Enhanced recovery versus conventional care in gastric cancer surgery: a meta-analysis of randomized and non-randomized controlled trials

AbstractIntroductionEnhanced recovery after surgery (ERAS) protocols have been successfully integrated into peri-operative management of different cancer surgeries such as colorectal cancer. Their value for gastric cancer surgery, however, remains uncertain.MethodsA search for randomized and observational studies comparing ERAS versus conventional care in gastric cancer surgery was performed according to PRISMA guidelines. Random-effects meta-analyses with inverse variance weighting were conducted, and quality of included studies was assessed using the Cochrane risk-of-bias tool and Newcastle-Ottawa scale (PROSPERO: CRD42017080888).ResultsTwenty-three studies involving 2686 patients were included. ERAS was associated with reduced length of hospital stay (WMD —2.47 days, 95% CI − 3.06 to − 1.89,P 
Source: Gastric Cancer - Category: Gastroenterology Source Type: research

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Egemen Cicek, Fatih Sumer, Ersin Gundogan, Cihan Gokler, Cuneyt KayaalpJournal of Minimal Access Surgery 2019 15(4):348-350Laparoscopic surgery for remnant gastric cancer has been reported in a limited number of cases, and data on post-operative complications are lacking. A 58-year-old male was admitted with remnant gastric cancer. He had undergone open subtotal gastrectomy 9 years ago for gastric cancer. Laparoscopic total gastrectomy was performed, and he was discharged on the 10th day uneventfully. The patient had complained of nausea and vomiting in the 2nd post-operative month. He clinically and radiologically diagnos...
Source: Journal of Minimal Access Surgery - Category: Surgery Authors: Source Type: research
Conclusions: The newly developed radiomic signature was a powerful predictor of LN metastasis and the radiomics nomogram could facilitate the preoperative individualized prediction of LN status. Introduction Gastric cancer (GC) is one of the most common malignant tumors and the second leading cause of cancer-related deaths worldwide (1). Accurate evaluation of lymph node metastasis (LNM) status in GC patients is vital for prognosis and treatment decisions (2–4). Some histopathologic factors and biomarkers (e.g., lymphatic invasion, matrix metalloproteinase-2) are found to be able to predict LNM in GC, but mos...
Source: Frontiers in Oncology - Category: Cancer & Oncology Source Type: research
Conclusions: Bariatric surgery appears to be capable of partially reversing the obesity-related epigenome. The identification of potential epigenetic biomarkers predictive for the success of bariatric surgery may open new doors to personalized therapy for severe obesity. Introduction Obesity is currently a huge healthcare problem, worldwide, and is a risk factor for several diseases such as type 2 diabetes (T2D), cardiovascular disease and cancer (1). As the prevalence of obesity reaches pandemic proportions, this metabolic disease is estimated to become the biggest cause of mortality in the near future (2). In fact,...
Source: Frontiers in Endocrinology - Category: Endocrinology Source Type: research
Rationale: Paraneoplastic dermatomyositis (DM) is an inflammatory disease of the connective tissue caused by immunologic events in the presence of malignant tumors, which are typically related to ovarian, pancreatic, stomach, and colon cancer. Traditional treatment of paraneoplastic DM includes combination therapy for the underlying malignancy with systemic steroids. Patient concerns: A 41-year-old woman presented with facial erythema and myalgia of the extremities. Diagnosis: The patient was diagnosed with DM associated with a fallopian-tube carcinoma. Interventions: The cancer staging surgery was performed via...
Source: Medicine - Category: Internal Medicine Tags: Research Article: Clinical Case Report Source Type: research
This study aimed to analyze the clinical features and risk factors for internal hernia after gastrectomy for gastric cancer.MethodsWe retrospectively analyzed internal hernia after gastrectomy for gastric cancer in 6474 patients between January 2003 and December 2016 at Seoul National University Bundang Hospital. Multivariable logistic regression was performed to evaluate risk factors.ResultsInternal hernias identified by computed tomography or surgical exploration were 111/6474 (1.7%) and the median interval time was 450 days after gastrectomy. Fourteen (0.9%) of the 1510 patients who underwent open gastrectomy and 97 (2....
Source: Gastric Cancer - Category: Gastroenterology Source Type: research
Abstract Staging laparoscopy (SL) is used to assess for radiographically occult metastatic disease and local resectability in selected patients with gastrointestinal malignancies. SL may avoid nontherapeutic laparotomy in patients with unresectable cancer and is associated with shorter length of hospital stay and time to receipt of systemic therapy compared with nontherapeutic laparotomy. With improvements in preoperative imaging, careful patient selection for SL is imperative. SL and peritoneal washings should be considered for patients with distal gastroesophageal and locally advanced gastric cancer before plann...
Source: Clinical Colorectal Cancer - Category: Cancer & Oncology Authors: Tags: Surg Oncol Clin N Am Source Type: research
This study aims to evaluate the clinical value of SL in treatment decision-making for advanced rectal cancer (RC) with near or complete obstructing tumors. Observational review of colorectal database at Tata Memorial Hospital from January 2013 to December 2016 identified 562 patients diagnosed and treated for advanced RC. Of the 562 cases, 48.7% (274) were clinically and radiologically diagnosed of near or complete obstructing advanced RC. Medical records of 34% (94/274) who underwent SL with diversion stoma (DS) were analyzed. In the absence of ascites, extensive peritoneal deposits, and unresectable liver metastases on S...
Source: Indian Journal of Surgical Oncology - Category: Cancer & Oncology Source Type: research
CONCLUSIONS: Minimally invasive robot-assisted liver resection is a safe technique; it allows overcoming many limits of conventional laparoscopy. This innovative, time-enduring Hub&Spoke may allow patients to undergo a proper standard of care also for complex surgical procedures, without the need of reaching referral centres. PMID: 29795060 [PubMed - as supplied by publisher]
Source: Minerva Chirurgica - Category: Surgery Tags: Minerva Chir Source Type: research
We report a 50-year-old gentleman who had undergone laparotomy and ileal resection for distal ileal adenocarcinoma presented with an isolated drain site metastasis after 1  year of completion of chemotherapy.
Source: Indian Journal of Surgical Oncology - Category: Cancer & Oncology Source Type: research
CONCLUSIONS The AHFI of succinylated gelatin (12 ml/kg) during the induction of anesthesia can improve splanchnic perfusion in elderly patients undergoing laparoscopic surgery for colorectal cancer and maintain good splanchnic perfusion even after a long period of pneumoperitoneum (60 minutes). AHFI can improve splanchnic perfusion in elderly patients undergoing laparoscopic colorectal surgery. PMID: 29382813 [PubMed - in process]
Source: Medical Science Monitor - Category: Research Tags: Med Sci Monit Source Type: research
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