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Query: UMLS:C0024623 (gastric cancer)
 36,219 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

The standard operation for gastric cancer is carried out for advanced gastric cancer with serosal invasion accompanying patent disseminative metastasis to the peritoneum of the omental bursa and lymph node metastases. It consists of subtotal or total gastrectomy, omentobursectomy and extended lymph node dissection. An early stage cancer, which in Japan accounts for almost a half of the resectable cases of gastric cancer, shows no serosal invasion, and lymph node metastases are rare if the cancer remains intramucosal. Such cases represent about a half the cases of the early stage cancer. The diagnosis of the early stage cancer, especially if it remains intramucosal, is made by means of preoperative radiological and endoscopic examinations and intraoperative examination. Since 1977 we have been performing a modified operation as well for cases of the early stage cancer. The surgical procedure is as follows: reduction in the size of gastric resection by 2/3, pylorus-preserving gastrectomy and proximal gastric resection; preservation of the distal portion of the greater omentum and transverse incision of the upper abdomen instead of upper midline incision to prevent ileus due to intestinal adhesion to abdominal wound around umbilicus; sparing bursectomy; narrowing the area of lymph node dissection; sparing thoracotomy for cancer in the esophagogastric junction; sparing splenopancreatectomy; preservation of the hepatic branch of the vagal nerve and postoperative temporary oral administration of cholagogue to prevent postgastrectomy cholelithiasis. In addition, the primary lesion is isolated from the blood circulation by means of ligation of the drainage veins to diminish metastasis through the blood vessels (hepatic metastasis, etc.), which is the main cause recurrence after surgery for the early stage cancer. The results of this new surgery are satisfactory; the five-year postoperative survival rate is 100.0% and it reduced the time needed for surgery, anesthesia and blood transfusion.
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PMID:[Modified operation for an early stage gastric cancer]. 202 97

A clinical evaluation of re-operation after primary gastric resection for stomach carcinoma as "Second Look Operation" was performed with reference to a surgical treatment for gastric remnant cancer. Ninety-one cases among gastrectomized patients with gastric cancer from 1973 to 1987 underwent re-operation. Gastric remnant cancer in 25 cases (27%), was the second indication for the operation next to ileus. It consisted of 17 cases of recurrent cancer and 8 cases of metachronous cancer. The mean interval between the primary and secondary laparotomy in the former (32 months) was significantly shorter than in the latter (117 months). Resectability of gastric remnant cancer was 100% (8/8) in metachronous cancer and 27% (9/33) in recurrent cancer. A long-term follow-up system for over 10 years with modern physical and laboratory examinations for gastrectomized patients has been a substitute for "Second Look Operation" for find cancer in the gastric remnant.
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PMID:[Gastric remnant cancer--physical and laboratory examination and results of treatment]. 273 42

A 65-year-old previously healthy housewife, gravida 3, para 3, was first diagnosed as Stage Ib carcinoma of the uterine cervix (poorly differentiated squamous cell carcinoma) and admitted. The external radiation of 5400 rad by telecobalt source was performed. No intracavitary radiation was added. After about 7 1/2 years the patient noticed a tumor of fist size on her buttocks, but she did not present in our clinic regularly. Because of enlarging tumor and general malaise she was readmitted a year later. On the fifth hospital day she died with ileus. Autopsy revealed osteosarcoma of buttocks in the radiation field, stomach cancer (tubular adenocarcinoma) with perforated peritonitis, and invasive mole of the uterine corpus. The patient's last pregnancy terminated as a full-term delivery at 26 years of age and she was 43 years at her menopause. The dormant period of invasive mole was 47 years after her last pregnancy, 30 years after her menopause, and at least 8 years after pelvic radiation.
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PMID:Long-dormant invasive mole associated with multiple malignancies. 299 95

Continuous hyperthermic peritoneal perfusion (CHPP) with a solution that contains mitomycin C (CHPP-M) has been clinically introduced as a prophylactic treatment for peritoneal recurrence of gastric cancer with serosal invasion. Two studies, each with a treated and a control group, were performed. In the historical control study the postoperative 3-year survival rate of patients (73.7%) in the treated group (n = 38) was significantly higher than the survival rate (52.7%) of those in the control group (n = 55) (P less than 0.04). In the random control study the survival rate (83%) of patients in the treated group (n = 26) was also higher than that (67.3%) of those in the control group (n = 21) in the 30 months that followed gastric surgery. However, there was no significant difference. In the historical control study with respect to the postoperative complications, anastomotic leak was observed in 8.5% of patients who were given CHPP-M and 12.8% patients who did not have CHPP-M. In the random control study anastomotic leak was observed in 3.1% of patients who had CHPP-M and 7.1% of patients who did not have CHPP-M. The incidence of adhesive ileus in patients having CHPP-M did not increase in historical or random control groups. Postoperative prolonged intestinal paresis or chemical peritonitis were not induced by CHPP-M. These results indicate that CHPP-M is a simple, safe, and readily available prophylactic therapy for peritoneal recurrence that may follow gastric cancer surgery.
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PMID:Prophylactic therapy for peritoneal recurrence of gastric cancer by continuous hyperthermic peritoneal perfusion with mitomycin C. 312 Nov 65

Fifty-nine consecutive patients (95 percent) with gastric cancer of the distal portion of the stomach were operated on with 95 percent subtotal gastrectomy between 1975 and 1980. The operations were for cure in all cases. Twenty-five patients were alive after 5 years, for a crude 5 year survival rate of 42 percent. The operative mortality rate was 5 percent (three patients). Twenty-four patients (41 percent) had complications, which consisted of postoperative respiratory infection in 11 patients (19 percent), postoperative ileus in 4 patients (7 percent), and subphrenic abscess in 2 patients (3.4 percent). In addition, there was one wound dehiscence and one liver rupture (with fatal outcome), one deep venous thrombosis, one urinary infection, and one wound infection. Only one patient (1.7 percent) had an anastomotic leak at the gastrojejunostomy site. Seven relaparotomies (12 percent) had to be performed for complications. We have concluded that, in patients with distal gastric cancer, 95 percent subtotal gastrectomy can result in a 5 year survival rate that is comparable to that reported in the literature for total gastrectomy, and it has the advantage of a very low rate of anastomotic leakage between the minute gastric remnant and the jejunum. Therefore, 95 percent subtotal gastrectomy is recommended over total gastrectomy in the treatment of distal gastric cancer.
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PMID:Near-total gastrectomy for gastric cancer. 334 15

Erythrocytes from a patient with blood type of A1 became nongenetically reactive with A (anti-B) serum, following the development of gastric cancer. Transient polyagglutinability was also apparent. The in vitro acetylation of the erythrocyte antigens abolished both the acquired B antigen and the polyagglutination. Although incubation of the heterologous type A1 erythrocytes with the patient's serum did not produce B antigen, deacetylase activity in the serum seems to relate to the acquired B antigen. In this case, either ileus as a result of metastatic adenocarcinoma of the stomach, or urinary tract infections could be the cause of the acquired B antigen.
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PMID:Acquired B antigen and polyagglutination in a patient with gastric cancer. 667 86

A 68-year-old male diagnosed as Borrmann 2 type gastric cancer (T3N3P3H0M0: Stage IVb) was treated by distal gastrectomy and administration of CDDP 50 mg+MMC 10 mg intraperitoneally. After operation intraperitoneal chemotherapy was continued until adhesional ileus occurred four months later. At reoperation peritoneal dissemination was not found either macroscopically or microscopically. After four months, and expandable metallic stent (Wallstent) was applied for malignant biliary stenosis due to lymph node metastasis. Although the patient died 23 months after the first operation, our loco-regional cancer therapy seemed effective for support of quality of life.
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PMID:[A case of gastric cancer with peritoneal dissemination and malignant biliary stenosis treated by loco-regional cancer therapy]. 885 7

The treatment of peritoneal dissemination of gastric cancer is mainly chemotherapy, but it use is often limited by ileus, hydronephrosis and jaundice. We employed a ureteral catheter for 6 patients with hydronephrosis due to peritoneal dissemination. Chemotherapy (CDDP + ADM + 5-FU or MTX + 5-FU) was administered in 5 patients. After ureteral catheterization, renal function was kept within normal ranges, so chemotherapy was performed safely. One of five patients became CR and the effect of the treatment was satisfactory (PR: 1, NC: 2). Thus, chemotherapy after ureteral catheterization may be effective for patients with peritoneal dissemination and hydronephrosis.
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PMID:[Chemotherapy for peritoneal dissemination in gastric cancer under ureteral catheterization]. 897 3

Between January 1985 and September 1994, 21 patients with psychiatric disorders underwent various forms of surgery at our hospital. There were 12 men and 9 women with an average age of 57.6 years. The coexisting psychiatric disorders were schizophrenia in 15 patients, depression in 2, dementia in 2, mental retardation with epilepsy in 1, and Parkinson's disease in 1. All the patients had been receiving neuroleptic medications for a long period. The indications for surgery were: cholelithiasis in 6 patients, acute appendicitis in 4, perforation of the small intestine in 3, incarceration of an inguinal hernia in 2, and esophageal cancer, stomach cancer, bleeding from a gastric ulcer, perforation of a duodenal ulcer, strangulating ileus, and burns in 1 patient each, respectively. All of the patients who underwent elective surgery were given epidural anesthesia with or without general anesthesia. Antipsychotic medications were given until just prior to surgery and recommenced concurrent with the first meal. Abnormal behavior was observed in 11 patients (52.4%) postoperatively, but all the patients were discharged in accordance with recovery from their surgical disorder. Intra- and postoperative hypotension resistant to intravenous catecholamine administration was recognized in 9 patients (42.9%), and this peculiar complication should be borne in mind when patients with psychiatric disorders require surgical management.
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PMID:Surgical treatment of patients with psychiatric disorders: a review of 21 patients. 913 Mar 38

T-type reservoir sheets (anti-adhesion sheets developed to prevent adhesions + reservoir) were intraperitoneally implanted in 16 patients with unresectable gastric cancer and postoperatively used to suction off ascitic fluid, to prevent cancerous adhesions of the intestines, and to intraperitoneally infuse anticancer drugs with a view to improving QOL and prolonging survival time. The results showed that whereas all of the patients had been class V according to intraoperative cytodiagnosis, postoperatively they were all class I-II and their ascites had either completely or temporarily resolved. Performance status (PS) improved in 14 patients (87.5%), and 14 patients (87.5%) were discharged. According to the Cancer Body Cavity Efficacy Rating Criteria (Japan Society for Cancer Therapy), CR was achieved in 10 cases, PR in 3 cases, NR in 3 cases, and the mean home care rate was 45.4%. Mean survival time to date, February 1997, is 7.8 months, two patients are alive, and the longest survival time has been 22 months. This method facilitates suctioning of ascitic fluid. It prevents irregular adhesions of the intestine, and protects against the development of ileus. It enables repeated intraperitoneal administration of high concentrations of anticancer drugs, uniformly, extensively, safely and easily. It facilitates intraperitoneal cytodiagnosis, ascitic fluid sampling, and monitoring of the efficacy of anticancer agents. The special features of this method are the high percentage of patients residing at home and the ability to administer intraperitoneal infusions of anticancer agents continually and repeatedly on an outpatient basis.
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PMID:[Anticancer drug intraperitoneal chemotherapy using T-type reservoir sheet for unresectable gastric cancer]. 964 18


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