scholarly journals Minimally Invasive Oncologic Upper Gastrointestinal Surgery can be Performed Safely on all Weekdays: A Nationwide Cohort Study

2021 ◽  
Author(s):  
Daan M. Voeten ◽  
Arthur K. E. Elfrink ◽  
Suzanne S. Gisbertz ◽  
Jelle P. Ruurda ◽  
Richard van Hillegersberg ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Esophageal Cancer ◽  
Cohort Study ◽  
Minimally Invasive ◽  
Surgical Outcomes ◽  
Gastrointestinal Surgery ◽  
Short Term ◽  
Esophagogastric Surgery ◽  
The Impact ◽  
Upper Gastrointestinal

Abstract Background Existing literature suggests deteriorating surgical outcome of esophagogastric surgery as the week progresses. However, these studies were conducted in the pre-centralization and pre-minimally invasive era. In addition, they failed to correct for fixed weekdays of esophagogastric cancer surgery among hospitals. This study aimed to describe the impact of weekday of minimally invasive upper gastrointestinal surgery on short-term surgical outcomes. Methods All patients registered in the Dutch Upper Gastrointestinal Cancer Audit who underwent curative minimally invasive esophageal or gastric carcinoma surgery in 2015–2019, were included in this nationwide cohort study. Using multilevel multivariable logistic regression, the impact of weekday of surgery on 14 short-term surgical outcomes was investigated. To correct for interhospital variance in fixed weekday(s) of surgery multilevel analyses was used. Results were adjusted for patient, tumor, and treatment characteristics using multivariable logistic regression analyses. Results This study included 4,102 patients undergoing minimally invasive upper gastrointestinal surgery (2,968 esophageal cancer and 1,134 gastric cancer patients). Weekday of surgery did not impact postoperative complications, severe postoperative complications, surgical/technical complications, medical complications, anastomotic leakage, complicated postoperative course, failure to rescue, surgical radicality, lymph node yield, 30-day/in-hospital mortality, reinterventions, length of ICU stay, 30-day readmission, and textbook outcome after neither esophageal cancer nor gastric cancer surgery. Conclusions Minimally invasive esophagogastric surgery can be performed safely on all weekdays with respect to short-term surgical outcomes, which is important information for operation room scheduling.

scholarly journals Application of robots in general surgery

2021 ◽  
Vol 64 (10) ◽  
pp. 678-687
Author(s):  
Jin Kyong Kim ◽  
Seung Yoon Yang ◽  
Sung Hyun Kim ◽  
Hyoung-Il Kim
Keyword(s):  
Robotic Surgery ◽  
Minimally Invasive ◽  
General Surgery ◽  
New Technologies ◽  
Gastrointestinal Surgery ◽  
Laparoscopic Approach ◽  
Comparative Trial ◽  
Endocrine Surgery ◽  
The Impact ◽  
Upper Gastrointestinal

Background: Application of robotic surgery in the field of general surgery has been increasing. This paper is an overview of the current uses and future perspectives of robotic surgery in four major divisions—endocrine, upper gastrointestinal, hepato-biliary-pancreatic (HBP), and colorectal surgery.Current Concepts: In endocrine surgery, cosmetic advantage is the highest priority when selecting a surgical approach for thyroidectomy. Currently, the transaxillary route is the most common approach. The introduction of the single-port system could maximize the advantages of this technique. In upper gastrointestinal surgery, the use of robots has the advantage of better retrieval of lymph nodes, less bleeding, earlier discharge, and less complications than the laparoscopic approach. However, a more prospective comparative trial is required to confirm those findings. In the HBP field, the indications of robotic surgery have expanded, starting with cholecystectomy to more challenging procedures, such as donor hepatectomy and pancreaticoduodenectomy. Meticulous dissection using robots could provide benefits to patients. In colorectal surgery, robotic surgery is an excellent technical tool for minimally invasive surgeries for rectal cancers, especially in male patients with narrow, deep pelvises. However, further studies are required to confirm the impact of robotic surgery on rectal cancers.Discussion and Conclusion: Robots are used to provide optimal surgical outcomes. Investigating new technologies and innovative surgical procedures is the highly important for a surgeon in the era of minimally invasive surgery.

scholarly journals Proximal gastrectomy with gastric tube reconstruction or jejunal interposition reconstruction in upper-third gastric cancer: which offers better short-term surgical outcomes?

BMC Surgery ◽  
2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Zhiguo Li ◽  
Yan Ma ◽  
Guiting Liu ◽  
Ming Fang ◽  
Yingwei Xue
Keyword(s):  
Gastric Cancer ◽  
Reflux Esophagitis ◽  
Surgical Outcomes ◽  
Gastric Tube ◽  
Proximal Gastrectomy ◽  
Jejunal Interposition ◽  
Short Term ◽  
Jejunal Interposition Reconstruction ◽  
Upper Third ◽  
Gastric Tube Reconstruction

Abstract Objective Proximal gastrectomy acts as a function-preserving operation for upper-third gastric cancer. The aim of this study was to compare the short-term surgical outcomes between proximal gastrectomy with gastric tube reconstruction and proximal gastrectomy with jejunal interposition reconstruction in upper-third gastric cancer. Methods A retrospective review of 301 patients who underwent proximal gastrectomy with jejunal interposition (JI) or gastric tube (GT) at Harbin Medical University Cancer Hospital between June 2007 and December 2016 was performed. The Gastrointestinal Symptom Rating Scale (GSRS) and Visick grade were used to evaluate postgastrectomy syndromes. Gastrointestinal fiberoscopy was used to evaluate the prevalence and severity of reflux esophagitis based on the Los Angeles (LA) classification system. Results The JI group had a longer operation time than the GT group (220 ± 52 vs 182 ± 50 min), but no significant difference in blood loss was noted. Compared to the GT group, the Visick grade and GSRS score were significantly higher. Reflux esophagitis was significantly increased in the GT group compared with the JI group. Conclusion Proximal gastrectomy is well tolerated with excellent short-term outcomes in patients with upper-third gastric cancer. Compared with GT construction, JI construction has clear functional advantages and may provide better quality of life for patients with upper-third gastric cancer.

Comparison of Long- and Short-term Outcomes in 845 Open and Minimally Invasive Gastrectomies for Gastric Cancer in the United States

2021 ◽  
Author(s):  
Masaya Nakauchi ◽  
Elvira Vos ◽  
Yelena Y. Janjigian ◽  
Geoffrey Y. Ku ◽  
Mark A. Schattner ◽  
...  
Keyword(s):  
United States ◽  
Gastric Cancer ◽  
Minimally Invasive ◽  
The United States ◽  
Short Term

scholarly journals A shared susceptibility locus in p53 for both gastric cancer and esophageal cancer in a northwestern Chinese population

2019 ◽  
Author(s):  
Juan Cao ◽  
Zhiqiang Chen ◽  
Jing Chen ◽  
Yanjie You ◽  
Chaoyong Tian ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Esophageal Cancer ◽  
Genetic Variants ◽  
Genetic Locus ◽  
Immunohistochemical Method ◽  
Regression Analyses ◽  
Gastrointestinal Cancers ◽  
P53 Expression ◽  
Increased Risk ◽  
Upper Gastrointestinal

Abstract Background Upper gastrointestinal cancers are the leading causes of cancer-related deaths in Northwest China and share many similarities in terms of histological type, risk factors and genetic variants. We hypothesized that shared common genetic SNPs among eight SNPs in the p53 pathway existed among Ningxia gastric cancer (GC) and esophageal cancer (EC) patients. Methods A total of 180 GC cases, 113 EC cases and 358 cancer-free control subjects from a high-incidence area for upper gastrointestinal cancers in Ningxia, China, were enrolled in this study. The genotyping of 8 SNPs was performed using PCR direct sequencing. P53 expression in GC and EC tissues was examined using the S-P immunohistochemical method. Multiple logistic regression analyses were used to estimate the association between genotypes and GC or EC risks. Kaplan-Meier and multivariate Cox regression analyses were carried out to evaluate the associations between genetic variants and overall survival. Result rs1042522 was a common genetic locus shared by both Ningxia GC and EC patients. Compared with the rs1042522 Pro allele, the rs1042522 Arg allele increased the GC risk by 1.810 times and the EC risk by 2.285 times. Additionally, patients who carried the rs1042522 Arg allele and who also smoked or consumed alcohol had an increased risk for GC and EC. Cox survival analysis showed that neither p53 nor rs1042522 had an effect on the prognosis of GC and EC patients. Conclusion rs1042522 was a common genetic locus responsible for susceptibility shared by both northwestern GC and EC Chinese patients. Tobacco smoking and alcohol drinking further enhanced the cancer risk in our study.

Effects of prognostic nutrition index on side effects and prognosis of radiotherapy and chemotherapy after radical gastrectomy.

2021 ◽  
Vol 39 (15_suppl) ◽  
pp. e16002-e16002
Author(s):  
Jiyu Liu ◽  
Hongmin Dong ◽  
Wenling Wang ◽  
Gang Wang ◽  
Huan Pan ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Overall Survival ◽  
Side Effects ◽  
Nutritional Support ◽  
Gastrointestinal Surgery ◽  
Prognostic Nutritional Index ◽  
Survival Prognosis ◽  
The Impact ◽  
Prognostic Nutrition Index ◽  
Support Treatment

e16002 Background: To investigate the impact of preoperative prognostic nutritional index (PNI) on the severity of radiotherapy and chemotherapy toxicity and survival prognosis in patients with gastric cancer through retrospective analysis and research in order to guide clinical nutritional support treatment for patients with gastric cancer. Methods: Through a retrospective cohort study，we analyzed the data of 191 patients with gastric cancer in the Department of Gastrointestinal Surgery of the Affiliated Hospital of Guizhou Medical University and Guizhou Cancer Hospital from January 2008 to December 2018. According to the cut-off value, the patients were divided into high PNI group (PNI≥47.7) and low PNI group (PNI < 47.7). We Compared the incidences of severe radiotherapy and chemotherapy toxicities and overall survival in high PNI group and low PNI group. and make Analysis of prognostic factors. Results: The low PNI group was more prone to severe radiochemotherapy hematological side effects than the high PNI group, and the postoperative survival time was shorter. Multivariate analysis showed that: TNM stage (P = 0.000) and PNI (P = 0.001) were Independent risk factors in predicting overall survival rate. Conclusions: The preoperative prognostic nutrition index is a useful factor for predicting the incidence of radiotherapy and chemotherapy toxicities in patients after gastric cancer surgery.It is one of the important factors affecting the prognosis of gastric cancer and helps to guide the nutritional support treatment of gastric cancer patients.

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