Gastric cancer

BACKGROUND: Robotic surgery has been developed with the aim of improving surgical quality and overcoming the limitations of conventional laparoscopy in the performance of complex mini-invasive procedures. The present study was designed to compare robotic and laparoscopic distal gastrectomy in the treatment of gastric cancer. METHODS: Between June 2008 and September 2015, 41 laparoscopic and 30 robotic distal gastrectomies were performed by a single surgeon at the same institution...

The ultrasonic Harmonic scalpel has demonstrated clinical and surgical benefits in dissection and coagulation. To evaluate its use in gastrectomy, we conducted a systematic review and meta-analysis of randomized controlled trials comparing the Harmonic scalpel to conventional techniques in gastrectomy for patients with gastric cancer. International databases were searched without language restrictions for comparisons in open or laparoscopic gastrectomy and lymphadenectomy. The meta-analysis used a random-effects model for all outcomes; continuous variables were analyzed for mean differences and dichotomous variables were analyzed for risk ratios...

BACKGROUND: Remnant gastric cancer (RGC) is one of the less prevalent gastric cancers. The purpose of this study was to explore the clinicopathological characteristics and results of the operation of RGC following distal gastrectomy. In particular, we examined factors related to prognosis. METHODS: Between January 1970 and December 2012, 122 patients with RGC following distal gastrectomy underwent further surgery and were analyzed retrospectively. RESULTS: Initial gastric diseases included benign (49 patients, 40...

BACKGROUND: Although our previous randomized controlled trial showed that there was no difference in postoperative complications after gastric cancer surgery between patients with and without a prophylactic drains (PDs), PDs are commonly used by most surgeons and at most institutions. However, these results have not yet been validated elsewhere. The purpose of this study was to analyze the incidence, characteristics, and risk factors for a postoperative percutaneous catheter drainage (PCD) procedure after gastric cancer surgery when PDs were not used...

OBJECTIVE: Use of ultrasonic surgical instrument is gaining popularity for dissection and coagulation in open surgery. However, there is still no consensus on the efficacy and safety of its use compared with conventional surgical technique in open gastrectomy for gastric cancer. The aim of this meta-analysis was to evaluate the role and surgical outcomes of ultrasonic dissection (UD) compared with conventional electrocautery (EC). METHODS: A systematic literature search was performed to identify all studies comparing UD and EC in gastric cancer surgery...

INTRODUCTION: Data on laparoscopic gastrectomy in patients with gastric cancer in the Western hemisphere are lacking. This study aimed to compare outcomes following laparoscopic versus open gastrectomy for gastric adenocarcinoma at a Western center. METHODS: Eighty-seven consecutive patients who underwent laparoscopic gastrectomy from November 2005 to April 2013 were compared with 87 patients undergoing open resection during the same time period. Patients were matched for age, stage, body mass index, and procedure (distal subtotal vs...

BACKGROUND: A steady decline in gastric cancer mortality rate over the last few decades is observed in Western Europe. However it is still not clear if this trend applies to Eastern Europe where high incidence rate of gastric cancer is observed. METHODS: This was a retrospective non-randomized, single center, cohort study. During the study period 557 consecutive patients diagnosed with gastric cancer in which curative operation was performed met the inclusion criteria...

BACKGROUND: Radical gastrectomy for gastric cancer is one of the most invasive procedures in gastrointestinal surgery. A few studies have found that an enhanced recovery after surgery (ERAS) protocol is useful in radical gastrectomy. The aim of this study was to evaluate the appropriate indication and feasibility of an ERAS protocol in radical gastrectomy. METHODS: We studied the clinical characteristics in 147 patients managed with an ERAS protocol after radical gastrectomy...

BACKGROUND: Advanced gastric cancer in the upper or middle third of the stomach is routinely treated with a total gastrectomy, albeit in some cases with higher morbidity and mortality. The aim of this study was to describe the morbimortality and survival results in total gastrectomy in a single center. METHODS: This retrospective study included patients with gastric adenocarcinoma treated with a total gastrectomy at a single Brazilian cancer center between January 1988 and December 2011...

BACKGROUND: Resection and anastomosis in laparoscopic distal gastrectomy can be performed extracorporeally or intracorporeally. Most surgeons have performed laparoscopy-assisted distal gastrectomy (LADG) because of technical difficulties of intracorporeal anastomosis. However, totally laparoscopic distal gastrectomy (TLDG) has recently been attempted and is expected to be feasible and less invasive compared with LADG. In this study, we tried to evaluate the clinical effect of the difference of invasiveness between TLDG and LADG, by way of a randomized prospective trial...

BACKGROUND: The purpose of this study was to show the feasibility and safety of pure single-port laparoscopic distal gastrectomy (SDG) by comparing its short-term outcomes with those of conventional multiport totally laparoscopic distal gastrectomy (TLDG). STUDY DESIGN: Prospectively collected data of 50 gastric cancer patients who underwent pure SDG from November 2011 through October 2013 were compared with the matched data of 50 TLDG patients. RESULTS: Mean operation time (144...

BACKGROUND: Survival estimates following surgical resection of gastric adenocarcinoma are traditionally reported as survival from the date of surgery. Conditional survival (CS) estimates, however, may be more clinically relevant by accounting for time already survived. We assessed CS following surgical resection for gastric adenocarcinoma. METHODS: We analyzed 807 patients who underwent resection for gastric adenocarcinoma from 2000 to 2012 at seven participating institutions in the U...

BACKGROUND: A proximal margin distance of 5 cm is advocated for resection of gastric adenocarcinoma (GAC). We assessed the prognostic value of proximal margin (PM) distance on survival outcomes after resection of distal GAC. METHODS: All patients who underwent resection of distal GAC (antrum/body) from 2000 to 2012 at seven institutions of the U.S. Gastric Cancer Collaborative were included. Patients with positive distal margins or macroscopic residual disease were excluded...

BACKGROUND: A pathologic complete response (pCR) can sometimes be induced by intensive or long-term neoadjuvant chemotherapy (NAC). This prognostic research study based on a systematic review of the literature evaluated the impact of a pCR on the long-term survival of gastric cancer (GC) patients. METHODS: Articles were extracted from PubMed and the Japanese medical search engine "Ichu-shi," using the terms "GC," "NAC," and "pCR." Articles were selected based on the following criteria: (1) full-text case report, (2) R0 resection following NAC for locally advanced GC, and (3) pathological complete response in both the primary stomach and in the lymph nodes...

BACKGROUND: Reduced-port laparoscopic surgery for patients with early gastric cancer has been rarely reported. The aim of this study was to introduce techniques of the reduced-port laparoscopy-assisted distal gastrectomy (duet LADG) in patients with early gastric cancer. METHODS: Duet LADG was performed by two persons, an operator and a scopist. Three 10 mm ports were used on the umbilicus and both sides of the lower abdomen. The same laparoscopic instruments were used for duet LADG as for conventional LADG...

BACKGROUND: Gastric stump carcinoma (GSC) has been studied after primary gastrectomy for benign disease but few studies have evaluated its correlation with gastric cancer. PATIENTS: We assessed 541 patients submitted to subtotal gastrectomy for early gastric cancer at least 15 years ago. RESULTS: GSC was diagnosed in 16 (2.9%) patients, giving a 4% cumulative risk of GSC 20 years after surgery. Diagnosis was made within 5 years of surgery in 10 patients and after 8 years in 6 cases...

OBJECTIVE: The aim of this study was to investigate the impact of adjuvant chemoradiotherapy (CRT) on survival of non-metastatic gastric cancer patients who had undergone an R1 resection. METHODS: We compared the survival of patients after an R1 gastric cancer resection from the population-based Netherlands Cancer Registry who did not receive adjuvant CRT (no-CRT group) with the survival of resected patients who had been treated with adjuvant CRT (CRT group) at our institute...

INTRODUCTION: Gastrointestinal anastomoses may require early evaluation and treatment via flexible endoscopic techniques when complications arise. There is reticence, however, to perform endoscopy given the applied mechanical forces. We aimed to identify the incidence of gastrointestinal anastomotic perforation or disruption resulting from endoscopy performed ≤6 weeks of anastomoses. METHODS: Review of patients from 2002 to 2013 who underwent flexible endoscopy within 6 weeks of creation of gastrointestinal anastomosis...

INTRODUCTION: Recent studies have shown that radical gastrectomy with extended lymphadenectomy is feasible in gastric cancer patients with liver cirrhosis, but in those studies the main proportion was Child-Pugh class A patients. It is still difficult to choose reasonable surgical strategies for gastric cancer patients with cirrhosis, especially for Child-Pugh class B patients. METHODS: We reviewed the medical records of patients with liver cirrhosis who had undergone radical gastrectomy between January 2001 and December 2012...

OBJECTIVE: The study assessed long-term shifting patterns in quality of life (QoL) after distal subtotal gastrectomy relative to an estimated healthy population QoL (HPQoL), and compared them to shifting patterns interpreted in terms of a preoperative QoL baseline. BACKGROUND: QoL data from 127 gastric cancer patients who underwent open distal subtotal gastrectomy were obtained at the preoperative period and at 6, 12, 18, 24, and 36 months after surgery. QoL data obtained from 127 age- and sex-adjusted healthy individuals were used to estimate HPQoL...