scholarly journals Robotic distal subtotal gastrectomy with D2 lymphadenectomy for advanced gastric cancer: a case report and technical description

2020 ◽  
Vol 2 (1) ◽  
pp. 18-21
Author(s):  
Francesco Giovanardi
Keyword(s):  
Gastric Cancer ◽  
Case Report ◽  
Three Dimensional ◽  
Subtotal Gastrectomy ◽  
Gastric Surgery ◽  
Robotic Systems ◽  
D2 Lymphadenectomy ◽  
Tips And Tricks ◽  
Technical Details ◽  
Three Dimensional Vision

Robotic systems have revolutionized the way we perform minimally invasive surgery and has facilitated the evolution of traditional laparoscopic gastric surgery. Surgeons have several advantages that can overcome some of the well-known limits of laparoscopy: three-dimensional vision, articulated instruments, the absence of tremors. These can give greater dexterity and precision in dissection and suturing movements that are key elements when performing complex and gentle reconstruction to restore digestive continuity. The present case shows the technical details and tips and tricks of a robotic surgical approach for a subtotal gastrectomy.

scholarly journals First Video Case Report of Chronic Retrograde Jejunojejunal Intussusception after Subtotal Gastrectomy with Braun’s Anastomosis

2017 ◽  
Vol 2017 ◽  
pp. 1-3
Author(s):  
Savaş Bayrak ◽  
Hasan Bektaş ◽  
Necdet Derici ◽  
Ekrem Çakar ◽  
Şükrü Çolak
Keyword(s):  
Weight Loss ◽  
Abdominal Pain ◽  
Case Report ◽  
Gastrointestinal Endoscopy ◽  
Subtotal Gastrectomy ◽  
Gastric Surgery ◽  
Upper Gastrointestinal Endoscopy ◽  
Video Presentation ◽  
Video Case Report ◽  
Upper Gastrointestinal

Intussusception, which is seen rarely in adults, is defined as the pulling or invagination of a part of the intestine into another segment of the intestine. In this case report we present chronic retrograde jejunojejunal intussusception following gastric surgery with Braun’s anastomosis in adult with video presentation. A 66-year-old woman, who had undergone gastric surgery 39 years ago and cholecystectomy 20 years ago, was admitted to our clinic with the complaints about weight loss, abdominal pain, nausea, and vomiting. Upper gastrointestinal endoscopy (UGISE) was applied, and patient was treated with surgery. This case report indicates that intussusception should be considered in the presence of clinical complaints following gastric surgery, as well as importance of endoscopy in diagnosis.

scholarly journals Robotic Sentinel Lymph Node Procedure After Endoscopic Submucosal Dissection of High Risk Early Gastric Cancer: A Case Report

2020 ◽  
pp. 1-3
Author(s):  
Alexander B.J. Borgstein ◽  
Alexander B.J. Borgstein ◽  
WJ Eshuis ◽  
SS Gisbertz ◽  
MI van Berge Henegouwen
Keyword(s):  
Gastric Cancer ◽  
Lymph Node ◽  
Sentinel Lymph Node ◽  
Early Gastric Cancer ◽  
Subtotal Gastrectomy ◽  
Lymph Node Involvement ◽  
D2 Lymphadenectomy ◽  
Robot Assisted ◽  
Sentinel Lymph Node Procedure ◽  
Additional Gastrectomy

Endoscopic resection (ER) is the treatment of choice for early gastric cancer (T1) without lymph node involvement. An additional gastrectomy with D2 lymphadenectomy is recommended if ER is considered as non-curative. Here, we present a case of a robot-assisted sentinel lymph node procedure performed with the use of duel-tracer, including ICG fluorescence and technetium-99, after a non-curative ESD for an early gastric tumor. Five “hot” lymph nodes were resected, one of which was positive for metastasis. A subtotal gastrectomy with D2 lymphadenectomy was performed additionally during the same procedure. This case presentation indicates the feasibility of a robot-assisted sentinel lymph node procedure in early gastric cancer.

scholarly journals Laparoscopy Assisted Distal Gastrectomy Versus Open Distal Gastrectomy for Patients with Gastric Cancer in A Middle Resources Country

2019 ◽  
pp. 1-6
Author(s):  
Hussein Fakhry ◽  
Anwar Tawfik Amin ◽  
Badawy M Ahmed
Keyword(s):  
Gastric Cancer ◽  
Distal Gastrectomy ◽  
Tnm Classification ◽  
Oral Intake ◽  
Gastric Surgery ◽  
Nodal Metastasis ◽  
D2 Lymphadenectomy ◽  
Open Distal Gastrectomy ◽  
Mortality And Morbidity ◽  
Distal Gastric Cancer

Background:Laparoscopic surgery with a small laparotomy has several advantages over conventional open surgery, including less invasiveness, less pain, earlier recovery, and better cosmoses. The aim of this study was to compare technical feasibility and early clinical outcomes of laparoscopy-assisted distal gastrectomy in comparison with open distal gastrectomy for gastric cancer in a developing country. Patients and methods :In this retrospective study, patients with distal gastric cancer were divided into two groups (a) patients underwent laparoscopy assisted distal gastrectomy (LADG) (21 patients) and (b) open distal gastrectomy (ODG) (21 patients). For the postoperative pathologic results, the tumor-nodal-metastasis (TNM) stage, grade of tumor differentiation, distal and proximal margins, the number of harvested lymph nodes were evaluated. Staging was done according to the 7th edition of the UICC tumor, node, and metastasis (TNM) classification. D1/D2 lymphadenectomy with curative R0 intention was attempted in all cases. Perioperative mortality and morbidity were assessed. Results:The time to initiate oral intake, and postoperative hospital stay were significantly shorter in the LADG group than in the ODG group (P < 0.001). The operative time in the LADG group was significantly less than that of the ODG group (P = 0.05). Blood loss and blood transfusion frequency were significantly lower (P < 0.0001) in the LADG group in comparison to ODG group. Conclusion:Laparoscopic-assisted distal gastrectomy for distal gastric cancer could be safe and feasible technique alternative to open gastrectomy in a middle income country, with at least similar short term surgical and oncological results. However, laparoscopic gastric surgery is in need to adequate training and technical support especially in D2 lymphadenectomy.

The prognostic significance of Cerb-B2 determination in gastric cancer.

2012 ◽  
Vol 30 (15_suppl) ◽  
pp. e14713-e14713
Author(s):  
Antonio CALDEIRA Fradique
Keyword(s):  
Gastric Cancer ◽  
Lymph Node ◽  
Lymph Node Metastases ◽  
Statistical Significance ◽  
Prognostic Significance ◽  
Subtotal Gastrectomy ◽  
D2 Lymphadenectomy ◽  
Tumor Aggressiveness ◽  
Resectable Gastric Cancer ◽  
Node Metastases

e14713 Background: The Cerb-B2/HER2 marker, is a glycoprotein encoded by the ERBB2 oncogene, belongs to the family of epidermal growth factor receptors (EGFR), which has based its application on tests of new therapeutic modalities (target therapy). Apart from this interest has been invoked its value as a marker of tumor aggressiveness, due to his role as a regulator of cell proliferation and migration and consequent invasiveness and metastization. However, the results as to the meaning prognosis of this molecular marker are controversial and with variations depending on the geographical zone. Results: From a total of 50 pts. with advanced resectable gastric cancer that underwent surgery with D2 lymphadenectomy, 38 pts. had a total gastrectomy, and 12 pts. had subtotal gastrectomy. A mean of 35.7 lymph nodes/pt were resected at surgery. In 68% of pts. positive lymph node metastases were present. Tumor HER2-neu overexpression was observed in 16 pts (32%), several other parameters of tumor aggressiveness were also present, without any statistical significance or relevance. Methods: To determine if the Cerb-B2 played a prognostic role in gastric cancer, a total of 50 pts. with advanced resectable gastric cancer, were submitted to gastrectomy with D2 lymphadenectomy. In all cases assessment for tumor HER2-neu overexpression was performed using immunohistochemistry (IHC). FISH was used as a confirmation method in tumors with 2+ expression by IHC. A correlation was made between the tumor HER2-neu expression and the following parameters: tumor location, size, histological type, depth of invasion, lymph node metastases and clinical staging. Results: From a total of 50 pts. with advanced resectable gastric cancer that underwent surgery with D2 lymphadenectomy, 38 pts. had a total gastrectomy, and 12 pts. had subtotal gastrectomy. A mean of 35.7 lymph nodes/pt were resected at surgery. In 68% of pts. positive lymph node metastases were present.Tumor HER2-neu overexpression was observed in 16 pts (32%), several other parameters of tumor aggressiveness were also present, without any statistical significance or relevance. Conclusions: The determination of Cerb-B2 / HER2 expression has not shown prognostic significance in this study.

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