149 patients with gastric epithelioma indicated the total gastrectomy in the army central hospital 108 during 1994-2000. The esophago-intestinal anastomotic leakage, a severe complication occurred in 2 patients among group received the esophago-intestinal anastomosis as method of omega. There was no this complication in group received the operation as method of lygidakis (making the false stomach). This study indicated that technique of anastomosis played an important role in the esophago-intestinal anastomotic leakage.
Stomach Neoplasms ; complications ; surgery ; therapeutics

149 patients with gastric epithelioglandular cancer were operated for the total gastrectomy in the Army Central Hospital No 108 from 1/1994 to 1/200 (male: 86; female: 63), average ages: 50, divided 2 groups according to the 2 methods of the different digestive circulation recovering. The results have shown that the rate of the tumors in the determined positions as vertical axis and perimeter of stomach the average size of the tumor, the average duration of operation and the rate of accidents were not different between two groups. The average rate of accident during operation was 6,7%, the rate of surgical complication was 18,1%.There was no death.
Accidents ; Complications ; Gastrectomy ; Stomach Neoplasms ; surgery ; therapeutics

A retrospeclive study was performed in 455 (282 males and 173 females) cases of gastric cancer presenting between 1990 and 1999. The average age of the patient was 52.17; a range of 16 to 80 years. 143 of these patients underwent subtotal gastrectomy. The postoperative morbidity and mortality common rates were 25/455 (5.4%) and 4/455 (0.8%). The morbidity and mortality rates were 11/143 (7.69%) and 1/143 (0.69%) for total gastrectomy cases. The morbidity and mortality rates were 14/312 (4.48%) and 3/312 (0.96%) for subtotal gastrectomy cases. The rate of anastigmatic leakage, stump of duodenum leakage, pancreatitis acute was 5/455 (1.09%), 2/455 (0.43%) and 2/455 (0.43%). They are main mortality causes.
Accidents ; Complications ; Therapeutics ; Stomach Neoplasms ; surgery

OBJECTIVETo discuss the clinicopathological factors for lymph node metastasis (LNM) in early gastric cancer (EGC), including age, gender, location, size, macroscopic type, depth of invasion, histological type, and lymphatic invasion, and the regulation of LNM in EGC.

DATA SOURCESThe data used in this review were mainly from PubMed articles published in English. The search terms were "early gastric cancer" and "lymph node metastasis".

STUDY SELECTIONArticles were selected if they reported the clinicopathological factors and regulation of LNM in EGC.

RESULTSThe prognosis of EGC is better than advanced gastric cancer, with over 90% 5-year survival rate. The main risk factors for LNM in EGC are tumor size, macroscopic type, depth of invasion, histological type, ulceration, and lymphatic invasion.

CONCLUSIONSLNM in EGC is a critical factor for assessment of prognosis and determination of therapeutic strategy. Endoscopic mucosal resection or endoscopic submucosal dissection should be considered when patients have low risk of LNM.

Female ; Humans ; Lymphatic Metastasis ; Male ; Stomach Neoplasms ; complications ; pathology ; surgery

OBJECTIVEThis review discusses the current status and progress in studies on gastric cancer with liver metastasis (GCLM), involving the routes, subtypes, and prognosis of GCLM; the genes and molecules associated with metastasis; the feasibility and value of each imaging modality; and current treatment options.

DATA SOURCESThe data used in this review were mainly from Medline and PubMed published in English from 2005 to August 2010. The search terms were "gastric cancer" and "liver metastasis".

STUDY SELECTIONArticles regarding the characteristics, diagnostic modalities, and various therapeutic options of GCLM were selected.

RESULTSThe prognosis of GCLM is influenced by the clinicopathological characteristics of primary tumors, as well as the presence of liver metastases. Improved understanding of related genes and molecules will lead to the development of methods of early detection and targeted therapies. For the diagnosis of GCLM, each imaging modality has its relative benefits. There remains no consensus regarding therapeutic options.

CONCLUSIONSEarly detection and characterization of liver metastases is crucial for the prognosis of gastric cancer patients. Multidisciplinary team discussions are required to design optimal treatment strategies, which should be based on the clinicopathological characteristics of each patient.

Humans ; Liver Neoplasms ; diagnosis ; drug therapy ; secondary ; surgery ; Stomach Neoplasms ; complications ; diagnosis ; drug therapy ; surgery

PURPOSE: The presence of gastrointestinal (GI) cancer and its treatment might aggravate patient nutritional status. Malnutrition is one of the major factors affecting the postoperative course. We evaluated changes in perioperative nutritional status and risk factors of postoperative severe malnutrition in the GI cancer patients. MATERIALS AND METHODS: Nutritional status was prospectively evaluated using patient-generated subjective global assessment (PG-SGA) perioperatively between May and September 2011. RESULTS: A total of 435 patients were enrolled. Among them, 279 patients had been diagnosed with gastric cancer and 156 with colorectal cancer. Minimal invasive surgery was performed in 225 patients. PG-SGA score increased from 4.5 preoperatively to 10.6 postoperatively (p<0.001). Ten patients (2.3%) were severely malnourished preoperatively, increasing to 115 patients (26.3%) postoperatively. In gastric cancer patients, postoperative severe malnourishment increased significantly (p<0.006). In univariate analysis, old age (>60, p<0.001), male sex (p=0.020), preoperative weight loss (p=0.008), gastric cancer (p<0.001), and open surgery (p<0.001) were indicated as risk factors of postoperative severe malnutrition. In multivariate analysis, old age, preoperative weight loss, gastric cancer, and open surgery remained significant as risk factors of severe malnutrition. CONCLUSION: The prevalence of severe malnutrition among GI cancer patients in this study increased from 2.3% preoperatively to 26.3% after an operation. Old age, preoperative weight loss, gastric cancer, and open surgery were shown to be risk factors of postoperative severe malnutrition. In patients at high risk of postoperative severe malnutrition, adequate nutritional support should be considered.
Colorectal Neoplasms/surgery ; Gastrointestinal Neoplasms/*surgery ; Humans ; Malnutrition/diagnosis ; *Nutritional Status ; Postoperative Complications ; Risk Factors ; Stomach Neoplasms/surgery

OBJECTIVETo investigate the safety and feasibility of laparoscopy-assisted combined radical resection for synchronous rectal and gastric cancer in elderly patients.

METHODSClinical data of two elderly patients undergoing laparoscopy-assisted combined radical resection for synchronous rectal and gastric cancer were analyzed retrospectively.

RESULTSThe two cases were 78 and 75 years old respectively. Both were complicated with many medical conditions. One case suffered from stage II cancer in the gastric body and stage IB rectal cancer, and the other suffered from stage IIIA gastric cancer and stage IB rectal cancer. Both cases had received laparoscopy-assisted combined radical resection for synchronous rectal and gastric cancer, with 5 cm of incision. The operative time was 260 and 255 min and the intraoperative bleeding was 60 and 80 ml respectively. No complication occurred intraoperatively. Time to resume oral intake was 4 and 5 days and length of postoperative hospital stay was 13 and 14 days respectively. No postoperative complication occurred. The patients were followed up for 13 and 12 months and no postoperative recurrence or metastasis was noticed.

CONCLUSIONLaparoscopy-assisted combined radical resection for elderly synchronous rectal and gastric cancer is safe and feasible when performed by surgeons with plentiful experience in laparoscopic technology, and associated with less injury and faster recovery.

Aged ; Female ; Humans ; Laparoscopy ; methods ; Rectal Neoplasms ; complications ; surgery ; Retrospective Studies ; Stomach Neoplasms ; complications ; surgery ; Treatment Outcome

Humans ; Enhanced Recovery After Surgery ; Stomach Neoplasms/surgery* ; Length of Stay ; Laparoscopy ; Postoperative Complications ; Gastrectomy

Gastric stump cancer (GSC) is a carcinoma arising from the remnant stomach following gastric surgery for benign or malignant disease, and is more common in men. The risk of morbidity has an obvious time dependence. GSC incidence is likely to rise with lengthening of the initial operation interval. The GSC time interval after malignant disease is significantly shorter than that of benign disease. GSC etiologies mainly include duodenogastric reflux and denervation of the gastric mucosa resulting in the change of the gastric environment after gastrectomy and the Helicobacter pylori infection. Due to atypical clinical symptoms, GSC is always identified at an advanced stage and the long-term survival rate is low. An optimal endoscopic surveillance system is essential to improve early detection rates. Treatments in GSC and primary gastric cancer are the same and include resection of the lesion and radical lymph node dissection. R0 resection is an important prognostic factor. Here we review previous reports with respect to epidemiological characteristics, etiology, clinical symptoms, treatment, and prognosis of GSC.
Gastrectomy ; Gastric Stump ; pathology ; surgery ; Helicobacter Infections ; complications ; Humans ; Lymph Node Excision ; Male ; Stomach Neoplasms ; surgery

With the development of population aging in our country, the incidence of gastrointestinal cancer is increasing. The risk of developing gastrointestinal cancer in elderly over 75 years was 5-6 times and the risk of death of gastrointestinal cancer was 7-8 times of the general population. As compared to non-elderly, the incidence of gastric cancer was not decreased obviously but the total incidence of colorectal cancer was increased more quickly. Therefore, screening of gastrointestinal cancer should be performed in the elderly for early discovery, diagnosis and treatment. Because of the insidious onset of the illness in elderly patients, gastrointestinal cancers are mostly diagnosed at advanced or late stage (stage III or IV). Well differentiated cancer is more common, such as papillary or tubular adenocarcinoma. Lauren type, Borrmann II or III are more common in gastric cancer, which are relatively favorable. Compared with non-elderly patients, many elderly patients also suffer from comorbid diseases with higher operation risk and postoperative complication rates. Therefore, we must pay great attention to the perioperative management and the surgical operation for the elderly patients. In this paper, several key issues involved the development trend of incidence and mortality of gastrointestinal cancer, the clinicopathological characteristics, the comorbidity and surgical treatment in the elderly patients with gastrointestinal cancer will be elaborated, aiming at promoting further attention to the clinical therapeutic strategies, management measures and prognostic factors for the elderly patients with gastrointestinal cancer.
Adenocarcinoma ; epidemiology ; surgery ; Aged ; China ; epidemiology ; Colorectal Neoplasms ; epidemiology ; surgery ; Comorbidity ; Humans ; Postoperative Complications ; Stomach Neoplasms ; epidemiology ; surgery