Annals of surgery
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Multicenter Study
A risk model for esophagectomy using data of 5354 patients included in a Japanese nationwide web-based database.
This study aimed to create a risk model of mortality associated with esophagectomy using a Japanese nationwide database. ⋯ This study was the first, as per our knowledge, to perform risk stratification for esophagectomy using a Japanese nationwide database. The 30-day and operative mortality rates were relatively lower than those in previous reports. The risk models developed in this study may contribute toward improvements in quality control of procedures and creation of a novel scoring system.
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Multicenter Study
Postoperative complications reduce adjuvant chemotherapy use in resectable pancreatic cancer.
To assess the impact of postoperative complications on the receipt of adjuvant chemotherapy. ⋯ Postoperative complications are common following pancreatic surgery and are associated with adjuvant chemotherapy omission and treatment delays.
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Multicenter Study
Hepatic resection associated with good survival for selected patients with intermediate and advanced-stage hepatocellular carcinoma.
The efficacy and safety of hepatic resection (HR) to treat patients with Barcelona Clinic Liver Cancer (BCLC) stage B and C hepatocellular carcinoma (HCC) was retrospectively assessed. ⋯ Our clinical and literature analyses suggest that in patients with HCC with preserved liver function, the presence of large, solitary tumors, multinodular tumors, macrovascular invasion, or PHT are not contraindications for HR.
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To evaluate long-term follow-up results after surgical treatment of intraductal papillary mucinous neoplasm (IPMN) to optimize postoperative surveillance strategies. ⋯ Pancreatic IPMNs recur in 10.7% of patients. Recurrence is correlated with the degree of dysplasia, and 5.4% of patients with benign or noninvasive IPMN have recurrences including distant metastasis. Thorough postoperative surveillance is needed not only for patients with invasive IPMN but also for those with benign or noninvasive IPMN, especially for patients with high-grade dysplasia.
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Metabolic syndrome (MetS) clusters the most dangerous cardiovascular disease risk factors. Although insulin resistance and central obesity play an important role in the pathogenesis, the factors that determine its development and ultimate remission after Roux-en-Y gastric bypass (RYGB) are not fully understood. ⋯ The metabolic score can be used to predict the remission of MetS after RYGB with high accuracy. Patients in high-risk groups might be managed more aggressively and low-risk patients may have their medication discontinued earlier with extra safety.