Surgery is the only hope to cure gastric cancer. The aim of surgery is the complete removal of the tumor (UICC RO-resection), which is known to be the only treatment modality proven effective and the most important treatment-related prognostic factor. The type of surgical treatment for gastric cancer is determined by the patient's medicosurgical status and the stage of disease. Improved survival and quality of life(QOL) are the major criteria for the therapeutic strategy. For patients with early gastric cancer, minimal invasive surgery is attempted for the improvement of QOL. Minimal invasive surgery can be performed only when there is no evidence for residual disease, especially in lymphnodes. Therefore, precise prediction and selection of node-negative patients is important for the application of minimal invasive surgery. However, long-term survival data are needed for these new techniques to become more generally accepted. For patients with advanced gastric cancer, aggressive and extended surgical approaches are recommended for the improvement of survival. Distal subtotal gastrectomy is the procedure of choice whenever tumor-free margin can be obtained, with the exception of proximal tumors that can be treated by total gastrectomy. Extended lymphadenectomy should be the choice of lymphadenectomy for experienced surgeons with a low morbidity and mortality. If a surgeon can perform combined resection of adjacent organs safely, it is recommended when a direct invasion is suspicious. Distal pancreatectomy should be avoided unless direct invasion is definite. Splenectomy for the purpose of lymph node dissection is be mandatory, and surgeons should consider preservation of the spleen when there is no definite splenic hilar lymph node enlargement or any direct invasion to the spleen. Cytoreductive surgery with intraperitoneal chemotherapy is a useful and promising procedure for the treatment of peritoneal metastasis. The therapeutic approach should be stratified according to the patient's status, tumor status,and QOL after resection. Above all, the treatment strategy should be specific and tailored to each patient for the improved survival and QOL.
Drug Therapy ; Gastrectomy ; Hope ; Humans ; Lymph Node Excision ; Lymph Nodes ; Mortality ; Neoplasm Metastasis ; Pancreatectomy ; Spleen ; Splenectomy ; Stomach Neoplasms* ; Surgeons

No abstract available.
Drug Therapy* ; Fistula*

No abstract available.
Neoplasm Metastasis* ; Stomach Neoplasms*

No Abstract Available.
Endothelial Cells* ; Vitrectomy*

No abstract available.
Adenocarcinoma*

No abstract available.
Colorectal Neoplasms*

The detection rate of early gastric cancer has been increasing owing to advances in diagnostic techniques. Several different types of minimally invasive approaches to improve quality of life have been developed for the treatment of EGC due to excellent prognosis of EGC patients. Although minimally invasive surgery for the treatment of EGC has gained its popularity, most surgeons are still performing conventional method of open surgery. Conventional Open surgery for the treatment of early gastric cancer, however, is needed to reduce the invasiveness under the influence of technique in MIS. Surgical treatment of EGC should be decided on a case-by-case basis and each surgeon's method of maximum competency.
Humans ; Prognosis ; Quality of Life ; Stomach Neoplasms

Leiomyosarcoma of the inferior vena cava(IVC) is a rare tumor and has a poor prognosis. Recently, newer imaging modalities including ultrasound, computed tomographic scan, magnetic resonance imaging and cavovenography make it possible to detect in its early stage of proression. The best therapeutic management is surgical resection and the effects of postoperative adjuvant therapies on patients' survival are still debatable. We report herein our experience of 45-year-old woman whose leiomyosarcoma of the IVC was successfully resected without reconstruction of the IVC.
Female ; Humans ; Leiomyosarcoma* ; Magnetic Resonance Imaging ; Middle Aged ; Prognosis ; Ultrasonography ; Vena Cava, Inferior*

PURPOSE: The Remeex (Mechanical External Regulation) sling is a mid-urethral sling that allows adjustment of the sling tension in the postoperative period. We evaluated the early outcomes of the procedure in patients in whom the success rate of tension-free slings is low, such as with intrinsic sphincter deficiency (ISD). MATERIALS AND METHODS: We included 17 women with urodynamically proven stress urinary incontinence (SUI) who underwent the Remeex procedure and were followed for at least 12 months. The patients were considered to have ISD on the basis of a Valsalva leak point pressure (VLPP) <60 cmH2O or a maximum urethral closure pressure (MUCP) <20 cmH2O. We analyzed parameters including history taking, urodynamic study (UDS), and postoperative clinical outcomes. Patient's success and satisfaction rates were evaluated after the procedure. Also, we asked about lower urinary tract symptoms (LUTSs) with a questionnaire, and the severity of LUTSs was assessed with the Visual Analog Scale (VAS) before and 12 months after the operation. RESULTS: The patients' mean age was 55.6+/-9.58 years. Four (23.5%) patients had mixed incontinence. Five patients (29.4%) had undergone previous surgery for SUI. At a mean follow-up of 13.3 months (range, 12-16 months), 14 patients (82.3%) were cured and 3 patients (17.6%) were improved. Four patients (23.5%) answered very satisfied and 13 patients (76.4%) answered satisfied on the satisfaction questionnaire. Also, LUTSs were improved except voiding pain (p<0.05). CONCLUSIONS: This procedure provides high cure and satisfaction rates. Our results demonstrate that the Remeex procedure is suitable for women with SUI with ISD.
Female ; Follow-Up Studies ; Humans ; Lower Urinary Tract Symptoms ; Postoperative Period ; Suburethral Slings ; Urinary Incontinence ; Urodynamics

No abstract available.