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Publisher: Springer-Verlag (Total: 2350 journals)

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Showing 1201 - 1400 of 2350 Journals sorted alphabetically
J. of Clinical Geropsychology     Hybrid Journal   (Followers: 1)
J. of Clinical Immunology     Hybrid Journal   (Followers: 14, SJR: 1.611, CiteScore: 3)
J. of Clinical Monitoring and Computing     Hybrid Journal   (Followers: 1, SJR: 0.712, CiteScore: 2)
J. of Clinical Psychology in Medical Settings     Hybrid Journal   (Followers: 14, SJR: 0.596, CiteScore: 2)
J. of Cluster Science     Hybrid Journal   (SJR: 0.332, CiteScore: 1)
J. of Coal Science and Engineering (China)     Hybrid Journal  
J. of Coastal Conservation     Hybrid Journal   (Followers: 5, SJR: 0.393, CiteScore: 1)
J. of Coatings Technology and Research     Hybrid Journal   (Followers: 5, SJR: 0.415, CiteScore: 2)
J. of Combinatorial Optimization     Hybrid Journal   (Followers: 6, SJR: 0.579, CiteScore: 1)
J. of Communications Technology and Electronics     Hybrid Journal   (Followers: 2, SJR: 0.273, CiteScore: 1)
J. of Community Genetics     Hybrid Journal   (SJR: 0.687, CiteScore: 1)
J. of Community Health     Hybrid Journal   (Followers: 8, SJR: 0.784, CiteScore: 2)
J. of Comparative Physiology A: Neuroethology, Sensory, Neural, and Behavioral Physiology     Hybrid Journal   (Followers: 10, SJR: 1.246, CiteScore: 2)
J. of Comparative Physiology B : Biochemical, Systemic, and Environmental Physiology     Hybrid Journal   (Followers: 5, SJR: 0.952, CiteScore: 2)
J. of Compassionate Health Care     Open Access   (Followers: 3)
J. of Computational Analysis and Applications     Hybrid Journal   (SJR: 0.396, CiteScore: 1)
J. of Computational Electronics     Hybrid Journal   (Followers: 4, SJR: 0.274, CiteScore: 1)
J. of Computational Neuroscience     Hybrid Journal   (Followers: 25, SJR: 0.888, CiteScore: 2)
J. of Computer and Systems Sciences Intl.     Hybrid Journal   (SJR: 0.316, CiteScore: 1)
J. of Computer Science and Technology     Open Access   (Followers: 5, SJR: 0.295, CiteScore: 1)
J. of Computer Virology and Hacking Techniques     Hybrid Journal   (Followers: 6, SJR: 0.271, CiteScore: 1)
J. of Computer-Aided Molecular Design     Hybrid Journal   (Followers: 3, SJR: 0.941, CiteScore: 3)
J. of Computers in Education     Hybrid Journal   (Followers: 12)
J. of Computing in Higher Education     Hybrid Journal   (Followers: 12, SJR: 1.019, CiteScore: 2)
J. of Consumer Policy     Hybrid Journal   (Followers: 7, SJR: 0.56, CiteScore: 2)
J. of Contemporary Mathematical Analysis     Hybrid Journal   (SJR: 0.353, CiteScore: 0)
J. of Contemporary Physics (Armenian Academy of Sciences)     Hybrid Journal   (Followers: 10, SJR: 0.229, CiteScore: 0)
J. of Contemporary Psychotherapy     Hybrid Journal   (Followers: 6, SJR: 0.473, CiteScore: 1)
J. of Control Theory and Applications     Hybrid Journal   (Followers: 2)
J. of Control, Automation and Electrical Systems     Hybrid Journal   (Followers: 9, SJR: 0.274, CiteScore: 1)
J. of Crop Science and Biotechnology     Hybrid Journal   (Followers: 3, SJR: 0.316, CiteScore: 1)
J. of Cross-Cultural Gerontology     Hybrid Journal   (Followers: 6, SJR: 0.506, CiteScore: 1)
J. of Cryptographic Engineering     Partially Free   (Followers: 4, SJR: 0.423, CiteScore: 2)
J. of Cryptology     Hybrid Journal   (Followers: 3, SJR: 0.347, CiteScore: 2)
J. of Cultural Economics     Hybrid Journal   (Followers: 2, SJR: 0.607, CiteScore: 2)
J. of Database Marketing & Customer Strategy Management     Hybrid Journal   (Followers: 10)
J. of Derivatives & Hedge Funds     Hybrid Journal   (Followers: 7)
J. of Developmental and Physical Disabilities     Hybrid Journal   (Followers: 7, SJR: 0.605, CiteScore: 1)
J. of Digital Imaging     Hybrid Journal   (Followers: 6, SJR: 0.54, CiteScore: 2)
J. of Direct Data and Digital Marketing Practice     Hybrid Journal   (Followers: 8, SJR: 0.157, CiteScore: 0)
J. of Dynamical and Control Systems     Hybrid Journal   (Followers: 1, SJR: 0.316, CiteScore: 1)
J. of Dynamics and Differential Equations     Hybrid Journal   (SJR: 1.208, CiteScore: 1)
J. of Earth Science     Hybrid Journal   (Followers: 9, SJR: 0.604, CiteScore: 1)
J. of Earth System Science     Open Access   (Followers: 49, SJR: 0.366, CiteScore: 1)
J. of East Asian Linguistics     Hybrid Journal   (Followers: 6, SJR: 0.319, CiteScore: 0)
J. of Echocardiography     Hybrid Journal   (Followers: 5, SJR: 0.337, CiteScore: 1)
J. of Ecology and Environment     Open Access   (Followers: 1, SJR: 0.171, CiteScore: 0)
J. of Economic Growth     Hybrid Journal   (Followers: 21, SJR: 5.529, CiteScore: 5)
J. of Economic Interaction and Coordination     Hybrid Journal   (SJR: 0.559, CiteScore: 1)
J. of Economics     Hybrid Journal   (Followers: 12, SJR: 0.434, CiteScore: 1)
J. of Economics and Finance     Hybrid Journal   (Followers: 6, SJR: 0.227, CiteScore: 0)
J. of Educational Change     Hybrid Journal   (Followers: 6, SJR: 0.932, CiteScore: 1)
J. of Elasticity     Hybrid Journal   (Followers: 6, SJR: 0.899, CiteScore: 2)
J. of Electroceramics     Hybrid Journal   (SJR: 0.427, CiteScore: 1)
J. of Electronic Materials     Hybrid Journal   (Followers: 4, SJR: 0.474, CiteScore: 2)
J. of Electronic Testing     Hybrid Journal   (Followers: 2, SJR: 0.191, CiteScore: 1)
J. of Electronics (China)     Hybrid Journal   (Followers: 4)
J. of Elementary Science Education     Hybrid Journal   (Followers: 8, SJR: 1.243, CiteScore: 3)
J. of Elliptic and Parabolic Equations     Hybrid Journal  
J. of Engineering Mathematics     Hybrid Journal   (SJR: 0.418, CiteScore: 1)
J. of Engineering Physics and Thermophysics     Hybrid Journal   (Followers: 1, SJR: 0.316, CiteScore: 0)
J. of Engineering Research     Open Access   (Followers: 1, SJR: 0.138, CiteScore: 0)
J. of Engineering Thermophysics     Hybrid Journal   (Followers: 4, SJR: 0.435, CiteScore: 1)
J. of Environmental Studies and Sciences     Partially Free   (Followers: 2, SJR: 0.404, CiteScore: 1)
J. of Ethology     Hybrid Journal   (Followers: 2, SJR: 0.591, CiteScore: 1)
J. of Evolution Equations     Hybrid Journal   (SJR: 1.588, CiteScore: 1)
J. of Evolutionary Biochemistry and Physiology     Hybrid Journal   (Followers: 1)
J. of Evolutionary Economics     Hybrid Journal   (Followers: 7, SJR: 0.518, CiteScore: 1)
J. of Experimental and Theoretical Physics     Hybrid Journal   (Followers: 3, SJR: 0.437, CiteScore: 1)
J. of Experimental Criminology     Hybrid Journal   (Followers: 48, SJR: 2.639, CiteScore: 4)
J. of Failure Analysis and Prevention     Hybrid Journal   (Followers: 5, SJR: 0.315, CiteScore: 1)
J. of Family and Economic Issues     Hybrid Journal   (Followers: 3, SJR: 0.587, CiteScore: 1)
J. of Family Violence     Hybrid Journal   (Followers: 41, SJR: 0.679, CiteScore: 1)
J. of Financial Services Marketing     Hybrid Journal   (Followers: 4, SJR: 0.289, CiteScore: 1)
J. of Financial Services Research     Hybrid Journal   (Followers: 25, SJR: 1.31, CiteScore: 1)
J. of Fixed Point Theory and Applications     Hybrid Journal   (SJR: 0.416, CiteScore: 1)
J. of Fluorescence     Hybrid Journal   (Followers: 3, SJR: 0.391, CiteScore: 2)
J. of Food Measurement and Characterization     Hybrid Journal   (SJR: 0.369, CiteScore: 1)
J. of Food Science and Technology     Hybrid Journal   (Followers: 6, SJR: 0.689, CiteScore: 2)
J. of Forest Research     Hybrid Journal   (Followers: 2, SJR: 0.371, CiteScore: 1)
J. of Forestry Research     Hybrid Journal   (Followers: 3, SJR: 0.401, CiteScore: 1)
J. of Fourier Analysis and Applications     Hybrid Journal   (Followers: 1, SJR: 1.024, CiteScore: 1)
J. of Friction and Wear     Hybrid Journal   (Followers: 7, SJR: 0.432, CiteScore: 1)
J. of Fusion Energy     Hybrid Journal   (Followers: 3, SJR: 0.411, CiteScore: 1)
J. of Gambling Studies     Hybrid Journal   (Followers: 7, SJR: 0.969, CiteScore: 2)
J. of Gastroenterology     Hybrid Journal   (Followers: 11, SJR: 2.322, CiteScore: 5)
J. of Gastrointestinal Cancer     Hybrid Journal   (Followers: 3, SJR: 0.414, CiteScore: 1)
J. of Gastrointestinal Surgery     Hybrid Journal   (Followers: 11, SJR: 1.556, CiteScore: 3)
J. of General Internal Medicine     Hybrid Journal   (Followers: 16, SJR: 1.612, CiteScore: 2)
J. of General Plant Pathology     Hybrid Journal   (SJR: 0.529, CiteScore: 1)
J. of Genetic Counseling     Hybrid Journal   (Followers: 6, SJR: 0.761, CiteScore: 2)
J. of Genetics     Open Access   (Followers: 5, SJR: 0.357, CiteScore: 1)
J. of Geodesy     Hybrid Journal   (Followers: 8, SJR: 2.399, CiteScore: 4)
J. of Geographical Sciences     Hybrid Journal   (Followers: 1, SJR: 0.759, CiteScore: 2)
J. of Geographical Systems     Hybrid Journal   (Followers: 4, SJR: 0.589, CiteScore: 2)
J. of Geometric Analysis     Hybrid Journal   (Followers: 2, SJR: 1.497, CiteScore: 1)
J. of Geometry     Hybrid Journal   (Followers: 1, SJR: 0.265, CiteScore: 0)
J. of Global Optimization     Hybrid Journal   (Followers: 4, SJR: 1.311, CiteScore: 2)
J. of Global Policy and Governance     Hybrid Journal   (Followers: 10)
J. of Grid Computing     Hybrid Journal   (Followers: 1, SJR: 0.698, CiteScore: 4)
J. of Happiness Studies     Hybrid Journal   (Followers: 26, SJR: 0.827, CiteScore: 2)
J. of Hematopathology     Hybrid Journal   (Followers: 3, SJR: 0.26, CiteScore: 0)
J. of Heuristics     Hybrid Journal   (Followers: 4, SJR: 1.008, CiteScore: 2)
J. of High Energy Physics     Hybrid Journal   (Followers: 17, SJR: 1.227, CiteScore: 4)
J. of Homotopy and Related Structures     Hybrid Journal   (SJR: 0.539, CiteScore: 0)
J. of Housing and the Built Environment     Hybrid Journal   (Followers: 7, SJR: 0.794, CiteScore: 2)
J. of Huazhong University of Science and Technology [Medical Sciences]     Hybrid Journal   (SJR: 0.406, CiteScore: 1)
J. of Ichthyology     Hybrid Journal   (Followers: 2, SJR: 0.284, CiteScore: 0)
J. of Immigrant and Minority Health     Hybrid Journal   (Followers: 12, SJR: 0.735, CiteScore: 1)
J. of Inclusion Phenomena and Macrocyclic Chemistry     Hybrid Journal   (Followers: 1)
J. of Indian Council of Philosophical Research     Hybrid Journal  
J. of Indian Philosophy     Hybrid Journal   (Followers: 9, SJR: 0.267, CiteScore: 0)
J. of Industrial Microbiology and Biotechnology     Hybrid Journal   (Followers: 16, SJR: 1.107, CiteScore: 3)
J. of Industry, Competition and Trade     Hybrid Journal   (Followers: 8, SJR: 0.333, CiteScore: 1)
J. of Infection and Chemotherapy     Hybrid Journal   (Followers: 2, SJR: 0.848, CiteScore: 2)
J. of Information Technology     Hybrid Journal   (Followers: 56, SJR: 1.752, CiteScore: 4)
J. of Information Technology Teaching Cases     Hybrid Journal   (Followers: 11, SJR: 0.135, CiteScore: 0)
J. of Infrared, Millimeter and Terahertz Waves     Hybrid Journal   (Followers: 2, SJR: 0.803, CiteScore: 2)
J. of Inherited Metabolic Disease     Hybrid Journal   (Followers: 2, SJR: 1.668, CiteScore: 3)
J. of Inorganic and Organometallic Polymers and Materials     Partially Free   (Followers: 10, SJR: 0.402, CiteScore: 2)
J. of Insect Behavior     Hybrid Journal   (Followers: 7, SJR: 0.521, CiteScore: 1)
J. of Insect Conservation     Hybrid Journal   (Followers: 10, SJR: 0.842, CiteScore: 2)
J. of Intelligent and Robotic Systems     Hybrid Journal   (Followers: 3, SJR: 0.537, CiteScore: 2)
J. of Intelligent Information Systems     Hybrid Journal   (Followers: 1, SJR: 0.481, CiteScore: 2)
J. of Intelligent Manufacturing     Hybrid Journal   (Followers: 3, SJR: 1.179, CiteScore: 3)
J. of Interventional Cardiac Electrophysiology     Hybrid Journal   (SJR: 1.017, CiteScore: 2)
J. of Intl. Business Studies     Hybrid Journal   (Followers: 37, SJR: 5.198, CiteScore: 7)
J. of Intl. Entrepreneurship     Hybrid Journal   (Followers: 12, SJR: 0.57, CiteScore: 2)
J. of Intl. Migration and Integration / Revue de l integration et de la migration internationale     Hybrid Journal   (Followers: 14, SJR: 0.499, CiteScore: 1)
J. of Intl. Relations and Development     Hybrid Journal   (Followers: 20, SJR: 0.758, CiteScore: 1)
J. of Labor Research     Hybrid Journal   (Followers: 19, SJR: 0.209, CiteScore: 1)
J. of Logic, Language and Information     Hybrid Journal   (Followers: 6, SJR: 0.361, CiteScore: 1)
J. of Low Temperature Physics     Hybrid Journal   (Followers: 3, SJR: 0.471, CiteScore: 1)
J. of Machinery Manufacture and Reliability     Hybrid Journal   (Followers: 2, SJR: 0.238, CiteScore: 0)
J. of Mammalian Evolution     Hybrid Journal   (Followers: 6, SJR: 1.19, CiteScore: 2)
J. of Mammary Gland Biology and Neoplasia     Hybrid Journal   (Followers: 2, SJR: 1.278, CiteScore: 3)
J. of Management and Governance     Hybrid Journal   (Followers: 9, SJR: 0.441, CiteScore: 1)
J. of Management Control     Hybrid Journal   (Followers: 6, SJR: 0.262, CiteScore: 1)
J. of Marine Science and Application     Hybrid Journal   (Followers: 2, SJR: 0.288, CiteScore: 1)
J. of Marine Science and Technology     Hybrid Journal   (Followers: 3, SJR: 0.784, CiteScore: 2)
J. of Maritime Archaeology     Hybrid Journal   (Followers: 17, SJR: 0.29, CiteScore: 1)
J. of Market-Focused Management     Hybrid Journal   (Followers: 2)
J. of Marketing Analytics     Hybrid Journal   (Followers: 5, SJR: 0.206, CiteScore: 1)
J. of Material Cycles and Waste Management     Hybrid Journal   (Followers: 2, SJR: 0.491, CiteScore: 2)
J. of Materials Engineering and Performance     Hybrid Journal   (Followers: 23, SJR: 0.611, CiteScore: 2)
J. of Materials Science     Hybrid Journal   (Followers: 22, SJR: 0.807, CiteScore: 3)
J. of Materials Science : Materials in Electronics     Hybrid Journal   (Followers: 4, SJR: 0.503, CiteScore: 2)
J. of Materials Science : Materials in Medicine     Hybrid Journal   (Followers: 4, SJR: 0.647, CiteScore: 3)
J. of Mathematical Biology     Hybrid Journal   (Followers: 9, SJR: 0.977, CiteScore: 2)
J. of Mathematical Chemistry     Hybrid Journal   (Followers: 3, SJR: 0.332, CiteScore: 1)
J. of Mathematical Fluid Mechanics     Hybrid Journal   (Followers: 8, SJR: 1.613, CiteScore: 1)
J. of Mathematical Imaging and Vision     Hybrid Journal   (Followers: 5, SJR: 0.724, CiteScore: 2)
J. of Mathematical Modelling and Algorithms     Hybrid Journal   (Followers: 1)
J. of Mathematical Sciences     Hybrid Journal   (SJR: 0.304, CiteScore: 0)
J. of Mathematics Teacher Education     Hybrid Journal   (Followers: 16, SJR: 1.006, CiteScore: 1)
J. of Maxillofacial and Oral Surgery     Hybrid Journal   (Followers: 3)
J. of Mechanical Science and Technology     Hybrid Journal   (Followers: 5, SJR: 0.553, CiteScore: 1)
J. of Medical and Biological Engineering     Hybrid Journal   (Followers: 4, SJR: 0.356, CiteScore: 1)
J. of Medical Humanities     Hybrid Journal   (Followers: 22, SJR: 0.249, CiteScore: 1)
J. of Medical Systems     Hybrid Journal   (SJR: 0.619, CiteScore: 3)
J. of Medical Toxicology     Hybrid Journal   (Followers: 5, SJR: 0.74, CiteScore: 2)
J. of Medical Ultrasonics     Hybrid Journal   (Followers: 2, SJR: 0.221, CiteScore: 1)
J. of Medicine and the Person     Hybrid Journal  
J. of Membrane Biology     Hybrid Journal   (Followers: 1, SJR: 0.567, CiteScore: 2)
J. of Micro-Bio Robotics     Hybrid Journal   (SJR: 0.783, CiteScore: 3)
J. of Microbiology     Hybrid Journal   (Followers: 8, SJR: 0.911, CiteScore: 2)
J. of Mining Science     Hybrid Journal   (Followers: 4, SJR: 0.316, CiteScore: 1)
J. of Molecular Evolution     Hybrid Journal   (Followers: 6, SJR: 0.911, CiteScore: 2)
J. of Molecular Histology     Hybrid Journal   (Followers: 4, SJR: 0.981, CiteScore: 2)
J. of Molecular Medicine     Hybrid Journal   (Followers: 11, SJR: 2.177, CiteScore: 5)
J. of Molecular Modeling     Hybrid Journal   (Followers: 4, SJR: 0.36, CiteScore: 1)
J. of Molecular Neuroscience     Partially Free   (Followers: 11, SJR: 0.974, CiteScore: 2)
J. of Mountain Science     Hybrid Journal   (Followers: 2, SJR: 0.442, CiteScore: 1)
J. of Muscle Research and Cell Motility     Hybrid Journal   (Followers: 1, SJR: 0.936, CiteScore: 2)
J. of Nanoparticle Research     Hybrid Journal   (Followers: 3, SJR: 0.528, CiteScore: 2)
J. of Natural Medicines     Hybrid Journal   (SJR: 0.643, CiteScore: 2)
J. of Near-Death Studies     Hybrid Journal   (Followers: 1)
J. of Nephrology     Hybrid Journal   (Followers: 4, SJR: 1.003, CiteScore: 2)
J. of Network and Systems Management     Hybrid Journal   (SJR: 0.264, CiteScore: 2)
J. of Neural Transmission     Hybrid Journal   (Followers: 2, SJR: 1.232, CiteScore: 3)
J. of Neuro-Oncology     Hybrid Journal   (Followers: 2, SJR: 1.168, CiteScore: 3)
J. of Neuroimmune Pharmacology     Hybrid Journal   (Followers: 1, SJR: 1.379, CiteScore: 3)
J. of Neurology     Hybrid Journal   (Followers: 16, SJR: 1.626, CiteScore: 3)
J. of NeuroVirology     Hybrid Journal   (Followers: 1, SJR: 1.475, CiteScore: 3)
J. of Nondestructive Evaluation     Hybrid Journal   (Followers: 9, SJR: 0.773, CiteScore: 2)
J. of Nonlinear Science     Hybrid Journal   (SJR: 1.568, CiteScore: 2)
J. of Nonverbal Behavior     Hybrid Journal   (Followers: 5, SJR: 0.92, CiteScore: 2)
J. of Nuclear Cardiology     Hybrid Journal   (SJR: 0.796, CiteScore: 2)
J. of Nutrition, Health and Aging     Hybrid Journal   (Followers: 24, SJR: 1.249, CiteScore: 3)
J. of Obstetrics and Gynecology of India     Hybrid Journal   (Followers: 4, SJR: 0.236, CiteScore: 0)
J. of Occupational Rehabilitation     Hybrid Journal   (Followers: 16, SJR: 0.88, CiteScore: 2)
J. of Ocean Engineering and Marine Energy     Hybrid Journal   (Followers: 4, SJR: 0.913, CiteScore: 2)
J. of Ocean University of China (English Edition)     Hybrid Journal   (Followers: 1, SJR: 0.265, CiteScore: 1)
J. of Oceanography     Hybrid Journal   (Followers: 11, SJR: 0.989, CiteScore: 2)
J. of Ocular Biology, Diseases, and Informatics     Hybrid Journal  
J. of Optical and Fiber Communications Reports     Hybrid Journal   (Followers: 4)
J. of Optics     Hybrid Journal   (Followers: 8)
J. of Optimization Theory and Applications     Hybrid Journal   (Followers: 5, SJR: 0.813, CiteScore: 1)
J. of Ornithology     Hybrid Journal   (Followers: 23)
J. of Orofacial Orthopedics / Fortschritte der Kieferorthopädie     Hybrid Journal   (SJR: 0.579, CiteScore: 1)

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Journal Cover
European Surgery
Journal Prestige (SJR): 0.2
Number of Followers: 8  
  Hybrid Journal Hybrid journal (It can contain Open Access articles)
ISSN (Print) 1682-4016 - ISSN (Online) 1682-8631
Published by Springer-Verlag Homepage  [2350 journals]
  • 59th Annual Meeting of The Austrian Society of Surgery
    • Pages: 1 - 118
      PubDate: 2018-05-01
      DOI: 10.1007/s10353-018-0526-0
      Issue No: Vol. 50, No. S1 (2018)
  • Contemporary liver surgery
    • Authors: Stefan Stättner
      Pages: 79 - 80
      PubDate: 2018-06-01
      DOI: 10.1007/s10353-018-0533-1
      Issue No: Vol. 50, No. 3 (2018)
  • Patient selection and perioperative optimisation in surgery for colorectal
           liver metastases
    • Authors: Benjamin D Jones; Robert Jones; Declan FJ Dunne; Tim Astles; Stephen W Fenwick; Graeme J Poston; Hassan Z Malik
      Pages: 87 - 92
      Abstract: Summary Background Clinical decision-making around the management of liver-limited stage IV colorectal cancer involves careful assessment of the potential risks and benefits of surgery. This balance can often be optimised through appropriate patient selection to ensure long-term benefit of any operation, with fastidious perioperative care to minimize risk. Methods We reviewed selected relevant articles from the existing literature. Results Multi-platform imaging is routinely used to determine distribution of disease and whether lesions are technically resectable, but what remains less clear is how to identify patients in whom resection is likely to deliver long-term benefits. A number of prognostic markers have been identified, with growing interest in direct assessment of tumour biology; genotyping of RAS status is routine in specific situations. Following a multidisciplinary team decision to proceed to surgery, patients undergo perioperative assessment and optimisation. Cardiopulmonary exercise testing helps to stratify perioperative risk: patients with low uptake of oxygen at the anaerobic threshold are known to have worse perioperative outcomes, and prehabilitation may offer the chance to reduce this risk. Intraoperative anaesthetic management is on a patient-by-patient basis but sub-normal hydration, epidural anaesthesia and steroids play a key role. Enhanced recovery after surgery programmes have improved perioperative outcomes while providing a potential economic benefit. Conclusion Despite very good perioperative results, surgical management is not curative for the majority of patients, highlighting the need to further refine patient selection and definition of treatment aim on a patient-by-patient basis.
      PubDate: 2018-06-01
      DOI: 10.1007/s10353-018-0539-8
      Issue No: Vol. 50, No. 3 (2018)
  • Optimal perioperative care in peri-hilar cholangiocarcinoma resection
    • Authors: Leonard M. Quinn; Declan F. J. Dunne; Robert P. Jones; Graeme J. Poston; Hassan Z. Malik; Stephen W. Fenwick
      Pages: 93 - 99
      Abstract: Summary Surgical resection remains the only proven curative treatment for peri-hilar cholangiocarcinoma. Despite recent advances in liver surgery techniques and perioperative care, resection for peri-hilar cholangiocarcinoma remains associated with significant morbidity and mortality. Considerable variation in the perioperative management of these patients exists. Optimal perioperative management has the potential to deliver improved outcomes. This article seeks to summarize the evidence underpinning best practice in the perioperative care of patients undergoing resection of peri-hilar cholangiocarcinoma. The authors also seek to identify areas where research efforts and future clinical trials should be targeted.
      PubDate: 2018-06-01
      DOI: 10.1007/s10353-018-0529-x
      Issue No: Vol. 50, No. 3 (2018)
  • Surgical techniques and strategies for the treatment of primary liver
           tumours: hepatocellular and cholangiocellular carcinoma
    • Authors: Eva Braunwarth; Stefan Stättner; Margot Fodor; Benno Cardini; Thomas Resch; Rupert Oberhuber; Daniel Putzer; Reto Bale; Manuel Maglione; Christian Margreiter; Stefan Schneeberger; Dietmar Öfner; Florian Primavesi
      Pages: 100 - 112
      Abstract: Summary Background Owing to remarkable improvements of surgical techniques and associated specialities, liver surgery has become the standard of care for hepatocellular carcinoma and cholangiocarcinoma. Although applied with much greater safety, hepatic resections for primary liver tumours remain challenging and need to be integrated in a complex multidisciplinary treatment approach. Methods This literature review gives an update on the recent developments regarding basics of open and laparoscopic liver surgery and surgical strategies for primary liver tumours. Results Single-centre reports and multicentre registries mainly from Asia and Europe dominate the surgical literature on primary liver tumours, but the numbers of randomized trials are slowly increasing. Perioperative outcomes of open liver surgery for hepatocellular and cholangiocellular carcinoma have vastly improved over the last decades, accompanied by some progress in terms of oncological outcome. The laparoscopic approach is increasingly being applied in many centres, even for patients with underlying liver disease, and may result in decreased morbidity. Liver transplantation represents a cornerstone in the treatment of early hepatocellular carcinoma and is indispensable to achieve long-term survival. In contrast, resection remains the gold standard for cholangiocarcinoma in most countries, but interventional techniques are on the rise. Conclusion Liver surgery for primary tumours is complex, with a need for high expertise in a multidisciplinary team to achieve acceptable outcomes. Technical developments and clinical stratification tools have optimized individual care, but further improvements in oncological survival will likely require enhanced pre- and postoperative systemic and local treatment options.
      PubDate: 2018-06-01
      DOI: 10.1007/s10353-018-0537-x
      Issue No: Vol. 50, No. 3 (2018)
  • Indications for liver surgery in benign tumours
    • Authors: Margot Fodor; Florian Primavesi; Eva Braunwarth; Benno Cardini; Thomas Resch; Reto Bale; Daniel Putzer; Benjamin Henninger; Rupert Oberhuber; Manuel Maglione; Christian Margreiter; Stefan Schneeberger; Dietmar Öfner; Stefan Stättner
      Pages: 125 - 131
      Abstract: Summary Background Management of benign liver tumours (BLT) is still object of discussion. Uncertainty still exists about patient selection, details of management, indications for surgical intervention and potential surgery-related complications. The up-to-date strategies for management of the most common benign solid tumours are recapitulated in this article. In addition, recommendations concerning practical issues are presented. Methods Available data from peer-reviewed publications associated with the major controversies concerning treatment strategies of solid BLT were selected through a PubMed literature search. Results Non-randomized controlled trials, retrospective series and case reports dominate the literature. Conservative management in BLT is associated with low overall morbidity and mortality when applied in an appropriate patient population. Surgical intervention is indicated solely in the presence of progressive symptoms and suspicion of a malignant change. Linking abdominal symptoms to BLT should be interpreted with caution. No evidence is recorded for malignant transformation in haemangiomas and focal nodular hyperplasia (FNH), while a subgroup of hepatocellular adenoma (HCA) is associated with malignancy. Follow-up controls of BLT at 3 and 6 months should be sufficient to prove the stability of the lesion and its benign nature, after which no long-term follow-up is required routinely. However, many questions regarding this topic remain without definitive answers in the literature. Conclusion Conservative management of solid BLT is a worldwide trend, but the available literature does not provide high-grade evidence for this strategy. Consequently, further prospective investigations on the unclear aspects are required. Hence, this article summarises practical highlights of therapeutic strategies.
      PubDate: 2018-06-01
      DOI: 10.1007/s10353-018-0536-y
      Issue No: Vol. 50, No. 3 (2018)
  • High vascular ligation in left-sided colon cancer surgery is safe and
    • Authors: Narimantas E. Samalavicius; Audrius Dulskas; Simonas Uselis; Edgaras Smolskas; Giedre Smailyte; Raimundas Lunevicius
      Abstract: Summary Background We aimed to evaluate the safety and adequacy of high vascular ligation in surgery for left-sided colon cancer. Methods Between 2007 and 2016, hand-assisted laparoscopic surgery was performed on 228 patients for descending or sigmoid colon cancer with high ligation of the inferior mesenteric artery and vein. We collected and prospectively studied demographic, clinical, and long-term outcome results. Complications were assessed with the Clavien–Dindo classification. The 5‑year survival (OS) and 5‑year disease-free survival (DFS) probability rates were calculated using Kaplan–Meier curves. Results There were 71 (31%) patients with stage I disease, 67 (29.7%) with stage II, 65 (28.4%) with stage III, and 25 (10.9%) with stage IV. The average harvested lymph node count was 16.5 ± 10 (range, 10–90). Length of postoperative hospital stay was 6.3 ± 3.2 days (range, 1–30). Eleven (4.82%) patients had complications, and three of them (1.3%) were re-operated. There was no anastomotic leakage detected in our group of patients. The five-year OS of all stages using Kaplan–Meier curves was 0.75 and the DFS was 0.8. Conclusion Our data support the opinion that high vascular ligation while performing surgery for left-sided colon cancer is safe. Long-term oncological outcomes were similar to those presented in other studies.
      PubDate: 2018-06-01
      DOI: 10.1007/s10353-018-0542-0
  • Esophageal and jejunal motility in patients with total gastrectomy
           reconstructed with Roux-en-Y loop
    • Authors: Marcelo A. Beltrán
      Abstract: Summary Background The standard technique for reconstruction of the intestinal transit after total gastrectomy for gastric cancer is the Roux-en-Y anastomosis between the esophagus and a jejunal loop, which prevents the reflux of alkaline intestinal juice. The purpose of this study was to analyze the esophageal body motility and the motility of the proximal jejunal loop in patients subjected to total gastrectomy. Patients and methods A prospective cohort of 17 total gastrectomy patients, operated on 5 years earlier, were studied using high-resolution esophageal manometry including the first 7 cm of the jejunal loop. Results Manometry results were similar for all patients, showing normal esophageal body motility, with the exception of the maximum intrabolus pressure that was elevated in all cases. The jejunal loop motility was disordered and ineffective. Conclusion Esophageal body motility was normal 5 years after total gastrectomy. However, maximum mean intrabolus pressure was elevated in all patients. The most plausible reason for this finding would be the resistance exerted by the motility of the jejunal loop. Although this abnormality might not explain the mild symptoms presented by some patients, its pathological consequences are of little relevance.
      PubDate: 2018-05-30
      DOI: 10.1007/s10353-018-0540-2
  • A comprehensive study of the mesopancreas as an extension of the
           pancreatic circumferential resection margin
    • Authors: Charlotte Maplanka
      Abstract: Summary Background and objectives Data on required excisions to achieve clear margins in pancreatic cancer are conflicting. Similarly, there are inconsistent protocols on aggressive lymphadenectomy. We review retropancreatic tissues, common metastatic lymph nodes and the mesopancreas with respect to pancreatic resection margins to improve our understanding of major sites for relapse that can be specifically targeted for effective treatments. Materials and methods This work is two-fold: keywords/phrases identified relevant publications on the mesopancreas and lymphadenectomy in PubMed databases; RCTs, original studies, prospective and retrospective studies were reviewed and results analysed. Results Retropancreatic tissues including the mesopancreas are major sites for incomplete resections and relapse. Nomenclature for the mesopancreas is moot; nonetheless, its contents form a network of a neurolymphovascular-rich microenvironment that furnishes pathways for invasion and metastasis. The “mesopancreas” is a rectangular prism-shaped, primary micrometastasis site that overlaps with pancreatic resection margins and common metastatic lymph nodes. Most common infiltrated lymph nodes in 599 patients were stations 13, 17, 14, 12, 8, 16 and 6. Extended lymphadenectomy offers no survival benefit but promotes accurate staging. Conclusion A better understanding of the relationship between the anatomical position of the mesopancreas, common metastatic lymph nodes and the pancreatic circumferential resection margin offers important future applications for targeted treatment approaches to control tumour spread, stage nodal disease and reduce disease burden in retropancreatic tissues, frequently infiltrated lymph nodes and other anatomically complex sites such as the superior mesenteric neurovascular pedicle. Excision of common metastatic lymph node stations can improve outcomes.
      PubDate: 2018-05-25
      DOI: 10.1007/s10353-018-0535-z
  • Laparoscopic gastrectomy and adjuvant hyperthermic intraperitoneal
           chemotherapy (HIPEC) using a closed system with turbulent-flow circuit:
           technical aspects and preliminary results of a pilot study
    • Authors: Daniele Bernardi; Emanuele Asti; Michele Punturieri; Alberto Luporini; Luigi Bonavina
      Abstract: Summary Background Intraoperative hyperthermic chemotherapy (HIPEC) is increasingly used in combination with cytoreductive surgery for the treatment of peritoneal carcinomatosis. The potential survival benefit of adjuvant HIPEC after curative gastrectomy has not been conclusively demonstrated. We describe a newly developed closed system for HIPEC and report the preliminary results of a pilot study. Methods Patients with locally advanced gastric carcinoma at a high risk for peritoneal recurrence were identified from a prospectively collected database. Laparoscopic total or subtotal gastrectomy combined with standard D2 lymphadenectomy was performed. Immediately after resection and 15 min before HIPEC treatment, intravenous induction chemotherapy with folinic acid and 5‑fluorouracil was administered. A closed-system HIPEC with turbulent-flow circuit (Combat PRS™, Peritoneum Recirculation System, Galmaz Biotech, Madrid, Spain) was used to perfuse the peritoneal cavity with a solution of oxaliplatin and glucose during 60 min. After washout of the peritoneal cavity and re-establishment of pneumoperitoneum, a Roux-en-Y esophagojejunostomy or gastrojejunostomy was performed. Results Between June 2017 and February 2018, 6 patients were treated according to this protocol. No major postoperative complications occurred. There were no intra- or postoperative complications related to the HIPEC procedure. All patients are alive and disease-free at 3–11 months of follow-up. Conclusions The preliminary results of this pilot study indicate the safety and feasibility of the closed HIPEC system with CO2 recirculation in selected patients undergoing laparoscopic total or subtotal gastrectomy for locally advanced gastric carcinoma.
      PubDate: 2018-05-24
      DOI: 10.1007/s10353-018-0538-9
  • Pseudopapillary tumours of the pancreas
    • Authors: Mark Portelli; Snezana Bozanic; David Pisani; Kelvin Cortis; Jo-Etienne Abela
      Abstract: Summary Background Solid pseudopapillary tumours, also known as Frantz’s tumours, are rare pancreatic lesions which usually occur in young 20–30 year-old women. They account for about 2% of all exocrine pancreatic tumours. They often present with vague abdominal pain and the diagnosis is frequently an incidental finding. Methods In this case series and narrative review, we attempt to update the current standpoint on primary pseudopapillary tumours. In this paper we present a case series of three subjects (2 females and 1 male) who were diagnosed with primary pseudopapillary tumours. Their treatment and follow-up is described in detail. Results These tumours will be discussed in the context of a literature review. Conclusions Surgical resection remains the primary method of treatment for this subtype of pancreatic tumours. The prognosis is excellent in patients who undergo resection.
      PubDate: 2018-05-18
      DOI: 10.1007/s10353-018-0520-6
  • Roux-en-Y versus Billroth I following distal gastrectomy
    • Authors: Haizhong Liu; Yujie Li
      Abstract: Summary Aim The aim of this study was to assess and validate the clinical efficacy of Roux-en-Y reconstruction (R-Y) when compared to Billroth I reconstruction (B-I) after distal gastrectomy (DG). Methods The authors identified the prospective, randomized, controlled trials comparing R‑Y with B‑I after DG for gastric cancer from January 1990 to July 2016 using PubMed, Web of Knowledge, Ovid’s database. The method of meta-analysis is performed to compare the complications and recurrences of R‑Y versus B‑I. Result Seven randomized controlled trials (RCTs) involving 1197 patients were included. Meta-analysis revealed that R‑Y reconstruction was associated with a significant reduction in the incidence of remnant gastritis (Odds ratios [OR] 2.58, 95%Confidence interval [CI]: 1.78, 3.74; P < 0.00001). No significant differences were observed between the groups in terms of intraoperative blood loss (Weighted mean difference [WMD] −20.97, 95%CI: −47.85, 5.92; P = 0.13), time to resumed oral intake (WMD −1.32, 95%CI: −6.39, 3.75; P = 0.61), reflux esophagitis (OR 1.71, 95%CI: 0.82, 3.57; P = 0.15), and recurrence (OR 1.10, 95%CI: 0.44, 2.71; P = 0.84). Moreover, the B‑I reconstruction method took significantly less time to perform as compared to R‑Y reconstruction (WMD −38.12, 95%CI: −50.50, −25.74; P < 0.00001) and postoperative hospital stay was shorter (WMD −2.96, 95%CI: −5.93, 0.00; P = 0.05), Conclusion The R‑Y reconstruction was effective in preventing gastritis, although R‑Y reconstruction after gastric resection was inferior to B‑I reconstruction in terms of taking more time to perform and a longer stay in hospital.
      PubDate: 2018-05-04
      DOI: 10.1007/s10353-018-0532-2
  • Liver resection for non-colorectal metastases
    • Authors: Christoph Schwarz; Klaus Kaczirek; Martin Bodingbauer
      Abstract: Summary Whereas liver resection for colorectal metastasis has become standard of care, hepatectomy in patients with non-colorectal metastases remains controversial, mainly due to a heterogeneous tumor biology and missing data from prospective trials. This review aims at giving an overview about the indications and limits of liver surgery in patients with an advanced disease of a non-colorectal malignancy. Even though prospective trials are largely missing, results from retrospective studies indicate a survival benefit for liver resection in selected patients. Thus, in metastasized patients, treatment strategies should be developed in a multidisciplinary tumor board including an experienced liver surgeon.
      PubDate: 2018-04-25
      DOI: 10.1007/s10353-018-0528-y
  • Technical advances and future perspectives in liver surgery
    • Authors: Marc A. Ward; Brice Gayet; Nicolas Tabchouri; Fabrizio Moisan; Gianfranco Donatelli; Stefan Stättner; David Fuks
      Abstract: Summary The current era of liver surgery is highlighted by low morbidity and mortality rates, innovative efforts to increase resectability, and overall improved survival for patients with both primary and metastatic lesions. The complexity of liver anatomy combined with the presence of several major vascular structures delayed the widespread application of minimally invasive surgical techniques to liver surgery compared to other intra-abdominal organs. However, our experience with minimally invasive surgery has greatly expanded over the past 20 years. Modern surgical techniques, emerging technologies, and novel chemotherapeutic agents have led to a significant increase in minimally invasive liver surgery worldwide. This review will focus on the modern technical advancements that make minimally invasive liver surgery successful and what we can expect in the future.
      PubDate: 2018-04-25
      DOI: 10.1007/s10353-018-0530-4
  • Mechanisms of dyspnoea in giant hiatus hernia: an indication to perform
    • Authors: Gregory Leighton Falk; Sophia C. Little
      Abstract: Summary Background The physiology of dyspnoea associated with giant hiatus hernia has not been well understood; however, it is generally considered a contraindication for surgery. Methods Recent studies into mechanisms and prevalence of dyspnoea are discussed. Results Recent studies suggest that dyspnoea is present in 80% of cases of massive hiatus hernia. Cardiac compression from massive hiatus hernia is a known contributor to dyspnoea in this patient group, as well as pulmonary aspiration. Conclusions Paradoxically, dyspnoea could be considered as an indication for surgery in patients presenting with giant hiatus hernia, once the mechanism is established. Novel points Dyspnoea in the presence of a substantially large hiatus hernia has long been considered unrelated and a contraindication to surgery. We present the results of varied studies that suggest dyspnoea, when the mechanism is established, is in fact an indication for surgery in giant hiatus hernia.
      PubDate: 2018-04-25
      DOI: 10.1007/s10353-018-0531-3
  • Surgery and the Eye of Horus: the myth of mankind (Part I)
    • Authors: Martin Riegler
      PubDate: 2018-04-19
      DOI: 10.1007/s10353-018-0525-1
  • New understanding of GERD and Barrett’s esophagus:
           histopathology-based disease management
    • Authors: Martin Riegler
      PubDate: 2018-04-18
      DOI: 10.1007/s10353-018-0524-2
  • Integrating interventional oncology in the treatment of liver tumors
    • Authors: D. Putzer; P. Schullian; E. Braunwarth; M. Fodor; F. Primavesi; B. Cardini; T. Resch; R. Oberhuber; M. Maglione; C. Margreiter; S. Schneeberger; S. Stättner; D. Öfner-Velano; W. Jaschke; R. J. Bale
      Abstract: Summary Background Percutaneous ablation techniques offer a vast armamentarium for local, minimally invasive treatment of liver tumors, nowadays representing an established therapeutic option, which is integrated in treatment algorithms, especially for non-resectable liver tumors. The results of ablative treatment compare very well to surgical treatment in liver lesions, and confirm that these techniques are a valuable option for bridging for transplantation. Different techniques have been established to perform tumor ablation, and the feasibility varies according to the procedure and technical skills of the operator, depending on the size and location of the liver lesion. In recent years, stereotactic multi-needle techniques using 3D trajectory planning, general anesthesia, and tube disconnection during needle placement have had a strong impact on the application range of ablation for liver tumors. Conclusion It is well known that creating a sufficient ablation margin and overlapping ablation zones is one key issue to enable ablation of large liver lesions with tumor-free margins (A0 ablation in analogy to R0 resection). Image fusion during treatment and follow-up assure highly accurate staging procedures and interventional planning. Novel aspects Review on the standards in ablation techniques for the treatment of liver tumors. Update on different ablation techniques, indications, and contraindications for percutaneous liver tumor treatment. Summary of recently published reports on liver tumor ablation.
      PubDate: 2018-04-13
      DOI: 10.1007/s10353-018-0521-5
  • Perioperative management of liver surgery—review on pathophysiology of
           liver disease and liver failure
    • Authors: Lukas Gasteiger; Stephan Eschertzhuber; Werner Tiefenthaler
      Abstract: Summary An increasing number of patients present for liver surgery. Given the complex pathophysiological changes in chronic liver disease (CLD), it is pivotal to understand the fundamentals of chronic and acute liver failure. This review will give an overview on related organ dysfunction as well as recommendations for perioperative management and treatment of liver failure-related symptoms.
      PubDate: 2018-04-13
      DOI: 10.1007/s10353-018-0522-4
  • Shaping the future of liver surgery
    • Authors: D. Pereyra; P. Starlinger
      Abstract: Summary Background While liver surgery has become a safe and feasible operation technique, the incidence of postoperative liver dysfunction still remains a central problem. Approximately 10% of patients undergoing liver resection were shown to develop liver dysfunction, which is associated with an increased risk of morbidity and mortality. Yet, to date there is no effective treatment option for postoperative liver dysfunction available. The development of postoperative liver dysfunction was linked to a disruption in the liver’s potential to regenerate. Thus, it is importance to elucidate the underlying mechanisms of liver regeneration and to find potential therapeutic targets for the treatment of patients with postoperative liver dysfunction. Methods A review of the literature was carried out. Results We report on potential future interventions for improvement of liver regeneration after surgical resection. Moreover, we evaluate the benefits and drawbacks of hepatic progenitor cell therapy and hematopoietic stem cell therapy. However, the most significant improvement seems to come from molecular targets. Indeed, von Willebrand factor and its pharmacologic manipulation are among the most promising therapeutic targets to date. Furthermore, using the example of platelet-based therapy, we stress the potentially adverse effects of treatments for postoperative liver dysfunction. Conclusion The present review reports on the newest advances in the field of regenerative science, but also underlines the need for more research in the field of postoperative liver regeneration, especially in regard to translational studies.
      PubDate: 2018-03-06
      DOI: 10.1007/s10353-018-0515-3
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