Randomised trial of laparoscopic versus small-incision cholecystectomy

Rhodes, Michael; Gompertz, Henry; Armstrong, Kit; Lennard, T. W. J.; Rees, B I; Mcmahon, A. J.; O'Dwyer, PatrickJ; Baxter, J. N.; Wellwood, J. M.; McClure, Neil; Gallagher, Anthony G.; McGuigan, Jim; Johnson, A.G; Majeed, A.W; Squirrel, D.M; Peacock, J.E; Nicholl, J.P; Pascu, O; Duca, S

doi:10.1016/s0140-6736(96)91109-5

Cited by 6 publications

(3 citation statements)

References 9 publications

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“…The overall biosynthesis in malignant cells thus results in the synthesis of shorter and less branched carbohydrate chains, as well as in increased sialylation and reduced sulfation [10,13,14]. Because the ¢nal structure of the oligosaccharide chains is mainly dictated by the activity or the expression levels of the relevant glycosyltransferases [10,15,16], and changes in these have been detected in human tumors, they have been considered the primary cause for the observed glycosylation abnormalities in malignant cells. However, no simple correlation between these enzymatic changes and the ¢nal structure of the produced oligosaccharide units has been shown to exist [17,18].…”

Section: Introductionmentioning

confidence: 99%

Abnormal glycosylation and altered Golgi structure in colorectal cancer: dependence on intra‐Golgi pH

2002

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Abnormal glycosylation of cellular glycoconjugates is a common phenotypic change in many human tumors. Here, we explore the possibility that an altered Golgi pH may also be responsible for these cancer-associated glycosylation abnormalities. We show that a mere dissipation of the acidic Golgi pH results both in increased expression of some cancer-associated carbohydrate antigens and in structural disorganization of the Golgi apparatus in otherwise normally glycosylating cells. pH dependence of these alterations was confirmed by showing that an acidification-defective breast cancer cell line (MCF-7) also displayed a fragmented Golgi apparatus, whereas the Golgi apparatus was structurally normal in its acidification-competent subline (MCF-7/AdrR). Acidification competence was also found to rescue normal glycosylation potential in MCF-7/AdrR cells. Finally, we show that abnormal glycosylation is also accompanied by similar structural disorganization and fragmentation of the Golgi apparatus in colorectal cancer cells in vitro and in vivo. These results suggest that an inappropriate Golgi pH may indeed be responsible for the abnormal Golgi structure and lowered glycosylation potential of the Golgi apparatus in malignant cells. ß

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Section: Introductionmentioning

confidence: 99%

Abnormal glycosylation and altered Golgi structure in colorectal cancer: dependence on intra‐Golgi pH

2002

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“…1b). Challenges to the study were intense [24,25] and included questions as to the high rate of conversion to open surgical methods, the number of cases undertaken by each practitioner, and various other issues that might suggest the conclusions to be less than valid. Other controlled studies (albeit no other blinded studies) have shown benefits clearly attributable to laparoscopic cholecystectomy.…”

Section: Rctsmentioning

confidence: 99%

Laparoscopy in paediatric urology: adoption of innovative technology

Peters

2003

BJU International

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“…Danach wird am Beispiel der laparo- [18]. Ungeachtet der Ergebnisse und der sich anschlieûenden Leserbriefe [33] hatte diese Publikation nicht den geringsten Einfluss auf den weiteren Siegeszug der laparoskopischen Cholezystektomie, die zu diesem Zeitpunkt in den Industrienationen bereits einen Anteil von 80 % bei der elektiven Versorgung der symptomatischen Cholezystektomie erreicht hatte [23,33]. [5, 6, 8 ± 10, 34].…”

Section: Originalarbeiten Und üBersichtenunclassified

Änderungen der chirurgischen Therapie aufgrund klinischer Studien?

Schwenk

Haase²,

Jm³

2002

Zentralbl Chir

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The randomised controlled clinical trial (RCT) is a powerful instrument to evaluate different therapeutic regimens. In a survey among 115 physicians visiting the 25th annual meeting of the Surgical Society of Berlin and Brandenburg, the RCT was judged to be very important when changes of therapeutic strategies are discussed. 90 % of all participants claimed to use data from RCTs in the clinical routine and 89 % would participate in such a trial. In official (e. g. discussions during coffee breaks at scientific meetings) or non-medical (e. g. non-scientific press or media) sources of information were assessed as irrelevant for decisions regarding therapeutic strategies. However, in contrast to this view laparoscopic cholecystectomy was introduced into clinical practice rapidly because patients informed by external (non-medical) sources preferred to be operated on with the "modern" technique. Clinical trials with a high level of evidence had no relevant influence on the rapid distribution of laparoscopic cholecystectomy. Controversial discussions concerning the extent of lymphadenectomy with gastric resection for carcinoma demonstrate that the value of excellent clinical RCTs is low if their results challenge a stable paradigma of the surgical scientific society. To allow a rational judgement, new surgical technologies should undergo a scientific gradual evaluation in agreement with the principles of evidence based medicine.

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Randomised trial of laparoscopic versus small-incision cholecystectomy

Cited by 6 publications

References 9 publications

Abnormal glycosylation and altered Golgi structure in colorectal cancer: dependence on intra‐Golgi pH

Abnormal glycosylation and altered Golgi structure in colorectal cancer: dependence on intra‐Golgi pH

Laparoscopy in paediatric urology: adoption of innovative technology

Änderungen der chirurgischen Therapie aufgrund klinischer Studien?

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