Current management of gastric cancer.

Gastric cancer is a disease with high incidence and mortality in our population. The prognosis of patients with this disease is closely related to the neoplasm stage at diagnosis, including the following characteristics of the tumor: extension into the gastric wall thickness, spread to locoregional lymph nodes and the ability to generate distant metastases, as described by the TNM classification. For localized tumors characterized only by invasion of mucosa or submucosa at diagnosis, survival at 5 years is between 70 and 95% with exclusive surgical management; however, when extension into the gastric wall is higher and/or there is locoregional nodal involvement, survival decreases to 20-30% at 5 years.

Rationale for gastrectomy with D2 lymphadenectomy in the treatment of gastric cancer.

Background: In the surgical management of gastric cancer, D2 lymphadenectomy aims to reduce the incidence of locoregional relapse, and to increase patient survival.

Methods: A prospective study was made of 126 consecutive patients operated upon for gastric cancer, with gastrectomy and D2 lymphadenectomy. Hospital morbidity and mortality, relapses, and patient survival after 5 years were studied.

Surgical treatment of recurrent gastric cancer.

Background: The value of programs to detect recurrence of a previously operated gastric cancer is a controversial subject. D2 lymphadenectomy achieves better local control and a lower local recurrence rate than D1 lymphadenectomy.

Methods: The results achieved with surgical treatment of recurrent gastric cancer in a series of 126 consecutive patients who had been treated with gastrectomy with D2 lymphadenectomy are reported.

[Morbidity and mortality in gastrectomy with D2 lymphadenectomy in a specialised unit].

Introduction: The combination of gastrectomy and D2 lymphadenectomy is still not a widely accepted therapeutic option by Western surgeons, due to its high post-operative morbidity and mortality.

Objective: To evaluate the morbidity and mortality in a series of patients with gastric cancer treated by gastrectomy and D2 lymphadenectomy, and compare these results with those published by centres with notable experience.

Patients And Method: A descriptive and prospective study on a series of 126 consecutive patients with gastric cancer treated by gastrectomy and D2 lymphadenectomy.

[Multifocal basaloid squamous carcinoma of the esophagus].

Basaloid-squamous carcinoma is a poorly-differentiated variety of squamous cell carcinoma. The most common location is the upper aerodigestive tract and the incidence of this entity in the esophagus is low. Despite advances in knowledge of the biology of these tumors, their recent description and their low frequency has hampered consensus on the therapeutic approach.

[Results of laparoscopic fundoplication in gastroesophageal reflux disease with atypical manifestations].

Introduction: Gastroesophageal reflux disease (GERD) may present with typical (heartburn and regurgitation) and atypical symptoms (cough, asthma, non-cardiac chest pain). Laparoscopic fundoplication has been performed for approximately 10 years, with results similar to or better than those obtained with open antireflux procedures. The aim of this study was to evaluate the clinical and functional results of laparoscopic fundoplication in patients with GERD and atypical symptoms.

Intra-abdominal follicular dendritic cell sarcoma.

Follicular dendritic cell (FDC) sarcoma is a very rare condition. We report here an intra-abdominal FDC sarcoma occurring as a mass, dependent on the celiac and left gastric lymph chains, that was completely excised. Eighteen months after surgery a recurrence at the liver pedicle was detected by a CT-scan and fully resected; in order to prevent another disease relapse postoperative radiotherapy was given.

[Enteral nutrition with needle catheter jejunostomy in esophageal anastomosis. Complications of the technique].

Objective: The aim of this study was to evaluate the presence of complications associated with the use of surgical needle catheter jejunostomy and tolerance to enteral nutrition.

Patients And Method: We performed a retrospective study of 58 consecutive patients, who underwent esophageal or gastric resection with esophageal anastomosis and needle catheter jejunostomy. The variables studied were initiation of enteral nutrition, duration of perfusion, complications associated with the use of jejunostomy, and tolerance to enteral nutrition.

[Quality of life after laparoscopic fundoplication for gastroesophageal reflux disease].

Objective: To evaluate our results in terms of satisfaction and quality of life in patients who underwent laparoscopic 360 degrees fundoplication for gastroesophageal reflux disease.

Patients And Method: We performed a cross-sectional study of 49 consecutive patients who underwent laparoscopic 360 degrees fundoplication for gastroesophageal reflux disease. All patients had been operated on more than 6 months previously by the same surgeon.

Esophageal squamous cell carcinoma after liver transplantation.

The occurrence of an oesophageal squamous cell carcinoma following liver transplantation is very infrequent. Such an event has been related to a history of alcohol-induced cirrhosis, as in other squamous cell tumours of the oropharynx. We report the case of a 64-year-old male patient diagnosed as having oesophageal squamous cell carcinoma six years after having had a liver transplant due to alcohol-induced cirrhosis.

Nonobstructive dysphagia and recovery of motor disorder after antireflux surgery.

Background: Changes in motor disorder after Nissen 360 degrees surgery were studied based on clinical signs of preoperative nonobstructive dysphagia.

Materials And Methods: Forty-seven patients undergoing Nissen 360 degrees fundoplication for gastroesophageal reflux were studied with pH recording and esophageal manometry before and 1 year after fundoplication. Amplitude of contraction of the distal third of the esophagus (ACDTE) and the presence of primary propulsive waves were studied.