Laparoscopy-assisted distal gastrectomy with systemic lymph node dissection: A phase II study following the learning curve

2005 ◽  
Vol 91 (1) ◽  
pp. 26-32 ◽  
Author(s):  
Michitaka Fujiwara ◽  
Yasuhiro Kodera ◽  
Shinichi Miura ◽  
Yasuaki Kanyama ◽  
Hiroyuki Yokoyama ◽  
...  
Keyword(s):  
Lymph Node ◽  
Learning Curve ◽  
Lymph Node Dissection ◽  
Phase Ii ◽  
Distal Gastrectomy ◽  
Phase Ii Study ◽  
Node Dissection

Final results of a multi-center, double-blind, randomized, placebo-controlled phase II study to assess the efficacy of MAGE-A3 immunotherapeutic as adjuvant therapy in stage IB/II non-small cell lung cancer (NSCLC)

2007 ◽  
Vol 25 (18_suppl) ◽  
pp. 7554-7554 ◽  
Author(s):  
J. Vansteenkiste ◽  
M. Zielinski ◽  
A. Linder ◽  
J. Dahabre ◽  
E. Esteban ◽  
...  
Keyword(s):  
Overall Survival ◽  
Lymph Node ◽  
Adjuvant Therapy ◽  
Lymph Node Dissection ◽  
Phase Ii ◽  
Phase Ii Study ◽  
Phase Iii ◽  
Node Dissection ◽  
Stage Ib ◽  
Disease Free

7554 Background: After complete resection, about 50% of patients with stages IB-II NSCLC disease die within 5 years. Adjuvant chemotherapy improves overall survival at the expense of substantial toxicity. Activity of MAGE-A3 immunotherapeutic (i.e. recombinant MAGE-A3 protein and a potent GlaxoSmithKline adjuvant) was previously demonstrated in metastatic melanoma. As about 35% of NSCLCs express MAGE-A3 antigen, post-operative MAGE-treatment may be a tumor-specific, well tolerated, and effective adjuvant therapy. Methods: Patients with completely resected, MAGE-A3 (+), stage pIB or pII were randomly assigned to postoperative MAGE-A3 or placebo (2:1), with 5 administration at 3-week intervals, followed by 8 administrations every 3 months. Randomization was stratified for stage (IB vs. II), histology (squamous vs. other), and lymph-node (LN) procedure (sampling vs. dissection). Primary endpoint was disease-free interval (DFI); other endpoints were safety, disease-free survival (DFS), and overall survival (OS). This exploratory Phase II study was designed to detect a clinically relevant HR with a 10% one-sided a. Results: 182 patients (122 stage IB, 60 stage II) from 59 centers in 14 countries were randomized over 2 years: Median age 63 (45–81); 87% male; 65% squamous cell carcinoma; 65% lymph-node dissection. After a median follow-up of 28 months, 67 recurrences and 45 deaths were recorded. Group comparisons of DFI, DFS and OS gave respectively a hazard ratio (HR) of 0.74 (95% CI 0.44–1.20, p=0.107), 0.73 (95% CI 0.45–1.16) and 0.66 (95% CI 0.36–1.20) in favor of the MAGE-A3 group. Overall, treatment was well tolerated, with excellent protocol compliance. Subset analysis also suggests that LN dissection may have an effect on survival. Conclusions: The final analysis of this randomized phase II study shows a positive trend for activity of MAGE-A3 treatement in NSCLC with a relative improvement of DFI and DFS of 27%. Further phase III evaluation is planned. This study also suggests that complete lymph-node dissection may have an effect on survival and should be confirmed prospectively. [Table: see text]

A Phase-II Clinical Trial of Laparoscopy-Assisted Distal Gastrectomy with D2 Lymph Node Dissection for Gastric Cancer Patients

2007 ◽  
Vol 14 (11) ◽  
pp. 3148-3153 ◽  
Author(s):  
Jun Ho Lee ◽  
Young-Woo Kim ◽  
Keun Won Ryu ◽  
Jong Ryul Lee ◽  
Chan Gyoo Kim ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Clinical Trial ◽  
Lymph Node ◽  
Cancer Patients ◽  
Lymph Node Dissection ◽  
Phase Ii ◽  
Distal Gastrectomy ◽  
Node Dissection ◽  
D2 Lymph Node Dissection ◽  
Gastric Cancer Patients

Learning Curve for Laparoscopy-assisted Distal Gastrectomy With Regional Lymph Node Dissection for Early Gastric Cancer

2008 ◽  
Vol 18 (3) ◽  
pp. 236-241 ◽  
Author(s):  
Chikara Kunisaki ◽  
Hirochika Makino ◽  
Naoto Yamamoto ◽  
Tsutomu Sato ◽  
Takashi Oshima ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Lymph Node ◽  
Early Gastric Cancer ◽  
Learning Curve ◽  
Lymph Node Dissection ◽  
Distal Gastrectomy ◽  
Regional Lymph Node ◽  
Node Dissection ◽  
Regional Lymph Node Dissection

scholarly journals Overlap Anastomosis for Digestive Reconstruction during Laparoscopic Distal Gastrectomy with Intensive Regional Lymph Node Dissection: Physiological Impact of Preserving the Mesenteric Autonomic Nerves in the Lifted Jejunal Limb

2018 ◽  
Vol 2018 ◽  
pp. 1-10
Author(s):  
Taku Kitano ◽  
Daiki Yasukawa ◽  
Yuki Aisu ◽  
Tomohide Hori
Keyword(s):  
Lymph Node ◽  
Lymph Node Dissection ◽  
Distal Gastrectomy ◽  
Surgical Techniques ◽  
Laparoscopic Distal Gastrectomy ◽  
Autonomic Nerve ◽  
Autonomic Nerves ◽  
Node Dissection ◽  
Regional Lymph Node Dissection

Laparoscopic gastrectomy is a treatment for gastric cancer, and isoperistaltic side-to-side reconstruction is called “overlap anastomosis.” The physiological advantages of preserving the autonomic nerves in the jejunal limb for digestive reconstruction are well known. Here, we focused on overlap anastomosis with autonomic nerve-preserved mesojejunum of the lifted jejunal limb for laparoscopic distal gastrectomy with intentional lymph node dissection. Our surgical techniques and technical pitfalls were described in detail. The jejunum was partially sacrificed to preserve the autonomic nerves in the lifted jejunal limb. The length of the staple line was 35 – 40 mm. The endostapler entry was carefully closed to avoid even subtle stenosis. Twelve patients were retrospectively evaluated with a follow-up of 5.0 ± 0.6 years. Histological findings according to the Japanese classification were stage IA or IB. Dietary intake and postoperative ambulation occurred at 3.3 ± 1.0 and 1.3 ± 0.5 days after surgery, respectively. Postoperative complications according to Clavien–Dindo classification were one each of grade I and grade II. Postoperative hospital stay was 6.7 ± 1.6 days. Five patients were medication-free at final follow-up, with no recurrence in any patient. Overlap anastomosis with autonomic nerve-preserved jejunal limb was safe and feasible for laparoscopic distal gastrectomy with lymph node dissection.

Right Superior Mediastinal Lymph Node Dissection in Thoracoscopic Surgery Using a Bipolar Sealing Device

2013 ◽  
Vol 8 (4) ◽  
pp. 258-263 ◽  
Author(s):  
Mitsuhiro Kamiyoshihara ◽  
Hitoshi Igai ◽  
Takashi Ibe ◽  
Natsuko Kawatani ◽  
Yoichi Ohtaki ◽  
...  
Keyword(s):  
Lymph Node ◽  
Lymph Nodes ◽  
Learning Curve ◽  
Lymph Node Dissection ◽  
Thoracoscopic Surgery ◽  
Mediastinal Lymph Node ◽  
Mediastinal Lymph Node Dissection ◽  
Node Dissection ◽  
Chest Drainage ◽  
Sealing Device

Objective This study investigated the use of a new bipolar sealing device (BSD) in right superior mediastinal lymph node dissection during thoracoscopic surgery. Methods The study population consisted of 42 consecutive patients undergoing lobectomy with right superior mediastinal lymph node dissection for primary lung cancer. Operative results were compared with those of conventional surgery in 42 background-matched controls. The primary endpoint for the present analysis was the success of right superior mediastinal lymph node dissection during thoracoscopic surgery using a BSD. The secondary endpoints included the duration of the operation, number of dissected lymph nodes, chest drainage volume and duration, postoperative hospital stay, morbidity, and mortality. Results The BSD was used successfully in 42 patients. No significant difference in duration of lymph node dissection, chest drainage volume, drainage duration, or number of dissected lymph nodes was observed between the study group and the controls. Because of a learning curve, the procedure initially took more than 20 minutes to complete, but surgical time was reduced to approximately 15 minutes after the procedure was performed in 15 patients. Conclusions Our method is safe and in no way inferior to the conventional procedure. The tendency of the learning curve suggests that a significantly shorter duration of lymph node dissection is possible using this method.

Learning curve analysis for lateral pelvic lymph node dissection in rectal cancers – Outcomes improve with experience

2021 ◽  
Author(s):  
Vivek Sukumar ◽  
Mufaddal Kazi ◽  
Jayesh Gori ◽  
Suman Kumar Ankathi ◽  
Akshay Baheti ◽  
...  
Keyword(s):  
Lymph Node ◽  
Learning Curve ◽  
Lymph Node Dissection ◽  
Pelvic Lymph Node Dissection ◽  
Curve Analysis ◽  
Pelvic Lymph Node ◽  
Node Dissection ◽  
Lateral Pelvic Lymph Node ◽  
Rectal Cancers
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