scholarly journals Role of systematic lymphadenectomy in postoperative mortality and morbidity in patients with gastric cancer

2004 ◽  
Vol 57 (7-8) ◽  
pp. 381-385
Author(s):  
Dejan Stevanovic ◽  
Dragan Radovanovic ◽  
Ivan Pavlovic ◽  
Nebojsa Mitrovic
Keyword(s):  
Gastric Cancer ◽  
Postoperative Complications ◽  
Gastric Carcinoma ◽  
Anastomotic Leakage ◽  
Surgical Techniques ◽  
Postoperative Mortality ◽  
Mortality And Morbidity ◽  
Systematic Lymphadenectomy

Introduction Surgical techniques and postoperative care for gastric cancer have significantly improved in recent years. However, whether postoperative morbidity and mortality rates after gastrectomy for gastric cancer have been reduced or not in recent years is still unclear. In this study we would like to point out the role of systematic lymphadenectomy in postoperative mortality and morbidity. Material and methods In this investigestion we analyzed two groups of patients. The first group of 126 patients with gastric carcinoma underwent peritumor lymphadenectomy D1. The second group of 114 patients with gastric carcinoma underwent more radical types of lymphadenectomy (D2, D2%, D3). In this study we analyzed differences between these two groups of patients in regard to:1) early postoperative mortality, 2) early postoperative complications and 3) long-term postoperative complications. Results Early postoperative mortality rate was 4.76% in D1 group and 5,26% in group with systematic lymphadenectomy (SL). 14.3% of patients in D1 group and 15.7% of patients in SL group had postoperative complications. The most frequent complications in D1 group were non-surgical complications of the respiratory system. In SL group the most common postoperative complications were anastomotic leakage (5/18, 27.77%) and wound infection (6/18. 33.3%). The most common long-term complications in both groups were: ventral postoperative hernia, anemia, small bowel obstruction and gallbladder calculosis. Discussion Early postoperative death occurred in patients with stage IV gastric cancer. The rates of anastomotic leakage, as main cause of early postoperative mortality and morbitity in patients with systematic lymphadenectomy, were reduced in the last few years with stapling surgery. Conclusions There were no significant differences in the postoperative mortality and morbidity rates between the two analyzed groups in our investigation.

scholarly journals Weekday of Surgery Affects Postoperative Complications and Long-Term Survival of Chinese Gastric Cancer Patients after Curative Gastrectomy

2017 ◽  
Vol 2017 ◽  
pp. 1-11
Author(s):  
Rong Li ◽  
Ai-min Leng ◽  
Ting Liu ◽  
Yan-wu Zhou ◽  
Jun-xian Zeng ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Postoperative Complications ◽  
Cancer Patients ◽  
Rank Test ◽  
Curative Gastrectomy ◽  
Term Survival ◽  
Long Term Survival ◽  
Gastric Cancer Patients

Many factors have been reported to affect the long-term survival of gastric carcinoma patients after gastrectomy; the present study took the first attempt to find out the potential role of weekday carried out surgery in the postoperative prognosis of gastric cancer patients. 463 gastric cancer patients have been followed up successfully. Pearsonχ2test was used for univariate analyses. Survival curves were constructed by using Kaplan-Meier method and evaluated by using the log-rank test. The Cox proportional hazard regression model was used to find out the risk factors, and subgroup analysis was conducted to rule out confounding factors. We found that the patients who underwent gastrectomy on the later weekday (Wednesday–Friday) more easily suffered from a higher postoperative morbidity. Weekday of surgery was one of the independent indicators for the prognosis of patients after gastric cancer surgery. However, the role of weekday of surgery was significantly weakened in the complications group. In conclusion, surgery performed in the later weekday was more likely to lead to increased postoperative complications and an unfavorable role in prognosis of Chinese gastric cancer patients after curative gastrectomy.

scholarly journals Multiorgan resection in patients with gastric cancer

2004 ◽  
Vol 57 (9-10) ◽  
pp. 480-486 ◽  
Author(s):  
Dragan Radovanovic ◽  
Dejan Stevanovic ◽  
Ivan Pavlovic ◽  
Aleksandar Bajec ◽  
Berislav Vekic ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Lymph Node ◽  
Advanced Gastric Cancer ◽  
Subtotal Gastrectomy ◽  
Postoperative Mortality ◽  
Control Group ◽  
Term Survival ◽  
Long Term Survival ◽  
Systematic Lymphadenectomy

Introduction Multiorgan resection for a malignancy is a very comlicated procedure, but there is always the question: does it work? In everyday clinical practice gastric cancer in phases III and IV is rather frequent. Unfortunately, our patients are under the age of 55 years. D2 lymphadenectomy is not as extensive as D2 %/ or D3, so one must ask himself if multiorgan resection is worth the risk. Material and methods We evaluated two groups of patients: group I consisted of 34 patients who underwent total or subtotal gastrectomy, systematic lymphadenectomy and resection of one or more organs; group II (control) consisted of 167 patients who underwent total or subtotal gastrectomy and systematic lymphadenectomy. These two groups of patients were analzyed in regard to: Bormann's classification, histopathologic type, early mortality, early postoperative complications, lymph node dissection and long-term survival. Results According to Bormann's classification the most common type of carcinoma in both groups was ulcerovegetativ tumor (70.6% in I and 58% in II). In the first group of patients a great number of patients had poorly differentiated adenocarcinomas (47%), while in the second group the most common histologic type was well differentiated intestinal carcinoma (28%). Patients with multiorgan resections had higher rates of early postoperative mortality and morbiditiy (mortality - 14.7% and complications - 26.5%) than patients in control group (mortality - 4.8% and complications - 11.4%). The most frequent causes of postopertive mortality and morbidity were anastomotic leakage and wound infections in both groups. Metastatic lymph node invelvement was higher in the first group (41%), than in the second (28%). Long-term survival was best in the control group (38.5 months). Patients with multiorgan resection had better survival (25.4 months) than inoperable cases (only 5 months). Discussion Patients undergoing multiorgan resection usually have advanced gastric cancer with tumor infiltration in surrounding structures. Only these cases are absolute indications for this radical operation, because patients have better chances fo survival. Conclusion Multiorgan resections are extensive procedures with high rates of postoperative mortality and morbiditiy, but represent the only way for better survival of patients with advanced gastric cancer.

The impact of infectious complications on long-term prognosis after curative resection for gastric cancer.

2019 ◽  
Vol 37 (4_suppl) ◽  
pp. 122-122
Author(s):  
Yukio Maezawa ◽  
Toru Aoyama ◽  
Hiroshi Tamagawa ◽  
Tsutomu Sato ◽  
Takashi Ogata ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Postoperative Complications ◽  
Anastomotic Leakage ◽  
Curative Resection ◽  
Operation Time ◽  
Significant Prognostic Factor ◽  
Long Term Prognosis ◽  
Postoperative Inflammatory Complications ◽  
The Impact

122 Background: Several studies have reported that postoperative complications such as anastomotic leakage affect long-term prognosis after gastric cancer surgery. This study aimed to determine whether or not long-term outcomes were affected by the postoperative inflammatory complications in patients who underwent curative resection for gastric cancer. Methods: The patients were retrospectively selected from the medical records of consecutive patients who underwent curative gastrectomy with nodal dissection for gastric cancer at Yokohama City University and Kanagawa Cancer Center from January 2000 to August 2015. Inflammatory complications were evaluated according to the Clavien-Dindo classification. Overall survival (OS) was compared between postoperative inflammatory complications (IC) and no-complication (NC) groups. Results: A total of 2,254 patients were eligible for inclusion in the present study. One hundred seventy-five patients had IC group, while 2,079 patients had not. Operation time (p < 0.001), blood loss (p < 0.001) was significantly greater in the IC group. The incidence of postoperative inflammatory complication grade 2 or higher was 8.5% in which, pancreatic fistula (2.8%), anastomotic leakage (1.8%) were occurred. The mortality rate was 0.18%. The five-year OS rates of the IC and NC groups were 74.9% and 83.2%, respectively. The difference was statistically significant (p = 0.015). Multivariate Cox’s proportional hazard analyses demonstrated that the postoperative inflammatory complications were a significant prognostic factor for OS. Conclusions: Postoperative inflammatory complications have an obvious impact on the OS in curatively resected gastric cancer patients. It is necessary to reduce the incidence of postoperative complications.

Glucocorticosteroids effects on brain development in the preterm infants: a role for microglia?

2021 ◽  
Vol 19 ◽  
Author(s):  
Zinni Manuela ◽  
Pansiot Julien ◽  
Elodie Billion ◽  
Baud Olivier ◽  
Mairesse Jérôme
Keyword(s):  
Brain Development ◽  
Preterm Infants ◽  
Adverse Outcomes ◽  
Mortality And Morbidity ◽  
Respiratory Problems ◽  
Neurodevelopmental Impairment ◽  
Short And Long Term ◽  
Abnormal Brain

: Prematurity, observed in 15 million births worldwide each year, is a clinical condition that is a major cause of neonatal mortality and morbidity in short and long term. Preterm infants are at high risk for developing respiratory problems, sepsis, and other morbidities leading to neurodevelopmental impairment and neurobehavioral disorders. Perinatal glucocorticosteroids have been widely used for the prevention and treatment of adverse outcomes linked to prematurity. However, despite their shortterm benefits due to their maturational properties, some clinical trials have shown an association between steroids exposure and abnormal brain development in infants born preterm. Neuroinflammation has emerged as a preeminent factor for brain injury in preterm infants, and the major role of microglia, the brain resident immune cells, has been recently highlighted. Considering the role of microglia in the modulation of brain development, the aim of this review is to summarize the effects of endogenous and exogenous glucocorticosteroids on brain development and discuss the possible role of microglia as a mediator of these effects.

IMPACT OF COGNITIVE DYSFUNCTION AND ROLE OF PHYSICAL EXERCISES TO ENHANCE COGNITIVE FUNCTIONS AMONG SUBJECTS WITH TYPE 2 DIABETES MELLITUS

2021 ◽  
pp. 47-48
Author(s):  
Manju Unnikrishnan ◽  
Titto Cherian
Keyword(s):  
Type 2 Diabetes ◽  
Cognitive Impairment ◽  
Cognitive Ability ◽  
Physical Performance ◽  
Cognitive Functions ◽  
Mortality And Morbidity ◽  
Causes Of Mortality

Diabetes has become a widespread epidemic, characterized by hyperglycemia resulting from an error in insulin secretion, insulin action, or both, and is one of the leading causes of mortality and morbidity worldwide. Studies reveal that diabetes is linked to long-term complications in the brain, which appear in the form of impaired cognitive ability compared to people without diabetes( Van Duinkerken et al 2020). Reduced physical performance is one of the most important problems faced by patients which has a direct relationship with an individual's cognitive ability. The study aims to analyse the direct and positive relationship between physical exercise and cognitive functions among people with type 2 diabetes, so this must be veried along with gaining a comprehensive understanding of cognitive impairment in diabetes and its effect on physical performance. vice versa. This study is based on the reviewed research results of various researchers. In this study, the term "cognitive impairment" in relation to diabetes refers to any deviation in cognitive performance compared to people without diabetes.

Safety of double and a half-layered esophagojejunal anastomosis in total gastrectomy with gastric cancer.

2020 ◽  
Vol 38 (15_suppl) ◽  
pp. e16563-e16563
Author(s):  
Pengfei Ma ◽  
Yuzhou Zhao ◽  
Xijie Zhang
Keyword(s):  
Gastric Cancer ◽  
Postoperative Complications ◽  
Blood Loss ◽  
Anastomotic Leakage ◽  
Total Gastrectomy ◽  
Operating Time ◽  
New Method ◽  
Control Group ◽  
Observation Group ◽  
Esophagojejunal Anastomosis

e16563 Background: Esophageal jejunal anastomotic fistula is still one of the serious postoperative complications of gastric cancer, the incidence was 1% ~ 16.5%. The aim of this study was to evaluate the safety of double and a half layered esophagojejunal anastomosis in total gastrectomy. Methods: The new method was called double and a half layered esophagojejunal anastomosis: esophagojejunal anastomosis was performed with a tubular stapler, then the anastomosis was reinforced by absorbable suture (Full-layer continuous suture, slurry muscularis embedding). The new method was used in observation group (n = 295). In the control group(n = 469),the esophagojejunal anastomosis was performed with a tubular stapler, then reinforced by intermittent suture with absorbable sutures. Data analysis including operating time, blood loss, anastomosis time, types and cases of postoperative complications, and postoperative hospitalization time. Results: The data of 764 patients who performed radical gastrectomy between May 2015 and May 2019 were analyzed retrospectively. 1.Surgery situations: The operating time (140.66±26.96 min vs 139.61±22.75min, t= 0.581, P> 0.05) blood loss (200.61±111.03ml vs214.45±114.09ml, t= -1.481, P> 0.05), anastomosis time (20.44±4.31min vs19.92±4.58min, t= 1.573, P> 0.05), postoperative hospitalization time (15.35±6.46 d vs15.89±5.58d, t= -1.229, P> 0.05) .2. Postoperative situations: the rates of anastomotic complications in observation group was 1.69% (5/295) and 4.69% (22/469) in control group, with a statistically significant difference between two groups( χ2 = 4.768, P< 0.05). The rates of anastomotic leakage in observation group was lower than that in the control group 1.02% (3/295) vs 3.41% (16/469) ( χ2 = 4.282, P< 0.05) . The severity of anastomotic leakage, anastomotic stenosis, anastomotic bleeding were no statistically significant differences between two groups( χ 2= 2.030,1.261,0.075, P> 0.05). Total postoperative complications: 101 cases (34.24%) in the observation group, 14 cases (4.75%) with severe complications, and 1 case death. 151 cases (32.2%) in the control group, 34 cases (7.25%) with serious complications, and 2 cases death ( χ2 = 0.838, Z = -1.465, P > 0.05). Conclusions: Double and a half layered esophagojejunal anastomosis is safe and feasible in total gastrectomy, which can reduce the incidence of anastomosis complications.

Sign in / Sign up

Export Citation Format

Share Document