Purpose: In Korea, the Health Insurance Review and Assessment Service (HIRA) mandates patient participation in outpatient multidisciplinary team (MDT) meetings as part of national cancer quality assessment. However, the necessity of involving patients and families in MDT discussions remains debatable. This study explored international expert perspectives on patient participation in gastric cancer MDTs. Methods: A cross-national expert survey was conducted in September 2021 among 15 gastric cancer specialists from Korea, China, Japan, Singapore, and the United States. The survey assessed the frequency of patient and family member attendance, perceived pros and cons, and preferences regarding mandatory versus selective involvement. Additionally, MDT structures and policies were reviewed by countries. Results: Most respondents reported that patients and families rarely or never attend MDT meetings: nine stated that patients are never included, three reported “usually not,” and three indicated “sometimes.” None consistently included patients. The most cited benefits were sharing opinions with patients and families simultaneously, followed by improved explanation of treatment and legal protection. Major concerns included hindered discussion, inefficiency, and logistical challenges. Only four respondents supported routine participation, while 11 favored case-dependent involvement. Conclusion International experts do not widely support mandatory patient participation in MDT meetings. A flexible approach that allows MDTs to operate with or without patient involvement may better reflect actual clinical practice.

PURPOSE: Metabolic surgery has been performed as a treatment option for uncontrolled type 2 diabetes (T2D), and several scoring systems for predicting postoperative T2D remission have been proposed. This study was designed to assess consistency of 3 existing scoring systems in patients with T2D duration <1 year. METHODS: This study included 186 patients with T2D enrolled in a university hospital prospective database between 2011 and 2013. Externally validated scoring systems for predicting T2D prognosis after metabolic surgery were identified and selected through systematic literature search. We assessed concordance between ABCD, DiaRem, and individualized metabolic surgery (IMS) scores in participants using kappa statistical analysis and 1-way analysis of variance. RESULTS: Of the participants, 52 and 82 patients were expected to have favorable T2D remission after metabolic surgery with ABCD score of 10–5 and DiaRem score of 0–7, respectively, and a slight-to-fair concordance was shown between the 2 scoring systems (kappa measure, 0.07; standard error [SE], 0.05 and kappa measure, 0.25; SE, 0.19, respectively). The DiaRem score increased with T2D severity determined by IMS score (P < 0.001), while the ABCD score showed no significant association with IMS score. CONCLUSION: ABCD and DiaRem scores showed significant discordance when applied to potential metabolic surgery candidates in whom postoperative T2D remission rate was highly expected. The IMS score showed a dose-response association with DiaRem score but had no significant association with the ABCD score.
Bariatric Surgery ; Diabetes Mellitus, Type 2 ; Humans ; Prognosis ; Prospective Studies

OBJECTIVETo evaluate the efficacy of laparoscopic sleeve gastrectomy(LSG) on improving glycemic control of morbidly obese patients with type 2 diabetes mellitus.

METHODSProspective study of 30 type 2 diabetes mellitus(T2DM) patients with BMI > or = 35 undergone LSG was carried out. Pre- and post-operative clinical parameters associated with diabetes mellitus 6 months after operation were evaluated. Data collected included demographics, weight loss(BMI, EWL%), diabetes control (FPG, HbA1C) and ghrelin.

RESULTSFasting plasma glucose and glycosylated hemoglobin concentration tests and clinical outcomes suggested LSG resulted in significant improvement or resolution of T2DM in all the 30 patients with CR 63%(19/30) and PR 37%(11/30).

CONCLUSIONSLSG can lead to significant changes in controlling glycemia on morbidly obese patients with T2DM in 6 months. Long-term efficacy needs further follow-up.

Adult ; Aged ; Diabetes Mellitus, Type 2 ; complications ; surgery ; Female ; Gastrectomy ; methods ; Humans ; Laparoscopy ; Male ; Middle Aged ; Obesity, Morbid ; complications ; surgery ; Prospective Studies ; Treatment Outcome ; Young Adult

OBJECTIVETo evaluate the safety and efficacy of laparoscopic compression anastomosis clip (LapCAC) for laparoscopic gastrointestinal anastomosis.

METHODSIn March, 2007, three gastric cancer patients undergone total gastrectomy (1 case) and distal gastrectomy (2 cases) received laparoscopic gastrointestinal anastomosis with LapCAC. The gastrointestinal anastomotic complications, first post-operational flatus, bowel movement and extrusion of clip device were observed.

RESULTSNo anastomotic complications such as leakage or obstruction were found. The clip was expelled with stool within 12-18 days. All the patients had good results in recovery of bowel function.

CONCLUSIONLapCAC is safe and simple for laparoscopic gastrointestinal anastomosis.

Adult ; Aged ; Chromium Alloys ; Female ; Gastrectomy ; instrumentation ; methods ; Gastroenterostomy ; instrumentation ; methods ; Humans ; Jejunum ; surgery ; Laparoscopy ; Male ; Middle Aged ; Stomach ; surgery ; Stomach Neoplasms ; surgery