[Combined resection and lymphatic excision in lung cancer--combined resection of the thoracic wall and pericardium and lymphatic excision].
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Female↗
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Results for “resectability”
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[Frontal deep rectal resection and the modified Hochenegg method. Incidence of recurrence after frontal deep rectal resection and after the Hochenegg method].
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Humans↗
[One alternative for presentation of a maxillary resection prosthesis where the resected part consists of one obturator closing, a hollow space].
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Denture Design↗
Incidence of epithelial dysplasia after partial gastric resection.
Because of the higher risk of cancer in the gastric stump, an increased incidence of pre-cancerous conditions should be exspected also in the resected stomach. Therefore, a combined endoscopic and bioptic study was performed in order to investigate the incidence of dysplasias in the gastric stump after resection for benign conditions. Among 101 patients with gastric resection, 2 cases were excluded from this study because of preceeding gastric cancer and one because of cancer of the gastric stump. In 43 of the remaining 98 patients, a Billroth-I-resection (gastroduodenostomy) had been carried out. In the remaining 55 patients with a Billroth-II-resection (gastroenterostomy) 9 had an additional enteroanastomosis of Braun whereas in the residual 46 patients this enteroanastomosis was lacking. This distinction was made because of a facultative or obligatory bile reflux. The average age of the B-I-group was 68 years, of the B-II-group with enteroanastomosis 69 years, and the B-II-group without enteroanastomosis 62 years. A non-operated group matched for age served as control group. Biopsy particles from the anastomotic region were gained by endoscopy and cut in step sections. The classification of dysplasias (degree I-III) followed the criteria given by Nagayo as modified by Grundmann. Inflammatory reactive changes were separated from these. A few changes could not be classified definitely and were listed as unclassified dysplasia. While dysplastic changes of low degree were quite numerous in every group, the dysplasias of higher degree were only found in a small number of cases. In the 46 cases with B-II-resection without Braun's enteroanastomosis, there were 5 dysplasia II and 3 dysplasia II. In the 9 cases with B-II-resection and with Braun's enteroanastomosis, there was 1 dysplasia I and no dysplasia III. In the 43 patient with B-I-resection only 2 dysplasia II and no dysplasia III were found. In the control group of 98 patients matched for age there were only 5 cases with dysplasia I and 1 case with dysplasia III. Patients with higher degrees of dysplasia showed a higher age and a longer interval after operation. There was also a correlation between higher degrees of dysplasia and severe atrophic changes in the mucosa. Correlating the degree of dysplasia with the reason for gastric resection, most of the dysplastic changes occurred in patients resected for gastric ulcer, whereas cases resected for duodenal ulcer showed only 2 dysplasias I. The discussion refers to the few data about dysplasia of the gastric stump available from the literature. Atrophic and increased regenerative changes obviously play a role in the pathogenesis of these dysplastic changes. As a causative factor the role of bile reflux is discussed. A further diagnostic and therapeutic regimen for the different forms of dysplasia is proposed.
Aged↗
Role of fat maldigestion in pathogenesis of steatorrhea in ileal resection. Fat digestion after two sequential test meals with and without cholestyramine.
To clarify the role of fat maldigestion in the pathogenesis of steatorrhea in patients with ileal resection the total and aqueous phase concentrations of bile acid and fatty acid were characterized in 8 such patients (5 patients with small ileal resection, bile acid diarrhea, and steatorrhea less than 20 g per day; 3 patients with large ileal resection, fatty acid diarrhea, and steatorrhea greater than 20 g per day) as well as 4 healthy control subjects after a morning and an afternoon liquid test meal. The study was then repeated with cholestyramine, 4 g being administered before each meal to induce fat maldigestion. After a conventional test meal, patients with large resections and severe steatorrhea had significantly lower aqueous phase concentrations of bile acids (and fatty acids) than patients with smaller resections or control subjects, explained in part by intraluminal precipitation of about one-half of the bile acids during digestion. When cholestyramine was administered before the meal, aqueous phase bile acid concentrations decreased in all patients, including the normal control subjects; the degree of fat maldigestion induced in the patients with small resections (and the control subjects) became similar to that present after the conventional test meal in the patients with large resections. Because steatorrhea increased little in the patients with small resections when cholestyramine was administered continuously, the data suggest that fat maldigestion per se does not induce severe fat malabsorption in patients with sufficient anatomical reserve, because such patients can absorb fat efficiently by utilizing the distal small intestine. In patients with large ileal resections, severe steatorrhea is explained in part by the combination of fat maldigestion and decreased surface area. It is also speculated that the steatorrhea occurring in patients with small resections and relatively normal fat digestion during two test meals may be explained by impaired fat digestion which occurs during the final meal of the day, which is often the largest meal.
Adult↗
Major hepatic resection for neoplasia: personal experience in 108 patients.
One hundred eight patients have undergone major hepatic resection by the senior author during the eight year period April 1970 to April 1978. Primary liver cancer was present in 36; metastatic colorectal cancer in 25, miscellaneous metastatic cancers in 15, hepatoblastoma in 5, gallbladder cancer in 4, and bile duct cancer in 3. Benign tumors, principally giant hemangioma, were resected in 20 additional patients. The 30 day operative mortality rate was 9% overall. Prior to 1975, 41 of the resections were done using the vascular isolation perfusion technique. The operative mortality rate of 17% for this technique is a reflection of early experience and the advanced stage of disease of many patients. The operative mortality for the standard resection has been only 4%. Subphrenic abscess has developed in only 13% of patients during the past three years. Postoperative hospitalization has been shortened, being a median of 13 days. The resectability rate for malignant disease was 33%. Forty-six percent of the resections were performed with curative intent. Fifty-four per cent were palliative, performed in individuals with regional spread or distant metastasis. After curative surgery, three year survival was 88% for individuals with primary liver cancer and 72% with metastatic colorectal cancer. After palliative resection, the rates were 31 and 0%, respectively. The three year survival rate is 46% overall, being 81% for the curative resection group and 18% for the palliative group. Tumor markers proved useful in monitoring patients after hepatic resection.
Bile Duct Neoplasms↗
[Experimental and clinical studies on blood coagulation and lysis system after hepatic resection (author's transl)].
Blood coagulation and lysis system was studied with other biochemical serum analysis in three groups of mongrel dogs; laparotomy without hepatic resection (group I), with 50% hepatic section (group II), and 70% hepatic resection (group III). In clinical studies, six cases of hepatic tumors and one case of hepatoma with cirrhosis were selected for examinations. All the data examined in group I were restored toward normal within 48 hours. Total serum protein level was significantly decreased after hepatic resection. The protein level in group III was lower than in group II on the 4th postoperative day (P less than 0.01). In clinical studies, low serum protein levels did not reach a preoperative value even 3 weeks after extended right hepatic lobectomy. Time course of Al-P and transaminase changes in clinical studies was similar to that in experimental study with dogs. Al-P and transaminase showed an abnormally high level in the patient with hepatic cirrhosis. Serum bilirubin levels were not increased after hepatic resection. In blood coagulation and lysis system, serum fibrinogen levels were markedly decreased: 50% reduction in group III and 30% reduction in group II on the first postoperative day. The degree of decrease in the fibrinogen level was proportional to the size of resected volume of the liver. On the other hand, in clinical studies fibrinogen levels were slightly decreased. In the case of hepatic resection with cirrhosis, however, the values were markedly decreased: 40% reduction on the 4th and 25% on the 21st postoperative days. Fibrinolysis system was accelerated group II and III. The acceleration continued until 3 weeks after hepatic resection. From these results it may be concluded that analysis of blood coagulation and lysis system after hepatic resection is useful in evaluating a residual hepatic function after partial resection and in selecting a treatment suitable for hepatic insufficiency.
Adolescent↗
Colonic interposition between the jejunum and ileum after massive small bowel resection in rats.
Most patients who undergo massive small bowel resection develop the "short bowel syndrome", which usually resolves as intestinal adaptation takes place. Some, in whom adaptation appears to be inadequate, remain severely incapacitated, and attempts have been made to improve absorption using a variety of surgical maneuvers. Successes have been recorded, but the procedures (of which reversal of a segment of small intestine to prolong the intestinal transit time has been most frequently used) are unpredictable and may actually be harmful. This study was designed to evaluate the theory that, because of the slow pattern of peristaltic activity inherent in the colon, the intestinal transit time could be safely and predictably prolonged after massive small bowel resection by transposing a segment of colon to between the jejunal and ileal remnants in an iso-peristaltic direction. The following procedures were performed, using 56 rats: (1) Resection of 80% or 90% of the small intestine. (2) Small bowel resection (80% or 90%) and iso-peristaltic jejuno-ileal colonic interposition. (3) Bowel anastomoses without resection. Intestinal function was subsequently evaluated by studying the following: (1) body weight; (2) blood count; (3) intestinal transit time (by contrast radiography); (4) intestinal absorption of sodium iodide, albumin, triolein and Vitamin B12 (using radioisotopic methods); (5) intestinal morphology. Colonic interposition did not have any significant effect following 80% small bowel resection. After 90% resection, colonic interposition increased the intestinal transit time significantly (p less than 0.001) without mortality or serious morbidity, and did not cause intestinal obstruction or prevent intestinal adaptation. Body weight and intestinal absorption were not increased significantly, but the study was too short to exclude an eventual beneficial effect in terms of body weight. It was concluded that iso-peristaltic colonic interposition is a safe and reliable method of prolonging the intestinal transit time after massive small bowel resection in the rat, thereby increasing the efficiency of absorption within the existing absorption capacity. The procedure has been found to be beneficial in dogs, and for reasons discussed, should be equally effective in man. Adjunctive surgery is not recommended at the time of resection in man, but should be considered if absorption remains severely impaired.
Animals↗
[Liver damage after resection of the stomach: evaluation of 215 cases (author's transl)].
Only 11% out of 215 patients with resection of the stomach had a normal liver if the term of the resection was not longer ago than 30 years. Contrarily the deposition of fat became less frequent with increasing distance from the operation term while deposition of iron (siderin) was demonstrable nearly equaly in all groups. Age and sex did not influence the behaviour of the liver after resection of the stomach. The information value by blood transaminase activity (GOT/GPT) decreases with the distance of time from the resection term. Alcoholics (n = 20) had less shares of post resection liver harms than non-alcoholics. Thus alcohol seems to be not a bigger risk for resectioned as for people with normal stomach. Repeated liver biopsies after different intervals of time pointed out that a change for the worse happened more often with increasing distance to the resection term. Therefore resected patients should be examined regularly, including liver biopsy, as to discover in time a growing up liver damage. After resection of the stomach discovered liver diseases refer to a damage caused by that stomach disease which induced the operation.
Adult↗
Endoscopic submucosal dissection for locally recurrent gastric neoplasia following endoscopic resection: a systematic review and meta-analysis.
BACKGROUND AND AIMS: Endoscopic submucosal dissection (ESD) for locally recurrent gastric neoplasia following endoscopic resection (ER) is technically challenging because of scar-related submucosal fibrosis. We performed a systematic review and meta-analysis to evaluate the efficacy and safety of salvage ESD in this setting. METHODS: Multiple databases were searched through December 2025 for studies reporting ESD outcomes for locally recurrent gastric lesions at or contiguous with a prior ER scar. Primary outcome was curative resection and need for surgery. Secondary outcomes were en bloc and R0 resection, local recurrence, delayed bleeding, and perforation. Meta-analyses were performed using a random effects model. Heterogeneity was assessed using I2. RESULTS: Seven studies (259 patients; 265 ESDs) were included. Across 5 studies and 243 ESDs, pooled curative resection rate was 69.7% (95% CI, 60.6-78.1; I2 = 38%), while 8.2% (95% CI, 3.3-14.6; I2 = 38.4%) required surgery. En bloc resection rate was 92.3% (95% CI, 79.1-99.7; I2 = 83.7%) across 6 studies, and pooled R0 resection rate was 87.5% (95% CI, 82.1-92.2; I2 = 0%) across 4 studies. Over a mean follow-up of 42 months, pooled local recurrence was 2.0% (95% CI, 0.0-9.7; I2 = 54.1%) across 6 studies. Delayed bleeding was 4.1% (95% CI, 0.8-9.0; I2 = 40.8%) and perforation was 4.1% (95% CI, 1.6-7.3; I2 = 0%). CONCLUSIONS: ESD for locally recurrent gastric neoplasia after ER achieves acceptable curative resection, high en bloc/R0 resection, and low local recurrence and morbidity. It is a viable organ-preserving option for appropriately selected patients, ideally performed at expert centers with close surveillance.
Humans↗
Recovery of immune competence after tumour resection in mice: correlation with loss of suppressor elements.
Changes in the immune competence and levels of suppressore elements were assessed by mitogen stimulation and in vitro antibody production, after resection of a transplantable sarcoma. Spleen cells from tumour-resected animals were found to have depressed responses to conA as well as to the antigens SRBC and DNP-LPS. This inability to respond was gradually overcome and, by Day 21 after resection, spleen cell competence had returned to normal levels. Suppressor cells isolated from the spleens of tumour-resected animals were capable of suppressing the conA response and PFC response of normal syngeneic spleen cells in vitro. The ability to suppress the conA response of normal cells disappeared by Day 1 after resection, while the ability to suppress the anti-SRBC and anti-DNP PFC response of normal cells disappeared by Day 8 and Day 14 respectively. Serum from tumour-resected mice was also found to be suppressive to the conA response of normal spleen cells. The inhibitory material responsible for suppression eluted with the Ig-containing fraction on Sephadex G-150. This inhibitory material gradually disappeared from the serum of tumour-resected mice and was no longer apparent by Day 14. Therefore, it appeared that the return of normal lymphocyte function after tumour-resection was concomitant with the disappearance of splenic suppressor cells and suppressive serum factor.
Animals↗
Comparison of the results of resection, bypass, and bypass with exclusion for ileocecal Crohn's disease.
Controversy continues regarding the optimal surgical treatment of Crohn's disease involving the ileum and cecum. Over 43-years, 161 patients underwent primary surgery for this disease at The New York Hospital-Cornell Medical Center. Resection was performed in 115 patients, bypass with exclusion in 25, and side-to-side ileotranverse colostomy in 21. Overall recurrence rates were 25% for resection, 63% for bypass with exclusion, and 75% for simple bypass. Expressed as 15 year follow-up, recurrence rate were 65% for resection, 82% for bypass with exclusion, and 94% for simple bypass. Much of the difference in final outcome was accounted for by early recurrence or by persistent disease in the two bypass groups. This amounted to 21% for the bypass with exclusion and 45% for simple bypass as compared to 3% for patients who had resection. Conclusions from this review are that 1) resection can be performed with a morbidity and mortality equivalent to either of the bypass procedures; 2) the recurrence rat following resection is significantly lower than bypass with exclusion or simple bypass, and amounts to about 4% per year; 3) continuing disease in the bypassed loop accounts for a high percentage of reoperations in the bypass groups, while appearance of new disease is the usual problem following resection; 4) resection is the surgical treatment of choice for ileocecal Crohn's disease.
Adult↗
Carcinoma of the hepatic hilus. Surgical management and the case for resection.
Tumor resection for treatment of carcinoma of the hepatic hilus was preferred over routine palliative decompression at the University Hospital Center, Rennes, France, in 1974. Since then, resection has been performed on 18 patients. In seven of these patients resection proved impractical because of the extension of a neoplasm into the portal vein or liver, therefore palliative decompression was performed. In 11 patients (61%) tumor resection, followed by reconstruction of the biliary tree, was performed successfully. All the resected tumors were adenocarcinomas of the proximal bile ducts. Four patients had simple hepatic duct resection. In two patients duct resection was associated with right lobectomy, in three patients with left lobectomy, in one patient with segmentectomy, and in one patient with excision of the right branch of the hepatic artery. There were two postoperative deaths. The mean survival time for the remaining nine patients is 521 days. Five patients were alive in August 1978, at intervals ranging from 175 to 1180 days after resection. These results contrast favorably with those obtained between 1968 and 1973, during which period nine patients had palliative decompression, with three postoperative deaths and a mean survival time of 164 days for the remaining six patients.
Adenoma, Bile Duct↗
Endoscopic mucosal resection with precutting vs. anchoring technique using snare tip for 10-25 mm nonpedunculated colorectal polyps: a randomized controlled trial.
BACKGROUND AND AIMS: Modified endoscopic mucosal resection (EMR) techniques using a snare tip, precutting EMR (P-EMR) and anchoring EMR (A-EMR), have been developed for the effective resection of nonpedunculated colorectal polyps measuring 10-25 mm. Although previous studies have compared either P-EMR or A-EMR with conventional EMR, no study has directly compared these two snare tip-assisted techniques within modified EMR. This study aimed to evaluate P-EMR and A-EMR in terms of the R0 resection rate and procedure duration. METHODS: This prospective randomized controlled trial enrolled patients with nonpedunculated colorectal polyps measuring 10-25 mm. The patients were randomly assigned to the P-EMR or A-EMR groups. The primary outcome was R0 resection rate, defined as en bloc resection with histologically tumor-free margins. Secondary outcomes included the injection-to-snaring time, total procedure time, and adverse events. RESULTS: Each group included 63 polyps, of which 126 were analyzed in the final evaluation. Both groups achieved high R0 resection rates (93.7% for P-EMR and 88.9% for A-EMR), with no significant difference ( P  = 0.344). However, the A-EMR group demonstrated significantly shorter injection-to-snaring time (181.8 ± 81.9 vs. 320.9 ± 143.5 s, P  < 0.001) and total procedure time (259.7 ± 139.7 vs. 479.8 ± 249.0 s, P  < 0.001). Adverse events, including intraprocedural and delayed bleeding, were comparable between the groups. CONCLUSION: Both P-EMR and A-EMR demonstrated high R0 resection rates for nonpedunculated polyps measuring 10-25 mm. However, A-EMR achieved these outcomes with a shorter procedure time than P-EMR.
Humans↗
Regeneration of nasal skeletal structures after subperiosteal and subperichondrial resection.
The degree of regeneration of nasal structures after surgical resection was evaluated in six mongrel dogs that underwent selective resection of the nasal bones and upper lateral cartilages. Preservation of the periosteal and periochondrial flaps was accomplished during the resection. In several cases, different tissues were interposed between the flaps before their closure. The dogs were killed at two-and eight-month intervals after the original resections. No evidence of new cartilage regeneration was found on microscopic evaluation in the region of the resected upper lateral cartilages. Minimal new bone foci were noted at the edge of the resected nasal bones in three of the cases. The findings failed to support any significant degree of nasal structure regeneration after resection.
Animals↗
Adult monkey coronoid process after resection of trigeminal nerve motor root.
A smaller or absent coronoid process has been reported, by some investigators but not by others, in growing animals following resection of the temporalis muscle. The trauma of resection, altered function, hemorrhage, scar tissue, and changes in vascularity may have influenced the results. The purpose of this experiment was to observe in adult Macaca mulatta the fully grown coronoid process after decreasing or eliminating neurofunctional activity of the temporalis muscle unilaterally without the trauma of local resection. In two males and three females the motor root of the trigeminal nerve which innervates the temporalis muscle was resected intracranially. In three control animals of both sexes the same surgical procedure was performed except for resection of the nerve. At postmortem, one year later, the temporalis muscle mass was atrophic on the resected side. There were no significant morphological differences, however, between the right and left sides of the mandible, including the coronoid process, regardless of which motor root of the fifth nerve had been resected, which side had been sham-operated, or sex. An extensive deposit of calculus on the buccal surfaces of the teeth on the operated nerve side was a consistent, conspicuous finding.
Animals↗
The importance of mediastinal lymph node invasion by pulmonary carcinoma in selection of patients for resection.
Resection results from 417 consecutive patients operated on between January 1, 1964, and December 30, 1969, were analyzed in March, 1976. This period was chosen to allow a five-year follow-up. The results of resection in 56 patients with invaded mediastinal nodes are reported. Mediastinoscopy to assess resectability was not used for any of the 417 patients. Our low incidence of mediastinal node invasion (56 out of 417, or 13.4%), a resectability rate of 97.4%, and a hospital mortality of 2.8% for resection of advanced carcinoma suggest that routine mediastinoscopy prior to resection is not necessary. Traditional methods of preoperative assessment and the use, when indicated, of extended resection for patients with mediastinal node invasion result in worthwhile salvage of patients with invaded mediastinal nodes.
Adenocarcinoma↗
Abdominosacral resection for carcinoma of the midrectum: ten years experience.
Abdominosacral resection allows curative resection of midrectal cancer with excellent preservation of sphincter function. In the last ten years 427 patients underwent resection for rectal carcinoma at University Hospital by one surgeon. (SAL) The operation, selected by preoperative sigmoidoscopic measurement, was anterior resection (AR) in 239, abdominosacral resection (ASR) in 100, and abdominoperineal resection (APR) in 88. Operative mortality was 1.7% for AR, 2% for ASR and 2.3% for APR. All patients were completely continent of stool and flatus after AR and ASR. Follow-up is complete in 194 of 195 patients treated five to ten years ago. Five year survival for curative resection (no distant metastases) was 67.3% after AR (66/98), 58.3% after ASR (21/36), and 50% after APR (15/30). For patients without tumor in lymph nodes, survival rates were 78.3% for AR, 64.3% for ASR and 63.2% for APR. With involvement of regional nodes, survival fell to 41.4% for AR, 37.5% for ASR and 27.3% for APR. For lesions at 5-8.5 cm, five year survival was 61.1% for ASR and 58.3% for APR. No statistical difference in survival time was noted when patients were matched for age, sex, level of lesion and extent of spread. Pelvic recurrences were detected in 16.7% after ASR, 15.3% after AR and 33.3% after APR. All of the pelvic recurrences after ASR and the majority of those after AR and APR occurred in patients with tumor invasion of perirectal fat. These data strongly support the applicability of ASR as an important advance in the treatment of midrectal cancer. Although technically demanding, ASR has permitted preservation of anal continence without sacrifice of long-term cure in approximately 50% of patients who would otherwise have required APR.
Abdomen↗