordance indices for each endpoint were 0.82 for in-hospital mortality, 0.79 for 30-day mortality, 0.64 for anastomotic leakage, 0.62 for surgical site infection besides anastomotic leakage, 0.63 for complications, and 0.62 for reoperation. The concordance indices of all four models included in the previous version showed improvement.Conclusion: This study successfully updated the risk calculators for predicting mortality and morbidity after low anterior resection using a model based on vast nationwide Japanese data.","PeriodicalId":11241,"journal":{"name":"Digestive Surgery","volume":"40 3-4","pages":"130-142"},"PeriodicalIF":2.7,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10272068","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

Level of Inferior Mesenteric Artery Ligation in Sigmoid Colon and Rectal Cancer Surgery: Analysis of Apical Lymph Node Metastasis and Recurrence. 乙状结肠和直肠癌症手术中肠下动脉结扎的水平：顶端淋巴结转移和复发的分析。

IF 2.7 3区医学

Digestive Surgery Pub Date : 2023-01-01 Epub Date: 2023-08-07 DOI: 10.1159/000533407

Yuya Nakamura, Tadayoshi Yamaura, Yousuke Kinjo, Kazu Harada, Makoto Kawase, Yusuke Kawabata, Satoshi Kanto, Yasumasa Ogo, Nobukazu Kuroda

{"title":"Level of Inferior Mesenteric Artery Ligation in Sigmoid Colon and Rectal Cancer Surgery: Analysis of Apical Lymph Node Metastasis and Recurrence.","authors":"Yuya Nakamura, Tadayoshi Yamaura, Yousuke Kinjo, Kazu Harada, Makoto Kawase, Yusuke Kawabata, Satoshi Kanto, Yasumasa Ogo, Nobukazu Kuroda","doi":"10.1159/000533407","DOIUrl":"10.1159/000533407","url":null,"abstract":"Introduction: Whether high or low ligation of the inferior mesenteric artery (IMA) is optimal for treating sigmoid colon and rectal cancers is controversial. The present study aimed to compare outcomes of high and low ligation of the IMA and determine the adequate extent of IMA lymph node dissection.Methods: Subjects were 455 consecutive stage I-III colorectal cancer patients who underwent curative surgery between 2011 and 2019. We assessed the association between the level of IMA ligation and overall survival and recurrence-free survival (RFS) by propensity score matching analysis. Clinicopathological features of IMA lymph node metastasis and recurrence patterns were analyzed.Results: After propensity score matching, the low ligation group had a significantly worse prognosis than that of the high ligation group for RFS (p = 0.039). Positive IMA lymph nodes were associated with pathological T3 or T4 stage and N2 stage. IMA lymph node recurrences in the high ligation group occurred at the superior left side of the IMA root. In contrast, all recurrences in the low ligation group occurred at the left colic artery bifurcation.Conclusion: High ligation of IMA is oncologically safe. However, even with high ligation, care must be taken to ensure adequate lymph node dissection.","PeriodicalId":11241,"journal":{"name":"Digestive Surgery","volume":" ","pages":"167-177"},"PeriodicalIF":2.7,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9944850","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

Systematic Review and Meta-Analysis of Clinical Outcomes after Enucleation of Pancreatic Metastases from Renal Cell Carcinoma. 肾细胞癌胰腺转移瘤去核后临床结果的系统评价和荟萃分析。

IF 2.7 3区医学

Digestive Surgery Pub Date : 2023-01-01 DOI: 10.1159/000528823

Stefania Brozzetti, Mariavittoria Carati, Antonio V Sterpetti

{"title":"Systematic Review and Meta-Analysis of Clinical Outcomes after Enucleation of Pancreatic Metastases from Renal Cell Carcinoma.","authors":"Stefania Brozzetti, Mariavittoria Carati, Antonio V Sterpetti","doi":"10.1159/000528823","DOIUrl":"https://doi.org/10.1159/000528823","url":null,"abstract":"Introduction: A systematic review and meta-analysis of the literature was carried out to determine the clinical and oncological outcome of patients who had enucleation of solitary pancreatic metastases from renal cell carcinoma.Methods: Operative mortality, postoperative complications, observed survival, and disease-free survival were analyzed. The clinical outcomes of patients who had enucleation were compared to those of 947 patients collected from the literature who had standard or atypical pancreatic resection for the same disease using propensity score matching.Results: There was no postoperative mortality in the 56 patients who had enucleation of pancreatic metastases from renal cell carcinoma. In 51 patients, postoperative complications could be analyzed. Ten patients (10/51 = 19.6%) had postoperative complications. Three patients (3/51 = 5.9%) had major complications (Clavien-Dindo III or more). Five-year observed survival rates and disease-free survival for patients with enucleation were 92% and 79%, respectively. These results compared favorably with those obtained in patients who had standard resection and other forms of atypical resection (also using propensity score matching). Patients who had partial pancreatic resection (atypical or not) with pancreatic-jejunal anastomosis had increased rates of postoperative complications and local recurrences.Conclusions: Enucleation of pancreatic metastases offers a valid solution in selected patients.","PeriodicalId":11241,"journal":{"name":"Digestive Surgery","volume":"40 1-2","pages":"9-20"},"PeriodicalIF":2.7,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9826791","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

Omentectomy as Part of Radical Surgery for Gastric Cancer: 5-Year Follow-Up Results of a Multicenter Prospective Cohort Study. 网膜切除术作为胃癌根治性手术的一部分:一项多中心前瞻性队列研究的5年随访结果

IF 2.7 3区医学

Digestive Surgery Pub Date : 2023-01-01 DOI: 10.1159/000530975

Kammy Keywani, Alexander B J Borgstein, Djamila Boerma, Stijn van Esser, Wietse J Eshuis, Mark I Van Berge Henegouwen, Johanna van Sandick, Suzanne S Gisbertz

{"title":"Omentectomy as Part of Radical Surgery for Gastric Cancer: 5-Year Follow-Up Results of a Multicenter Prospective Cohort Study.","authors":"Kammy Keywani, Alexander B J Borgstein, Djamila Boerma, Stijn van Esser, Wietse J Eshuis, Mark I Van Berge Henegouwen, Johanna van Sandick, Suzanne S Gisbertz","doi":"10.1159/000530975","DOIUrl":"https://doi.org/10.1159/000530975","url":null,"abstract":"Introduction: Curative therapy for gastric cancer usually consists of perioperative chemotherapy combined with a radical (R0) gastrectomy. In addition to a modified D2 lymphadenectomy, a complete omentectomy is recommended. However, there is little evidence for a survival benefit of omentectomy. This study presents the follow-up data of the OMEGA study.Methods: This multicenter prospective cohort study included 100 consecutive patients with gastric cancer undergoing (sub)total gastrectomy with complete en bloc omentectomy and modified D2 lymphadenectomy. Primary outcome of the current study was 5-year overall survival. Patients with or without omental metastases were compared. Pathological factors associated with locoregional recurrence and/or metastases were tested with multivariable regression analysis.Results: Of 100 included patients, five had metastases in the greater omentum. Five-year overall survival was 0.0% in patients with omental metastases and 44.2% in patients without omental metastases (p = 0.001). Median overall survival time for patients with or without omental metastases was 7 months and 53 months. A (y)pT3-4 stage tumor and vasoinvasive growth were associated with locoregional recurrence and/or metastases in patients without omental metastases.Conclusion: The presence of omental metastases in gastric cancer patients who underwent potentially curative surgery was associated with impaired overall survival. Omentectomy as part of radical gastrectomy for gastric cancer might not contribute to a survival benefit in case of undetected omental metastases.","PeriodicalId":11241,"journal":{"name":"Digestive Surgery","volume":"40 1-2","pages":"76-83"},"PeriodicalIF":2.7,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10206761","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

Computed Tomography-Defined Body Composition as Prognostic Parameter in Acute Mesenteric Ischemia. 将计算机断层扫描确定的身体成分作为急性肠系膜缺血的预后参数

IF 2.7 3区医学

Digestive Surgery Pub Date : 2023-01-01 Epub Date: 2023-09-14 DOI: 10.1159/000534093

Christoph Schwartner, Matthias Mehdorn, Ines Gockel, Manuel Florian Struck, Jakob Leonhardi, Markus Rositzka, Sebastian Ebel, Timm Denecke, Hans-Jonas Meyer

{"title":"Computed Tomography-Defined Body Composition as Prognostic Parameter in Acute Mesenteric Ischemia.","authors":"Christoph Schwartner, Matthias Mehdorn, Ines Gockel, Manuel Florian Struck, Jakob Leonhardi, Markus Rositzka, Sebastian Ebel, Timm Denecke, Hans-Jonas Meyer","doi":"10.1159/000534093","DOIUrl":"10.1159/000534093","url":null,"abstract":"Introduction: Body composition comprising low-skeletal muscle mass (LSMM) and subcutaneous and visceral adipose tissue (SAT and VAT) can be assessed by using cross-sectional imaging modalities. Previous analyses suggest that these parameters harbor prognostic relevance in various diseases. Aim of this study was to analyze possible associations of body composition parameters on mortality in patients with clinically suspected acute mesenteric ischemia (AMI).Methods: All patients with clinically suspected AMI were retrospectively assessed between 2016 and 2020. Overall, 137 patients (52 female patients, 37.9%) with a median age of 71 years were included in the present analysis. For all patients, the preoperative abdominal computed tomography (CT) was used to calculate LSMM, VAT, and SAT.Results: Overall, 94 patients (68.6%) of the patient cohort died within 30 days within a median of 2 days, range 1-39 days. Of these, 27 patients (19.7%) died within 24 h. According to the CT, 101 patients (73.7%) were classified as being visceral obese, 102 patients (74.5%) as being sarcopenic, and 69 patients (50.4%) as being sarcopenic obese. Skeletal muscle index (SMI) was lower in non-survivors compared to survivors (37.5 ± 12.4 cm2/m2 vs. 44.1 ± 13.9 cm2/m2, p = 0.01). There were no associations between body composition parameters with mortality in days (SMI r = 0.07, p = 0.48, SAT r = -0.03, p = 0.77, and VAT r = 0.04, p = 0.68, respectively). In Cox regression analysis, a nonsignificant trend for visceral obesity was observed (HR: 0.62, 95% CI: 0.36-1.05, p = 0.07).Conclusion: SMI might be a valuable CT-based parameter, which could help discriminate between survivors and non-survivors. Further studies are needed to elucidate the associations between body composition and survival in patients with AMI.","PeriodicalId":11241,"journal":{"name":"Digestive Surgery","volume":" ","pages":"225-232"},"PeriodicalIF":2.7,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10716866/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10240727","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

The Impact of Paratracheal Lymphadenectomy on Lymph Node Yield and Short-Term Outcomes in Esophagectomy for Cancer: A Nation-Wide Propensity Score-Matched Analysis. 气管旁淋巴结切除术对食管癌患者食管切除术中淋巴结产量和短期预后的影响:一项全国性倾向评分匹配分析。

IF 2.7 3区医学

Digestive Surgery Pub Date : 2023-01-01 DOI: 10.1159/000530019

B Feike Kingma, Eliza R C Hagens, Mark I Van Berge Henegouwen, Alicia S Borggreve, Jelle P Ruurda, Suzanne S Gisbertz, Richard van Hillegersberg

{"title":"The Impact of Paratracheal Lymphadenectomy on Lymph Node Yield and Short-Term Outcomes in Esophagectomy for Cancer: A Nation-Wide Propensity Score-Matched Analysis.","authors":"B Feike Kingma, Eliza R C Hagens, Mark I Van Berge Henegouwen, Alicia S Borggreve, Jelle P Ruurda, Suzanne S Gisbertz, Richard van Hillegersberg","doi":"10.1159/000530019","DOIUrl":"https://doi.org/10.1159/000530019","url":null,"abstract":"Introduction: The balance between potential oncological merits and surgical risks is unclear for the additional step of performing paratracheal lymphadenectomy during esophagectomy for cancer. This study aimed to investigate the impact of paratracheal lymphadenectomy on lymph node yield and short-term outcomes in patients who underwent this procedure in the Netherlands.Methods: Patients who underwent neoadjuvant chemoradiotherapy followed by transthoracic esophagectomy were included from the Dutch Upper Gastrointestinal Cancer Audit (DUCA). After propensity score matching Ivor Lewis and McKeown approaches separately, lymph node yield and short-term outcomes were compared between patients who underwent paratracheal lymphadenectomy versus patients who did not.Results: Between 2011 and 2017, 2,128 patients were included. Some 770 patients (n = 385 vs. n = 385) and 516 patients (n = 258 vs. n = 258) were matched for the Ivor Lewis and McKeown approaches, respectively. Paratracheal lymphadenectomy was associated with a higher lymph node yield in Ivor Lewis (23 vs. 19 nodes, p < 0.001) and McKeown (21 vs. 19 nodes, p = 0.015) esophagectomy. There were no significant differences in complications or mortality. After Ivor Lewis esophagectomy, paratracheal lymphadenectomy was associated with longer length of stay (12 vs. 11 days, p < 0.048). After McKeown esophagectomy, paratracheal lymphadenectomy was associated with more re-interventions (30% vs. 18%, p = 0.002).Conclusions: Paratracheal lymphadenectomy resulted in a higher lymph node yield but also in longer length of stay after Ivor Lewis and more re-interventions following McKeown esophagectomy.","PeriodicalId":11241,"journal":{"name":"Digestive Surgery","volume":"40 1-2","pages":"58-68"},"PeriodicalIF":2.7,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9830099","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

Serum Creatinine and Amylase in Drain to Predict Pancreatic Fistula Risk after Pancreatoduodenectomy. 引流管中血清肌酐和淀粉酶预测胰十二指肠切除术后胰瘘风险。

IF 2.7 3区医学

Digestive Surgery Pub Date : 2023-01-01 Epub Date: 2023-10-20 DOI: 10.1159/000533869

Yunda Song, Subo Zhang

{"title":"Serum Creatinine and Amylase in Drain to Predict Pancreatic Fistula Risk after Pancreatoduodenectomy.","authors":"Yunda Song, Subo Zhang","doi":"10.1159/000533869","DOIUrl":"10.1159/000533869","url":null,"abstract":"Introduction: The identification of patients with low risk of clinically relevant postoperative pancreatic fistula (CR-POPF) and postoperative hemorrhage (PPH) can guide drain removal after pancreatoduodenectomy (PD). However, drain fluid amylase (DFA) ≤5,000 U/L on postoperative day (POD) 1 does not robustly predict the absence of CR-POPF.Methods: Consecutive patients undergoing PD at Sun Yat-sen University Cancer Center between July 2018 and October 2021 were analyzed. Recursive partitioning analysis was used to classify patients into groups with different risks of CR-POPF and PPH.Results: Among 288 consecutive patients included, 99 patients (34.38%) developed CR-POPF (86 grade B and 13 grade C). Patients with CR-POPF had increased levels of preoperative creatinine (CRE) and POD1 CRE. The combination of POD1 CRE (>104 μmol/L or not) and POD1 DFA (>5,000 U/L or not) stratified patients into subgroups with the maximum difference in CR-POPF risk. The CR-POPF rates were 17.82% (36/202) in group A (POD1 CRE ≤104 μmol/L and POD1 DFA ≤5,000 U/L), 53.33% (8/15) in group B (POD1 CRE >104 μmol/L and POD1 DFA ≤5,000 U/L), and 77.46% (55/71) in group C (POD1 DFA >5,000 U/L). The PPH rates were 1.98% (4/202), 20.00% (3/15), and 19.72% (14/71) in groups A, B, and C, respectively.Conclusion: Patients with POD1 DFA ≤5,000 U/L and POD1 CRE >104 μmol/L have a high risk of CR-POPF and may not benefit from early drain removal. Patients with POD1 DFA ≤5,000 U/L and POD1 CRE ≤104 μmol/L have low risk of CR-POPF and PPH.","PeriodicalId":11241,"journal":{"name":"Digestive Surgery","volume":" ","pages":"205-215"},"PeriodicalIF":2.7,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10716868/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49689233","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Thyroid Incidentalomas: Incidence and Oncological Implication in Patients with Esophageal Cancer. 甲状腺偶发瘤：食管癌患者的发病率和肿瘤学意义

IF 2.7 3区医学

Digestive Surgery Pub Date : 2023-01-01 Epub Date: 2023-09-07 DOI: 10.1159/000534027

Jasmijn R van Doesburg, Marianne C Kalff, Daan M Voeten, Anton F Engelsman, Saskia Jol, Mark I van Berge Henegouwen, Freek Daams, Suzanne S Gisbertz

{"title":"Thyroid Incidentalomas: Incidence and Oncological Implication in Patients with Esophageal Cancer.","authors":"Jasmijn R van Doesburg, Marianne C Kalff, Daan M Voeten, Anton F Engelsman, Saskia Jol, Mark I van Berge Henegouwen, Freek Daams, Suzanne S Gisbertz","doi":"10.1159/000534027","DOIUrl":"10.1159/000534027","url":null,"abstract":"Introduction: Thyroid incidentalomas are often encountered during imaging performed for the workup of esophageal cancer. Their oncological significance is unknown. This study aimed to establish incidence and etiology of thyroid incidentalomas found during the diagnostic workup of esophageal cancer.Methods: All esophageal cancer patients referred to or diagnosed at the Amsterdam UMC between January 2012 and December 2016 were included. Radiology and multidisciplinary team meeting reports were reviewed for presence of thyroid incidentalomas. When present, the fluorodeoxyglucose-positron emission tomography/computed tomography (18FDG-PET/CT) or CT was reassessed by a radiologist. Primary outcome was the incidence and etiology of thyroid incidentalomas.Results: In total, 1,110 esophageal cancer patients were included. Median age was 66 years, most were male (77.2%) and had an adenocarcinoma (69.4%). For 115 patients (10.4%), a thyroid incidentaloma was reported. Two thyroidal lesions proved malignant. One was an esophageal cancer metastasis (0.9%) and one was a primary thyroid carcinoma (0.9%). Only the primary thyroid carcinoma resulted in treatment alteration. The other malignant thyroid incidentaloma was in the context of disseminated esophageal disease and ineligible for curative treatment.Conclusion: In this study, thyroid incidentalomas were only very rarely oncologically significant. Further etiological examination should only be considered in accordance with the TI-RADS classification system and when clinical consequences are to be expected.","PeriodicalId":11241,"journal":{"name":"Digestive Surgery","volume":" ","pages":"216-224"},"PeriodicalIF":2.7,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10182823","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}

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