European journal of surgical oncology : the journal of the European Society of Surgical Oncology and the British Association of Surgical Oncology
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To construct an artificial neural network (ANN) model to predict survival after liver resection for colorectal cancer (CRC) metastases. ⋯ For the first time ANNs were used to successfully predict individual long-term survival for patients following liver resection for CRC metastases. In the future, more complex prognostic factors can be incorporated into the ANN model to increase its predictive ability.
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Meta Analysis
Patients get more long-term benefit from central pancreatectomy than distal resection: a meta-analysis.
Central pancreatectomy (CP) protects more normal pancreatic parenchyma than distal pancreatectomy (DP), but the safety, feasibility and long-term benefit of CP are inconclusive. This meta-analysis aims to ascertain the relative merits of CP. ⋯ CP was still an acceptable and feasible procedure, especially when considering the postoperative pancreatic function preservation ability by CP.
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Postoperative care for major elective cancer surgery is frequently provided on the Intensive Care Unit (ICU). ⋯ Elective cancer surgery represents a significant part of all ICU admissions, with a short length of stay and low mortality.
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Comparative Study
Placement of an arterial hepatic catheter after a major hepatectomy for colorectal liver metastases: is this safe?
Studies have suggested that hepatic arterial infusion of chemotherapy (HAI) after resection of colorectal liver metastasis (CRLM) may improve patient's survival. The placement of a catheter in the hepatic artery at the time of hepatic surgery should therefore be considered in patients at high risk of hepatic recurrence. The aim of this study was to compare post-operative outcomes in patients who underwent at least a major hepatectomy (≥3 segments) for CRLM with or without catheter placement. ⋯ Although the placement of an arterial catheter during a major hepatectomy does not significantly increase the rate of postoperative complications two patients died post-operatively in this study from vascular thrombosis. In case of extended and complex hepatectomy, with a higher risk of post-operative complications, delaying the catheter placement could be recommended.
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Considering the morbidity and mortality after abdominal surgery for rectal cancer, our aim was to determine whether local excision in Stage I rectal cancer provides long-term survival equivalent to TME surgery, particularly in elderly patients. ⋯ Local excision has a poor outcome in the elderly. A negative selection bias towards old age and high co-morbidity could explain this. Hartmann's procedure has a high risk for mortality and local recurrence in younger patients.