• 대한위암학회:학술대회논문집
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• 2003.11a
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• pp.55-55
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• 2003

• Journal of Gastric Cancer
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• v.10 no.1
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• pp.19-25
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• 2010

Purpose: Laparoscopy-assisted gastrectomy (LAG) is gaining wider acceptance as a minimally invasive treatment for early gastric cancer, but the safety, efficacy and clinical benefits of this type of surgery are still unclear. The purpose of this study is to compare laparoscopy-assisted gastrectomy (LADG) and conventional open distal gastrectomy (CODG) for early gastric cancer (EGC) according to the changes of the postoperative nutritional status and acute inflammatory reaction. Materials and Methods: Eighty seven patients with EGC and who underwent a LADG between March 2006 and May 2009 at Daegu Catholic University Hospital, was enrolled. Over the same period, we enrolled 30 patients who underwent CODG and they were confirmed to have EGC from their pathology. The clinico-pathological features and serologic parameters were evaluated from the medical records and then retrospectively analyzed. Results: There were no differences in the preoperative white blood cell (WBC), C-reactive protein (CRP) level, albumin level, the T4/T8 ratio and the other clinical data between the two groups. The total WBC counts gradually increased and they were significant lower at the $1^{st}$ and $3^{rd}$ postoperative days in the LADG group than that in the CODG group (P=0.001 and 0.008, respectively). The postoperative CRP levels were significantly lower at postoperative $5^{th}$ day in the LADG group (P<0.001). The postoperative albumin and T4/T8 ratio gradually decreased, and the T4/T8 ratio was significantly higher at the $3^{rd}$ postoperative day in the LADG group compared to that in the CODG group (P=0.003). Conclusion: This study demonstrates that the LADG has less of an influence on an acute inflammatory reaction than does CODG. Therefore, it is one of the safe and feasible procedures for the treatment of early gastric cancer.

• Journal of Gastric Cancer
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• v.7 no.1
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• pp.42-46
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• 2007

Usually in the subtotal gastrectomy, the left and the right gastric arteries, as well as the left and the right gastroepiploic arteries are ligated. Thus, to avoid a blue stomach surgeons preserve the spleen and the short gastric arteries. When a radical subtotal gastrectomy with splenectomy is performed, meticulous caution is necessary; otherwise, the subtotal gastrectomy might have to be changed to a total gastrectomy to prevent a blue stomach. We report the case of a 67-year-old woman who had distal stomach cancer with a splenic solitary mass, for which splenic meatastasis could be excluded. We planned and performed a laparoscopy-assisted radical subtotal gastrectomy with splenectomy as the diagnostic and therapeutic option. In this case, to avoid a remnant stomach infarction or total gastrectomy we saved the left gastric artery and vein with clearing perivascular soft tissue, lymphatics, and lymph nodes. Thus the radical therapeutic goal was reached, and serious complications were avoided.

• 대한위암학회:학술대회논문집
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• 2005.10a
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• pp.43-43
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• 2005

• 대한위암학회:학술대회논문집
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• 2003.11a
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• pp.52-52
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• 2003

• Journal of Yeungnam Medical Science
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• v.20 no.2
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• pp.105-116
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• 2003

Definitely, treatment for gastric cancer is primarily surgical. Detection in early stage of disease and complete surgical resection is the best way to cure gastric cancer. If surgery is planned, careful preoperative evaluation and corrections of physiologic and psychologic abnormalities are essential to reduce perioperative morbidity or mortality. Basic principle of gastrectomy for gastric cancer is an en bloc resection of tumor with adequate margins of normal tissue and with regional lymph nodes and omental tissues. To complete these principles, regional lymph nodes and all omental tissues should be removed altogether during performing various types of gastric resection. The lymph node dissection is one of the most effective procedures for gastric cancer to achieve curative resection. The basic types of gastric resection are distal subtotal gastrectomy and total gastrectomy according to the condition of primary lesions and the status of lymph node metastases. When the primary lesion is located near the esophagogastric junction, it is sometimes hard for a surgeon to select adequate surgical method. Postoperative quality of life in a patient has become a very important factor to be considered in every step of surgical therapy. With increasing incidence of early gastric cancer, a number of surgical trials for limited surgery or endoscopic procedures have been performed, but the long-term clinical results should be carefully analyzed to define the clinical relevance of these new techniques. For patients with disseminated gastric cancer, a palliative procedure can be performed to improve quality of life of patients and to avoid immediate death due to the cancer-related complications.

• Journal of Gastric Cancer
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• v.6 no.1
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• pp.52-56
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• 2006

A 69-year old man presented with severe epigastric pain for 1 day. He had early gastric cancer at the antrum and underwent a distal subtotal gastrectomy and Billorth II gastrojejunostomy one month later without any post-operative complications. Radiologic examination revealed a large amount of retroperitoneal free air formation. Because of unremitting pain and unstable vital sign, exploratory laparotomy was followed. During the operation, a perforated duodenal diverticulum at the posterior wall of the 2nd portion of the duodenum was identified. He underwent diverticulectomy and primary closure. He was discharged on the 18th post operative day and has been followed up without any evidence of comlpication for several months.

• Journal of Gastric Cancer
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• v.6 no.2
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• pp.69-75
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• 2006

Purpose: We aimed to investigate the effect of oral Saccharomyces cerevisiae Hansen CBS 5926 therapy (Saccharomyces boulardii) on gastrointestinal symptoms and nutrition in gastrectomized patients. Materials and Methods: Ninety patients who underwent a gastrectomy due to early gastric cancer were randomly divided into case and control (placebo) groups and were given medicine or placebos for 12 weeks. The gastrointestinal symptom rating and the nutritional status were evaluated by using double blind methods at 4, 16, and 20 weeks after discharge. Results: The ratio of males to females was 2.3 : 1, and the mean age was $56.3{\pm}10.2$ years. The numbers of subtotal gastrectomies and total gastrectomies were 69 and 21, respectively. Fourteen (15.6%) patients dropped, of whom 5 belonged to the case group. Of the remaining 76 patients, those in the case group had higher levels of serum albumin (P=0.046). For patients who underwent subtotal gastrectomy (n=57), the case group had higher level of serum albumin (P=0.049). Conclusion: This double blind study showed that oral Saccharomyces boulardii therapy could improve the postoperative nutrition of gastrectomized patients because gastrectomized patients with oral Saccharomyces boulardii therapy had higher levels of serum albumin than the control group.

• Journal of Gastric Cancer
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• v.6 no.2
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• pp.103-108
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• 2006

Purpose: The circular stapled Billroth I gastrectomy has been gradually popularized because of several advantages. Thus, this study aims to identify what to be supplemented for the safety of this technique by examining the potential complication after the circular stapled Billroth I gastrectomy. Materials and Methods: This study selected 594 patients who underwent the circular stapled Billroth I gastrectomy because of the gastric cancer in our department of surgery from Jan. 1998 to Dec. 2004 as the subjects. As of Jan. 2001 when the bleeding on the anastomosis site was visually checked through the small incision at the opposite curvature to the lesion of the stomach to be resected and so the operation was completed, the patients were divided into the Group I (n=219) and Group II (n=375), which were the patients before and after Jan. 2001, respectively. Then, the clinical characteristics and postoperative anastomotic complications of both groups were compared. Results: For the comparison of complications between two groups, the anastomotic leakage was found in four cases in Group I and three cases in Group II (p=0.196). The stenosis on the anastomosis region was not observed in both groups. The bleeding on the anastomosis region illustrates the statistically significant difference between Group I and Group II, with 43 cases and 2 cases, respectively (P=0.0019). Conclusion: The circular stapled Billroth I gastrectomy is recommended because of several advantages of this technique. However, the bleeding on the anastomosis site may be indicated as the critical issue. Accordingly, the visual check on the bleeding on the anastomosis site during the operation will improve the safety of circular stapler.

• The Journal of the Korea Contents Association
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• v.16 no.9
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• pp.649-657
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• 2016

This study is aim to investigate how applying a critical pathway(CP) to stomach cancer patients affects their recovery and treatment. The subjects were 165 patients over the age of 20 who were diagnosed with stomach cancer at the gastrointestinal clinic of C hospital and who underwent laparoscopic subtotal gastrectomy. The case group inclueded 102 patients who underwent laparoscopic subtotal gastrectomy with applying the CP from October 2008 to September 2009. The control group included 63 patients who underwent laparoscopic subtotal gastrectomy without applying the CP from September 2007 to September 2008. Pain at the time of discharge was significantly lower in the CP applicated group than in the non-applicated group (Odds ratio [OR], 0.07; 95% Confidence interval [CI], 0.03-0.21). The CP applied group was significantly lower than non-applied group in total hospitalization days (CP applied group: 8.95[1.33], non-applied group: 10.69[4.04], p<0.001) and in postoperative hospitalization days (CP applied group: 7.16[0.94], non-applied group: 8.79[3.90], p<0.001). In conclusion, application of a critical pathway to laparoscopic subtotal gastrectomy reduced pain at the time of discharge, total hospitalization days and postoperative hospitalization days.