DOCSLIB.ORG

Thursdaymarch 14, 2002: Basic Science Forum Abstracts BS01 BS03

Total Page：16

File Type：pdf, Size：1020Kb

Download full-text PDF Read full-text
Thursdaymarch 14, 2002: Basic Science Forum Abstracts BS01 BS03 THURSDAYMarch 14, 2002: Basic Science Forum Abstracts BS01 BS03 EXCISION OF LAPAROSCOPIC PORT SITES INCREASES THE LIKE- RAPID FLOW CO2 LAPAROSCOPY AEROSOLISES CANCER CELLS LIHOOD OF WOUND METASTASES IN AN EXPERIMENTAL MODEL INTO PERITONEAL CAVITY BUT NOT PORT SITES IN A NEW RAT David I Watson MD FRACS, Tanya Ellis BSc (hons), Paul Leeder MODEL 1KS Zayyan FRCSE, 1JS Christie-Brown MRCPath, 1S Van MD FRCS, Susan J Neuhaus PhD, Thomas Dodd FRACP, Glyn G Noorden, 2C-Y Yiu FRCS, 1DP Sellu FRCS, 1RT Mathie PhD , 1Division Jamieson MS FACS, FRACS, The University of Adelaide Department of Surgery, Anaesthetics and Intensive Care, Imperial College School of Surgery, Royal Adelaide Hospital, Adelaide, South Australia, AUSTRALIA of Medicine, Hammersmith Hospital, London, UK, 2Whittington Background: Hospital, London, UK Case reports of patients developing tumour metastases at port Background: The role of CO2 in the pathogenesis of tumor recur- sites following laparoscopic surgery have prompted the develop- rences after laparoscopy remains controversial. This study was ment of preventive strategies to address this potential problem, designed to determine if rapid flow of CO2 contributed to the disper- including local excision of the port sites. Whilst this strategy is cur- sal of free cancer cells during laparoscopy in a new rat model. rently used clinically, its efficacy has not been established. Methods: A novel rat model of desufflation without trocar was Methods: developed and 55 Fischer rats were randomised into three groups: A 24 immune competent Dark Agouti rats underwent laparoscopy (rapid flow of CO2 at 0.67L/min, n=20), B (slow flow at 0.44L/min, and standardized intraperitoneal laceration of an implanted abdomi- n=20) and C (gasless laparoscopy, n=15). CO2 was vented via a port- nal flank tumour, using an established laparoscopic cancer model. less surgical valve that filtered cells. After suspending the abdominal Rats were randomized to either control (n=12) or wound excision wall, half of the animals in each group (non-recovery) were injected (n=12) groups. Both groups underwent laparoscopy using CO2 intraperitoneally with 7.5 x 106 immunolabelled rat colon cancer cells insufflation, and 2 mini-laparoscopy ports. In the wound excision (RCC2) while the other half (recovery), received 7.5 x 106 viable RCC2 group one of the port site wounds was excised following desuffla- prior to insufflation or gasless laparoscopy. Non-recovery animals tion of the abdominal cavity. One week later the port site wounds were killed after insufflation and parietal peritoneal and port site spec- were excised for histological examination. imens were examined for RCC2 by fluorescence microscopy (FM) and Results: flow cytometry (FC). The recovery animals were killed at four weeks Wound involvement with tumour was significantly more common for evidence of wound recurrence. following wound excision, compared with untreated controls (9 of Results: Nine of ten non-recovery animals in A had RCC2 on FM or 12 versus 2 of 12, p=0.002). In the wound excision group, tumour FC compared to two in each of non-recovery B and C (p=0.018). Two metastases arose preferentially in the excised port site wound. of these nine also had RCC2 in their portless valves. Two recovery A Conclusions: animals developed wound recurrence at 4 weeks compared to zero in This study suggests that excision of laparoscopy port site wounds following laparoscopic surgery for cancer does not prevent the sub- the other groups (p=0.315) sequent development of port site tumors. Furthermore, the excision Conclusions: Rapid flow of CO2 aerosolised free cancer cells into the of port sites may actually increase the risk of tumour metastases peritoneal cavity but not the port sites, thus supporting a role for CO2 arising in port sites, suggesting that the clinical application of this in the intraperitoneal dispersal of free tumour but not port site recur- strategy should be re-evaluated. rence. BS02 BS04 INCREASED TUMOR SPREAD AFTER CONVERSION FROM LAPARO- EFFECT OF SURGICAL TRAUMA ON EPCAM VACCINE INDUCED TUMOR SPECIFIC CELL CYTOTOXICITY AND ANTIBODY PRODUC- SCOPIC TO OPEN SURGERY Lars Brinkmann MD, Beate Richter MD, TION Irena Kirman, M.D., Ph.D., Alexandra Maydelman, Zisan Asi, Tobias Weberschock MD, Claus-Georg Schmedt MD, Carsten N Gutt B.A., Daniel Feingold, M.D., Marc Bessler, M.D., Richard L. Whelan, MD Department of General Surgery, J-W Goethe University Frankfurt, Department of Surgery, Columbia University, New York, NY Germany Surgical trauma inhibits immune function. Our goal was to study the Background: effect of surgical intervention on the development of a specific In up to 20% of tumor resection laparoscopic surgery is forced to immune response to EpCAM, a tumor associated protein. Methods: convert to conventional open technique based on diverse complicated EpCAM protein and the adjuvant MPLA were incorporated in alginate intra-abdominal conditions. Concerning the effect of conversion from beads. Control beads contained alginate only. The beads were laparoscopic to open surgery on tumor growth and spread only few implanted 3 weeks before surgery in all mice. The following experi- data are available. In terms of conversion stronger surgical manipula- mental groups (n=5) were included: anesthesia control + control beads tion and longer total operating time could have an important impact (AC-contr), anesthesia control + vaccine beads (AC-vac), open surgery on the immune function and tumor growth. + control beads (OS-contr), open surgery + vaccine beads (OS-vac), Methods: CO2 pneumopertioneum (pneumo) + control beads (CO2-contr) and 60 male WAG/Rij rats were randomised into four groups: laparoto- CO2 pneumo + vaccine beads (CO2-vac). Following surgery, mice my (Open, n = 15), laparoscopy (CO2, n = 14), early and late conver- were inoculated with EpCAM transfected C26 (C26-EpCAM) cells. Tumors were allowed to grow 5 weeks. Subsequently, blood was sion from laparoscopy to laparotomy after 30 minutes (CV 30, n = 15) obtained, mice sacrificed, their splenocytes isolated and frozen. The and after 60 minutes (CV 60, n = 15). Metastasis were induced by concentration of anti-EpCAM IgG in plasma was determined by ELISA. intrasplenic tumor cell (50,000 cells, CC531) inoculation during proce- EpCAM specific killing was assayed by flow cytometry using PI stain- dure. Total operating time was 90 minutes. Regarding CV 60 total ing and fluorescently labeled C26-EpCAM cells. Student’s t-test was operating time was 120 minutes. 28 days following surgery tumor used for statistical analysis. Results All immunized mice developed growth was evaluated regarding number, diameter and cancer index greater cytotoxic response to C26-EpCAM than their respective con- of tumor nodes. Data were analysed by Kruskal-Wallis Test. trols: AC-vac, vs AC-contr, (p<0.02), OS-vac, vs OS-contr, (p<0.01) and Results: CO2-vac, vs CO2-contr, (p<0.02). However, anti-EpCAM IgG increased After late conversion (CV 60) total tumor growth was significantly significantly in AC-vac, 3.12+/-0.78 ug/ml vs AC-contr, 0.02+/-0.04 increased compared to laparoscopy and laparotomy (p < 0.05). There ug/ml (p<0.01) and in CO2-vac, 1.22+/-0.73 ug/ml vs CO2-contr, 0.02+/- was no significant difference between Open, CO2 and CV 30. CV 30 0.04 ug/ml (p<0.01), but not in OS-vac, 0.64±1.06 ug/ml vs OS-contr, showed less tumor growth than CV 60. 0.002+/-0.64. (Tumor growth is subject of a separate abstract.) Conclusions: Conclusions Perioperatively administered encapsulated EpCAM-MPLA Conversion from laparoscopic to open surgery might result in vaccine induces specific cell mediated and antibody mediated stronger tumor growth than laparoscopic surgery (CO2) or conven- immune response in the setting of anesthesia alone or C02 pneumo. tional open surgery without conversion. From the oncological view an Although vaccination in the open surgery mice also induced a cell- mediated response, a diminished antibody response was observed early decision for conversion seems to be strongly recommended. after laparotomy. Underline denotes presenter. * denotes resident paper. http://www.8thworldcongress.org/ 77 THURSDAYMarch 14, 2002: Basic Science Forum Abstracts BS05 BS07 THE HYPOXIC PNEUMOPERITONEUM INDUCES AUGMENTED MALIGNANT POTENTIAL VIA NF-KB MEDIATED METALLOPROTEASE ALTERATIONS OF T LYMPHOCYTE SUBSETS AND TH1/TH2 BAL- UPREGULATION PF Ridgway MD, S Olsen MD, P Ziprin MD, PA ANCE FOLLOWING LAPAROSCOPY-ASSISTED DISTAL GASTRECTOM Paraskeva MD, DH Peck PhD, AW Darzi MD., Academic Surgical Unit, Kyuzo Fujii, M.D., Kazuhiro Yasuda,M.D., Masafumi Inomata,M.D., Imperial College Faculty of Medicine, St. Mary’s Hospital, London, UK Norio Shiraishi,M.D.,Yosuke Adachi,M.D., Seigo Kitano, M.D. Background: The hypoxic pneumoperitoneum causes an increased Department of Surgery I, Oita Medical University, Oita, Japan malignant potential in vitro although the antecedent mechanism is abstract: [Objective] Postoperative immunosuppression is less in unclear. The authors hypothesise that Matrix Metalloproteases (MMP), laparoscopic surgery than open surgery. There is no report about the lacking a hypoxic response element, are up regulated via a Nuclear alterations of the circulating T lymphocyte and natural killer (NK) cell Factor kappa B (NF-kB) dependant pathway. subsets following laparoscopy-assisted distal gastrectomy (LADG) and Methods: The Colonic (SW1222) tumour cell line was exposed to a conventional open distal gastrectomy (ODG) for early gastric cancer. gas displacement hypoxic model at various time points. Breast (MDA- The aim of this study was to compare the immunosuppression after MB231) cells were used to evaluate adenocarcinoma specificity. LADG to ODG. Invasion across a Matrigel coated 8um Transwell filters as well as cell [Materials and methods] Patients with early gastric cancer were viability was assessed using a MTS non-radioactive cell proliferation divided into two groups, LADG group (n=10) and ODG group (n=10) . assay (Promega). Activity of MMP 2 and 9 were assessed using gelatin Blood was taken on the preoperative day, the first, third and seventh zymography.
Load more

Recommended publications
  • Intestinal Staple Line Reinforcement Using Matristem
    Surgical Science, 2015, 6, 65-70 Published Online February 2015 in SciRes. http://www.scirp.org/journal/ss http://dx.doi.org/10.4236/ss.2015.62011 Intestinal Staple Line Reinforcement Using MatriStem Kent C. Sasse, David Warner*, Sean M. Ward, Walter Mandeville, Rebecca Evans Department of Physiology & Cell Biology, University of Nevada School of Medicine, Reno, USA Email: *[email protected] Received 31 December 2014; accepted 10 February 2015; published 13 February 2015 Copyright © 2015 by authors and Scientific Research Publishing Inc. This work is licensed under the Creative Commons Attribution International License (CC BY). http://creativecommons.org/licenses/by/4.0/ Abstract Background: Staple line reinforcement material has been demonstrated to raise the burst pres- sure threshold after linear intestinal stapling. Numerous bioprosthetic materials have been uti- lized in surgical practice. Porcine urinary bladder matrix (ACell, Inc.) is an extracellular matrix material derived from porcine bladder used to reinforce surgically repaired soft tissue, and facili- tate the body’s regenerative capacity. Objective: This study represents the first evaluation of uri- nary bladder matrix in gastrointestinal staple line reinforcement. Methods: Pathogen-free pigs underwent midline laparotomy under general anesthesia. Small intestinal division was performed with an endoscopic linear stapler. Nineteen intestinal divisions were performed with urinary bladder matrix staple line reinforcement, and twenty divisions were unreinforced. Staple lines were then subjected to burst pressure analysis by intraluminal infusion of dyed Krebs solution at an infusion rate of 20 ml·min−1 under manometric monitoring. Upon visible staple line extravasa- tion, intraluminal pressure was recorded. Results: Intestinal staple lines reinforced with urinary bladder matrix exhibited significantly higher burst pressure threshold (p < 0.05).
    [Show full text]
  • Microsurgery: Free Tissue Transfer and Replantation
    MICROSURGERY: FREE TISSUE TRANSFER AND REPLANTATION John R Griffin MD and James F Thornton MD HISTORY In 1964 Nakayama and associates15 reported In the late 1890s and early 1900s surgeons began what is most likely the first clinical series of free- approximating blood vessels, both in laboratory ani- tissue microsurgical transfers. The authors brought mals and human patients, without the aid of magni- vascularized intestinal segments to the neck for cer- fication.1,2 In 1902 Alexis Carrel3 described the vical esophageal reconstruction in 21 patients. The technique of triangulation for blood vessel anasto- intestinal segments were attached by direct microvas- mosis and advocated end-to-side anastomosis for cular anastomoses in vessels 3–4mm diam. Sixteen blood vessels of disparate size. Nylen4 first used a patients had a functional esophagus on follow-up of monocular operating microscope for human ear- at least 1y. drum surgery in 1921. Soon after, his chief, Two separate articles in the mid-1960s described Holmgren, used a stereoscopic microscope for the successful experimental replantation of rabbit otolaryngologic procedures.5 ears and rhesus monkey digits.16,17 Komatsu and 18 In 1960 Jacobson and coworkers,6 working with Tamai used a surgical microscope to do the first laboratory animals, reported microsurgical anasto- successful replantation of a completely amputated moses with 100% patency in carotid arteries as digit in 1968. That same year Krizek and associ- 19 small as 1.4mm diameter. In 1965 Jacobson7 was ates reported the first successful series of experi- able to suture vessels 1mm diam with 100% patency mental free-flap transfers in a dog model.
    [Show full text]
  • Urotoday International Journal®
    UIJ UroToday International Journal® Percutaneous Dilatation of Non-malignant Ureteroenteric Anastomotic Strictures in Patients with Urinary Diversion After Cystectomy for Bladder Cancer: 7 Patients Sallami Satáa, Olfa Zrayer, Habiba Mizouni, Sami Ben Rhouma, Mohamed Hmidi, Mourad Gargaouri, Maher Chtourou Submitted June 18, 2012 - Accepted for Publication July 23, 2012 ABSTRACT Background: The management of ureterointestinal stricture in patients who have undergone urinary diversion can be challenging. Endourological techniques have been increasingly used in recent years for such strictures. Objectives: We report our experience and evaluate our results on balloon antegrade dilatations for benign ureteroenteric anastomotic strictures after total cystectomy and urinary diversion by ileal conduit. Patients and Methods: Between December 1990 and May 2009, 8 balloon dilatations were performed on 7 patients with a mean age of 56.6 years (range: 50 to 72) to treat ureterointestinal strictures. Strictures were dilated percutaneously via the antegrade approach under fluoroscopic control. A ureteral multi-hole catheter was left for 6 to 8 weeks. Success was defined as radiological resolution of obstruction and the ability to recover normal activity in the absence of flank pain, infection, or the need for ureteral stents or nephrostomy tubes. Results: The development of strictures occurred a mean of 4.5 months after urinary diversion. Eight renal units were treated (5 left, 3 right), including 1 bilateral procedure. There were 6 complete and 2 partial strictures. The operative time did not exceed 45 minutes. No major complications were encountered during or after these procedures. The overall success rate was 43%. Three patients required open reimplantation. Six of 7 patients showed satisfactory outcomes and 1 patient was lost to follow-up.
    [Show full text]
  • The Use of Cyanoacrylate in Surgical Anastomosis: an Alternative to Microsurgery
    [Downloaded free from http://www.jstcr.org on Tuesday, June 29, 2010, IP: 41.185.132.78] SUrGiCAL opiNioN The Use of Cyanoacrylate in Surgical Anastomosis: An Alternative to Microsurgery G. M. Bot, K. G. Bot1, J. O. Ogunranti2, J. A. Onah2, A. Z. Sule, I. Hassan3, E. D. Dung Department of Surgery, Jos University Teaching Hospital, ABSTRACT 1Faculty of Medical Science, University of Jos, 2Department of Anatomy, University of Jos, 3Department of Surgery, To present anastomosis with cyanoacrylate as a cheap, Aminu Kano University Teaching Hospital, Plateau State, simple, fast, and available technique for anastomosis in Nigeria urological, vascular, gynecological, and general surgical procedures. This method may in the future be a good alternative to microsurgery, particularly in centers where INTRODUCTION facilities are unavailable and the financial implication is unbearable for the patient. Cyanoacrylate is an adhesive or glue that is available in different chemical forms ranging from he use of cyanoacrylate is not widespread despite ethylcyanoacrylate (superglue) to Isobutylcyanoacrylate a number of published studies on the subject.[1] and octylcyanoacrylate (dermerbond), which is in TCyanoacrylate is an adhesive that was first clinical use. Anastomosis with cyanoacrylate requires discovered by Dr. Harry Coover and Fred Joyner in the the application of stay sutures, a luminal stent and the [2] subsequent application of the adhesive. The adhesives with Kodak laboratory. Cyanoacrylates were first synthesized lower molecular weights produce a rigid and patent region by Airdis in 1949, while Coover et al. described their of anastomosis, while the higher molecular compounds adhesive property and suggested their possible use as produce a consistency close to the normal tissue.
    [Show full text]
  • The Plastic Surgery Research Council 59Th Annual Meeting Abstract Supplement EDITORIAL BOARD
    PSRC Supplement Abstracts Online at www.PRSJournal.comSee the VOLUME 133 • NUMBER 3S • MARCH 2014 SUPPLEMENT www.PRSJournal.com Supplement to Plastic and Reconstructive Surgery ® Journal of the American Society of Plastic Surgeons Official Organ of the American Association of Plastic Surgeons Official Organ of the American Society of Maxillofacial Surgeons Official Organ of the Plastic Surgery Research Council The Plastic Surgery Research Council 59th Annual Meeting Abstract Supplement EDITORIAL BOARD Plastic and Reconstructive Surgery EDITOR-IN-CHIEF ASSOCIATE EDITORS SECTION EDITORS Rod J. Rohrich, M.D. William Peter Adams, Jr ., Department of Plastic Surgery Maurice Nahabedian University of Texas Dallas, Texas Washington, D.C. BREAST Southwestern Medical Center Al Aly, Orange, Calif. 5959 Harry Hines Blvd., POB1 David A. Hidalgo Suite 300 Charles E. Butler, Houston, Texas COSMETIC Dallas, Texas 75390-8820 New York, N.Y. [email protected] Grant W. Carlson, Atlanta, Ga. David W. Chang, Chicago, Ill. Paul S. Cederna CO-EDITOR EXPERIMENTAL James M. Stuzin, M.D. Peter G. Cordeiro, New York, N.Y. Ann Arbor, Mich. 3225 Aviation Avenue, Suite 100 Coconut Grove, Fla. 33133-4753 Joseph J. Disa, New York, N.Y. Matthew J. Concannon HAND/ REVIEW EDITOR Gregory A. Dumanian, Chicago, Ill. Columbia, Mo. PERIPHERAL NERVE Ronald P. Gruber, M.D. Steven Fagien, Boca Raton, Fla. 3318 Elm Street (Oculoplastic Surgeon) Scott P. Bartlett PEDIATRIC/ Oakland, Calif. 94609-3012 Philadelphia, Pa. Jeffrey A. Fearon, Dallas, Texas CRANIOFACIAL ASPS ADVERTISING EDITOR Robert D. Galiano, Chicago, Ill. Dennis P. Orgill Charles N. Verheyden, M.D., Bahman Guyuron, Lyndhurst, Ohio Boston, Mass. RECONSTRUCTIVE Ph.D. 2401 S.
    [Show full text]
  • A Fo Dh Ww Doh L
    THE EFFECTS OF INDWELLING TRANSURETHRAL CATHETERIZATION AND TUBE CYSTOSTOMY ON URETHRAL ANASTOMOSES IN DOGS by Anjyilla Joye Cooley Thesis submitted to the Faculty of the Virginia Polytechnical Institute and State University in partial fulfillment of the requirements for the degree of MASTER OF SCIENCE in Veterinary Medical Sciences APPROVED: — 7). W——_. Don R. Waldron, Chairman Mark M. Smith refory C. Troy a fo Dh Ww Doh L. Barber May, 1996 Blacksburg, Virginia KEY WORDS: Urethra, wound healing, urinary diversion Mad es panel THE EFFECTS OF INDWELLING TRANSURETHRAL CATHETERIZATION AND TUBE CYSTOSTOMY ON URETHRAL ANASTOMOSES IN DOGS by Anjilla Joye Cooley Committee Chairman: Don R. Waldron Veterinary Medical Sciences This study compared the effects of urinary diversion by tube cystostomy catheterization, urethral catheterization and tube cystostomy and urethral catheterization on healing urethral anastomoses in the canine urethra. Fifteen intact, mature males were divided into three groups of five dogs. Urodynamic studies were performed under halothane anesthesia preoperatively and at ten weeks postoperatively. Urethral anastomosis was performed in all dogs over a urethral catheter with 4-0 polyglyconate. Group U dogs (n=5) received transurethral catheters. Group C dogs (n=5) received tube cystostomy catheters, and Group B dogs (n=5 ) had both a transurethral catheter and a cystostomy tube placed. All dogs had catheters maintained with a closed urine collection system for seven days. Dogs were observed for ten weeks following surgery, and urinalysis and urine cultures were performed on weeks 1, 4, and 8. Preoperative evaluations were repeated ten weeks postoperatively just prior to termination of the study. Radiographic and histopathologic evaluation of the urethral specimen was performed.
    [Show full text]
  • GLOSSARY of TREATMENT TERMS (Referenced from the Training Manual Prepared by the American College of Surgeons Commission on Cancer)
    Appendix 15 GLOSSARY OF TREATMENT TERMS (referenced from the training manual prepared by the American College of Surgeons Commission on Cancer) Abdominal-perineal resection: Surgical procedure used in the treatment of colorectal cancer that requires a combined approach through the abdomen and the perineum. Complications include ureteral injury, urinary dysfunction, urinary tract infections, sexual dysfunction, perineal and abdominal wound infections, and stomal complications. Adjuvant therapy: A therapy that aids another, such as chemotherapy, after surgery. Allogenic bone marrow transplantation: Transplanting bone marrow from one person to another person who is of the same tissue type. Amputation: The removal of a limb or other appendage or outgrowth of the body. Anti-oncogenes: Genes having the ability to regulate growth and inhibit carcinogenesis. Antrectomy: Excision of the antrum. Autologous bone marrow transplatation: Transplanting the patient’s own bone marrow after ablative treatment. BCG: Bacille Calmette Guerin vaccine, a tuberculosis vaccine, containing living, avirulent, bone-strain tubercle bacilli. It is administered by a special technique using a multiple puncture disk and is used in immunotherapy for the treatment of cancer, particularly malignant melanoma and bladder cancer. Bilobectomy: Removal of two lobes. Bilroth I: Pylorectomy with end-to-end anastomosis of the upper portion of the stomach to the duodenum. Bilroth II: Partial gastric resection with closure of duodenal stump and gastrojejunostomy. Biospy: Removal
    [Show full text]
  • Intracorporeal Esophagojejunostomy Using a Circular Or a Linear Stapler in Totally Laparoscopic Total Gastrectomy: a Propensity-Matched Analysis
    J Gastric Cancer. 2019 Jun;19(2):193-201 https://doi.org/10.5230/jgc.2019.19.e17 pISSN 2093-582X·eISSN 2093-5641 Original Article Intracorporeal Esophagojejunostomy Using a Circular or a Linear Stapler in Totally Laparoscopic Total Gastrectomy: a Propensity-Matched Analysis So Hyun Kang 1, Yo-Seok Cho,1 Sa-Hong Min 1, Young Suk Park 1, Sang-Hoon Ahn 1,2, Do Joong Park 1,2, Hyung-Ho Kim 1,2 1Department of Surgery, Seoul National University Bundang Hospital, Seongnam, Korea 2Department of Surgery, Seoul National University College of Medicine, Seoul, Korea Received: Dec 16, 2018 ABSTRACT Revised: Apr 9, 2019 Accepted: Apr 9, 2019 Purpose: There is no consensus on the optimal method for intracorporeal Correspondence to esophagojejunostomy (EJ) in laparoscopic total gastrectomy (LTG). This study aims to Hyung-Ho Kim compare 2 established methods of EJ anastomosis in LTG. Department of Surgery, Seoul National Materials and Methods: University Bundang Hospital, 82 Gumi-ro A total of 314 patients diagnosed with gastric cancer that underwent 173-beon-gil, Bundang-gu, Seongnam 13620, LTG in the period from January 2013 to October 2016 were enrolled in the study. In 254 Korea. patients, the circular stapler with purse-string “Lap-Jack” method was used, and in the other E-mail: [email protected] 60 patients the linear stapling method was used for EJ anastomosis. After propensity score Copyright © 2019. Korean Gastric Cancer matching, 58 were matched 1:1, and retrospective data for patient characteristics, surgical Association outcome, and post-operative complications was reviewed. This is an Open Access article distributed Results: The 2 groups showed no significant difference in age, body mass index, or other under the terms of the Creative Commons clinicopathological characteristics.
    [Show full text]
  • Videofluoroscopic Evaluation in Oropharyngeal Swallowing After Radical Esophagectomy with Lymphadenectomy for Esophageal Cancer
    ANTICANCER RESEARCH 27: 4249-4254 (2007) Videofluoroscopic Evaluation in Oropharyngeal Swallowing after Radical Esophagectomy with Lymphadenectomy for Esophageal Cancer HIROYUKI KATO, TATSUYA MIYAZAKI, MAKOTO SAKAI, AKIHIKO SANO, NARITAKA TANAKA, HITOSHI KIMURA, TAKANORI INOSE, AHMAD FARIED, KANA SAITO, MAKOTO SOHDA, MASANOBU NAKAJIMA, YASUYUKI FUKAI, NORIHIRO MASUDA, MINORU FUKUCHI, RYOKUHEI MANDA, HITOSHI OJIMA, KATSUHIKO TSUKADA and HIROYUKI KUWANO Department of General Surgical Science (Surgery I), Gunma University, Graduate School of Medicine, Maebashi, 371-8511, Japan Abstract. Background: After esophagectomy a swallowing lowest. The results of the swallowing evaluation using abnormality is the predominant symptom for esophageal videofluoroscopy suggest that to avoid oropharyngeal cancer. The aims of this study were to examine (i) swallowing abnormalities the intrathoracic or cervical oropharyngeal swallowing by comparing pre- and post- anastomosis with posterior mediastinal route should be chosen operative period, and (ii) the relationship between as reconstruction after esophagectomy if possible. oropharyngeal swallowing and the alimentary reconstruction route after esophagectomy. Patients and Methods: We studied Esophageal carcinoma is considered as one of the most 27 patients in the upright position using videofluoroscopy in difficult malignancies to cure (1, 2). Esophagectomy is the the lateral projection. Each patient was studied during 10 mL mainstay of therapy for malignancy of the esophagus (3). barium swallows in the pre- and post-operative period. Results: Although the whole stomach can be used as an esophageal Of the 27 patients studied, alimentary reconstruction with the substitute after esophageal resection, the most general retrosternal route (RS group) was performed in 8 patients, that gastric reconstruction after an esophagectomy is the gastric with posterior mediastinal route (PM group) in 8 patients, and tube (4, 5).
    [Show full text]
  • Omental Wrapping” Technique with Autologous Onlay Flap/Graft Ureteroplasty for the Management of Long Ureteral Strictures
    2878 Original Article The application of the “omental wrapping” technique with autologous onlay flap/graft ureteroplasty for the management of long ureteral strictures Jie Wang1#, Baiyu Zhang2#, Jian Fan1#, Sida Cheng1, Shubo Fan1, Lu Yin1, Zhihua Li1, Hua Guan1, Kunlin Yang1, Xuesong Li1 1Department of Urology, Peking University First Hospital, Institute of Urology, Peking University, National Urological Cancer Center, Beijing, China; 2Department of Urology, The First Affiliated Hospital of Kunming Medical University, Kunming, China Contributions: (I) Conception and design: J Wang, B Zhang; (II) Administrative support: X Li; (III) Provision of study materials or patients: X Li, K Yang; (IV) Collection and assembly of data: S Fan, L Yin, Z Li, H Guan; (V) Data analysis and interpretation: J Fan, S Cheng; (VI) Manuscript writing: All authors; (VII) Final approval of manuscript: All authors. #These authors contributed equally to this work. Correspondence to: Kunlin Yang; Xuesong Li. Department of Urology, Peking University First Hospital, Institute of Urology, Peking University, National Urological Cancer Center, No. 8 Xishiku St, Xicheng District, Beijing 100034, China. Email: [email protected]; [email protected]. Background: To present our experience with the “omental wrapping” technique in laparoscopic and robotic ureteroplasty using onlay flaps or grafts for the management of long proximal or middle ureteral strictures. Methods: This is a retrospective review of 25 patients with long proximal or middle ureteral strictures who underwent laparoscopic and robotic onlay flaps or grafts ureteroplasty using an omental flap to reinforce an anastomosis site between August 2018 and November 2019. Perioperative and follow-up data were collected. Results: Sixteen laparoscopic procedures and nine robotic procedures were performed successfully.
    [Show full text]
  • New Approaches Towards Risk Assessment, Diagnosis and Prevention Strategies of Colorectal Anastomotic Leakage
    New approaches towards risk assessment, diagnosis and prevention strategies of colorectal anastomotic leakage Niels Komen 1 De druk van dit proefschrift werd mede mogelijk gemaakt door: Erasmus Universiteit Rotterdam, Erasmus MC Afdeling Heelkunde, De Financiële Makelaar, Arseus Medical B.V., Covidien Printing: D. Provo N.V., Gierle, Belgium Cover image: Associated Press © Copyright of the published articles is with the corresponding journal or otherwise with the author. No part of this book may be reproduced, stored in a retrieval system, or transmitted in any form or by any means without permission of the author or the corresponding journal. Rotterdam 2014 2 New Approaches Towards Risk Assessment, Diagnosis and Prevention Strategies of Colorectal Anastomotic Leakage Nieuwe benaderingen van risico bepaling, diagnose en preventie strategieën van colorectale naadlekkage Proefschrift ter verkrijging van de graad van doctor aan de Erasmus Universiteit Rotterdam op gezag van de rector magnificus Prof.dr. H.A.P. Pols en volgens besluit van het College voor Promoties. De openbare verdediging zal plaatsvinden op vrijdag 9 mei 2014 om 13:30 uur door Nicolaas Antonius Petrus Komen geboren te Oisterwijk 3 Promotiecommissie Promotor Prof.dr. J.F. Lange Overige leden Prof.dr. C.H.J. van Eijck Prof.dr. C. Verhoef Prof.dr. J.H.W. de Wilt Copromotor Prof.dr. J. Jeekel 4 Table of Contents Part 1 General introduction 7 Part 2 Risk assessment 21 Chapter 1 23 After-hours colorectal surgery: a risk factor for anastomotic leakage Chapter 2 39 Calcium score: a new risk factor for colorectal anastomotic leakage Chapter 3 53 Long-term and Perioperative Corticosteroids in Anastomotic leakage: A Prospective Study of 259 Left-Sided Colorectal Anastomoses Chapter 4 71 Riolan’s arch: confusing, misnomer, and obsolete.
    [Show full text]
  • Automated Uretero-Intestinal Anastomosis with Absorbable Staples
    Journal of Endourology Automated Uretero-Intestinal Anastomosis with Absorbable Staples Bollom M., Grosskopf V., Paulsen S., Theisen J. ABSTRACT Bladder cancer is the 5th most common cancer in the United States. When cancer cells invade the bladder muscle, surgical removal of the bladder, called radical cystectomy, is the desired treatment. A neobladder is formed out of a portion of intestine, and the ureters are currently attached via absorbable sutures. We have designed rigid absorbable staples comprised of 85:15 poly(lactide-co-glycolide) (PLGA) and a surgical anastomosis stapler to fire two concentric rings of six staples each. Degradation testing shows that the staples will retain strength for at least 20 days, long enough to promote healing of the tissue. Functional testing shows that the average grip strength of a single staple is 5.34 ± 1.5 N and 11.58 ± 2.28 N for a single suture stitch. Future testing will analyze the anastomosis strength of 12 staples fired using the circular stapler. INTRODUCTION According to the National Cancer Institute, bladder cancer is the 5th most common cancer in the United States. In 2012, there will be over 73,000 new cases reported in the United States and 15,000 people will die from bladder cancer1. When the tumors invade the bladder muscle, the desired treatment is radical cystectomy, surgical removal of the entire bladder2. Following removal of the bladder, a surgeon will commonly construct a new, internal neobladder using a portion of the intestine. The ureters are currently attached to the neobladder with absorbable sutures. This attachment must be watertight so urine does not leak into the abdominal cavity.
    [Show full text]