Journal of gastrointestinal surgery : official journal of the Society for Surgery of the Alimentary Tract
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J. Gastrointest. Surg. · Oct 2009
Outcome after resection of hepatic and pulmonary metastases of colorectal cancer.
Multimodal therapies (especially surgery of metastases and "aggressive" chemotherapy) in patients with metastases of colorectal cancers (CRC) are increasingly performed and may provide long-term survival in selected patients with more than one location of metastases. In the current literature, there are only few studies with relatively low patient numbers reporting on the outcome after resection of both hepatic and pulmonary metastases of CRC. We therefore evaluated survival of patients who underwent sequential resection of hepatic and pulmonary metastases under potentially curative intention. ⋯ In selected patients with metastasized CRC resection of both hepatic and pulmonary metastases may improve survival rates or even provide long-term survival. Patients with lung as the first site of metastatic disease (either lung only or in combination with hepatic metastases) have a significantly worse outcome than patients with metastases primarily confined to the liver.
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J. Gastrointest. Surg. · Oct 2009
Comparative StudyAn analysis of trends and growth factor receptor expression of GI carcinoid tumors.
The purpose of our study was twofold: (1) to determine the incidence, patient and tumor characteristics, and outcome of patients with gastrointestinal carcinoid tumors using the Surveillance, Epidemiology and End Results (SEER) database, and (2) to delineate the expression pattern of growth factor receptors (GFRs) in carcinoid tumors. ⋯ Over the 12-year analysis period, 18,180 patients were identified with carcinoid tumors of the foregut, midgut, and hindgut; the incidence of carcinoid tumors increased approximately 2-fold during this time period. Of the patients with carcinoid tumors, there was a trend of increased expression of VEGFR and IGFR, particularly in the foregut and midgut carcinoids. Analysis of the SEER database confirms that the incidence of carcinoid tumors is increasing with an approximate doubling in the number of carcinoid cases from 1990 to 2002. Furthermore, an increase in VEGFR and IGFR expression suggests that GFR inhibitors may be effective adjuvant therapy for carcinoid cancer.
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J. Gastrointest. Surg. · Oct 2009
National complication rates after pancreatectomy: beyond mere mortality.
National studies on in-hospital pancreatic outcomes have focused on mortality. Non-fatal morbidity affects a greater proportion of patients. ⋯ Despite improvements in mortality, complication rates remain substantial and largely unchanged. They predict in-hospital mortality, prolonged hospital stay, and delayed return to home. The impact on healthcare costs and quality of life deserves further study.
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J. Gastrointest. Surg. · Oct 2009
Perioperative selective decontamination of the digestive tract (SDD) in elective colorectal surgery.
Selective decontamination of the digestive tract (SDD) decreases morbidity and mortality in critically ill patients and morbidity in patients undergoing esophageal resection. This study analyzes the effect of perioperative SDD in patients undergoing elective colorectal surgery on postoperative infections and anastomotic leakage. ⋯ Perioperative SDD in elective colorectal surgery seems to reduce postoperative surgical complications including infectious complications and anastomotic leakage. Prospective, randomized, placebo-controlled studies are needed to confirm this conclusion.
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J. Gastrointest. Surg. · Oct 2009
Association of allogeneic blood transfusions and long-term survival of patients with gastric cancer after curative gastrectomy.
The relationship between perioperative allogeneic blood transfusions and poor prognosis in patients with gastric cancer remains controversial. The aim of this study is to examine the effect of perioperative blood transfusions on long-term survival of patients undergoing curative gastric resection for gastric cancer. ⋯ Allogeneic blood transfusion is an independent prognostic factor for long-term survival in gastric cancer patients.