scholarly journals The Feasibility of Laparoscopic Gastrectomy for Remnant Gastric Cancer

2019 ◽  
Vol 103 (9-10) ◽  
pp. 435-442
Author(s):  
Hideki Kawamura ◽  
Susumu Shibasaki ◽  
Tadashi Yoshida ◽  
Tatsushi Shimokuni ◽  
Hideyasu Sakihama ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Laparoscopic Gastrectomy ◽  
Operation Time ◽  
Morbidity Rate ◽  
Safe Procedure ◽  
Remnant Gastric Cancer ◽  
Protein Levels ◽  
Reactive Protein ◽  
Significant Difference ◽  
Study Population

We compared laparoscopic gastrectomy for remnant gastric cancer (LRG) with open gastrectomy for remnant gastric cancer (ORG) to assess the safety and invasive nature of LRG. This study was a retrospective study. The study population consisted of 27 consecutive patients who underwent gastrectomy for remnant gastric cancer. Of these, 15 underwent ORG between January 2003 and April 2007, and 12 underwent LRG between May 2007 and January 2013. The operation time was not significantly different between the 2 groups. However, blood loss was significantly less in the LRG group than in the ORG group. No intraoperative blood transfusion was required. There was no significant difference in morbidity rate between the LRG (1/12, 8.3%) and ORG (4/15, 26.7%) groups, and no patients died in either group. Body temperature on postoperative day (POD) 7 (P = 0.034); systolic blood pressure on PODs 6 (P = 0.042) and 7 (P = 0.035); and heart rate on POD 7 (P = 0.049) were significantly lower in the LRG group than in the ORG group. No significant differences were observed in white blood cell count, or C-reactive protein and serum albumin levels between the groups. Serum total protein levels were significantly higher on POD 1 (P = 0.020), and the number of lymphocytes was significantly higher on POD 7 in the LRG group than in the ORG group (P = 0.036). Pain scores on POD 7 were significantly lower in the LRG group than in the ORG group (P = 0.033). LRG is a technically feasible and safe procedure.

c-erbB-2 Oncoprotein Content in Gastric Cancer and in Adjacent Mucosa

2000 ◽  
Vol 15 (3) ◽  
pp. 231-234 ◽  
Author(s):  
I. García ◽  
F. Vizoso ◽  
A. Andicoechea ◽  
P. Fernandez ◽  
C. Suarez ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Patient Characteristics ◽  
Neoplastic Tissue ◽  
Primary Tumors ◽  
Protein Levels ◽  
Adjacent Mucosa ◽  
Significant Difference ◽  
Study Population ◽  
Gastric Cancer Patients ◽  
Neoplastic Tissues

The aim of this study was to evaluate, by means of an immunoenzymatic assay, the membranous and cytosolic c-erbB-2 oncoprotein contents in primary tumors and in adjacent mucosa from gastric cancer patients. Fifty-two patients with primary gastric adenocarcinomas were enrolled in this prospective study. c-erbB-2 protein levels were significantly higher in membranous than in cytosolic samples, both in neoplastic tissues (median: 3602 vs 525 NHU/mg protein; p<0.0001) and in adjacent mucosa samples (median: 3174 vs 509 NHU/mg protein; p<0.0001). Nevertheless, there was a significant positive relation between membranous and cytosolic c-erbB-2 protein contents in both neoplastic tissue (p<0.001) and adjacent mucosa (p<0.001) samples. There was no significant difference in the membranous c-erbB-2 protein content between neoplastic tissues and adjacent mucosa samples. However, the cytosolic c-erbB-2 content was significantly higher in neoplastic tissues than in adjacent mucosa (p<0.05). Finally, the results did not show any significant correlations of these oncoprotein contents with patient characteristics, clinicopathologic parameters and overall survival of the study population.

scholarly journals “Micro Hand S” Surgical Robot vs Laparoscopic Gastrectomy for Gastric Cancer: Comparison of Short-Term Outcomes

2020 ◽  
Author(s):  
Yuan-Bing Yao ◽  
Guo-Hui Wang ◽  
Yong Liu ◽  
Bo Yi ◽  
Zheng Li ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Laparoscopic Gastrectomy ◽  
Operation Time ◽  
Surgical Robot ◽  
R0 Resection ◽  
Robotic Gastrectomy ◽  
Short Term ◽  
Significant Difference ◽  
Grade Ii ◽  
Comprehensive Complications Index

Abstract Background Expensive cost of surgery has limited the use of surgical robot in China. The emergence of “Micro Hand S” surgical robot provides more choices for surgical treatment. Our study was to evaluate the safety and feasibility of “Micro Hand S” surgical robotic gastrectomy for gastric cancer. Methods Perioperative data of 75 patients who underwent “Micro Hand S” surgical robotic gastrectomy (RG) or laparoscopic gastrectomy (LG) at the Department of General Surgery, Third Xiangya Hospital, Central South University from June 2017 to January 2019 were collected to compare the short-term outcomes between the two groups. Results No statistically significant difference was found in baseline characteristics between the two groups (P > 0.05). RG group had longer operation time (P < 0.01). The harvested lymph nodes were comparable between the two groups (P = 0.084). There were five positive margins in the LG group, and the R0 resection rate was comparable between the two groups (P = 0.247). 16 complications occurred in the RG group according to the Clavien-Dindo classification system, 6 in grade I, and 10 in grade II. 68 complications happened in the LG group, 22 in grade I, 44 in grade II, 1 in grade IIIa and 1 in grade IVa. The comprehensive complications index (CCI) was similar between the two groups (P = 0.895). Intraoperative blood loss, surgical resection, reconstruction of the digestive tract intraoperative blood transfusion, Chemoradiotherapy, pathological type, degree of differentiation, proximal resection margin, time of first flatus, time of liquid diet, time of abdominal drainage tube extraction, and hospital stay for RG and LG were similar too (P > 0.05). Conclusion “Micro Hand S” surgical robotic gastrectomy is safe and feasible. Keywords Surgical robot; Gastric cancer; Gastrectomy; Safety; Feasibility

The safety assessment of robotic versus laparoscopic gastrectomy for gastric cancer using a propensity score matching method.

2019 ◽  
Vol 37 (4_suppl) ◽  
pp. 55-55
Author(s):  
Rie Makuuchi ◽  
Tetsuro Toriumi ◽  
Yuhei Waki ◽  
Kenichi Nakamura ◽  
Satoshi Kamiya ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Propensity Score ◽  
Propensity Score Matching ◽  
Laparoscopic Gastrectomy ◽  
Clinical Stage ◽  
Operation Time ◽  
Amylase Level ◽  
Randomized Controlled ◽  
Phase Ii Studies ◽  
Significant Difference

55 Background: We have previously reported the safety of robotic gastrectomy (RG) for clinical Stage IA or IB gastric cancer in single arm phase II studies. To date, a number of retrospective case control studies comparing RG and laparoscopic gastrectomy (LG) have been performed. However, since randomized controlled trials have never been conducted, no definitive conclusion demonstrating benefits of RG over LG has been demonstrated. In this study, we aimed to evaluate the safety of RG compared to LG using propensity score matching (PSM) methods. Methods: We retrospectively reviewed 766 consecutive patients who underwent either RG (n = 231) or LG (n = 535) for gastric cancer between January 2012 and December 2017. A 1:1 PSM was performed with the matched variables of age, sex, body mass index, performance status, clinical Stage, type of gastrectomy, and extent of lymphadenectomy. We compared short-term outcomes between the patients who underwent RG (RG group) and LG (LG group). Results: After PSM analysis, 231 patients were included in the RG group and 230 in the LG group. Intraoperative blood loss was similar between the groups. Operation time was significantly longer in the RG group (326 min vs. 281 min, P < 0.001). Significantly more lymph nodes were retrieved in the RG group (42 vs. 38.5, P = 0.031). Serum CRP level were significantly lower in the RG group in postoperative day 3 (9.0 mg/dL vs. 9.8 mg/dL, P = 0.049) and 6 (3.1 mg/dL vs. 3.7 mg/dL, P = 0.034), and drain amylase level in postoperative day 3 was also significantly lower in the RG group (612 U/L vs. 856 U/L, P < 0.001). Overall postoperative complication (Clavien–Dindo classification grade IIIA or greater) was similar between the groups (RG: 3.9% vs. LG: 5.6%, P = 0.656). However, pancreatic fistula tended to be less frequent in the RG group than in the LG group (0.4% vs. 2.2%, P = 0.122), although it did not reach statistically significant difference. Conclusions: Although RG takes longer operation time, it appears to be less invasive than LG with the possibility of decreased postoperative complications. To validate the results, randomized controlled trial should be performed.

scholarly journals Laparoscopic proximal gastrectomy with double-tract reconstruction for upper third gastric cancer

BMC Surgery ◽  
2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Shuo-meng Xiao ◽  
Ping Zhao ◽  
Zhi Ding ◽  
Rui Xu ◽  
Chao Yang ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Proximal Gastrectomy ◽  
Operation Time ◽  
Nutrition Status ◽  
Proximal Gastric Cancer ◽  
Double Tract Reconstruction ◽  
Significant Difference ◽  
Laparoscopic Proximal Gastrectomy ◽  
Gastric Cancer Patients ◽  
Upper Third

Abstract Background Proximal gastrectomy with double-tract reconstruction (DTR) has been used for upper third gastric cancer as a function-preserving procedure. However, the safety and feasibility of laparoscopic proximal gastrectomy (LPG) with DTR remain uncertain. This study compared open proximal gastrectomy (OPG) with DTR and LPG with DTR for proximal gastric cancer. Methods Sixty-four patients who had undergone OPG with DTR and forty-six patients who had undergone LPG with DTR were enrolled in this case–control study. The clinical characteristics, surgical outcomes and postoperative nutrition index were analysed retrospectively. Results The operation time was significantly longer in the LGP group than in the OPG group (258.3 min vs 205.8 min; p = 0.00). However, the time to first flatus and postoperative hospital stay were shorter in the LPG group [4.0 days vs 3.5 days (p = 0.00) and 10.6 days vs 9.2 days (p = 0.001), respectively]. No significant difference was found between the two groups in the number of retrieved lymph nodes, complications or reflux oesophagitis. The nutrition status was assessed using the haemoglobin, albumin, prealbumin and weight levels from pre-operation to six months after surgery. No significant difference was found between the groups. Conclusion LPG with DTR can be safely performed for proximal gastric cancer patients by experienced surgeons.

scholarly journals Diagnostic Value of C-Reactive Protein in Discrimination between Uncomplicated and Complicated Parapneumonic Effusion

Diagnostics ◽  
2020 ◽  
Vol 10 (10) ◽  
pp. 829
Author(s):  
Yana Kogan ◽  
Edmond Sabo ◽  
Majed Odeh
Keyword(s):  
Area Under The Curve ◽  
Diagnostic Value ◽  
Parapneumonic Effusion ◽  
C Reactive Protein ◽  
Diagnostic Efficacy ◽  
Reactive Protein ◽  
Significant Difference ◽  
Study Population ◽  
Complicated Parapneumonic Effusion

Objectives: The role of serum C-reactive protein (CRPs) and pleural fluid CRP (CRPpf) in discriminating uncomplicated parapneumonic effusion (UCPPE) from complicated parapneumonic effusion (CPPE) is yet to be validated since most of the previous studies were on small cohorts and with variable results. The role of CRPs and CRPpf gradient (CRPg) and of their ratio (CRPr) in this discrimination has not been previously reported. The study aims to assess the diagnostic efficacy of CRPs, CRPpf, CRPr, and CRPg in discriminating UCPPE from CPPE in a relatively large cohort. Methods: The study population included 146 patients with PPE, 86 with UCPPE and 60 with CPPE. Levels of CRPs and CRPpf were measured, and the CRPg and CRPr were calculated. The values are presented as mean ± SD. Results: Mean levels of CRPs, CRPpf, CRPg, and CRPr of the UCPPE group were 145.3 ± 67.6 mg/L, 58.5 ± 38.5 mg/L, 86.8 ± 37.3 mg/L, and 0.39 ± 0.11, respectively, and for the CPPE group were 302.2 ± 75.6 mg/L, 112 ± 65 mg/L, 188.3 ± 62.3 mg/L, and 0.36 ± 0.19, respectively. Levels of CRPs, CRPpf, and CRPg were significantly higher in the CPPE than in the UCPPE group (p < 0.0001). No significant difference was found between the two groups for levels of CRPr (p = 0.26). The best cut-off value calculated by the receiver operating characteristic (ROC) analysis for discriminating UCPPE from CPPE was for CRPs, 211.5 mg/L with area under the curve (AUC) = 94% and p < 0.0001, for CRPpf, 90.5 mg/L with AUC = 76.3% and p < 0.0001, and for CRPg, 142 mg/L with AUC = 91% and p < 0.0001. Conclusions: CRPs, CRPpf, and CRPg are strong markers for discrimination between UCPPE and CPPE, while CRPr has no role in this discrimination.

scholarly journals Kinetics of C-reactive protein, interleukin-6 and -10, and phospholipase A2-II in severely traumatized septic patients

2010 ◽  
Vol 67 (11) ◽  
pp. 893-897 ◽  
Author(s):  
Zeljko Lausevic ◽  
Goran Vukovic ◽  
Biljana Stojimirovic ◽  
Jasna Trbojevic-Stankovic ◽  
Vladimir Resanovic ◽  
...  
Keyword(s):  
Phospholipase A2 ◽  
Injury Severity ◽  
C Reactive Protein ◽  
Surgical Intensive Care ◽  
Septic Complications ◽  
Mean Values ◽  
Protein Levels ◽  
Reactive Protein ◽  
Significant Difference ◽  
Kinetics Of

Background/Aim. Injury-induced anergy is one of the key factors contributing to trauma victims' high susceptibility to sepsis. This group of patients is mostly of young age and it is therefore essential to be able to predict as accurately as possible the development of septic complications, so appropriate treatment could be provided. The aim of this study was to assess kinetics of interleukin (IL) -6 and -10, phospholipase A2- II and C-reactive protein (CRP) in severely traumatized patients and explore the possibilities for early detection of potentially septic patients. Methods. This prospective study included 65 traumatized patients with injury severity score (ISS) > 18, requiring treatment at surgical intensive care units, divided into two groups: 24 patients without sepsis and 41 patients with sepsis. C-reactive protein, IL-6 and -10 and phospholipase A2 group II, were determined within the first 24 hours, and on the second, third and seventh day of hospitalization. Results. Mean values of IL-6 and phospholipase A2-II in the patients with and without sepsis did not show a statistically significant difference on any assessed time points. In the septic patients with ISS 29-35 and > 35 on the days two and seven a statistically significantly lower level of IL-10 was found, compared with those without sepsis and with the same ISS. C-reactive protein levels were significantly higher in septic patients with ISS 18-28 on the first day. On the second, third and seventh day CRP levels were significantly lower in the groups of septic patients with ISS 29-35 and > 35, than in those with the same ISS but without sepsis. Conclusion. Mean levels of CRP on the first day after the injury may be useful predictor of sepsis development in traumatized patients with ISS score 18-28. Mean levels of CRP on the days two, three and seven after the injury may be a useful predictor of sepsis development in traumatized patients with ISS score more than 28. Mean levels of IL-10 on the second and seventh day after the injury may be a useful predictor of sepsis development in traumatized patients with ISS score > 28.

scholarly journals Intelligent Algorithm-Based Magnetic Resonance Imaging in Radical Gastrectomy under Laparoscope

2021 ◽  
Vol 2021 ◽  
pp. 1-8
Author(s):  
Wenkui Mo ◽  
Cansong Zhao
Keyword(s):  
Gastric Cancer ◽  
Operation Time ◽  
Laparoscopic Group ◽  
Postoperative Hospital Stay ◽  
Intraoperative Blood Loss ◽  
Resonance Imaging ◽  
Intelligent Algorithm ◽  
Short Term ◽  
Laparoscopy Group ◽  
Significant Difference

The study focused on the influence of intelligent algorithm-based magnetic resonance imaging (MRI) on short-term curative effects of laparoscopic radical gastrectomy for gastric cancer. A convolutional neural network- (CNN-) based algorithm was used to segment MRI images of patients with gastric cancer, and 158 subjects admitted at hospital were selected as research subjects and randomly divided into the 3D laparoscopy group and 2D laparoscopy group, with 79 cases in each group. The two groups were compared for operation time, intraoperative blood loss, number of dissected lymph nodes, exhaust time, time to get out of bed, postoperative hospital stay, and postoperative complications. The results showed that the CNN-based algorithm had high accuracy with clear contours. The similarity coefficient (DSC) was 0.89, the sensitivity was 0.93, and the average time to process an image was 1.1 min. The 3D laparoscopic group had shorter operation time (86.3 ± 21.0 min vs. 98 ± 23.3 min) and less intraoperative blood loss (200 ± 27.6 mL vs. 209 ± 29.8 mL) than the 2D laparoscopic group, and the difference was statistically significant ( P < 0.05 ). The number of dissected lymph nodes was 38.4 ± 8.5 in the 3D group and 36.1 ± 6.0 in the 2D group, showing no statistically significant difference ( P > 0.05 ). At the same time, no statistically significant difference was noted in postoperative exhaust time, time to get out of bed, postoperative hospital stay, and the incidence of complications ( P > 0.05 ). It was concluded that the algorithm in this study can accurately segment the target area, providing a basis for the preoperative examination of gastric cancer, and that 3D laparoscopic surgery can shorten the operation time and reduce intraoperative bleeding, while achieving similar short-term curative effects to 2D laparoscopy.

scholarly journals Laparoscopic infrapyloric lymph nodes dissection through the right bursa omentalis approach for gastric cancer

BMC Surgery ◽  
2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Kun Yang ◽  
Wei-Han Zhang ◽  
Kai Liu ◽  
Xin-Zu Chen ◽  
Xiao-Long Chen ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Lymph Nodes ◽  
Laparoscopic Gastrectomy ◽  
Operation Time ◽  
D2 Lymphadenectomy ◽  
Estimated Blood Loss ◽  
Bursa Omentalis ◽  
The Mean ◽  
Infrapyloric Lymph Nodes ◽  
The Right

Abstract Background A complete dissection of infrapyloric lymph nodes is the key to a curative gastrectomy, which can be sometimes technically challenging in laparoscopic surgery. Methods One hundred and eighteen patients with gastric cancer undergoing laparoscopic gastrectomy with D2 lymphadenectomy in which the infrapyloric lymph nodes were dissected through the right bursa omentalis approach were included. The clinicopathologic characteristics and surgical outcomes were analyzed retrospectively. Results The laparoscopic gastrectomy with D2 lymphadenectomy was successful in all 118 patients with no open conversion. The mean operation time was 246.6 ± 45.7 min. The mean estimated blood loss was 87.0 ± 35.9 mL. Postoperative complications occurred in 17.8% of the patients, which were treated successfully with conservative therapy or aspiration in all. There were no No.6 lymphadenectomy-associated complications, such as injury of transverse colon, vessels of mesocolon, pancreas or duodenum, no pancreatitis, pancreatic leakage or postoperative hemorrhage. The mean postoperative hospital stay was 9.6 ± 3.7 days. On average, the total lymph nodes harvested were 36.8 ± 12.9, in which the ones from the infrapyloric area were 5.1 ± 3.1. Conclusion Laparoscopic dissection of infrapyloric lymph nodes through the right bursa omentalis approach seems to be feasible and safe, facilitating a more complete No.6 lymphadenectomy for gastric cancer.

scholarly journals Laparoscopic gastrectomy for remnant gastric cancer: a comprehensive review and case series

2014 ◽  
Vol 19 (1) ◽  
pp. 287-292 ◽  
Author(s):  
Shigeru Tsunoda ◽  
Hiroshi Okabe ◽  
Eiji Tanaka ◽  
Shigeo Hisamori ◽  
Motoko Harigai ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Laparoscopic Gastrectomy ◽  
Case Series ◽  
Remnant Gastric Cancer ◽  
Comprehensive Review

EVALUATION OF MEAT IN THE INFANT DIET

PEDIATRICS ◽  
1952 ◽  
Vol 10 (4) ◽  
pp. 463-473
Author(s):  
HOWARD M. JACOBS ◽  
GEORGE S. GEORGE
Keyword(s):  
Total Protein ◽  
Infant Nutrition ◽  
Physical Growth ◽  
Morbidity Rate ◽  
Control Group ◽  
Average Weight ◽  
Protein Requirements ◽  
Protein Levels ◽  
Young Infants ◽  
Significant Difference

A commercially prepared lean meat was fed to young infants as a supplement to a diet already adequate in all food factors. In those infants first fed meat under 2 months of age, there was improvement in physical growth as determined by weight and height measurements. The same group demonstrated an improvement in hemoglobin levels; the elimination of the physiologic drop in total protein levels of the serum, with a prompt sustained rise in values, the greater part of which was composed of the globulin fraction. In those infants first fed meat after 2 months of age, there was a slight improvement in average weight gain, but no significant difference was noted in other body measurements, total protein, albumin or globulin fractions, or hemoglobin levels. Illness rates for the two years of the study demonstrated a 40% lower morbidity rate in the meat-fed group as compared to the control group. In striving for the optimum in infant nutrition protein requirements should be evaluated both quantitatively and qualitatively.

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