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Publisher: Springer-Verlag   (Total: 2335 journals)

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Showing 1201 - 1400 of 2335 Journals sorted alphabetically
J. of Community Genetics     Hybrid Journal   (Followers: 1, SJR: 0.727, h-index: 14)
J. of Community Health     Hybrid Journal   (Followers: 8, SJR: 0.921, h-index: 44)
J. of Comparative Physiology A: Neuroethology, Sensory, Neural, and Behavioral Physiology     Hybrid Journal   (Followers: 7, SJR: 1.087, h-index: 74)
J. of Comparative Physiology B : Biochemical, Systemic, and Environmental Physiology     Hybrid Journal   (Followers: 4, SJR: 1.126, h-index: 59)
J. of Compassionate Health Care     Open Access   (Followers: 1)
J. of Computational Analysis and Applications     Hybrid Journal   (SJR: 0.291, h-index: 19)
J. of Computational Electronics     Hybrid Journal   (Followers: 3, SJR: 0.511, h-index: 20)
J. of Computational Neuroscience     Hybrid Journal   (Followers: 19, SJR: 1.068, h-index: 60)
J. of Computer and Systems Sciences Intl.     Hybrid Journal   (SJR: 0.27, h-index: 13)
J. of Computer Science and Technology     Open Access   (Followers: 5, SJR: 0.437, h-index: 31)
J. of Computer Virology and Hacking Techniques     Hybrid Journal   (Followers: 7, SJR: 0.151, h-index: 2)
J. of Computer-Aided Molecular Design     Hybrid Journal   (Followers: 4, SJR: 0.995, h-index: 78)
J. of Computers in Education     Hybrid Journal   (Followers: 7)
J. of Computing in Higher Education     Hybrid Journal   (Followers: 12, SJR: 0.363, h-index: 21)
J. of Consumer Policy     Hybrid Journal   (Followers: 5, SJR: 0.704, h-index: 30)
J. of Contemporary Mathematical Analysis     Hybrid Journal   (SJR: 0.237, h-index: 5)
J. of Contemporary Physics (Armenian Academy of Sciences)     Hybrid Journal   (Followers: 1, SJR: 0.197, h-index: 6)
J. of Contemporary Psychotherapy     Hybrid Journal   (Followers: 4, SJR: 0.397, h-index: 23)
J. of Control Theory and Applications     Hybrid Journal   (Followers: 2, SJR: 0.359, h-index: 19)
J. of Control, Automation and Electrical Systems     Hybrid Journal   (Followers: 7, SJR: 0.231, h-index: 9)
J. of Crop Science and Biotechnology     Hybrid Journal   (Followers: 7)
J. of Cross-Cultural Gerontology     Hybrid Journal   (Followers: 3, SJR: 0.631, h-index: 29)
J. of Cryptographic Engineering     Partially Free   (Followers: 5, SJR: 0.989, h-index: 11)
J. of Cryptology     Hybrid Journal   (Followers: 2, SJR: 1.443, h-index: 55)
J. of Cultural Economics     Hybrid Journal   (Followers: 2, SJR: 0.539, h-index: 29)
J. of Database Marketing & Customer Strategy Management     Hybrid Journal   (Followers: 8, SJR: 0.149, h-index: 8)
J. of Derivatives & Hedge Funds     Hybrid Journal   (Followers: 7, SJR: 0.114, h-index: 5)
J. of Developmental and Physical Disabilities     Hybrid Journal   (Followers: 8, SJR: 0.574, h-index: 29)
J. of Digital Imaging     Hybrid Journal   (Followers: 8, SJR: 0.578, h-index: 35)
J. of Direct Data and Digital Marketing Practice     Hybrid Journal   (Followers: 7, SJR: 0.154, h-index: 6)
J. of Dynamical and Control Systems     Hybrid Journal   (Followers: 2, SJR: 0.4, h-index: 26)
J. of Dynamics and Differential Equations     Hybrid Journal   (SJR: 1.418, h-index: 31)
J. of Earth Science     Hybrid Journal   (Followers: 8, SJR: 0.483, h-index: 16)
J. of Earth System Science     Open Access   (Followers: 40, SJR: 0.448, h-index: 32)
J. of East Asian Linguistics     Hybrid Journal   (Followers: 5, SJR: 0.537, h-index: 20)
J. of Echocardiography     Hybrid Journal   (Followers: 4, SJR: 0.22, h-index: 3)
J. of Economic Growth     Hybrid Journal   (Followers: 23, SJR: 3.273, h-index: 63)
J. of Economic Interaction and Coordination     Hybrid Journal   (SJR: 0.263, h-index: 12)
J. of Economics     Hybrid Journal   (Followers: 9, SJR: 0.418, h-index: 23)
J. of Economics and Finance     Hybrid Journal   (Followers: 6, SJR: 0.272, h-index: 19)
J. of Educational Change     Hybrid Journal   (Followers: 7, SJR: 0.961, h-index: 21)
J. of Elasticity     Hybrid Journal   (Followers: 5, SJR: 0.851, h-index: 45)
J. of Electroceramics     Hybrid Journal   (SJR: 0.577, h-index: 57)
J. of Electronic Materials     Hybrid Journal   (Followers: 3, SJR: 0.609, h-index: 75)
J. of Electronic Testing     Hybrid Journal   (Followers: 2, SJR: 0.372, h-index: 27)
J. of Electronics (China)     Hybrid Journal   (Followers: 4, SJR: 0.112, h-index: 9)
J. of Elementary Science Education     Hybrid Journal   (Followers: 8)
J. of Engineering Mathematics     Hybrid Journal   (SJR: 0.347, h-index: 37)
J. of Engineering Physics and Thermophysics     Hybrid Journal   (Followers: 1, SJR: 0.288, h-index: 11)
J. of Engineering Research     Open Access   (SJR: 0.145, h-index: 5)
J. of Engineering Thermophysics     Hybrid Journal   (Followers: 1, SJR: 0.763, h-index: 9)
J. of Environmental Studies and Sciences     Partially Free   (Followers: 2)
J. of Ethology     Hybrid Journal   (Followers: 2, SJR: 0.609, h-index: 25)
J. of Evolution Equations     Hybrid Journal   (SJR: 0.826, h-index: 26)
J. of Evolutionary Biochemistry and Physiology     Hybrid Journal   (SJR: 0.145, h-index: 11)
J. of Evolutionary Economics     Hybrid Journal   (Followers: 8, SJR: 0.492, h-index: 52)
J. of Experimental and Theoretical Physics     Hybrid Journal   (Followers: 4, SJR: 0.458, h-index: 39)
J. of Experimental Criminology     Hybrid Journal   (Followers: 31, SJR: 1.445, h-index: 28)
J. of Failure Analysis and Prevention     Hybrid Journal   (Followers: 5, SJR: 0.261, h-index: 15)
J. of Family and Economic Issues     Hybrid Journal   (Followers: 6, SJR: 0.396, h-index: 32)
J. of Family Violence     Hybrid Journal   (Followers: 17, SJR: 0.639, h-index: 56)
J. of Financial Services Marketing     Hybrid Journal   (Followers: 3, SJR: 0.273, h-index: 10)
J. of Financial Services Research     Hybrid Journal   (Followers: 16, SJR: 0.572, h-index: 36)
J. of Fixed Point Theory and Applications     Hybrid Journal   (SJR: 0.644, h-index: 13)
J. of Fluorescence     Hybrid Journal   (Followers: 3, SJR: 0.465, h-index: 56)
J. of Food Measurement and Characterization     Hybrid Journal   (SJR: 0.307, h-index: 4)
J. of Food Science and Technology     Hybrid Journal   (Followers: 5, SJR: 0.441, h-index: 29)
J. of Forest Research     Hybrid Journal   (Followers: 3, SJR: 0.495, h-index: 27)
J. of Forestry Research     Hybrid Journal   (Followers: 6, SJR: 0.304, h-index: 14)
J. of Fourier Analysis and Applications     Hybrid Journal   (Followers: 1, SJR: 1.18, h-index: 42)
J. of Friction and Wear     Hybrid Journal   (Followers: 6, SJR: 0.373, h-index: 7)
J. of Fusion Energy     Hybrid Journal   (Followers: 3, SJR: 0.387, h-index: 19)
J. of Gambling Studies     Hybrid Journal   (Followers: 4, SJR: 1.171, h-index: 57)
J. of Gastroenterology     Hybrid Journal   (Followers: 12, SJR: 1.651, h-index: 88)
J. of Gastrointestinal Cancer     Hybrid Journal   (Followers: 3, SJR: 0.304, h-index: 39)
J. of Gastrointestinal Surgery     Hybrid Journal   (Followers: 5, SJR: 1.64, h-index: 99)
J. of General Internal Medicine     Hybrid Journal   (Followers: 13, SJR: 1.804, h-index: 134)
J. of General Plant Pathology     Hybrid Journal   (SJR: 0.554, h-index: 22)
J. of Genetic Counseling     Hybrid Journal   (Followers: 4, SJR: 0.902, h-index: 39)
J. of Genetics     Open Access   (Followers: 4, SJR: 0.458, h-index: 28)
J. of Geodesy     Hybrid Journal   (Followers: 8, SJR: 2.173, h-index: 56)
J. of Geographical Sciences     Hybrid Journal   (Followers: 1, SJR: 0.8, h-index: 23)
J. of Geographical Systems     Hybrid Journal   (Followers: 3, SJR: 0.822, h-index: 39)
J. of Geometric Analysis     Hybrid Journal   (SJR: 1.491, h-index: 27)
J. of Geometry     Hybrid Journal   (Followers: 1, SJR: 0.272, h-index: 15)
J. of Global Optimization     Hybrid Journal   (Followers: 4, SJR: 0.992, h-index: 60)
J. of Global Policy and Governance     Hybrid Journal   (Followers: 8)
J. of Grid Computing     Hybrid Journal   (SJR: 1.414, h-index: 37)
J. of Hand and Microsurgery     Hybrid Journal   (Followers: 1)
J. of Happiness Studies     Hybrid Journal   (Followers: 15, SJR: 0.881, h-index: 39)
J. of Hematopathology     Hybrid Journal   (Followers: 3, SJR: 0.2, h-index: 13)
J. of Heuristics     Hybrid Journal   (Followers: 5, SJR: 1.308, h-index: 50)
J. of High Energy Physics     Hybrid Journal   (Followers: 5, SJR: 1.052, h-index: 153)
J. of Homotopy and Related Structures     Hybrid Journal   (SJR: 0.232, h-index: 2)
J. of Housing and the Built Environment     Hybrid Journal   (Followers: 6, SJR: 0.648, h-index: 28)
J. of Huazhong University of Science and Technology [Medical Sciences]     Hybrid Journal   (SJR: 0.344, h-index: 19)
J. of Ichthyology     Hybrid Journal   (Followers: 4, SJR: 0.304, h-index: 10)
J. of Immigrant and Minority Health     Hybrid Journal   (Followers: 8, SJR: 0.759, h-index: 37)
J. of Inclusion Phenomena and Macrocyclic Chemistry     Hybrid Journal   (Followers: 1, SJR: 0.331, h-index: 46)
J. of Indian Philosophy     Hybrid Journal   (Followers: 11, SJR: 0.127, h-index: 12)
J. of Indian Prosthodontic Society     Open Access   (SJR: 0.164, h-index: 7)
J. of Industrial Microbiology and Biotechnology     Hybrid Journal   (Followers: 12, SJR: 0.966, h-index: 80)
J. of Industry, Competition and Trade     Hybrid Journal   (Followers: 6, SJR: 0.327, h-index: 15)
J. of Infection and Chemotherapy     Hybrid Journal   (Followers: 1, SJR: 0.673, h-index: 46)
J. of Information Technology     Hybrid Journal   (Followers: 49, SJR: 1.474, h-index: 55)
J. of Information Technology Teaching Cases     Hybrid Journal   (Followers: 7)
J. of Infrared, Millimeter and Terahertz Waves     Hybrid Journal   (Followers: 1, SJR: 1.25, h-index: 36)
J. of Inherited Metabolic Disease     Hybrid Journal   (Followers: 2, SJR: 1.389, h-index: 77)
J. of Inorganic and Organometallic Polymers and Materials     Partially Free   (Followers: 7, SJR: 0.338, h-index: 33)
J. of Insect Behavior     Hybrid Journal   (Followers: 9, SJR: 0.569, h-index: 39)
J. of Insect Conservation     Hybrid Journal   (Followers: 10, SJR: 0.872, h-index: 43)
J. of Intelligent and Robotic Systems     Hybrid Journal   (Followers: 2, SJR: 0.629, h-index: 43)
J. of Intelligent Information Systems     Hybrid Journal   (Followers: 1, SJR: 0.691, h-index: 43)
J. of Intelligent Manufacturing     Hybrid Journal   (Followers: 4, SJR: 1.397, h-index: 54)
J. of Interventional Cardiac Electrophysiology     Hybrid Journal   (SJR: 0.93, h-index: 43)
J. of Intl. Business Studies     Hybrid Journal   (Followers: 27, SJR: 4.208, h-index: 130)
J. of Intl. Entrepreneurship     Hybrid Journal   (Followers: 8, SJR: 0.549, h-index: 23)
J. of Intl. Migration and Integration / Revue de l integration et de la migration internationale     Hybrid Journal   (Followers: 12, SJR: 0.308, h-index: 13)
J. of Intl. Relations and Development     Hybrid Journal   (Followers: 20, SJR: 0.793, h-index: 22)
J. of Labor Research     Hybrid Journal   (Followers: 15, SJR: 0.394, h-index: 27)
J. of Logic, Language and Information     Hybrid Journal   (Followers: 7, SJR: 0.288, h-index: 25)
J. of Low Temperature Physics     Hybrid Journal   (Followers: 2, SJR: 0.531, h-index: 52)
J. of Machinery Manufacture and Reliability     Hybrid Journal   (Followers: 2, SJR: 0.203, h-index: 7)
J. of Mammalian Evolution     Hybrid Journal   (Followers: 5, SJR: 1.134, h-index: 37)
J. of Mammary Gland Biology and Neoplasia     Hybrid Journal   (Followers: 1, SJR: 2.252, h-index: 83)
J. of Management and Governance     Hybrid Journal   (Followers: 12, SJR: 0.805, h-index: 33)
J. of Management Control     Hybrid Journal   (Followers: 4, SJR: 0.605, h-index: 6)
J. of Marine Science and Application     Hybrid Journal   (Followers: 3, SJR: 0.439, h-index: 11)
J. of Marine Science and Technology     Hybrid Journal   (Followers: 3, SJR: 0.235, h-index: 19)
J. of Maritime Archaeology     Hybrid Journal   (Followers: 21, SJR: 0.228, h-index: 8)
J. of Market-Focused Management     Hybrid Journal   (Followers: 2)
J. of Marketing Analytics     Hybrid Journal   (Followers: 3)
J. of Material Cycles and Waste Management     Hybrid Journal   (Followers: 3, SJR: 0.449, h-index: 22)
J. of Materials Engineering and Performance     Hybrid Journal   (Followers: 24, SJR: 0.544, h-index: 40)
J. of Materials Science     Hybrid Journal   (Followers: 19, SJR: 0.836, h-index: 123)
J. of Materials Science : Materials in Electronics     Hybrid Journal   (Followers: 3)
J. of Materials Science : Materials in Medicine     Hybrid Journal   (Followers: 4)
J. of Mathematical Biology     Hybrid Journal   (Followers: 12, SJR: 1.011, h-index: 71)
J. of Mathematical Chemistry     Hybrid Journal   (Followers: 5, SJR: 0.497, h-index: 45)
J. of Mathematical Fluid Mechanics     Hybrid Journal   (Followers: 5, SJR: 1.22, h-index: 22)
J. of Mathematical Imaging and Vision     Hybrid Journal   (Followers: 3, SJR: 0.901, h-index: 53)
J. of Mathematical Modelling and Algorithms     Hybrid Journal   (Followers: 2, SJR: 0.414, h-index: 23)
J. of Mathematical Sciences     Hybrid Journal   (SJR: 0.272, h-index: 23)
J. of Mathematics Teacher Education     Hybrid Journal   (Followers: 13, SJR: 1.062, h-index: 20)
J. of Maxillofacial and Oral Surgery     Hybrid Journal   (Followers: 2)
J. of Mechanical Science and Technology     Hybrid Journal   (Followers: 5, SJR: 0.589, h-index: 26)
J. of Medical and Biological Engineering     Hybrid Journal   (Followers: 1, SJR: 0.387, h-index: 18)
J. of Medical Humanities     Hybrid Journal   (Followers: 19, SJR: 0.299, h-index: 18)
J. of Medical Systems     Hybrid Journal   (Followers: 1, SJR: 0.717, h-index: 44)
J. of Medical Toxicology     Hybrid Journal   (Followers: 4, SJR: 0.874, h-index: 28)
J. of Medical Ultrasonics     Hybrid Journal   (Followers: 2, SJR: 0.18, h-index: 13)
J. of Medicine and the Person     Hybrid Journal  
J. of Membrane Biology     Hybrid Journal   (Followers: 1, SJR: 0.738, h-index: 82)
J. of Micro-Bio Robotics     Hybrid Journal   (SJR: 0.28, h-index: 3)
J. of Microbiology     Hybrid Journal   (Followers: 7, SJR: 0.741, h-index: 43)
J. of Mining Science     Hybrid Journal   (Followers: 5, SJR: 0.317, h-index: 16)
J. of Molecular Evolution     Hybrid Journal   (Followers: 9, SJR: 0.952, h-index: 108)
J. of Molecular Histology     Hybrid Journal   (Followers: 2, SJR: 0.755, h-index: 48)
J. of Molecular Medicine     Hybrid Journal   (Followers: 15, SJR: 2.165, h-index: 113)
J. of Molecular Modeling     Hybrid Journal   (Followers: 4, SJR: 0.466, h-index: 50)
J. of Molecular Neuroscience     Partially Free   (Followers: 9, SJR: 0.988, h-index: 69)
J. of Mountain Science     Hybrid Journal   (Followers: 3, SJR: 0.418, h-index: 15)
J. of Muscle Research and Cell Motility     Hybrid Journal   (Followers: 1, SJR: 1.264, h-index: 55)
J. of Nanoparticle Research     Hybrid Journal   (Followers: 3, SJR: 0.583, h-index: 84)
J. of Natural Medicines     Hybrid Journal   (SJR: 0.602, h-index: 28)
J. of Near-Death Studies     Hybrid Journal   (Followers: 2)
J. of Nephrology     Hybrid Journal   (Followers: 5, SJR: 0.689, h-index: 55)
J. of Network and Systems Management     Hybrid Journal   (SJR: 0.466, h-index: 26)
J. of Neural Transmission     Hybrid Journal   (Followers: 2, SJR: 1.034, h-index: 86)
J. of Neuro-Oncology     Hybrid Journal   (Followers: 3, SJR: 1.274, h-index: 90)
J. of Neuroimmune Pharmacology     Hybrid Journal   (Followers: 1, SJR: 1.662, h-index: 45)
J. of Neurology     Hybrid Journal   (Followers: 13, SJR: 1.429, h-index: 105)
J. of NeuroVirology     Hybrid Journal   (Followers: 1, SJR: 0.979, h-index: 69)
J. of Nondestructive Evaluation     Hybrid Journal   (Followers: 9, SJR: 0.863, h-index: 27)
J. of Nonlinear Science     Hybrid Journal   (Followers: 1, SJR: 1.887, h-index: 42)
J. of Nonverbal Behavior     Hybrid Journal   (Followers: 3, SJR: 0.723, h-index: 47)
J. of Nuclear Cardiology     Hybrid Journal   (SJR: 1.024, h-index: 68)
J. of Nutrition, Health and Aging     Hybrid Journal   (Followers: 18, SJR: 0.919, h-index: 60)
J. of Obstetrics and Gynecology of India     Hybrid Journal   (Followers: 7, SJR: 0.214, h-index: 6)
J. of Occupational Rehabilitation     Hybrid Journal   (Followers: 12, SJR: 0.811, h-index: 51)
J. of Ocean Engineering and Marine Energy     Hybrid Journal   (Followers: 1)
J. of Ocean University of China (English Edition)     Hybrid Journal   (Followers: 1, SJR: 0.237, h-index: 11)
J. of Oceanography     Hybrid Journal   (Followers: 7, SJR: 0.796, h-index: 52)
J. of Ocular Biology, Diseases, and Informatics     Hybrid Journal   (SJR: 0.183, h-index: 11)
J. of Optical and Fiber Communications Reports     Hybrid Journal   (Followers: 3)
J. of Optics     Hybrid Journal   (Followers: 5, SJR: 0.214, h-index: 8)
J. of Optimization Theory and Applications     Hybrid Journal   (Followers: 3, SJR: 0.898, h-index: 65)
J. of Ornithology     Hybrid Journal   (Followers: 22)
J. of Orofacial Orthopedics / Fortschritte der Kieferorthopädie     Hybrid Journal   (SJR: 0.574, h-index: 33)
J. of Orthopaedic Science     Hybrid Journal   (Followers: 5, SJR: 0.708, h-index: 48)
J. of Paleolimnology     Hybrid Journal   (Followers: 5, SJR: 0.984, h-index: 64)
J. of Parasitic Diseases     Hybrid Journal   (Followers: 2, SJR: 0.298, h-index: 9)
J. of Pediatric Neuropsychology     Hybrid Journal   (Followers: 1)
J. of Pest Science     Hybrid Journal   (Followers: 2, SJR: 1.341, h-index: 28)
J. of Pharmaceutical Health Care and Sciences     Open Access  
J. of Pharmaceutical Innovation     Hybrid Journal   (Followers: 8, SJR: 0.524, h-index: 17)
J. of Pharmaceutical Investigation     Hybrid Journal   (Followers: 1, SJR: 0.331, h-index: 6)
J. of Pharmacokinetics and Pharmacodynamics     Hybrid Journal   (Followers: 21, SJR: 0.708, h-index: 46)
J. of Phase Equilibria and Diffusion     Hybrid Journal   (Followers: 19, SJR: 0.433, h-index: 36)
J. of Philosophical Logic     Hybrid Journal   (Followers: 8, SJR: 0.704, h-index: 26)

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Journal Cover European Surgery
  [SJR: 0.171]   [H-I: 15]   [4 followers]  Follow
    
   Hybrid Journal Hybrid journal (It can contain Open Access articles)
   ISSN (Print) 1682-4016 - ISSN (Online) 1682-8631
   Published by Springer-Verlag Homepage  [2335 journals]
  • Current strategies for preoperative conditioning of the liver to expand
           criteria for resectability of hepatic metastases
    • Authors: H. M. Hau; H. -M. Tautenhahn; M. Schmelzle; H. M. Morgul; M. Moche; M. Bartels; D. Uhlmann
      Pages: 180 - 190
      Abstract: Summary Background Colorectal cancer (CRC) is among the most commonly diagnosed cancers, and the liver is its most frequent metastatic site. Colorectal liver metastases (CLM) are synchronous in 15–25 % of the CRC patients and metachronous in 20–25 %. In recent decades, 5-year-overall survival following curative liver resection of CLM has increased to 35–58 %. This improvement owes largely to advances in CLM multimodality treatment. Methods In recent years, the CLM resectability criteria have also shifted, following several encouraging studies reporting the possibility of R0 resection for all tumors while preserving a sufficient volume of residual liver. In this context, multimodal approaches including portal vein embolization (PVE), associating liver partition with portal vein ligation for staged hepatectomy (ALPPS) and two-stage hepatectomy after neoadjuvant chemotherapy were developed to induce hypertrophy of the future liver remnant (FLR) to fulfill minimal liver volume requirements. Liver function tests and scores could be a helpful tool in patient selection and prediction limit of the hepatic parenchymal reserve. Results Generally, at least 20 % of the total liver volume should be preserved in the case of a healthy liver, whereas at least 30–60 % should be preserved for livers impaired by chemotherapy-associated steatosis or hepatitis. Further use of ischemic or pharmacological preconditioning of FLR tissue such as stem cell transplantation could help to prepare the liver for extended resections and to avoid postoperative liver failure. Conclusion Because of shifting CLM resectability criteria and encouraging survival rates following curative resection in the context of multimodality treatment, extended liver surgery for CLM is increasing. To condition the liver for extensive surgery and to ensure adequate postoperative liver function, several approaches were developed and routinely practiced in clinical centers.
      PubDate: 2016-08-01
      DOI: 10.1007/s10353-015-0381-1
      Issue No: Vol. 48, No. 4 (2016)
       
  • Simultaneous resection of primary colorectal cancer and synchronous liver
           metastases is associated with a high cardiovascular complication rate
    • Authors: J. Schuld; M. von Heesen; B. Jung; S. Richter; O. Kollmar
      Pages: 221 - 227
      Abstract: Summary Background Optimal timing of liver surgery for synchronous metastases regarding a simultaneous or two-staged procedure is still controversially discussed. As randomized controlled trials are ethically disputable due to potential advantages of the simultaneous approach, the following matched pair analysis was performed to investigate feasibility and short-term outcome of the additional simultaneous hepatic approach compared to colorectal surgery alone. Methods A total of 74 patients undergoing simultaneous resection of primary colorectal cancer and synchronous liver metastases (CRC + LM) were individually case matched with patients receiving only colorectal surgery for Union for International Cancer Control (UICC) stage I-III cancer (CRC) according to: age, gender, American Society of Anesthesiologists (ASA) score, location, and T-stage of the primary tumor. Postoperative complications and risk factors for morbidity and mortality were analyzed retrospectively using univariate, multivariate, and binary logistic regression analyses. Results According to matching criteria both groups showed no differences regarding demographics and operative techniques for the primary colorectal tumor. In the CRC + LM group 4 major hepatectomies, 7 anatomic, 43 nonanatomic and 20 multiple nonanatomic resections were performed. Inhospital mortality (CRC vs. CRC + LM) was 2.7 versus 4.1 % and overall morbidity was 33.8 versus 35.1 %, respectively. Cardiovascular complications were significantly higher in the CRC + LM than in the CRC group (13.5 vs. 2.7 %). Multivariate analysis revealed that not simultaneous resection procedure but presence of chronic pulmonary disease was an independent risk factor. Conclusions Simultaneous resection procedures can be recommended in almost all patients without chronic pulmonary disease as well as chronic heart disease. Careful precautions, especially in patients with chronic pulmonary diseases, should be taken to avoid a high possibility of postoperative cardiovascular complications.
      PubDate: 2016-08-01
      DOI: 10.1007/s10353-015-0382-0
      Issue No: Vol. 48, No. 4 (2016)
       
  • Retrospective analysis of prognostic factors in patients with duodenal
           adenocarcinoma
    • Authors: P. Téoule; M. Distler; M. Niedergethmann; T. Gaiser; F. Rückert; R. Grützmann; T. J. Wilhelm
      Pages: 228 - 234
      Abstract: Summary Background Sporadic duodenal cancer is a rare cancer entity. Therefore, the prognostic significance of clinicopathologic features is unknown. This study aimed to identify prognostic factors and compare survival with other tumour entities of the same anatomical region. Methods We retrospectively studied medical records of 22 patients with duodenal adenocarcinoma (DAC), who underwent resection in two German centres for pancreatic surgery (1994–2012). Mean time of follow-up was 51.3 months. Predictive factors were evaluated by log rank analysis. Results Whipple surgery was performed in seven cases (31.8 %), pylorus preserving pancreaticoduodenectomy in 14 cases (63.6 %) and partial duodenectomy in one case (4.5 %). R0-resection was achieved in 86.4 %. In all, 50% of our patients had nodal positive disease. Overall morbidity was 59.1 % and perioperative mortality was 9.1 %. Survival after resection was 63.6 % and 59.0 % (3- and 5-years). There was no significant survival difference between patients with DAC and ampullary cancer, but survival was longer compared with patients with pancreatic cancer. Conclusions Mortality seems to be high after resection of DAC. However, radical surgery should be performed due to the high number of patients with nodal positive disease. No definite prognostic factors were identified. The prognosis after resection of duodenal cancer can be compared with patients with ampullary cancer.
      PubDate: 2016-08-01
      DOI: 10.1007/s10353-015-0374-0
      Issue No: Vol. 48, No. 4 (2016)
       
  • Treatment of Boerhaave’s Syndrome: Specialized Esophago-Gastric Unit
           Experience on Twelve Patients
    • Authors: Filippo Landi; Sandra Castro; Amaia Gantxegi; Paolo Bertoli; Nivardo Rodríguez; Jordi Pradell; Alejandro Solis; Manuel Armengol
      Pages: 235 - 240
      Abstract: Background Boerhaave’s syndrome is a rare condition of spontaneous esophageal rupture with high mortality. Treatment is a challenging issue, diagnosis is difficult and early surgery is the most important prognostic factor. Methods This article presents a case series of 12 patients treated in our specialized unit between 2005 and 2013. Medical records and imaging reports from the specialized upper gastrointestinal surgery unit at a university hospital were reviewed. Results The median age was 59 years (37–83), the male/female ratio was 11/1 and half of the patients did not have any sign of pleural effusion at chest x‑ray. The diagnosis was made in 66 % of cases (8/12) by computed tomography. Nine patients were referred, and treatment delay was greater than 24 h in six patients. Ten patients were operated, and two were treated conservatively. A transabdominal approach was performed in five patients, with esophageal suture with gastric fundus patch being the most common procedure (5/10). Two patients underwent simple esophageal suture. One patient had mediastinal and pleural drainage with no other intervention. Two patients required bipolar esophageal exclusion. Three patients underwent reoperation for empyema, and one required esophagectomy. Mortality was 25 % (3/12): two operated patients and one who had been treated conservatively. The median intensive care unit stay was 15 days (5–61), and the median hospital stay was 33 days (5–97). Conclusions When combined with mediastinal debridement and pleural drainage, primary transhiatal esophageal repair for Boerhaave’s syndrome is associated with acceptable morbidity and mortality, regardless of treatment delay. Conservative treatment should be reserved for carefully selected patients.
      PubDate: 2016-08-01
      DOI: 10.1007/s10353-016-0392-6
      Issue No: Vol. 48, No. 4 (2016)
       
  • Gastric carcinoma presenting with severe rectal stenosis:
           ‘Schnitzler’s metastasis’: case report and review
           of the literature
    • Authors: Z. S. Derici; S. Sokmen
      Pages: 246 - 249
      Abstract: Background Distant metastasis of primary gastric carcinoma may occur via venous, lymphatic spread and/or peritoneal seeding. Herein we report on an atypical presentation of clinical, endoscopic, and radiologic features of metastatic gastric adenocarcinoma with symptoms mainly due to rectal carcinomatous involvement. Methods Case report and review of the literature Results We presented the case of 39-year-old-woman with a clinical history of 6 months of dyspepsia, abdominal discomfort, and constipation, who was admitted to hospital with a full-blown picture of mechanical bowel obstruction. These symptoms occurred owing to secondary linitis plastica of the rectum. An extended Hartmann procedure was performed, and the patient was referred to systemic chemotherapy. The overall survival was 5.5 months. The symptoms, findings, preoperative management, and treatment choices are discussed with a review of published cases of Schintzler’s metastasis. Conclusion Gastric linitis plastica is the most common cause of secondary neoplastic infiltration of the colon. An unusual case of Schnitzler’s metastasis to the rectum, synchronously or metachronously, should occur from diffuse type signet-ring cell gastric carcinoma. The clinical findings of severe rectal stenosis with a poorly differentiated gastric adenocarcinoma must call attention to the entity of rectal Schnitzler’s metastasis.
      PubDate: 2016-08-01
      DOI: 10.1007/s10353-016-0390-8
      Issue No: Vol. 48, No. 4 (2016)
       
  • Celiac artery compression of patients undergoing pancreatic surgery
           – a case series
    • Authors: A. Pötscher; F. Längle
      Abstract: Summary Background Celiac artery compression due to the median arcuate ligament is a rare but not an uncommon finding in patients undergoing pancreaticoduodenectomy (PD). Due to the interruption of the collateral pathways during surgery, celiac artery compression may be associated with fatal complications. Case reports In this paper, we present three patients with celiac artery compression undergoing PD. In the first case, celiac artery compression was recognized during surgery, but nevertheless the patient died postoperatively because of ongoing Klebsiella sepsis. In the second case, we did not recognize it during initial surgery so further complications could have been avoided. In the third case, compression was detected during PD and the postoperative course was without complications. Conclusion Preoperative abdominal CT scan should be evaluated very carefully in order to identify celiac artery compression. Otherwise absence or limitation of blood flow within the common hepatic artery (CHA) during surgery should lead surgeon to suspect presence of compression of the celiac artery.
      PubDate: 2016-09-15
      DOI: 10.1007/s10353-016-0443-z
       
  • Esophagectomy for eosinophilic esophagitis: how to avoid it
    • Authors: Alfredo J Lucendo
      Abstract: Summary Patients with eosinophilic esophagitis (EoE) can currently benefit from an evidence-based medical and dietary treatment according to knowledge accumulated from observational studies and randomized controlled trials, the results of which were summarized in several systematic reviews and meta-analyses. Surgery is relegated to solving some uncommon complications of EoE and has been exclusively applied in a handful of cases of esophageal perforation. This letter to the editor criticizes the only case of elective esophagectomy carried out in a 27-year-old male with EoE and longstanding dysphagia, which was unresponsive to obstinate endoscopy-based treatment. Despite medical and dietary treatment, strategies in EoE must still be improved and basing the clinical management of sufferers on the application of therapies with demonstrated effectiveness instead of empirical strategies is highly desirable.
      PubDate: 2016-09-08
      DOI: 10.1007/s10353-016-0441-1
       
  • The preliminary role of circulating tumor cells obtained from the hepatic
           or portal veins in patients with hepatobiliary–pancreatic cancer
    • Authors: Naokazu Chiba; Yuta Abe; Yosuke Ozawa; Kosuke Hikita; Masaaki Okihara; Toru Sano; Koichi Tomita; Kiminori Takano; Shigeyuki Kawachi
      Abstract: Summary Background Metastases, which result from circulating tumor cells (CTC) that have detached from the primary cancer and survived in distant organs, cause the majority of cancer deaths. The present study aimed to assess the prognostic relevance of CTC in patients with hepatobiliary–pancreatic cancer. Methods A total of 30 consenting patients were enrolled. Pre-resection blood samples were obtained from the hepatic or portal veins of patients, respectively. CTCs were analyzed using the CellSearch system and isolated using antibodies against the epithelial cell adhesion molecule and cytokeratin. Patients were separated into 2 groups based on their CTC counts. The CTC-positive group included patients with baseline CTC counts >10/7.5 ml. Results Of the 30 patients, 12 (40 %) were considered CTC positive. CTC-positive patients had a shorter 1‑year progression-free survival (PFS) than CTC-negative patients (71.1 % vs. 36.4 %, p = 0.0324); however, no difference was observed in the 3‑year overall survival (47.1 % vs. 45.5 %, p = 0.7576). In particular, CTC-positive pancreatic carcinoma patients had a shorter 1‑year PFS (22.2 % vs. 0.0 % for CTC-negative, p = 0.0018). Conclusions Elevated CTC from hepatic or portal veins might predict a shorter PFS in patients with hepatobiliary–pancreatic cancer, particularly those with pancreatic carcinoma.
      PubDate: 2016-08-26
      DOI: 10.1007/s10353-016-0439-8
       
  • Selected papers from the European Federation Congress of the International
           College of Surgeons in Prague and Pilsen, 2015
    • PubDate: 2016-08-25
      DOI: 10.1007/s10353-016-0442-0
       
  • Surgical approach is superior to palliative treatment
           in oligometastatic lung cancer
    • Authors: Till Plönes; Alberto Lopez-Pastorini; Erich Stoelben
      Abstract: Summary Background The majority of patients with lung cancer are diagnosed in a metastatic state, in which prognosis is rather poor. Chemotherapy can improve median overall survival by only a few months, but a small percentage of these patients suffer only from oligometastatic diseases and may therefore be treated with curative intend. In this study, we compared two groups of patients with oligometastatic lung cancer, who received palliative treatment or multimodal treatment with a surgical approach. Methods We conducted a retrospective review of all patients with synchronous extrapulmonary oligometastatic disease diagnosed between 2010 and 2013. All data were extracted from the medical database of our department and further analysed. Results There were 52 patients diagnosed with oligometastatic lung cancer between 2010 and 2013. A cohort of 32 patients was treated surgically in a multimodal approach, but 19 patients refused surgery. These patients were treated by palliative chemotherapy or other palliative treatments, such as radiochemotherapy etc. Median overall survival was 18 months in the surgically treated group and 6 months in the palliative group (p < 0.001). In the surgically treated group, survival was correlated to pathologic T stage (pT1 29 months, pT2 13 months and pT3 13 months median overall survival, p < 0.05) and lymph node involvement (with mediastinal lymph node involvement 13 months and without mediastinal lymph node involvement 28 months median overall survival). Conclusion We conclude that surgery may have a beneficial effect in multimodal treatment of oligometastatic lung cancer. A prospective randomized study is necessary and may be feasible.
      PubDate: 2016-08-16
      DOI: 10.1007/s10353-016-0437-x
       
  • Violent death and trauma in Norse mythology: a systematic reading of
           the Prose Edda
    • Authors: Antonis A. Kousoulis; Konstantinos S. Mylonas; Konstantinos P. Economopoulos
      Abstract: Summary Background This paper attempts to assess surgical knowledge presented in Norse mythology. The Prose Edda constitutes the most comprehensive source of Norse mythology. Literature and myth offer unique educational insights into life practices of previous eras, provided approached with a cautious and unbiased perspective. Methods English translations of Gylfaginning and Skáldskaparmál, texts from the Prose Edda, were systematically reviewed. International Statistical Classification of Diseases and Related Health Problems, 10th edition (ICD-10) definitions for trauma and violent death were utilized. A basic tabulation was followed for the recording of extracted data, including the chapter, characters involved and the text extract. Recorded cases were categorized by applying three distinct classifications and assessed by body part affected, cause of morbidity/mortality and character involved. Results A total of 52 cases of trauma were identified (19 cases in Gylfaginning and 33 in Skaldskaparsmal). In 27 cases of injury the afflicted body region was unspecified, but in the majority of specified cases it concerned a craniofacial trauma. 37 events were an outcome of personal assault, whereas 11 occurred during warfare. Moreover, three cases were suicides and one an accident. Critical assessment of the texts indicates that the predominant theme of Gylfaginning is the struggles of Norse Gods, whilst Skáldskaparmál tales revolve mostly around humans. Notably, a lack of allusion to medical knowledge and surgical practice is observed. Conclusion The systematic reading of the Prose Edda highlights the common theme of violence in Norse Mythology and distinguishes beheading in battle. The absence of documentation on medical practice is in accordance with the fact that Scandinavian mythological texts rarely elaborate on disease.
      PubDate: 2016-08-15
      DOI: 10.1007/s10353-016-0438-9
       
  • Tuff, tailored and tiny: under the skies of surgery
    • Authors: F. M. Riegler
      PubDate: 2016-08-02
      DOI: 10.1007/s10353-016-0440-2
       
  • Large bowel cancer in the setting of inflammatory bowel disease
    • Authors: Gianluca Pellino; Rosa Marcellinaro; Guido Sciaudone; Alfonso Reginelli; Pasquale Esposito; Gabriele Riegler; Silvestro Canonico; Vincenzo Villanacci; Francesco Selvaggi
      Abstract: Summary Background Inflammatory bowel diseases (IBDs) are a well-known risk factor for the development of colorectal cancer (CRC). This risk relates to different aspects of the disease, such as the duration, activity, and extension, and tends to increase in the presence of associated conditions, such as family history of CRC or some extra-intestinal manifestations. Rectal cancer (RC) in IBD has been poorly investigated. Methods We reviewed the scientific literature for data on the features and management of RC in the setting of IBD. Here, we provide a practical insight into the diagnosis and management of the condition. Results Several genetic and environmental factors promote the development of CRC, including alterations of intestinal microflora and mutations in the genes responsible for the cell cycle and for DNA mismatch repair. Dysplasia is the main evidence of a clear conversion of normal epithelium to cancer. Dysplasia is often multifocal, in contrast to sporadic CRC, which explains the tendency toward the development of synchronous and metachronous CRC in patients with IBD. Other conditions that need attention are strictures, for which the threshold for surgery must be low. Treatment of RC in patients with IBD follows the same oncologic criteria as non-IBD-related RC, but patients are often diagnosed at more advanced stages, suggesting that this is frequently overlooked. This is ultimately associated with poorer outcomes in IBD patients. Conclusion There is a pressing need for more data on IBD-related RC. Implementing knowledge will result in optimization of survival for these patients.
      PubDate: 2016-07-18
      DOI: 10.1007/s10353-016-0434-0
       
  • Surgical use of fibrin glue-coated collagen patch for non-hemostatic
           indications
    • Authors: Dimitrios Sampanis; Maria Siori
      Abstract: Summary TachoSil and its predecessor products, TachoComb and TachoComb H, have been extensively used in a variety of multidisciplinary surgical settings since being introduced in the early 1990s. However, to date, TachoSil remains the first and only dual action patch for general tissue sealing and is frequently used in variety of surgical indications other than haemostasis. Classically, TachoSil is indicated for improvement of haemostasis. However, there is recently some evidence suggesting that it can be successfully used in promoting tissue healing, which could be useful in various non-hemostatic indications. TachoSil is safe and well tolerated, with occurrence of adverse events similar in TachoSil and non-TachoSil treated patients in controlled trials. The clinical implications of such an approach are obvious. Despite its cost, potential benefits could easily translate into cost savings due to avoidance of complications and to reduction of duration of hospital stay. Existing data are limited and further randomized controlled studies are needed to accurately establish the role of TachoSil for non-hemostatic indications in a variety of surgical indications, such as in abdominal and gastrointestinal surgery, pulmonary surgery, cardiothoracic surgery, renal surgery, gynecology, neurosurgery and more.
      PubDate: 2016-07-14
      DOI: 10.1007/s10353-016-0436-y
       
  • Advances in diagnosing GERD
    • Authors: Oliver Owen Koch; Stavros A. Antoniou
      Abstract: Summary Background This article aims to summarize the current technology available for evaluating esophageal function and gastroesophageal reflux disease (GERD), and to assess which of these examinations are necessary before antireflux surgery. Methods The Medline database was queried to identify relevant published information. Results Esophageal function testing is a useful adjunct to confirm or reject the diagnosis of GERD. Emerging technologies and new diagnostic methods may provide a better sensitivity in diagnosing GERD symptoms and could help in finding the right treatment for each patient. However, studies are needed to prove that these new tests truly add essential information. Conclusion Of the current available methods to identify the right treatment for each patient with symptoms of GERD, ambulatory reflux monitoring is still the most important one. Optimal preoperative diagnostic work-up for GERD should include pH testing along with upper endoscopy, barium esophagram, and manometry.
      PubDate: 2016-07-01
      DOI: 10.1007/s10353-016-0435-z
       
  • Role of needle core biopsy in patients presenting with a breast lump
           associated with trauma
    • Authors: M. A. Parvaiz; C. Richardson; B. Isgar
      Abstract: Summary Background Patients often present to the breast clinic with a lump following trauma to the breast. Routinely, triple assessment is performed on such patients. We investigated whether a proportion of them can be safely diagnosed on the basis of clinical and radiological assessment without the need for histological confirmation. Methods We prospectively assessed all patients with a history of trauma presenting to the breast clinic over a 5-year period. Results We included 135 patients, constituting 1 % of total patients seen. They were divided into two groups for analysis. Group A included patients with trauma-related pathologies (n = 70, 52 %), comprising 47 haematomas and 23 fat necrosis. This group had a higher proportion of anti-coagulant usage (20/70). Owing to concordant clinical and radiological benign features, core biopsy was only carried out in 16 cases (23 %). All patients in this group were followed up to confirm clinical and radiological resolution of findings with no case of delayed cancer diagnosis. Group B included patients with incidental pathologies (n = 65, 48 %), consisting of 23 cancers and 42 benign lesions. Comparatively fewer patients (13/65) were on anti-coagulants. They had a history of minimal trauma and mostly no bruising, but found a lump on self-examination. The 23 cancer patients in this group had prompt triple assessment and no delay in cancer treatment. Conclusion Triple assessment is vital in patients with suspicious clinical or radiological breast lesions. However, a core biopsy can be avoided in patients with a clear history of trauma with concordant clinical and radiological features and follow-up confirming complete resolution of findings.
      PubDate: 2016-06-24
      DOI: 10.1007/s10353-016-0425-1
       
  • Esophagectomy for eosinophilic esophagitis
    • Authors: Tomoyuki Irino; Mavroudis Voultsos; Jon A. Tsai; Mats Lindblad; Magnus Nilsson; Ioannis Rouvelas
      Abstract: Summary Background Eosinophilic esophagitis (EoE) is a chronic allergen-driven disease in which eosinophilic infiltration of the esophagus results in fibrosis, causing symptoms of esophageal dysfunction. The natural history of EoE frequently results in progressive deterioration of patients’ quality of life. In selected cases, progressive manifestations of disease cannot be managed with the conventional treatment options, and patients therefore suffer from poor quality of life. Methods We present the case of a 27-year-old male patient whose therapy for long-standing EoE did not prevent his clinical deterioration, which in turn gradually led to worsening quality of life owing to the degree and extent of esophageal fibrosis-associated remodeling. The patient eventually underwent a combined thoracoscopic/laparoscopic esophagectomy as a last resort aimed at alleviating the severe esophageal dysfunction and poor quality of life that he experienced. Results The patient underwent a minimally invasive esophagectomy and recovered quickly, gaining weight as early as 4 weeks after surgery. The patient returned 5 months later complaining of dysphagia regarding solid food. Gastroscopy showed a mild anastomotic stenosis that was dilated to 18 mm. During follow-up, the patient gained 15 kg compared with his lowest body weight prior to surgery and has remained symptom free 2.5 years after his surgery. Conclusion Surgery can be considered as a last-resort option for managing the refractory manifestations of EoE and its complications.
      PubDate: 2016-06-21
      DOI: 10.1007/s10353-016-0433-1
       
  • The cleft lift procedure for complex pilonidal disease
    • Authors: Paola De Nardi; Paolo Giovanni Gazzetta; Guido Fiorentini; Giovanni Guarneri
      Abstract: Summary Background The cleft lift procedure was introduced for the treatment of pilonidal sinus disease, with the aim of shifting the healing line off the midline. The aim of the present study is to provide a tuitional description of the cleft lift procedure for the treatment of complex pilonidal sinus disease. Methods After successful treatment of 40 cases of complex pilonidal disease, photographs recorded from the operations were reviewed and screened in order to present the indications, the key stages of the operation, the surgical variants, and the results. Results All of the procedures were performed as 1‑day surgery with no intraoperative complications. Partial wound dehiscence was experienced by 12.5 % of patients. No recurrence was observed after a mean follow-up of 21 months. Conclusion This technique is easy to learn and to perform, with minimal patient discomfort, limited in-patient stay, early recovery, and a good healing rate.
      PubDate: 2016-06-16
      DOI: 10.1007/s10353-016-0428-y
       
  • Clinical and inflammatory response to first ileocolic resection for
           Crohn’s disease
    • Authors: Hanna Ribbing Wilén; Per-Olof Nyström; Leif Törkvist; Johannes Blom
      Abstract: Summary Background The intention of the first ileocolic resection in Crohn’s disease is to remove local disease, which relieves symptoms of intestinal obstruction, but should also relieve clinically significant systemic inflammation and allow discontinuation of corticosteroids. Methods By means of five clinically relevant criteria for continued specific treatment, we evaluated the response of 117 patients to their first ileocolic resection for Crohn’s disease, which was undertaken at Karolinska University Hospital, Stockholm, Sweden, between 2000 and 2010. The five criteria were the persistence of systemic inflammation and continued or resumed corticosteroid therapy, high defecation frequency or presence of a stoma, and the need for new bowel surgery within 1 year. The presence of systemic inflammation and use of anti-inflammatory drugs were assessed 1 month preoperatively and 6–12 months after surgery. Other events of interest were assessed within 12 months. Results The median age was 31 years and 51 patients (44 %) were women. In all, 54 patients (46 %) were operated on within the first year of diagnosis and episodes of bowel obstruction were the prime surgical indication in 80 (68 %) patients. Of the patients, 100 (85 %) had an ileocolic resection and 17 (15 %) had terminal ileal surgery. As anticipated, C‑reactive protein (CRP), albumin, and hemoglobin concentrations all normalized significantly after surgery but 15 (13 %) patients still had CRP values of ≥ 30 mg/l and one fourth (29/117, 25 %) still used corticosteroids. Seventeen patients (15 %) had six or more defecations per day or a temporary stoma and four (3 %) patients had new surgery for symptomatic Crohn’s disease. Altogether, 46 (39 %) patients met one or more of the criteria for continued or renewed treatment within 1 year with a higher risk in patients with ileocolic disease as compared with ileal disease when adjusted for age and reoperation (p = 0.030). Conclusion The curable intention of the first ileocolic resection for Crohn’s disease often fails, as the need for continued or renewed medical or surgical treatment in the first year is high.
      PubDate: 2016-06-10
      DOI: 10.1007/s10353-016-0426-0
       
  • Morbidity and mortality of colorectal cancer surgery in octogenarians
    • Authors: Nurkan Törer
      Abstract: Summary Objectives The aim of this study was to determine common problems, preoperative assessment criteria, and postoperative morbidity and mortality of octogenarians with colorectal cancer. Materials and method We screened the medical records of patients aged 80 years or older (study group) and that of patients of 50–59 years of age (control group) who were operated for colon cancer. Demographic features, comorbidities, American Society of Anaesthesiologists (ASA) score, urgency of operation, tumor localization, presence of colostomy, duration of hospital stay, admission to and duration of stay in the intensive care unit (ICU), TNM (Tumor, Node, Metastasis) stage, postoperative morbidity, and mortality rates were recorded. Results The medical records of 23 patients aged above 80 years and 39 patients aged between 50–59 years were screened retrospectively. The two groups did not differ significantly with respect to the morbidity rate but the mortality rate was significantly higher in the study group (p = 0.583 and p = 0.016, respectively). The study group patients needed significantly more ostomy creation procedures. In the analysis of the octogenarian groups, the ASA score or the presence of comorbidities had no discernible effect on the morbidity and mortality rates. Conclusion Specific preoperative evaluations are needed for prediction of mortality risk in geriatric patients. Rational criteria for performing protective ostomy should also be determined in octogenarians.
      PubDate: 2016-06-08
      DOI: 10.1007/s10353-016-0414-4
       
 
 
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