Annals of Surgery
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The Association of Coloproctology of Great Britain and Ireland Study of Large Bowel Obstruction Caused by Colorectal Cancer
Annals of Surgery - Tập 240 Số 1 - Trang 76-81 - 2004
ROENTGEN EXAMINATION OF THE ABDOMINAL ORGANS FOLLOWING OXYGEN INFLATION OF THE PERITONEAL CAVITY
Annals of Surgery - Tập 70 Số 1 - Trang 95-100 - 1919
Survival and Functional Outcome After Prolonged Intensive Care Unit Stay
Annals of Surgery - Tập 231 Số 2 - Trang 262-268 - 2000
Interrupted or Continuous Slowly Absorbable Sutures For Closure of Primary Elective Midline Abdominal Incisions
Annals of Surgery - Tập 249 Số 4 - Trang 576-582 - 2009
Reduced Rate of Dehiscence After Implementation of a Standardized Fascial Closure Technique in Patients Undergoing Emergency Laparotomy
Annals of Surgery - Tập 265 Số 4 - Trang 821-826 - 2017
Sarcopenia and Postoperative Complication Risk in Gastrointestinal Surgical Oncology
Objective:
The aim of the study was to evaluate sarcopenia as a predictor of postoperative risk of major and total complications after surgery for gastrointestinal cancer.
Background:
Sarcopenia is associated with poor survival in gastrointestinal cancer patients, but the role of sarcopenia as prognostic tool in surgical oncology has not been established, and no consensus exists regarding assessment and management of sarcopenic patients.
Methods:
We performed a systematic search for citations in EMBASE, Web of Science, and PubMed from 2004 to January 31, 2017. Random effects meta-analyses were used to estimate the pooled risk ratio for postoperative complications by Clavien-Dindo grade (total complications: grade ≥2; major complications: grade ≥3) in patients with sarcopenia versus patients without sarcopenia. Stratified analyses were performed by sarcopenia criteria, cutoff level, assessment methods, study quality, cancer diagnosis, and “Enhanced Recovery After Surgery” care.
Results:
Twenty-nine studies (n = 7176) were included with sarcopenia prevalence ranging between 12% and 78%. Preoperative incidence of sarcopenia was associated with increased risk of major complications (risk ratio 1.40; 95% confidence interval, 1.20–1.64; P < 0.001; I
2 = 52%) and total complications (risk ratio 1.35; 95% confidence interval, 1.12–1.61; P = 0.001; I
2 = 60%). Moderate heterogeneity was found for both meta-analyses. Subgroup analyses showed that sarcopenia remained a consistent risk factor across stratification by sarcopenia criteria, assessment methods, study quality, and diagnoses.
Conclusions:
Sarcopenia was associated with an increased risk of complications after gastrointestinal tumor resection, but lack of methodological consensus hampers the interpretation and clinical utilization of these findings. Combining assessment of muscle mass with measures of physical function may increase the prognostic value and accuracy in preoperative risk stratification.
Annals of Surgery - Tập 268 Số 1 - Trang 58-69 - 2018
Standardized Surgical Primary Repair for Burst Abdomen Reduces the Risk of Fascial Redehiscence
Objective:
To determine whether a standardized surgical primary repair for burst abdomen could lower the rate of fascial redehiscence.
Summary Background Data:
Burst abdomen after midline laparotomy is associated with increased morbidity and mortality. The surgical treatment is poorly investigated but known for a poor outcome with high rates of re-evisceration (redehiscence).
Methods:
This study was a single-center, interventional study comparing rates of fascial redehiscence after surgery for burst abdomen in a study cohort (July 2014–April 2019) to a historical cohort (January 2009–December 2013). A standardized surgical strategy was introduced for burst abdomen: The abdominal wall was closed using a slowly absorbable running suture in a mass closure technique with “large bites” of 3 cm in “small steps” of 5 mm, in an approximate wound–suture ratio of 1:10. Demographics, comorbidities, preceding type of surgery, and surgical technique were registered. The primary outcome was fascial redehiscence. The secondary outcome was 30- and 90-day mortality.
Results:
The study included 186 patients with burst abdomen (92 patients in the historical cohort vs 94 patients in the study cohort). No difference in sex, performance status, comorbidity, or body mass index was found. In 77% of the historical cohort and 80% of the study cohort, burst abdomen occurred after emergency laparotomy (P = 0.664). The rate of redehiscence was reduced from 13% (12/92 patients) in the historical cohort to 4% (4/94 patients) in the study cohort (P = 0.033). There was no difference in 30- or 90-day mortality.
Conclusion:
Standardized surgical primary repair for burst abdomen reduced the rate of fascial redehiscence.
Annals of Surgery - Tập 274 Số 6 - Trang e1115-e1118 - 2021
THE PROGNOSTIC SIGNIFICANCE OF DIRECT EXTENSION OF CARCINOMA OF THE COLON AND RECTUM
Annals of Surgery - Tập 139 Số 6 - Trang 846-852 - 1954
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