Experience of Distal Gastrectomy By Minilaparotomy With Laparoscopic-Assistance for Nonoverweight Patients With T1N0-1 Gastric Cancer

2011 ◽  
Vol 96 (2) ◽  
pp. 104-110 ◽  
Author(s):  
Hideyuki Ishida ◽  
Toru Ishiguro ◽  
Norimichi Okada ◽  
Kensuke Kumamoto ◽  
Keiichiro Ishibashi ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Distal Gastrectomy ◽  
Skin Incision ◽  
Protein Levels ◽  
Reactive Protein ◽  
Cell Counts ◽  
Simple Alternative ◽  
Laparoscopic Assistance ◽  
White Blood Cell Counts ◽  
Laparoscopic Assisted

Abstract To evaluate the usefulness of laparoscopic assistance for curative distal gastrectomy by minilaparotomy, 19 patients (body mass index ≤25.0 kg/m2) with T1N0-1 gastric cancer who underwent distal gastrectomy with a minilaparotomy (skin incision ≤7 cm) with laparoscopic assistance (LA (+) group) were compared with 19 historic controls who underwent equivalent surgery by minilaparotomy without laparoscopic assistance (LA (−) group). The percentage of patients with blood loss more than 300 mL tended to be lower in the LA (+) group (5.3% versus 31.6%, P  =  0.09). The first flatus passage was earlier (P  =  0.04), serum C-reactive protein levels on postoperative day 1 were lower (P  =  0.04), and white blood cell counts on postoperative day 1 tended to be lower (P  =  0.07) in the LA (+) group. Minilaparotomy with laparoscopic assistance seems to be less invasive compared with pure minilaparotomy. This procedure is considered to be a simple alternative to standard laparoscopic-assisted distal gastrectomy in selected patients with T1N0-1 gastric cancer.

Acute Phase Reactants Predict the Risk of Amputation in Diabetic Foot Infection

2011 ◽  
Vol 101 (1) ◽  
pp. 1-6 ◽  
Author(s):  
Baris Akinci ◽  
Serkan Yener ◽  
Sena Yesil ◽  
Nur Yapar ◽  
Yasin Kucukyavas ◽  
...  
Keyword(s):  
Acute Phase ◽  
Diabetic Foot ◽  
Post Treatment ◽  
C Reactive Protein ◽  
Acute Phase Reactants ◽  
Protein Levels ◽  
Reactive Protein ◽  
Diabetic Foot Infections ◽  
Cell Counts ◽  
White Blood Cell Counts

Background: Prediction of amputation would aid clinicians in the management of diabetic foot infections. We aimed to assess the predictive value of baseline and post-treatment levels of acute phase reactants in the outcome of patients with diabetic foot infections. Methods: We collected data prospectively during minimum follow-up of 6 months in patients with infected diabetic foot ulcers hospitalized in Dokuz Eylul University Hospital between January 1, 2003, and January 1, 2008. After excluding patients who did not attend the hospital for follow-up visits regularly (n = 36), we analyzed data from 165 foot ulcer episodes. Results: Limb ischemia and osteomyelitis were much more frequent in patients who underwent amputation. Wagner grade, which assesses ulcer depth and the presence of osteomyelitis or gangrene, was higher in patients who needed amputation. Ulcer size was slightly larger in the amputation group. Baseline and post-treatment C-reactive protein levels, erythrocyte sedimentation rates, white blood cell counts, and platelet counts were significantly elevated in patients who underwent amputation. Albumin levels were significantly suppressed in the amputation group. Univariate analysis showed that a 1-SD increase in baseline and post-treatment C-reactive protein levels, erythrocyte sedimentation rates, and white blood cell counts and a 1-SD decrease in post-treatment albumin levels were significantly associated with increased risk of amputation. Post-treatment C-reactive protein level was strongly associated with amputation risk. Conclusions: Circulating levels of acute phase reactants were associated with amputation risk in diabetic foot infections. (J Am Podiatr Med Assoc 101(1): 1–6, 2011)

scholarly journals Comparison of Three Different Minimally Invasive Procedures of Distal Gastrectomy for Nonoverweight Patients with T1N0-1 Gastric Cancer

2013 ◽  
Vol 98 (3) ◽  
pp. 259-265
Author(s):  
Norihiro Haga ◽  
Toru Ishiguro ◽  
Kouki Kuwabara ◽  
Kensuke Kumamoto ◽  
Youichi Kumagai ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Minimally Invasive ◽  
Distal Gastrectomy ◽  
Standard Procedure ◽  
Laparoscopic Approach ◽  
Minimal Invasiveness ◽  
Small Incision ◽  
Laparoscopic Assistance ◽  
Minilaparotomy Approach ◽  
Laparoscopic Assisted

Abstract Laparoscopic-assisted distal gastrectomy has recently come to be a standard procedure for the treatment of early gastric cancer1–5 in select patients. The minimal invasiveness associated with laparoscopic procedures for the resection of gastrointestinal cancer has been repeatedly explained in part by the short incision that is required.6–11 We used two different approaches to perform distal gastrectomies for the resection of gastric cancer as minimally invasive alternatives to a standard laparoscopic approach prior to our surgical team's complete mastery of the skills required for laparoscopic oncological surgery for gastric cancer.9,12 If the minimal invasiveness associated with laparoscopic-assisted gastrectomy can be explained by the small incision, a gastrectomy via a small incision without the use of a pneumoperitoneum may provide a similar outcome in patients. However, to our knowledge, such a comparison has not been previously made. We compared the minimal invasiveness of three different approaches (minilaparotomy, minilaparotomy approach with laparoscopic assistance, and standard laparoscopic-assisted approach) to performing a distal gastrectomy for T1N0-1 gastric cancer in nonoverweight patients (body mass index, ≤25 kg/m2) performed within a limited study period.

scholarly journals Serum Leptin Levels, Nutritional Status, and the Risk of Healthcare-Associated Infections in Hospitalized Older Adults

Nutrients ◽  
2022 ◽  
Vol 14 (1) ◽  
pp. 226
Author(s):  
Elena Paillaud ◽  
Johanne Poisson ◽  
Clemence Granier ◽  
Antonin Ginguay ◽  
Anne Plonquet ◽  
...  
Keyword(s):  
Nutritional Status ◽  
Nutritional Assessment ◽  
Mini Nutritional Assessment ◽  
Healthcare Associated Infections ◽  
Serum Leptin ◽  
Protein Levels ◽  
Reactive Protein ◽  
Cell Counts ◽  
Hospitalized Older Adults ◽  
Healthcare Associated

We aimed to determine whether serum leptin levels are predictive of the occurrence of healthcare-associated infections (HAIs) in hospitalized older patients. In a prospective cohort, 232 patients had available data for leptin and were monitored for HAIs for 3 months. Admission data included comorbidities, invasive procedures, the Mini Nutritional Assessment (MNA), BMI, leptin, albumin and C-reactive protein levels, and CD4 and CD8 T-cell counts. Multivariate logistic regression modelling was used to identify predictors of HAIs. Of the 232 patients (median age: 84.8; females: 72.4%), 89 (38.4%) experienced HAIs. The leptin level was associated with the BMI (p < 0.0001) and MNA (p < 0.0001) categories. Women who experienced HAIs had significantly lower leptin levels than those who did not (5.9 μg/L (2.6–17.7) and 11.8 (4.6–26.3), respectively; p = 0.01; odds ratio (OR) (95% confidence interval): 0.67 (0.49–0.90)); no such association was observed for men. In a multivariate analysis of the women, a lower leptin level was significantly associated with HAIs (OR = 0.70 (0.49–0.97)), independently of comorbidities, invasive medical procedures, and immune status. However, leptin was not significantly associated with HAIs after adjustments for malnutrition (p = 0.26) or albuminemia (p = 0.15)—suggesting that in older women, the association between serum leptin levels and subsequent HAIs is mediated by nutritional status.

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