Gastric cancer is one of the most common neoplasms in Japan, and it is also the second leading cause of cancer-related deaths worldwide. Nowadays, infection with Helicobacter pylori (H. pylori) is a known risk factor ...Gastric cancer is one of the most common neoplasms in Japan, and it is also the second leading cause of cancer-related deaths worldwide. Nowadays, infection with Helicobacter pylori (H. pylori) is a known risk factor for the development of gastric cancer. Therefore, gastric cancer should be considered as an infectious disease, and in fact, prophylactic eradication of H. pylori may prevent the development of metachronous gastric carcinoma. Before the role of H. pylori was understood, a different approach was used. Recently even after the cancer has developed, some newer therapeutic approaches have been pursued. These newer treatments have been summarized as "minimally invasive therapies" and use endoscopic or laparoscopic techniques. In addition, robotic approaches are being developed that seem to hold a great potential to change the surgical approach. Since basic understanding and treatment of the disease have both changed signif icantly over the last decade, we present a review of current advances in gastric cancer research and therapy.展开更多
We report a case of sporadic gastric carcinoid tumor successfully treated by two-stage laparoscopic surgery.A 38-year old asymptomatic woman was referred to our hospital for evaluation of a submucosal tumor of the sto...We report a case of sporadic gastric carcinoid tumor successfully treated by two-stage laparoscopic surgery.A 38-year old asymptomatic woman was referred to our hospital for evaluation of a submucosal tumor of the stomach.Endoscopic examination showed a solitary submucosal tumor without ulceration or central depression on the posterior wall of the antrum and biopsy specimens were not sufficient to determine the diagnosis.Endoscopic ultrasound revealed a tumor nearly 2 cm in diameter arising from the muscle layer and a computed tomography scan showed the tumor enhanced in the arterial phase.Laparoscopic wedge resection was performed for definitive diagnosis.Pathologically,the tumor was shown to be gastric carcinoid infiltrating the muscle layer which indicated the probability of lymph node metastasis.Serum gastrin levels were normal.As a radical treatment,laparoscopy-assisted distal gastrectomy with regional lymphadenectomy was performed 3 wk after the initial surgery.Finally,pathological examination revealed no lymph node metastasis.展开更多
文摘Gastric cancer is one of the most common neoplasms in Japan, and it is also the second leading cause of cancer-related deaths worldwide. Nowadays, infection with Helicobacter pylori (H. pylori) is a known risk factor for the development of gastric cancer. Therefore, gastric cancer should be considered as an infectious disease, and in fact, prophylactic eradication of H. pylori may prevent the development of metachronous gastric carcinoma. Before the role of H. pylori was understood, a different approach was used. Recently even after the cancer has developed, some newer therapeutic approaches have been pursued. These newer treatments have been summarized as "minimally invasive therapies" and use endoscopic or laparoscopic techniques. In addition, robotic approaches are being developed that seem to hold a great potential to change the surgical approach. Since basic understanding and treatment of the disease have both changed signif icantly over the last decade, we present a review of current advances in gastric cancer research and therapy.
文摘目的比较腹腔镜保留幽门及迷走神经的胃切除术(laparoscopy-assisted pylorus-vagus nerve preserving gastrectomy,LAPPG)与腹腔镜远端胃切除术(laparoscopy-assisted distal gastrectomy,LADG)治疗早期胃中部癌的术式安全性、术后短期并发症及住院费用,评价LAPPG治疗早期胃中部癌的可行性.方法回顾性分析2016-06/2017-08间在上海交通大学医学院附属仁济医院胃肠外科行腹腔镜手术治疗的112例早期胃中部癌的临床病理资料、手术方式、围手术期恢复、术后并发症及住院总费用,其中46例为LAPPG组,66例为LADG组.结果两组患者的临床基线资料比较:年龄、性别、BMI、分化类型差异无统计学意义(P>0.05).两组患者的手术时间、术中失血量、肿瘤最大直径、清扫淋巴结个数差异均无统计学意义(P>0.05).LAPPG组患者近端肿瘤切缘(2.3 cm±1.49 cm vs 3.5cm±1.29 cm,P=0.001)及远端肿瘤切缘(3.1 cm±2.06 cm vs 4.0 cm±2.11 cm,P=0.038)均短于LADG组.两组患者的术后住院时间、术后首次排气时间、术后拔除胃管时间、术后首次下床活动时间、术后恢复流质时间、术后拔除引流管时间、及术后并发症发生率(≥D indoⅡ级)差异均无统计学意义(P>0.05).住院总费用方面LAPPG组低于LADG组(4.6万±0.5万vs 5.3万±0.4万,P=0.004).结论在确保肿瘤根治性的前提下开展LAPPG治疗早期胃中部癌是安全有效的,且降低了患者的住院总费用.
文摘We report a case of sporadic gastric carcinoid tumor successfully treated by two-stage laparoscopic surgery.A 38-year old asymptomatic woman was referred to our hospital for evaluation of a submucosal tumor of the stomach.Endoscopic examination showed a solitary submucosal tumor without ulceration or central depression on the posterior wall of the antrum and biopsy specimens were not sufficient to determine the diagnosis.Endoscopic ultrasound revealed a tumor nearly 2 cm in diameter arising from the muscle layer and a computed tomography scan showed the tumor enhanced in the arterial phase.Laparoscopic wedge resection was performed for definitive diagnosis.Pathologically,the tumor was shown to be gastric carcinoid infiltrating the muscle layer which indicated the probability of lymph node metastasis.Serum gastrin levels were normal.As a radical treatment,laparoscopy-assisted distal gastrectomy with regional lymphadenectomy was performed 3 wk after the initial surgery.Finally,pathological examination revealed no lymph node metastasis.
