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Early gastric cancer surgery

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https://www.readbyqxmd.com/read/28325187/postgastrectomy-syndromes-and-nutritional-considerations-following-gastric-surgery
#1
REVIEW
Jeremy L Davis, R Taylor Ripley
Postgastrectomy syndromes result from altered form and function of the stomach. Gastrectomy disrupts reservoir capacity, mechanical digestion and gastric emptying. Early recognition of symptoms with prompt evaluation and treatment is essential. Many syndromes resolve with minimal intervention or dietary modifications. Re-operation is not common but often warranted for afferent and efferent loop syndromes and bile reflux gastritis. Preoperative nutritional assessment and treatment of common vitamin and mineral deficiencies after gastrectomy can reduce the incidence of chronic complications...
April 2017: Surgical Clinics of North America
https://www.readbyqxmd.com/read/28288840/additive-endoscopic-resection-may-be-sufficient-for-the-patients-with-positive-lateral-margin-after-endoscopic-resection-of-early-gastric-cancer
#2
Hae Won Kim, Jie-Hyun Kim, Jun Chul Park, Mi Young Jeon, Yong Chan Lee, Sang Kil Lee, Sung Kwan Shin, Hyun Soo Chung, Sung Hoon Noh, Jong Won Kim, Seung Ho Choi, Jae Jun Park, Young Hoon Youn, Hyojin Park
BACKGROUNDS AND AIM: No well-established treatment strategies exist for lateral margin positivity (LM+) alone after endoscopic resection (ER) of early gastric cancer (EGC). Thus, we aimed to clarify treatment strategy of non-curative resection (non-CR) with LM + alone after ER in EGC. METHODS: Among 2,065 patients with EGC treated by ER, 76 (3.6%) exhibiting only LM+ after non-CR of EGC were reviewed retrospectively. Of these, 28 underwent gastrectomy, 25 argon plasma coagulation (APC), and 23 re-ER...
March 10, 2017: Gastrointestinal Endoscopy
https://www.readbyqxmd.com/read/28279465/the-asian-perspective-on-the-surgical-and-adjuvant-management-of-esophagogastric-cancer
#3
REVIEW
Yukinori Kurokawa, Mitsuru Sasako
In East Asia, D2 dissection has been routine surgical procedure for curable advanced gastric cancer. More extended surgery than D2 is reserved for borderline resectable disease with extended nodal metastasis. The addition of radiation therapy to adjuvant chemotherapy failed to improve the outcome after D2 dissection. Because many patients are diagnosed in East Asia with early-stage disease, postoperative adjuvant chemotherapy is preferred, and S-1 monotherapy or capecitabine-oxaliplatin is standard care. Neoadjuvant chemotherapy may be preferred for stage III tumors; for borderline resectable tumors, preoperative chemotherapy is under study given the limitations of postoperative adjuvant chemotherapy in high-risk patients...
April 2017: Surgical Oncology Clinics of North America
https://www.readbyqxmd.com/read/28247105/neoadjuvant-chemotherapy-for-gastric-adenocarcinoma-in-japan
#4
REVIEW
Yasuhiro Kodera
Surgery had been and remains a mainstay in the treatment of gastric cancer. The Japanese surgical oncologists employed surgery-first approach to treat gastric cancer because of the widespread use of D2 lymph node dissection and the high incidence of oncologically resectable cancer, and early attempts at the multimodality treatment strategy featured surgery followed by postoperative chemotherapy. Although evidence to treat Stage II/III gastric cancer with this strategy is now abundant in the Far East, poor compliance of the post-gastrectomy patients to intense combination chemotherapies has been a limitation associated with this strategy...
February 28, 2017: Surgery Today
https://www.readbyqxmd.com/read/28246501/how-do-surgical-stress-and-low-perioperative-serum-protein-and-albumin-impact-upon-short-term-morbidity-and-mortality-in-gastric-cancer-surgery
#5
Alexandru Munteanu, Doru Munteanu, Stefan Tigan, Adrian Bartos, Cornel Iancu
BACKGROUND: Patients undergoing surgery for gastric cancer may be expected to develop a certain range of postoperative complications. This retrospective cohort study determined if gauging the serum value of total proteins and albumins before and especially after surgery can predict an undesired short term outcome in patients with gastric resections for cancer, as we have not found studies debating the link between low postoperative total proteins or albumins and early postoperative morbidity...
2017: Clujul Medical (1957)
https://www.readbyqxmd.com/read/28241187/mismatch-repair-deficiency-microsatellite-instability-and-survival-an-exploratory-analysis-of-the-medical-research-council-adjuvant-gastric-infusional-chemotherapy-magic-trial
#6
Elizabeth C Smyth, Andrew Wotherspoon, Clare Peckitt, David Gonzalez, Sanna Hulkki-Wilson, Zakaria Eltahir, Matteo Fassan, Massimo Rugge, Nicola Valeri, Alicia Okines, Madeleine Hewish, William Allum, Sally Stenning, Matthew Nankivell, Ruth Langley, David Cunningham
Importance: Mismatch repair (MMR) deficiency (MMRD) and microsatellite instability (MSI) are prognostic for survival in many cancers and for resistance to fluoropyrimidines in early colon cancer. However, the effect of MMRD and MSI in curatively resected gastric cancer treated with perioperative chemotherapy is unknown. Objective: To examine the association among MMRD, MSI, and survival in patients with resectable gastroesophageal cancer randomized to surgery alone or perioperative epirubicin, cisplatin, and fluorouracil chemotherapy in the Medical Research Council Adjuvant Gastric Infusional Chemotherapy (MAGIC) trial...
February 23, 2017: JAMA Oncology
https://www.readbyqxmd.com/read/28226358/-laparoscopic-segmental-gastrectomy-for-early-gastric-cancer
#7
Lai Xu, Beizhan Niu, Xiyu Sun, Menghua Dai, Yi Xiao
OBJECTIVE: To investigate the feasibility of segmental pylorus-reservation gastrectomy in patients with early gastric cancer. METHOD: A retrospective cohort study on clinical data of 6 patients strictly met the criteria of early gastric cancer locating in the middle of the stomach undergoing laparoscopic segmental gastrectomy from January 2014 to April 2016 at Department of General Surgery, Peking Union Medical College Hospital was carried out. Preoperative clinical staging revealed T1N0M0 for all the cases...
February 25, 2017: Zhonghua Wei Chang Wai Ke za Zhi, Chinese Journal of Gastrointestinal Surgery
https://www.readbyqxmd.com/read/28226350/-value-of-endoscopy-application-in-the-management-of-complications-after-radical-gastrectomy-for-gastric-cancer
#8
Yiqun Zhang, Pinghong Zhou
Endoscopy plays an important role in the diagnosis and treatment of postoperative complications of gastric cancer. Endoscopic intervention can avoid the second operation and has attracted wide attention. Early gastric anastomotic bleeding after gastrectomy is the most common. With the development of technology, emergency endoscopy and endoscopic hemostasis provide a new treatment approach. According to the specific circumstances, endoscopists can choose metal clamp to stop bleeding, electrocoagulation hemostasis, local injection of epinephrine or sclerotherapy agents, and spraying specific hemostatic agents...
February 25, 2017: Zhonghua Wei Chang Wai Ke za Zhi, Chinese Journal of Gastrointestinal Surgery
https://www.readbyqxmd.com/read/28226349/-prevention-and-treatment-of-complications-related-to-the-digestive-tract-reconstruction-in-laparoscopic-gastric-cancer-surgery
#9
Junsheng Peng, Shi Chen
With the development of laparoscopic techniques and equipments, laparoscopic-assisted, even total laparoscopic radical surgery for gastric cancer can be performed successfully. However, the incidence of postoperative complications is higher in the laparoscopy group as compared to the open-surgery group, which is still the barrier for the total laparoscopic radical gastrectomy. Similar to open surgery, the major complications of digestive tract reconstruction after laparoscopic radical gastrectomy are anastomotic leakage, anastomotic bleeding, anastomotic stricture and stenosis of input or output loop...
February 25, 2017: Zhonghua Wei Chang Wai Ke za Zhi, Chinese Journal of Gastrointestinal Surgery
https://www.readbyqxmd.com/read/28226347/-prevention-and-treatment-for-complications-in-the-application-of-new-technology-for-stomach-cancers
#10
Xiangqian Su, Chuanyong Zhou, Hong Yang
With the rapid advancement of minimally invasive new technology, laparoscopic surgery and robotic surgery are now regarded as the main direction in surgical treatment for stomach cancers. Recent evidence has confirmed the safety and feasibility of laparoscopic surgery for early gastric cancer and advanced gastric cancer. However, gastrointestinal surgeons should pay more attention to complications after laparoscopic gastrectomy because of rich blood supply, complex tissue layers and lymph node metastasis. Common complications related to laparoscopic surgery are associated with laparoscopic instruments and operating, intra-abdominal bleeding, anastomotic leakage, anastomotic bleeding, pancreatic leakage, duodenal stump leakage, lymphatic leakage and so on...
February 25, 2017: Zhonghua Wei Chang Wai Ke za Zhi, Chinese Journal of Gastrointestinal Surgery
https://www.readbyqxmd.com/read/28226342/-strategies-for-prevention-and-treatment-of-postoperative-complications-of-gastric-cancer
#11
Xinyu Qin, Hongshan Wang, Yihong Sun
Postoperative complications after gastric cancer surgery has their own specificity and complexity, and the strategies for prevention and treatment should be of equal emphasis on both theory and technology. Based on the knowledge and familiarity with different postoperative complications, to efficiently prevent them, it is not only necessary to strengthen the training of acknowledged operative strategy, smooth and precise surgical techniques, but also to address the importance of overall preoperative assessment for patients, to treat the basic diseases, and to improve and correct their general conditions...
February 25, 2017: Zhonghua Wei Chang Wai Ke za Zhi, Chinese Journal of Gastrointestinal Surgery
https://www.readbyqxmd.com/read/28226330/nutritional-recovery-after-open-and-laparoscopic-distal-gastrectomy-for-early-gastric-cancer-a-prospective-multicenter-comparative-trial-ccog1204
#12
Hidenobu Matsushita, Chie Tanaka, Kenta Murotani, Kazunari Misawa, Seiji Ito, Yuichi Ito, Mitsuro Kanda, Yoshinari Mochizuki, Kiyoshi Ishigure, Toyohisa Yaguchi, Jin Teramoto, Hiroshi Nakayama, Yoshihisa Kawase, Michitaka Fujiwara, Yasuhiro Kodera
BACKGROUND: Little information from prospective clinical trials is available on the influences of surgical approaches on postoperative body compositions and nutritional status. We designed a prospective non-randomized trial to compare postoperative chronological changes in body composition and nutritional status between laparoscopic and open distal gastrectomy for stage I gastric cancer (GC). METHODS: Body compositions and nutritional indicators in blood tests were measured at the baseline and at the 1st, 3rd, 6th, and 12th postoperative months (POM)...
February 23, 2017: Digestive Surgery
https://www.readbyqxmd.com/read/28217755/lymphadenectomy-in-elderly-high-risk-patients-should-it-be-different
#13
REVIEW
Laura Ruspi, Federica Galli, Vincenzo Pappalardo, Davide Inversini, Francesco Martignoni, Luigi Boni, Gianlorenzo Dionigi, Stefano Rausei
The global aging of population will lead a greater number of elderly patients to undergo surgical procedure in a near future. Concerning gastric cancer, the impact of lymphadenectomy on survival has been demonstrated in RCTs, and extended lymphadenectomy is now considered as gold standard of treatment in non-early tumors. However, the role of age as a prognostic factor and the benefit of extended surgery in elderly/high-risk patients are not clearly defined yet. From our revision of literature, it seems that surgery for gastric cancer may have a further tailorization, considering not only the stage of disease, but also patients' age and comorbidities...
2017: Transl Gastroenterol Hepatol
https://www.readbyqxmd.com/read/28210705/gastric-esd-may-be-useful-as-accurate-staging-and-decision-of-future-therapeutic-strategy
#14
Ai Fujimoto, Osamu Goto, Toshihiro Nishizawa, Yasutoshi Ochiai, Joichiro Horii, Tadateru Maehata, Teppei Akimoto, Satoshi Kinoshita, Seiji Sagara, Motoki Sasaki, Toshio Uraoka, Naohisa Yahagi
Background and study aims We sometimes perform gastric endoscopic submucosal dissection (ESD) for total pathologic diagnosis when preoperative diagnosis is difficult. In the present study we analyzed the treatment outcomes and adverse events of diagnostic ESD for early gastric cancer (EGC). Patients and methods We conducted a retrospective analysis of 18 consecutive cases of EGC in 18 patients with a suspected out-of-indication diagnosis who underwent diagnostic ESD, between June 2010 and November 2014...
February 2017: Endoscopy International Open
https://www.readbyqxmd.com/read/28206972/circular-rnas-signature-predicts-the-early-recurrence-of-stage-iii-gastric-cancer-after-radical-surgery
#15
Yan Zhang, Jin Li, Jiang Yu, Hao Liu, Zhiyong Shen, Gentai Ye, Tingyu Mou, Xiaolong Qi, Guoxin Li
Tumor recurrence is usually detected within one year after radical resection of stage III gastric cancer. This study aimed to establish the expression profile and determine potential circular RNAs (circRNAs) and predict the early recurrence of stage III gastric cancer. We identified 46 differently expressed circRNAs between cancer and adjacent normal tissues through circRNA microarray. We further screened eight indicators related to early recurrence. We subsequently divided the remaining cases into two cohorts...
February 11, 2017: Oncotarget
https://www.readbyqxmd.com/read/28205030/safety-and-feasibility-of-reduced-port-robotic-distal-gastrectomy-for-gastric-cancer-a-phase-i-ii-clinical-trial
#16
Seungho Lee, Jin Kyong Kim, Youn Nam Kim, Dong-Su Jang, Yoo Min Kim, Taeil Son, Woo Jin Hyung, Hyoung-Il Kim
INTRODUCTION: Theoretically, reducing the number of ports required in minimally invasive surgery for gastric cancer would further minimize trauma associated therewith. Advances in single-site surgery have afforded surgeons the ability to perform reduced-port distal gastrectomy via a robotic approach using the Single-Site™ system, eliminating restrictions on the movement of surgical instruments. METHODS: This phase I/II study was designed as a single-arm prospective trial of reduced-port robotic distal gastrectomy (RRDG) by a single surgeon (NCT02347956)...
February 15, 2017: Surgical Endoscopy
https://www.readbyqxmd.com/read/28203132/modified-devine-exclusion-for-unresectable-distal-gastric-cancer-in-symptomatic-patients
#17
María Carmen Fernández-Moreno, Roberto Martí-Obiol, Fernando López, Joaquín Ortega
BACKGROUND: In patients with outlet obstruction syndrome and/or severe anemia secondary to unresectable gastric cancer (GC), partial stomach-partitioning gastrojejunostomy, or modified Devine exclusion, is a surgical alternative. METHODS: A retrospective study was conducted on patients with unresectable distal GC treated with modified Devine exclusion as palliative surgery between February 2005 and December 2015. It consisted of a series of 10 patients with outlet obstruction syndrome and/or severe anemia...
January 2017: Case Reports in Gastroenterology
https://www.readbyqxmd.com/read/28197897/middle-segment-preserving-pancreatectomy-for-metachronous-intraductal-papillary-mucinous-neoplasm-after-pancreatoduodenectomy-a-case-report
#18
Mihoko Yamada, Teiichi Sugiura, Yukiyasu Okamura, Takaaki Ito, Yusuke Yamamoto, Ryo Ashida, Katsuhiko Uesaka
Total pancreatectomy has occasionally been performed to treat patients with multiple lesions (such as intraductal papillary mucinous neoplasm (IPMN)) or patients who have undergone repeated pancreatic resection. However, deficiencies of the exocrine and endocrine functions worsen patients' quality of life. Recently, there have been several case reports citing middle segment-preserving pancreatectomy (MSPP) as a safe procedure and beneficial with respect to preservation of the exocrine and endocrine functions...
December 2017: Surgical Case Reports
https://www.readbyqxmd.com/read/28194522/a-prospective-multi-institutional-validity-study-to-evaluate-the-accuracy-of-clinical-diagnosis-of-pathological-stage-iii-gastric-cancer-jcog1302a
#19
Takeo Fukagawa, Hitoshi Katai, Junki Mizusawa, Kenichi Nakamura, Takeshi Sano, Masanori Terashima, Seiji Ito, Takaki Yoshikawa, Norimasa Fukushima, Yasuyuki Kawachi, Takahiro Kinoshita, Yutaka Kimura, Hiroshi Yabusaki, Yasunori Nishida, Yoshiaki Iwasaki, Sang-Woong Lee, Takashi Yasuda, Mitsuru Sasako
BACKGROUND: Neoadjuvant chemotherapy (NAC) followed by radical surgery is a promising strategy to improve survival of patients with stage III gastric cancer, but is associated with the risk of preoperative overdiagnosis by which patients with early disease may receive unnecessary intensive chemotherapy. METHODS: We assessed the validity of a preoperative diagnostic criterion in a prospective multicenter study. Patients with gastric cancer with a clinical diagnosis of T2/T3/T4, M0, except for diffuse large tumors and extensive bulky nodal disease, were eligible...
February 13, 2017: Gastric Cancer
https://www.readbyqxmd.com/read/28185027/safety-and-feasibility-of-minimally-invasive-gastrectomy-during-the-early-introduction-in-the-netherlands-short-term-oncological-outcomes-comparable-to-open-gastrectomy
#20
H J F Brenkman, J P Ruurda, R H A Verhoeven, R van Hillegersberg
BACKGROUND: Minimally invasive techniques for gastric cancer surgery have recently been introduced in the Netherlands, based on a proctoring program. The aim of this population-based cohort study was to evaluate the short-term oncological outcomes of minimally invasive gastrectomy (MIG) during its introduction in the Netherlands. METHODS: The Netherlands Cancer Registry identified all patients with gastric adenocarcinoma who underwent gastrectomy with curative intent between 2010 and 2014...
February 9, 2017: Gastric Cancer
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