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At least 73 records · Page 4Linked to original sources
PubMed1977

Effect of small bowel resection on the gastric mucosa in the rat.

Male Sprague-Dawley rats (120 to 130 gm), unoperated, sham-operated, and those with a 50% resection of the proximal small intestine, were studied after periods of 3, 6, 9, or 12 months. Differences in body weight and in the surface area, thickness, volume, and cellular content of the gastric mucosa between these three groups of animals were compared and statistically analyzed. After an initial loss in body weight, animals with small bowel resection and sham-operated animals attained weights equivalent to unoperated controls. Comparison of the groups for mucosal surface areas of the body of the stomachs showed no significant differences at the 3-, 6-, or 9-month periods. However, 12 months after surgery, the mucosal surface area of stomachs from resected animals was significantly greater than in corresponding controls. At 3, 6, and 9 months after resection, the thickness and volume of the gastric mucosa and the epithelial cell populations (parietal and nonparietal) of the gastric glands were significantly greater than in controls. However, at 12 months, there was no significant difference in any of these parameters between the controls and the experimental animals. The DNA content of the gastric mucosa was significantly greater for animals with small bowel resection than for corresponding controls at 1 and 6 months after surgery. It is concluded that hyperplasia of the gastric glands exists for at least 9 months after proximal small bowel resection in the rat. This hyperplastic response may be responsible for the previously observed (N Engl J Med 272:509-514, 1965; Surgery 65:292-297, 1969) gastric hypersecretion associated with extensive small bowel resection.

Animals↗
PubMed1976

Liver resection for cancer.

Liver resection was performed for primary and secondary cancer in 46 patients. Left lobe resection was performed in 11 patients, right lobe resection in 22 and extended right lobe resection in 13. There was no post-operative mortality after left lobe resection, 9 after right lobe and 5 after extended right lobe resection. Ten patients have survived two years after the liver resection. This surgical procedure seems to be of benefit especially for patients with primary liver cancer and with metastases from cancer coli-recti.

Adult↗
PubMed1975

Elective carotid artery resection.

A retrospective study of carotid artery resection disclosed a 64% mortality when resection was performed on an emergency basis, as compared with 14% when the surgery was undertaken electively. This concurs with other studies that have demonstrated increased survival rates when elective carotid artery resection has superseded carotid artery rupture, and reemphasizes the need for a more accurate means of predicting individual tolerance for loss of the carotid artery. Use of the ocular plethysmograph (OPG) is proposed as a simple and accurate means of evaluating the adequacy of collateral hemispheric blood flow to compensate for a potentially resectable carotid artery. Eleven patients have been evaluated using this technique. Nine were predicted to successfully tolerate carotid artery resection, while intolerance was predicted for the remaining two. Four of the nine patients have undergone resection of the artery with no neurologic sequelae to date.

Aged↗
PubMed1977

Treatment of carcinoma of the sigmoid colon and upper rectum. A comparison of local segmental resection and left hemicolectomy.

We report a retrospective study of 107 cases of carcinoma of the sigmoid colon and upper rectum treated for primary cure at the University of California at Los Angeles Hospital between 1955 and 1970. Excluded from this analysis were patients treated by abdominoperineal resection, local excision, fulguration, or abdominoperineal pull-through procedures. Ninety-one patients were treated by local segmental resection and 16 by left hemicolectomy. Both groups were similar in regard to patient age and general health, lesion size, location, and pathological Duke's classification. Five-year survival was 70.3% after local segmental resection and 56.3% after left hemicolectomy. Hospital mortality was 1% after the former and 6.2% after the latter. Rate of recurrence after local segmental resection was 41% of that seen after left hemicolectomy, while complications were one-third as great. The present results after local segmental resection are comparable to the results reported in the literature when hemicolectomy was the procedure used. The data presented suggest that local segmental resection is an effective cancer operation for carcinoma of the sigmoid and upper rectum, and is fraught with a lesser morbidity and mortality than a radical left hemicolectomy.

Adult↗
PubMed1975

Full thickness chest wall resection for recurrent breast carcinoma involving the bony chest wall.

Solitary recurrent breast cancer involving the bony chest wall (parasternal recurrence) is curable when no evidence of systemic spread is found. Radical full thickness chest wall resection is an effective mode of treatment; it remains the only available treatment for patients whose chest wall recurrence fails to respond to radiation therapy, and in those who develop complications due to heavy irradiation. This report covers a review of the records of 52 patients treated at Memorial Hospital by chest wall resection for recurrent breast cancer between 1950 and 1972. The technique of chest wall resection and immediate plastic reconstruction is described. The gross and determinate 5-year survival rates for patients who underwent chest wall resection as the initial mode of therapy for chest wall recurrence were 43% and 57%, respectively. On the other hand, when chest wall resection was performed on those patients whose chest wall recurrences failed to respond to radiation therapy, the gross and determinate 5-year survival rates dropped to 16% and 19%. Full thickness chest wall resection with immediate plastic reconstruction when employed as the first mode of therapy for chest wall recurrences provides a significant 5-year survival rate, and has a definite place in the management of recurrent breast cancer.

Breast Neoplasms↗
PubMed1976

Small-bowel resection. Oral intake is the stimulus for hyperplasia.

Small-bowel resection leads to hyperplasia of the residual small intestine, However, the factors initiating small-bowel hyperplasia are not clearly understood, although oral intake either by direct contact with the small bowel or via hormonal or neurovascular factors has been suggested as the major stimulus. In order to determine whether oral intake is an obligatory prerequisite for small-intestinal hyperplasia, we compared rats one week after undergoing a 70-cm proximal intestinal resection with sham-operated animals. Resected, orally fed rats demonstrated small-intestinal hyperplasia, whereas resected and sham-operated intravenously alimented rats did not. There were no differences in gut weight, mucosal weight, mucosal protein, or DNA between resected or sham-operated intravenously alimented rats. These data provide direct experimental proof that oral intake is a necessary stimulus for small-intestinal hyperplasia after resection.

Animals↗
PubMed1976

Resectability and regeneration of liver in postsinusoidal block.

To study resectability and regeneration of cirrhotic liver, hemodynamic changes following partial hepatectomy were observed in dogs with presinusoidal block caused by ligation of the portal vein or with postsinusoidal block caused by ligation of the hepatic veins after portacaval anastomosis, since cirrhosis of the liver in man is mainly of postsinusoidal block occasionally accompanied by presinusoidal block. With a presinusoidal block, resection of 50 per cent liver was tolerated well, but with postsinusoidal block only less than 30 per cent could be resected. Thus the functional reserve of the liver with postsinusoidal block seems to be much less than that of presinusoidal block. After major hepatic resection the weight of the remnant liver with a dual blood supply increased markedly, while with a postsinusoidal block it increased slightly and with a presinusoidal block there was no change. Histometric studies showed that regeneration was prominent in the remnant liver with a dual blood supply, slight with a postsinusoidal block, and even less with a presinusoidal block. Thus, the liver with a postsinusoidal block possesses more extensive regenerative capacity but shows much lower resectability than with a presinusoidal block. Therefore, the resectability of the liver associated with cirrhosis seems to be more closely related to its functional reserve capacity than to its regenerative capacity.

Animals↗
PubMed1979

Pituitary hormones and the small bowel: effect of hypophysectomy on intestinal adaptation to small bowel resection in the rat.

The influence of pituitary hormones on intestinal adaptation to small bowel resection was studied by examining jejunal and ileal structure and function in control and in sham-operated rats, and in animals with 50% proximal or distal resection which were divided into three main groups: normally-fed, hypophysectomized. and pair-fed. The pituitary was removed 2 weeks before intestinal surgery and gut structure and function were studied 4 weeks later. The effectiveness of hypophysectomy was confirmed by histological examination of the aspirated pituitary, and by showing a significant subsequent reduction in weight of the testes and adrenals. Food intake and body weight fell significantly after removing the pituitary; intestinal surgery caused a transient further decrease in food intake. Measurements of intestinal villus height and crypt depth, indices of mucosal mass (mucosal wet weight, protein and DNA content/cm intestine), measurements of mucosal alpha-glucosidase activity, and in vivo galactose absorption/unit length of intestine all showed comparable results. In rats with an intact intestine, resection resulted in mucosal hyperplasia and increased segmental absorption. Following hypophysectomy, there was marked mucosal hypoplasia and hypofunction which seemed to be due largely to associated hypophagia since comparable changes were found in the pair-fed, sham-operated rats. However following pituitary removal, both distal jejunum and proximal ileum retained their capacity to regenerate though the magnitude of this adaptive change was much greater in the resected, pair-fed rats suggesting that hypophagia alone cannot explain the diminished adaptation to resection after hypophysectomy. By inference, pituitary hormones do influence the adaptive response to resection.

Adaptation, Physiological↗
PubMed1978

Enteric hyperoxaluria: dependence on small intestinal resection, colectomy, and steatorrhoea in chronic inflammatory bowel disease.

The importance of intestinal resection, exclusion of the colon, and steatorrhoea for secondary hyperoxaluria was studied in 81 patients with Crohn's disease and 12 patients with ileostomy after colectomy for ulcerative colitis during a metabolic regime including a fixed oral supply of fat, calcium, and oxalate. Hyperoxaluria (greater than 48 mg (greater than 0.5 mmol) per 24 h) was present in 21 patients with Crohn's disease. All but one half or more of the colon preserved. Renal oxalate excretion was related to the amount of ileum resected. 14C-oxalate absorption was significantly higher in patients with ileal resection and the whole colon preserved than in patients with ileal resection plus hemicolectomy, despite the fact that the latter group had the most extensive ileal resections. Faecal fat and oxalate excretion agreed well in patients without ileostomy (r = 0.76, p less than 0.001), and renal oxalate excretion was significantly higher in patients with steatorrhea and the colon preserved than in patients without steatorrhoea. In all 93 patients 14C-oxalate absorption and renal oxalate excretion was positively correlated with a coefficient of correlation of 0.76 (p less than 0.001). No correlation was present between 47Ca- and 14C-oxalate absorption. The study confirm that a preserved colon is necessary for secondary hyperoxaluria and stresses the importance of ileal resection and steatorrhoea.

Adult↗
PubMed1975

Resection of left ventricular aneurysm. Report of 277 patients.

The prognosis of patients with LVA (left ventricular aneurysm) treated medically has been uniformly poor. Surgical resection of the ventricular aneurysm has been the treatment of choice at the Texas Heart Institute since 1958. A more accurate evaluation of patients with LVA by selective coronary arteriography has demonstrated significant associated CAD in over 75 percent of these patients. Since 1969, 125 patients with at lease one vessel suitable for bypass (group II) have undergone single, double or triple ACB in association with LVA resection; and 51 patients (group III) without significant conc-omitant CAD underwent LVA resection alone. To evaluate the efficacy of combined ACB and LVA resection, patients in group II and group III were compared to a third group of 101 patients who underwent LVA resection alone from 1958 to 1969 (group I). Operative mortality was higher in group I (19.8%) as compared to group II (12.8%) and group III (9.5%). Higher mortality was found to be related to a coronary artery score above 8.9, presence of left main coronary lesion, posterior or inferior location of the LVA, severe concomitant mitral valve insufficiency and incomplete revascularization of the remaining ventricular myocardium after LVA resection. Lower mortality and improved long-term results found in groups II and III as compared to group I appear to justify our choice of a "complete operation" in patients with LVA.

Coronary Artery Bypass↗
PubMed1975

[Problems of extensive resection of small intestine in newborn infants and infants].

Massive resection of the small intestine in neonates and infants is mostly necessitated as a result of atresias, stenosis or circulatory disorders. At this period of life, the term "sub-total resection of the small intestine" is not applied in a standard way. Most authors use it when the residual small intestine is 75 cm or less in lenght. The survival prospects after sub-total resection of the small intestine are determined not only by the absolute length of the remaining small intestine; it is important which part can be preserved. Distal resections lead to a particularly serious malabsorption syndrome. In ileal resections, lipid absorption is disturbed owing to the lack of absorption of bile acids. A chologenous diarrhea results. The absorption functions (which are largely eliminated directly after the operation) recover in a regular pattern. The more orally localized functions (carbohydrate) recover more quickly than the more distally localized (lipid absorption). Surgical measures to slow the passage of intestinal contents have been applied with varying success in animal experiments. Clinical experience is largely lacking (only five cases). Various mechanisms for compensation after extensive resection of the small intestine in neonates (increase in length of the intestine, mucosal hypertrophy or greater cell density) are being discussed. These are only occasionally observed and the factors on which they depend are mostly obscure.

Age Factors↗
PubMed1978

Hormone levels following wedge resection in polycystic ovary syndrome.

A study of serum estradiol, progesterone, 17alpha-hydroxy-progesterone, testosterone, dihydrotestosterone, dehydroepiandrosterone (DHA), delta4-androstenedione (delta4-A), FSH, and LH was carried out in one of three sisters having polycystic ovarian disease for a period of 18 days before wedge resection, at the time of surgery, and for 24 days following wedge resection. The mean levels of 17alpha-hydroxyprogesterone, testosterone, DHA, delta4-A, and LH were remarkably elevated prior to wedge resection. There was considerable day-to-day variation. Serum LH varied from 12.5 to 70.5 mIU/ml with a mean of 41.03 +/- 3.55 mIU/ml. Serum estradiol and progesterone levels were generally higher than those found in the early follicular phage. Wedge resection resulted in a fall in serum estradiol, progesterone, 17alpha-hydroxyprogesterone, DHA, and delta4-A. Ovarian secretion of the last four steroids was confirmed by a study of the ovarian vein blood obtained at the time of surgery. An estradiol peak occurred on the 14th post wedge resection day with smaller increases in 17alpha-hydroxyprogesterone, DHA and delta4-A. An increase in serum LH occurred on the 15th post wedge resection day with a peak on Day 16 accompanied by increases in FSH and progesterone. The postovulatory rise of progesterone was accompanied by reduction of serum LH levels to those generally found in the early part of the menstrual cycle. Various hypotheses for the ovulatory failure are discussed.

Adolescent↗
PubMed1975

Pyrimidine biosynthetic enzymes in rat intestine after small bowel resection.

After small bowel resection in the rat, mucosal hyperplasia and an increase in nucleic acid synthesis and cell proliferation occur in remaining small intestine. Male Sprague-Dawley rate underwent resection of 50 cm of proximal or distal intestine or sham operation. One month and 6 months after surgery, aspartate transcarbamylase, dihydroorotase, and uridine kinase were assayed in whole mucosa, and in some instances, in crypt mucosa ffrom the remaining intestinal segment. In control bowel, enzyme activity was significantly greater proximal compared with distal segments. One month after proximal or distal resection, mucosal enzyme activity per cm of gut was greater in the remnant bowel compared with controls. There was no such difference at 6 months. Specific enzyme activity of whole mucosa did not increase after resection because the assay was influenced by the disproportionately large contribution of villous protein. Specific enzyme activity (including thymidine kinase) of isolated crypt mucosa was significantly increased 1 month after distal resection. In addition, [3H]thymidine uptake into DNA of crypt mucosa from proximal remnants was also significantly increased. These results indicate that after small bowel resection, the enzymes of pryimidine biosynthesis increase in remaining bowel and parallel the accelerated rate of cell proliferation.

Adaptation, Physiological↗
PubMed1979

[Occurrence of cancer in the gastric stump after stomach resection].

The investigation of 654 patients with gastric resection on the occasion of benign gastric diseases (17 with duodenal and 6 with gastric ulcers and 2 with polyps of the stomach) revealed cancer origination in the remaining part of the stomach in 25 patients (3.82%). The average of the patients at resection was 41 and the cancer confirmation in the stomach remaining part--63 (cancer process develops after about an average of 22 years--from 8 to 38 years after the resection)--in 16 of the patients in the region of the anastomosis and in the rest--at a distance from it. Cancer in the stomach remaining part was admitted in 28 per cent on the base of clinical-laboratory data, roentgenologically was diagnosed and admitted in 64 per cent and fibrogastroscopically in 52 per cent. In 80 per cent of the patients positive cancer results were obtained by purposeful gastrobiopsy. Severe atrophic gastritis in the adjoining mucosa was found in 88 per cent of the examined. Radical operation treatment (total and subtotal gastric resection) was performed to 44 per cent of the patients, the rest were inoperable. The resected stomach is a precancerosis dur to which the patients should be enlisted in the dispensary system (particularly after the 10th year after the resection) and every year to be clinically, laboratory and endoscopically-biopsy controlled with a view to the timely diagnosis of the cancer of the stomach remaining part.

Adult↗
PubMed1978

[Influence of small bowel resections on some aspects of digestive secretions in rat (author's transl)].

Some aspects of the digestive secretions both in intact rats (control group) and in rats with resection of 50% and 80% of the small intestine starting from ileocecal valve have been studied. In every animal, the volume of duodenal content, total content of bile salts and amylasic activity have been analysed under the following experimental conditions: fasting, feeding with two diets containing 4% and 20% of fat, and intravenous injections of pancreozymin (2 UI/kg). Total content of bile salts and amylasic activity decrease in resected rats under fasting and feeding. This decrease is greater when larger portions of the intestine are removed. Rats injected with pancreozymin react in a similar way. The amylasic activity decrease in the resected rats indicates a pancreatic hypofunction caused by the resection and cannot be compensated by administration of pancreozymin. Measurements of seric cholesterol show that a 50% resection causes a decrease form normal levels and a 80% resection makes it significant.

Amylases↗
PubMed2026

Neoadjuvant Systemic Therapy for Resectable Intrahepatic Cholangiocarcinoma: From Retrospective Studies to Randomized Evidence.

Complete resection remains the only potentially curative treatment for localized intrahepatic cholangiocarcinoma (iCCA), yet postoperative recurrence is common, particularly in patients with high-risk disease. Neoadjuvant systemic therapy may permit earlier control of occult micrometastatic disease, optimize the delivery of systemic treatment, and provide an in vivo assessment of tumor biology prior to major hepatectomy. These potential benefits must be balanced against treatment-related toxicity, surgical delay, and the risk of disease progression precluding resection. Early evidence was primarily derived from retrospective studies, which yielded inconsistent survival outcomes and exhibited substantial vulnerability to confounding and treatment-selection bias. The single-arm NEO-GAP trial subsequently demonstrated the feasibility of administering neoadjuvant gemcitabine, cisplatin, and nab-paclitaxel followed by surgical resection. More recently, the randomized phase II-III ZSAB-neoGOLP trial showed that neoadjuvant gemcitabine-oxaliplatin, lenvatinib, and toripalimab followed by surgery prolonged median event-free survival compared with upfront surgery (median: 18.0 vs. 8.7 months) without substantially compromising surgical feasibility. However, the interim overall survival analysis was inconclusive, and the generalizability of these findings beyond selected, medically fit patients treated at Chinese centers remains uncertain. This narrative review critically appraises the evolving evidence, discusses patient selection and perioperative treatment, and identifies priorities for future research. Current evidence supports the selective consideration of neoadjuvant therapy in medically fit patients with technically resectable but oncologically high-risk iCCA, rather than its routine use in all resectable cases.

GOLP↗
PubMed1978

Resection of postinfarction left ventricular aneurysm with and without revascularization.

Twenty-four patients had resection of their ventricular aneurysm and 29 had resection plus revascularization. Sixty percent of the patients received no blood in the heart lung machine during surgery or at any time during hospitalization. One of 24 patients with ventricular resection and two of 29 patients with resection plus revascularization died during hospitalization, for an overall mortality of 5.7%. Fifty of the 53 patients had an ejection fraction of 0.4 or less and 23 of these had an ejection fraction of 0.2 or less. Survival rate was 75.5% at four years for all 53 patients compared to only 12% of patients alive at five years with medical treatment. For the patient with a large ventricular aneurysm, resection and myocardial revascularization can be performed with a low risk even for the patient with poorly functioning residual myocardium.

Adult↗
PubMed1978

An aggressive approach to marginally resectable lung cancer.

Between July 1968 and December 1974, 53 patients with lung cancer were planned for preoperative irradiation and surgery. All patients were considered clinically marginally resectable because of advanced local disease, 4 Stage II patients, with limited pulmonary reserve and 49 Stage III patients. Most patients received 3000 to 4000 rad followed in two weeks by thoracotomy. Forty-six patients were explored and 38 were resectable. Twelve patients are alive with a median follow-up of 48 months. The cumulative 5-year survival of all resectable patients is 27%. The survival of patients with marginally resectable lung cancer treated by accelerated radiotherapy followed by aggressive surgery approaches the survival experience of patients with primary resectable lung cancer and is superior to such patients treated with radiation therapy alone.

Bronchial Fistula↗