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排序方式: 共有1226条查询结果,搜索用时 31 毫秒
1.
Susumu Shibasaki Koichi Suda Masaya Nakauchi Kenichi Nakamura Kenji Kikuchi Kazuki Inaba Ichiro Uyama 《World journal of gastroenterology : WJG》2020,26(11):1172-1184
BACKGROUND Minimally invasive surgery for gastric cancer(GC) has gained widespread use as a safe curative procedure especially for early GC.AIM To determine risk factors for postoperative complications after minimally invasive gastrectomy for GC.METHODS Between January 2009 and June 2019, 1716 consecutive patients were referred to our division for primary GC. Among them, 1401 patients who were diagnosed with both clinical and pathological Stage Ⅲ or lower GC and underwent robotic gastrectomy(RG) or laparoscopic gastrectomy(LG) were enrolled. Retrospective chart review and multivariate analysis were performed for identifying risk factors for postoperative morbidity.RESULTS Morbidity following minimally invasive gastrectomy was observed in 7.5% of the patients. Multivariate analyses demonstrated that non-robotic minimally invasive surgery, male gender, and an operative time of ≥ 360 min were significant independent risk factors for morbidity. Therefore, morbidity was compared between RG and LG. Accordingly, propensity-matched cohort analysis revealed that the RG group had significantly fewer intra-abdominal infectious complications than the LG group(2.5% vs 5.9%, respectively; P = 0.038), while no significant differences were noted for other local or systemic complications.Multivariate analyses of the propensity-matched cohort revealed that non-robotic minimally invasive surgery [odds ratio = 2.463(1.070–5.682); P = 0.034] was a significant independent risk factor for intra-abdominal infectious complications.CONCLUSION The findings showed that robotic surgery might improve short-term outcomes following minimally invasive radical gastrectomy by reducing intra-abdominal infectious complications. 相似文献
2.
《The surgeon》2015,13(5):267-270
BackgroundThere remains debate as to whether quality of life (QoL) is better for patients following sub-total gastrectomy (SG) or total gastrectomy (TG) for cancer. Both have similar survival rates provided an R0 resection is performed and in many series the morbidity and mortality after TG is higher than SG. The aim of this study was to evaluate the QoL in patients after TG and SG for cancer.MethodAll surviving patients who had undergone TG or SG between 1994 and 2009 were identified from a prospectively collected database and sent the European Organisation for Research and Treatment of Cancer (EORTC) core questionnaire (QLQ-C30 v.3) and the gastric module (QLQ-STO22).ResultsFrom a total of 261 patients who had undergone TG or SG in the study period, 91 were still alive and 53 responded. There was no significant difference between the QoL between TG and SG based on functional scales and global health status. However dysphagia and eating restrictions were significantly worse in the TG group.ConclusionThis study has demonstrated that there is no difference in overall QoL in patients with TG or SG although eating restrictions and dysphagia are worse after TG. 相似文献
3.
Gastric strongyloidiasis and megaduodenum are rare diseases. Gastrointestinal (GI) strongyloidiasis has many clinical features. One of them is megaduodenum. We describe a case of a 32-years-old man who has come to us from an endemic area for Strongyloides stercoralis. He had had megaduodenum diagnosed in his childhood. We submitted him to two surgeries. He has recovered just after the second surgery, a Roux-en-Y partial gastrectomy. After that, his follow-up was uneventful and the patient has gained 10 kg in weight. Histopathology confirmed gastric strongyloidiasis. In conclusion, if patients arrive from an endemic area of S. stercoralis and if they present GI symptoms or a previous diagnosis of megaduodenum, they must be considered for a histological evaluation for gastric strongyloidiasis. 相似文献
4.
5.
Symptomatic and Clinical Improvement in Morbidly Obese Patients with Gastroesophageal Reflux Disease Following Roux-en-Y Gastric Bypass 总被引:3,自引:0,他引:3
Background: Patients who suffer with gastroesophageal reflux Disease (GERD) endure a worsening of symptoms as their weight
increases. When medical treatment of this condition in the morbidly obese patients fails, surgical intervention may be indicated.
Choosing a procedure which not only helps achieve weight control but which also relieves symptoms and complications of GERD
is the goal. We present a review of patients who have undergone Roux-en-Y Gastric Bypass (RYGBP) and related procedures for
this disease. Methods: One hundred eighty-eight patients undergoing surgery for morbid obesity and for GERD in 1992-1996 were
contacted by mail or phone. All of these patients had undergone preoperative esophagogastroduodenoscopy to grade the severity
of their disease. Their preoperative symptoms were compared to those experienced postoperatively. Results: One hundred thirty
patients underwent a RYGBP with modified Hill fundopexy, 22 patients underwent a distal gastrectomy with modified Hill fundopexy,
8 patients underwent distal gastrectomy alone and 28 patients underwent RYGBP alone. There have been no deaths. There were
nine surgical complications, eight early and one at 2.5 years postoperation. Follow-up is 4-48 months. The average BMI dropped
from 43 to 30.2 kg/m2. Whereas all patients were on some form of medical therapy before surgery, only 14 reported the need for medication postoperatively.
Conclusions: Surgical intervention for weight control and treatment of GERD has been highly successful in our experience both
with respect to weight control and to the reduction of reflux symptoms. Depending upon endoscopic and operative findings a
RYGBP with or without an antireflux procedure can provide dramatic improvement. Gastrectomy with antireflux modifications
is appropriate in selected cases. 相似文献
6.
目的:探讨全胃切除术后较理想的消化道重建方式。方法:对近6年来122例施行全胃切除术患者的临床资料进行回顾性分析。全胃切除后消化道重建分别采用全胃切除术后消化道重建Orr式Roux-en-Y食管空肠吻合术、P型空肠袢食管空肠Roux-en-Y吻合术和远端空肠反口贮袋的Roux-en-Y食管空肠吻合术。结果:3种术式在食后烧灼感、进食量、进食次数、体重下降、倾倒综合征、血红蛋白、白蛋白等指标的比较,无明显差异(均P>0.05)。P型空肠袢食管空肠Roux-en-Y吻合术组所用手术时间显著多于Orr组及反口组(P<0.05)。反口组的贮袋大小及半排空时间显著优于Orr组及P袢组(P<0.05)。结论:远端空肠反口贮袋的Roux-en-Y吻合术是一种值得推荐的新型全胃切除术后消化道重建方法。 相似文献
7.
目的:探讨胃切除后急性胆囊炎的微创治疗的方法和效果。方法:回顾性分析28例胃切除术后近期(<4周)并发急性胆囊炎患者的临床资料。全组均明确诊断后先行常规非手术治疗,经24h治疗后症状体征无缓解的病例加行B超引导下经皮经肝胆囊穿刺置管引流术(PTGD)。结果:5例经非手术治疗缓解;23例加行PTGH,穿刺置管成功率100%。置管抽吸胆汁后症状体征即明显减轻,3~7d后症状体征完全消失。结论:超声引导下经皮经肝胆囊穿刺置管引流术治疗胃切除术后近期并发急性胆囊炎效果确切,创伤小,患者恢复快,具有明显的优越性。 相似文献
8.
胃癌10和11组淋巴结转移及其清扫 总被引:5,自引:0,他引:5
目的:研究胃癌脾门淋巴结(No.10)和脾动脉周围淋巴结(No.11)转移规律,进一步探讨No.10和11清扫的必要性和方法。方法:1991年-2000年132例行全胃切除,D2以上淋巴结清扫的胃癌患者,回顾性研究临床病理资料,包括性别、年龄、肿瘤部位、大小、浸润深度、病理类型、其他淋巴结转移等对No.10和11转移的影响,比较全胃切除和全胃联合脏器切除的并发症发生率。结果:胃癌具有较高的No.10或11淋巴结转移率(18.9%),Logistic回归分析表明,胃癌部位、病理类型、浸润深度和大小弯淋巴结转移五项临床病理指标影响No.10和U转移率。联合脏器切除的并发症发生率(32%)明显高于单纯全胃切除(11.2%),联合肢体尾切除增加肠下脓肿发生率,而脾切除并不增加全胃切除的危险性。结论:No.10和11在胃癌有较高的转移率和特定的转移规律,预防性和治疗性的清扫实属必要,联合左侧肢体尾加脾切除增加手术危险性,应严格掌握的适应证。而保留胰腺,切除脾血管和脾清扫No.10.和ll淋巴结合理可靠。 相似文献
9.
Hiroshi Uno Yoshihiro Izawa Kiyoshi Sagara Tamotsu Koyama Tokutaro Makita Chia-Yuan Hsu-Chang Mitsugi Sugiyama 《Journal of bone and mineral metabolism》1990,8(1):10-16
The effect of 1α-hydroxyvitamin D3 (1α(OH)D3) on the metabolic bone disorders developed in gastrectomized rats were investigated biochemically and histomorphologically.
1α(OH)D3 was suspended in 0.2 % Triton-X-100 aqueous solution after dissolving in a very small amount of ethanol, was given orally
to the rats for 10 weeks. The sham operated animals and the gastrectomy control animals received the vehicle alone. Gastrectomy
was followed by the development of the metabolic bone disorders after 10 weeks of observation. This was characterized by reduction
in ash content of the femur and histologically by a disappearance of the trabecular bone in tibial metaphysis. Decrease Ca
absorption from the intestines was demonstrated by a radiotracer technique. Biochemical studies showed significant decreases
in serum 25(OH)D concentration in gastrectomized rats. These findings suggest that gastrectomy partially impairs intestinal
absorption of calcium and results in a negative calcium balance, which may contribute to the development of bone metabolic
disorders in rats. The administration of 1α(OH)D3 increased dose-dependently serum calcium and Ca absorption from the intestine and prevented the development of bone metabolic
disorders histomorphologically. 相似文献
10.
Reports the case of a 60-year-old woman who underwent R2 total gastrectomy, and subsequent palliation of painful symptom
recurrence via a membrane-covered metal stent.
Received: 13 June 1996/Accepted: 31 July 1996 相似文献