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Surgery, surgical oncology, upper gi,

S A Sethuraman, V K Dhar, D A Habib, J E Sussman, S A Ahmad, S A Shah, B J Tsuei, J J Sussman, Daniel E Abbott
BACKGROUND: Small bowel necrosis after enteral feeding through a jejunostomy tube (tube feed necrosis, TFN) is a rare, serious complication of major abdominal surgery. However, strategies to reduce the incidence and morbidity of TFN are not well established. Here, in the largest series of TFN presented to date, we report our institutional experience and a comprehensive review of the literature. METHODS: Eight patients who experienced TFN from 2000 to 2014 after major abdominal surgery for oncologic indications at the University of Cincinnati were reviewed...
September 27, 2017: Journal of Gastrointestinal Surgery: Official Journal of the Society for Surgery of the Alimentary Tract
Santiago Reimondez, Federico Moser, Pablo S Maldonado, Álvaro Alcaraz, Alejandro M Rossini, Lucio R Obeide
Gastrointestinal stromal tumors are the most common mesenchymal neoplasms of the gastrointestinal tract. Recently, many studies have addressed the laparoscopic management of these tumors. The aim of this study was to evaluate the safety and efficacy of laparoscopic atypical gastrectomy in the resolution of these neoplasms. In the period between January 2009 and December 2015, 24 patients with suspected gastric GIST less than 5 cm in size underwent surgery under this approach. Abscense of peritoneal and liver metastases and immunohistochemistry expression of CD117 antigen were considered as inclusion criteria...
2017: Medicina
Hylke J F Brenkman, Nicole I van der Wielen, Jelle P Ruurda, Maarten S van Leeuwen, Joris J G Scheepers, Donald L van der Peet, Richard van Hillegersberg, Ronald L A W Bleys, Miguel A Cuesta
BACKGROUND: It is imperative for surgeons to have a proper knowledge of the omental bursa in order to perform an adequate dissection during minimally invasive surgery (MIS) of the upper gastrointestinal (GI) tract. This study aimed to describe (1) the various approaches which can be used to enter the bursa and to perform a complete lymphadenectomy, (2) the boundaries and anatomical landmarks of the omental bursa as seen during MIS, and (3) whether a bursectomy should be performed for oncological reasons in upper GI cancer...
July 2017: Journal of Thoracic Disease
M Mazzola, C Bertoglio, M Boniardi, C Magistro, P De Martini, P Carnevali, L Morini, G Ferrari
INTRODUCTION: Certain surgical interventions, especially those involving upper GI tract remain challenging, due to high morbidity and mortality rates. The study of frailty in the surgical population has allowed the identification of those patients with a higher risk of poor postoperative outcomes. There remains a lack of evidence regarding the possibility of improving these results through a preoperative holistic management of the patients. The aim of this study is to evaluate whether preoperative treatment, in carefully selected patients, can improve the outcome following surgery...
August 2017: European Journal of Surgical Oncology
L A D Busweiler, M G Schouwenburg, M I van Berge Henegouwen, N E Kolfschoten, P C de Jong, T Rozema, B P L Wijnhoven, R van Hillegersberg, M W J M Wouters, J W van Sandick
BACKGROUND: Quality assurance is acknowledged as a crucial factor in the assessment of oncological surgical care. The aim of this study was to develop a composite measure of multiple outcome parameters defined as 'textbook outcome', to assess quality of care for patients undergoing oesophagogastric cancer surgery. METHODS: Patients with oesophagogastric cancer, operated on with the intent of curative resection between 2011 and 2014, were identified from a national database (Dutch Upper Gastrointestinal Cancer Audit)...
May 2017: British Journal of Surgery
Johan L Dikken, Mark I van Berge Henegouwen, Vincent K Y Ho, Daniel Henneman, Rob A E M Tollenaar, Michel W J M Wouters, Johanna W van Sandick
305 Background: There is a known volume-outcome association for complex surgial procedures such as oncologic gastric resections. The aim of this study was to describe the process of centralization for gastric cancer surgery in the Netherlands in relation to other types of upper gastrointestinal (GI) cancer resections and to investigate whether the quality of gastric cancer surgery is affected by the overall experience with those related complex surgical procedures. METHODS: Data on all patients (n = 4251) who underwent surgical treatment for non metastatic invasive gastric cancer between 2005-2013 were obtained from the Netherlands Cancer Registry...
March 2016: Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology
Miguel A Cuesta, Nicole van der Wielen, Jennifer Straatman, Donald L van der Peet
Since the first laparoscopic procedure, there has been an steady increase in advanced minimally invasive surgery. These procedures include oncological colorectal, hepatobiliary and upper gastrointestinal surgery. Implementation of these procedures requires different and new skills for the surgeons who wish to perform these procedures. To accomplish this surgical teaching program, a mentorship seems the most ideal method to teach the apprentice surgeon these specific skills. At the VU medical center a teaching program for a minimally-invasive esophagectomy for esophageal cancer started in 2009...
January 2017: Annals of Medicine and Surgery
Graziano Ceccarelli, Enrico Andolfi, Alessia Biancafarina, Aldo Rocca, Maurizio Amato, Marco Milone, Marta Scricciolo, Barbara Frezza, Egidio Miranda, Marco De Prizio, Andrea Fontani
BACKGROUND: Although there is no agreement on a definition of elderly, commonly an age cutoff of ≥65 or 75 years is used. Nowadays most of malignancies requiring surgical treatment are diagnosed in old population. Comorbidities and frailty represent well-known problems during and after surgery in elderly patients. Minimally invasive surgery offers earlier postoperative mobilization, less blood loss, lower morbidity as well as reduction in hospital stay and as such represents an interesting and validated option for elderly population...
February 2017: Aging Clinical and Experimental Research
Horia Doran, Traian Pătraşcu
AIM: In general and digestive surgical departments, an accurate diagnosis and appropriate treatment of our patients require a wide and continuous access to endoscopy. As many surgical clinics have already developed their own endoscopy units, we plead for the future presence of at least 1 or 2 surgeons, board certified in endoscopy, in every surgical department. METHOD: We have retrospectively analyzed the activity of the endoscopic unit as a part of the Surgical Clinic of "œDr...
July 2016: Chirurgia
Cecilia Gavazzi, Silvia Colatruglio, Filippo Valoriani, Vincenzo Mazzaferro, Annarita Sabbatini, Roberto Biffi, Luigi Mariani, Rosalba Miceli
BACKGROUND: Weight loss is frequent in patients with gastrointestinal (GI) cancer. Nutritional status deteriorates throughout anti-cancer treatment, mostly after major surgery, increasing complications, reducing tolerance and worsening the final prognosis. Enteral nutrition is safe and effective in malnourished patients undergoing major GI surgery. Randomised trials aimed at investigating the effects of home enteral nutrition (HEN) in post-surgical patients with GI cancer are lacking...
September 2016: European Journal of Cancer
Dimitrios Ntourakis, Georgios Mavrogenis
AIM: To investigate the cooperative laparoscopic and endoscopic techniques used for the resection of upper gastrointestinal tumors. METHODS: A systematic research of the literature was performed in PubMed for English and French language articles about laparoscopic and endoscopic cooperative, combined, hybrid and rendezvous techniques. Only original studies using these techniques for the resection of early gastric cancer, benign tumors and gastrointestinal stromal tumors of the stomach and the duodenum were included...
November 21, 2015: World Journal of Gastroenterology: WJG
U Seeland, U Heger, K Heise, K Ott
Systematic analyses of gender effects in gastrointestinal malignancies are currently lacking, partly because sex and gender have not been used as stratification criteria in major studies on the topic. It is, however, indisputable that gastrointestinal tumours differ in risk factors, incidence and prognosis between the genders. This review summarises the most important findings on differences related to biological sex and sociocultural gender and discusses anatomic specifics with immediate significance for surgical interventions...
June 2015: Zentralblatt Für Chirurgie
I Hornstein, C Schwarz, S Ebbing, M Hoppe-Lotichius, G Otto, H Lang, T J Musholt
BACKGROUND: Only limited data exist on the treatment and outcome of adrenal metastases that derive from different primary tumor entities. Due to the lack of evidence, it is difficult to determine the indication for surgical resection. METHODS: We assessed the outcome of 45 patients (28 men, 17 women) with adrenal metastases who underwent surgery (1990-2014). The median age at the time of adrenal surgery was 62 years (range 44-77 years). We were able to evaluate follow-up data of 41 patients...
April 2015: Langenbeck's Archives of Surgery
William B Robb, Mathieu Messager, Caroline Gronnier, Williams Tessier, Flora Hec, Guillaume Piessen, Christophe Mariette
BACKGROUND: Perioperative oncologic treatments provide a survival benefit for junctional and gastric adenocarcinoma (JGA) and esophageal cancer (EC). Whether neoadjuvant therapy toxicity (NTT) correlates with increased perioperative risk remains unclear. We aimed to evaluate the impact of grade III/IV NTT on postoperative and oncologic outcomes in resected upper gastrointestinal malignancies. METHODS: A multicenter retrospective analysis was performed on consecutive patients who benefited from neoadjuvant chemo(radio)therapy followed by surgery between 1997 and 2010 for JGA (first cohort, n = 653) and for EC (second cohort, n = 640)...
October 2015: Annals of Surgical Oncology
Dario Raimondo, Emanuele Sinagra, Tiziana Facella, Francesca Rossi, Marco Messina, Massimiliano Spada, Guido Martorana, Pier Enrico Marchesa, Rosario Squatrito, Giovanni Tomasello, Attilio Ignazio Lo Monte, Giancarlo Pompei, Ennio La Rocca
In the setting of the curative oncological surgery, the gastric surgery is exposed to complicated upper gastrointestinal leaks, and consequently the management of this problem has become more critically focused than was previously possible. We report here three cases of placement of a partially silicone-coated SEMS (Evolution Controlled Release Esophageal Stent System, Cook Medical, Winston-Salem, NC, USA) in patients who underwent total gastrectomy with Roux-en-Y end-to-side esophagojejunostomy for a gastric adenocarcinoma...
2014: Case Reports in Gastrointestinal Medicine
S P Mönig, S H Chon, J Weindelmayer, G de Manzoni, A H Hölscher
Minimally invasive operative procedures are increasingly being used for treating tumors of the upper gastrointestinal tract. While minimally invasive surgery (MIS) has become established as a standard procedure for benign tumors and gastrointestinal stromal tumors (GIST) based on current studies, the significance of MIS in the field of gastric cancer is the topic of heated debate. Until now the majority of studies and meta-analyses on gastric cancer have come from Asia and these indicate the advantages of MIS in terms of intraoperative blood loss, minor surgical complications and swifter convalescence although without any benefits in terms of long-term oncological results and quality of life...
August 2014: Der Chirurg; Zeitschrift Für Alle Gebiete der Operativen Medizen
Alexander P Boddy, James M L Williamson, Mark N Vipond
INTRODUCTION: Centralisation of oesophagogastric (OG) resectional services has been proposed to improve patient outcomes in terms of perioperative mortality and long-term survival. Centralisation of services occurred in Gloucester 5 years ago. The aim of this paper is to assess if local patient outcomes have benefited from centralisation. METHODS: All oesophagogastric resections performed in our unit over a 15-year period (10-years pre-centralisation and 5-years post-centralisation) were assessed retrospectively...
2012: International Journal of Surgery
Gh Ghidirim, I Mishin, I Gagauz, M Vozian, A Cernii, M Cernat
BACKGROUND: Gastrointestinal stromal tumors (GISTs) are low-grade malignant tumors that may arise anywhere in the alimentary tract, and in the past, most of them were diagnosed as intestinal leiomyoma or leiomyosarcoma. GISTs of the duodenum make up only 4.5% of all GISTs. MATERIALS AND METHODS: We report a patient presented with upper GI bleeding who exhibited radiological findings of a tumor in the third portion of the duodenum. The patient underwent a segmental duodenectomy...
2011: Romanian Journal of Morphology and Embryology, Revue Roumaine de Morphologie et Embryologie
F Tamás Molnár, Ors Péter Horváth, László Farkas, Imre Gerlinger, László Pajor, Dezsô Kelemen, Károly Kalmár Nagy, György Tizedes, Gábor Pavlovics, József Bódis, Péter Gocze, György Szekeres
Oncologic surgery and pTNM staging require systemic removal of the locoregional lymphnodes. While the optimal extent and therapeutical and/or prognostic value of the lymphadenectomy/sampling are debated organ by organ and (sub)speciality by (sub)speciality, relevance of the lymphnode sytem-tumor concept itself is beyond doubt. Loss of information and existence of traps on the "surgical field-microscope" pathway is an international phenomenon, calling for solution. An integrated sterile and disposable lymphnode tray system is presented here for applications in the different fields of cancer surgery of the upper GI tract, retroperitoneum (gynecology, urology) and ear-nose-throat surgery...
February 2011: Magyar Sebészet
Roozbeh Rassadi, Richard M Dickerman, Ernest L Dunn, Paul R Tarnasky, Jeffrey D Linder, Alejandro Mejia, Stephen S Cheng, D Rohan Jeyarajah
BACKGROUND: Reduced resident work hours over the last several years have led to inadequate exposure to hepatopancreaticobiliary (HPB) and complex upper gastrointestinal (UGI) surgical procedures. Therefore, residents are seeking additional training in this field. The purpose of this study is to determine the role of a new fellowship model in the training of general surgery residents in complex HPB/UGI diseases. METHODS: We propose a surgical training model in benign as well as malignant diseases of the UGI tract...
May 2008: Journal of Surgical Education
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