Early outcomes of robotic distal gastrectomy with D2 lymphadenectomy for gastric cancer at Binh Dan Hospital

2021 ◽  
Vol 11 (2) ◽  
Author(s):  
Vĩnh Hưng Trần ◽  
Keyword(s):  
Gastric Cancer ◽  
Da Vinci ◽  
Operating Time ◽  
Case Series ◽  
Viet Nam ◽  
Safe Procedure ◽  
Robotic Gastrectomy ◽  
Female Ratio ◽  
Male Female Ratio ◽  
Operative Staging

Abstract Introduction: Gastric cancer is one of the five most common malignancies in Vietnam and worldwide. Recently, robotic gastrectomy with lymphadenectomy has become a new trend in the treatment of gastric cancer. In Vietnam, we conducted this study to assess the safety and feasibility of this procedure. Patients and methods: Descriptive study with a case series enrolled 13 patients with lower third gastric cancer underwent gastrectomy with lymphadenectomy by Si-generation da Vinci robot at Binh Dan Hospital from 01/01/2017 to 31/07/2019. Results: Male/female ratio was 2.25:1. The median age was 56.92 ± 8.66 years old. The pre-operative staging (cTNM) was mostly stage III. Robot docking time was 15 ± 7.36 minutes. The total operating time was 225.38 ± 36.43 minutes. The average blood loss during surgery was 66.15 ± 23.64 ml. There were no intraoperative accident as well as early postoperative complication. The postoperative hospital stay was 7.62 ± 0.87 days. The total number of metastatic lymph nodes was 1.62 ± 1.61 nodes. The postoperative staging was IIIA (53.85%), IIB (23.08%), IIA (15.38%) and IB (7.69%) respectively. Conclusions: Robotic gastrectomy is a safe procedure with promising indexes during and after surgery. Key word: Gastric cancer, robotic surgery. Tóm tắt Đặt vấn đề: Ung thư dạ dày (UTDD) là một trong năm loại ung thư phổ biến nhất tại Việt Nam và trên thế giới. Phẫu thuật robot cắt dạ dày và nạo hạch trở thành xu hướng điều trị mới trong UTDD. Tại Việt Nam, chúng tôi tiến hành nghiên cứu sau để tìm hiểu tính an toàn và khả thi của phương pháp phẫu thuật này. Đối tượng và phương pháp nghiên cứu: Nghiên cứu mô tả hàng loạt ca: 13 trường hợp ung thư dạ dày 1/3 dưới được phẫu thuật bằng robot da Vinci thế hệ Si tại bệnh viện Bình Dân từ 01/01/2017 đến 31/7/2019. Kết quả: Tỉ lệ nam : nữ là 2,25 : 1. Độ tuổi trung bình là 56,92 ± 8,66 tuổi. Giai đoạn bệnh trước mổ (cTNM) đa số là giai đoạn III. Thời gian docking robot là 15 ± 7,36 phút. Thời gian mổ toàn bộ là 225,38 ± 36,43 phút. Lượng máu mất trong mổ là 66,15 ± 23,64 ml. Tỉ lệ tai biến và biến chứng sớm là 0%. Thời gian nằm viện sau mổ là 7,62 ngày ± 0,87 ngày. Tổng số hạch di căn là 1,62 ± 1,61 hạch. Giai đoạn bệnh sau mổ bao gồm IIIA (53,85%), IIB (23,08%), IIA (15,38%), IB (7,69%). Kết luận: Phẫu thuật bằng robot cắt dạ dày là một phương pháp phẫu thuật an toàn với các chỉ số trong mổ và sau mổ đầy khả quan. Từ khóa: Phẫu thuật robot, ung thư dạ dày.

scholarly journals Outcomes of laparoscopic proximal gastrectomy with jejunal interposition for proximal early gastric cancer

2018 ◽  
Vol 8 (4) ◽  
Author(s):  
Viet Trung Lam ◽  
Vo Vinh Loc Nguyen
Keyword(s):  
Gastric Cancer ◽  
Early Gastric Cancer ◽  
Proximal Gastrectomy ◽  
Case Series ◽  
Jejunal Interposition ◽  
Surgical Approaches ◽  
Safe Procedure ◽  
Female Ratio ◽  
Laparoscopic Proximal Gastrectomy

Abstract Introduction: Proximal gastrectomy is one of the modified surgical approaches for early gastric cancer located in the upper stomach instead of total gastrectomy. The preserving stomach helps for storage, digestion, and absorption of food and prevents anemia. Proximal gastrectomy with jejunal interinterposition has been reported to prevent and diminuate postoperative complications, such as reflux esophagitis and anastomotic stricture. Laparoscopic proximal gastrectomy (LPG) with jejunal interposition has been reported in the world with promising results. Aim of this study is to evaluate the feasibility and results of LPG with jejunal interposition for proximal early gastric cancer. Material and Methods: Descriptive prospective study ofconsecutive cases of laparoscopic proximal gastrectomy for early gastric cancer located in the upper stomach was conducted at Department of Digestive Surgery of Cho Ray hospital from 1/2015 to 6/2018, . Results: Of 8 cases of LPG for early gastric cancer located in the upper stomach was enrolled. Patients mean age was 55,5. Male/female ratio was 3/1. Tumor located at cardia in 7 cases and in fundus in 1 case. All the tumors were adenocarcinoma at cT1N0M0 stage. Mean operative time was 150 minutes. There was no intraoperative accident. Mean harvested lymph nodes were 5. There was no lymph node metastasis. No morbidity was noted. Mean postoperative hospital stay was 7 days. All patients tolerated well with food and have no regurgitation. With mean follow-up period of 28 months, there was no recurrence and mortality. Conclusion: Our initial case series demonstrated that LPG with jejunal interposition is a feasible, safe procedure and offering good functional and oncological outcomes. Futher follow-up time and more data should be needed to evaluate the effectiveness of this operation.

Adult Hemophagocytic Lymphohistiocytosis: Clinical Presentation and Follow-Up in a Consecutive Series of Ten Patients.

Blood ◽  
2006 ◽  
Vol 108 (11) ◽  
pp. 3845-3845
Author(s):  
Keisuke Shirai ◽  
Alberto Montero ◽  
Jesse Powell ◽  
Lydia Christiansen ◽  
John Lazarchick
Keyword(s):  
Hemophagocytic Lymphohistiocytosis ◽  
Case Reports ◽  
Case Series ◽  
Hematologic Malignancies ◽  
Neurological Involvement ◽  
Consecutive Series ◽  
Female Ratio ◽  
Etoposide Treatment ◽  
Male Female Ratio ◽  
Underlying Causes

Abstract Hemophagocytic Lymphohistiocytosis (HLH) is very rare in adults but can be fatal without treatment. Reports in adults are limited to case reports and very small case series. Clinically it is characterized by fever, hepatosplenomegaly, lymphadenopathy, severe cytopenias, hepatic dysfunction, coagulopathy, as well as neurological involvement. This syndrome is associated with diverse processes including: infection, rheumatologic, and hematologic malignancies. Presently, the underlying cause of HLH is unknown. We present a cosecutive series of 10 adults with HLH diagnosed at our institution between 2004–2006. All diagnoses were confirmed by pathology. The median age was 59 years (range: 18–73 years), and a male: female ratio of 4:1. All patients uniformly presented with fever. Half of the patients presented with evidence of hepatomegaly or splenomegaly. The most predominant laboratory abnormalities included: leukopenia or thrombocytopenia (100%), and elevation of liver enzymes (50%). EBV IgG was positive in 8 of 10 patients. The underline illnesses associated with HLH were diverse. The underlying causes were as follows; acute leukemia (n=2), infection (n=2), rheumatologic (n=2), post transplant (n=2) sickle cell disease (n=2), unknown (n=2). Mortality rate was 60% with a median survival time since diagnosis of 58 days. One patient is still on maintenance cyclosporin after etoposide treatment. One patient is on steroid and cytoxan. One patient recovered just with supportive care. In conclusion, due to the high morality rate associated with HLH, early treatment with immunosuppressant is warranted and attempts to identify underlying cause.

Behaviors of adult stomach cancer: a retrospective study of 95 cases

2019 ◽  
Vol 7 (2) ◽  
pp. 163-151
Author(s):  
Richard G Dong ◽  
Meilan J Harris
Keyword(s):  
Gastric Cancer ◽  
Stomach Cancer ◽  
Tumor Tissue ◽  
Young Patients ◽  
Considerable Variability ◽  
Female Ratio ◽  
Aggressive Disease ◽  
Pathological Characteristics ◽  
Male Female Ratio ◽  
Md Anderson

Stomach cancer mostly affects older people and the average age of people when they are diagnosed is 69 years old. About 6 of every 10 people diagnosed with stomach cancer each year are 95 or older. Further, gastric cancer is an aggressive disease with nonspecific early symptoms. Its incidence and prognosis in young patients has shown considerable variability. To better understand gastric in these young patients, we revised 95 young patients aged <30 diagnosed with gastric cancer at MD Anderson Center from January 2008 through February 2013, including age at diagnosis, sex, tumor histology, ethnicity and type of treatment to demonstrate its specific clinical and pathological characteristics. The presented data show that 96.6% of tumor tissue histology was adenocarcinoma, male/female ratio was 1.1:1 and no significant relationship to the tobacco or alcohol used. Furthermore, the median survival time of these 95 patients was 5.8 months, 71.4% with late diagnosis and 41% has gastric family history. Further 49.6% with symptoms of ulcer that do not improve under adequate medical management. Our concluded is that adult gastric cancer exhibits different tumor behavior with delay diagnosis that affects the prognosis of the tumor.

scholarly journals Similar Operative Outcomes between the da Vinci Xi® and da Vinci Si® Systems in Robotic Gastrectomy for Gastric Cancer

2019 ◽  
Vol 19 (2) ◽  
pp. 165 ◽  
Author(s):  
Rana M. Alhossaini ◽  
Abdulaziz A. Altamran ◽  
Seohee Choi ◽  
Chul-Kyu Roh ◽  
Won Jun Seo ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Da Vinci ◽  
Da Vinci Xi ◽  
Robotic Gastrectomy ◽  
Operative Outcomes ◽  
Da Vinci Si

Concurrent dural and perimedullary arteriovenous fistulas at the craniocervical junction: case series with special reference to angioarchitecture

2013 ◽  
Vol 118 (2) ◽  
pp. 451-459 ◽  
Author(s):  
Kenichi Sato ◽  
Toshiki Endo ◽  
Kuniyasu Niizuma ◽  
Miki Fujimura ◽  
Takashi Inoue ◽  
...  
Keyword(s):  
Case Series ◽  
Vascular Anomaly ◽  
Craniocervical Junction ◽  
Posterolateral Approach ◽  
Pathophysiological Mechanism ◽  
Arterial Aneurysm ◽  
Female Ratio ◽  
Arteriovenous Fistulas ◽  
Male Female Ratio ◽  
The Right

Object Dural arteriovenous fistulas (DAVFs) and perimedullary arteriovenous fistulas (PAVFs) are uncommonly associated in the craniocervical junction. The purpose of this study was to describe the clinical and angiographic characteristics of such concurrent lesions. Methods Authors reviewed 9 cases with a coexistent DAVF and PAVF at the craniocervical junction. Clinical presentation, angiographic characteristics, intraoperative findings, and treatment outcomes were assessed. Results All patients (male/female ratio 5:4; mean age 66.3 years) presented with subarachnoid hemorrhage. Angiography revealed that 8 patients had both a DAVF and PAVF on the same side, whereas 1 patient had 3 arteriovenous fistulas, 1 DAVF, and 1 PAVF on the right side and 1 DAVF on the left side. All of the fistulas shared dilated perimedullary veins (anterior spinal vein, 7 cases; anterolateral spinal vein, 2 cases) as a main drainage route. The shared drainage route was rostrally directed in 8 of 9 cases. Eight patients exhibited an arterial aneurysm on the distal side of the feeding arteries to the PAVF, and the aneurysm in each case was intraoperatively confirmed as a bleeding point. One patient had ruptured venous ectasia at the perimedullary fistulous point. All patients underwent direct surgery via a posterolateral approach. No recurrence was observed in the 4 patients who underwent postoperative angiography, and no rebleeding event was recorded among any of the 9 patients during the follow-up period (mean 38.4 months). Conclusions The similarity of the angioarchitecture and the close anatomical relationship between DAVF and PAVF at the craniocervical junction suggested that these lesions are pathogenetically linked. The pathophysiological mechanism and anatomical features of these lesions represent a unique vascular anomaly that should be recognized angiographically to plan a therapeutic strategy.

scholarly journals Effect of marsupialization on the healing of fistulotomy wounds of simple anal fistula: a randomized control trial

2018 ◽  
Vol 5 (6) ◽  
pp. 2035
Author(s):  
Mohamed M. Raslan
Keyword(s):  
Postoperative Pain ◽  
Anal Fistula ◽  
Operative Time ◽  
Operating Time ◽  
Healing Time ◽  
Complete Healing ◽  
Female Ratio ◽  
Inadequate Sample Size ◽  
Male Female Ratio

Background: An anal fistula is traditionally treated by fistulotomy, adding marsupialization of fistulotomy wounds is optional. The aim of the current study was to compare the outcomes of fistulotomy with marsupialization and fistulotomy alone for simple anal fistula on healing rates and post-operative complicationsMethods: 50 patients with simple anal fistula randomly allocated to two groups fistulotomy alone group (F)and fistulotomy with marsupialization group(FM). The primary outcome was the healing time secondary outcomes included postoperative pain, operating time, incontinence and recurrence.Results: Mean age of group (F) patients was 37.55 ± 1.96 years with a male: female ratio of 19:6 while the mean age of group (FM) patients was 36.30 ± 3.03 years with a male: female ratio of 21:4. Mean operative time in the group (F) was 23.5±3.3 minutes while in the group (FM) It was 29.00± 4.595 minutes difference is statistically significant. Mean time for complete healing in group (F) was 6.9 ±0.73 weeks while in group (FM) was 4.80 ±0.96 weeks difference is significant statistically. Mean postoperative pain score by visual analogue scale in the group (F) was 3.4 ± 1.2 while in the group (FM) it was 3.3 ± 1.3 this difference is statistically non-significant. No recurrences or incontinence.Conclusions: Study demonstrated faster-wound healing when adding marsupialization to fistulotomy compared to fistulotomy alone. There is an increase operative time with marsupialization. This effect is minimal when compared with the benefits of enhanced healing. Limitations are mainly the inadequate sample size and inadequate follow-up period. 

scholarly journals Histopathological Analysis of Gastric Cancers in University of Ilorin Teaching Hospital: A 20-Year Review

2021 ◽  
Vol 4 (1) ◽  
pp. 85-95
Author(s):  
KA Suleiman ◽  
EAO Afolayan ◽  
OOK Ibrahim ◽  
A Ahmed ◽  
SK Abubakar-Akanbi
Keyword(s):  
Gastric Cancer ◽  
Late Presentation ◽  
Histopathological Analysis ◽  
Tubular Adenocarcinoma ◽  
Endoscopic Screening ◽  
Female Ratio ◽  
Gastric Cancers ◽  
Male Female Ratio ◽  
Alarm Features

Gastric cancer is a relatively common malignancy in Nigeria. Gastric cancer varies from region, being 4th to 20th in proportion to other malignancies. The symptom and signs are often non-specific with the early stages of the disease. This may be responsible for late presentation and poor prognosis. This is a 20-year retrospective analysis of 107 histopathologically confirmed gastric cancers in the department of pathology. This study aimed to analyze the Histopathological patterns of all the gastric cancer cases diagnosed in U.I.T.H Ilorin, over a twenty-year period. Gastric cancers were classified according to WHO 2010 and Lauren classification of gastric cancers. A total of 107 cases of gastric cancers diagnosed, that met the inclusion criteria, were analyzed with male: female ratio of 1.3:1 out of which epithelial malignancy accounted for 93.5% with tubular adenocarcinoma representing the commonest epithelial subtype. Epithelial malignancy is the commonest histological type in this area. Therefore, it is recommended that patients above 40 years with dyspepsia and other alarm features should undergo routine endoscopic screening.

scholarly journals EXPERIENCES OF SURGICAL MANAGEMENT OF FRACTURE SHAFT OF HUMERUS IN ADULTS USING ENDER NAIL

2021 ◽  
Vol 5 (6) ◽  
Author(s):  
Amit Ranjan Vidyarthi ◽  
Alok Sobhan Datta
Keyword(s):  
Minimally Invasive ◽  
Functional Outcome ◽  
Operating Time ◽  
Shaft Fracture ◽  
Fracture Pattern ◽  
Female Ratio ◽  
Duration Of Surgery ◽  
Male Female Ratio ◽  
Humerus Shaft

Background: This study was conducted at the Department of Orthopaedics, I.P.G.M.E& R & SSKM Hospital, Kolkata, West Bengal, with the objective to achieve quick union and minimal soft tissue disruption, least neurovascular complications and good functional outcome. In this study, 30 patients were selected on random basis from those attending the Outpatient Department and Emergency Room, between January 2015 to August 2016, with humerus shaft fractures. Among these, 76% of the patients were in age group (<40 years) with age range 22-60 years with mean age 35 years .The male : female ratio was 6.7:1 . In our study majority (73%) of the patients have type AO 12A3 fracture .Mean duration of injury was 9.633 days. Mean duration of surgery in our study was 74.33 minutes, with range of 45-95 minutes, indicating a short operating time and minimum radiation exposure. During intraoperative period no complications and difficulties were experienced. The complications of our operative period were only 13%. Mean duration of follow up was 13.7 months with range from 9-18 months without any no loss at follow up. All fractures united. Mean duration of union was 17 weeks. In this study, 80%  patients had excellent grading, 17% have good grading and 3% had fair grading on the basis of MEPS and UCLA  score  combining shoulder and elbow functional outcome .In the present study, we dealt with the association of different parameters with respect to grading fracture pattern and type .This study showed that Ender’s nailing for closed humerus shaft fracture provided satisfactory clinical ,radiological, and functional outcome ,was minimally invasive ,had less infection rate and least neurovascular complications, thus promising a viable option for treatment of closed shaft humerus fracture. Keywords: Closed fracture shaft Of humerus ; Adults, Minimally invasive , Ender’s Nail ; Fracture union.    

Aetiology of arthritis in hospitalised children: an observational study

2015 ◽  
Vol 100 (8) ◽  
pp. 742-747 ◽  
Author(s):  
Camille Aupiais ◽  
Brice Ilharreborde ◽  
Catherine Doit ◽  
Audrey Blachier ◽  
Marie Desmarest ◽  
...  
Keyword(s):  
Septic Arthritis ◽  
Tertiary Care ◽  
Case Series ◽  
First Episode ◽  
Tertiary Care Centre ◽  
Female Ratio ◽  
Fluid Analysis ◽  
Case Series Study ◽  
Male Female Ratio ◽  
Series Study

Background and objectiveArthritis in children has many causes and includes septic and viral arthritis, reactive arthritis and juvenile idiopathic arthritis (JIA). We aimed to describe the different types of arthritis among children hospitalised for a first episode of arthritis.DesignRetrospective, descriptive case series study.SettingA French tertiary care centre.PatientsChildren under 16 years of age hospitalised for an arthritis episode between 1 January 2008 and 31 December 2009.Main outcome measuresDemographic and clinical features were compared with χ2 or Fisher's exact tests and non-parametric tests.Results173 children were hospitalised for a first episode of arthritis during the study period, with a male/female ratio of 1.14. The most frequent cause of hospitalisation was septic arthritis (43.4% of cases, 69.3% of which were due to Kingella kingae and 10.7% to Staphylococcus aureus). JIA was responsible for 8.1% of cases and arthritis without any definitive diagnosis for 40.4%. Median age at diagnosis was 2.7 years (IQR 0.3–14.6) and was lower in the septic arthritis group (1.5 years; 1.1–3.4) than in the JIA group (4.7 years; 2.5–10.9) (p<0.01). Septic arthritis involved a single joint in 97.3% of cases, while JIA involved four joints in 14.3% of cases and two to four joints in 28.6% of cases (p<0.01).ConclusionsSeptic arthritis was the most frequent cause of arthritis in hospitalised children. Despite the increasing application of microbiological molecular methods to synovial fluid analysis, further measures are required to improve the diagnosis of arthritis of unknown cause.

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