The usefulness of Roux-en-Y reconstruction with aboral pouch following total gastrectomy for gastric cancer.

2017 ◽  
Vol 35 (4_suppl) ◽  
pp. 209-209
Author(s):  
Shirou Iwagami ◽  
Sugihara Hidetaka ◽  
Takao Mizumoto ◽  
Tatsuo Kubota ◽  
Nobutomo Miyanari ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Total Gastrectomy ◽  
Prognostic Nutritional Index ◽  
Short Term ◽  
Common Procedure ◽  
Term Outcome ◽  
Nutritional Parameters ◽  
Nutritional Index ◽  
One Year ◽  
Outcome Of Surgery

209 Background: Patients with gastric cancer that involves the upper part of the stomach should undergo total gastrectomy for their curative resection. Roux-en-Y reconstruction is the most common procedure followingtotal gastrectomy. However, this reconstruction causes them various postgastrectomy symptoms and problems of their nutritional status and QOL. Although the development of the new reconstruction to prevent these symptoms have being carried out, we have not generally established procedures. Methods: To compare the feasibility and the nutritional parameters of the patients with Roux-en-Y reconstruction with aboral pouch following total gastrectomy to the simple Roux-en-Y. From February 2011 to June 2014, sixty three patients with gastric cancer underwent total gastrectomy. We analyzed the short-term outcome of surgery and the nutritional parameters in two groups. Results: The aboral pouch was created as a side to side anastomosis approximately 50 cms distal to the esophagojejunostomy, 12 cm in length. Most nutritional parameters after surgery were similar in two groups. However, lymphocyte, serum albumin and prognostic nutritional index in aboral pouch group one year later were good tendency compared with simple Roux-en-Y group. Conclusions: Roux-en-Y reconstruction with aboral pouch might become one of the standard methods after total gastrectomy for gastric cancer.

The Preoperative Prognostic Nutritional Index Predicts Short-Term and Long-Term Outcomes of Patients with Stage II/III Gastric Cancer: Analysis of a Multi-Institution Dataset

2019 ◽  
Vol 37 (2) ◽  
pp. 135-144 ◽  
Author(s):  
Masahiro Sasahara ◽  
Mitsuro Kanda ◽  
Seiji Ito ◽  
Yoshinari Mochizuki ◽  
Hitoshi Teramoto ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Area Under The Curve ◽  
Prognostic Nutritional Index ◽  
Stage Ii ◽  
Long Term Outcomes ◽  
Short Term ◽  
Nutritional Index ◽  
Appropriate Treatment ◽  
Disease Free

Background/Aims: Identification of nutritional indicators to predict short-term and long-term outcomes is necessary to provide appropriate treatment to patients with gastric cancer. Methods: We designed an analysis of a multicenter dataset of patients with gastric cancer who underwent gastrectomy between 2010 and 2014. We enrolled 842 eligible patients who had stage II/III gastric cancer. The area under the curve (AUC) values were compared among prognostic nutritional index (PNI), calculated as 10 × albumin g/dL + 0.005 × total lymphocyte count/mm3, and its constituents, and the predictive value of preoperative PNI for postoperative short-term and long-term outcomes was evaluated. Results: Preoperative PNI exhibited higher AUC values (0.719) for 1-year survival than its constituents, and the optimal cutoff value was 47. The disease-free and overall survival of patients in the PNI-low group were significantly shorter compared with those in the PNI-high group. The prognostic difference between the PNI-high and PNI-low groups was significantly greater in the subgroup of patients who underwent total gastrectomy. Clinically relevant postoperative complications were more frequently observed in the PNI-low group. Conclusions: The preoperative PNI is a useful predictor reflecting the incidence of complications after gastrectomy and the prognosis of patients with stage II/III gastric cancer.

scholarly journals The role of prognostic nutritional index for clinical outcomes of gastric cancer after total gastrectomy

2020 ◽  
Vol 10 (1) ◽  
Author(s):  
Zhu Xishan ◽  
Zhao Ye ◽  
Ma Feiyan ◽  
Xuan Liang ◽  
Wu Shikai
Keyword(s):  
Gastric Cancer ◽  
Cancer Patients ◽  
Total Gastrectomy ◽  
Disease Free Survival ◽  
Prognostic Nutritional Index ◽  
Tnm Stage ◽  
Nutritional Index ◽  
Gastric Cancer Patients ◽  
The Relationship ◽  
Univariate Analyses

Abstract The purpose of this article is to evaluate the relationship between the nutrition-based microenvironment and clinicopathological information for gastric cancer patients and to investigate the prognostic value of nutrition index for gastric cancer patients undergoing total gastrectomy. We retrospectively collected clinical information of 245 gastric cancer patients who underwent total gastrectomy in our hospital between January 1st 2005 and December 30th 2015. According to the prognostic nutritional index (PNI) level, they were divided into low PNI (< 43) group and high PNI (≥ 43) group. The relationship between PNI and the disease-free survival (DFS) and overall survival (OS) were analyzed by statistical analysis. Univariate analyses demonstrated that TNM stage (p = 0.025), patients age (p = 0.042), lymph node metastasis (p = 0.028), tumor differentiation (p = 0.037) and a low PNI (p = 0.033) were closely correlated with a poor prognosis. In multivariate analysis, TNM stage (p = 0.027) and a low PNI (p = 0.041) were found to be independently associated with poor survival. Additionally, when age was considered as a stratified factor, univariate analyses demonstrated that low PNI correlated with shorter DFS in non-elderly (< 65) patients (p = 0.022) and shorter DFS (p = 0.036) and OS (p = 0.047) in elderly (≥ 65) patients. The low prognostic nutritional index is an independent risk factor associated with poor gastric cancer survival which represents the nutritional microenvironment. Patients with low pre-operative prognostic nutritional index levels should be observed more closely after surgery to prevent the occurrence of post-operative complications in the near future.

scholarly journals Nutritional Results of Roux-en-Y Pouch Reconstruction After Total Gastrectomy for Gastric Cancer

2018 ◽  
Vol 103 (7-8) ◽  
pp. 409-414
Author(s):  
Chikashi Shibata ◽  
Ryuji Nakamura ◽  
Hitoshi Ogawa ◽  
Kaori Koyama ◽  
Kazuaki Mukouda ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Serum Albumin ◽  
Total Gastrectomy ◽  
Lymphocyte Count ◽  
Prognostic Nutritional Index ◽  
Total Lymphocyte Count ◽  
Stage I ◽  
Nutritional Index ◽  
Pouch Reconstruction ◽  
Nutritional Advantage

Objective: The aim of the present study was to describe the nutritional advantage of pouch reconstruction. Summary of background data: Roux-en-Y (RY) pouch reconstruction might improve patients' quality of life compared with RY reconstruction without a pouch after total gastrectomy for gastric cancer. Methods: Clinical records were retrospectively reviewed in 9 and 30 patients with gastric cancer for stages I to III diseases in the pouch and RY groups, respectively, and perioperative and nutritional results were studied. Nutritional results were studied for hemoglobin, serum albumin, total lymphocyte count, and prognostic nutritional index for 5 years postoperatively. Results: Intraoperative blood loss did not differ between 2 groups, and operative time in the pouch group was prolonged compared with the RY group. All parameters we studied for nutritional results did not differ between the pouch and RY groups in patients with stages I to III diseases. When nutritional results were investigated in patients with stage I diseases, the total lymphocyte count at 2 years and prognostic nutritional index at 2 and 3 years postoperatively were greater in the pouch group than RY group, but the increase was not obvious at 4 to 5 years after the operation, and serum albumin and hemoglobin did not differ between 2 groups. Conclusions: These results indicate that the nutritional advantage of pouch reconstruction is very limited after total gastrectomy because the nutritional benefits of pouch reconstruction were observed in 2 of 4 parameters in patients with stage I at 2 and 3 years postoperatively.

scholarly journals Preoperative Prognostic Nutritional Index Predicts Long-term Outcome in Gastric Cancer: A Propensity Score-matched Analysis

2018 ◽  
Vol 38 (8) ◽  
pp. 4735-4746 ◽  
Author(s):  
NORIYUKI HIRAHARA ◽  
YOSHITSUGU TAJIMA ◽  
YUSUKE FUJII ◽  
TETSU YAMAMOTO ◽  
RYOJI HYAKUDOMI ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Propensity Score ◽  
Prognostic Nutritional Index ◽  
Term Outcome ◽  
Long Term Outcome ◽  
Nutritional Index

Short-Term Results of Laparoscopic Esophagojejunostomy using Linear Staplers after Total Gastrectomy for Gastric Cancer

2017 ◽  
Vol 152 (5) ◽  
pp. S1245
Author(s):  
Toshinaga Nabae ◽  
Toshitatu Ogino ◽  
Hideyo Kimura ◽  
Shiho Nishimura ◽  
Takanori Mei ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Total Gastrectomy ◽  
Short Term

Bulimia nervosa: treatment and short-term outcome

1986 ◽  
Vol 16 (1) ◽  
pp. 65-70 ◽  
Author(s):  
L. K. George Hsu ◽  
Diane Holder
Keyword(s):  
Treatment Outcome ◽  
Bulimia Nervosa ◽  
Response To Treatment ◽  
Dropping Out ◽  
Methodological Issues ◽  
Short Term ◽  
Term Outcome ◽  
Short Term Outcome ◽  
Duration Of Illness ◽  
One Year

SynopsisFifty-six bulimia nervosa patients were treated by means of a behavioural approach and followed for at least one year after completion or dropping out of treatment. Outcome was encouraging in about half of the patients and several psychiatric indicators, such as duration of illness and response to treatment, were identified. The significance of the findings and unresolved methodological issues are discussed.

scholarly journals Short-term and long-term outcomes of robotic, laparoscopic and open radical gastrectomy in gastric cancer: A single-center retrospective study

2019 ◽  
Author(s):  
Weifan Zhang ◽  
Xinhui Zhao ◽  
Zhao Liu ◽  
Hui Dang ◽  
Lei Meng ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Lymph Nodes ◽  
Learning Curve ◽  
Operation Time ◽  
Open Gastrectomy ◽  
Short Term ◽  
Term Outcome ◽  
Long Term Outcome ◽  
Estimated Blood Loss

Abstract Background: Few studies on the comparison among robotic, laparoscopic, and open gastrectomy had been reported in gastric cancer . The goal of this study was to evaluate the advantages of robotic-assisted gastrectomy (RAG) by comparing with laparoscopic-assisted gastrectomy(LAG) and open gastrectomy (OG). Methods: 147 gastric cancer patients who underwent gastrectomy were enrolled and retrospectively analyzed between January 2017 and July 2019. Short-term outcomes such as operation time, intraoperative estimated blood loss(EBL),number of retrieved lymph nodes, postoperative recovery, learning curve, and long-term outcome such as overall survival(OS) was compared among RAG, LAG and OG groups. Results: RAG group included 47 patients, 44 in the LAG, and 61 in the OG. Basic information such as gender, age, BMI, ASA degree were similar among three groups, and there were no statistically significances in pathological TNM staging, tumor resection extent, resection margin, methods of reconstruction( P ＞0.05). The cumulative sum(CUSUM) method showed that learning curve of RAG reached stability after 17 cases . For short-term outcomes, the RAG group had the shortest EBL( P =0.033), the shortest time to first flatus( P ＜0.001), shortest time to first intake liquid diet ( P =0.004),shortest postoperative hospital stay ( P =0.023)and the largest number of retrieved lymph nodes( P =0.044),the longest operation time( P ＜0.001), the most expensive treatment cost( P ＜0.001),however, there were no significant differences in postoperative drainage, postoperative white blood cell(WBC)count and early complications among three group( P ＞0.05). In addition to long-term outcome, similar OS was observed in three groups. Conclusion: Compared with LAG and OG, RAG has certain advantages in short-term outcomes and is a safe and reliable surgical method. But still need further prospective, multi-center research to confirm this.

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