909 results on '"Gastric resection"'
Search Results
2. Quality of Life Following the Surgical Management of Gastric Cancer Using Patient-Reported Outcomes: A Systematic Review.
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Vallance, Patrick Cullen, Mack, Lloyd, Bouchard-Fortier, Antoine, and Jost, Evan
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STOMACH cancer , *PATIENT reported outcome measures , *QUALITY of life , *GASTRECTOMY , *DATA extraction , *GASTRIC bypass - Abstract
Introduction: Surgical management of gastric adenocarcinoma can have a drastic impact on a patient's quality of life (QoL). There is high variability among surgeons' preferences for the type of resection and reconstructive method. Peri-operative and cancer-specific outcomes remain equivalent between the different approaches. Therefore, postoperative quality of life can be viewed as a deciding factor for the surgical approach. The goal of this study was to interrogate patient QoL using patient-reported outcomes (PROs) following gastrectomy for gastric cancer. Methods: This systematic review was registered at Prospero and followed PRISMA guidelines. Medline, Embase, and Scopus were used to perform a literature search on 18 January 2020. A set of selection criteria and the data extraction sheet were predefined. Covidence (Melbourne, Australia) software was used; two reviewers (P.C.V. and E.J.) independently reviewed the articles, and a third resolved conflicts (A.B.F.). Results: The search yielded 1446 studies; 308 articles underwent full-text review. Ultimately, 28 studies were included for qualitative analysis, including 4630 patients. Significant heterogeneity existed between the studies. Geography was predominately East Asian (22/28 articles). While all aspects of quality of life were found to be affected by a gastrectomy, most functional or symptom-specific measures reached baseline by 6–12 months. The most significant ongoing symptoms were reflux, diarrhoea, and nausea/vomiting. Discussion: Generally, patients who undergo a gastrectomy return to baseline QoL by one year, regardless of the type of surgery or reconstruction. A subtotal distal gastrectomy is preferred when proper oncologic margins can be obtained. Additionally, no one form of reconstruction following gastrectomy is statistically preferred over another. However, for subtotal distal gastrectomy, there was a trend toward Roux-en-Y reconstruction as superior to abating reflux. [ABSTRACT FROM AUTHOR]
- Published
- 2024
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3. Classification of GIST and other benign gastric tumors based on minimally invasive surgical strategy.
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Morales-Conde, Salvador, Socas, María, Alarcón, Isaias, Senent-Boza, Ana, Domínguez Mezquita, Blanca, and Balla, Andrea
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BENIGN tumors , *GASTROINTESTINAL tumors , *CLASSIFICATION , *PENIS curvatures , *OPERATIVE surgery , *GASTROINTESTINAL stromal tumors , *GASTROPARESIS - Abstract
Purpose: Gastrointestinal mesenchymal tumors (GMTs) include malignant, intermediate malignancy, and benign lesions. The aim is to propose a new surgical classification to guide the intraoperative minimally invasive surgical strategy in case of non-malignant GMTs less than 5 cm. Methods: Primary endpoint is the creation of a classification regarding minimally invasive surgical technique for these tumors based on their gastric location. Secondary endpoint is to analyze the R0 rate and the postoperative morbidity and mortality rates. Tumors were classified in two groups based on their morphology (group A: exophytic, group B: transmural/intragastric). Each group is then divided based on the tumor location and consequently surgical technique used in subgroup: AI (whole stomach area) and AII (iuxta-cardial and pre-pyloric areas) both for the anterior and posterior gastric wall; BIa (greater curvature on the anterior and posterior wall), BIb (lesser curvature on the anterior wall); BII (iuxta-cardial and pre-pyloric area in the anterior and posterior wall, including the lesser curvature on the posterior wall). Results: Forty-two patients were classified and allocated in each subgroup: 17 in AI, 2 in AII, 5 in BIa, 3 in BIb, and 15 in BII. Two postoperative Clavien-Dindo I complications (4.8%, subgroup BIa and BIb) occurred. One patient (2.4%, subgroup AI) underwent reintervention due to R0 resection. Conclusions: This classification proved to be able to classify gastric lesions based on their morphology, location, and surgical treatment, obtaining encouraging perioperative results. Further studies with wider sample of patients are required to draw definitive conclusions. [ABSTRACT FROM AUTHOR]
- Published
- 2023
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4. Classification of GIST and other benign gastric tumors based on minimally invasive surgical strategy
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Morales-Conde, Salvador, Socas, María, Alarcón, Isaias, Senent-Boza, Ana, Domínguez Mezquita, Blanca, and Balla, Andrea
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- 2024
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5. Geometric modification of Billroth-II gastric resection with computational fluid dynamics (CFD) method: assessment of anastomotic leak and duodenogastric reflux risks
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Pirhan, Yavuz, Uğur, Levent, and Kurşun, Burak
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- 2024
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6. Distal Gastrectomy with D2 Nodal Dissection
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Hoshi, Hisakazu, Scott-Conner, Carol E. H., editor, Kaiser, Andreas M., editor, Nguyen, Ninh T., editor, Sarpel, Umut, editor, and Sugg, Sonia L., editor
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- 2022
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7. Routine postoperative nasogastric or nasojejunal tube placement may be unnecessary after gastric resection.
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Alemdar, Ali and Yeşiltaş, Metin
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GASTRECTOMY , *NASOENTERAL tubes , *POSTOPERATIVE care , *SURGICAL complications , *HISTOPATHOLOGY , *ADENOCARCINOMA - Abstract
Objectives: The purpose of this study was to investigate the effects of not using routine nasogastric (NG) or nasojejunal (NJ) tubes on postoperative complications in gastric cancer patients undergoing resection. Methods: This study includes 250 patients who underwent gastric resection diagnosed with gastric adenocarcinoma between November 2011 and December 2021. The patients were divided into two groups: those who routinely use NG or NJ tube in the early postoperative period and those who do not. Postoperative complications and length of hospital stay were compared between the two groups. Results: Demographic, surgical, and histopathological characteristics were similar between the two groups. Oral feeding was started earlier in the non- NG or NJ tube group. There was no difference between the two groups regarding the length of hospital stay (p = 0.065). Severe postoperative complications (Clavien Dindo ≥ 3) were significantly lower in patients who did not use a nasogastric or nasojejunal tube (p = 0.001). Two patients in the NG/NJ tube group and one in the non-NG/NJ tube group developed anastomotic leakage. Conclusions: According to the results of our study, routine NG or NJ tube use does not reduce postoperative severe complications or length of hospital stay. [ABSTRACT FROM AUTHOR]
- Published
- 2023
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8. 胃癌胃切除术后维生素B12 缺乏与补充的研究进展.
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韩菲 and 朱华
- Abstract
Copyright of Practical Pharmacy & Clinical Remedies is the property of Editorial Department of Practical Pharmacy & Clinical Remedies and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)
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- 2023
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9. Gastric Tissue Stapler Comparison Study
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- 2020
10. Safety and Efficacy of Simultaneous Resection of Gastric Carcinoma and Synchronous Liver Metastasis—A Western Center Experience.
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Minciuna, Corina-Elena, Tudor, Stefan, Micu, Alexandru, Diaconescu, Andrei, Alexandrescu, Sorin Tiberiu, and Vasilescu, Catalin
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GASTRECTOMY ,LIVER metastasis ,STOMACH cancer ,LIVER surgery ,SURGICAL emergencies ,HEMORRHAGIC shock - Abstract
Background and objectives: Gastric cancer (GC) is often diagnosed in the metastatic stage. Palliative systemic therapy is still considered the gold standard, even for patients with resectable oligometastatic disease. The aim of the current study is to assess the potential benefit of up-front gastric and liver resection in patients with synchronous resectable liver-only metastases from GC (LMGC) in a Western population. Materials and Methods: All patients with GC and synchronous LMGC who underwent gastric resection with or without simultaneous resection of LMs between January 1997 and December 2016 were selected from the institutional records. Those with T4b primary tumors or with unresectable or more than three LMs were excluded from the analysis. All patients who underwent emergency surgery for hemorrhagic shock or gastric perforation were also excluded. Results: Out of 28 patients fulfilling the inclusion criteria, 16 underwent simultaneous gastric and liver resection (SR group), while 12 underwent palliative gastric resection (GR group). The median overall survival (OS) of the entire cohort was of 18.81 months, with 1-, 3- and 5-year OS rates of 71.4%, 17.9% and 14.3%, respectively. The 1-, 3- and 5-year OS rates in SR group (75%, 31.3% and 25%, respectively) were significantly higher than those achieved in GR group (66.7%, 0% and 0%, respectively; p = 0.004). Multivariate analysis of the entire cohort revealed that the only independent prognostic factor associated with better OS was liver resection (HR = 3.954, 95% CI: 1.542–10.139; p = 0.004). Conclusions: In a Western cohort, simultaneous resection of GC and LMGC significantly improved OS compared to patients who underwent palliative gastric resection. [ABSTRACT FROM AUTHOR]
- Published
- 2022
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11. Laparoscopic vs. Open Gastrectomy for Locally Advanced Gastric Cancer: A Propensity Score-Matched Retrospective Case-Control Study
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Stefano Caruso, Rosina Giudicissi, Martina Mariatti, Stefano Cantafio, Gian Matteo Paroli, and Marco Scatizzi
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gastric cancer ,gastric resection ,minimally invasive surgery ,laparoscopic gastrectomy ,open gastrectomy ,Neoplasms. Tumors. Oncology. Including cancer and carcinogens ,RC254-282 - Abstract
Introduction: Minimally invasive surgery has been increasingly used in the treatment of gastric cancer. While laparoscopic gastrectomy has become standard therapy for early-stage gastric cancer, especially in Asian countries, the use of minimally invasive techniques has not attained the same widespread acceptance for the treatment of more advanced tumours, principally due to existing concerns about its feasibility and oncological adequacy. We aimed to examine the safety and oncological effectiveness of laparoscopic technique with radical intent for the treatment of patients with locally advanced gastric cancer by comparing short-term surgical and oncologic outcomes of laparoscopic versus open gastrectomy with D2 lymphadenectomy at two Western regional institutions. Methods: The trial was designed as a retrospective comparative matched case-control study for postoperative pathological diagnoses of locally advanced gastric carcinoma. Between January 2015 and September 2021, 120 consecutive patients who underwent curative-intent laparoscopic gastrectomy with D2 lymph node dissection were retrospectively recruited and compared with 120 patients who received open gastrectomy. In order to obtain a comparison that was as homogeneous as possible, the equal control group of pairing (1:1) patients submitted to open gastrectomy who matched those of the laparoscopic group was statistically generated by using a propensity matched score method. The following potential confounder factors were aligned: age, gender, Body Mass Index (BMI), comorbidity, ASA, adjuvant therapy, tumour location, type of gastrectomy, and pT stage. Patient demographics, operative findings, pathologic characteristics, and short-term outcomes were analyzed. Results: In the case-control study, the two groups were clearly comparable with respect to matched variables, as was expected given the intentional primary selective criteria. No statistically significant differences were revealed in overall complications (16.7% vs. 20.8%, p = 0.489), rate of reoperation (3.3% vs. 2.5%, p = 0.714), and mortality (4.2% vs. 3.3%, p = 0.987) within 30 days. Pulmonary infection and wound complications were observed more frequently in the OG group (0.8% vs. 4.2%, p < 0.01, for each of these two categories). Anastomotic and duodenal stump leakage occurred in 5.8% of the patients after laparoscopic gastrectomy and in 3.3% after open procedure (p = 0.072). The laparoscopic approach was associated with a significantly longer operative time (212 vs. 192 min, p < 0.05) but shorter postoperative length of stay (9.1 vs. 11.6 days, p < 0.001). The mean number of resected lymph nodes after D2 dissection (31.4 vs. 33.3, p = 0.134) and clearance of surgical margins (97.5% vs. 95.8%, p = 0.432) were equivalent between the groups. Conclusion: Laparoscopic gastrectomy with D2 nodal dissection appears to be safe and feasible in terms of perioperative morbidity for locally advanced gastric cancer, with comparable oncological equivalency with respect to traditional open surgery.
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- 2022
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12. Evaluation of anemia as a postoperative risk factor in the evolution of patients with gastric resection for malignancies
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Bogdan Dumitriu, Sebastian Valcea, Gabriel Andrei, and Mircea Beuran
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anemia ,postoperative risk factors ,gastric resection ,gastric cancer ,Medicine - Abstract
Introduction. Gastric cancer remains among the top three digestive diseases with the highest mortality rates in the world. Treatment of gastric cancer is multidisciplinary, gastric resection being essential for the best result. Anemia is one of the most common comorbidities present in patients diagnosed with gastric cancer. Materials and Methods. This is a retrospective analytical study over a period of 6 years (2014-2019). It is based on 114 consecutive gastric resections for cancer performed by a single team using exclusively resection and reconstruction stapling methods. The study aims to investigate a correlation between the presence of preoperative anemia and the incidence of postoperative morbidity and mortality. Results. Preoperative anemia was found in 70% of patients, with about half of these patients presenting with mild anemia. Most postoperative complications were grade I and II according to the Clavien Dindo scale. Anemia was correlated with an increase in infectious complications, anastomotic leaks and secondary peritoneal abscesses, pancreatic complications after multivisceral resection and length of hospital stay. Conclusions. Preoperative anemia is a risk factor that exposes the cancer patient to an increased incidence of life-threatening postoperative complications. In addition, it also extends the length of hospital stay and costs. Therefore, special attention should be paid to the identification and reduction of anemia before extensive gastric surgery in order to obtain the best possible therapeutic result.
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- 2021
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13. SURGICAL TREATMENT OF ACUTE COMPLICATED DUODENAL ULCER.
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Maxim Bilyachenko, Kurbanov, Anton, and Povch, Oleg
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DUODENAL ulcers , *HEMORRHAGE , *ENDOSCOPY , *PALLIATIVE treatment , *HEMOSTASIS - Abstract
The aim. To analyze treatment approaches and tactics and improve acutely complicated duodenal ulcers (DU) treatment results. Materials and methods. The results of the analysis of the surgical treatment of acutely complicated duodenal ulcers (a combination of 3 and/or 4 combined complications) are presented for 2 periods: the 1st (2000-2014) years (group A) - 47 patients, the 2nd (2015-2021) years (group B) - 34 patients. Results. 81 (100 %) patients were operated on for acutely complicated duodenal ulcers, of which 68 (84.3 %) patients had a combination of three complications, and 13 (15.7 %) had four complications. Out of 81 patients, 72 had bleeding complications, which is 89.3 %. Complications of ulcer perforation - in 36 patients, 44.7 % of all other complications. Based on the obtained analysis data, there is a steady trend towards an increase in the share of organ-sparing operations (OSO) by 1.6 times (from 50.9 % to 81.4 %), a decrease in the number of gastric resections (GR) by 2.9 times (from 14.9 % to 4.9 %) and palliative operations (PO) by 3.2 times (from 15.8 % to 4.9 %) with a relatively stable number of performed organ-preserving operations (OPO): in group A - 17 (24.6 %) interventions, in group B - 4 (21.1 %). Conclusions. The use of modern measures of endoscopic hemostasis made it possible to adequately prepare and operate on patients in the delayed period, and their share from the first period to the second increased by 2.9 times. The number of patients who underwent emergency surgery with ulcer perforation and bleeding as combined complications decreased in the second period compared to the first by 2.5 times, which is associated with the widespread use of modern proton pump inhibitors (PPIs) in the conservative treatment of DU. The number of complications and mortality of this cohort of patients also significantly decreased due to the use of endoscopic hemostasis methods, making it possible to stabilize and prepare patients on the operating table. According to the analysis results, it became known that the chosen active-individualized tactics and the use of developed algorithms for choosing the type of surgical intervention made it possible to achieve a stable level of postoperative mortality at 8.1 %. [ABSTRACT FROM AUTHOR]
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- 2022
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14. Parcelar gastric resection in association with bowel resections as part of debulking surgery for advanced stage ovarian cancer – a case report
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Nicolae Bacalbasa, Irina Balescu, and Adnan Al Aloul
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ovarian cancer ,peritoneal carcinomatosis ,gastric resection ,bowel resection ,Medicine (General) ,R5-920 ,Surgery ,RD1-811 - Abstract
Ovarian cancer represents one of the most aggressive gynecological malignancies affecting women worldwide, associated with significant rates of cancer related death within the first years after the initial diagnostic. The poor survival rates are usually explained by the presence of disseminated lesions even from the beginning. In such situations, the digestive tube is one of the most commonly involved territory, therefore necessitating extended resections in order to achieve complete cytoreduction. The aim of this paper is to report the case of a 53 year old patient who was diagnosed with peritoneal carcinomatosis from ovarian cancer, presenting multiple levels of digestive tract involvement due to the presence of disseminated tumoral masses. Therefore the patients was submitted to multiple digestive resections represented by parcelar gastrectomy, segmental ileal resection and subtotal colectomy. In order to minimize the risks of developing severe postoperative complications – due to the relatively high number of anastomoses – the continuity of the digestive tract was established by a terminal ileostomy, considering that creation of a ileorectal anastomosis would be too dangerous in the context of multiple digestive resections. The postoperative evolution was simple, the patient being further submitted to adjuvant treatment.
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- 2021
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15. Enhanced Perioperative Mobilization (EPM) Trial (EPMIII)
- Published
- 2017
16. The clinical impact of frailty on the postoperative outcomes of patients undergoing gastrectomy for gastric cancer: a propensity-score matched database study.
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Lee, David Uihwan, Kwon, Jean, Han, John, Fan, Gregory Hongyuan, Hastie, David Jeffrey, Lee, Ki Jung, and Karagozian, Raffi
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- *
STOMACH cancer , *FRAILTY , *TREATMENT effectiveness , *GASTRECTOMY , *RESPIRATORY insufficiency , *ONCOLOGIC surgery - Abstract
Background: Frailty aggregates a composite of geriatric and elderly features that is classified into a singular syndrome; literature thus far has proven its influence over postoperative outcomes. In this study, we evaluate the effects of frailty following gastrectomy for gastric cancer. Methods: 2011–2017 National Inpatient Sample was used to isolate patients with gastric cancer undergoing gastrectomy; from this, the Johns Hopkins ACG frailty criteria were applied to segregate frailty-present and absent populations. The case–controls were matched using propensity-score matching and compared to various endpoints. Results: Post match, there were 1171 with and without frailty who were undergoing gastrectomy for gastric cancer. Those with frailty had higher mortality (6.83 vs 3.50% p < 0.001, OR 2.02 95% CI 1.37–2.97), length of stay (16.7 vs 12.0d; p < 0.001), and costs ($191,418 vs $131,367; p < 0.001); frail patients also had higher rates of complications including wound complications (3.42 vs 0.94% p < 0.001, OR 3.73 95% CI 1.90–7.31), infection (5.98 vs 3.67% p = 0.012, OR 1.67 95% CI 1.13–2.46), and respiratory failure (6.32 vs 3.84% p = 0.0084, OR 1.69 95% CI 1.15–2.47). In multivariate, those with frailty had higher mortality (p < 0.001, aOR 2.04 95% CI 1.38–3.01), length of stay (p < 0.001, aOR 1.40 95% CI 1.37–1.43), and costs (p < 0.001, aOR 1.46 95% CI 1.46–1.46). Conclusion: This study finding demonstrates the presence of frailty is an independent risk factor of adverse outcomes following gastrectomy; as such, it is important that these high-risk patients are stratified preoperatively and provided risk-averting procedures to alleviate their frailty-defining features. [ABSTRACT FROM AUTHOR]
- Published
- 2022
- Full Text
- View/download PDF
17. Laparoscopic vs. Open Gastrectomy for Locally Advanced Gastric Cancer: A Propensity Score-Matched Retrospective Case-Control Study.
- Author
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Caruso, Stefano, Giudicissi, Rosina, Mariatti, Martina, Cantafio, Stefano, Paroli, Gian Matteo, and Scatizzi, Marco
- Subjects
- *
STOMACH tumors , *LENGTH of stay in hospitals , *MINIMALLY invasive procedures , *RETROSPECTIVE studies , *CASE-control method , *GASTRECTOMY , *LAPAROSCOPY , *DESCRIPTIVE statistics , *REOPERATION , *BODY mass index , *SURGICAL excision , *LYMPH node surgery , *COMORBIDITY - Abstract
Introduction: Minimally invasive surgery has been increasingly used in the treatment of gastric cancer. While laparoscopic gastrectomy has become standard therapy for early-stage gastric cancer, especially in Asian countries, the use of minimally invasive techniques has not attained the same widespread acceptance for the treatment of more advanced tumours, principally due to existing concerns about its feasibility and oncological adequacy. We aimed to examine the safety and oncological effectiveness of laparoscopic technique with radical intent for the treatment of patients with locally advanced gastric cancer by comparing short-term surgical and oncologic outcomes of laparoscopic versus open gastrectomy with D2 lymphadenectomy at two Western regional institutions. Methods: The trial was designed as a retrospective comparative matched case-control study for postoperative pathological diagnoses of locally advanced gastric carcinoma. Between January 2015 and September 2021, 120 consecutive patients who underwent curative-intent laparoscopic gastrectomy with D2 lymph node dissection were retrospectively recruited and compared with 120 patients who received open gastrectomy. In order to obtain a comparison that was as homogeneous as possible, the equal control group of pairing (1:1) patients submitted to open gastrectomy who matched those of the laparoscopic group was statistically generated by using a propensity matched score method. The following potential confounder factors were aligned: age, gender, Body Mass Index (BMI), comorbidity, ASA, adjuvant therapy, tumour location, type of gastrectomy, and pT stage. Patient demographics, operative findings, pathologic characteristics, and short-term outcomes were analyzed. Results: In the case-control study, the two groups were clearly comparable with respect to matched variables, as was expected given the intentional primary selective criteria. No statistically significant differences were revealed in overall complications (16.7% vs. 20.8%, p = 0.489), rate of reoperation (3.3% vs. 2.5%, p = 0.714), and mortality (4.2% vs. 3.3%, p = 0.987) within 30 days. Pulmonary infection and wound complications were observed more frequently in the OG group (0.8% vs. 4.2%, p < 0.01, for each of these two categories). Anastomotic and duodenal stump leakage occurred in 5.8% of the patients after laparoscopic gastrectomy and in 3.3% after open procedure (p = 0.072). The laparoscopic approach was associated with a significantly longer operative time (212 vs. 192 min, p < 0.05) but shorter postoperative length of stay (9.1 vs. 11.6 days, p < 0.001). The mean number of resected lymph nodes after D2 dissection (31.4 vs. 33.3, p = 0.134) and clearance of surgical margins (97.5% vs. 95.8%, p = 0.432) were equivalent between the groups. Conclusion: Laparoscopic gastrectomy with D2 nodal dissection appears to be safe and feasible in terms of perioperative morbidity for locally advanced gastric cancer, with comparable oncological equivalency with respect to traditional open surgery. [ABSTRACT FROM AUTHOR]
- Published
- 2022
- Full Text
- View/download PDF
18. Risk Factors and Clavien–Dindo Classification of Postoperative Complications After Laparoscopic and Open Gastrectomies for Gastric Cancer: A Single-Center, Large Sample, Retrospective Cohort Study
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Lian B, Chen J, Li Z, Ji G, Wang S, Zhao Q, and Li M
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gastric cancer ,laparoscope ,gastric resection ,postoperative complication ,claviendindo classification ,Neoplasms. Tumors. Oncology. Including cancer and carcinogens ,RC254-282 - Abstract
Bo Lian,* Jie Chen,* Zhengyan Li, Gang Ji, Shiqi Wang, Qingchuan Zhao, Mengbin Li Department of Digestive Surgery, National Clinical Research Center for Digestive Diseases, Xijing Hospital of Digestive Diseases, The Fourth Military Medical University, Xi’an, People’s Republic of China*These authors contributed equally to this workCorrespondence: Mengbin Li Email limbin@fmmu.edu.cnBackground: Laparoscopy has been increasingly used for the surgery of gastric cancer. However, the postoperative complications are still under-investigated and the short-term results of laparoscopic gastrectomy remain controversial. This study aimed to explore the differences of postoperative complications between laparoscopic and open radical gastrectomies in patients with gastric cancer through the large sample size, retrospective cohort study, and evaluate the safety of laparoscopy in patients who underwent radical gastrectomy.Patients and Methods: A total of 2,966 patients with gastric cancer (TNM I∼III) who underwent laparoscopy or open gastrectomy from February 2009 to March 2016 were enrolled in this study. Complications were categorized according to the Clavien–Dindo classification. The incidence and severity of complications between laparoscopic and open gastrectomy were compared using one-to-three propensity score matching (PSM) analysis. Logistic regression analyses were performed to identify risk factors related to postoperative complications.Results: A total of 2,966 patients were included in the study, including 687 (23.2%) in the LG (Laparoscopy gastrectomies) group and 2,279 (76.8%) in the OG (open gastrectomies) group. After PSM, a well-balanced cohort of 2,373 patients (676 cases in the LG group and 1,697 cases in the OG group) was further analyzed. The results showed that the incidence of overall complications in the LG group was significantly less than the OG group (15.4% vs 20.8%, P=0.003). However, the severe complications of the LG group showed no difference towards the OG group (5.8% vs 5.8%, P=0.952). Multivariate analysis revealed that laparoscopic surgery is a protective factor for the reduction of postoperative complications. Age ≥ 60 years, ASA classification IIIc and estimated blood loss ≥ 200 mL were confirmed as independent risk factors of overall complications.Conclusion: Compared with traditional open gastrectomy, LG is safe and feasible with less trauma and fewer complications for patients with gastric cancer.Keywords: gastric cancer, laparoscopy, gastric resection, postoperative complication, Clavien–Dindo classification
- Published
- 2020
19. Prophylaxis of damage of extrahepatic biliary ducts and pancreatic ducts while performance of gastric resection in accordance to Billroth II method for complicated duodenal ulcers
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D. V. Maksymchuk, V. I. Mamchich, and V. D. Maksymchuk
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pyloroduodenal ulcer ,perforation ,hemorrhage ,penetration ,gastric resection ,duodenal stump ,mobilization of duodenum ,biliary ducts ,pancreatic gland. ,Surgery ,RD1-811 - Abstract
Objective. To elaborate a method of mobilization and a method of closure of “complex handed” duodenal stump while operating for complicated giant penetrating pyloroduodenal ulcers with the aim to prevent iatrogenic damage of extrahepatic biliary ducts and pancreatic ducts and to improve the results of surgical treatment of this pathology. Materials and metods. In the investigation 46 patients were included, who were operated on for complicated giant penetrating pyloroduodenal ulcers. Giant pyloroduodenal ulcers have had more than 2.5 cm size. The method of duodenal mobilization and the method of suturing of a “complex” duodenal stump were proposed. The method of duodenal mobilization consists of duodenotomy in the zone of a cicatricial-ulcerative transformation and intraintestinal digital upper and anterior stretching towards yourself of all duodenal walls from adhesive process, what includes mobilization of upper-horizontal and of part of descending duodenum portiions, using incision of visceral peritoneum along right and left edges of colon on a distance, sufficient to form its stump without tension. The method of suturing of a “complex” duodenal stump consists of duodenotomy in the affected zone of circular ulcer process. This permits to determine a degree of ulcerative stenosis, to exterritorize the ulcer and after duodenal mobilization, using the above mentioned method, to apply the duodenal mobilized walls for formation of a stump. Application of a one-raw interrupted screw-up sutures permits to distribute the pressure load along all sutures what enhances a mechanical strength of the sutures placed. Results. Average duration of the operation have constituted 136.6 min (95% CI: 125.2; 152.0); a stationary stay - from 7 to 26 bed-days, 15.7 days (95% CI: 13.1; 18.2) at average. Among early postoperative morbidity there were: infection in the wound zone - 2 (4.3%), pneumonia (4.3%), stroke - 1 (2.2%), pulmonary thromboembolism - 1 (2.2%), insufficiency of the duodenal stump sutures - 1 (2.2%) observation. Postoperative mortality have constituted 4.3%, 2 patients died, in 1 (2.2%) pulmonary thromboembolism was the cause of the death, and in 1 (2.2%) - hemorrhagic insult. The duodenal stump sutures insufficiency and extensive serous-fibrinous peritonitis were revealed in the patient on the 6th postoperative day in 1 (2,2%) patient. In 1 year 31 patients were examined: while performing of fibrogastroscopy in 1 (3.2%) patient the ulcer of posterior wall of gastrojejunoanastomosis was revealed, in 7 (22.6%) - superficial gastritis, in 1 (3.2%) - erosive gastritis of gastric stump. Conclusion. The proposed procedure for duodenal mobilization and the method of the duodenal stump formation in a complicated giant circular pyloroduodenal ulcer permits to minimize a possibility of the stump sutures insufficiency occurrence as well as the prevention of iatrogenic damage of biliary and pancreatic ducts, involved in the ulcer infiltrate, injury, and may be recommended for application in clinical practice. Special attention must be drawn to duodenal decompression in postoperative period and to intestinal stimulation.
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- 2020
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20. Readmissions after cytoreductive surgery and hyperthermic intraperitoneal chemotherapy—a national population-based study
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Paul Dranichnikov, Wilhelm Graf, and Peter H. Cashin
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Readmission ,Peritoneal metastases ,HIPEC ,Morbidity ,Gastric resection ,Surgery ,RD1-811 ,Neoplasms. Tumors. Oncology. Including cancer and carcinogens ,RC254-282 - Abstract
Abstract Background Comprehensive readmission morbidity studies after cytoreductive surgery (CRS) and hyperthermic intraperitoneal chemotherapy (HIPEC) are scarce. This study aimed to investigate readmissions and in-hospital morbidity after CRS and HIPEC. Methods The national in-hospital patient register was used to identify patients via the HIPEC ICD code JAQ10 2004–2014. Data were retrieved from the index CRS/HIPEC treatment and from all HIPEC-related readmissions within 6 months. Univariate/multivariate logistical analyses were performed to identify risk factors for reinterventions and readmissions. Results A total of 519 patients (mean age 56 years) had a mean hospital stay of 27 days. Within 6 months, 150 readmissions for adverse events were observed in 129 patients (25%) with 67 patients requiring an intervention (13%). Totally 179 patients (34%) required a reintervention during the first 6 months with 85 (16%) requiring a reoperation. Of these 179 patients, 83 patients (46%) did not undergo the intervention at the HIPEC centre. Gastric resection was the only independent risk factor for in-hospital intervention, and advanced age for readmission. Conclusion Morbidity causing HIPEC-related readmission was higher than expected with almost half of the interventions occurring outside the HIPEC centre. Gastric resection and high age are independent predictors of morbidity and readmission.
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- 2020
- Full Text
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21. Safety and Efficacy of Simultaneous Resection of Gastric Carcinoma and Synchronous Liver Metastasis—A Western Center Experience
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Corina-Elena Minciuna, Stefan Tudor, Alexandru Micu, Andrei Diaconescu, Sorin Tiberiu Alexandrescu, and Catalin Vasilescu
- Subjects
gastric cancer ,synchronous liver metastasis ,liver resection ,gastric resection ,Medicine (General) ,R5-920 - Abstract
Background and objectives: Gastric cancer (GC) is often diagnosed in the metastatic stage. Palliative systemic therapy is still considered the gold standard, even for patients with resectable oligometastatic disease. The aim of the current study is to assess the potential benefit of up-front gastric and liver resection in patients with synchronous resectable liver-only metastases from GC (LMGC) in a Western population. Materials and Methods: All patients with GC and synchronous LMGC who underwent gastric resection with or without simultaneous resection of LMs between January 1997 and December 2016 were selected from the institutional records. Those with T4b primary tumors or with unresectable or more than three LMs were excluded from the analysis. All patients who underwent emergency surgery for hemorrhagic shock or gastric perforation were also excluded. Results: Out of 28 patients fulfilling the inclusion criteria, 16 underwent simultaneous gastric and liver resection (SR group), while 12 underwent palliative gastric resection (GR group). The median overall survival (OS) of the entire cohort was of 18.81 months, with 1-, 3- and 5-year OS rates of 71.4%, 17.9% and 14.3%, respectively. The 1-, 3- and 5-year OS rates in SR group (75%, 31.3% and 25%, respectively) were significantly higher than those achieved in GR group (66.7%, 0% and 0%, respectively; p = 0.004). Multivariate analysis of the entire cohort revealed that the only independent prognostic factor associated with better OS was liver resection (HR = 3.954, 95% CI: 1.542–10.139; p = 0.004). Conclusions: In a Western cohort, simultaneous resection of GC and LMGC significantly improved OS compared to patients who underwent palliative gastric resection.
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- 2022
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22. Flexible Robotic Endoscopy Systems and the Future Ahead
- Author
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Seah, Tian En Timothy, Do, Thanh Nho, Takeshita, Nobuyoshi, Ho, Khek Yu, Phee, Soo Jay, Wu, George Y., Series editor, and Sridhar, Subbaramiah, editor
- Published
- 2018
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23. PARCELAR GASTRIC RESECTION IN ASSOCIATION WITH BOWEL RESECTIONS AS PART OF DEBULKING SURGERY FOR ADVANCED STAGE OVARIAN CANCER – A CASE REPORT.
- Author
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Bacalbasa, Nicolae, Balescu, Irina, and Al Aloul, Adnan
- Subjects
- *
GASTRECTOMY , *OVARIAN cancer , *PERITONEAL cancer , *SURVIVAL rate , *ALIMENTARY canal , *FALLOPIAN tubes , *INDUCED ovulation - Abstract
Ovarian cancer represents one of the most aggressive gynecological malignancies affecting women worldwide, associated with significant rates of cancer related death within the first years after the initial diagnostic. The poor survival rates are usually explained by the presence of disseminated lesions even from the beginning. In such situations, the digestive tube is one of the most commonly involved territory, therefore necessitating extended resections in order to achieve complete cytoreduction. The aim of this paper is to report the case of a 53 year old patient who was diagnosed with peritoneal carcinomatosis from ovarian cancer, presenting multiple levels of digestive tract involvement due to the presence of disseminated tumoral masses. Therefore the patients was submitted to multiple digestive resections represented by parcelar gastrectomy, segmental ileal resection and subtotal colectomy. In order to minimize the risks of developing severe postoperative complications – due to the relatively high number of anastomoses – the continuity of the digestive tract was established by a terminal ileostomy, considering that creation of a ileorectal anastomosis would be too dangerous in the context of multiple digestive resections. The postoperative evolution was simple, the patient being further submitted to adjuvant treatment. [ABSTRACT FROM AUTHOR]
- Published
- 2021
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24. Minimally Invasive Treatment of Gastric GIST
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Moreno-Sanz, Carlos, Cuesta, Miguel A., and Cuesta, Miguel A., editor
- Published
- 2017
- Full Text
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25. Partial Gastrectomy with Billroth II Reconstruction
- Author
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Danks, Roy R., Hoballah, Jamal J., editor, Scott-Conner, Carol E. H., editor, and Chong, Hui Sen, editor
- Published
- 2017
- Full Text
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26. Peptic Ulcer Disease for the Acute Care Surgeon
- Author
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Sixta, Sherry L., Davis, Millard Andrew, Moore, Laura J., editor, and Todd, S. Rob, editor
- Published
- 2017
- Full Text
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27. Quality of Life After Curative Resection for Gastric Cancer: Survey Metrics and Implications of Surgical Technique.
- Author
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Hu, Yinin and Zaydfudim, Victor M.
- Subjects
- *
GASTRECTOMY , *STOMACH cancer , *OPERATIVE surgery , *ONCOLOGIC surgery , *QUALITY of life - Abstract
Gastric cancer is one of the most common cancers worldwide, and radical gastrectomy is an integral component of curative therapy. With improvements in perioperative morbidity and mortality, attention has turned to short- and long-term post-gastrectomy quality of life (QoL). This article reviews the common psychometric surveys and preference-based measures used among patients following gastrectomy. It also provides an overview of studies that address associations between surgical decision-making and postoperative health-related QoL. Further attention is focused on reported associations between technical aspects of the operation, such as extent of gastric resection, minimally-invasive approach, pouch-based conduits, enteric reconstruction, and postoperative QoL. While there are several randomized studies that include QoL outcomes, much remains to be explored. The relationship between symptom profiles and preference-based measures of health state utility is an area in need of further research. [ABSTRACT FROM AUTHOR]
- Published
- 2020
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28. Does Reconstruction Type After Gastric Resection Matters for Type 2 Diabetes Improvement?
- Author
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Costa, Mariana, Trovão Lima, Artur, Morais, Tiago, Almeida, Rui F., Nora, Mário, Guimarães, Marta, and Monteiro, Mariana P.
- Subjects
- *
GASTRIC bypass , *TYPE 2 diabetes , *GASTRECTOMY , *JEJUNOILEAL bypass , *OPERATIVE surgery , *GASTROINTESTINAL surgery , *BODY mass index - Abstract
Background: Gastrointestinal (GI) surgery involving gastric resection and bypass of intestinal segments was reported to facilitate glucose control in obese patients with type 2 diabetes (T2D).Aim: Our aim was to assess whether the type of post-gastrectomy GI reconstruction also influences glucose control in T2D patients with BMI below 35 kg/m2 submitted to gastrointestinal surgery without bariatric intention.Methods: A cohort of T2D Caucasian patients (n = 40) with upper GI malignancy (n = 33) or complicated reflux disease (n = 7) were submitted to either a gastrectomy plus Billroth II (BII) gastrojejunal anastomosis (n = 17), a gastrectomy plus Roux-en-Y gastrojejunostomy (RY) reconstruction (n = 18; subtotal gastrectomy n = 7 and total gastrectomy n = 11), or atypical gastrectomy without reconstruction (no-R) (n = 5). Patients were evaluated before and 2 years after surgery for body weight, Hb1Ac, need of glucose lowering drugs, and presence of diabetes.Results: Body mass index (BMI) decreased after every surgical procedure when compared to baseline (- 0.9 ± 0.8 kg/m2 for BII vs - 4.3 ± 2.6 kg/m2 for RY vs - 4.6 ± 2.5 kg/m2 for no-R, p < 0.05), which was only significantly different after RY surgeries. Diabetes remission occurred in 5.9% of BII patients, in 27.8% of RY patients, and 0% of no-R patients, while in patients with persistent T2D, the needs for glucose-lowering drugs were significantly also decreased after RY (31.3% BII vs 66.7% RY vs 25% no-R, p = 0.03).Conclusions: T2D Caucasian patients undergoing post-gastrectomy GI reconstructions without a bariatric intention experience a significant improvement of T2D, in a magnitude that could be influenced by the technical procedure performed in favor of RY reconstruction. Thus, presence of T2D should be taken into consideration when deciding for the type of post-gastrectomy GI reconstruction. [ABSTRACT FROM AUTHOR]- Published
- 2020
- Full Text
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29. Bedeutung der Splenektomie im Rahmen der operativen Behandlung des Magenkarzinoms.
- Author
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Gastinger, Ingo, Heine, Kristin, Otto, Ronny, Meyer, Frank, Wolff, Stefanie, and Croner, Roland
- Abstract
Background: The value of simultaneous splenectomy as part of an oncologically adequate resection for gastric cancer has been controversially discussed over the last decades. Methods: As part of a prospective multicenter observational study data were obtained from patients admitted to hospital with histologically diagnosed primary gastric cancer or adenocarcinoma of the esophagogastric junction (AEG). The profiles of care of patients who had undergone surgical treatment in 141 surgical departments from 1 January 2007 to 31 December 2009 were collated. Overall, 2897 patients were enrolled in the study (tumor resection, n = 2545). Results: The overall splenectomy rate was 11.1% (n = 283) and the highest proportion was found in AEG tumor lesions (19.4%). In the whole group of patients as well as depending on the tumor site, there was a higher preoperative comorbidity in splenectomized patients. While the rate of general postoperative complications after splenectomy was significantly increased in all patients and also depending on various tumor sites, there were no differences in the rate of specific postoperative complications. A significantly higher hospital mortality comparing the splenectomy group of patients with those in whom the spleen could be preserved, was only observed in AEG-associated tumor lesions (15.2% vs. 5.0%). All splenectomized patients showed a shorter long-term survival (p < 0.001) compared to resections with a preserved spleen (18 months vs. 36 months). Conclusion: In the surgical treatment of gastric cancer, splenectomy can be considered a negative predictor for a worse perioperative outcome and a worse long-term survival. [ABSTRACT FROM AUTHOR]
- Published
- 2020
- Full Text
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30. Readmissions after cytoreductive surgery and hyperthermic intraperitoneal chemotherapy—a national population-based study.
- Author
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Dranichnikov, Paul, Graf, Wilhelm, and Cashin, Peter H.
- Subjects
- *
CYTOREDUCTIVE surgery , *HYPERTHERMIC intraperitoneal chemotherapy , *GASTRECTOMY - Abstract
Background: Comprehensive readmission morbidity studies after cytoreductive surgery (CRS) and hyperthermic intraperitoneal chemotherapy (HIPEC) are scarce. This study aimed to investigate readmissions and in-hospital morbidity after CRS and HIPEC. Methods: The national in-hospital patient register was used to identify patients via the HIPEC ICD code JAQ10 2004–2014. Data were retrieved from the index CRS/HIPEC treatment and from all HIPEC-related readmissions within 6 months. Univariate/multivariate logistical analyses were performed to identify risk factors for reinterventions and readmissions. Results: A total of 519 patients (mean age 56 years) had a mean hospital stay of 27 days. Within 6 months, 150 readmissions for adverse events were observed in 129 patients (25%) with 67 patients requiring an intervention (13%). Totally 179 patients (34%) required a reintervention during the first 6 months with 85 (16%) requiring a reoperation. Of these 179 patients, 83 patients (46%) did not undergo the intervention at the HIPEC centre. Gastric resection was the only independent risk factor for in-hospital intervention, and advanced age for readmission. Conclusion: Morbidity causing HIPEC-related readmission was higher than expected with almost half of the interventions occurring outside the HIPEC centre. Gastric resection and high age are independent predictors of morbidity and readmission. [ABSTRACT FROM AUTHOR]
- Published
- 2020
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31. Esophagus and Stomach
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Bracale, Umberto, Cabras, Francesco, Lidia, Ristovich, Merola, Giovanni, Elisabetta, Plonka, Pignata, Giusto, Pignata, Giusto, editor, Bracale, Umberto, editor, and Lazzara, Fabrizio, editor
- Published
- 2016
- Full Text
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32. Laparoscopic Partial Gastrectomy with Roux-en-Y Gastrojejunostomy Reconstruction
- Author
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Roberts, Kurt E., Salluzzo, Jennifer L., Hoballah, Jamal J., editor, Scott-Conner, Carol E. H., editor, and Chong, Hui Sen, editor
- Published
- 2017
- Full Text
- View/download PDF
33. Laparoscopic Distal Gastrectomy with Billroth II Reconstruction
- Author
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Wood, Stephanie, Duffy, Andrew J., Hoballah, Jamal J., editor, Scott-Conner, Carol E. H., editor, and Chong, Hui Sen, editor
- Published
- 2017
- Full Text
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34. Minimally Invasive Approach to Gastric GISTs: Analysis of a Multicenter Robotic and Laparoscopic Experience with Literature Review
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Graziano Ceccarelli, Gianluca Costa, Michele De Rosa, Massimo Codacci Pisanelli, Barbara Frezza, Marco De Prizio, Ilaria Bravi, Andrea Scacchi, Gaetano Gallo, Bruno Amato, Walter Bugiantella, Piergiorgio Tacchi, Alberto Bartoli, Alberto Patriti, Micaela Cappuccio, Klara Komici, Lorenzo Mariani, Pasquale Avella, and Aldo Rocca
- Subjects
gastrointestinal stromal tumor ,GISTs ,robotic surgery ,laparoscopic surgery ,gastric resection ,minimally invasive surgery ,Neoplasms. Tumors. Oncology. Including cancer and carcinogens ,RC254-282 - Abstract
Background: Gastrointestinal stromal tumors (GISTs) are most frequently located in the stomach. In the setting of a multidisciplinary approach, surgery represents the best therapeutic option, consisting mainly in a wedge gastric resection. (1) Materials and methods: Between January 2010 to September 2020, 105 patients with a primary gastrointestinal stromal tumor (GISTs) located in the stomach, underwent surgery at three surgical units. (2) Results: A multi-institutional analysis of minimally invasive series including 81 cases (36 laparoscopic and 45 robotic) from 3 referral centers was performed. Males were 35 (43.2%), the average age was 66.64 years old. ASA score ≥3 was 6 (13.3%) in the RS and 4 (11.1%) in the LS and the average tumor size was 4.4 cm. Most of the procedures were wedge resections (N = 76; 93.8%) and the main operative time was 151 min in the RS and 97 min in the LS. Conversion was necessary in five cases (6.2%). (3) Conclusions: Minimal invasive approaches for gastric GISTs performed in selected patients and experienced centers are safe. A robotic approach represents a useful option, especially for GISTs that are more than 5 cm, even located in unfavorable places.
- Published
- 2021
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35. Bile Reflux and Gastroparesis
- Author
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Roses, Robert E., Fraker, Douglas L., Pawlik, Timothy M., editor, Maithel, Shishir K., editor, and Merchant, Nipun B., editor
- Published
- 2015
- Full Text
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36. Stomach
- Author
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Maker, Vijay K., Guzman-Arrieta, Edgar D., Maker, Vijay K., and Guzman-Arrieta, Edgar D.
- Published
- 2015
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- View/download PDF
37. Surgical scales: Primary closure versus gastric resection for perforated gastric ulcer - A surgical debate
- Author
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Mahir Gachabayov, Valentin Babyshin, Oleg Durymanov, and Dmitriy Neronov
- Subjects
Gastrectomy ,gastric resection ,gastric ulcer ,giant ulcer ,perforated ulcer ,primary ulcer repair ,Surgery ,RD1-811 - Abstract
Perforated gastric ulcer is one of the most life-threatening complications of peptic ulcer disease with high morbidity and mortality rates. The surgical strategy for gastric perforation in contrast with duodenal perforations often requires consilium and intraoperative debates. The subject of the debate is a 59-year-old male patient who presented with perforated giant gastric ulcer complicated by generalized peritonitis and severe sepsis. The debate is based on a systematized table dividing all factors into three groups and putting them on surgical scales. Pathology-related factors influencing the decision-making are size and site of perforation, local tissue inflammation, signs of malignancy, simultaneous complications of peptic ulcer, peritonitis, and sepsis. Besides these factors, patient- and healthcare-related factors should also be considered.
- Published
- 2017
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38. Single-Access Laparoscopic Approach for Gastric Surgery (Hiatal Hernia Repair and Gastric Resections)
- Author
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Dapri, Giovanni, Cadière, Guy Bernard, Pignata, Giusto, editor, Corcione, Francesco, editor, and Bracale, Umberto, editor
- Published
- 2014
- Full Text
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39. Pathogenesis, diagnosis and treatment of reflux esophagitis in patients after gastric surgery
- Author
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O. N. Minushkin, L. V. Maslovskiy, A. G. Shuleshova, and N. S. Nazarov
- Subjects
резекция желудка ,эрозивный рефлюкс-эзофагит ,омепразол ,удхк ,gastric resection ,erosive reflux esophagitis ,omeprazole ,udca ,Medicine - Abstract
The article describes the experience of treatment of erosive reflux esophagitis in 30 patients after gastric resection, having mixed reflux determined by 24-hour esophageal pH-impedancemetry. Pharmacotherapy for background and maintenance treatment included a combination of PPI (Omez) with UDCA (Livodexa). The efficacy of different dosages of the drugs was evaluated in 2 groups of patients during background treatment: group 1 received Livodexa 10 mg/kg in combination with Omez 20 mg per day, group 2 received Livodexa 15 mg/kg in combination with Omez 40 mg/day. During maintenance treatment, subgroup 1 received Livodexa 2.5 mg/kg and Omez 20 mg, subgroup 2 - 5.0 mg/kg Livodxa and Omez 20 mg per day for 2 months. Changes in the clinical and endoscopic patterns were evaluated. The study showed that, according to the clinical and endoscopic data, Livodexa 15 mg/kg and Omez 40 mg/day for 112 days for erosive RE was effective in 76.6% (23) of cases. In the remaining 7 (23.4%) patients erosions healed by the 140th day of treatment. With regard to maintenance treatment, the combination of Livodexa 5.0 mg/kg with Omez 20 mg/day was effective.
- Published
- 2015
- Full Text
- View/download PDF
40. Evaluation of anemia as a postoperative risk factor in the evolution of patients with gastric resection for malignancies
- Author
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Gabriel Nicolae Andrei, Mircea Beuran, Bogdan Dumitriu, Sebastian Valcea, and Pharmacy, Bucharest, Romania
- Subjects
medicine.medical_specialty ,Anemia ,business.industry ,Mortality rate ,Incidence (epidemiology) ,gastric cancer ,Cancer ,gastric resection ,medicine.disease ,anemia ,Surgery ,Postoperative risk ,medicine ,Medicine ,In patient ,postoperative risk factors ,Risk factor ,Gastric resection ,business - Abstract
Introduction. Gastric cancer remains among the top three digestive diseases with the highest mortality rates in the world. Treatment of gastric cancer is multidisciplinary, gastric resection being essential for the best result. Anemia is one of the most common comorbidities present in patients diagnosed with gastric cancer. Materials and Methods. This is a retrospective analytical study over a period of 6 years (2014-2019). It is based on 114 consecutive gastric resections for cancer performed by a single team using exclusively resection and reconstruction stapling methods. The study aims to investigate a correlation between the presence of preoperative anemia and the incidence of postoperative morbidity and mortality. Results. Preoperative anemia was found in 70% of patients, with about half of these patients presenting with mild anemia. Most postoperative complications were grade I and II according to the Clavien Dindo scale. Anemia was correlated with an increase in infectious complications, anastomotic leaks and secondary peritoneal abscesses, pancreatic complications after multivisceral resection and length of hospital stay. Conclusions. Preoperative anemia is a risk factor that exposes the cancer patient to an increased incidence of life-threatening postoperative complications. In addition, it also extends the length of hospital stay and costs. Therefore, special attention should be paid to the identification and reduction of anemia before extensive gastric surgery in order to obtain the best possible therapeutic result.
- Published
- 2021
41. EYUNOGASTROPLASTICА AS AN EFFECTIVE METHOD FOR PREVENTING FUNCTIONAL DISORDERS AFTER PROXIMAL GASTRIC RESECTION
- Subjects
medicine.medical_specialty ,business.industry ,Stomach ,Group ii ,Anastomosis ,Body weight ,Gastroenterology ,Upper digestive tract ,medicine.anatomical_structure ,Internal medicine ,Medicine ,Digestive tract ,Reflux esophagitis ,business ,Gastric resection - Abstract
The analysis of the results of treatment of 97 patients who were operated from surgical diseases of the cardiac stomach. Proximal gastric resection (PRG) was performed using isoperistaltic jejunogastroplasty (modified by Merendino-Dillard) (50 people – group I) and with direct esophagogastroanastomosis (47 people – group II). 12 and 24 months after the operation, an X-ray and endoscopic examination of the upper digestive tract was performed, assessing the severity of functional disorders (nutritional status, body weight deficiency, reflux esophagitis, anastomosis) Results. After 2 years or more, 5.9% of patients ate more than 6 times a day in group I, while in group II, 23.3% (p
- Published
- 2021
42. Accurate endoscopic identification of the afferent limb at the Y anastomosis using the fold disruption sign after gastric resection with Roux‐en‐Y reconstruction
- Author
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Takahisa Ogawa, Hiroaki Kusunose, Haruka Okano, Toshitaka Sakai, Tetsuya Ohira, Takeshi Shimizu, Shinsuke Koshita, Kei Ito, Keisuke Yonamine, Fumisato Kozakai, Kazuaki Miyamoto, and Yoshihide Kanno
- Subjects
Cholangiopancreatography, Endoscopic Retrograde ,medicine.medical_specialty ,Endoscopic retrograde cholangiopancreatography ,medicine.diagnostic_test ,business.industry ,Anastomosis, Surgical ,Gastroenterology ,Lumen (anatomy) ,Adhesion (medicine) ,Anastomosis, Roux-en-Y ,Anastomosis ,Balloon ,medicine.disease ,Roux-en-Y anastomosis ,Surgery ,Gastrectomy ,Humans ,Medicine ,Radiology, Nuclear Medicine and imaging ,Gastric resection ,business ,Retrospective Studies ,Sign (mathematics) - Abstract
In patients with Roux-en-Y (RY) reconstruction for gastric resection, the newly defined "fold disruption" (FD) sign can be useful to distinguish the afferent limb from the efferent limb at the Y anastomosis when balloon endoscopy-assisted endoscopic retrograde cholangiopancreatography (BE-ERCP) is performed. The FD sign was defined as endoscopic findings of the internal folds disrupted toward the afferent limb and continued toward the efferent limb at the Y anastomosis. In this prospective observational study, the accuracy of the FD sign was evaluated for those who underwent BE-ERCP after gastric resection with RY reconstruction. Of 28 patients for whom the accuracy could be evaluated among 30 enrolled patients, the afferent limb was identified using the FD sign with 100% accuracy. For the other two patients, the scope could not reach the target lumen due to severe intestinal adhesion in one and reached the target lumen without recognition of the Y anastomosis in the other. There was no patient for whom the FD sign could not be judged for any reason, such as a blurred anastomosis line, unclear folds, sticky discharge and blood coating the surface, when the Y anastomosis was recognized. The FD sign was a highly accurate tool for distinguishing the afferent limb from the efferent limb in patients after gastric resection with RY reconstruction. This study was registered in UMIN (issued ID, UMIN000038326).
- Published
- 2021
43. To the technique of gastric resection for highly located ulcers
- Author
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Yu. B. Bagrov
- Subjects
medicine.medical_specialty ,business.industry ,digestive, oral, and skin physiology ,Medicine ,General Medicine ,Gastric resection ,business ,Surgery - Abstract
Gastric resection in high ulcers can often be difficult. The removal of up to two-thirds of the stomach, according to Finsterer, is undesirable, and the imposition of an anastomosis on the part of the stomach, hidden in the left hypochondrium, seems to be a rather serious intervention.
- Published
- 2021
44. Метод формування гастродуоденоанастомозу за умов резекції шлунка
- Subjects
виразкова хвороба ,резекція шлунка ,термінолатеральний анастомоз ,peptic ulcer ,gastric resection ,terminolateral anastomosis - Abstract
In order to improve the results of stomach resection and to avoid postgastroresection syndromes the authors propose a procedure of forming terminolateral anastomosis elaborated and introduced into practice by them which insures a portioned-rhythmic evacuation of the gastric contents., Для покращання результатів резекції шлунка, запобігання розвитку постгастрорезекційних синдромів пропонується розроблений та впроваджений у практику спосіб формування термінолатерального анастомозу, який забезпечує порційно-ритмічну евакуацію шлункового вмісту.
- Published
- 2022
45. The Role of Laparoscopy in Emergency Treatment of Complications after Laparoscopic and Endoscopic Procedures
- Author
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Corcione, Francesco, Cuccurullo, Diego, Pirozzi, Felice, Sciuto, Antonio, La Barbera, Camillo, Mandalà, Stefano, and Mandalà, Vincenzo, editor
- Published
- 2012
- Full Text
- View/download PDF
46. Минуле, сучасне та майбутнє хірургічного лікування виразкової хвороби (50-річний досвід інституту)
- Author
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N.V. Prolom, V.M. Ratchick, A.M. Babii, S.A. Таrabarov, and B.F. Shevchenko
- Subjects
medicine.medical_specialty ,business.industry ,Ulcer surgery ,medicine.medical_treatment ,General surgery ,Peptic ulcer surgery ,Disease ,Gastroenterostomy ,medicine.disease ,digestive system diseases ,Conservative treatment ,Peptic ulcer ,Medicine ,business ,Surgical treatment ,Gastric resection - Abstract
The article presents the literature data and the results of the author’s own research on the development of peptic ulcer surgery in the historical aspect. It is shown that the evolution of the knowledge about the etiopathogenesis of peptic ulcer influenced the development of methods for surgical interventions. The main periods of development of peptic ulcer surgery are identified: the first period (1842–1881) — the time of the formation of gastric surgery; the second period (1880–90s) — the time of gastric surgery becoming an independent clinical discipline; the third period (the end of the 19th century — 1920s) — the time of peptic ulcer surgery development, when gastroenterostomy was the method of choice in surgical treatment; the fourth period (1930–60s) — the time when the pathogenetic principles of peptic ulcer surgery appeared; gastric resection served as a method of choice; the fifth (the final) period (1970–90s — present time) — the summing up of the 150-year history of ulcer surgery, when doctors tend to conservative treatment of this complex pathology, and surgical intervention in peptic ulcer is directed only to сorrection of disease complications, without destroying the digestive system. It is shown that the historical experience, the thorny path of hopes and disappointments that doctors have taken when searching an optimal approaches to the surgical treatment of peptic ulcer, will help surgeons, therapists, morphologists and physiologists in the future.
- Published
- 2021
47. Perforated Peptic Ulcer
- Author
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Scott-Conner, Carol E. H., Chassin, Jameson L., and Scott-Conner, Carol E.H., editor
- Published
- 2014
- Full Text
- View/download PDF
48. Laparoscopic subtotal gastrectomy in morbid obese patients: a valid option to laparoscopic gastric bypass in particular circumstances (prospective study).
- Author
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Braghetto, Italo, Martinez, Gustavo, Korn, Owen, Zamorano, Marcelo, Lanzarini, Enrique, and Narbona, Enrique
- Subjects
- *
GASTRECTOMY , *LAPAROSCOPIC surgery , *GASTRIC bypass , *OVERWEIGHT persons , *SURGICAL complications - Abstract
Background: Laparoscopic Roux-en-Y Gastric Bypass (LRYGB) without resection of the distal stomach is largely performed over the world for morbid obesity. Potential risk of gastric remnant carcinoma development has been suggested.Purpose: To present the results obtained after LRYGB with resection of distal stomach.Method: This prospective study includes 400 consecutive patients. The mean body weight was 105.9 ± 16.8 Kg (range 83-145 kg), and body mass index (BMI) was 38.5 ± 4.4 kg/m2 (32.9-50.3). Postoperative morbid-mortality and follow-up were analyzed.Results: Operative time was 128.5 ± 18.7 min, hospital discharge occurred at 3rd postoperative day, postoperative complications occurred in 9.25%, early surgical complications were observed in 3% and medical complications 4%, late surgical complications occurred 2.25%, no mortality was observed. At 1 year follow-up, BMI was 25.3 ± 2.7 kg/m2 with % of weight loss (%WL) of 84.6 + 19.1%. At five years follow-up very similar values were observed.Conclusion: The results obtained after LRYGB with resection of distal stomach are similar to results published after non resection LRYGB regarding early and late results and can be indicated in high risk areas of gastric carcinoma. [ABSTRACT FROM AUTHOR]
- Published
- 2018
- Full Text
- View/download PDF
49. Giant gastric lipoma presenting as GI bleed: Enucleation or Resection?
- Author
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Termos, Salah, Reslan, Ossama, Alqabandi, Omar, AlDuwaisan, Abdullah, Al-Subaie, Saud, Alyatama, Khalifa, Alali, Mohammad, and AlSaleh, Ahmad
- Abstract
Introduction Gastric lipomas are unusual benign lesions and account for less than 1% of all tumours of the stomach and 5% of all gastrointestinal lipomas (Thompson et al.2003; Fernandez et al. 1983 [1,2] ). Although predominantly asymptomatic and indolent; they may present with gastric outlet obstruction and upper gastrointestinal (GI) bleeding owing to size and ulceration. Only a few cases have been reported, presenting large in size with massive GI bleeding (Alcalde Escribano et al. 1989; Johnson et al. 1981 [3,4] ). Presentation of case We report the case of a 62-year-old gentleman who presented to the emergency department with massive upper GI hemorrhage. He was initially resuscitated and stabilized. Later gastroscopy showed a large submucosal tumour (Fig. 1). Biopsy revealed adipose tissue. Computed tomography (CT) scan of the abdomen and pelvis showed a huge well defined oval soft tissue lesion measuring about 16 × 8 × 8 cm. The mass noted a homogenous fat density arising from the posterior wall of stomach with no extramural infiltration (Fig. 2). The tumour was completely enucleated through an explorative gastrotomy incision (Fig. 4). Discussion and conclusion Massive bleeding secondary to a giant gastric lipoma is a rare finding of a rare disease. The majority of cases in the literature result in major gastric resection. Familiarity with its radiological findings and a high index of suspicion can lead to proper diagnosis in the acute setting. If malignancy is carefully ruled out, stomach preserving surgery is an optimal treatment option. [ABSTRACT FROM AUTHOR]
- Published
- 2017
- Full Text
- View/download PDF
50. Biliary Stones and Gastrectomy
- Author
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De Manzoni, Giovanni, Giacopuzzi, Simone, Borzellino, Giuseppe, Cordiano, Claudio, Borzellino, Giuseppe, and Cordiano, Claudio
- Published
- 2008
- Full Text
- View/download PDF
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