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BACKGROUND During prolonged laparoscopic operations with carbon dioxide (CO2) pneumoperitoneum (PP), hypercapnia with significant acidosis has been reported to occur in some patients with pulmonary dysfunction. An alternate inert insufflation gas like helium (He) could avoid this problem. METHODS This prospective, IRB-approved study compared the(More)
Adrenalectomy for metastatic cancer is rarely performed. The survival benefit for patients undergoing resection of isolated adrenal metastases is not clear. The goal of this study was to compile a series of such cases from national and international sources and examine patient survival. The patient series was derived from published series and case reports,(More)
Ischemic colitis (IC) is an infrequent but serious complication of abdominal aortic surgery. Prior reports have generally described small, selected populations. The aim of this paper is to evaluate characteristics of clinically diagnosed IC in a large non-referral-based population. Using national Veterans Affairs (VA) computer data sets, we identified all(More)
BACKGROUND Merkel cell carcinoma (MCC) is a rare and aggressive neuroendocrine tumor of dermal origin. Treatment recommendations are limited owing to a paucity of retrospective data and an absence of prospective data. The objective of this study was to determine current therapeutic trends and their impact upon outcome. METHODS A retrospective study (1983(More)
BACKGROUND Early case reports suggest more frequent and rapid recurrences of carcinoma of the gallbladder after laparoscopic cholecystectomy (LC) than after open cholecystectomy. This cancer has a poor prognosis and occurs in 1 percent of patients who undergo cholecystectomies. STUDY DESIGN A recent community hospital series of gallbladder carcinoma (GBC)(More)
OBJECTIVE The outcomes of patients with squamous cell carcinoma of the anal canal treated by either sphincter-preserving procedures or radical surgery were evaluated, with the goals of identifying factors predicting treatment failure and quantifying results of salvage therapy in patients with recurrent disease. BASIC PROCEDURES A population-based study on(More)
UNLABELLED The follow-up of patients after potentially curative resection of colon cancer has important clinical and financial implications for patients and society, yet the ideal surveillance strategy is unknown. PURPOSE The aim of this study was to determine the current follow-up practice pattern of a large, diverse group of experts. METHODS The 1,663(More)
A total of 1,180 patients underwent palliative surgery for pancreatic cancer in the 158 hospitals of the U.S. Department of Veterans Affairs from 1987 to 1991. Using computerized data files, we analyzed these procedures according to type of procedure (gastric bypass only [GO], biliary bypass only [BO], or combined biliary and gastric bypass [BG]), survival,(More)
To assess the effect of tumor stage on the surgical palliation of pancreatic cancer, 350 cancers from 74 U.S. Department of Veterans Affairs (DVA) hospitals from 1987 to 1991 were staged from pathologic and operative data, then grouped by initial surgery: biliary bypass only (BO), gastric bypass only (GO), or combined biliary and gastric bypass (BG).(More)
BACKGROUND The influence of hospital experience and referral patterns on the operative mortality rate of pancreaticoduodenectomy was studied in a worldwide hospital system. METHODS We analyzed computerized data on pancreatic cancer patients from U.S. Department of Defense (DOD) hospitals from 1989 to 1994. RESULTS Six hundred ninety-eight patients had(More)