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您的检索式：作者名="Joseph M Plummer"
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| 1 | Comparative analysis of open and laparoscopic colectomy for malignancy in a developing country显示文摘AIM: To compare the short-term, including oncologic, outcomes of open vs laparoscopic colectomy for cancer in a developing country. METHODS: The records of patients who underwent elective open and laparoscopic colectomies for cancer at the University Hospital of the West Indies between January 2005 and December 2010 were retrospectively reviewed. Demographic(age, gender, Charlson comorbidity index score), peri-operative, post-operative and oncologic data were collected for each patient. Specific oncologic variables included lymph node yield, pathologic stage, grade, proximal, distal and circumferential margin involvement. Fisher's exact, Mann-Whitney, and binary logistic regression tests were used for analysis. Significance level was set atP < 0.05. RESULTS: There were 87 cases for open colectomy(OC) and 17 cases for laparoscopic colectomy(LC). Demographics did not significantly differ between OC and LC groups. Intra-operative blood loss and postoperative analgesic requirements did not significantly differ between groups. There was a trend towards longer operating times in OC group and shorter hospital stay in the LC group. Lymph node yield(14 vs 14, P = 0.619), proximal(10 cm vs 7 cm, P = 0.353) and distal(8 cm vs 8 cm, P = 0.57) resection margin distance and circumferential margin involvement(9 vs 0, P = 0.348) did not significantly differ between groups. Thirty-day morbidity was equivalent between groups(22 vs 6, P = 0.774). There were 6 deaths within 30 d of initial procedure, all in the OC group(6.9%). CONCLUSION: Laparoscopic colectomy in a developing country is oncologically safe and represents a option for colonic malignancies in these regions. Such data encourage the continued laparoscopic development. | Pierre-Anthony Leake Kristen Pitzul Patrick O Roberts Joseph M Plummer | 2013 | World Journal of Gastrointestinal Surgery2013，5，11： | 8 |
| 2 | Recent advances in the management of rectal cancer: No surgery, minimal surgery or minimally invasive surgery显示文摘Over the last decade,with the acceptance of the need for improvements in the outcome of patients affected with rectal cancer,there has been a significant increase in the literature regarding treatment options available to patients affected by this disease.That treatment related decisions should be made at a high volume multidisciplinary tumor board,after pre-operative rectal magnetic resonance imaging and the importance of total mesorectal excision(TME)are accepted standard of care.More controversial is the emerging role for watchful waiting rather than radical surgery in complete pathologic responders,which may be appropriate in 20%of patients.Patients with early T1 rectal cancers and favorable pathologic features can be cured with local excision only,with transanal minimal invasive surgery(TAMIS)because of its versatility and almost universal availability of the necessary equipment and skillset in the average laparoscopic surgeon,emerging as the leading option.Recent trials have raised concerns about the oncologic outcomes of the standard'top-down'TME hence transanal TME(Ta TME'bottom-up')approach has gained popularity as an alternative.The challenges are many,with a dearth of evidence of the oncologic superiority in the long-term for any given option.However,this review highlights recent advances in the role of chemoradiation only for complete pathologic responders,TAMIS for highly selected early rectal cancer patients and Ta TME as options to improve cure rates whilst maintaining quality of life in these patients,while we await the results of further definitive trials being currently conducted. | Joseph M Plummer Pierre-Anthony Leake Matthew R Albert | 2017 | World Journal of Gastrointestinal Surgery2017，9，6： | 6 |
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