Background: Laparoscopy-assisted gastrectomy requires a lot of disposable products. So we compared the cost between laparoscopy-assisted gastrectomy and open surgery.Patients and methods: For comparison we used five cases each of open distal gastrectomy (ODG), laparoscopy-assisted distal gastrectomy (LADG), open total gastrectomy (OTG) and laparoscopy assisted total gastrectomy (LATG). In this study, we defined the profit of gastrectomy as below and we used the list price for all products. Profit of gastrectomy=Fee for gastrectomy-(Costs of all single use products-Demandable fee for single-use products)Results: Mean profits of ODG and LADG were 278,756.2 yen and 190,292.8 yen. The difference was 88,463.4 yen. Mean profits of OTG and LATG were 395,922.6 yen and 330,653.6 yen. The difference was 65,269 yen. Mean hospital charges, mean length of hospital stay, mean hospital charges per day of ODG, LADG, OTG and LATG were 1,390,464 yen, 21.4 days, 65,140.0 yen and 1,484,254.0 yen, 18.8 days, 80,805.4 yen and 1,956,664.0 yen, 24.4 days, 82,397.1 yen and 1,686,936.0 yen, 18.4 days, 91,894.8 yen, respectively.Conclusion: The turnover of laparoscopic gastrectomy was higher than open gastrectomy, but, the profit was lower because of high costs of disposable products. Hospital charges were not higher but the charge per day was higher because of a shorter hospital stay.
Gastrectomy ; Laparoscopy ; Hospitals ; Mean ; Financial cost

Objective: The benefits of combining cancer screenings with clinical surveys have become increasingly obvious as cancer morbidity and mortality have steadily increased. This paper discusses a study on the current status of and issues surrounding breast cancer screening in a clinical survey. The study also investigated the patients' awareness of the benefits of breast cancer screening. A secondary aim of the study was to promote mammographic screening.;Subjects and Methods: During the 72 months between April 1999 and March 2005, a total of 36,505 women underwent clinical surveys in our hospital. In October 2002, mammographic examination was included as an optional part of the routine physical examination. We evaluated the results of breast cancer screening with or without mammographic examination and used a questionnaire to investigate the patients' awareness of the benefits of breast cancer screening.;Results: Compared with the pre-2001 results, the detection rate of breast cancer significantly increased after 2003 when physical examination was combined with mammographic examination. Our study also found that both elderly patients and those residing in the suburbs of Sapporo City tended to choose physical examination alone rather than combining it with mammographic examination. An analysis of the questionnaires collected from these patients indicates they had a poor understanding of and lacked awareness of the benefits of mammographic examinations during breast cancer screenings.;Conclusions: The inclusion of mammographic screenings with clinical surveys was found to be significantly useful in the detection of breast cancer. Further continued education is needed for women, particularly the elderly and residents in the suburbs, so they understand the benefits of breast cancer screening by mammographic examination for the early detection of breast cancer and, consequently, decreased mortality of the disease.
Breast neoplasm screen NOS ; Clinical ; benefits ; Awareness ; Surveys

Background: In the end stage of malignant bone and soft tissue tumors with lung metastasis, it is often necessary to relieve symptoms of dyspnea due to tumor enlargement and carcinomatous lymphangitis. We report a case in which nasal continuous positive airway pressure (nasal CPAP) was effective as a palliative treatment. Case: A 66-year-old male underwent wide resection with a diagnosis soft tissue sarcoma of right femur. Four years after surgery, he was hospitalized for hilar lymph node metastasis, multiple bone metastases, and carcinomatous lymphangitis. He was treated with nasal CPAP for dyspnea, and communication was possible until the day before his death. Discussion: For end-stage respiratory symptoms, medication therapy such as morphine or steroids is often used for palliation, but often symptoms are not sufficiently improved. Nasal CPAP might be a useful treatment for palliation for rapidly progressing respiratory failure.