Role of immunotherapy in gastric cancer with liver metastasis.

Gastric cancer continues to be a significant issue for public health, marked by its widespread occurrence and high mortality rates, even as the incidence of the disease shows a declining trend. The liver is the primary site for metastatic spread, with the peritoneum, lungs, and bones also being common targets. With the advent of biologic treatments and the introduction of immunotherapy for patients with metastatic conditions, the options to treat metastatic gastric cancer have expanded.

Impact of Clostridium difficile Infection Versus Colonization on Postoperative Outcomes After Oncological Colorectal Surgery: An Observational Single-Center Study With Propensity Score Analysis.

Background: There is limited research available concerning the risk anastomotic leakage in the context of Clostridium difficile infection (CDI). Herein, we aim to elucidate the correlation between CDI, encompassing both preoperative asymptomatic C. difficile carriers (CDC) and postoperative hospital acquired C.

Splenectomy Does Not Increase Early Morbidity in Patients Undergoing Total Gastrectomy: A Case-Control Study with Propensity Score Analysis.

Aim: In gastric cancer (GC), D2 lymph node dissection is, alongside negative-margins gastrectomy, of paramount importance. There is a debate between Western and Eastern scientific communities concerning the risk-benefit balance with respect to splenectomy, as Western countries are inclined to perform spleen-preserving gastrectomy due to an increased risk for postoperative complications. In Eastern countries (such as Japan) this is not the case.

Evaluation of Changes in Circulating Cell-Free DNA as an Early Predictor of Response to Chemoradiation in Rectal Cancer-A Pilot Study.

The objective of this study was to investigate quantitative changes in cell-free DNA (cfDNA) found in the bloodstream of patients with locally advanced rectal cancer who received neoadjuvant long-course chemoradiation, assuming a change in DNA fragments release during therapeutic stress. This was a prospective observational study that involved 49 patients who had three distinct pathologies requiring neoadjuvant chemoradiation: 18 patients with breast cancer, 18 patients with cervical cancer, and 13 patients with rectal cancer. Both breast cancer and cervical cancer patients were used as a control groups.

Age, blood tests and comorbidities and AIMS65 risk scores outperform Glasgow-Blatchford and pre-endoscopic Rockall score in patients with upper gastrointestinal bleeding.

Background: Upper gastrointestinal (GI) bleeding is a life-threatening condition with high mortality rates.

Aim: To compare the performance of pre-endoscopic risk scores in predicting the following primary outcomes: In-hospital mortality, intervention (endoscopic or surgical) and length of admission (≥ 7 d).

Methods: We performed a retrospective analysis of 363 patients presenting with upper GI bleeding from December 2020 to January 2021.

Laparoscopic versus open resection of primary colorectal cancers and synchronous liver metastasis: a systematic review and meta-analysis.

Purpose: Combined resection of primary colorectal cancer and associated liver metastases is increasingly common. This study compares peri-operative and oncological outcomes according to surgical approach.

Methods: The study was registered with PROSPERO.

TECHNICAL DIFFICULTIES AND PROCEDURAL COMPLICATIONS IN CLOSING MALIGNANT ESOPHAGEAL-RESPIRATORY FISTULAS.

The aim of the study was to outline technical difficulties and procedural complications of using partially covered esophageal self-expandable metal stents (SEMSs) in malignant esophageal respiratory fistulas (ERFs) as a palliative treatment option. In this study, 150 patients with malignant dysphagia underwent treatment with SEMSs. A total of 36 ERFs were detected through endoscopic or clinical assessment.

Postoperative Quality Assessment Score Can Select Patients with High Risk for Locoregional Recurrence in Colon Cancer.

Background: Monitoring surgical quality has been shown to reduce locoregional recurrence (LRR). We previously showed that the arterial stump length (ASL) after complete mesocolic excision (CME) is a reproducible quality instrument and correlates with the lymph-node (LN) yield. We hypothesized that generating an LRR prediction score by integrating the ASL would predict the risk of LRR after suboptimal surgery.

Hair EDX Analysis-A Promising Tool for Micronutrient Status Evaluation of Patients with IBD?

Micronutrient deficiencies can arise in various conditions, including inflammatory bowel diseases (IBD), and diagnosing these deficiencies can be challenging in the absence of specific clinical signs. The aim of this study was to evaluate the status of various trace elements hair concentration in IBD patients compared to a healthy control group and to identify potential correlations between the micronutrient status and relevant parameters related to disease activity. The concentrations of iron, magnesium, calcium, zinc, copper, manganese, selenium and sulfur in the hair of 37 IBD patients with prior diagnosed IBD (12 Crohn's disease and 25 ulcerative colitis) and 31 healthy controls were evaluated by Energy Dispersive X-Ray spectroscopy (EDX).

Leptin and adiponectin dynamics at patients with rectal neoplasm - Gender differences.

Background: Numerous studies associate adipokines with colorectal malignancy, but few data deal with patients suffering exclusively of rectal carcinoma (RC).

Aims: We evaluated leptin and adiponectin levels in RC patients compared to healthy population and their dynamics after surgery.

Material And Methods: Serum leptin and adiponectin were evaluated before surgery in 59 RC consecutive patients (38 males and 21 females), and in age and weight matched healthy controls.

Tumor-facing hepatocytes significantly contribute to mild hyperthermia-induced targeting of rat liver metastasis by PLGA-NPs.

The effect of mild hyperthermia (MHT) on nanoparticle (NP) accumulation in rat model liver metastasis and the contribution of neoplastic and non-neoplastic cells were characterized. CdSe/ZnS QD-doped poly(lactic-co-glycolic acid) (PLGA) NPs (155 ± 10 nm) were delivered via the ileocolic vein to metastatic livers 15 min after localized MW irradiation (1 min, 41 °C) or in normothermia (37 °C, NT). Quantitative analysis of tissue sections by confocal fluorescence microscopy 1 h after NP injection showed no NP tumor accumulation in NT.

Post-operative computed tomography scan - reliable tool for quality assessment of complete mesocolic excision.

Background: Quality control in colon cancer surgery is an ongoing debate ever since standardization proved to be highly efficient in improving survival in rectal cancer. Complete mesocolic excision (CME) is widely acclaimed as the new gold-standard in colon cancer resections, thus it is imperative to establish quality criteria of CME in order to make it easily understood and verified by surgeons worldwide. One simple and reproducible tool could be the measurement of arterial stumps postoperatively and a straightforward way to test its reliability is to test it in a comparative study between CME and non-CME surgery.

New experimental model for single liver lobe hyperthermia in small animals using non-directional microwaves.

Purpose: Our aim was to develop a new experimental model for in vivo hyperthermia using non-directional microwaves, applicable to small experimental animals. We present an affordable approach for targeted microwave heat delivery to an isolated liver lobe in rat, which allows rapid, precise and stable tissue temperature control.

Materials And Methods: A new experimental model is proposed.

Giant solitary gastric Peutz-Jeghers polyp mimicking a malignant gastric tumor: the largest described in literature.

A solitary Peutz-Jeghers polyp is defined as a unique polyp occurring without associated mucocutaneous pigmentation or a family history of Peutz-Jeghers syndrome. Gastric solitary localization is a rare event, with only eight reported cases to date. We report herein the case of a 43-year old woman who presented with upper gastrointestinal bleeding, severe anemia, weight loss and asthenia.

Immune therapies for malignant mesothelioma.

Malignant mesothelioma (MM) is a rare disease which can develop in pleura, pericardium or peritoneum and in which the therapies available have limited efficacy and are associated with various side effects. Therefore, there is a need for more targeted and more effective therapies which are able to halt the disease progression. Among them immune therapies actively or passively directed against various structures of the MM cells seem to be particularly promising given their inhibitory potential demonstrated in both experimental and early clinical studies.

Lymph node status assessed through the log odds ratio - a better tool in the prognosis of colorectal cancer relapse.

The current literature related to colorectal cancer shows there is a great inhomogeneity in patient outcome, even between patients in the same stage, which means that the TNM staging does not seem enough anymore to make a therapeutic decision. This is why many of the recent studies focus on the study of prognostic and predictive factors that would make the therapeutic decision-making process more accurate. In the current study, we focused on the study of two lymph node based scores - the lymph node ratio and the log odds ratio and the morphological characteristics of the tumor to try to see if any of them can predict a more aggressive tumor behavior in order to approach the patient in an appropriate way.

Preoperative warm-up using a virtual reality simulator.

Background And Objectives: All modern surgical procedures require a high level of cognitive and psychomotor skills achieved using different training methods, but could be influenced by fatigue and other psychological factors. We evaluated the effect of warm-up exercises on operative laparoscopic performances.

Methods: The surgical team operated on a consecutive series of 20 patients with gallstones.

Incomplete deployment of an expandable metallic stent in a patient with esophageal malignant stenosis.

The use of self expandable metallic stents (SEMS) in the palliation of dysphagia due to malignant esophageal stenosis is a gold standard. Covered stents are used in all cases with overt air-digestive fistula or high potential for fistula development. The procedure is associated with a low incidence of procedure-related complications.

Adrenal schwannoma.

Background: Adrenal schwannomas are very rare tumors that are difficult to diagnose preoperatively. We report the case of a left adrenal schwannoma incidentally discovered in a 55-year-old man during a postoperative checkup for a cutaneous malignant melanoma.

Methods: The biological evaluation was unremarkable, and the radiological examination revealed the adrenal mass that was first considered a metastatic lesion.

Multiple peritoneal hydatid disease after rupture of a multivesicular hepatic hydatid cyst. Case report.

We report the peculiar case of a young woman with hepatic hydatid cysts, with numerous peritoneal disseminations (56 cysts) incidentally diagnosed during a caesarian section. The case was managed, surgically preceded and followed by systemic treatment with albendazole. Surgical treatment addressed both the hepatic cyst and the peritoneal hydatid disease aiming to preserve involved abdominal organs.

Right adrenal abscess -- an unusual complication of acute apendicitis.

Acute appendicitis represents one of the most frequent abdominal emergencies encountered in everyday surgical practice. Local infectious complications are not unusual and retroperitoneal abscesses after acute retrocaecal appendicitis have been previously described. The authors present the case of a 22-years-young female patient, admitted for a right iliac fossa abscess, secondary to gangrenous appendicitis.

Cost-effectiveness of endoscopically placed stents in the palliation of locally advanced esophageal carcinoma.

The study assessed 50 consecutive patients presenting advanced esophageal carcinoma, in order to evaluate the cost-effectiveness of endoscopic palliation of dysphagia. Cases were divided into groups according to the type of therapy: Group A - surgical resections; Group B - gastrostomy, jejunostomy, surgical bypass or no palliation; Group C - endoscopic palliation. A retrospective study analysed early mortality, length of hospital stay and cost of therapy.

Postoperative survival in advanced gastric cancer.

We assessed the postoperative survival in 143 consecutive patients with advanced gastric cancer. Police databases represented a very powerful research tool and allowed a response rate of 94.4%.

Stenting for cervical tracheo-esophageal malignant fistula: a case report.

Esophago-respiratory neoplastic fistulas present serious problems of management, mostly because of the severe status of the patient. The authors present the case of a 49-year-old patient with a malignant eso-tracheal fistula manifesting as mild dysphagia and dyspnoea. An endoscopic palliative treatment of the fistula was performed introducing a metallic coated stent into the esophagus.