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1.
Lymphoepithelial tumors of the pancreas are rare cystic tumors characterized by the presence of a keratinizing squamous epithelium and a dense lymphoid infiltrate on histologic examination. This case report describes the first lymphoepithelial tumor to be resected from the pancreatic head by pancreaticoduodenectomy. This case is also the first in which the cyst was found to be secondarily infected. The radiologic and clinicopathologic features of these unusual tumors are discussed. 相似文献
2.
Lauren S. Tufts Emma D. Jarnagin Jessica R. Flynn Mithat Gonen Jose G. Guillem Philip B. Paty Garrett M. Nash Joshua J. Smith Iris H. Wei Emmanouil Pappou Michael I. DAngelica Peter J. Allen T. Peter Kingham Vinod P. Balachandran Jeffrey A. Drebin Julio Garcia-Aguilar William R. Jarnagin Martin R. Weiser 《HPB : the official journal of the International Hepato Pancreato Biliary Association》2019,21(2):181-186
Background
Surgical site infections (SSIs) are a major cause of morbidity, mortality, and healthcare costs, and patients undergoing simultaneous colorectal/liver resections are at an especially high SSI risk.Methods
Data were collected on all patients undergoing synchronous colorectal/liver resection from 2011 to 2016 (n = 424). The intervention, implemented in 2013, included 13 multidisciplinary perioperative components. The primary endpoints were superficial/deep and organ space SSIs. Secondary endpoints were hospital length of stay (LOS) and 30-day readmission rate. To control for changes in SSI rates independent of the intervention, interrupted time series analysis was conducted.Results
Overall, superficial/deep, and organ space SSIs decreased by 60.5% (p < 0.001), 80.6% (p < 0.001), and 47.6% (p = 0.008), respectively. In the pre-intervention cohort (n = 231), there were 79 (34.2%), 31 (13.4%), and 48 (20.8%) total, superficial/deep, and organs space SSIs, respectively. In the post-intervention cohort (n = 193), there were 26 (13.5%), 5 (2.6%), and 21 (10.9%) total, superficial/deep, and organs space SSIs, respectively. Median LOS decreased from 9 to 8 days (p < 0.001). Readmission rates did not change (p = 0.6). Interrupted time series analysis found no significant trends in SSI rate within the pre-intervention (p = 0.35) and post-intervention (p = 0.55) periods.Conclusion
In combined colorectal/liver resection patients, implementation of a multidisciplinary care bundle was associated with a 61% reduction in SSIs, with the greatest impact on superficial/deep SSI, and modest reduction in LOS. The absence of trends within each time period indicated that the intervention was likely responsible for SSI reduction. Future efforts should target further reduction in organ space SSI. 相似文献3.
Caitlin A. McIntyre MD Sharon A. Lawrence MD Allison L. Richards PhD Joanne F. Chou MPH Winston Wong MD Marinela Capanu PhD Michael F. Berger PhD Mark T. A. Donoghue PhD Kenneth H. Yu MD Anna M. Varghese MD David P. Kelsen MD Wungki Park MD Vinod P. Balachandran MD T. Peter Kingham MD Michael I. D’Angelica MD Jeffrey A. Drebin MD PhD William R. Jarnagin MD Christine A. Iacobuzio-Donahue MD PhD Peter J. Allen MD Eileen M. O’Reilly MD 《Cancer》2020,126(17):3939-3949
4.
Canter RJ Kesmodel SB Heitjan DF Veeramachaneni NK Mokadam NA Drebin JA Fraker DL 《Annals of surgical oncology》2005,12(9):733-742
Background Isolated hepatic perfusion has been used in patients with colorectal cancer (CRC) metastatic to the liver. We sought to determine whether perfusion with antisense oligodeoxynucleotides results in the downregulation of β-catenin and whether this improves tumor response to isolated limb perfusion (ILP) in a heterotopic model of human CRC.Methods Adenomatous polyposis coli–mutant human CRC xenografts were implanted into athymic rats. Animals were randomized to the following groups: (1) no treatment, (2) control ILP, (3) melphalan ILP, (4) ILP with antisense specific for β-catenin, (5) ILP with nonspecific antisense, and (6) melphalan plus β-catenin–specific antisense ILP. Tumor response and Western blot analysis of protein expression were evaluated.Results The maximal decrease (mean ± SE) in tumor volume was 0% ± 10% for no treatment, 19% ± 14% for control ILP, 58% ± 3% for melphalan ILP, 58% ± 9% for β-catenin–specific ILP, 13% ± 19% for nonspecific antisense ILP, and 73% ± 6% for melphalan plus β-catenin–specific ILP (P < .05 for melphalan ILP, β-catenin–specific ILP, and melphalan plus antisense ILP). Tumor regrowth was delayed for 6 days after control ILP, 24 days after melphalan ILP, 20 days after β-catenin–specific ILP, 10 days after nonspecific antisense ILP, and 60 days after melphalan plus β-catenin–specific ILP (P < .05 for melphalan plus β-catenin–specific ILP compared with all others). Western blotting revealed prolonged suppression of β-catenin expression after β-catenin–specific ILP.Conclusions Short-term β-catenin antisense treatment improves tumor response rates after ILP in a rodent model of human CRC.Presented in part at the Surgical Forum of the American College of Surgeons, Chicago, Illinois, October 19–23, 2003. 相似文献
5.
Five-year survival after resection of hepatic metastases from colorectal cancer in patients screened by positron emission tomography with F-18 fluorodeoxyglucose (FDG-PET) 总被引:20,自引:0,他引:20
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Fernandez FG Drebin JA Linehan DC Dehdashti F Siegel BA Strasberg SM 《Annals of surgery》2004,240(3):438-450
OBJECTIVE: To report the first 5-year overall survival results in patients with colorectal carcinoma metastatic to the liver who have undergone hepatic resection after staging with [18F] fluoro-2-deoxy-D-glucose-positron emission tomography (FDG-PET). SUMMARY BACKGROUND DATA: The 5-year overall survival after hepatic resection for colorectal cancer metastases without preoperative FDG-PET has been established in 19 studies (6070 patients). The median 5-year overall survival rate in these studies is 30% and has not improved over time. FDG-PET detects unsuspected tumor in 25% of patients considered to have resectable hepatic metastasis by conventional staging. METHODS: From March 1995 to June 2002, all patients having hepatic resection for colorectal cancer metastases had preoperative FDG-PET. A prospective database was maintained. RESULTS: One hundred patients (56 men, 44 women) were studied. Metastases were synchronous in 52, single in 63, unilateral in 78, and <5 cm in diameter in 60. Resections were major (>3 segments) in 75 and resection margins were > or = 1 cm in 52. Median follow up was 31 months, with 12 actual greater than 5-year survivors. There was 1 postoperative death. The actuarial 5-year overall survival was 58% (95% confidence interval, 46-72%). Primary tumor grade was the only prognostic variable significantly correlated with overall survival. CONCLUSIONS: Screening by FDG-PET is associated with excellent postresection 5-year overall survival for patients undergoing resection of hepatic metastases from colorectal cancer. FDG-PET appears to define a new cohort of patients in whom tumor grade is a very important prognostic variable. 相似文献
6.
7.
Volumetric rendering techniques: applications for three-dimensional imaging of the hip 总被引:1,自引:0,他引:1
Fishman EK; Drebin B; Magid D; Scott WW Jr; Ney DR; Brooker AF Jr; Riley LH Jr; St. Ville JA; Zerhouni EA; Siegelman SS 《Radiology》1987,163(3):737-738
Volumetric rendering is a new approach to three-dimensional (3D) imaging that overcomes many of the drawbacks of currently available surface-rendering systems. Its application on the Pixar Imaging System in two cases of acetabular fracture was assessed to illustrate the features of the technique. The fast-computing architecture and large memory of this system allow rapid generation of a series of high-quality 3D images in each plane of rotation (x or spinal axis, z or somersaulting axis) that can be viewed as independent static images or as an animated real-time video loop. Editing to remove the normal contralateral hemipelvis enhances appreciation of acetabular abnormalities. Every pixel of computed tomographic data is preserved, allowing representation of both soft tissue and bone as translucent overlap. The presentation of data also allows detection of subtle abnormalities and features and minimizes the artifact generation common in surface-rendered images. 相似文献
8.
Priya M. Puri Ammara A. Watkins Tara S. Kent Laura Maggino Jenna Gates Jeganathan Mark P. Callery Jeffrey A. Drebin Charles M. Vollmer 《Journal of gastrointestinal surgery》2018,22(1):88-97
Introduction
This study aims to understand patients’ perspectives and satisfaction with choosing surgery for the treatment of pancreatic cystic lesions (PCLs).Methods
A 62-question survey was administered to 113 patients who had a resection for a PCL by 12 surgeons at two pancreatic specialty centers (2004–2016). Patients’ final diagnoses and perioperative outcomes were correlated to the survey’s results using univariate analysis.Results
Fear of cancer was quite or extremely important in most respondents’ decision to have surgery (95.4%). Respondents were quite or fully satisfied with the outcomes of surgery (91.1%) and with the decision-making process (89.3%). Distress from anxiety about the cyst before surgery (58.6%) largely outweighed that from postsurgical lifestyle changes (14.4%). Furthermore, 88.7% of patients with pathologically non-malignant disease were quite or fully satisfied with their decision to have surgery, and patients with mucinous neoplasms reported high satisfaction rates independent of grade of dysplasia or malignancy (p = 0.641).Conclusion
Patients with a resected PCL are highly satisfied with their decision to have surgery, regardless of the final diagnosis or clinical outcome. Fear of cancer is the main driver in the decision-making process, and the anxiety of harboring a cyst is a greater cause of distress than are postsurgical lifestyle changes.9.
10.
Minimally invasive gastrectomy for gastric adenocarcinoma in the United States: Utilization and short‐term oncologic outcomes
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