No abstract available.
Cardia* ; Esophagus* ; Stents*

No abstract available.
Adenocarcinoma* ; Cardia* ; Stomach*

PURPOSE: Laparoscopic gastric wedge resection (LWR) is being increasingly performed as a safe and effective treatment for gastric submucosal tumors (SMTs). However, there are few studies on the factors associated with operation time of LWR for gastric SMTs. The purpose of this study was to determine the factors associated with the operation time of LWR for gastric SMTs. METHODS: Between June 2001 and December 2008, 58 patients with gastric SMTs underwent LWR. We analyzed the clinicopathologic data, perioperative parameters and outcomes, and surgeon's experience retrospectively. We also analyzed the factors associated with the operation time of LWR for gastric SMTs. RESULTS: Among 58 patients that underwent LWR, exogastric wedge resection (n=48) was mainly performed. Transgastric wedge resection (n=8) took the longest amount of time. Intraoperative GFS (n=7) was frequently performed for smaller tumors. When the tumor was located at the cardia and fundus, more time was needed for LWR of the SMTs. There was no correlation of the operation time with the clinicopathologic data and surgeon's experience; however, the tumor location (axis) and the approach used for the resection of the stomach were statistically correlated with the operation time. CONCLUSION: The operation time of LWR for gastric SMTs was related to the tumor location (according to gastric axis) and the approach used for the resection of the stomach. If the tumor location was identified precisely and the proper approach for resection of the stomach was determined preoperatively, the operation time of LWR for gastric SMTs might be reduced.
Cardia ; Humans ; Retrospective Studies ; Stomach

Breaking in the site of connection of esophage and cardia is a rare condition in the close abdomen trauma with a high mortality. Its cause is usually a sudden rise of pressure in the abdomen cavity or an error in operation. Early diagnosis is most importance. Tomography is helpful to diagnose the emphysema in the chest in abdomen surgery is an approach od choise
Wounds and Injuries ; Liver ; Abdomen ; Cardia

Cardia ; Gastric Fundus ; Humans ; Stomach Neoplasms ; surgery

PURPOSE: Due to the biological characteristics of cardia cancer, prognosis is poor. It is therefore essential to achieve a sufficient proximal resection margin to maximize survival. The authors studied gastric cardia cancer, focusing on adenocarcinoma. METHODS: One-hundred fifty patients who were diagnosed with gastric cardia cancer and underwent surgery between January 1990 and December 2006 by a single surgeon were included in this study. RESULTS: Of the 150 cases, 141 were adenocarcinomas, 4 were carcinomas, and 3 were leiomyosarcomas. In the adenocarcinoma group, the male-to-female ratio was 2.62:1. There were 2, 60, and 79 (56.0%) cases of adenocarcinoma type I, II, and III, respectively, and there were 32 (22.7%), 18 (12.8%), 70 (49.6%), and 21 (14.9%) cases of stage I, II, III, and IV tumors, respectively. The mean distance from the proximal tumor to the resection margin was 1.93+/-2 cm pathologically, and there was tumor invasion of the resection margin in 4 cases (2.8%). In the 10 cases of extended surgery in type II, the mean distance was 5.85+/-3.67 cm, with no tumor invasion of the resection margin. Recurrence occurred in 30 (21.3%) cases, and 5 of those cases were local anastomotic site recurrences. Cumulative survival was 81.3%, 77.8%, 51.4%, and 28.6% for stage I, II, III, and IV tumors, respectively. CONCLUSION: Although it is possible to remove the tumor with an appropriate resection margin by only an abdominal incision, the surgeon should always keep in mind the possibility of a thoracoabdominal incision when operating on a patient with esophageal infiltration.
Adenocarcinoma ; Cardia ; Esophagogastric Junction ; Humans ; Leiomyosarcoma ; Population Characteristics ; Prognosis ; Recurrence

Sarcomatoid carcinoma is a rare neoplasm of epithelial origin but consists partly of variable differentiated tumor cells of mesenchymal origin. Accurate diagnosis, including differentiation from adenocarcinoma or gastrointestinal stromal tumor, is difficult. We experienced three cases of sarcomatoid carcinoma of the stomach, and describe the radiological and pathologic findings. One case involved a polypoid mass in the antrum, another a mass with a large ulcer mimicking a Bormann type-II adenocarcinoma in the body, while in the third case, an intraluminal bulky mass arising from the cardia of the stomach was present. This was not differentiated from cancer or stromal tumor.
Adenocarcinoma ; Cardia ; Diagnosis ; Gastrointestinal Stromal Tumors ; Stomach* ; Ulcer

BACKGROUND/AIMS: The aim of the study is to evaluate the results of endoscopic mucosal resection (EMR) for early gastric cancer (EGC) and to investigate the factors with influence the complete resection. METHODS: We retrospectively analyzed 109 lesions from 108 patients with EGC treated by EMR at Samsung medical center from November 1994 to June 2003. We compared completely resected group with incompletely resected group with regards to size, location, histologic types before and after EMR, methods of procedure, and complication. RESULTS: The mean size of lesions was 11.3+/-6.5 mm. Eighty two of them were located in the antrum and angle, twenty six in the body, and one in the cardia of stomach. Endoscopically elevated lesions (type I, IIa) were 52 cases and depressed lesions (type IIc) were 40 cases. Histologically curative resection was done in 74 of 109 cases (67.9%). All but one cases have been observed without recurrence for a mean period of 11.1 months. Histologically incomplete resection in 35 cases included 9 positive cancer cell in resection margin, 25 submucosal cancer infiltration, 2 reconstruction failure, 1 lymphatic involvement and 1 signet ring cell type cancer. Complications related to EMR included 9 cases of bleeding and 3 cases of perforation. In comparison of two groups, complete resection rate was significantly higher when tumor was located in the antrum or angle than body or cardia of stomach (p=0.006). CONCLUSIONS: Our results show that EMR is one effective curative treatment modality in highly selected patient with EGC and location of lesion is an important factor influencing the success of complete resection.
Cardia ; Hemorrhage ; Humans ; Recurrence ; Retrospective Studies ; Stomach ; Stomach Neoplasms*

BACKGROUND/AIMS: Endoscopic mucosal resection can cure early gastric cancer. The risk of lymphatic metastasis is related to the depth of submucosal invasion by the mucosal malignancy, with a resection depth of 500 micrometer generally accepted as a safe cut-off. However, excessive thinning induced by stretching of the resected tissue sometimes preventing a precise diagnosis. We studied the effects of stretching on different layers and sites of gastric tissue. METHODS: Porcine stomachs were cut into 2.0x2.0 cm pieces, and pieces from body were stretched to 2.5, 3.0, and 3.5 cm. Pieces from the cardia, body, and antrum were also stretched to 3.0 cm. The thickness of each layer was measured and analyzed statistically. RESULTS: Whole gastric wall and submucosal layers showed gradual thinning, with stretching to 3.5 cm tearing the tissues and resulting in imperfect extension. The submucosa was thinner in body tissue than in cardia and antrum tissues. Stretching to 3.0 cm induced a consistent decrease in submucosal thickness (30-70%). The change in thickness varied widely between individual samples. CONCLUSIONS: A resection margin of 500 micrometer might be insufficient for the complete removal of malignancy. Moreover, the thickness of the submucosal layer differs with the gastric site and between individuals. Future studies are needed to confirm the findings in human tissue.
Cardia ; Gastric Mucosa ; Gastroscopy ; Humans ; Lymphatic Metastasis ; Stomach ; Stomach Neoplasms

BACKGROUND/AIMS: There was some technical difficulty in applying the hemoclip on the posterior wall of the body, cardia of the stomach and posterior wall of duodenum because the angle of approach was tangential. Use of transparent cap on the tip of the endoscope could reduce some of these problems. The purpose of this study was to examine the efficacy of endoscopic hemoclipping using a transparent cap. METHODS: From August 1997 to July 2000, 74 patients with bleeding peptic ulcer and stigmata of recent hemorrhage were treated with endoscopic hemoclipping. There was technical difficulty in applying the hemoclip in 18 patients and the transparent cap was used. RESULTS: There was no statistically significant difference between the patients treated with cap and the patients treated without cap in initial hemostasis rate (91.1% vs 94.4%), rebleeding rate (11.8% vs 11.7%), and permanent hemostasis rate (92.9% vs 94.4%). CONCLUSIONS: Use of transparent cap on the tip of the endoscope was an efficient method when the angle of approach was tangential.
Cardia ; Christianity ; Duodenum ; Endoscopes ; Hemorrhage ; Hemostasis ; Humans ; Peptic Ulcer ; Stomach