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splenectomy in gástric cancer

Xin Ji, Tao Fu, Zhao-De Bu, Ji Zhang, Xiao-Jiang Wu, Xiang-Long Zong, Zi-Yu Jia, Biao Fan, Yi-Nan Zhang, Jia-Fu Ji
BACKGROUND: Surgery for advanced gastric cancer (AGC) often includes dissection of splenic hilar lymph nodes (SHLNs). This study compared the safety and effectiveness of different approaches to SHLN dissection for upper- and/or middle-third AGC. METHODS: We retrospectively compared and analyzed clinicopathologic and follow-up data from a prospectively collected database at the Peking University Cancer Hospital. Patients were divided into three groups: in situ spleen-preserved, ex situ spleen-preserved and splenectomy...
October 3, 2016: BMC Cancer
Han Liang, Jingyu Deng
Based upon studies from randomized clinical trials, the extended (D2) lymph node dissection is now recommended as a standard procedure for local advanced gastric cancer worldwide. However, the rational extent lymphadenectomy for local advanced gastric cancer has remained a topic of debate in the past decades. Due to the limitation of low metastatic rate in para-aortic nodes (PAN) in JCOG9501, the clinical benefit of D2+ para-aortic nodal dissection (PAND) for patients with stage T4 and/or stage N3 disease, which is very common in China and other countries except Japan and Korea, cannot be determined...
August 2016: Chinese Journal of Cancer Research, Chung-kuo Yen Cheng Yen Chiu
Hironori Shiozaki, Yusuke Shimodaira, Elena Elimova, Roopma Wadhwa, Kazuki Sudo, Kazuto Harada, Jeannelyn S Estrella, Prajnan Das, Brian Badgwell, Jaffer A Ajani
Surgical management of gastric cancer improves survival. However, for some time, surgeons have had diverse opinions about the extent of gastrectomy. Researchers have conducted many clinical studies, making slow but steady progress in determining the optimal surgical approach. The extent of lymph node dissection has been one of the major issues in surgery for gastric cancer. Many trials demonstrated that D2 dissection resulted in greater morbidity and mortality than D1 dissection. However, long-term outcomes demonstrated that D2 dissection resulted in longer survival than D1 dissection...
2016: Chinese Journal of Cancer
Sayaka Arisaka, Ryuji Kosaka, Chikara Kunisaki, Yasushi Ichikawa, Hirotoshi Akiyama, Mitsuko Furuya, Kenichi Ohashi, Itaru Endo
A 70-year-old man with left abdominal pain was referred to our hospital, and was diagnosed with type 1 advanced gastric cancer with lymph node metastasis. Neoadjuvant chemotherapy(NAC)with docetaxel and S-1 combination was administered. After 2 courses of chemotherapy, total gastrectomy with D2 lymph node dissection, splenectomy, and cholecystectomy were performed. Pathologically, viable cancer cells were not evident in the primary lesion and lymph nodes. The pathological response of NAC was judged to be Grade 3...
July 2016: Gan to Kagaku Ryoho. Cancer & Chemotherapy
Shinsuke Sato, Erina Nagai, Yusuke Taki, Masaya Watanabe, Michiro Takahashi, Yusuke Kyoden, Ko Ohata, Hideyuki Kanemoto, Noriyuki Oba, Keisei Taku, Makoto Suzuki, Masakazu Takagi
Gastric cancer patients with main portal vein tumor thrombus usually have a short survival time, owing to its aggressive behavior. Herein, we report a long-surviving case of gastric cancer with main portal vein tumor thrombus. A 78-year-old man presenting with anorexia and body weight loss was diagnosed with gastric cancer. The patient was referred to our hospital for further examination and treatment. Endoscopy revealed a type 3 tumor (8.0 cm in length) in the body of the stomach. Biopsy led to the diagnosis of moderately differentiated adenocarcinoma...
August 2016: Clinical Journal of Gastroenterology
Takeshi Sano, Mitsuru Sasako, Junki Mizusawa, Seiichiro Yamamoto, Hitoshi Katai, Takaki Yoshikawa, Atsushi Nashimoto, Seiji Ito, Masahide Kaji, Hiroshi Imamura, Norimasa Fukushima, Kazumasa Fujitani
OBJECTIVE: To clarify the role of splenectomy in total gastrectomy for proximal gastric cancer. BACKGROUNDS: Splenectomy in total gastrectomy is associated with increased operative morbidity and mortality, but its survival benefit is unclear. Previous randomized controlled trials were underpowered and inconclusive. METHODS: We conducted a multiinstitutional randomized controlled trial. Proximal gastric adenocarcinoma of T2-4/N0-2/M0 not invading the greater curvature was eligible...
June 8, 2016: Annals of Surgery
Keishiro Aoyagi, Junya Kizaki, Taro Isobe, Yoshito Akagi
BACKGROUND: Many neuroendocrine carcinomas exhibit medullary infiltration and expanded proliferation. Differentiated tubular adenocarcinoma is frequently seen in the superficial region in many neuroendocrine carcinoma cases. However, the present case showed non-medullary infiltration and signet ring cell carcinoma in the superficial region, with intramural metastases distributed throughout the whole of the stomach. CASE REPORT: A 67-year-old man was referred to our institution for treatment of gastric cancer...
2016: American Journal of Case Reports
V V Oleksenko, S V Efetov, K A Aliev
AIM: To analyze immediate and remote results of surgical treatment of 480 patients with gastric cancer who underwent total gastrectomy. MATERIAL AND METHODS: The study group included 371 patients who had spleen-preserving D2 lymphodissection during gastrectomy and control group consisted of 109 patients after D2 lymphodissection with splenectomy. Duration of surgery was 183.7±33.8 and 184.1±30.9 min in study and control groups respectively (p=0.72), blood loss - 330...
2015: Khirurgiia
Maurizio Degiuli, Giovanni De Manzoni, Alberto Di Leo, Domenico D'Ugo, Erica Galasso, Daniele Marrelli, Roberto Petrioli, Karol Polom, Franco Roviello, Francesco Santullo, Mario Morino
D2 procedure has been accepted in Far East as the standard treatment for both early (EGC) and advanced gastric cancer (AGC) for many decades. Recently EGC has been successfully treated with endoscopy by endoscopic mucosal resection or endoscopic submucosal dissection, when restricted or extended Gotoda's criteria can be applied and D1+ surgery is offered only to patients not fitted for less invasive treatment. Furthermore, two randomised controlled trials (RCTs) have been demonstrating the non inferiority of minimally invasive technique as compared to standard open surgery for the treatment of early cases and recently the feasibility of adequate D1+ dissection has been demonstrated also for the robot assisted technique...
March 14, 2016: World Journal of Gastroenterology: WJG
Han Liang
Based upon studies from randomized clinical trials, the extended (D2) lymph node dissection is now recommended as a standard procedure for local advanced gastric cancer worldwide. However, the rational extent lymphadenectomy for local advanced gastric cancer has remained a topic of debate in the past decades. Patients with more lymph nodes harvested may have better survival. Negative node count may provide prognostic information for gastric cancer patients. The extranodal metastasis is significantly associated with the survival of gastric cancer patients and should be incorporated into N stage...
February 2016: Zhonghua Wei Chang Wai Ke za Zhi, Chinese Journal of Gastrointestinal Surgery
V Marek, R Zahorec, J Palaj, S Durdik
Surgical treatment of gastric cancer with liver metastasis (GCLM) is currently a frequent topic of discussion at professional surgical symposia. There is a low number of patients and a lack of large clinical multi-center studies describing the benefits of this treatment approach. The article describes a patient with GCLM, growing through stomach wall serosa, invading the spleen hilum, distal part of pancreas with metastasis to S7 of the right liver lobe. The patient had total gastrectomy performed with D2 lymphadenectomy, distal pancreatectomy with splenectomy, resection of diaphragm and RFA of the metastatic lesion in S7 of the liver...
2016: Bratislavské Lekárske Listy
Tadayoshi Hashimoto, Shigeyuki Tamura, Atsushi Takeno, Hirokazu Taniguchi, Tomo Ishida, Yasufumi Sato, Yoshihiro Morimoto, Hiroki Kusama, Katsunori Matsushita, Kei Kimura, Yoshiteru Katsura, Kanae Nitta, Yoshiaki Ohmura, Yoshinori Kagawa, Masatsugu Okishiro, Hideki Sakisaka, Chiyomi Egawa, Yutaka Takeda, Takeshi Kato
A 71-year-old man was admitted to our hospital for epigastric pain. Upper gastrointestinal endoscopy revealed a type 2- like ulcerative lesion in the posterior wall of the upper and middle part of the stomach. Endoscopic biopsies showed malignant T-cell lymphoma histologically. A chest CT scan revealed a nodule in the apex of right lung, suggestive of primary lung cancer. A total gastrectomy with D2 lymphadenectomy and distal pancreatectomy with splenectomy was performed. Seventy-three days after surgery, the patient developed a lung abscess in the middle lobe of the right lung...
November 2015: Gan to Kagaku Ryoho. Cancer & Chemotherapy
Hideaki Ohyagi, Masaaki Kume, Yoshinori Shinohara, Satsuki Takahashi, Masahiro Saito, Masashi Zuguchi, Yoshitaka Enomoto, Ken Saito, Katsu Hirayama, Naoto Takahashi
A 58-year-old woman was admitted to our hospital for evaluation of left flank pain. Abdominal computed tomography showed a greatly enlarged splenic tumor with a massive portal vein tumor thrombosis (PVTT). We suspected non-Hodgkin lymphoma (NHL) based on the high values of serum soluble interleukin-2 receptor and lactate dehydrogenase. Because there was no superficial lymph node enlargement, ultrasound-guided percutaneous trans-hepatic needle biopsy was performed to obtain a pathological diagnosis of PVTT, instead of a splenectomy, after the patient had provided informed consent...
December 2015: [Rinshō Ketsueki] the Japanese Journal of Clinical Hematology
Leandro Cardoso Barchi, Carlos Eduardo Jacob, Maurice Youssef Franciss, Guilherme Tommasi Kappaz, Edison Dias Rodrigues Filho, Bruno Zilberstein
BACKGROUND: Intracorporeal digestive tract reconstruction after minimally invasive total gastrectomy may be challenging, even when using the da Vinci® Surgical System. This may be due to intrinsic difficulties during oesophago-jejunal anastomosis (EJA). The aim of this study was to describe a simple way to perform digestive tract reconstruction after robotic total gastrectomy (RTG) for gastric cancer and the results of its application in a small series of cases. METHODS: In the last 2 years, six patients with gastric adenocarcinoma have been treated by RTG, four male and two female, with mean age of 59...
December 9, 2015: International Journal of Medical Robotics + Computer Assisted Surgery: MRCAS
Masahiro Watanabe, Takahiro Kinoshita, Naoki Enomoto, Hidehito Shibasaki, Toshirou Nishida
BACKGROUND: Significance of splenic hilar node dissection with splenectomy is now denied for advanced gastric cancer of upper one-third of the stomach without invasion to the greater curvature by the Japan Clinical Oncology Group 0110, a pivotal randomized study from Japan. However, a question remains for tumors which involve the greater curvature, as this study excluded such tumors. METHODS: We retrospectively analyzed 421 consecutive patients with gastric cancer who underwent curative total gastrectomy with splenectomy from 1992 to 2009...
May 2016: World Journal of Surgery
Shinsuke Usui, Masaki Tashiro, Shigeo Haruki, Kaida Arita, Koji Ito, Akiyo Matsumoto, Noriaki Takiguchi
INTRODUCTION: Splenic hilar lymph node dissection via a splenectomy for advanced proximal gastric cancer remains controversial. Recently, a laparoscopic spleen-preserving hilar lymph node dissection procedure was described in several publications. To assess the feasibility and safety of spleen-preserving laparoscopic total gastrectomy with D2 lymphadenectomy (LTG-D2), the present retrospective study compared the short-term surgical outcomes between spleen preservation and splenectomy during laparoscopic D2 total gastrectomy (LTG-D2S)...
February 2016: Asian Journal of Endoscopic Surgery
Felipe J F Coimbra, Wilson Luiz da Costa, Héber S C Ribeiro, Alessandro L Diniz, André Luís de Godoy, Igor Correia de Farias, Antonio Moris Cury Filho, Marcello Ferretti Fanelli, Maria Dirlei F S Begnami, Fernando Augusto Soares
BACKGROUND: Resections have long been recommended for patients with incurable gastric cancer. However, high morbidity rates and more efficient chemotherapy regimens have demanded more accurate patient selection. The aim of this study was to analyze the results of gastric cancer patients treated with noncurative resection in a single cancer center. METHODS: Medical charts of patients treated with a noncurative resection between January 1988 and December 2012 were analyzed...
April 2016: Annals of Surgical Oncology
Ji-Won Han, Seong-Ho Kong, Cheong-Il Shin, Seung-Kee Min, Sang-Il Min, Tae Han Kim, Jun-Young Yang, Seung-Young Oh, Yun-Suhk Suh, Hyuk-Joon Lee, Han-Kwang Yang
BACKGROUND: Postoperative portomesenteric venous thrombosis (PMVT) is a rare but potentially serious complication of gastric surgery. This study analyzed the incidence, characteristics, risk factors, and outcomes of PMVT following gastric surgery. METHODS: Medical records of patients who underwent gastric surgery between January 2007 and December 2012 were reviewed retrospectively. The risk factors of PMVT were analyzed by a logistic regression analysis with control group matched 1:4 by age, sex, and cancer stage and by a Poisson regression analysis with unmatched control group...
October 2016: Gastric Cancer
Hideki Ushiku, Kei Hosoda, Keishi Yamashita, Natsuya Katada, Shiro Kikuchi, Harukazu Tsuruta, Masahiko Watanabe
BACKGROUND: Understanding risk factors of surgical site infections (SSIs) in gastrectomy is important to provide the best treatment for the patients with gastric cancer. METHODS: This is a retrospective observational study using the medical records of 790 patients with gastrectomy from 2005 through 2009. SSIs were classified into incisional SSIs (iSSIs) and organ/space SSIs (o/sSSIs). RESULTS: iSSIs and o/sSSIs were detected in 41 (5.2%) patients and 68 (8...
2015: Digestive Surgery
Hiroki Sugita, Eri Oda, Masahiko Hirota, Shinji Ishikawa, Shinjiro Tomiyasu, Hiroshi Tanaka, Tetsumasa Arita, Yasushi Yagi, Hideo Baba
BACKGROUND: To date, the optimal surgical strategy for remnant gastric cancer has not been determined. The purpose of this study was to clarify the significance of lymphadenectomy with splenectomy in remnant gastric cancer surgery. METHODS: This retrospective cohort study was conducted at the Kumamoto Regional Medical Center. The primary endpoint was overall survival after surgery. We retrospectively analyzed the clinicopathologic features, surgical treatments, and long-term prognosis of remnant gastric cancer patients treated with total gastrectomy...
April 2016: Surgery
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