Partially edentulous patients with a crossed occlusion have poor denture support, retention, and stability. Moreover, residual abutments showed a poor prognosis due to denture rotation. The use of a conical double crown removable partial denture to establish proper horizontal and vertical interocclusal relationships, it can establish a stable occlusal plane and occlusal contacts providing a sufficient restorative space and a favorable functional and aesthetic outcome. In this case, a patient with an anteriorposterior crossed occlusion with mandibular prognathism and no occluding teeth in habitual centric position was treated with a conical double crown removable partial denture. After diagnostic cast analysis and digital diagnosis, provisional prosthesis templates were fabricated. It was possible to intuitive and appropriate vertical dimension determination and esthetic evaluation were performed. Definitive prosthesis with proper function and aesthetics can be fabricated by the digital and conventional treatment process.

Partially edentulous patients with a crossed occlusion have poor denture support, retention, and stability. Moreover, residual abutments showed a poor prognosis due to denture rotation. The use of a conical double crown removable partial denture to establish proper horizontal and vertical interocclusal relationships, it can establish a stable occlusal plane and occlusal contacts providing a sufficient restorative space and a favorable functional and aesthetic outcome. In this case, a patient with an anteriorposterior crossed occlusion with mandibular prognathism and no occluding teeth in habitual centric position was treated with a conical double crown removable partial denture. After diagnostic cast analysis and digital diagnosis, provisional prosthesis templates were fabricated. It was possible to intuitive and appropriate vertical dimension determination and esthetic evaluation were performed. Definitive prosthesis with proper function and aesthetics can be fabricated by the digital and conventional treatment process.

Partially edentulous patients with a crossed occlusion have poor denture support, retention, and stability. Moreover, residual abutments showed a poor prognosis due to denture rotation. The use of a conical double crown removable partial denture to establish proper horizontal and vertical interocclusal relationships, it can establish a stable occlusal plane and occlusal contacts providing a sufficient restorative space and a favorable functional and aesthetic outcome. In this case, a patient with an anteriorposterior crossed occlusion with mandibular prognathism and no occluding teeth in habitual centric position was treated with a conical double crown removable partial denture. After diagnostic cast analysis and digital diagnosis, provisional prosthesis templates were fabricated. It was possible to intuitive and appropriate vertical dimension determination and esthetic evaluation were performed. Definitive prosthesis with proper function and aesthetics can be fabricated by the digital and conventional treatment process.

The long-term use of an implant overdenture shows problems, such as wear of attachment, concentrated occlusal forces on the anterior teeth, fracture of artificial teeth and rotation of denture. By transitioning to an Implant-assisted removable partial denture (IARPD) using additional implant placement, the problems can be solved. In this case report, a transition was made from implant overdenture to IARPD utilizing surveyed crowns to distribute occlusal forces concentrated on anterior teeth and to prevent denture rotation in a skeletal Class III patient. Design of definitive prosthesis with appropriate function and aesthetics was determined through several stages of provisional restorations. In this case, appropriate posterior occlusion and maintenance of peri-implant bone level of definitive prosthesis were observed.

PURPOSE: This study assessed the feasibility of near-infrared (NIR) imaging with indocyanine green (ICG) in investigating the completeness of laparoscopic lymph node (LN) dissection for gastric cancer. MATERIALS AND METHODS: Patients scheduled for laparoscopic gastrectomy for treating gastric cancer were enrolled in the study. After intraoperative submucosal ICG injection (0.05 mg/mL), LN dissection was performed under conventional laparoscopic light. After dissection, the LN stations of interest were examined under the NIR mode to locate any extra ICG-stained (E) tissues, which were excised and sent for pathologic confirmation. This technique was tested in 2 steps: infra-pyloric LN dissection (step 1) and review of all stations after proper radical node dissection (step 2). RESULTS: In step 1, 15 patients who underwent laparoscopic pylorus-preserving gastrectomy (LPPG) and 15 patients who underwent laparoscopic distal gastrectomy (LDG) were examined. Seven and 2 E-tissues were obtained during LPPG and LDG, respectively. From the retrieved E-tissues, 1 and 0 tissue obtained during LPPG and LDG, respectively, was confirmed as LN. In step 2, 20 patients were enrolled (13 D1+ dissection and 7 D2 dissection). Six E-tissues were retrieved from 5 patients, and 1 tissue was confirmed as LN in the pathologic review. Overall, 15 E-tissues were detected and removed, and 2 tissues were confirmed as LNs in the pathologic review. Both nodes were from LN station #6, with 1 case each in the LDG and LPPG groups. CONCLUSIONS: NIR imaging may provide additional node detection during laparoscopic LN dissection for gastric cancer, especially in the infra-pyloric area.
Diagnostic Imaging ; Gastrectomy* ; Humans ; Indocyanine Green* ; Lymph Node Excision* ; Lymph Nodes* ; Stomach Neoplasms*

The authors found out that this article was omitted “Funding section” for grant support.

PURPOSE: The aim of this study was to establish an anthropometric reference of the stomach for gastric cancer surgery and a modeling formula to predict stomach length. MATERIALS AND METHODS: Data were retrieved for 851 patients who underwent total gastrectomy at the Seoul National University Hospital between 2008 and 2013. Clinicopathological data and measurements from a formalin-fixed specimen were reviewed. The lengths (cm) of the greater curvature (GC) and lesser curvature (LC) were measured. Anthropometric data of the stomach were compared according to age, body weight, height (cm), and body mass index. To predict stomach length, two multiple regression analyses were performed. RESULTS: The mean lengths of the GC and LC were 22.2±3.1 cm and 16.3±2.6 cm, respectively. The men’s GC length was significantly greater than the women’s (22.4±3.1 cm vs. 21.2±2.9 cm, P=0.003). Patients aged >70 years showed significantly longer LC than those aged <50 years (16.9±2.9 cm vs. 15.9±2.4 cm, P=0.002). Patients with body weights >70 kg showed significantly longer GC than those with body weights <55 kg (23.0±2.9 cm vs. 21.4±3.2cm, P<0.001). In the predicted models, 4.11% of the GC was accounted for by age and weight; and 4.94% of the LC, by age, sex, height, and weight. CONCLUSIONS: Sex, age, height, and body weight were associated with the length of the LC, while sex and body weight were the only factors that were associated with the length of the GC. However, the prediction model was not sufficiently strong.
Body Mass Index ; Body Weight ; Gastrectomy ; Humans ; Organ Size ; Seoul ; Stomach Neoplasms ; Stomach*

PURPOSE: The European Organization for Research and Treatment of Cancer quality-of-life questionnaire-OG25 was developed to evaluate the quality of life in patients with stomach and esophageal cancer. The following are included in the OG25 but not in the STO22: odynophagia, choked when swallowing, weight loss, trouble eating with others, trouble swallowing saliva, trouble talking, and trouble with coughing. In this study, we evaluated the quality of life of gastrectomized patients using both, the OG25 and the STO22. MATERIALS AND METHODS: A total of 138 patients with partial gastrectomy (PG) (distal gastrectomy=91; pylorus-preserving gastrectomy= 47) and 44 patients with total gastrectomy (TG) were prospectively evaluated. Body weight and scores from the OG25 and STO22 were evaluated preoperatively and at 3 weeks, 3 months, and 6 months after surgery. RESULTS: Patients with TG had significant weight loss compared to patients with PG. At 3 months, TG was associated with worse scores for dysphagia, eating, odynophagia, trouble eating with others, trouble with taste, and weight loss on the OG25. TG was also associated with dysphagia, eating restrictions, and anxiety on the STO22. The OG25 helped differentiate between the groups with respect to weight loss, odynophagia, choked when swallowing, and trouble eating with others. The OG25 scores changed over time and were significantly different. CONCLUSIONS: The OG25 is a more sensitive and useful scale than the STO22 for evaluating the quality of life of gastrectomized patients, especially those with total gastrectomy.
Anxiety ; Body Weight ; Cough ; Deglutition ; Deglutition Disorders ; Eating ; Esophageal Neoplasms ; Gastrectomy* ; Humans ; Prospective Studies ; Quality of Life* ; Saliva ; Stomach ; Stomach Neoplasms ; Weight Loss

PURPOSE: This study evaluated the functional and oncological outcomes of proximal gastrectomy (PG) in comparison with total gastrectomy (TG) for upper-third early gastric cancer (EGC). MATERIALS AND METHODS: The medical records of upper-third EGC patients who had undergone PG (n=192) or TG (n=157) were reviewed. The PG group was further subdivided into patients who had undergone conventional open PG (cPG; n=157) or modified laparoscopy-assisted PG (mLAPG; n=35). Patients who had undergone mLAPG had a longer portion of their intra-abdominal esophagus preserved than patients who had undergone cPG. Surgical morbidity, recurrence, long-term nutritional status, and the incidence of reflux esophagitis were compared between the groups. RESULTS: The rate of postoperative complications was significantly lower for PG than TG (16.7% vs. 31.2%), but the five-year overall survival rate was comparable between the two groups (99.3% vs. 96.3%). Postoperative levels of hemoglobin and albumin were significantly higher for patients who had undergone PG. However, the incidence of reflux esophagitis was higher for PG than for TG (37.4% vs. 3.7%; P<0.001). mLAPG was related to a lower incidence of reflux esophagitis after PG (P<0.001). CONCLUSIONS: Compared to TG, PG showed an advantage in terms of postoperative morbidity and nutrition, and there was a comparable prognosis between the two procedures. Preserving the intra-abdominal esophagus may lower the incidence of reflux esophagitis associated with PG.
Esophagitis, Peptic* ; Esophagus ; Gastrectomy* ; Humans ; Incidence ; Laparoscopy ; Medical Records ; Nutritional Status ; Postoperative Complications ; Prognosis ; Recurrence ; Stomach Neoplasms* ; Survival Rate

PURPOSE: Intracorporeal anastomosis is the most difficult procedure during pure single-incision distal gastrectomy (SIDG) that affects its generalization. We introduced unaided delta-shaped anastomosis (uDelta), a novel anastomosis technique, for gastroduodenostomy after pure SIDG, and compared the results with those of previously reported Roux-en-Y anastomosis (RY). MATERIALS AND METHODS: Between March 2014 and March 2015, SIDG with D1+ lymph node dissection was performed for early gastric cancer through a 2.5-cm transumbilical incision without any additional port. uDelta was performed by the operator alone, without any intracorporeal assistance. RESULTS: uDelta was performed on 11 patents, and uncut RY was performed on 5-patients without open or multiport conversion. R0 resection was performed in all cases. No significant differences were observed in mean age and body mass index between patients who underwent uDelta or RY. Mean operation times were 214.5+/-36.2 minutes for uDelta and 240.8+/-65.9 minutes for RY, which was not significantly different. Reconstruction time for uDelta was shorter than that for RY, with marginal statistical significance (26.1+/-8.3 minutes vs. 38.0+/-9.1 minutes, P=0.05). There were no intraoperative transfusions, 30-day mortality, or anastomosis-related complications in either group. Average length of hospital stay was 8.2+/-1.9 days in the uDelta group and 7.2+/-0.8 days in the RY group (P=0.320). CONCLUSIONS: After carefully considering indications, uDelta can be a feasible and can be a reproducible reconstruction method after SIDG in early gastric cancer.
Anastomosis, Roux-en-Y* ; Body Mass Index ; Gastrectomy* ; Gastroenterostomy ; Generalization (Psychology) ; Humans ; Laparoscopy ; Length of Stay ; Lymph Node Excision ; Mortality ; Stomach Neoplasms*