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| 1 | National trends in resection of the distal pancreas显示文摘AIM:To investigate national trends in distal pancreatectomy(DP) through query of three national patient care databases.METHODS:From the Nationwide Inpatient Sample(NIS,2003-2009),the National Surgical Quality Improvement Project(NSQIP,2005-2010),and the Surveillance Epidemiology and End Results(SEER,2003-2009) databases using appropriate diagnostic and procedural codes we identified all patients with a diagnosis of a benign or malignant lesion of the body and/or tail of the pancreas that had undergone a partial or distal pancreatectomy.Utilization of laparoscopy was defined in NIS by the International Classification of Diseases,Ninth Revision correspondent procedure code;and in NSQIP by the exploratory laparoscopy or unlisted procedure current procedural terminology codes.In SEER,patients were identified by the International Classification of Diseases for Oncology,Third Edition diagnosis codes and the SEER Program Code Manual,third edition procedure codes.We analyzed the databases with respect to trends of inpatient outcome metrics,oncologic outcomes,and hospital volumes in patients with lesions of the neck and body of the pancreas that underwent operative resection.RESULTS:NIS,NSQIP and SEER identified 4242,2681 and 11 082 DP resections,respectively.Overall,laparoscopy was utilized in 15%(NIS) and 27%(NSQIP).No significant increase was seen over the course of the study.Resection was performed for malignancy in 59%(NIS) and 66%(NSQIP).Neither patient Body mass index nor comorbidities were associated with operative approach(P = 0.95 and P = 0.96,respectively).Mortality(3% vs 2%,P = 0.05) and reoperation(4% vs 4%,P = 1.0) was not different between laparoscopy and open groups.Overall complications(10% vs 15%,P < 0.001),hospital costs [44 741 dollars,interquartile range(IQR) 28 347-74 114 dollars vs 49 792 dollars,IQR 13 299-73 463,P = 0.02] and hospital length of stay(7 d,IQR 4-11 d vs 7 d,IQR 6-10,P < 0.001) were less when laparoscopy was utilized.One and two year survival after resection for malignancy were unchanged over the course of the study(ductal adenocarinoma 1-year 63.6% and 2-year 35.1%,P = 0.53;intraductal papillary mucinous neoplasm and nueroendocrine 1-year 90% and 2-year 84%,P = 0.25).The majority of resections were performed in teaching hospitals(77% NIS and 85% NSQIP),but minimally invasive surgery(MIS) was not more likely to be used in teaching hospitals(15% vs 14%,P = 0.26).Hospitals in the top decile for volume were more likely to be teaching hospitals than lower volume deciles(88% vs 43%,P < 0.001),but were no more likely to utilize MIS at resection.Complication rate in teaching and the top decile hospitals was not significantly decreased when compared to non-teaching(15% vs 14%,P = 0.72) and lower volume hospitals(14% vs 15%,P = 0.99).No difference was seen in the median number of lymph nodes and lymph node ratio in N1 disease when compared by year(P = 0.17 and P = 0.96,respectively).CONCLUSION:There appears to be an overall underutilization of laparoscopy for DP.Centralization does not appear to be occurring.Survival and lymph node harvest have not changed. | Armando Rosales-Velderrain Steven P Bowers Ross F Goldberg Tatyan M Clarke Mauricia A Buchanan John A Stauffer Horacio J Asbun | 2012 | World Journal of Gastroenterology2012，18，32： | 8 |
| 2 | Accumulating Sequence of Ignitions From a Propagating Pulse显示文摘 | Dold J W Short M Clarke J F | 1995 | Combustion and Flame1995，100，3： | 1 |
| 3 | Topographic ooze: Building the eastern margin of Tibet by lower crustal flow显示文摘 | SCHLUNEGGER F MELZER J CLARK M K | 2000 | Geology2000，28，： | 1 |
| 4 | Insights into shell deposition in the Antarctic bivalve Laternula ellipti ca zgene discovery in the mantle transcriptome using 454 pyrosequencing显示文摘 | Clark M S Thorne M A Vieira F A | 2010 | BMC Genomics2010，11，： | 1 |
| 5 | Randomized phase Ⅲ trial of high-dose interleukin-2 versus subcutaneous interleukin-2 and interferon in patients with metastatic renal cell carcinoma显示文摘 | McDermott D F Regan M Clark J I | 2005 | J Clini Oncol2005，23，1： | 1 |
| 6 | Stem cells, cancer, and cancer stem cells显示文摘 | Reya T Morrison S J Clarke M F | 2001 | Nature2001，414，6859： | 1 |
| 7 | Applying the principles of stem-cell biology to cancer 显示文摘 | Pardal T Clarke M F Morrison S J | 2003 | Nature Rev Cancer2003，3，12： | 1 |
| 8 | Luminescence dating of loess from the Liujiapo section, central China显示文摘 | Musson F M Clarke M L Wintle A G | 1994 | Quaternary Science Reviews1994，13，： | 1 |
| 9 | The development of the current limiting protector (CLP)显示文摘 | Herbert M Pflanz Thomas F Clark Albani O J | 1981 | IEEE Transactions on Power Apparatus and Systems1981，100，7： | 1 |
| 10 | Isolation of the gene encoding an immunodominant membrane pro- tein of apple proliferation phytoplasma, and expression and characterization of the gene product 显示文摘 | BERG M DAVIES D L CLARK M F | 1999 | Microbi- ology1999，145，： | 1 |
| 11 | Treatment with 1, 25-dihydroxyvitamin D3 reduces impairment of human osteoblast functions during cellular aging in eulture显示文摘 | VEIBORG M BAUAN S I CLARK B F | 2001 | J Cellular Physiol2001，186，2： | 1 |
| 12 | Andesite and dacite genesis via contrasting processes: The geology and geochemistry of El Valle Volcano, Panama显示文摘 | DEFANT M J CLARK L F STEWART R H | 1991 | Contrib Mineral Petrol1991，106，： | 1 |
| 13 | PEN110 treatment functionally inactivates the PBMNCs present in RBC units: comparison to the effects of exposure to gamma irradiation显示文摘 | LOREN D F GILBERT D CLARK M E | 2002 | Transfusion2002，42，10： | 1 |
| 14 | Hardware for digitally controlled scanned probe microscopes显示文摘 | Clark S M Baselt D R Spence C F | 1992 | Review of Scientific Instruments1992，10，： | 1 |
| 15 | Stem cells,cancer,and cancer stem cells显示文摘 | Reya T Morrison S J Clark M F | 2001 | Nature2001，414，6859： | 1 |
| 16 | Detection of strains of Apple chlorotic leaf spot virus by F(ab) 2-based indirect ELISA显示文摘 | Barba M Clark M F | 1986 | Acta Horticulturae1986，193，： | 1 |
| 17 | Maintenance of mycoplasma-like organisms occurring in Pyras species by micropropagatin and their eliminatin by tetracycline therapy 显示文摘 | DAVIES D L CLARK M F | 1994 | Plant pathology1994，43，4： | 1 |
| 18 | The effects of small-dose ketamine on propofol sedation: respiration, postoperative mood, perception,cognition, and pain显示文摘 | MORTERO R F CLARK L D TOLAN M M | 2001 | Anesthesia & Analgesia2001，92，6： | 1 |
| 19 | Facts and recommendations about total homocysteine determinations:an expert opinion显示文摘 | Refsum H Smith A D Ueland P M Nexo E Clarke R McPartlinJ Johnston C Engbaek F SchneedeJ McPartlin C Scott J M | 2004 | Clinical Chemistry2004，50，1： | 1 |
| 20 | RECK--a newly discovered inhibitor of metastasis with prognostic significance in multiple forms of cancer显示文摘 | CLARK J C THOMAS D M CHOONG P F | 2007 | Cancer Metastasis Rev2007，26，： | 1 |
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