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Total gastrectomy

Vivian E Strong, Sepideh Gholami, Manish A Shah, Laura H Tang, Yelena Y Janjigian, Mark Schattner, Luke V Selby, Sam S Yoon, Erin Salo-Mullen, Zsofia K Stadler, David Kelsen, Murray F Brennan, Daniel G Coit
OBJECTIVE: The aim of this study was to describe postoperative outcomes of total gastrectomy at our institution for patients with hereditary diffuse gastric cancer (HDGC). BACKGROUND: HDGC, which is mainly caused by germline mutations in the E-cadherin gene (CDH1), renders a lifetime risk of gastric cancer of up to 70%, prompting a recommendation for prophylactic total gastrectomy. METHODS: A prospective gastric cancer database identified 41 patients with CDH1 mutation who underwent total gastrectomy during 2005 to 2015...
October 17, 2016: Annals of Surgery
Jennifer Muir, Melyssa Aronson, Mary-Jane Esplen, Aaron Pollett, Carol J Swallow
BACKGROUND: Hereditary diffuse gastric cancer (HDGC) syndrome is caused by germline mutations in the CDH1 gene and carries a lifetime gastric cancer risk of approximately 70 % in men and 56 % in women. Current consensus guidelines recommend that people of age ≥20 who harbor a CDH1 mutation undergo prophylactic total gastrectomy (PTG). However, the decision to proceed with a major visceral resection for prophylactic reasons may be difficult, especially since long-term outcomes are not well defined...
October 17, 2016: Journal of Gastrointestinal Surgery: Official Journal of the Society for Surgery of the Alimentary Tract
Chang Min Lee, Da Won Park, Do Hyun Jung, You Jin Jang, Jong-Han Kim, Sungsoo Park, Seong-Heum Park
In Korea, proximal gastrectomy has recently attracted attention as a better choice of function-preserving surgery for proximal early gastric cancer than total gastrectomy. Of the various strategies to overcome reflux symptoms from remnant stomach, double tract reconstruction not only reduces the incidence of anastomosis-related complications, but is also sufficiently reproducible as a laparoscopic procedure. Catching up with the recent rise of single-port laparoscopic surgeries, we performed a pure single-port laparoscopic proximal gastrectomy with DTR...
September 2016: Journal of Gastric Cancer
Sunghwan Kim, Jeongmin Choi, Tae Han Kim, Seong-Ho Kong, Yun-Suhk Suh, Jong Pil Im, Hyuk-Joon Lee, Sang Gyun Kim, Seung-Yong Jeong, Joo Sung Kim, Han-Kwang Yang
PURPOSE: The purpose of this study was to determine the effect of a prior gastrectomy on the difficulty of subsequent colonoscopy, and to identify the surgical factors related to difficult colonoscopies. MATERIALS AND METHODS: Patients with a prior gastrectomy who had undergone a colonoscopy between 2011 and 2014 (n=482) were matched (1:6) to patients with no history of gastrectomy (n=2,892). Cecal insertion time, intubation failure, and bowel clearance score were compared between the gastrectomy and control groups, as was a newly generated comprehensive parameter for a difficult/incomplete colonoscopy (cecal intubation failure, cecal insertion time >12...
September 2016: Journal of Gastric Cancer
Lucy Chen, Lisa Liberatore, Tom Chin, Scott Walker, Helen Fanous, Michelle M Nash, Lindita Rapi, Jennie Huckle, Jeffrey S Zaltzman, G V Ramesh Prasad
BACKGROUND: Ensuring reliable gastrointestinal drug absorption of orally-administered immunosuppressive medications posttransplant is critical to ensuring graft survival. METHODS: A 66 year old man of East Asian origin with a previous total gastrectomy was evaluated for living donor kidney transplantation. Pretransplant pharmacokinetic testing was performed to determine the most appropriate posttransplant medication strategy. The Gastrointestinal Quality of Life Index and Gastrointestinal Rating Scale questionnaires were administered to gauge immunosuppressive medication-related side effects in the absence of a stomach...
September 29, 2016: Transplantation
Na Wang, Honglan Zhou, Xuesong Song, Jinguo Wang
BACKGROUND: Sufentanil is widely used for patient-controlled intravenous analgesia (PCIA). Oxycodone has a powerful analgesic effect and mild side effects. We conducted this study to compare the efficacy of oxycodone and sufentanil for PCIA on postoperative pain after laparoscopic radical gastrectomy. METHODOLOGY: A total of fifty patients scheduled for laparoscopic radical gastrectomy were equally randomized to receive postoperative pain treatment with either oxycodone (Group O) or sufentanil (Group S) for 48 h postoperatively...
September 2016: Anesthesia, Essays and Researches
Jia-Bin Wang, Chao-Hui Zheng, Ping Li, Jian-Wei Xie, Jian-Xian Lin, Jun Lu, Qi-Yue Chen, Long-Long Cao, Mi Lin, Chang-Ming Huang
BACKGROUND: Comorbidity is a predictor of postoperative complications in gastrectomy. However, it remains unclear which comorbidities are predictors of postoperative complications in gastric cancer patients who have undergone laparoscopy-assisted total gastrectomy (LATG). The purpose of this study was to evaluate the effect of comorbidities on the surgical outcomes of patients with gastric cancer after LATG. METHODS: We retrospectively collected data on 1657 gastric cancer patients who underwent LATG between January 2008 and December 2015...
October 14, 2016: Surgical Endoscopy
Siva T Gounder, Delendra Rasith Wijayanayaka, Rinki Murphy, Delwyn Armstrong, Richard G Cutfield, David Dw Kim, Michael Graham Clarke, Nicholas J Evennett, Martyn Lee Humphreys, Steven John Robinson, Michael Wc Booth
AIM: To provide a longitudinal analysis of the direct healthcare costs of providing laparoscopic sleeve gastrectomy (LSG) and laparoscopic Roux-en-Y gastric bypass (LRYGB) surgery service in the context of a randomised control trial (RCT) of obese patients with type 2 diabetes in Waitemata District Health Board, Auckland, New Zealand. METHODS: The Waitemata District Health Board costing system was used to calculate costs in New Zealand Dollars (NZD) associated with all pre- and post-operative hospital clinic visits, peri-operative care, hospitalisations and medication costs up to one year after bariatric surgery...
October 14, 2016: New Zealand Medical Journal
Eun Young Kim, Hyun Woo Yim, Cho Hyun Park, Kyo Young Song
BACKGROUND: The clinical outcomes for postoperative complications (PCs) after gastrectomy depend on early diagnosis and intensive treatment. The aim of this study was to investigate the role of C-reactive protein (CRP) as an early predictor of PCs after gastrectomy for gastric cancer. METHODS: A total of 334 consecutive patients who underwent gastrectomy for gastric cancer in 2014 were enrolled in this study. Blood samples were obtained preoperatively, and at postoperative days 1 and 4 for the measurement of inflammatory markers (white blood cell, neutrophil, and platelet counts, and CRP)...
October 12, 2016: Surgical Endoscopy
Qi-Yue Chen, Chang-Ming Huang, Chao-Hui Zheng, Ping Li, Jian-Wei Xie, Jia-Bin Wang, Jian-Xian Lin, Jun Lu, Long-Long Cao, Mi Lin, Ru-Hong Tu
BACKGROUND: To investigate the long-term outcome of laparoscopic radical gastrectomy (LAG) for gastric cancer (GC) with preoperative enlarged lymph nodes (LNs). METHODS: We retrospectively collected data on 855 patients who underwent LAG for GC. The patients were divided into large (>10 mm) and small (≤10 mm) LN groups (LG and SG) based on the preoperative size of the LNs. The outcomes were compared using a 1:1 propensity score-matching method. The enlarged LNs were divided into five areas according to their location...
October 9, 2016: Oncotarget
Małgorzata Szczuko, Natalia Komorniak, Monika Hoffmann, Joanna Walczak, Agata Jaroszek, Bartosz Kowalewski, Krzysztof Kaseja, Dominika Jamioł-Milc, Ewa Stachowska
BACKGROUND: The aim of this study was to evaluate the effect of sleeve gastrectomy (SG) and Roux-en-Y-bypass (RYGB) on anthropometric and biochemical parameters, including changes in glucose levels, lipid profile and liver function. Drastic decrease in all lipid fractions a few weeks or months after the surgery could be regarded as favourable, but low level of HDL is an independent risk factor for heart diseases. Extreme load on the liver without preparation of the patient to the surgery can have negative consequences...
October 11, 2016: Obesity Surgery
Dooin Lee, Jae Hoon Lee, Dongho Choi, Chang Moo Kang, Jae Uk Chong, Song-Chul Kim, Kyeong Geun Lee
BACKGROUND: Stomach cancer is the second most commonly diagnosed cancer in Korea. Although the long-term survival outcome has improved, secondary primary tumors from periampullary regions are increasing inevitably and pancreaticoduodenectomy (PD) following gastrectomy is challenging. This study evaluates the surgical outcomes of PD following gastrectomy and suggests the optimum method for reconstruction. METHODS: Patients who underwent curative PD with a history of gastric resection between 2005 and 2015 were assessed retrospectively...
October 11, 2016: World Journal of Surgery
Fady Saleh, Aristithes G Doumouras, Scott Gmora, Mehran Anvari, Dennis Hong
BACKGROUND: Bariatric surgery centres of excellence are relatively new in Canada and were first started in Ontario in 2009. This study presents short-term outcomes of Canada's largest bariatric collaborative, from Ontario, during its first 3 years. METHODS: We performed a population-based cohort study that included all patients (age ≥ 18) who received a Roux-en-Y gastric bypass or sleeve gastrectomy for the purpose of weight loss from March 2009 to April 2012 within Ontario...
July 2016: CMAJ Open
Chang Ho Hwang, Dong Jin Park, Gyu Yeol Kim
A 58-year-old woman, who had undergone total gastrectomy for early gastric cancer 9 years previously, visited the outpatient clinic complaining of progressive difficulty in walking for 15 d. Laboratory examinations showed macrocytic anemia and a decreased serum vitamin B12 concentration and increased serum concentrations of folate, vitamin E and copper. Magnetic resonance imaging showed multifocal high signal intensities along the posterior column of the cervical and thoracic spinal cord. Treatment consisted of intramuscular injections of vitamin B12 for 7 d, which increased her serum level of vitamin B12 to normal...
October 7, 2016: World Journal of Gastroenterology: WJG
Patchaya Boonchaya-Anant, Nitchakarn Laichuthai, Preaw Suwannasrisuk, Natnicha Houngngam, Suthep Udomsawaengsup, Thiti Snabboon
Objective. Obesity is a risk factor for hypogonadotropic hypogonadism in men. Weight loss has been shown to improve hypogonadism in obese men. This study evaluated the early changes in sex hormones profile after bariatric surgery. Methods. This is a prospective study including 29 morbidly obese men. Main outcomes were changes in serum levels of total testosterone (TT), free testosterone (cFT), SHBG, estradiol, adiponectin, and leptin at 1 and 6 months after surgery. Results. The mean age of patients was 31 ± 8 years and the mean BMI was 56...
2016: International Journal of Endocrinology
Haruhisa Suzuki, Ichiro Oda, Seiichiro Abe, Masau Sekiguchi, Satoru Nonaka, Shigetaka Yoshinaga, Yutaka Saito, Takeo Fukagawa, Hitoshi Katai
BACKGROUND: Clinical outcomes of early gastric cancer (EGC) patients after noncurative endoscopic submucosal dissection (ESD) have not been fully elucidated; we therefore aimed to clarify these outcomes. METHODS: A total of 3058 consecutive patients with 3474 clinically diagnosed EGCs at initial onset underwent ESD with curative intent at our hospital between 1999 and 2010. We retrospectively assessed the following clinical outcomes of noncurative gastric ESD patients with a possible risk of lymph node (LN) metastasis by dividing patients into two groups with different treatment strategies (additional gastrectomy and simple follow-up): presence of LN metastasis at the time of gastrectomy, incidence of LN and distant metastases during the follow-up period, clinicopathological factors associated with metastasis, and 5-year disease-specific survival (DSS)...
October 8, 2016: Gastric Cancer
Zensho Ito, Mikio Kajihara, Yasunobu Kobayashi, Tomoya Kanai, Yoshihiro Matsumoto, Kazuki Takakura, Toyokazu Yukawa, Toshifumi Ohkusa, Seita Koyama, Hiroo Imazu, Hiroshi Arakawa, Mitsuru Ohata, Shigeo Koido
Primary hepatic angiosarcoma is a very rare malignancy with a poor prognosis. Because patients present with no specific symptoms, the cancer can grow undetected and most cases are diagnosed too late for resection. We present the case of a 78-year-old Japanese man admitted to our hospital with massive hematemesis and melena. A total gastrectomy had previously been performed on the patient to treat gastric cancer. Endoscopic injection sclerotherapy was performed to control the bleeding from varices over the anastomosis...
May 2016: Case Reports in Gastroenterology
Yongzheng Xie, Fangjun Li, Xuequn Ren
OBJECTIVE: This study aims to explore the application value of sentinel lymph node (SLN) biopsy in patients with Stage II advanced gastric cancer and its effects on prognosis. MATERIALS AND METHODS: A total of 43 patients with Stage II gastric cancer (experimental group) admitted to our department from March 2011 to February 2013 underwent radical operation using SLN biopsy, and 51 patients with gastric cancer D2 (the control group) received conventional radical operation...
October 2016: Journal of Cancer Research and Therapeutics
Xiao Du, Hong-Xu Zhou, Si-Qin Zhang, Hao-Ming Tian, Zong-Guang Zhou, Zhong Cheng
BACKGROUND: The metabolic effects of laparoscopic sleeve gastrectomy (LSG) and laparoscopic Roux-en-Y gastric bypass (LRYGB) in type 2 diabetes (T2D) patients who do not meet National Institutes of Health indications has not been well studied. OBJECTIVES: To compare the effectiveness of LSG and LRYGB in Chinese T2D patients with body mass index (BMI)<35 kg/m(2). SETTING: University hospital, China. METHODS: A nonrandomized cohort of patients who underwent LRYGB (n = 64) and LSG (n = 19) were followed up for 3 years and the outcomes (weight loss and remission of diabetes and other metabolic parameters) were compared...
August 31, 2016: Surgery for Obesity and related Diseases: Official Journal of the American Society for Bariatric Surgery
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
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