Background: The incidence of adenocarcinoma of the gastric cardia is rising in Western countries. This study evaluates prognostic factors associated with surgical management of this cancer.
Study Design: Medical records of consecutive patients with gastric cardial cancer treated by surgical resection from 1991 through 2001 were reviewed. Survival was analyzed using the Kaplan-Meier method. Prognostic factors were evaluated using log-rank test and Cox regression. Mean followup period was 34 months.
Results: Eighty-two patients met study inclusion criteria. Median patient age was 65 years (range 86 to 22). Fifty-nine (72%) patients had type II tumors and 23 (28%) patients had type III tumors, according to the Siewert classification for gastroesophageal junction tumors. Twenty-seven (33%) patients underwent total esophagectomy, 24 (29%) patients underwent extended gastrectomy with thoracotomy, and 31 (38%) patients underwent extended gastrectomy without thoracotomy. Overall postoperative 5-year survival rate was 30%. On multivariate analysis, patient age 65 years and older, absence of lymph node metastasis, and R0 resection emerged as factors independently associated with improved postoperative survival. Frequency with which proximal resection margin was infiltrated with cancer was a function of gross margin length and T stage. Proximal gross margin length of at least 6 cm was required to achieve a microscopically negative proximal margin for T3 and T4 cancers.
Conclusions: Achieving R0 resection should be the goal of surgical therapy for the gastric cardial cancer. The surgical approach should be tailored to individual patients to achieve this goal.
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http://dx.doi.org/10.1016/j.jamcollsurg.2004.08.015 | DOI Listing |
J Laparoendosc Adv Surg Tech A
January 2025
Department of General Surgery, Children's Hospital, Zhejiang University School of Medicine, National Clinical Research Center for Child Health, Hangzhou, China.
The incidence of multiple magnetic foreign body (MMFB) ingestion in children is rising, which poses a serious risk for gastrointestinal tract injury. In the current study, the clinical characteristics were analyzed to enhance awareness among parents and caregivers, treatment experiences were summarized and discussed, and optimal treatment plans were identified. A retrospective analysis was performed on 130 pediatric patients with MMFB ingestion at the Children's Hospital Affiliated with Zhejiang University School of Medicine, between June 2016 and June 2023.
View Article and Find Full Text PDFLymphat Res Biol
January 2025
Ankara Bilkent City Hospital, Physical Medicine and Rehabilitation Hospital, Health Science University, Ankara, Turkiye.
The aim of this study was to comparatively determine the frequency of breast cancer-related lymphedema (BCRL) by using prospective monitoring with perometer and circumferential measurements in a group of patients who underwent breast cancer surgery. We also aimed to evaluate the relationship between volume changes and functional status and quality of life (QoL) in patients with breast cancer-related subclinical lymphedema. Patients who had unilateral breast cancer surgery for breast were assessed with circumferential and perometer, respectively, for volumes at baseline, 3rd-month, 6th-month, 9th-month, and 12th-month by the same physiotherapist.
View Article and Find Full Text PDFJAMA Netw Open
January 2025
Division of Cardiothoracic and Vascular Surgery, Columbia University Irving Medical Center, New York, New York.
Importance: It remains unknown whether outcomes of the Placement of Aortic Transcatheter Valves 3 (PARTNER 3) and Evolut Low Risk trials are comparable with surgical outcomes in nontrial settings, considering the added risk of concomitant cardiac operations.
Objective: To compare 30-day mortality and stroke incidences of patients in the surgical aortic valve replacement (SAVR) arm of low-risk trials with those of similar patients in the US Society of Thoracic Surgeons Adult Cardiac Surgery Database (STS ACSD).
Design, Setting, And Participants: A cross-sectional sampling study was conducted of adults in the STS ACSD with severe aortic stenosis at low surgical risk for AVR who underwent SAVR during the years low-risk AVR trials (PARTNER 3 and Evolut Low Risk) were enrolling (calendar years 2016-2018).
J Laparoendosc Adv Surg Tech A
January 2025
Department of General Surgery, The Children's Hospital, Zhejiang University School of Medicine, National Clinical Research Center for Child Health, Hangzhou, China.
Surgery for choledochal cysts (CDC) in children younger than 6 months is relatively rare. We report our experience and compare the results between Da Vinci robot-assisted hepaticojejunostomy (RAHJ) and laparoscopic-assisted hepaticojejunostomy (LAHJ) in children younger than 6 months to treat CDC. A retrospective study was conducted on all children under 6 months of age who underwent RAHJ or LAHJ at the Children's Hospital, Zhejiang University School of Medicine, from July 2018 to November 2023.
View Article and Find Full Text PDFObes Surg
January 2025
Division of Bariatric and Metabolic Surgery, University General Hospital of Patras, Patras, Greece.
Background: Weight loss after sleeve gastrectomy (SG) demonstrates significant diversity in the long term and the implicated mechanisms behind suboptimal clinical response (SCR) or recurrent weight gain (RWG) need to be scrutinized. This study retrospectively examines weight-loss trajectories, aiming to identify critical time points to optimize follow-up strategies and guide future prospective research.
Methods: This is a single-center, retrospective study of 104 patients that underwent SG.
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