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Gastric cancer mortality related to direct radiographic and endoscopic screening:A retrospective study

World Journal of Gastroenterology 2021年第33期27卷 5595-5609页

作者： Hiroaki Hagiwara Fumitaka Moki yukiko yamashita Kazuki Saji Keigo Iesaki Hiromitsu Suda Department of Internal Medicine Hagiwara ClinicMaebashi 379-2106GunmaJapan Maebashi Medical Association Maebashi 371-0035GunmaJapan Gunma Health Foundation Maebashi 371-0005GunmaJapan Department of Internal Medicine and Surgery Yamashita ClinicMaebashi 371-0016GunmaJapan Department of Internal Medicine Saji ClinicMaebashi 371-0133GunmaJapan Department of Internal Medicine Iesaki ClinicMaebashi 371-0805GunmaJapan Department of Pediatrics Suda Kids ClinicMaebashi 371-0813GunmaJapan

BACKGROUND Despite its decreased incidence in Japan,gastric cancer continues among the leading causes of cancer-related deaths in both men and ***,efforts are still required to lower the mortality rate of gastric cancer in *** City introduced endoscopic gastric cancer screening in 2004,and participants are able to choose between direct radiography and ***,we expected to see a decrease in mortality rate from gastric cancer after introducing endoscopic screening and a difference in mortality rate reduction between screening *** To evaluate the impact on gastric cancer mortality rate of two types of gastric cancer screening in Maebashi City,*** Participants aged 40 to 79 years of the Maebashi City gastric cancer screening program in 2006 who were screened by direct radiography(n=11155)or endoscopy(n=10747)were *** were followed until March 31,2012,by cross-referencing their data against the Gunma Prefecture cancer registry *** compared the detection rate of gastric ***,we compared the mortality rate between the two *** Cox proportional hazards model was used to estimate the hazard ratio(HR)of gastric cancer ***,the reduction in gastric cancer mortality rate associated with each screening method was *** Gastric cancer was detected in 22 participants undergoing direct radiography(detection rate,0.20%)and in 52 participants undergoing endoscopy(detection rate,0.48%).However,most gastric cancers detected by endoscopic screening were early cancers that may not have resulted in *** found no significant difference in gastric cancer mortality rate between participants receiving annual screening and those who do *** the number of gastric cancer deaths in the direct radiography group was set as 1 in the Cox proportional hazard analysis,the HR of gastric cancer death was 1.368(95%CI:0.7308-2.562)in the overall group of *** results showed no s

关键词： Gastric cancer Radiography Endoscopy Population-based cancer screening Mortality reduction

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Comparison of Clinical Problems in Thoracoscopic Esophagectomy between Prone Position with Pneumothorax Procedure and Lateral Position

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Open Journal of Anesthesiology 2013年第3期3卷 148-151页

作者： Yoshihiro Kasagi Ryu Okutani yukiko Komatsu Yutaka Oda Yoshito yamashita Department of Anesthesiology Osaka City General Hospital and Children’s Hospital 2-13-22 Miyakojima-Hondori Miyakojima- Ku Osaka Japan Department of Digestive Surgery Osaka City General Hospital and Children’s Hospital 2-13-22 Miyakojima- Hondori Miyakojima-Ku Osaka Japan

Study Objective: We compared the effects of intraoperative body position on blood gas and fluid balance in patients undergoing a thoracoscopic esophagectomy as well as during operation and postoperative laboratory data. Design: Prospective study. Setting: Operating room and intensive care unit. Patients: ASA physical status 1 and 2 patients (n = 26), scheduled for elective thoracoscopic esophagectomy and immediate reconstruction under general anesthesia with one-lung ventilation were enrolled. Interventions: Patients were assigned to either the lateral (n = 16) or prone (n = 10) position groups based on the planned intraoperative body position. A pneumothorax procedure was concomitantly performed only in the prone position group. Measurements: Fluid balance, PaO2/FIO2 ratio (P/F ratio), and maximum PaCO2 during the operation and postoperative laboratory data were analyzed. Main Results: There were no significant differences between the groups for amount of blood loss, blood transfusion, fluid infusion, or urine output. The P/F ratio during one-lung ventilation was significantly higher in the prone than the lateral position group (379 ± 122 vs. 297 ± 67 mmHg, p = 0.017), as was maximum intraoperative PaCO2 (72.2 ± 15.6 vs. 48.3 ± 6.3 mmHg, p Conclusions: A thoracoscopic esophagectomy in the prone position performed concomitantly with a CO2 pneumothorax procedure resulted in a significantly better P/F ratio during one-lung ventilation as compared to the lateral position, indicating that the prone position is more advantageous for oxygenation.

关键词： Thoracoscopic Esophagectomy Prone Position Lateral Position CO2 Pneumothorax Oxygenation

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