• Title/Summary/Keyword: gastrointestinal surgery

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Efficacy and Safety of Bevacizumab in Chinese Patients with Metastatic Colorectal Cancer

  • Zhu, Li-Ming;Zhao, Ya-Zhen;Ju, Hai-Xing;Liu, Lu-Ying;Chen, Lei;Liu, Bi-Xia;Xu, Qi;Luo, Cong;Ying, Jie-Er;Yang, Yun-Shan;Zhong, Hai-Jun
    • Asian Pacific Journal of Cancer Prevention
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    • v.15 no.16
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    • pp.6559-6564
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    • 2014
  • Objective: To evaluate the efficacy and safety of bevacizumab in the treatment of patients with metastatic colorectal cancer (mCRC). Methods: In a single-center, observational study of 91 Chinese patients with mCRC who received bevacizumab in combination with chemotherapy was conducted. Objective response rates (ORRs), progression-free survival (PFS), overall survival (OS) and adverse events were recorded, and the relationships between various clinical factors and PFS or OS were evaluated by Cox proportional hazards models. Results: Treatment with bevacizumab and chemotherapy was effective and tolerable. Univariate analysis showed that PFS and OS were significantly associated with the Eastern Cooperative Oncology Group performance status (ECOG-PS) score, duration of bevacizumab exposure, and whether chemotherapy was continued after discontinuation of bevacizumab treatment. A multivariate analysis showed that the duration of bevacizumab exposure and whether chemotherapy was continued after discontinuation of bevacizumab were independent prognostic factors for PFS and OS. Conclusion: In Chinese mCRC population, the shorter the duration of exposure to bevacizumab and chemotherapy, the worse the prognosis is.

Chronic Gastric Volvulus with Laparoscopic Gastropexy after Endoscopic Reduction: A Case Report

  • Lee, Hye Yeon;Park, Jung Hyun;Kim, Sung Geun
    • Journal of Gastric Cancer
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    • v.15 no.2
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    • pp.147-150
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    • 2015
  • Gastric volvulus is an uncommon clinical entity. There are three types of gastric volvulus; organoaxial, mesenteroaxial and combined type. This condition can lead to a closed-loop obstruction or strangulation. Traditional surgical therapy for gastric volvulus is based on an open approach. Here we report a successful case of a patient with chronic gastric volvulus with a laparoscopic treatment. A 79-year-old woman came to the emergency department with epigastric pain accompanied by nausea for 2 weeks. Abdominal computed tomography revealed markedly distended stomach with transposition of gastroesophageal Junction and gastric antrum. Barium meal study revealed presence of the antrum was folded over 180 degrees that was located above gastroesophageal junction. We attempted an endoscopic reduction, but it was unsuccessful. The patient got laparoscopic anterior gastropexy. Based on our result, laparoscopic gastropexy can be considered as a good choice of the treatment for gastric volvulus.

The Single Incision Laparoscopic Intragastric Wedge Resection of Gastric Submucosal Tumor

  • Na, Jin-Uk;Lee, Sang-Il;Noh, Seung-Moo
    • Journal of Gastric Cancer
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    • v.11 no.4
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    • pp.225-229
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    • 2011
  • Purpose: Laparoscopic wedge resection of gastric submucosal tumor may be difficult in case of the endophytic mass or the mass located unreachable area such as cardia, and intragastric approach can be useful. We would present the experiences of the intragastric wedge resection. Materials and Methods: There were 7 patients diagnosed as gastric submucosal tumor and underwent the intragastric wedge resection at Surgery, Chungnam National University Hospital. We reviewed medical record. Results: There were 3 male and 4 female. Mean age was 65 years-old (57~73). Mean body mass index was 26.28 kg/$m^2$ (21.28~35.30). Location of lesions was 4 cardia, 2 fundus and 1 midbody, respectively. Mean operation time was 83.6 minutes (70~105). All patients were healed without any complication. Mean postoperative hospital stay was 5.4 days (4~6). Mean size was 2.7 cm (2.3~3.8). Pathologic finding was 5 gastrointestinal stromal tumor and 2 leiomyoma. Conclusions: The single incision intragastric wedge resection of gastric submucosal tumor is feasible and acceptable, especially in mass of gastric upper part.

Surgical Treatment for a Primary Arterioenteric Fistula between a Common Iliac Artery Aneurysm and the Terminal Ileum with Massive Bleeding (대량출혈을 동반한 총장골동맥류와 회장 사이에 생긴 일차성 동맥-장관루의 치험)

  • Lee, Hyung-Chae;Jun, Hee-Jae;Choi, Kwang-Ho;Lee, Yang-Haeng;Hwang, Youn-Ho;Lee, Seong-Kwang
    • Journal of Chest Surgery
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    • v.42 no.5
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    • pp.635-638
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    • 2009
  • A 72-year-old man with progressive, unexplained lower gastrointestinal bleeding presented to the emergency department with abdominal pain and shock. Computed tomography of the abdomen showed a fistula between a right common iliac artery aneurysm and the small intestine. Laparotomy demonstrated a saccular aneurysm of the common iliac artery with a fistulous communication to the terminal ileum. Aneurysmectomy, aortoiliac graft replacement and segmental ileocecal resection with end-to-side anastomosis were all successfully performed. For a patient having an arterioenteric fistula along with lower gastrointestinal bleeding, making an early diagnosis using computed tomography and then performing immediate surgery can be expected to save the patient's life.

Acupuncture and Moxiburstion Alleviates Chronic Postoperative Pain as a Comlication of Gastrointestinal Surgery: Apropos 8 Cases (침구치료를 통해 소화기계 수술 후 발생한 만성적 수술 후 통증이 호전된 환자 8례)

  • Choi, Jun-Yong;Kim, So-Yeon;Cho, Min-Kyoung;Kim, Do-Hyung;Park, Seung-Chan;Kwon, Jung-Nam;Hong, Jin-Woo;Lee, In;Park, Seong-Ha;Han, Chang-Woo
    • Journal of Physiology & Pathology in Korean Medicine
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    • v.26 no.2
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    • pp.206-211
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    • 2012
  • Here we described 8 patients treated with acupuncture and moxiburstion due to chronic postoperative pain as a comlication of gastrointestinal surgery. The patients were suffering from pain that continued for more than 6 months after laparotomy for gastric cancer (n=1), rectal cancer (n=2), cholangiocarcinoma (n=2), hepatocellular carcinoma (n=2) and ischemic colitis (n=1), respectively. Mean time elased from surgery were 31.25(${\pm}21.72$)months, pain grade on first visit by VAS(visual analogue scale, 0~10mm) was 3.75(${\pm}0.97$)point, and acupuncture and moxiburstion were performed 12.63(${\pm}5.74$)times during 5.5(${\pm}2.4$)weeks, on average. At the end of treatment, pain was decreased 2.75(${\pm}0.97$)point compared to first visit. Based on the that results, it is reasonable to assume that acupuncture and moxiburstion can be effective to persistent post-surgical pain after laparotomic gastrointestinal surgery, at least to some laparotomized patients.

Association Between C1019T Polymorphism in the Connexin 37 Gene and Helicobacter Pylori Infection in Patients with Gastric Cancer

  • Jing, Yuan-Ming;Guo, Su-Xia;Zhang, Xiao-Ping;Sun, Ai-Jing;Tao, Feng;Qian, Hai-Xin
    • Asian Pacific Journal of Cancer Prevention
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    • v.13 no.5
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    • pp.2363-2367
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    • 2012
  • Objective: To investigate the association between the connexin 37 C1019T polymorphism and Helicobacter pylori infection in patients with gastric cancer. Methods: 388 patients with gastric cancer (GC), 204 with chronic superficial gastritis (CSG) were studied. H. pylori was detected by gastric mucosal biopsies biopsy dyeing method. Connexin 37 gene polymorphism 1019 site genotypes were determined by gene sequencing technology. Genotypes and alleles frequencies were compared. Results: (1) Connexin37 gene 1019 site distribution frequency (CC type, TC type, TT type) in the CSG group was 18.1%, 45.1% and 36.8%; in the stomach cancer group it was 35.1%, 45.9% and 19.%, conforming to the Hardy-Weinberg euilibrium. (2) In comparison with CSG group, the frequency of Connexin37 C allele was higher in the gastric cancer group (58.0% vs 40.7%, OR = 2.01, 95%CI = 1.58-2.57, P < 0.01). The prevalence of gastric cancer risk was significantly increased in the carriers of C allele (CC+TC) than in TT homozygote (OR = 2.47, 5%CI = 1.68- 3.610. (3) Gastric cancer patients complicated with Hp infection 211 cases, gastric cancer group of the male patients with HP positive patients with 187 cases, 40 cases of female patients with negative patients, 24 cases were HP positive, negative in 137 cases, control group male patients, 28 cases were Hp positive, negative in 95 patients, female patients with Hp positive 6 cases, 75 cases were negative. On hierarchical analysis, the male group OR value was 15.9 (95%CI to 9.22-27.3), and the female OR was 2.19 (95%CI 0.88-5.59), indicating a greater contribution in males (P <0.01). After elimination of gender effects, positive HP and gastric cancer were closely related (OR 8.82, 95% CI: 5.45-14.3). (4) The distribution frequency of C allele in patients with Hp infection was much higher than that in Hp negative cases in the GC group (64.5% vs 47.0%, OR = 2.05, 95%CI = 1.54-2.74, P < 0.01). Compared with TT homozygotes, (CC+TC) genotype prevalence of gastric cancer risk increased significantly (OR = 2.96, 5%CI = 1.76-2.99 ). Conclusion: The T allele in the connexin37 gene might not only be associated with gastric cancer but also with H. pylori infection.

Role of PET Scan in Gastric Cancer as a Diagnostic Tool (위암에시 PET의 임상적 역할)

  • Cheon, Gi-Jeong;Kim, Byung-Il;Lim, Sang-Moo
    • 대한위암학회:학술대회논문집
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    • 2002.10a
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    • pp.24-33
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    • 2002
  • Clinical application of positron emission tomography (PET) is rapidly increasing for the detection and staging of cancer at whole-body studies performed with the glucose analogue tracer 2-[fluorine-18]fluoro-2-deoxy-D-glucose (FDG). Although FDG PET cannot match the anatomic resolution of conventional imaging techniques in gastrointestinal and abdominal organs, it is particularly useful for identification and characterization of whole body at the same time. FDG PET can show foci of metastatic disease that may not be apparent at conventional anatomic imaging and can aid in the characterization of indeterminate soft-tissue masses. Most gastrointestinal cancer need to surgical management. FDG PET can improve the selection of patients for surgical treatment and thereby reduce the morbidity and mortality associated with inappropriate surgery. FDG PET is also useful for the early detection of recurrence and the monitoring of therapeutic effect. The gastrointestinal cancers, such as gastroeso-phageal cancer, colorectal cancer, liver cancer and pancreatic cancer, are common malignancies in Korea. PET is one of the most promising and useful methodology for the management of gastric cancer as well as other gastrointestinal cancers.

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Role of PET Scan in Gastric Cancer as a Diagnostic Tool (위암에서 PET의 임상적 역할)

  • Cheon, Gi-Jeong;Kim, Byung-Il;Lim, Sang-Moo
    • Journal of Gastric Cancer
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    • v.2 no.4
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    • pp.184-190
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    • 2002
  • Clinical application of positron emission tomography (PET) is rapidly increasing for the detection and staging of cancer at whole-body studies performed with the glucose analogue tracer 2-[fluorine-18]fluoro-2-deoxy-D-glucose (FDG). Although FDG PET cannot match the anatomic resolution of conventional imaging techniques in gastrointestinal and abdominal organs, it is particularly useful for identification and characterization of whole body at the same time. FDG PET can show foci of metastatic disease that may not be apparent at conventional anatomic imaging and can aid in the characterization of indeterminate soft-tissue masses. Most gastrointestinal cancer need to surgical management. FDG PET can improve the selection of patients for surgical treatment and thereby reduce the morbidity and mortality associated with inappropriate surgery. FDG PET is also useful for the early detection of recurrence and the monitoring of therapeutic effect. The gastrointestinal cancers, such as gastroesophageal cancer, colorectal cancer, liver cancer and pancreatic cancer, are common malignancies in Korea. PET is one of the most promising and useful methodology for the management of gastric cancer as well as other gastrointestinal cancers.

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Spontaneous Neonatal Gastric Perforation (신생아 위 자연천공)

  • Jung, Sung-Eun;Yang, Sook-Jin;Chun, Yong-Soon;Lee, Soong-Cheol;Park, Kwi-Won;Kim, Woo-Ki
    • Advances in pediatric surgery
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    • v.2 no.2
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    • pp.110-114
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    • 1996
  • Spontaneous gastric perforation is an important but rare cause of gastrointestinal perforation in neonates. Just over 200 cases have been reported in the literatures. In spite of recent surgical advances in its managements, mortality rate has been reported as high as 25-50%. Because of physiologic differences, immature immune mechanisms, variations in gastrointestinal flora and poor localization of perforation, a neonate with gastric perforation is at high risk. The pathogenesis is greatly debated. Five patients with spontaneous neonatal gastric perforation who were operated upon at the Department of Pediatric Surgery, Seoul National University Hospital from 1980 to 1993 were reviewed. Four patients were male and one female. The first indication of perforation was 1 day to 6 days of life. All of 5 perforations were located along the greater curvature of the stomach. The size of perforation ranged from 2 cm to 10 cm. Debridement and primary closure were performed in all patients. The operative mortality was 40%(2 of 5). The cause of perforation was not identified in all cases. Prematurity and necrotizing enterocolitis, synchronous or metachronous, were thought to he crucial prognostic factors. Earlier recognition and surgical intervention are necessary to reduce morbidity and mortality.

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Laparoscopic Meckel's Diverticulectomy in Children (소아에서 복강경을 이용한 메켈씨 게실 절제술)

  • Han, Seok-Joo;Kim, Jun-Young;Huh, Jeong-Wook;Han, Ai-Ri;Hwang, Eui-Ho
    • Advances in pediatric surgery
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    • v.7 no.2
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    • pp.157-161
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    • 2001
  • Meckel's diverticulum is one of the common causes of gastrointestinal bleeding in the pediatric patient requiring laparotomy. Two children with Meckel's diverticulum have been successfully treated by laparoscopic excision. Both patients recovered without incident and were discharged at 3 and 5 days after surgery. The authors believe that laparoscopic diverticulectomy is a safe, effective. and minimal invasive treatment of Meckel's diverticulum in children.

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