Can Proximal Gastrectomy with Double-Tract Reconstruction Replace Total Gastrectomy? A Propensity Score Matching Analysis.

Background: This retrospective cohort study compared proximal gastrectomy (PG) with double-tract reconstruction (DTR) versus total gastrectomy (TG) with Roux-en-Y reconstruction in terms of clinical outcomes.

Methods: All consecutive patients with upper early gastric cancer (EGC) who underwent PG-DTR or TG in 2008-2016 were selected. TG patients who matched PG-DTR patients in age, sex, body mass index, clinical stage, and ASA score were selected by propensity score matching.

Tumor localization using radio-frequency identification clip marker: experimental results of an ex vivo porcine model.

Purpose: With the widespread use of minimally invasive surgery, tumor detection is becoming more difficult. We present the experimental results of a radio-frequency identification (RFID) lesion detection system in an ex vivo porcine model.

Methods: The efficacy and feasibility of a newly developed RFID lesion detection system were examined.

Atraumatic Liver Retraction Using Nelaton Catheters During Totally Laparoscopic Gastrectomy.

This study introduces a novel technique for liver retraction during laparoscopic gastrectomy and assesses its impact on postoperative recovery. This study included 139 patients in whom Nelaton catheters (n=57) or Nathanson retractors (n=82) were used for liver retraction. Serum liver enzyme levels were measured preoperatively and on the first, second, third, fifth, and seventh postoperative days.

Risk factors for lymph node metastasis in mucosal gastric cancer and re-evaluation of endoscopic submucosal dissection.

Purpose: The selection of the appropriate treatment strategy for patients with mucosal gastric cancer (MGC) remains controversial. In the present study, we aimed to determine the risk factors for lymph node (LN) metastasis in MGC and reassess the role of endoscopic submucosal dissection (ESD).

Methods: We examined 1,191 MGC patients who underwent curative gastrectomy between January 2005 and December 2014.

Necrotizing soft tissue infection: analysis of the factors related to mortality in 30 cases of a single institution for 5 years.

Purpose: Necrotizing soft tissue infection is the infection of the soft tissue with necrotic changes. It is rare, but results in high mortality. We analyzed the characteristics of patients, prognosis, and mortality factors after reviewing 30 cases of a single hospital for 5 years.

Comparison Between Billroth-II with Braun and Roux-en-Y Reconstruction After Laparoscopic Distal Gastrectomy.

Purpose: This study aims to compare the effectiveness of Billroth-II with Braun and Roux-en-Y reconstruction after laparoscopic distal gastrectomy.

Methods: From April 2010 to August 2012, 66 patients underwent laparoscopic distal gastrectomy (Billroth-II with Braun reconstruction, 26; Roux-en-Y, 40). The patients' data were collected prospectively and reviewed retrospectively.

Duodenal stump fistula after gastrectomy for gastric cancer: risk factors, prevention, and management.

Purpose: A duodenal stump fistula is one of the most severe complications after gastrectomy for gastric cancer. We aimed to analyze the risk factors for this problem, and to identify the methods used for its prevention and management.

Methods: We retrospectively reviewed the clinical data of 716 consecutive patients who underwent curative gastrectomy with a duodenal stump for gastric cancer between 2008 and 2013.

Effect of extramucin pools in gastric cancer patients.

Purpose: Mucinous gastric adenocarcinoma (MGC) is defined by the World Health Organization as a gastric adenocarcinoma with >50% extracellular mucin pools within the tumors. In this study, we attempted to analyze the clinicopathologic features of patients pathologically diagnosed as gastric cancer with lower than 50% tumor volume of extracellular mucin pool adenocarcinoma (LEMPC). We compared MGC versus nonmucinous gastric adenocarcinoma (NMGC).

Various features of laparoscopic tailored resection for gastric submucosal tumors: a single institution's results for 168 patients.

Background: Laparoscopic resection is a standard procedure for gastric submucosal tumors. Herein, we analyzed the features of various laparoscopic approaches.

Methods: Between January 2007 and November 2013, 168 consecutive patients who underwent laparoscopic resection for gastric submucosal tumors were enrolled.

Intracorporeal esophagojejunostomy using the double stapling technique after laparoscopic total gastrectomy: A retrospective case-series study.

Aim: To introduce a simple and safe anvil insertion technique to esophagus during laparoscopic total gastrectomy (LTG).

Methods: Between July 2010 and December 2012, 58 consecutive patients with early gastric cancer underwent LTG were enrolled. We performed a simple and safe Roux-en-Y esophagojejunostomy using the double stapling technique to all patients.

Single-incision intragastric resection for upper and mid gastric submucosal tumors: a case-series study.

Purpose: Laparoscopic gastric wedge resection is a standard treatment for removing gastric submucosal tumors (SMTs). So far, however, there have been few reports of single-incision laparoscopic intragastric wedge resection. Our aim was to describe this procedure and our experience with it.

Risk factors for delayed gastric emptying caused by anastomosis edema after subtotal gastrectomy for gastric cancer.

Background/aims: Delayed gastric emptying (DGE) is one of the most troublesome complications after subtotal gastrectomy for gastric cancer. We evaluated operative and perioperative variables to assess for independent risk factors of DGE caused by anastomosis edema.

Methodology: The study retrospectively reviewed clinical data of 382 consecutive patients who underwent subtotal gastrectomy for gastric cancer between 2009 and 2011 at a single institution.

Solitary Peutz-Jeghers-type appendiceal hamartomatous polyp growing into the terminal ileum.

Solitary Peutz-Jeghers type hamartomatous polyp is rare. It is considered to be related to a variant Peutz-Jeghers syndrome (PJS) and may be a separate disease entity. A 50-year-old man was referred to our hospital with a diagnosis of intussusception in the terminal ileum and underwent segmental ileal resection with appendectomy.

Mucin expression in gastric cancer: reappraisal of its clinicopathologic and prognostic significance.

Context: The clinical validity of mucin expression in gastric cancer is debated. Whereas several reports demonstrate a correlation between mucin expression and prognosis, others deny such an association.

Objectives: This survival analysis study aims to elucidate the prognostic significance of mucin expression in gastric cancer.

Validation of circulating miRNA biomarkers for predicting lymph node metastasis in gastric cancer.

We validated candidate biomarkers using circulating miRNAs by analyzing serum miRNA concentrations from patients with gastric cancer (GC) to predict lymph node (LN) metastasis. In a pilot study, serum levels of miR-21, miR-27a, miR-106b, miR-146a, miR-148a, miR-223, and miR-433 were compared in 10 healthy donors, 16 LN-positive patients with GC, and 15 LN-negative patients with GC. Then, we compared the level of three miRNAs (miR-21, miR-146a, and miR-148a) with the total of 79 GC patients with or without LN metastasis.

Clinicopathological characteristics and prognosis of remnant gastric cancer.

Purpose: The long-term survival rate of gastric cancer patients after surgery has recently increased as a result of making an early diagnosis of gastric cancer. Therefore, the incidence of remnant gastric cancer is increasing. This study was performed to evaluate the clinicopathological characteristics and prognosis of patients with remnant gastric cancer.

Is Surgical Treatment Necessary after Non-curative Endoscopic Resection for Early Gastric Cancer?

Purpose: Additional surgery is commonly recommended in gastric cancer patients who have a high risk of lymph node metastasis or a positive resection margin after endoscopic resection. We conducted this study to determine factors related to residual cancer and to determine the appropriate treatment strategy.

Materials And Methods: A total of 28 patients who underwent curative gastrectomy due to non-curative endoscopic resection for early gastric cancer between January 2006 and June 2009 were enrolled in this study.

Characterization of antigenic determinants in ApxIIA exotoxin capable of inducing protective immunity to Actinobacillus pleuropneumoniae challenge.

Actinobacillus pleuropneumoniae is the causative agent of porcine pleuropneumonia. Among the virulence factors of the pathogen, ApxIIA, a bacterial exotoxin, is expressed by many serotypes and presents a plausible target for vaccine development. We characterized the region within ApxIIA that induces a protective immune response against bacterial infection using mouse challenge model.

Coagulase-positive staphylococcal necrotizing fasciitis subsequent to shoulder sprain in a healthy woman.

Necrotizing fasciitis (NF) is a deep infection of the subcutaneous tissue that progressively destroys fascia and fat; it is associated with systemic toxicity, a fulminant course, and high mortality. NF most frequently develops from trauma that compromises skin integrity, and is more common in patients with predisposing medical conditions such as diabetes mellitus, atherosclerosis, alcoholism, renal disease, liver disease, immunosuppression, malignancy, or corticosteroid use. Most often, NF is caused by polymicrobial pathogens including aerobic and anaerobic bacteria.

Double stapling Roux-en-Y reconstruction in a laparoscopy-assisted distal gastrectomy.

Purpose: The purpose of this study is to introduce the technical details of double stapling Roux-en-Y (R-Y) reconstruction and evaluate its short-term results.

Methods: Twenty-three patients who underwent a laparoscopy assisted distal gastrectomy with R-Y reconstruction between May 2007 and December 2008 were enrolled in this study. This investigation analyzed the clinicopathological data, the surgical data, and the postoperative outcome.

Lymph node metastasis from intestinal-type early gastric cancer: experience in a single institution and reassessment of the extended criteria for endoscopic submucosal dissection.

Background: Given the increasing use of endoscopic resection as a therapeutic modality for cases of early gastric cancer (EGC), it is very important to define strict criteria for the use of endoscopic mucosal resection and endoscopic submucosal dissection. To date, the criteria are almost entirely based on Japanese literature evaluating the risk of lymph node (LN) metastasis in patients with EGC.

Objective: To analyze our own experience with the factors affecting LN metastasis and to reappraise the extended criteria for endoscopic submucosal dissection.

Is there any synergic effect for coadministration of mitomycin C and halofuginone on the skin wound healing?

Objective: This study compared the potencies of the antifibrotic agents mitomycin C (MMC) and halofuginone (HFN) and investigated whether coadministration of these agents produces synergic effects in an animal skin wound model.

Subjects And Methods: Twenty male Sprague-Dawley rats were used for this study. After a full-thickness excisional wound was made on the dorsum of each rat, each rat was treated with topical mitomycin, intraperitoneal HFN, or both.

Roux-en-Y gastrojejunostomy using modified hemi-double stapling.

For reconstruction after distal gastrectomy, the Roux-en-Y gastrojejunostomy is superior to the Billroth II gastrojejunostomy in terms of bile reflux. Roux-en-Y gastrojejunostomy prevents reflux gastritis, esophagitis, and carcinogenesis of the gastric remnant. However, the Roux-en-Y gastrojejunostomy is relatively complicated and lengthy.

Is it possible to differentiate gastric GISTs from gastric leiomyomas by EUS?

Aim: To evaluate the ultrasonography (EUS) features of gastric gastrointestinal stromal tumors (GISTs) as compared with gastric leiomyomas and then to determine the EUS features that could predict malignant GISTs.

Methods: We evaluated the endoscopic EUS features in 53 patients with gastric mesenchymal tumors confirmed by histopathologic diagnosis. The GISTs were classified into benign and malignant groups according to the histological risk classification.

The role of hedgehog signaling during gastric regeneration.

Background: Hedgehog signaling plays critical roles during embryonic development. It is also involved in tissue regeneration and carcinogenesis in various adult tissues. Moreover, it regulates the maintenance of cancer stem cells and adult stem cells.