• 제목/요약/키워드: Early surgery

검색결과 3,389건 처리시간 0.03초

Five-year Survival Associated with Stage I Gastric Cancer after Resection of Early Recurrence at Nodal Station No. 14v: a Case Report

  • Abe, Iku;Kinoshita, Takahiro;Kaito, Akio;Sunagawa, Hideki;Watanabe, Masahiro;Sugita, Shizuki;Tonouchi, Akiko;Sato, Reo
    • Journal of Gastric Cancer
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    • 제17권2호
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    • pp.186-191
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    • 2017
  • The role of nodal station No. 14v (along the superior mesenteric vein) in lymphadenectomy for distal gastric cancer remains elusive. A 73-year-old woman underwent endoscopic submucosal dissection for gastric cancer, and was referred to our division for additional surgery because of pathologically non-curative resection. A laparoscopic distal gastrectomy with D1+ dissection was performed, with a final diagnosis of pT1bN1M0, Stage IB (2 nodal metastases to No. 6). Four months post-surgery, abdominal computed tomography revealed a 14-mm solitary nodule along the superior mesenteric vein. The lesion was excised and pathologically identified as a lymph node metastasis. Adjuvant chemotherapy with tegafur-gimeracil-oteracil potassium (S-1) was administered for the metastasis. Presently the patient survives without recurrence, 5.5 years after the second operation. Our findings suggest that there is lymphatic flow from the No. 6 to the No. 14v nodal station. Some patients with a No. 6 metastasis may benefit from a No. 14v lymphadenectomy, even in early-staged disease.

Outcomes of Local Excision for Early Rectal Cancer: a 6-year Experience from the Largest University Hospital in Thailand

  • Lohsiriwat, Varut;Anubhonganant, Worabhong;Prapasrivorakul, Siriluck;Iramaneerat, Cherdsak;Riansuwan, Woramin;Boonnuch, Wiroon;Lohsiriwat, Darin
    • Asian Pacific Journal of Cancer Prevention
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    • 제14권9호
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    • pp.5141-5144
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    • 2013
  • Background: This study aimed to determine clinical outcomes of local excision for early rectal cancer from a University Hospital in Thailand. Materials and Methods: We performed a retrospective review of 22 consecutive patients undergoing local excision for early rectal cancer (clinical and radiological T1/T2) from 2005-2010 at the Faculty of Medicine, Siriraj Hospital, Mahidol University, Bangkok. Data were collected from patients' medical records, including demographic and clinical characteristics, pathological report and surgical outcomes. Results: This study included 10 males and 12 females, with average age of 68 years. Nineteen patients (86%) underwent transanal excision and the others had trans-sacral excision. Median operative time was 45 minutes. Postoperative complications occurred in 2 patients (9%); 1 fecal fistula and 1 wound infection following trans-sacral excision. There was no 30-day postoperative mortality. Median hospital stay was 5 days. Pathological reports revealed T1 lesion in 12 cases (55%), T2 lesion in 8 cases (36%) and T3 lesion in 2 cases (9%). Eight patients received additional treatment; one re-do transanal excision, two proctectomies, and five adjuvant chemoradiation. During the median follow-up period of 25 months, local recurrence was detected in 4 patients (18%); two cases of T2 lesions with close or positive margins, and two cases of T3 lesions. Three patients with local recurrence underwent salvage abdominoperineal resection. No local recurrence was found in T1/T2 lesions with free surgical margins. Conclusions: Local excision is a feasible and acceptable alternative to radical resection only in early rectal cancer with free resection margins and favorable histopathology.

Current Status of Robotic-assisted Surgery in Gastric Cancer

  • Eli Kakiashvili
    • Journal of Digestive Cancer Research
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    • 제4권2호
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    • pp.99-106
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    • 2016
  • Minimally invasive surgery for gastric cancer has increased in popularity during the last two decades mainly in the Asia for patients with early-stage cancer. Nevertheless, the development of laparoscopic surgery for gastric cancers in the Western world has been slow because of the advanced stage at diagnosis for which LG is not yet considered an acceptable alternative to standard open surgery. RAG has been reported as a safe alternative to conventional surgery for treating of early gastric carcinoma. We assess the current status of robotic surgery in the treatment of gastric cancer focusing on the technical details, postoperative outcome, oncological considerations and future perspectives. In gastrectomy the biggest advantage of the robotic approach is the ease and reproducibility of lymphadenectomy. Reports also show that even the intra corporeal digestive restoration is facilitated by use of the robotic approach, particularly following TG. Additionally, the accuracy of robotic dissection is confirmed by decreased blood loss in comparison to conventional laparoscopy. The learning curve and technical reproducibility also appear to be shorter with robotic surgery and, consequently, robotics can help to standardize and diffuse minimally invasive surgery in the treatment of gastric cancer. While published reports have shown no significant differences in surgical morbidity, mortality, or oncological adequacy between robot-assisted and conventional gastrectomy. There are some advantages in terms of postoperative recovery of patients after robotic surgery. More studies are needed to assess the true indications and oncological effectiveness of robotic use in the treatment of gastric carcinoma.

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동영상을 이용한 수술 후 초기 운동교육이 슬관절 전치환술 노인 환자의 운동지식 및 운동이행도에 미치는 효과 (Effects of Early Exercise Education using Video on Exercise Knowledge and Compliance of Elderly Patients Who Undergo Total Knee Replacement Surgery)

  • 김윤정;강희영
    • 한국간호교육학회지
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    • 제22권3호
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    • pp.316-325
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    • 2016
  • Purpose: This study was conducted to identify the effects of early exercise education using videos on exercise knowledge and compliance of elderly patients who undergo total knee replacement surgery. Methods: This is a quasi-experimental study with a nonequivalent control group non-synchronized design. The participants were 70 elderly patients who had total knee arthroplasty in the C university hospital located in G city, Korea. Thirty-five patients were assigned to an experimental group and the other patients were assigned to a control group. After the total knee arthroplasty, the early exercise education accompanied by watching video instruction was conducted on the experimental group at post-operation second and third day for 15 minutes. General exercise education was administered to the control group. The exercise knowledge and compliance of the elderly patients were measured through structured questionnaires. Conclusion: The results of this study indicate that early exercise education using videos has positive effects to improve the exercise knowledge and compliance of elderly patients after total knee arthroplasty. This early exercise education can be used going forward as nursing intervention for elderly patients who undergo total knee replacement surgery.

Consideration of Cardia Preserving Proximal Gastrectomy in Early Gastric Cancer of Upper Body for Prevention of Gastroesophageal Reflux Disease and Stenosis of Anastomosis Site

  • Kim, Jihoon;Kim, Sungsoo;Min, Young-Don
    • Journal of Gastric Cancer
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    • 제12권3호
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    • pp.187-193
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    • 2012
  • Purpose: The aim of this study is to evaluate the feasibility and safety of cardia preserving proximal gastrectomy, in early gastric cancer of the upper third. Materials and Methods: A total of 10 patients were diagnosed with early gastric cancer of the upper third through endoscopic biopsy. The operation time, length of resection free margin, number of resected lymph nodes and postoperative complications, gastrointestinal symptoms, nutritional status, anastomotic stricture, and recurrence were examined. Results: There were 5 males and 5 females. The mean age was $56.5{\pm}0.5$ years. The mean operation time was $188.5{\pm}0.5$ minutes (laparoscopic operation was 270 minutes). Nine patients were T1 stage (T2 : 1), and N stage was all N0. The mean number of resected lymph nodes was $25.2{\pm}0.5$. The length of proximal resection free margin was $3.1{\pm}0.1$ cm and distal was $3.7{\pm}0.1$ cm. Early complications were surgical site infection (1), bleeding (1), and gastro-esophageal reflux disease (1) (this symptom was improved with medication). Late complications were dyspepsia (3) (this symptom was improved without any treatment), and others were nonspecific results of endoscopy or symptom. Conclusions: Cardia preserving proximal gastrectomy was feasible for early gastric cancer of the upper third. Further evaluation and prospective research will be required.

Oral Potentially Malignant Disorders among Dental Patients: a Pilot Study in Jordan

  • Hassona, Y.;Scully, C.;Almangush, A.;Baqain, Z.;Sawair, F.
    • Asian Pacific Journal of Cancer Prevention
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    • 제15권23호
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    • pp.10427-10431
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    • 2015
  • Background: To determine the prevalence, types, and risk factors of oral potentially malignant disorders (OPMDs) among a group of Arab Jordanian dental patients, and to evaluate their awareness and attitudes toward early diagnosis and treatment. Materials and Methods: A total of 1,041 patients attending a University Hospital for dental care were examined for the presence of OPMDs. Histopathological examination was performed on all cases clinically diagnosed and patients were directly interviewed to evaluate their knowledge and attitudes toward early detection and treatment of oral cancer. Results: The prevalence of OPMDs overall was 2.8%. Lichen planus/lichenoid lesions were the most common lesions (1.8%) followed by leukoplakias (0.48%), chronic hyperplastic candidiosis (0.38%), and erythroplakia (0.096%). Smoking, alcohol, and age (>40 years) were the main identifiable risk factors. Patients with OPMDs displayed a general lack of awareness and negative attitudes towards early diagnosis and treatment. Conclusions: OPMDs among Arab dental patients are relatively uncommon and awareness about oral cancer among Jordanian dental patients is low. Interventions to improve public knowledge about oral cancer and attitudes toward early diagnosis and treatment are urgently indicated.

Core decompression for early-stage avascular necrosis of the humeral head: current concepts and techniques

  • Michael D. Scheidt;Saleh Aiyash;Dane Salazar;Nickolas Garbis
    • Clinics in Shoulder and Elbow
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    • 제26권2호
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    • pp.191-204
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    • 2023
  • Avascular necrosis (AVN) of the humeral head is a rare, yet detrimental complication. Left untreated, humeral head AVN frequently progresses to subchondral fracturing and articular collapse. Cases of late-stage humeral head AVN commonly require invasive procedures including humeral head resurfacing, hemiarthroplasty, and total shoulder arthroplasty (TSA) to improve clinical outcomes. However, in cases of early-stage AVN, core decompression of the humeral head is a viable and efficacious short-term treatment option for patients with pre-collapse AVN of the humeral head to improve clinical outcomes and prevent disease progression. Several techniques have been described, however, a percutaneous, arthroscopic-assisted technique may allow for accurate staging and concomitant treatment of intraarticular pathology during surgery, although further long-term clinical studies are necessary to assess its overall outcomes compared with standard techniques. Biologic adjunctive treatments, including synthetic bone grafting, autologous mesenchymal stem cell/bone marrow grafts, and bone allografts are viable options for reducing the progression of AVN to further collapse in the short term, although long-term follow-up with sufficient study power is lacking in current clinical studies. Further long-term outcome studies are required to determine the longevity of core decompression as a conservative measure for early-stage AVN of the humeral head.

두경부 악성 종양환자에서 조기 방사선치료를 위한 구강관리법에 대한 임상적 연구 (The clinical study of oral care for early radiation therapy in the head and neck cancer patients)

  • 문원규;유재하;차인호;김형준;정영수;이천의;이종영;유미현
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • 제36권6호
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    • pp.473-480
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    • 2010
  • Introduction: Tooth requiring extraction before radiotherapy in head and neck cancer patients should be performed as long as possible before the initiation of radiation therapy. Conventionally, a minimum 2-week waiting primary healing period is recommended. Although the above 2-week period is ideal, it is not uncommon for the radiotherapist and cancer patient to feel an urgent need to proceed with radiotherapy despite the need for dental care. Therefore, alternative approaches for early radiotherapy, including conservative endodontic treatment and a 1-week waiting primary healing period after dental extraction at the time of radiotherapy were considered and applied based on a literature review Materials and Methods: The clinical study involved 120 head and neck cancer patients who were treated at Wonju Christian Hospital, Wonju College of Medicine, Yonsei University, from January 1995 to December 2004. Results: In the clinical study, there were no specific complications, such as, post-extraction wound infections, radiation osteitis and osteoradionecrosis over the recent 10 years despite the early radiotherapy. Conclusion: Based on the clinical study, a minimum 1-week waiting primary healing period for oral care before radiotherapy is suitable for early radiotherapy in head and neck cancer patients.