Annals of Surgery Open最新文献_第9页

A Surgical Collaborative to Empower Medical Student Research 增强医学生研究能力的外科合作项目

Annals of Surgery Open Pub Date : 2024-02-09 DOI: 10.1097/as9.0000000000000390

Spoorthi Kamepalli, Joseph R. Junkin, Syed S. Bakhtiyar, Ashley Montgomery, Michael DiLeo, T. Galvan, John A Goss, Abbas A. Rana

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Comment on Article “Postoperative Serum Hyperamylasemia Adds Sequential Value to the Fistula Risk Score in Predicting Pancreatic Fistula After Pancreatoduodenectomy” 评论文章 "术后血清高淀粉酶血症为瘘管风险评分增添了预测胰十二指肠切除术后胰腺瘘管的连续性价值

Annals of Surgery Open Pub Date : 2024-02-09 DOI: 10.1097/as9.0000000000000391

Ziqiang Du, Rui Du, Yanfei Yang

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Comment on Article “Postoperative Serum Hyperamylasemia Adds Sequential Value to the Fistula Risk Score in Predicting Pancreatic Fistula After Pancreatoduodenectomy” 评论文章 "术后血清高淀粉酶血症为瘘管风险评分增添了预测胰十二指肠切除术后胰腺瘘管的连续性价值

Annals of Surgery Open Pub Date : 2024-02-09 DOI: 10.1097/as9.0000000000000391

Ziqiang Du, Rui Du, Yanfei Yang

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Pilot Trial on Ischemic Conditioning of the Gastric Conduit in Esophageal Cancer: Feasibility and Impact on Anastomotic Leakage (TIGOAL-I) 食管癌胃导管缺血调节试验：可行性及对吻合口渗漏的影响（TIGOAL-I）

Annals of Surgery Open Pub Date : 2024-02-05 DOI: 10.1097/as9.0000000000000379

María-Carmen Fernández-Moreno, María Eugenia Barrios Carvajal, Fernando López Mozos, Roberto Martí Obiol, Jorge Guijarro Rozalén, Elisabetta Casula, Joaquín Ortega

{"title":"Pilot Trial on Ischemic Conditioning of the Gastric Conduit in Esophageal Cancer: Feasibility and Impact on Anastomotic Leakage (TIGOAL-I)","authors":"María-Carmen Fernández-Moreno, María Eugenia Barrios Carvajal, Fernando López Mozos, Roberto Martí Obiol, Jorge Guijarro Rozalén, Elisabetta Casula, Joaquín Ortega","doi":"10.1097/as9.0000000000000379","DOIUrl":"https://doi.org/10.1097/as9.0000000000000379","url":null,"abstract":"\u0000 \u0000 To evaluate the feasibility, safety, and effectiveness of gastric conditioning using preoperative arterial embolization (PAE) before McKeown esophagectomy at a tertiary university hospital.\u0000 \u0000 \u0000 \u0000 Cervical anastomotic leakage (AL) is a common complication of esophagectomy. Limited clinical evidence suggests that gastric conditioning mitigates this risk.\u0000 \u0000 \u0000 \u0000 This pilot randomized clinical trial was conducted between April 2016 and October 2021 at a single-center tertiary hospital. Eligible patients with resectable malignant esophageal tumors, suitable for cervical esophagogastrostomy, were randomized into 2 groups: one receiving PAE and the other standard treatment. The primary endpoints were PAE-related complications and incidence of cervical AL.\u0000 \u0000 \u0000 \u0000 The study enrolled 40 eligible patients. PAE-related morbidity was 10%, with no Clavien-Dindo grade III complications. Cervical AL rates were similar between the groups (35% vs 25%, P = 0.49), even when conduit necrosis was included (35% vs 35%, P = 1). However, AL severity, including conduit necrosis, was higher in the control group according to the Clavien-Dindo ≥IIIb (5% vs 30%, P = 0.029) and Comprehensive Complication Index (20.9 vs 33.7, P = 0.01). No significant differences were found in other postoperative complications, such as pneumonia or postoperative mortality.\u0000 \u0000 \u0000 \u0000 PAE is a feasible and safe method for gastric conditioning before McKeown minimally invasive esophagectomy and shows promise for preventing severe AL. However, further studies are required to confirm its efficacy.\u0000","PeriodicalId":503165,"journal":{"name":"Annals of Surgery Open","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-02-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139863261","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Pilot Trial on Ischemic Conditioning of the Gastric Conduit in Esophageal Cancer: Feasibility and Impact on Anastomotic Leakage (TIGOAL-I) 食管癌胃导管缺血调节试验：可行性及对吻合口渗漏的影响（TIGOAL-I）

Annals of Surgery Open Pub Date : 2024-02-05 DOI: 10.1097/as9.0000000000000379

María-Carmen Fernández-Moreno, María Eugenia Barrios Carvajal, Fernando López Mozos, Roberto Martí Obiol, Jorge Guijarro Rozalén, Elisabetta Casula, Joaquín Ortega

{"title":"Pilot Trial on Ischemic Conditioning of the Gastric Conduit in Esophageal Cancer: Feasibility and Impact on Anastomotic Leakage (TIGOAL-I)","authors":"María-Carmen Fernández-Moreno, María Eugenia Barrios Carvajal, Fernando López Mozos, Roberto Martí Obiol, Jorge Guijarro Rozalén, Elisabetta Casula, Joaquín Ortega","doi":"10.1097/as9.0000000000000379","DOIUrl":"https://doi.org/10.1097/as9.0000000000000379","url":null,"abstract":"\u0000 \u0000 To evaluate the feasibility, safety, and effectiveness of gastric conditioning using preoperative arterial embolization (PAE) before McKeown esophagectomy at a tertiary university hospital.\u0000 \u0000 \u0000 \u0000 Cervical anastomotic leakage (AL) is a common complication of esophagectomy. Limited clinical evidence suggests that gastric conditioning mitigates this risk.\u0000 \u0000 \u0000 \u0000 This pilot randomized clinical trial was conducted between April 2016 and October 2021 at a single-center tertiary hospital. Eligible patients with resectable malignant esophageal tumors, suitable for cervical esophagogastrostomy, were randomized into 2 groups: one receiving PAE and the other standard treatment. The primary endpoints were PAE-related complications and incidence of cervical AL.\u0000 \u0000 \u0000 \u0000 The study enrolled 40 eligible patients. PAE-related morbidity was 10%, with no Clavien-Dindo grade III complications. Cervical AL rates were similar between the groups (35% vs 25%, P = 0.49), even when conduit necrosis was included (35% vs 35%, P = 1). However, AL severity, including conduit necrosis, was higher in the control group according to the Clavien-Dindo ≥IIIb (5% vs 30%, P = 0.029) and Comprehensive Complication Index (20.9 vs 33.7, P = 0.01). No significant differences were found in other postoperative complications, such as pneumonia or postoperative mortality.\u0000 \u0000 \u0000 \u0000 PAE is a feasible and safe method for gastric conditioning before McKeown minimally invasive esophagectomy and shows promise for preventing severe AL. However, further studies are required to confirm its efficacy.\u0000","PeriodicalId":503165,"journal":{"name":"Annals of Surgery Open","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-02-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139803375","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Don’t Ask Us to Stop Cycling: A Surgical Perspective 不要要求我们停止骑自行车：外科视角

Annals of Surgery Open Pub Date : 2024-02-02 DOI: 10.1097/as9.0000000000000380

Ali B. Abbasi, Alan Zambeli-Ljepović

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Don’t Ask Us to Stop Cycling: A Surgical Perspective 不要要求我们停止骑自行车：外科视角

Annals of Surgery Open Pub Date : 2024-02-02 DOI: 10.1097/as9.0000000000000380

Ali B. Abbasi, Alan Zambeli-Ljepović

引用次数: 0

Neoadjuvant Chemoradiotherapy Upregulates the Immunogenicity of Cold to Hot Tumors in Esophageal Cancer Patients 新辅助化放疗可提高食管癌患者冷肿瘤对热肿瘤的免疫原性

Annals of Surgery Open Pub Date : 2024-02-02 DOI: 10.1097/as9.0000000000000385

Yushi Nagaki, Satoru Motoyama, Yusuke Sato, A. Wakita, H. Fujita, Kohei Kemuriyama, Ryohei Sasamori, Shu Nozaki, K. Nomura, Y. Minamiya

{"title":"Neoadjuvant Chemoradiotherapy Upregulates the Immunogenicity of Cold to Hot Tumors in Esophageal Cancer Patients","authors":"Yushi Nagaki, Satoru Motoyama, Yusuke Sato, A. Wakita, H. Fujita, Kohei Kemuriyama, Ryohei Sasamori, Shu Nozaki, K. Nomura, Y. Minamiya","doi":"10.1097/as9.0000000000000385","DOIUrl":"https://doi.org/10.1097/as9.0000000000000385","url":null,"abstract":"\u0000 \u0000 To test the hypothesis that neoadjuvant chemoradiotherapy (NACRT) is more effective against hot esophageal squamous cell carcinoma (ESCC) and that it may upregulate tumor immunogenicity.\u0000 \u0000 \u0000 \u0000 There have been several recent reports showing the efficacy of immune check-point inhibitors (ICIs) against esophageal cancer, especially immunologically hot tumors. In addition, several studies have suggested that chemotherapy and radiotherapy may convert cold tumors to hot tumors.\u0000 \u0000 \u0000 \u0000 Of 105 ESCC patients who underwent surgery after NACRT between 2010 and 2018 at our hospital, 99 whose biopsy tissue samples were obtained were enrolled. Based on immunohistochemical analysis, tumors that were FOXA1 (+) and/or EYA2 (+) were defined as hot tumors, others were cold tumors. We then investigated the association between tumor immunogenicity and clinicopathological features.\u0000 \u0000 \u0000 \u0000 The 29 patients with hot tumors before NACRT had a significantly better 5-year disease-specific survival (DSS) rate than the remaining 70 patients with cold tumors (85% vs 64%; P = 0.036). In a multivariate analysis, tumor immunogenicity was a significant independent predictor of DSS. Of 68 patients without a pathological complete response (non-pCR) in their primary tumor, 51 (75%) had hot tumors after NACRT. Moreover, 75% (36/48) of tumors that were cold before NACRT were converted to hot tumors after NACRT.\u0000 \u0000 \u0000 \u0000 Patients with hot ESCC tumors treated with NACRT plus esophagectomy had a better prognosis than those with cold tumors. NACRT upregulated cold tumor immunogenicity to hot tumors, suggesting NACRT may increase the sensitivity of ESCC to adjuvant ICIs.\u0000","PeriodicalId":503165,"journal":{"name":"Annals of Surgery Open","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-02-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139810629","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Neoadjuvant Chemoradiotherapy Upregulates the Immunogenicity of Cold to Hot Tumors in Esophageal Cancer Patients 新辅助化放疗可提高食管癌患者冷肿瘤对热肿瘤的免疫原性

Annals of Surgery Open Pub Date : 2024-02-02 DOI: 10.1097/as9.0000000000000385

Yushi Nagaki, Satoru Motoyama, Yusuke Sato, A. Wakita, H. Fujita, Kohei Kemuriyama, Ryohei Sasamori, Shu Nozaki, K. Nomura, Y. Minamiya

{"title":"Neoadjuvant Chemoradiotherapy Upregulates the Immunogenicity of Cold to Hot Tumors in Esophageal Cancer Patients","authors":"Yushi Nagaki, Satoru Motoyama, Yusuke Sato, A. Wakita, H. Fujita, Kohei Kemuriyama, Ryohei Sasamori, Shu Nozaki, K. Nomura, Y. Minamiya","doi":"10.1097/as9.0000000000000385","DOIUrl":"https://doi.org/10.1097/as9.0000000000000385","url":null,"abstract":"\u0000 \u0000 To test the hypothesis that neoadjuvant chemoradiotherapy (NACRT) is more effective against hot esophageal squamous cell carcinoma (ESCC) and that it may upregulate tumor immunogenicity.\u0000 \u0000 \u0000 \u0000 There have been several recent reports showing the efficacy of immune check-point inhibitors (ICIs) against esophageal cancer, especially immunologically hot tumors. In addition, several studies have suggested that chemotherapy and radiotherapy may convert cold tumors to hot tumors.\u0000 \u0000 \u0000 \u0000 Of 105 ESCC patients who underwent surgery after NACRT between 2010 and 2018 at our hospital, 99 whose biopsy tissue samples were obtained were enrolled. Based on immunohistochemical analysis, tumors that were FOXA1 (+) and/or EYA2 (+) were defined as hot tumors, others were cold tumors. We then investigated the association between tumor immunogenicity and clinicopathological features.\u0000 \u0000 \u0000 \u0000 The 29 patients with hot tumors before NACRT had a significantly better 5-year disease-specific survival (DSS) rate than the remaining 70 patients with cold tumors (85% vs 64%; P = 0.036). In a multivariate analysis, tumor immunogenicity was a significant independent predictor of DSS. Of 68 patients without a pathological complete response (non-pCR) in their primary tumor, 51 (75%) had hot tumors after NACRT. Moreover, 75% (36/48) of tumors that were cold before NACRT were converted to hot tumors after NACRT.\u0000 \u0000 \u0000 \u0000 Patients with hot ESCC tumors treated with NACRT plus esophagectomy had a better prognosis than those with cold tumors. NACRT upregulated cold tumor immunogenicity to hot tumors, suggesting NACRT may increase the sensitivity of ESCC to adjuvant ICIs.\u0000","PeriodicalId":503165,"journal":{"name":"Annals of Surgery Open","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-02-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139870652","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Predictors and Significance of Readmission after Esophagogastric Surgery: A Nationwide Analysis 食管胃手术后再入院的预测因素和意义：全国性分析

Annals of Surgery Open Pub Date : 2024-01-26 DOI: 10.1097/as9.0000000000000363

R. Evans, S. Kamarajah, Felicity Evison, Xiaoxu Zou, Ben Coupland, Ewen A. Griffiths

{"title":"Predictors and Significance of Readmission after Esophagogastric Surgery: A Nationwide Analysis","authors":"R. Evans, S. Kamarajah, Felicity Evison, Xiaoxu Zou, Ben Coupland, Ewen A. Griffiths","doi":"10.1097/as9.0000000000000363","DOIUrl":"https://doi.org/10.1097/as9.0000000000000363","url":null,"abstract":"\u0000 \u0000 The aim of this study is to identify risk factors for readmission after elective esophagogastric cancer surgery and characterize the impact of readmission on long-term survival. The study will also identify whether the location of readmission to either the hospital that performed the primary surgery (index hospital) or another institution (nonindex hospital) has an impact on postoperative mortality.\u0000 \u0000 \u0000 \u0000 Over the past decade, the center-volume relationship has driven the centralization of major cancer surgery, which has led to improvements in perioperative mortality. However, the impact of readmission, especially to nonindex centers, on long-term mortality remains unclear.\u0000 \u0000 \u0000 \u0000 This was a national population-based cohort study using Hospital Episode Statistics of adult patients undergoing esophagectomy and gastrectomy in England between January 2008 and December 2019.\u0000 \u0000 \u0000 \u0000 This study included 27,592 patients, of which overall readmission rates were 25.1% (index 15.3% and nonindex 9.8%). The primary cause of readmission to an index hospital was surgical in 45.2% and 23.7% in nonindex readmissions. Patients with no readmissions had significantly longer survival than those with readmissions (median: 4.5 vs 3.8 years; P < 0.001). Patients readmitted to their index hospital had significantly improved survival as compared to nonindex readmissions (median: 3.3 vs 4.7 years; P < 0.001). Minimally invasive surgery and surgery performed in high-volume centers had improved 90-day mortality (odds ratio, 0.75; P < 0.001; odds ratio, 0.60; P < 0.001).\u0000 \u0000 \u0000 \u0000 Patients requiring readmission to the hospital after surgery have an increased risk of mortality, which is worsened by readmission to a nonindex institution. Patients requiring readmission to the hospital should be assessed and admitted, if required, to their index institution.\u0000","PeriodicalId":503165,"journal":{"name":"Annals of Surgery Open","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-01-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139593115","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0