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Gastric Cancer And Laparoscopic Surgery

K C Zhang, L Chen
It has been thirty years since the three-dimensional (3D) laparoscopy was put into clinical use. The advantages of 3D laparoscopy are depth perception, high cost-efficacy, tactile feedback, education for basic procedures in laparoscopy and accurate operation. Currently, high-level of evidence for 3D laparoscopy in gastric cancer is still lacking. The advantage of 3D laparoscopy could be maximized in complicated procedures, like hilar lymphadenectomy and totally laparoscopic reconstruction in gastrectomy. In order to acquire optimal depth perception, optimal standing position and stereoacuity check should be emphasized for surgeons in 3D laparoscopic surgery...
August 1, 2018: Zhonghua Wai Ke za Zhi [Chinese Journal of Surgery]
Jie Jiao, Shaozhuang Liu, Cheng Chen, A Maimaiti, Qingsi He, Sanyuan Hu, Wenbin Yu
Introduction: At present, the main treatment of gastric cancer is surgical resection combined with radiotherapy and chemotherapy, the most important part of which is radical gastrectomy. Laparoscopic radical gastrectomy for advanced gastric cancer is difficult to operate, and whether it can achieve the same curative effect with the laparotomy is still controversial. Materials and Methods: This study retrospectively analysed the clinical data of 269 gastric cancer patients surgically treated by our medical team from May 2011 to December 2015 for comparative analysis of the clinical efficacy of laparoscopic-assisted radical gastrectomy and traditional open radical gastrectomy...
August 7, 2018: Journal of Minimal Access Surgery
Kazunari Misawa, Takaki Yoshikawa, Seiji Ito, Haruhiko Cho, Yuichi Ito, Takashi Ogata
BACKGROUND: Duodenal stump fistula (DSF) after gastrectomy is of low frequency but a critical complication in gastric cancer surgery. Manual oversewing for reinforcement of the duodenal stump is not applicable when free longitudinal margin is short and has technical difficulties in laparoscopic surgery. This trial evaluated the safety and feasibility of using a linear stapler with bioabsorbable polyglycolic acid (PGA) sheet for duodenal stump closure and reinforcement in gastric cancer surgery...
August 13, 2018: World Journal of Surgery
Ho Seok Seo, Yoon Ju Jung, Ji Hyun Kim, Cho Hyun Park, Han Hong Lee
BACKGROUND: This study presents the initial feasibility of three-port right-side approach-duet totally laparoscopic distal gastrectomy (R-duet TLDG) with uncut Roux-en-Y (R-Y) reconstruction for the treatment of lower- or middle-third gastric cancer. METHODS: A total of 30 patients who underwent R-duet TLDG with uncut R-Y reconstruction for gastric cancer were enrolled. All patients were treated at the Catholic Medical Center. Reconstructions were performed intracorporeally without special instruments...
August 8, 2018: Journal of Laparoendoscopic & Advanced Surgical Techniques. Part A
Jun Kinoshita, Sachio Fushida, Masahide Kaji, Katsunobu Oyama, Daisuke Fujimoto, Yasuo Hirono, Tomoya Tsukada, Takashi Fujimura, Shigekazu Ohyama, Kazuhisa Yabushita, Naotaka Kadoya, Koji Nishijima, Tetsuo Ohta
BACKGROUND: Acetaminophen is used in multimodal therapy for postoperative pain management. However, the additional effects of acetaminophen in combination with thoracic epidural analgesia (TEA) are not well understood. This prospective, multicenter randomized study was conducted to evaluate the efficacy of routine intravenous (i.v.) acetaminophen in combination with TEA for the management of postoperative pain in gastric cancer surgery. METHODS: A total of 120 patients who underwent distal gastrectomy were randomly assigned in a 1:1 ratio to receive i...
August 7, 2018: Gastric Cancer
Yuki Ushimaru, Takeshi Omori, Yoshiyuki Fujiwara, Yoshitomo Yanagimoto, Keijiro Sugimura, Kazuyoshi Yamamoto, Jeong-Ho Moon, Hiroshi Miyata, Masayuki Ohue, Masahiko Yano
BACKGROUND: Securing the surgical margin is the most essential and important task in curative surgery. However, it is difficult to accurately identify the tumor location during laparoscopic surgery for gastric cancer, and existing methods, such as preoperative endoscopic marking with tattooing and clipping, have multiple disadvantages. AIMS: We investigated the feasibility and safety of indocyanine green (ICG) fluorescence marking for determining the tumor location during laparoscopic gastrectomy...
August 6, 2018: Journal of Gastrointestinal Surgery: Official Journal of the Society for Surgery of the Alimentary Tract
K Lassen, L S Nymo, F Olsen, K Søreide
Background: Length of hospital stay (LOS) may serve as a surrogate measure of healthcare quality and resource use, particularly when transfers of care and readmissions are accounted for. This study aimed to benchmark true hospital stay by measuring index, transfer and readmission stays across the range of digestive cancer surgery. Methods: A cohort study of all patients undergoing resection for cancer of the oesophagus, stomach, liver, pancreas, colon or rectum in 2012-2016 was undertaken...
August 2018: BJS open
Hitomi Takechi, Nobuaki Fujikuni, Yuki Takemoto, Kazuaki Tanabe, Hironobu Amano, Toshio Noriyuki, Masahiro Nakahara
INTRODUCTION: Laparoscopic and endoscopic cooperative surgery (LECS) is a minimally invasive hybrid procedure that facilitates the precise dissection of gastrointestinal malignancies. We report the use of LECS as palliative treatment for a patient with advanced gastric cancer at a high risk due to comorbidities. PRESENTATION OF CASE: A 68-year-old woman with general malaise was admitted to the hospital and received multiple transfusions for anemia. Endoscopy examination detected an ulcerative lesion in the stomach...
July 21, 2018: International Journal of Surgery Case Reports
Ying-Xu Li, Deng-Hua Fang, Tian-Xi Liu
This study aimed to introduce this surgical technique laparoscopic sleeve gastrectomy combined with single-anastomosis duodenal-jejunal bypass (LDJB-LSG), and to confirm this new surgical technique was safe in the treatment of type 2 diabetes mellitus (T2DM) of patients with body mass index (BMI) higher than 27.5 kg/m but lower than 32.5 kg/m.A total of 34 T2DM patients with (BMI) higher than 27.5 kg/m but lower than 32.5 kg/m were admitted to our department between January 2014 and October 2016, of whom 25 received laparoscopic gastric bypass surgery (LRYGB) and 9 received LDJB-LSG...
August 2018: Medicine (Baltimore)
Toshiyasu Ojima, Masaki Nakamura, Mikihito Nakamori, Keiji Hayata, Masahiro Katsuda, Junya Kitadani, Shimpei Maruoka, Toshio Shimokawa, Hiroki Yamaue
BACKGROUND: Laparoscopic gastrectomy (LG) has several benefits as a treatment of gastric cancer (GC), including reduced pain, early recovery of intestinal function, and shorter hospital stay. LG still has several drawbacks, however, including limited range of movement, amplification of hand tremors, and inconvenient surgical positioning. Around the peripancreatic area, laparoscopic lymph node dissection, therefore, remains challenging; postoperative pancreatic fistula occurs in around 4-7% of patients undergoing LG...
July 31, 2018: Trials
Salaam Sadi, Paul H Sugarbaker, Timothy Shope
INTRODUCTION: Morbidly obese patients may require a laparotomy to resect a malignancy. In some patients the cancer resection can be combined with the bariatric procedure to concomitantly treat both diseases. PRESENTATION OF CASE: A morbidly obese patient with peritoneal metastases from an appendiceal mucinous neoplasm was evaluated and definitively treated with Cytoreductive surgery and hyperthermic intraperitoneal chemotherapy (HIPEC), at the same time the patient was treated for morbid obesity with sleeve gastrectomy and removal of a previous laparoscopic adjustable gastric banding (LAGB)...
July 9, 2018: International Journal of Surgery Case Reports
Christophoros S Kosmidis, Georgios D Koimtzis, Georgios Anthimidis, Nikolaos Varsamis, Stefanos Atmatzidis, Ioannis S Koskinas, Triantafyllia Koletsa, Katerina Zarampouka, Eleni Georgakoudi, Sofia Baka, Christophoros Efthimiadis, Maria S Kosmidou, Georgios Kouklakis
BACKGROUND The first gastric resection for stomach cancer was performed in 1879, and the first gastric resection for gastric ulcer disease was performed in 1882. During the 1990s, the first laparoscopic gastrostomies were reported. During the past decade, laparoscopic techniques have developed rapidly, gaining wide clinical acceptance. Minimally invasive surgery is now shifting the balance away from traditional open methods. We report 2 cases of endoscopically assisted laparoscopic local gastric resections for both gastric cancer and gastric ulcer disease...
July 28, 2018: American Journal of Case Reports
So Hyun Kang, Yoontaek Lee, Sa-Hong Min, Young Suk Park, Sang-Hoon Ahn, Do Joong Park, Hyung-Ho Kim
BACKGROUND: The application of ERAS protocol has widely gained acceptance after gastrointestinal surgery. Well-designed, randomized, control trials are needed to evaluate fully its safety and efficacy in the field of gastric cancer. This study aims to compare the enhanced recovery after surgery (ERAS) protocol and the conventional perioperative care program after totally laparoscopic distal gastrectomy (TLDG) in gastric cancer. METHODS: Patients with gastric cancer indicated for TLDG were randomly assigned to either the ERAS group or the conventional group...
July 26, 2018: Annals of Surgical Oncology
Aingeru Sarriugarte, Luca Arru, Silviu Makai-Popa, Martina Goergen, Francisco Javier Ibañez-Aguirre, Juan Santiago Azagra
INTRODUCTION: Total gastrectomy is a surgery with significant perioperative morbidity and mortality, being considered the treatment of choice in proximal gastric cancer. First described in 1980, our group reported and standardized totally laparoscopic 95% gastrectomy in 2014. This technique aims to reduce the complications of total gastrectomy while maintaining oncological radicality. We present the initial results from a cohort of consecutive cases after performing the technique for 4 years at 2 hospital centers...
July 20, 2018: Cirugía Española
W W Jin, C Lu, Y P Mou, X W Xu, R C Zhang, Y C Zhou, Z Y Qian, C J Huang
Objective: To evaluate the safety and feasible of adjacent organ resection during laparoscopic pancreaticoduodenectomy(LPD), and summary the surgical strategies. Methods: Clinical data of 15 adjacent organ resections combined with LPD from March 2013 to September 2017 were reviewed.There were 10 male and 5 female patients aging from 20 to 86 years, and the body mass index ranged from 19.6 to 34.5 kg/m(2).Two patients had previous abdominal surgical history.Two patients underwent preoperative chemotherapy. Results: The resected adjacent organs included liver( n =4), stomach( n =3), colon( n =6), right kidney with embolectomy and vasoplastic of inferior vena cava( n =1), and spleen artery aneurysms( n =1)...
July 1, 2018: Zhonghua Wai Ke za Zhi [Chinese Journal of Surgery]
Manabu Yamamoto, Mototsugu Shimokawa, Hiroyuki Kawano, Mitsuhiko Ohta, Daisuke Yoshida, Kazuhito Minami, Masahiko Ikebe, Masaru Morita, Yasushi Toh
BACKGROUND: Laparoscopic surgery is frequently performed, and laparoscopic gastrectomy (LG) is also widely performed for gastric cancer. Elderly population with gastric cancer has increased in East Asia, including in Japan. METHODS: We examined 1131 patients with gastric cancer who underwent laparoscopic and open standard surgeries (OG). A total of 921 patients of age < 75 years (non-E group) and 210 patients of age ≥ 75 years (E group) underwent surgery for gastric cancer...
July 20, 2018: Surgical Endoscopy
Arif Emre, Mehmet Sertkaya, Sami Akbulut, Ozan Erbil, Nursel Yurttutan, İlhami Taner Kale, Ertan Bülbüloğlu
Objective: The aim of the present study was to share our experiences of the use of self-expandable metallic stent for the upper gastrointestinal tract disease. Material and Methods: We retrospectively reviewed the medical records of 18 patients who underwent self-expandable metallic stent implantation procedure for anastomosis stricture, anastomosis leak, or spontaneous fistula of the upper gastrointestinal tract at two different surgery clinics. Self-expandable metallic stent implantation procedures were performed while keeping the patient under sedation and the correct stent localization was verified using fluoroscopy...
2018: Turkish Journal of Surgery
Yosuke Seki, Kazunori Kasama, Tatsuro Tanaka, Satoshi Baba, Masayoshi Ito, Yoshimochi Kurokawa
This case involved a 64-year-old female patient with a BMI of 35.3 kg/m2 and poorly controlled type 2 diabetes mellitus. Preoperative upper gastrointestinal endoscopy revealed chronic, atrophic gastritis. Helicobacter pylori antibody was negative. The patient underwent laparoscopic sleeve gastrectomy with duodenal-jejunal bypass as a metabolic surgery to treat obesity and type 2 diabetes mellitus. At 1 year postoperatively, routine endoscopy detected a flat elevated lesion at the distal gastric sleeve, near the posterior wall of the antrum; biopsy revealed adenocarcinoma...
July 17, 2018: Asian Journal of Endoscopic Surgery
J J Wang, Y Wang, Y J Fang, T Liu, Y F Wu
Objective: To explore the safety and reliable of low pressure laparoscopy in old patients, and the advantage over conventional pressure laparoscopy. Methods: Sixty-six patients(≥70 year) with gastric cancer from 2014.4 to 2017.4 were enrolled, and they were divided into three groups randomly. The value of Ejection Fraction (EF), central venous pressure (CVP), B-type natriuretic peptide (BNP), O(2) pressure, CO(2) pressure, complications of three groups were compared and analysis. Results: There was no differences between low-pressure laparoscopic group, conventional laparoscopic group and laparotomy group in age, gender, EF, oxygen pressure, CVP ( P >0...
June 26, 2018: Zhonghua Yi Xue za Zhi [Chinese medical journal]
Satoshi Ida, Naoki Hiki, Takeaki Ishizawa, Yugo Kuriki, Mako Kamiya, Yasuteru Urano, Takuro Nakamura, Yasuo Tsuda, Yosuke Kano, Koshi Kumagai, Souya Nunobe, Manabu Ohashi, Takeshi Sano
Purpose: Postoperative pancreatic fistula is a serious and fatal complication of gastrectomy for gastric cancer. Blunt trauma to the parenchyma of the pancreas can result from an assistant's forceps compressing and retracting the pancreas, which in turn may result in pancreatic juice leakage. However, no published studies have focused on blunt trauma to the pancreas during laparoscopic surgery. Our aim was to investigate the relationship between compression of the pancreas and pancreatic juice leakage in a swine model...
June 2018: Journal of Gastric Cancer
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