检索结果-南通市图书馆

Efficacy and safety of laparoscopic vs open gastrectomy after neoadjuvant therapy for locally advanced gastric cancer

维普期刊数据库

同方期刊数据库评论

在线全文

学校读者我要写书评

暂无评论

World Journal of Clinical Cases 2023年第32期11卷 7795-7805页

作者： Chang-Da Yu Ke Zhang Department of General Surgery Jiujiang First People’s HospitalJiujiang 332000Jiangxi ProvinceChina

BACKGROUND laparoscopic gastrectomy(LG)is widely accepted as a minimally invasive approach for the treatment of early gastric cancer.However,its role in locally advanced gastric cancer(LAGC)after neoadjuvant therapy(NAT)remains controversial.This study aimed to compare the efficacy and safety of LG vs open gastrectomy(OG)after NAT for the treatment of LAGC.AIM To compare the efficacy and safety of LG vs OG after NAT for LAGC.METHODS We conducted a prospective study of 76 patients with LAGC who underwent NAT followed by LG(n=38)or OG(n=38)between 2021 and 2023.The primary endpoint was overall survival(OS),and the secondary endpoints were diseasefree survival(DFS),surgical complications,and quality of life(QOL).RESULTS The two groups had comparable baseline characteristics,with a median follow-up period of 24 mo.The 3-year OS rates in the LG and OG groups were 68.4%and 60.5%,respectively(P=0.42).The 3-year DFS rates in the LG and OG groups were 57.9%and 50.0%,respectively(P=0.51).The LG group had significantly less blood loss(P<0.001),a shorter hospital stay(P<0.001),and a lower incidence of surgical site infection(P=0.04)than the OG group.There were no significant differences in other surgical complications between the groups,including anastomotic leakage,intra-abdominal abscess,or wound dehiscence.The LG group had significantly better QOL scores than the OG group regarding physical functioning,role functioning,global health status,fatigue,pain,appetite loss,and body image at 6 months postoperatively(P<0.05).CONCLUSION LG after NAT is a viable and safe alternative to OG for the treatment of LAGC,with similar survival outcomes and superior short-term recovery and QOL.LG patients had less blood loss,shorter hospitalizations,and a lower incidence of surgical site infections than OG patients.Moreover,the LG group had better QOL scores in multiple domains 6 mo postoperatively.Therefore,LG should be considered a valid option for patients with LAGC who undergo NAT,particularly for those who prioritize postoperative recov

关键词： laparoscopic gastrectomy Open gastrectomy Neoadjuvant therapy Locally advanced gastric cancer Efficacy Safety

Robotic total gastrectomy for carcinoma in the remnant stomach:a comparison with laparoscopic total gastrectomy

在线全文

维普期刊数据库

学校读者我要写书评

暂无评论

Gastroenterology Report 2021年第6期9卷 583-588页

作者： Zheng-Yan Li Jia-Jia Liu Pei-Wu Yu Yong-Liang Zhao Yan Shi Zi-Yan Luo Bin Wu Jun-Jie Wang Feng Qian Department of General Surgery Center for Minimally Invasive Gastrointestinal SurgerySouthwest HospitalThird Military Medical UniversityChongqingP.R.China

Background Total gastrectomy for carcinoma in the remnant stomach(CRS)remains a technically demanding procedure.Whether robotic surgery is superior,equal,or inferior to laparoscopic surgery in patients with CRS is unclear.This study was designed to compare the efficacy and safety of robotic total gastrectomy(RTG)and laparoscopic total gastrectomy(LTG)for the treatment of CRS.Methods In this cohort study,we retrospectively analysed the data from patients who underwent RTG or LTG for CRS at Southwest Hospital(Chongqing,China)between May 2006 and October 2019.The surgical outcomes,post-operative complications,and survival outcomes between the two groups were compared.Results Compared with LTG,RTG was associated with similar effective operation time(272.0 vs 297.9 min,P=0.170),higher total costs(105,967.2 vs 81,629.5 RMB,Plaparoscopic groups in terms of conversion rate,time to first flatus,time to first soft diet,post-operative hospital stay,post-operative complications,R0 resection rate,and number of retrieved lymph nodes(all P>0.05).The 3-year disease-free survival and 3-year overall survival rates were comparable between the two groups(65.5%vs 57.5%,P=0.918;69.0%vs 60.0%,P=0.850,respectively).Conclusions RTG is a safe and feasible procedure for the treatment of CRS and could serve as an optimal treatment for CRS.

关键词： robotic gastrectomy laparoscopic gastrectomy total gastrectomy carcinoma in the remnant stomach

Digestive tract reconstruction options after laparoscopic gastrectomy for gastric cancer

在线全文

维普期刊数据库

学校读者我要写书评

暂无评论

World Journal of Gastrointestinal Oncology 2020年第1期12卷 21-36页

作者： Jian Shen Xiang Ma Jing Yang Jian-Ping Zhang Department of General Surgery The Second Affiliated Hospital of Nanjing Medical UniversityNanjing 210011Jiangsu ProvinceChina Cardiovascular Center The Second Affiliated Hospital of Nanjing Medical UniversityNanjing 210011Jiangsu ProvinceChina

In addition to the popularity of laparoscopic gastrectomy(LG),many reconstructive procedures after LG have been reported.Surgical resection and lymphatic dissection determine long-term survival;however,the election of a reconstruction procedure determines the postoperative quality of life for patients with gastric cancer(GC).Presently,no consensus exists regarding the optimal reconstructive procedure.In this review,the current state of digestive tract reconstruction after LG is reviewed.According to the determining influence of the tumor site on the procedures of surgical resection and reconstruction,we divide these reconstruction procedures into three categories consistent with the resection procedures.We focus on the technical tips of every reconstruction procedure and examine the surgical outcomes(length of surgery and blood loss)and postoperative complications(anastomotic leakage and stricture)to facilitate gastrointestinal surgeons to understand the merits and demerits of every reconstruction procedure.

关键词： Digestive tract reconstruction laparoscopic gastrectomy Gastric cancer Quality of life

Short- and long-term outcomes associated with enhanced recovery after surgery protocol vs conventional management in patients undergoing laparoscopic gastrectomy

在线全文

维普期刊数据库

学校读者我要写书评

暂无评论

World Journal of Gastroenterology 2020年第37期26卷 5646-5660页

作者： Yu-Long Tian Shou-Gen Cao Xiao-Dong Liu Ze-Qun Li Gan Liu Xing-Qi Zhang Yu-Qi Sun Xin Zhou Dao-Sheng Wang Yan-Bing Zhou Department of Gastrointestinal Surgery Affiliated Hospital of Qingdao UniversityQingdao 266003Shandong ProvinceChina

BACKGROUND At present,the enhanced recovery after surgery(ERAS)protocol is widely implemented in the field of gastric surgery.However,the effect of the ERAS protocol on the long-term prognosis of gastric cancer has not been reported.AIM To compare the effects of ERAS and conventional protocols on short-term outcomes and long-term prognosis after laparoscopic gastrectomy.METHODS We retrospectively analyzed the data of 1026 consecutive patients who underwent laparoscopic gastrectomy between 2012 and 2015.The patients were divided into either an ERAS group or a conventional group.The groups were matched in a 1:1 ratio using propensity scores based on covariates that affect cancer survival.The primary outcomes were the 5-year overall and cancer-specific survival rates.The secondary outcomes were the postoperative short-term outcomes and inflammatory indexes.RESULTS The patient demographics and baseline characteristics were similar between the two groups after matching.Compared to the conventional group,the ERAS group had a significantly shorter postoperative hospital day(7.09 d vs 8.67 d,P<0.001),shorter time to first flatus,liquid intake,and ambulation(2.50 d vs 3.40 d,P<0.001;1.02 d vs 3.64 d,P<0.001;1.47 d vs 2.99 d,P<0.001,respectively),and lower medical costs($7621.75 vs$7814.16,P=0.009).There was a significantly higher rate of postoperative complications among patients in the conventional group than among those in the ERAS group(18.1 vs 12.3,P=0.030).Regarding inflammatory indexes,the C-reactive protein and procalcitonin levels on postoperative day 3/4 were significantly different between the two groups(P<0.001 and P=0.025,respectively).The ERAS protocol was associated with significantly improved 5-year overall survival and cancer-specific survival rates compared with conventional protocol(P=0.013 and 0.032,respectively).When stratified by tumour stage,only the survival of patients with stage III disease was significantly different between the two groups(P=0.044).CONCLUSION Adherence to the ERAS protocol improv

关键词： Enhanced recovery after surgery Conventional management laparoscopic gastrectomy Short-term outcomes Survival

Comparison of laparoscopic Versus Open gastrectomy with D2 Lymph Node Dissection for Advanced Gastric Cancer: a Meta-analysis

在线全文

维普期刊数据库

学校读者我要写书评

暂无评论

Comparison of Laparoscopic Versus Open Gastrectomy with D2 L...

作者： MAC SANDRIE MARIELLA 重庆医科大学

学位级别：硕士

For many decades,D2 procedure has been accepted in Far East as the standard treatment for both early(EGC)and advanced gastric cancer(AGC).In case of AGC,the debate on the extent of nodal dissection has been open for many years in order to highlight the safety and efficacy of treatment,hence this study.A comprehensive literature research was performed in PubMed to identify studies that compared laparoscopic-assisted gastrectomy(LAG)and open gastrectomy(OG)with D2 lymph node dissection(D2-LND)for treatment of AGC for the last five years.Data of interest were checked and subjected to meta-analysis with RevMan 5.3 software.The pooled risk ratios(RR)and weighted mean difference(WMD)with 95%confidence intervals(CI)were calculated.Overall,19 studies were included in this meta-analysis.LG had some advantages over OG,including shorter hospitalization(WMD-2.31;95%CI-4.09 to-0.53;P = 0.01),less blood loss(WMD-120.49;95%CI-174.27 to-66.71;P<0.01),faster bowel recovery(WMD-0.55;95%CI-0.86 to-0.24;P 0.01)and earlier ambulation(WMD-0.75;95%CI-1.38 to-0.11;P = 0.02).In terms of surgical and oncological safety,LG could achieve similar lymph nodes(WMD,-0.94,95%CI,-2.95 to 1.06;P＝0.36),a lower complication rate[odds ratio(OR),0.80;95%CI 0.68,0.97;P = 0.02],and overall survival(OS)and disease-free survival(DFS)comparable to OG.In conclusion:for AGCs,both techniques(LAG and OG)appeared comparable in short-and long-term results.More time was needed to perform LAG;nonetheless,it had some advantages in achieving faster postoperative recovery over OG.In order to clarify this controversial issue ongoing trials and future studies are needed.

关键词： Advanced gastric cancer laparoscopic gastrectomy Open gastrectomy D2 lymph node dissection meta-analysis

Perspectives of laparoscopic surgery for gastric cancer

同方学位论文库评论

在线全文

同方学位论文库

学校读者我要写书评

暂无评论

Chinese Journal of Cancer Research 2022年第5期34卷 533-538页

作者： Jeong Ho Song Sang-Uk Han Department of Surgery Ajou University School of MedicineSuwon 16499Republic of Korea

gastrectomy is the main treatment option for gastric cancer patients. laparoscopic approach has become popular as an alternative to open method during the last decades, and clinical trials have revealed safety and feasibility in the short-and long-term outcomes of laparoscopic gastrectomy. The aim of this review is to summarize the results of prospective clinical trials and propose future perspectives for laparoscopic gastrectomy.

关键词： Gastric cancer laparoscopic gastrectomy minimally-invasive surgery

Research progress of minimally invasive surgery for gastric cancer

维普期刊数据库

同方期刊数据库评论

在线全文

学校读者我要写书评

暂无评论

中国癌症研究:英文版 2023年第4期35卷 343-353页

作者： Hao Su Zhaode Bu Key Laboratory of Carcinogenesis and Translational Research(Ministry of Education/Beijing) Center of Gastrointestinal CancerPeking University Cancer Hospital&InstituteBeijing 100142China

Since the first laparoscopic radical surgery for early gastric cancer 30 years ago, there has been a gradual shift from“open” to “minimally invasive” surgery for gastric cancer. This transition is due to advancements in refined anatomy, enlarged field of view, faster recovery, and comparable oncological outcomes. Several high-quality clinical studies have demonstrated the safety and effectiveness of laparoscopy in the treatment of both early and locally advanced gastric cancer. The role of perioperative chemotherapy in managing locally advanced gastric cancer has been widely recognized, and there have been continuous breakthroughs in the exploration of targeted therapy and immunotherapy for perioperative treatment. Additionally, the application of indocyanine green near-infrared imaging technology, 3D laparoscopic technology, and robotic surgery systems has further improved the accuracy and minimally invasive nature of gastric cancer surgeries. Looking ahead, the field of minimally invasive surgery for gastric cancer is expected to become more standardized, resulting in a significant enhancement in the quality of life for gastric cancer patients.

关键词： Minimally invasive gastric cancer laparoscopic gastrectomy research progress

Minimally invasive surgery for gastro-oesophageal junction adenocarcinoma: Current evidence and future perspectives

维普期刊数据库

同方期刊数据库评论

在线全文

学校读者我要写书评

暂无评论

World Journal of Gastrointestinal Oncology 2023年第10期15卷 1675-1690页

作者： Rodica Birla Petre Hoara Florin Achim Valeriu Dinca Diana Ciuc Silviu Constantinoiu Adrian Constantin Department of General Surgery Carol Davila UniversityBucharest 011172Romania Department of General Surgery Carol Davila University of Medicine and PharmacyBucharest 020021Romania Faculty of Medicine “Titu Maiorescu”UniversityBucharest 031593Romania

Minimally invasive surgery is increasingly indicated in the management of malignant disease.Although oesophagectomy is a difficult operation,with a long learning curve,there is actually a shift towards the laparoscopic/thoracoscopic/robotic approach,due to the advantages of visualization,surgeon comfort(robotic surgery)and the possibility of the whole team to see the operation as well as and the operating surgeon.Although currently there are still many controversial topics,about the surgical treatment of patients with gastro-oesophageal junction(GOJ)adenocarcinoma,such as the type of open or minimally invasive surgical approach,the type of oesophago-gastric resection,the type of lymph node dissection and others,the minimally invasive approach has proven to be a way to reduce postoperative complications of resection,especially by decreasing pulmonary complications.The implementation of new technologies allowed the widening of the range of indications for this type of surgical approach.The short-term and long-term results,as well as the benefits for the patient-reduced surgical trauma,quick and easy recovery-offer this type of surgical treatment the premises for future development.This article reviews the updates and perspectives on the minimally invasive approach for GOJ adenocarcinoma.

关键词： Gastro-oesophageal adenocarcinoma Minimally invasive oesophagectomy laparoscopic gastrectomy Abdomino-mediastinal lymph node dissection Indocyanine green fluorescence imaging

Distribution of splenic artery lymph nodes and splenic hilar lymph nodes

在线全文

维普期刊数据库

学校读者我要写书评

暂无评论

World Journal of Gastrointestinal Surgery 2023年第5期15卷 812-824页

作者： Yuya Umebayashi Satoru Muro Masanori Tokunaga Toshifumi Saito Yuya Sato Toshiro Tanioka Yusuke Kinugasa Keiichi Akita Department of Gastrointestinal Surgery Tokyo Medical and Dental UniversityTokyo 113-8519Japan Department of Clinical Anatomy Tokyo Medical and Dental UniversityTokyo 113-8519Japan

BACKGROUND Total gastrectomy with splenectomy is the standard treatment for advanced proximal gastric cancer with greater-curvature invasion.As an alternative to splenectomy,laparoscopic spleen-preserving splenic hilar lymph node(LN)dissection(SPSHLD)has been developed.With SPSHLD,the posterior splenic hilar LNs are left behind.AIM To clarify the distribution of splenic hilar(No.10)and splenic artery(No.11p and 11d)LNs and to verify the possibility of omitting posterior LN dissection in laparoscopic SPSHLD from an anatomical standpoint.METHODS Hematoxylin&eosin-stained specimens were prepared from six cadavers,and the distribution of LN No.10,11p,and 11d was evaluated.In addition,heatmaps were constructed and three-dimensional reconstructions were created to visualize the LN distribution for qualitative evaluation.RESULTS There was little difference in the number of No.10 LNs between the anterior and posterior sides.For LN No.11p and 11d,the anterior LNs were more numerous than the posterior LNs in all cases.The number of posterior LNs increased toward the hilar side.Heatmaps and three-dimensional reconstructions showed that LN No.11p was more abundant in the superficial area,while LN No.11d and 10 were more abundant in the deep intervascular area.CONCLUSION The number of posterior LNs increased toward the hilum and was not neglectable.Thus,surgeons should consider that some posterior No.10 and No.11d LNs may remain after SPSHLD.

关键词： Gastric cancer laparoscopic gastrectomy Anatomy Splenic hilar lymph node laparoscopic spleen-preserving splenic hilar lymph node dissection