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postoperative complications and weight loss following jejunostomy tube feeding after total gastrectomy for advanced adenocarcinomas

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Chinese Journal of Cancer Research 2017年第4期29卷 333-340页

作者： hylke j.f.brenkman stéphanie v.s.roelen elles steenhagen jelle p.ruurda richard van hillegersberg cancer center department of surgeryuniversity medical center utrechtPO Box 855003508 GAUtrechtthe Netherlands internal medicine and dermatology department of dieteticsuniversity medical center utrechtPO Box 855003508 GAUtrechtthe Netherlands

Objective： patients undergoing total gastrectomy for cancer are at risk of malnourishment. The aim of this self- controlled study was to examine the effect of jejunostomy tube feeding （JTF） and other factors on postoperative weight and the incidence of jejunostomy-related complications in patients undergoing total gastrectomy for cancer. Methods： All consecutive patients who underwent total gastrectomy for gastric cancer with jejunostomy plaeement were included from a prospective single-center database （2003-2014）. Jejunostomy-related complications and postoperative weight changes were evaluated up to 12 months after surgery. Multivariable linear regression analysis was performed to identify factors associated with weight loss 12 months after gastreetomy. Results： Of 113 patients operated in the study period, 65 received JTF after total gastrectomy for a median duration of 18 d [interquartile range （IQR）, 10-55 d]. Jejunostomy-related complieations occurred in 11 （17%） patients, including skin leakage （n=3） and peritoneal leakage （n=2）, luxation （n=3）, occlusion （n=2）, infection （n=l） and torsion （n=l）. In 2 （3%） patients, a reoperation was needed due to jejtmostomy-related complications. The mean preoperative weight of patients was 71.8 kg （100%）, and remained stable during JTF （73.9 kg, 103%, p=0.331）. After JTF was stopped, the mean weight of patients decreased to 64.9 kg （90%） at 12 months after surgery （p〈0.001）. A high preoperative body mass index （BMI）（〉_25 kg/m2） was associated with high postoperative weight loss compared to patients with a low BMI （〈25 kg/m2）（16.3% vs. 8.6%, p=0.016）. Conclusions： JTF can prevent weight loss in the early postoperative phase. However, this is at the prize of possible complications. As weight loss in the long term is not prevented, routine JTF should be re-evaluated and balanced against the selected use in preoperatively malnourished patients. Special attention should be paid to patients with a high preoperative BMI, who ar

关键词： Gastric cancer total gastrectomy jejunostomy tube feeding weight

Survival trends of patients with non-metastatic gastric adenocarcinoma in the US and European countries:the impact of decreasing resection rates

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Cancer Communications 2022年第7期42卷 648-662页

作者： Lei Huang Lina Jansen Rob H.A.Verhoeven jelle p.ruurda Liesbet Van Eycken Harlinde De Schutter Jan Johansson Mats Lindblad Tom B.Johannesen Vesna Zadnik Tina Zagar Sjoerd M.Lagarde Cornelis J.Hvan de Velde petra Schrotz-King Hermann Brenner Division of Clinical Epidemiology and Aging Research German Cancer Research Center(DKFZ)Heidelberg 69120Germany Medical Faculty Heidelberg of Heidelberg University Heidelberg 69120Germany German Cancer Consortium German Cancer Research CenterHeidelberg 69120Germany Department of Research&Development Netherlands Comprehensive Cancer OrganizationUtrecht 3501 DBThe Netherlands Department of Medical Oncology Amsterdam University Medical CentersAmsterdam 1105 AZThe Netherlands Department of Surgery University Medical Center UtrechtUtrecht 3508 GAThe Netherlands Belgian Cancer Registry Brussels B-1210Belgium Department of Esophageal and Gastric Surgery Lund University HospitalLund 22185Sweden Department of Clinical Science Interventionand TechnologyDivision of SurgeryKarolinska University HospitalStockholm 17176Sweden Registry Department The Cancer Registry of NorwayOslo 0379Norway Epidemiology and Cancer Registry Institute of Oncology LjubljanaLjubljana 1000Slovenia Department of Surgery Erasmus Medical Centre-University Medical Centre RotterdamRotterdam 3015 CEThe Netherlands Department of Surgical Oncology Leiden University Medical CenterLeiden 2300 RCThe Netherlands Division of preventive Oncology German Cancer Research Center and National Center for Tumor DiseasesHeidelberg 69120Germany

Background:We previously observed decreasing resection rates of nonmetastatic gastric adenocarcinoma(GaC)in the US and some European *** and to what extent these trends affect the trends in overall survival(OS)of patients with non-metastatic GaC at the population level remain *** large international population-based cohort study aimed to assess the impact of the previously observed decreasing resection rates on multivariable-adjusted trends in the long-term OS of patients with non-metastatic ***:Individual-level data of patients with non-metastatic GaC were obtained from the national cancer registries of the Netherlands,Belgium,Sweden,Norway,and Slovenia,and the US Surveillance,Epidemiology,and End Results *** analyzed data for each country *** between year of diagnosis and OS were assessed using Cox proportional hazards regression model with adjustment for multiple prognostic variables,with and without including resection and chemotherapy as potential explanatory ***:A total of 66,398 non-metastatic GaC patients diagnosed in 2003-2016 were analyzed,with an accumulated follow-up of 172,357 *** adjustment for resection,OS was improved only slightly in the US[hazard ratio(HR)_(per year)=0.99;HR_(≥vs.provement was observed in the investigated European countries,with OS even worsening in Sweden(HR_(per year)=1.03;HR_(≥vs.per year)=0.98;HR_(≥vs.poral trend became insignificant in *** Slovenia(HR_(per year)=0.99;HR_(≥vs.per year)=0.97;HR_(≥vs.proved OS over time emerged after resection *** OS in patients undergoing resection was observed in the US,the Netherlands,and *** for chemotherapy did not alter the observed *** analyses by tumor location showedm

关键词： gastric adenocarcinoma resection rate adjusted overall survival temporal trend prognostic factors international population-based cohort study

Worldwide practice in gastric cancer surgery

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World Journal of Gastroenterology 2016年第15期22卷 4041-4048页

作者： Hylke JF Brenkman Leonie Haverkamp jelle p ruurda Richard van Hillegersberg Department of Surgery University Medical Center Utrecht

AIM: To evaluate the current status of gastric cancer surgery ***: An international cross-sectional survey on gastric cancer surgery was performed amongst international upper gastro-intestinal surgeons. All surgical members of the International Gastric Cancer Association were invited by e-mail to participate. An English web-based survey had to be filled in with regard to their surgical preferences. Questions asked included hospital volume, the use of neoadjuvant treatment, preferred surgical approach, extent of the lymphadenectomy and preferred anastomotic technique. The invitations were sent in September 2013 and the survey was closed in January ***: The corresponding specific response rate was 227/615(37%). The majority of respondents: originated from Asia( 5 4 %), performed > 2 1 gastrectomies per year(79%) and used neoadjuvant chemotherapy(73%). An open surgical procedure was performed by the majority of surgeons for distal gastrectomy for advanced cancer(91%) and total gastrectomy for both early and advanced cancer(52% and 94%). A minimally invasive procedure was preferred for distal gastrectomy for early cancer(65%). In Asia surgeons preferred a minimally invasive procedure for total gastrectomy for early cancer also(63%). A D1+ lymphadenectomy was preferred in early gastric cancer(52% for distal, 54% for total gastrectomy) and a D 2 lymphadenectomy was preferred in advanced gastric cancer(93% for distal, 92% for total gastrectomy) CONCLUSION: Surgical preferences for gastric cancer surgery vary between surgeons worldwide. Although the majority of surgeons use neoadjuvant chemotherapy, minimally invasive techniques are still not widely adapted.

关键词： Gastric cancer Gastrectomy Laparoscopy neoplasm minimally invasive surgery

Strategies to reduce pulmonary complications after esophagectomy

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World Journal of Gastroenterology 2013年第39期19卷 6509-6514页

作者： Teus J Weijs jelle p ruurda Grard Ap Nieuwenhuijzen Richard van Hillegersberg Misha Dp Luyer Department of Surgery University Medical Center Utrecht3584 CX UtrechtThe Netherlands Department of Surgery Catharina Hospital Eindhoven5623 EJ EindhovenThe Netherlands

Esophagectomy,the surgical removal of all or part of the esophagus,is a surgical procedure that is associated with high morbidity and *** complications are an especially important postoperative ***,many perioperative strategies to prevent pulmonary complications after esophagectomy have been investigated and introduced in daily clinical ***,we review these strategies,including improvement of patient performance and technical advances such as minimally invasive surgery that have been implemented in recent ***,interventions such as methylprednisolone,neutrophil elastase inhibitor and epidural analgesia,which have been shown to reduce pulmonary complications,are *** of the commonly applied routine nasogastric decompression,delay of oral intake and prophylactic mechanical ventilation are unclear,and many of these strategies are also evaluated ***,we will discuss recent insights and new developments aimed to improve pulmonary outcomes after esophagectomy.

关键词： Esophagectomy Complications pneumonia Acute lung injury Acute respiratory distress syndrome

机器人辅助的腹腔镜Heller肌切开术的早期经验

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世界核心医学期刊文摘（胃肠病学分册） 2005年第6期1卷 60-61页

作者： ruurda J.p. Gooszen H.G. Breeders I.A.M.J. 王志宇 Dept. of Surgery H.P. G04.228 University Medical Centre Utrecht P.O. Box 85500 NL-3508 GA Utrecht Netherlands Dr.

Heller myotomy for achalasia is routinely performed laparoscopically. This offers patients significant benefits compared to open surgery. Surgeons, however, are limited in their manipulation and visualization during laparoscopic interventions. Robotic telemanipulation systems were introduced with the objective of alleviating these limitations. The purpose of this study was to demonstrate the efficacy and safety of performing a Heller myotomy with the use of a robotic telemanipulation system. Fourteen patients were operated on with the da Vinci robot system. Robotic system set-up time, per-and postoperative complications, blood loss, operating time and hospital stay were recorded. Follow-up included manometry and symptom score. The robotic system set-up time was 15 min (10-15). Thirteen procedures (13/14: 93%) were completed by laparoscopic surgery. One procedure was converted because of inadequate exposure. One peroperative mucosal perforation was closed laparoscopically. The median blood loss was 10 mL (10-200). Median operating time was 90 min (75-150). Hospitalization ranged from 2 to 8 days (median 3). No complications occurred during a 30-day postoperative period. Dysphagia was relieved in 12/14 patients (86%). Heartburn was present postoperatively in 2/14 patients (14%). Manometry showed a significant decrease in median lower oesophageal sphincter (LOS) pressure from 2.9 preoperatively to 1 kpa postoperatively (p = 0.008). Robot-assisted laparoscopic Heller myotomy was demonstrated to be safe and effective in reducing basal LOS pressure and dysphagia. The results of this study clearly support the feasibility of the use of this system in performing a delicate laparoscopic surgical procedure. The use of a robotic system was experienced as being highly supportive in manipulation and visualization by the surgical team involved.

关键词：早期经验肌切开术 Heller 腔镜机器人系统贲门失弛缓症腹腔镜操作失血量开腹手术操作时间

CT评分系统对食管切除术后吻合口瘘的诊断效能:与经验性CT评估相比较

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国际医学放射学杂志 2017年第6期 747-747页

作者： L.Goense p.M.Stassen F.J.Wessels p.S.van Rossum J.p.ruurda M.S.van Leeuwen 刘瑶 Department of Surgery University Medical Center Utrecht

摘要目的建立评估食管切除术后吻合口瘘的CT预测评分系统,并将其与经验性CT评估进行比较。方法分析2003年—2014年间食管切除颈部吻合术后,临床怀疑吻合

关键词：吻合口瘘食管切除术诊断效能经验性 CT

供应胃管动脉的钙化:食管术后吻合口漏的一项新危险因素

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国际医学放射学杂志 2015年第2期 167-167页

作者： p.S.N.van Rossum L.Haverkamp H.M.Verkooijen M.S.van Leeuwen R.van Hillegersberg J.p.ruurda 庞国栋 Department of Surgery University Medical Centre UtrechtHeidelberglaan 1003584CX Utrecht the Netherlands

摘要目的本研究旨在应用血管钙化评分系统并根据食管癌病人食管切除与胃管重建术后的吻合口漏的发生来评估胃管的供血动脉钙化的数量和位置的关系。材料与方法

关键词：吻合口漏动脉钙化病人胃管动脉

Observatory science with eXTp

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Science China(physics,Mechanics & Astronomy) 2019年第2期62卷 97-138页

作者： Jean J.M.in 't Zand Enrico Bozzo JinLu Qu Xiang-Dong Li Lorenzo Amati Yang Chen Immacolata Donnarumma Victor Doroshenko Stephen A.Drake Margarita Hernanz peter A.Jenke Thomas J.Maccarone Simin Mahmoodifar Domitilla de Martino Alessandra De Rosa Elena M.Rossi Antonia Rowlinson Gloria Sala Giulia Stratta Thomas M.Tauris Joern Wilms XueFeng Wu ping Zhou Iván Agudo Diego Altamirano Jean-Luc Atteia Nils A.andersson M.Cristina Baglio David R.Ballantyne Altan Baykal Ehud Behar Tomaso Belloni Sudip Bhattacharyya Stefano Bianchi Anna Bilous pere Blay Joao Braga Sφren Brandt Edward F.Brown Niccolo Bucciantini Luciano Burderi Edward M.Cackett Riccardo Campana Sergio Campana piergiorgio Casella Yuri Cavecchi Frank Chambers Liang Chen Yu-peng Chen Jér?me Chenevez Maria Chernyakova ChiChuan Jin Riccardo Ciolfi Elisa Costantini Andrew Cumming Antonino D'Aì Zi-Gao Dai Filippo D'Ammando Massimiliano De pasquale Nathalie Degenaar Melania Del Santo Valerio D'Elia Tiziana Di Salvo Gerry Doyle Maurizio Falanga XiLong Fan Robert D.Ferdman Marco Feroci Federico Fraschetti Duncan K.Galloway Angelo F.Gambino poshak Gandhi MingYu Ge Bruce Gendre Ramandeep Gill Diego G?tz Christian Gouiffès paola Grandi Jonathan Granot Manuel Güdel Alexander Heger Craig O.Heinke Jeroen Homan Rosario Iaria Kazushi Iwasawa Luca Izzo Long Ji peter G.Jonker Jordi José jelle S.Kaastra Emrah Kalemci Oleg Kargaltsev Nobuyuki Kawai Laurens Keek Stefanie Komossa Ingo Kreykenbohm Lucien Kuiper Devaky Kunneriath Gang Li En-Wei Liang Manuel Linares Francesco Longo FangJun Lu Alexander A.Lutovinov Denys Malyshev Julien Malzac Antonios Manousakis Ian McHardy Missagh Mehdipour Yunpeng Men Mariano Méndez Roberto p.Mignani Romana Mikusincova M.Coleman Miller Giovanni Miniutti Christian Motch Joonas Nättilä Emanuele Nardini Torsten Neubert paul T.O'Brien Mauro Orlandini Julian p.Osborne Luigi pacciani Stéphane paltani Maurizio paolillo Iossif E.papadakis Biswajit paul Alberto pellizzoni Uria peretz Miguel A.pérez Torres Emanuele perinati Chanda prescod-Weinstein pablo Reig SRON Netherlands Institute for Space Research Department of Astronomy University of Geneva Key Laboratory for particle Astrophysics Institute of High Energy PhysicsChinese Academy of Sciences School of Astronomy and Space Science Nanjing University INAF-IASF Bologna ASI Via del Politecnico snc INAF-Istituto di Astrofisica e planetologie Spaziali Institut für Astronomie und Astrophysik Tübingen Universit?t Tübingen NASA Goddard Space Flight Center ICREA&Institute of Space Sciences(IEEC-CSIC) Campus UABCarrer de Can Magrans CSpAR SPA University of Alabama in Huntsville Department of physics Texas Tech University INAF Osservatorio Astronomico di Capodimonte Leiden Observatory Leiden University Anton pannekoek Institute University of Amsterdam ASTRON Netherlands Institute for Radio Astronomy Universitat politecnica de Catalunya(UpC-IEEC) Universitádegli Studi di Urbino‘Carlo Bo’ Max-planck-Institut für Radioastronomie Dr.Karl-Remeis-Sternwarte and Erlangen Centre for Astroparticle physics(ECAp) Friedrich Alexander Universit?t Erlangen-Nurnberg purple Mountain Observatory Chinese Academy of Sciences Instituto de Astrofysíca de Andalucia-CSIC Department of physics and Astronomy University of Southampton IRAp Universitéde ToulouseCNRSUPSCNES Mathematical Sciences and STAG Research Centre University of Southampton New York University Abu Dhabi Center for Relativistic Astrophysics School of PhysicsGeorgia Institute of Technology physics Department Middle East Technical University Department of physics Technion-Israel Institute of Technology INAF Osservatorio Astronomico di Brera Tata Institute of Fundamental Research Dipartimento di Matematica e Fisica Universitàdegli Studi Roma Tre Instituto de Astrofísica de Canarias Instituto Nacional de pesquisas Espaciais-INpE National Space Institute Technical University of Denmark(DTU Space) Department of physics and Astronomy Michigan State University INAF Osservatorio Astrofisico di Arcetri Dipartimento di Fisica Universitádegli Studi di Cagliari Department of physics and A

In this White paper we present the potential of the enhanced X-ray Timing and polarimetry(eXTp) mission for studies related to Observatory Science targets. These include flaring stars, supernova remnants, accreting white dwarfs, low and high mass X-ray binaries, radio quiet and radio loud active galactic nuclei, tidal disruption events, and gamma-ray bursts. eXTp will be excellently suited to study one common aspect of these objects: their often transient nature. Developed by an international Consortium led by the Institute of High Energy physics of the Chinese Academy of Science, the eXTp mission is expected to be launched in the mid 2020s.

关键词： space research in struments nuclear astrophysics flare stars accretion and accretion disks mass loss and stellar winds cataclysmic binaries X-ray binaries supernova remnants active galactic nuclei X-ray bursts gamma-ray bursts gravitational waves