Laparoscopic Gastrojejunostomy Versus Endoscopic Stenting as a Palliative Treatment for Gastric Outlet Obstruction.

Gastric outlet obstruction (GOO) is a common complication in advanced stage upper gastrointestinal malignancies. The symptoms of severe nausea and protracted vomiting can lead to a decline in quality of life and cachexia. Symptoms of GOO can be effectively managed with either operative or nonoperative palliative interventions.

Should Advanced Age Preclude Surgical Treatment of Gastrointestinal Stromal Tumor?

Surgical resection is a gold standard treatment for gastrointestinal stromal tumors (GISTs). It can be performed by minimally invasive surgery approach in most of the patients. It has been shown that advanced age is not a clear poor prognostic factor in patients who underwent surgery for GIST.

Urgent Paraesophageal Hernia: Can We Do Better?

Paraesophageal hernia (PEH) is a relatively common pathology in the Western population. It may be asymptomatic, but ∼50% of patients with PEH have symptoms that may mimic gastrointestinal, respiratory, and cardiac pathology. Surgery is recommended in all acute cases of PEH, but indications for surgical intervention in asymptomatic or nonacutely symptomatic patient remain unclear.

Laparoscopic Completion Total Gastrectomy for Remnant Gastric Cancer Compared to Laparoscopic Total Gastrectomy in Short- and Medium-Term Results.

The incidence of remnant gastric cancer is increasing in recent years. The advantages of minimally invasive surgery for gastric cancer are well established. However, laparoscopic completion total gastrectomy for remnant gastric cancer harbors difficulties due to adhesions, changed configuration of the anatomical organs, and changes on the lymphatic flow.

Anterior reconstruction of the esophageal hiatus: a novel approach for the repair of large diaphragmatic hernias.

: Paraesophageal hernias (PEH) often require surgical repair. The standard approach, primary posterior hiatal repair, has been associated with a high recurrence rate. Over the past few years, we have developed a new approach for repairing these hernias, which we believe restores the original anatomy and physiology of the esophageal hiatus.

Chronic pain following totally extra-peritoneal inguinal hernia repair: a randomized clinical trial comparing glue and absorbable tackers.

Purpose: Chronic pain following inguinal hernia repair occurs in up to 20% of patients. The underlying mechanism probably involves sensory nerve damage and abnormal healing that might be influenced by the materials chosen for mesh fixation. The main objective of this study was to compare glue and absorbable tackers on the rate of chronic pain after surgery in patients undergoing totally extraperitoneal inguinal hernia repair (TEP).

Clinical Outcome of Novel Reconstruction of Double Shouldering Technique after Proximal Gastrectomy.

Purpose: Various reconstruction methods have been proposed to reduce reflux after proximal gastrectomy, and we report here a double shouldering technique. The purpose of this study is to compare the novel double shouldering technique with conventional esophagogastrostomy in terms of short term and 3-year clinical outcome.

Methods: A retrospective observational case control study was performed on 63 patients for cT1N0 upper third gastric cancer who underwent proximal gastrectomy from January 2012 to November 2016 at the National Cancer Center, Korea.

Marginal ulcer causing delayed anastomotic perforation following one anastomosis gastric bypass (OAGB).

Background: One anastomosis gastric bypass (OAGB) is gaining favor. Anastomotic perforation is a dreaded complication.

Objectives: To describe a series of patients presenting with delayed (> 90 days) perforation of a marginal ulcer (MU) following OAGB.

Mesh fixation using novel bio-adhesive coating compared to tack fixation for IPOM hernia repair: in vivo evaluation in a porcine model.

Background: Mesh fixation in hernia repair is currently based on penetrating sutures or anchors, with proven early and late complications such as pain, adhesions, erosions, and anchor migration. In an attempt to reduce these complications, a bio-adhesive-based self-fixation system was developed. The purpose of this study was to assess the performance and safety of this novel self-adhesive mesh (LifeMesh™) by comparing it with standard tack fixation.

European association for endoscopic surgery (EAES) consensus statement on single-incision endoscopic surgery.

Background: Laparoscopic surgery changed the management of numerous surgical conditions. It was associated with many advantages over open surgery, such as decreased postoperative pain, faster recovery, shorter hospital stay and excellent cosmesis. Since two decades single-incision endoscopic surgery (SIES) was introduced to the surgical community.

A comparative study of totally laparoscopic distal gastrectomy versus laparoscopic-assisted distal gastrectomy in gastric cancer patients: Short-term operative outcomes at a high-volume center.

Objective: Laparoscopic gastrectomy has been established as a standard treatment for early gastric cancer, and its use is increasing recently. Compared with the conventional laparoscopy-assisted distal gastrectomy (LADG), totally laparoscopic distal gastrectomy (TLDG) involves intracorporeal reconstruction, which can avoid the additional incision, resulting in pain reduction and early recovery. This study aimed to compare the short-term postoperative outcomes of TLDG LADG in gastric cancer in a high-volume center.

T-Helper 1 Immune Response in Metastatic Lymph Nodes of Pancreatic Ductal Adenocarcinoma: A Marker For Prolonged Survival.

Background: Although lymph node (LN) metastases is considered a grave prognostic sign in pancreatic ductal adenocarcinoma (PDAC), patients with positive lymph nodes (PLN) constitute a heterogeneous group. Our purpose was to identify morphological and immune parameters in the primary tumor and in PLN of resected PDAC patients, which could further stratify these patients to different subgroups.

Methods: We retrospectively evaluated histological and immunohistochemical characteristics of 66 patients with PDAC who were operated at our institution.

Analysis of histological and immunological parameters of metastatic lymph nodes from colon cancer patients reveals that T-helper 1 type immune response is associated with improved overall survival.

Lymph node (LN) involvement in colonic carcinoma (CC) is a grave prognostic sign and mandates the addition of adjuvant treatment. However, in light of the histological variability and outcomes observed, we hypothesized that patients with LN metastases (LNM) comprise different subgroups.We retrospectively analyzed the histological sections of 82 patients with CC and LNM.

Laparoscopic Distal Pancreatectomy: Learning Curve and Experience in a Tertiary Center.

Background: Although laparoscopic distal pancreatectomy (LDP) is gradually recognized as a safe and effective alternative to open distal pancreatectomy (ODP), it is not yet widely accepted.

Objective: We describe our experience, with emphasis on the learning curve of LDP.

Methods: Patients who underwent distal pancreatectomy (DP) between January 2011 and August 2014 were included.

Assessment of the clinical usefulness of imaging modalities in identifying postoperative upper gastrointestinal tract leaks requiring reoperation.

Purpose: To assess the usefulness of imaging modalities in the diagnosis and determination of whether postoperative upper gastrointestinal tract leak (UGITL) requires operative intervention.

Methods: : Patients with suspected UGITL who underwent reoperation ≤ 30 days after the primary operation with intraoperative confirmation of leaks were identified. Data of those patients who had undergone computerized tomography (CT) or upper gastrointestinal contrast study (UGIS) before reoperation were reviewed.

Abdominal computed tomography for diagnosing postoperative lower gastrointestinal tract leaks.

Background: Computed tomography (CT) is the most readily available imaging tool for diagnosis of postoperative lower gastrointestinal tract (LGIT) leak. The accuracy and sensitivity of CT for diagnosing a leak from a hollow viscous or anastomotic bowel leakage are still not well established. This retrospective study was conducted in order to define the role of CT in this setting.

Headaches in women undergoing in vitro fertilization and embryo-transfer treatment.

Background: In vitro fertilization and embryo transfer has become a common therapeutic modality in modern fertility medicines. Treatment protocols are associated with exaggerated hormonal fluctuations in order to promote multiple follicular development and support of embryo survival. Estrogen is considered to be closely linked to migraine, and its extreme serum level fluctuations have been considered to trigger migrainous headaches.