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| 1 | 为十二指肠的胃肠的 stromal 肿瘤的有限切除术:外科的管理和临床的结果显示文摘 AIM:To analyze our experience in patients with duodenal gastrointestinal stromal tumors(GIST) and review the appropriate surgical approach.METHODS:We retrospectively reviewed the medical records of all patients with duodenal GIST surgically treated at our medical institution between 2002 and 2011.Patient files,operative reports,radiological charts and pathology were analyzed.For surgical therapy open and laparoscopic wedge resections and segmental resections were performed for limited resection(LR).For extended resection pancreatoduodenectomy was performed.Age,gender,clinical symptoms of the tumor,anatomical localization,tumor size,mitotic count,type of resection resectional status,neoadjuvant therapy,adjuvant therapy,risk classification and follow-up details were investigated in this retrospective study.RESULTS:Nine patients(5 males/4 females) with a median age of 58 years were surgically treated.The median follow-up period was 45 mo(range 6-111 mo).The initial symptom in 6 of 9 patients was gastrointestinal bleeding(67%).Tumors were found in all four parts of the duodenum,but were predominantly located in the first and second part of the duodenum with each 3 of 9 patients(33%).Two patients received neoadjuvant medical treatment with 400 mg imatinib per day for 12 wk before resection.In one patient,the GIST resection was done by pancreatoduodenectomy.The 8 LRs included a segmental resection of pars 4 of the duodenum,5 wedge resections with primary closure and a wedge resection with luminal closure by Roux-Y duodeno-jejunostomy.One of these LRs was done minimally invasive;seven were done in open fashion.The median diameter of the tumors was 54 mm(14-110 mm).Using the Fletcher classification scheme,3/9(33%) tumors had high risk,1/9(11%) had intermediate risk,4/9(44%) had low risk,and 1/9(11%) had very low risk for aggressive behaviour.Seven resections showed microscopically negative transsection margins(R0),two showed positive margins(R1).No patient developed local recurrence during follow-up.The one patient who underwent pancreatoduodenectomy died due to progressive disease with hepatic metastasis but without evidence of local recurrence.Another patient died in complete remission due to cardiac disease.Seven of the nine patients are alive disease-free.CONCLUSION:In patients with duodenal GIST,limited surgical resection with microscopically negative margins,but also with microscopically positive margins,lead to very good local and systemic disease-free survival. | Jens Hoeppner Birte Kulemann Goran Marjanovic Peter Bronsert Ulrich Theodor Hopt | 2013 | World Journal of Gastrointestinal Surgery2013，5，2： | 11 |
| 2 | Impact of remote ischemic preconditioning on wound healing in small bowel anastomoses显示文摘AIM: To investigate the influence of remote ischemic preconditioning (RIPC) on anastomotic integrity. METHODS: Sixty male Wistar rats were randomized to six groups. The control group (n = 10) had an end-to-end ileal anastomosis without RIPC. The preconditioned groups (n = 34) varied in time of ischemia and time of reperfusion. One group received the amino acid L-arginine before constructing the anastomosis (n = 9). On postoperative day 4, the rats were re-laparotomized, and bursting pressure, hydroxyproline concentration, intra-abdominal adhesions, and a histological score concerning the mucosal ischemic injury were collected. The data are given as median (range).RESULTS: On postoperative day 4, median bursting pressure was 124 mmHg (60-146 mmHg) in the control group. The experimental groups did not show a statistically significant difference (P > 0.05). Regarding the hydroxyproline concentration, we did not find any significant variation in the experimental groups. We detected significantly less mucosal injury in the RIPC groups. Furthermore, we assessed more extensive intra-abdominal adhesions in the preconditioned groups than in the control group. CONCLUSION: RIPC directly before performing small bowel anastomosis does not affect anastomotic stability in the early period, as seen in ischemic preconditioning. | Philipp Anton Holzner Birte Kulemann Simon Kuesters Sylvia Timme Jens Hoeppner Ulrich Theodor Hopt Goran Marjanovic | 2011 | World Journal of Gastroenterology2011，17，10： | 2 |
| 3 | Circulating Tumor Cells Found in Patients With Localized and Advanced Pancreatic Cancer显示文摘 | Birte Kulemann Martha B. Pitman Andrew S. Liss Nakul Valsangkar Carlos Fernández-del Castillo Keith D. Lillemoe Jens Hoeppner Mari Mino-Kenudson Andrew L. Warshaw Sarah P. Thayer | 2015 | Pancreas2015，，4： | 1 |
| 4 | Covered self-expanding stent treatment for anastomotic leakage:outcomes in esophagogastric and esophagojejunal anastomoses显示文摘 | Hoeppner J Kulemann B Seifert G | 2014 | Surg Endosc2014，28，5： | 1 |
| 5 | Sonic Hedgehog in pancreatic cancer: From bench to bedside, then back to the bench显示文摘 | David E. Rosow Andrew S. Liss Oliver Strobel Stefan Fritz Dirk Bausch Nakul P. Valsangkar Janivette Alsina Birte Kulemann Joo Kyung Park Junpei Yamaguchi Jennifer LaFemina Sarah P. Thayer | 2012 | Surgery2012，，： | 1 |
| 6 | Magnetic resonance spectroscopy of the fetal brain 显示文摘 | Denise Pugash Martin Krssak Vanessa Kulemann | 2009 | Prenat Diagn2009，29，4： | 1 |
| 7 | Multimodal treatment of locally advanced esophageal adenocarcinoma: Which regimen should we choose? Outcome analysis of perioperative chemotherapy versus neoadjuvant chemoradiation in 105 patients显示文摘 | Jens Hoeppner Katja Zirlik Thomas Brunner Peter Bronsert Birte Kulemann Olivia Sick Goran Marjanovic Ulrich Theodor Hopt Frank Makowiec | 2014 | J. Surg. Oncol2014，，： | 1 |
| 8 | Postpancreatectomy hemorrhage-incidence, treatment, and risk factors in over 1,000 pancreatic resections显示文摘 | Wellner UF Kulemann B Lapshyn H | 2014 | J Gastrointest Surg2014，18，3： | 1 |
| 9 | Intraoperativecrystalloid overload leads to substantial inflammatory infiltrationof intestinal anastomoses -A histomorphological analysis 显示文摘 | Kulemann B Timme S Seifert G | 2013 | Surgery2013，154，： | 1 |
| 10 | Covered self-expan- ding stent treatment for anastomotic leakage:outcomes in esopha- gogastric and esophagojejunal anastomoses 显示文摘 | Hoeppner J Kulemann B Seifert G | 2014 | Surg Endose2014，28，5： | 1 |
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