• Title/Summary/Keyword: cancer surgery

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Clinical Impact of Polyglycolic Acid Mesh to Reduce Pancreas-Related Complications After Minimally Invasive Surgery for Gastric Cancer: A Propensity Score Matching Analysis

  • Motonari Ri;Manabu Ohashi;Rie Makuuchi;Masaru Hayami;Takeshi Sano;Souya Nunobe
    • Journal of Gastric Cancer
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    • v.24 no.2
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    • pp.220-230
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    • 2024
  • Purpose: Prevention of pancreas-related complications after gastric cancer surgery is critical. Polyglycolic acid (PGA) mesh reduces postoperative pancreatic fistula formation following pancreatic resection. However, the clinical efficacy of PGA mesh in gastric cancer surgery has not been adequately investigated. Materials and Methods: This retrospective study compared the short-term outcomes between two groups: patients who underwent minimally invasive R0 gastrectomy for gastric cancer with the use of a PGA mesh (PGA group) and those without the use of a PGA mesh (non-PGA group) at the Cancer Institute Hospital, Tokyo, between January 2019 and May 2023. Propensity score matching (PSM) was performed to adjust for the possible confounding factors. Results: A total of 834 patients were initially included, of whom 614 (307 in each group) remained after PSM. The amylase levels in the drained abdominal fluid on postoperative days 1 and 3 were similar between the PGA and non-PGA groups. The PGA group had a significantly lower incidence of pancreas-related complications of Clavien-Dindo grade ≥2 than that in the non-PGA group (6.8% vs. 2.9%, P=0.025). In subgroup analyses, the odds ratio for pancreas-related complications appeared to be better in the PGA group than in the non-PGA group in patients with American Society of Anesthesiologists Physical Status Classification score of 2 or 3, those operated via a laparoscopic approach, and those undergoing procedures other than proximal gastrectomy. Conclusions: The use of PGA mesh significantly reduced pancreas-related complications after minimally invasive surgery for gastric cancer and might thus benefit patients at risk of such complications.

A Study on Dietary Patterns, Dietary Behaviors and Life Styles before and after Breast Cancer Surgery

  • Kyung-Ja Chang;Sei-Hyun Ahn
    • Korean Journal of Community Nutrition
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    • v.3 no.5
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    • pp.722-728
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    • 1998
  • The purpose of this study was to compare dietary patterns, dietary behaviors and life styles before and after breast cancer surgery in Korea. The subjects were 220 females who underwent surgery for stage I-III breast cancer at general hospitals. Food intake, eating habits, snacks, eating-out, use of nutritional supplements and healthy foods, and drinking and smoking habits were studied using a questionnaire. SAS program was used for statistical analysis of the data. The results are as follows : 1) Most subjects were housewives aged more than 40 years. 2) After breast cancer surgery, intakes of fruits and vegetables were increased and those of meat, salty and spicy foods were decreased. 3) There was a significant difference in takes of caffeine beverages, snacks, fast foods and instant foods before and after breast cancer surgery. 4) There was a significant difference in meal regularity and skipping breakfast before and after breast cancer surgery. 5) The frequency of eating-out was decreased and low-fat foods, such as Japanese foods, were preferred after breast cancer surgery. 6) Nutritional supplements and natural healthy foods were used more after breast cancer surgery. 7) Most subjects were non-smokers and drank little alcohol and the rate of regular drinking significantly decreased after breast cancer surgery. Therefore, there was a significant difference in dietary patterns and behaviors resulting form breast cancer. Further more, dietary factors may be a contributing factor in the incidence at breast cancer in Korea.

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Impact of Surgery on Oligometastatic Pancreatic Cancer: Current Status and Future Perspectives

  • Masayuki Sho;Satoshi Yasuda;Minako Nagai;Kota Nakamura;Taichi Terai;Yuichiro Kohara
    • Journal of Digestive Cancer Research
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    • v.11 no.1
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    • pp.1-8
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    • 2023
  • Pancreatic cancer treatment has advanced. In particular, effective chemotherapy regimen development has fundamentally altered the therapeutic concept and strategy for pancreatic cancer treatment. Consequently, the prognosis of patients with pancreatic cancer has gradually improved. Conversion surgery for locally advanced pancreatic cancer may offer long-term survival or even a full recovery in some individuals. In contrast, metastatic pancreatic cancer has long been considered a surgical contraindication because aggressive surgical resection of the metastatic lesions does not prolong patient survival. Unexpectedly positive benefits of anticancer therapy in recent clinical experience were observed even with metastatic pancreatic cancer. To date, little evidence presented the success of surgical resection for metastatic pancreatic cancer treatment in such rare cases. However, hope and concern are growing that surgical intervention, even in patients with metastatic cancer, may result in favorable outcomes. Several studies suggested different surgical intervention effects depending on metastasis sites and patterns. Thus, this review summarizes the current status of surgery in the multidisciplinary treatment of oligometastatic pancreatic cancer and discusses future perspectives.

Robot-Assisted Pulmonary Resection For Lung Cancer (폐암에서 로봇을 이용한 폐절제술)

  • Lee, Hyun-Sung;Jang, Hee-Jin
    • Korean Journal of Bronchoesophagology
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    • v.17 no.2
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    • pp.92-97
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    • 2011
  • MMinimally invasive surgery (MIS) for early stage lung cancer has been an important treatment modality. However, the ergonomic discomfort and counterintuitive instruments hindered the application of video-assisted thoracic surgery (VATS) to more advanced procedures. To improve the compliance with MIS, robotic surgery was adopted. This advance aimed to alleviate the shortcomings of VATS by maximizing the comfort of the surgeon while providing instruments that enabled technically demanding operations and three-dimensional views with increased freedom for intrathoracic movement owing to EndoWrist$^{(R)}$. In this session, we introduced the clinical applications and its results of robot-assisted thoracic surgery in the field of lung cancer surgery. In conclusion, robot-assisted pulmonary resection with lymph node dissection for lung cancer is safe as well as feasible, and it results in a satisfying postoperative outcome. Robot-assisted surgery may provide a good alternative to conventional open or thoracoscopic surgery for lung cancer, provided that the cost effectiveness and long-term prognosis are confirmed.

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Comparison of Psychological Influence on Breast Cancer Patients Between Breast-conserving Surgery and Modified Radical Mastectomy

  • Sun, Meng-Qing;Meng, Ai-Feng;Huang, Xin-En;Wang, Mei-Xiang
    • Asian Pacific Journal of Cancer Prevention
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    • v.14 no.1
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    • pp.149-152
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    • 2013
  • Objective: To compare the influence of breast-conserving surgery (BCS) and modified radical mastectomy (MRM) on the psychological state of breast cancer patients. Methods: Patients receiving MRM or BCS, and fulfilling the study criteria, were recruited. Patients were required to complete a self-reporting inventory (SCL-90) on admission and 6 months after surgery and a self-rating depression scale (SDS) when discharged from hospital and 6 months after surgery. Results: A total of 70 patients received MRM and 50 BCS. Compared with the national standard, patients suffered to some extent psychological problems on admission, at discharge from hospital and at 6 months after surgery. Patients received BCS had a higher score of SDS compared with those with MRM when discharged from hospital. However, 6 months after surgery, SDS score increased in MRM and decreased in the BCS group, so the difference was significant. Conclusion: The short-term psychological state of patients receiving BCS is worse than that with MRM but superior to MRM 6 months postoperatively. BCS imposed less influence on long term psychological state of breast cancer patients compared with MRM.

A Report on "Debates on the Strategy for Treating Gastric Cancer" at the Congress of the KoreanGastric Cancer Association

  • Kim, Sung-Geun;Park, Cho-Hyun;Kim, Kyung-Mi;Kim, Jae-Gue;Kim, Hyung-Ho;Park, Wong-Sang;Park, Jong-Jae;Lee, Mun-Su;Jung, Hyun-Chul;Jung, Hun-Yong;Han, Sang-Wook;Hyung, Woo-Jin;The Academic Committee of The Korean Gastric Cancer Association, The Academic Committee of The Korean Gastric Cancer Association;Ryu, Sung-Yeop;Kim, Wook;Yook, Jung-Hwan;Jeung, Hei-Cheul;Jung, In-Ho;Park, Do-Joong;Oh, Sang-Hun;Ryu, Keun-Won;Chin, Hyung-Min;Lee, Sang-Ho;Kim, Min-Chan
    • Journal of Gastric Cancer
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    • v.10 no.3
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    • pp.141-148
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    • 2010
  • We have always attempted to create a standard treatment protocol for patients with gastric cancer. However, many debates still exist regarding gastric cancer treatment. For the past 2 years, at the Annual Congress of the Korean Gastric Cancer Association, we have presented a grand symposium on the "Debates on the strategy for treating gastric cancer". In 2008, four major topics were discussed and voted on after discussion. The four major topics were proximal location treatment for early gastric cancer, management choices for pyloric obstruction with advanced gastric cancer, management of liver metastasis, and reconstruction methods after a distal gastrectomy. The opinions of the audience for six minor topics were expressed by an electronic voting system. In 2009, the four main topics were treatment for submucosal tumor sized around 2 cm, laparoscopic gastrectomy in T2N1 gastric cancer, choices for managing gastric lymphoma, and application of a pylorus preserving procedure for early gastric cancer at the antrum. The opinions of the audience for these six minor topics were expressed by an electronic voting system, as was conducted in 2008. It was good opportunity to identify a point of contact about the debates on managing gastric cancer. The results of these debates and studies will identify the best methods to treat patients with gastric cancer.

Current Status of Lung Cancer and Surgery Based on Studies Using a Nationwide Database

  • Kim, Dohun;Lee, Jung-Won
    • Journal of Chest Surgery
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    • v.55 no.1
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    • pp.1-9
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    • 2022
  • Lung cancer is a fatal disease, highlighting the importance of research on related topics, including surgery for lung cancer. However, systematic research analyzing surgery on a national scale is limited. This study aimed to investigate the research on lung cancer using nationwide data in South Korea and to analyze trends in lung cancer surgery, including its clinical implications. Published articles and data from the Korean National Health Insurance database were used. Although the incidence and mortality of lung cancer have been improving, it is predicted to be the most common and fatal type of cancer in South Korea in 2021. The number of surgical procedures for lung cancer is increasing, especially among women, those ≥76 years of age, residents of non-metropolitan cities, and middle-income patients. Lobectomy and sublobectomy, including segmentectomy, are increasingly common. However, the proportion of pneumonectomy relative to other procedures is not increasing. Surgery has shown a reasonable survival rate, especially after lobectomy, but survival remains poor in patients ≥76 years of age who undergo pneumonectomy. The frequency of lung cancer surgery is increasing concomitantly with various socioeconomic changes. Lobectomy has become increasingly common, and the clinical results of surgery are satisfactory. Further research on the changing composition of surgical candidates is required.

Clinical Outcomes of Reduced-Port Laparoscopic Surgery for Patients With Sigmoid Colon Cancer: Surgery With 1 Surgeon and 1 Camera Operator

  • Oh, Jung Ryul;Park, Sung Chan;Park, Sung Sil;Sohn, Beonghoon;Oh, Hyoung Min;Kim, Bun;Kim, Min Jung;Hong, Chang Won;Han, Kyung Su;Sohn, Dae Kyung;Oh, Jae Hwan
    • Annals of Coloproctology
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    • v.34 no.6
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    • pp.292-298
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    • 2018
  • Purpose: This study compared the perioperative clinical outcomes of reduced-port laparoscopic surgery (RPLS) with those of conventional multiport laparoscopic surgery (MPLS) for patients with sigmoid colon cancer and investigated the safety and feasibility of RPLS performed by 1 surgeon and 1 camera operator. Methods: From the beginning of 2010 until the end of 2014, 605 patients underwent a colectomy for sigmoid colon cancer. We compared the characteristics, postoperative outcomes, and pathologic results for the patients who underwent RPLS and for the patients who underwent MPLS. We also compared the clinical outcomes of single-incision laparoscopic surgery (SILS) and 3-port laparoscopic surgery. Results: Of the 115 patients in the RPLS group, 59 underwent SILS and 56 underwent 3-port laparoscopic surgery. The MPLS group included 490 patients. The RPLS group had shorter operating time ($137.4{\pm}43.2minutes$ vs. $155.5{\pm}47.9minutes$, P < 0.001) and shorter incision length ($5.3{\pm}2.2cm$ vs. $7.8{\pm}1.2cm$, P < 0.001) than the MPLS group. In analyses of SILS and 3-port laparoscopic surgery, the SILS group showed younger age, longer operating time, and shorter incision length than the 3-port surgery group and exhibited a more advanced T stage, more lymphatic invasion, and larger tumor size. Conclusion: RPLS performed by 1 surgeon and 1 camera operator appears to be a feasible and safe surgical option for the treatment of patients with sigmoid colon cancer, showing comparable clinical outcomes with shorter operation time and shorter incision length than MPLS. SILS can be applied to patients with favorable tumor characteristics.