Six patients had total gastrectomy because of carcinoma followed by jejunum isoperistaltic interposition according to Longmire. A jejunal biopsy was taken in every case during operation and three and six months later endoscopically for morphometric and functional evaluation of small bowel mucosa. Three months after the operation a rise of L-phenylalanin in vitro uptake, an increase in villus height, surface area and a deepening of the crypts with raised mitotic activity of the crypt cells was found. The ratio of villus height to crypt depth was increased, although not significantly. On the other hand the activity of sucrase was initially decreased. Six months postoperatively all parameters had become normal besides the disaccharidases. These changes may be due to adaptive mucosal hyperplasia after small bowel resection or to luminal mucosal damage followed by compensatory hyperregeneration. Finally a humoral stimulus for mucosal hyperplasia as a postoperative effect is discussed.
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J Natl Cancer Inst
January 2025
Center for Cancer Research, National Cancer Institute, National Institutes of Health, Bethesda, MD, USA.
Background: Adolescents and young adults (AYA) with germline CDH1 variants are at risk of overtreatment when precancer lesions are detected with endoscopic screening. We characterize diffuse-type gastric cancer prevalence and survival in AYA managed with prophylactic total gastrectomy (PTG) or endoscopic surveillance.
Methods: Prospective cohort study of 188 individuals aged 39 and younger enrolled from January 27, 2017, to May 1, 2023.
ANZ J Surg
January 2025
Department of Surgery, The Univeristy of Adelaide, The Queen Elizabeth Hospital, Adelaide, South Australia, Australia.
Background: Due to limited healthcare resources, there is global incentive to maximize efficacy while minimizing patient harm. Given the low rate of cancer diagnoses made via routine histopathological analysis of surgical specimens, a selective approach has been proposed as a viable alternative. This systematic review aimed to evaluate effectiveness of cancer detection and costs with a selective approach.
View Article and Find Full Text PDFAnn Gastroenterol Surg
January 2025
Aim: The reconstruction methods after proximal gastrectomy (PG) are varied but not standardized. This study was performed to evaluate the short-term clinical outcomes between double tract reconstruction (DTR) and double flap technique (DFT).
Methods: We retrospectively reviewed and collected data of patients who underwent DTR and DFT after laparoscopic proximal gastrectomy (LPG), respectively, between January 2020 and March 2023.
Aim: In this study, we evaluated the difference in short-term outcomes and postoperative nutritional status between subtotal gastrectomy (sTG) and proximal gastrectomy (PG) to determine the optimal surgical treatment for early gastric cancer in the upper third of the stomach.
Methods: Patients who underwent laparoscopic or robotic sTG or PG at the Shizuoka Cancer Center in Shizuoka between January 2014 and December 2020 were enrolled in this retrospective study. Patient characteristics, surgical outcomes, endoscopic findings, and postoperative nutritional changes, including blood tests, body weight, psoas muscle, and subcutaneous and visceral adipose tissue, were measured and compared between the two groups.
Ann Gastroenterol Surg
January 2025
The Japanese Society of Gastroenterological Surgery Tokyo Japan.
Aim: This study aimed to evaluate the technical safety and feasibility of gastrectomy for super-elderly patients ≥85-y-old with gastric cancer and to clarify the risk factors for serious postoperative complications in these patients.
Methods: Between 2017 and 2020, 10,203 patients who underwent distal gastrectomy (DG) and 2580 patients who underwent total gastrectomy (TG) were reviewed from the Japanese National Clinical Database. All possible preoperative factors were used to explore the risk factors for serious postoperative complications in the super-elderly patients with gastric cancer.
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