Abstract:
OBJECTIVE:The aim of this study was to compare the short- and long-term outcomes of malnourished gastric cancer patients who underwent laparoscopic or open radical gastrectomy. BACKGROUND:Preoperative malnutrition is an independent risk factor for postoperative mortality and morbidity in major gastrointestinal surgery. However, whether laparoscopic surgery can improve the short- and long-term outcomes of malnourished gastric cancer patients has not been determined. METHODS:We reviewed prospectively collected data from 2441 patients with gastric cancer between January 2009 and December 2014 and compared the short- and long-term outcomes in malnourished gastric cancer patients who underwent laparoscopic or open radical gastrectomy. Nutritional risk factors included weight loss >10% within 6 months, body mass index <18.5 kg/m2, Subjective Global Assessment Grade C, and serum albumin <3.0 g/dL. RESULTS:Overall, 501 patients (20.52%) were classified as malnourished. Patients with gastric stump carcinoma, neoadjuvant chemotherapy, distant metastases, palliative operation, or the presence of other malignancies were excluded. Finally, a total of 412 patients were analyzed; 304 in the laparoscopic group and 108 in the open group. There were no significant differences between the two groups regarding the clinicopathological characteristics. However, the operation time (181 ± 53 vs. 253 ± 81 min), intraoperative blood loss (80 ± 116 vs. 322 ± 502 mL), time to first ambulation (2.21 ± 1.04 vs. 2.55 ± 1.50 days), liquid diet (4.91 ± 1.61 vs. 5.72 ± 2.09 days) and semiliquid diet (7.67 ± 1.56 vs. 9.53 ± 2.09 days) as well as the postoperative hospital stay duration (13.00 ± 6.56 vs. 15.22 ± 6.87 days) were significantly lower in the laparoscopic group than those in the open group (p < 0.05). The instances of overall complications (laparoscopic vs. open: 18.4 vs. 30.6%, p = 0.008) and pneumonia (laparoscopic vs. open: 10.9 vs. 19.4%, p = 0.023) were significantly lower in the laparoscopic group. With a median follow-up of 31.0 months (range 1.0-88.0), the 3-year overall survival (OS), recurrence-free survival (RFS), and cancer-specific survival (CSS) rates for the entire cohort were 58.9, 54.0 and 63.0%, respectively. Further analysis showed that the OS (57.5 vs. 59.4%, p = 0.560), RFS (51.8 vs. 54.8%, p = 0.441) and CSS (62.8 vs. 63.0%, p = 0.789) between the laparoscopic and open groups, respectively, were no significantly different. Further analysis showed no significant differences in the OS rates of the two groups of patients stratified by tumor stage (p > 0.05). CONCLUSION:Compared with open radical gastrectomy, laparoscopy would reduce the postoperative complications especially pneumonia and shorten the postoperative hospital stay for patients with preoperative malnutrition without affecting their long-term survival.
journal_name
World J Surgjournal_title
World journal of surgeryauthors
Zheng HL,Lu J,Zheng CH,Li P,Xie JW,Wang JB,Lin JX,Chen QY,Lin M,Tu RH,Huang CMdoi
10.1007/s00268-017-4138-9subject
Has Abstractpub_date
2018-01-01 00:00:00pages
195-203issue
1eissn
0364-2313issn
1432-2323pii
10.1007/s00268-017-4138-9journal_volume
42pub_type
杂志文章abstract:BACKGROUND:Sepsis is common in surgical patients, and its presence influences the outcomes in those to undergo surgery. Factors such as advanced age, presence of comorbidities and many other conditions increase mortality in surgical patients with sepsis. The sequential organ failure assessment (SOFA) score simplified i...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/s00268-020-05708-7
更新日期:2020-11-01 00:00:00
abstract::Trends are changing in the management of infants and children with indirect inguinal hernias. Advances in neonatal intensive care have resulted in the survival of many small premature infants who have a high incidence of inguinal hernia. The rate of incarceration, strangulation, and gonadal infarction in these babies ...
journal_title:World journal of surgery
pub_type: 杂志文章,评审
doi:10.1007/BF01658863
更新日期:1989-09-01 00:00:00
abstract:BACKGROUND:The long-term course after peptic ulcer perforation is unclear, but because the ulcer population is generally older and has concomitant disease, the long-term prognosis may be expected to be poor. METHODS:In a study based on prospective data collection, all patients with peptic ulcer perforation treated at ...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/s00268-007-9370-2
更新日期:2008-03-01 00:00:00
abstract::Medieval contracts for medical treatment are, without doubt, evidence of proper and adequate insight into the quality of operations performed centuries ago. Historical archives in Dalmatian cities have preserved a certain number of such contracts. Their contents assist in better understanding our historical heritage. ...
journal_title:World journal of surgery
pub_type: 历史文章,杂志文章
doi:10.1007/s002680010176
更新日期:2000-08-01 00:00:00
abstract:INTRODUCTION:Acute intestinal ischemia is in most cases a lethal condition with a low survival rate. Risk factors of perioperative mortality are poorly defined. The aim of this study was to define risk factors that predict an adverse outcome of acute mesenteric ischemia (AMI). METHODS:A total of 132 consecutive patien...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/s00268-005-0560-5
更新日期:2006-08-01 00:00:00
abstract:BACKGROUND:Postoperative ileus is a common problem with significant clinical and economic consequences. We hypothesized that Gastrografin may have therapeutic utility by accelerating the recovery of postoperative ileus after colorectal surgery. The aim of this trial was to study the impact of oral Gastrografin administ...
journal_title:World journal of surgery
pub_type: 杂志文章,随机对照试验
doi:10.1007/s00268-015-3260-9
更新日期:2016-01-01 00:00:00
abstract:BACKGROUND:Self-expanding metallic stents (SEMS) have been used as a bridge to surgery in patients with obstruction by colorectal cancer, but the oncologic safety of this technique has not yet been established. The aim of the present study was to compare the outcomes of bridge to surgery after SEMS insertion and nonobs...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/s00268-009-0007-5
更新日期:2009-06-01 00:00:00
abstract:BACKGROUND:Pain syndromes of somatic and neuropathic origin are considered to be the main causes of chronic pain after open inguinal hernia repair. Nerve-identification during open hernia repair is suggested to be associated with less postoperative chronic pain. The aim of this study was to define clinically relevant s...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/s00268-006-0376-y
更新日期:2007-02-01 00:00:00
abstract:INTRODUCTION:Thyroid cancer (TC) incidence has been increasing in recent years. The aim of this study was to investigate our institution-based estimates of operative volumes for TC over the last three decades. MATERIALS AND METHODS:This was a retrospective cohort study of patients undergoing thyroid surgery at our ins...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/s00268-015-3322-z
更新日期:2016-03-01 00:00:00
abstract:BACKGROUND:Surgical treatment of amiodarone-associated thyrotoxicosis (AAT) is effective although fewer than 100 cases have been reported world wide. MATERIALS AND METHODS:We reviewed 14 patients treated with total thyroidectomy by a single surgeon from 1998 to 2005. RESULTS:There were 11 male and 3 female patients w...
journal_title:World journal of surgery
pub_type: 杂志文章,评审
doi:10.1007/s00268-005-0673-x
更新日期:2006-11-01 00:00:00
abstract::There is little information on the pharmacokinetics and pharmacodynamics of doxorubicin (DXR) administered during locoregional treatments of colon carcinoma under hyperthermic conditions. The aim of this study was to evaluate distribution and activity of DXR in healthy tissue and tumor tissues under hyperthermic condi...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/s00268-003-6804-3
更新日期:2003-06-01 00:00:00
abstract:BACKGROUND:Adrenocortical carcinoma (ACC) is a rare and aggressive malignancy with poor prognosis, as a majority of patients present with advanced disease. Current adjuvant strategies for metastatic patients include mitotane or other cytotoxic agents and carry a significant morbidity as well as a low (<10 %) 5-year sur...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/s00268-014-2532-0
更新日期:2014-06-01 00:00:00
abstract:BACKGROUND:Currently, there are no objective reports evaluating the quality of the South African surgical training. The aim of this study is to evaluate the current state of surgical training in South Africa from an external impartial point of view and to rate the experience of short-term supernumerary registrars and f...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/s00268-019-05034-7
更新日期:2019-09-01 00:00:00
abstract:BACKGROUND:Mutations in BRCA1 and BRCA2 confer an increased risk to breast and other cancers, but to date there have only been limited numbers of studies of BRCA1- and BRCA2-associated cancers among Asians. Malaysia is a multiracial country with three main races: Malays, Chinese, Indians. We determined whether tumor pa...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/s00268-009-0146-8
更新日期:2009-10-01 00:00:00
abstract::Fingertip injuries constitute a large portion of the traumatic injuries sustained to the hand and are frequently associated with significant disability for the patient. While many methods are available for the treatment of such injuries, quite often only certain procedures are appropriate for a particular digit in any...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/BF01675641
更新日期:1991-07-01 00:00:00
abstract:BACKGROUND:Transient postthyroidectomy hypocalcemia occurs in up to 30% of patients. We evaluated the effect of vitamin D deficiency on postthyroidectomy hypocalcemia. METHODS:Data were collected prospectively between January 2006 and March 2009. A total of 166 consecutive total thyroidectomies were analyzed regarding...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/s00268-010-0872-y
更新日期:2011-02-01 00:00:00
abstract:BACKGROUND:The Mangled Extremity Severity Score (MESS) was constructed as an objective quantification criterion for limb trauma. A MESS of or greater than 7 was proposed as a cut-off point for primary limb amputation. Opinions concerning the predictive value of the MESS vary broadly in the literature. The aim of this s...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/s00268-019-05263-w
更新日期:2020-03-01 00:00:00
abstract::Patients with obstructive jaundice (OJ) that requires surgery often have malnutrition associated with increased perioperative morbidity. This study investigated the factors influencing nutritional derangements in these patients. A series of 46 OJ patients were investigated prospectively (28 malignant tumors, 18 benign...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/s002680020043
更新日期:2001-04-01 00:00:00
abstract:BACKGROUND AND AIM:Previous studies have shown that microscopic vessel invasion (MVI) occurs in hepatocellular carcinoma (HCC) with a treatment history due to its poorer malignant behavior in comparison with primary HCC. The aim of the present study was to determine the predictors of MVI and overall survival in HCC pat...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/s00268-018-4658-y
更新日期:2018-11-01 00:00:00
abstract:BACKGROUND:The profile and management of self-inflicted abdominal stab wounds (SI-ASW) patients is still obscure. METHODS:The National Trauma Data Bank (2012) was queried for adults with abdominal stab wounds (n = 9544). Patients with SI-ASW (n = 1724) and non-SI-ASW (n = 7820) were compared. Predictors for non-therap...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/s00268-017-4083-7
更新日期:2017-11-01 00:00:00
abstract::Axillary dissection in patients with breast cancer is associated with significant morbidity. Because 85% of the patients with a cancer < or = 1 cm have negative axillary nodal status, axillary dissection in these patients is only a staging procedure. A study of the sentinel lymph node (SLN) biopsy has been developed t...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/s00268-001-0272-4
更新日期:2002-05-01 00:00:00
abstract:BACKGROUND:Chagas disease is a serious public health issue in South and Central America due to its high prevalence, morbidity, and mortality. The esophageal form of the disease leads to achalasia and consequent megaesophagus. In advanced or recurrent cases of megaesophagus, there is no consensus for which of three esta...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/s00268-013-2445-3
更新日期:2014-06-01 00:00:00
abstract::Idiopathic portal hypertension (IPH) requires invasive measures to prevent rupture and bleeding of esophagogastric varices. However, the long-term results of shunt surgery for IPH have not been reported. In particular, the pros and cons of surgery that preserves the spleen and its long-term hematologic effects have no...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/s00268-005-7656-9
更新日期:2005-08-01 00:00:00
abstract::During the course of tumor progression the differentiated morphologic and functional characteristics of differentiated thyroid carcinomas (DTC) disappear. This corresponds to more aggressive growth, metastatic spread, and loss of iodine uptake. Experimental data give strong evidence that differentiated functions of io...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/s002689900436
更新日期:1998-06-01 00:00:00
abstract::The safe and permissible limits of hepatectomy in obstructive jaundice patients and the usefulness of preoperative portal embolization (PE) for increasing the limit for safe hepatectomy were examined. We classified 416 patients with hepatectomy performed over 9 years under the following headings: normal liver function...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/s00268-004-7128-7
更新日期:2004-05-01 00:00:00
abstract:BACKGROUND:Whilst injuries are a major cause of disability and death worldwide, a large proportion of people in low- and middle-income countries lack timely access to injury care. Barriers to accessing care from the point of injury to return to function have not been delineated. METHODS:A two-day workshop was held in ...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/s00268-020-05571-6
更新日期:2020-09-01 00:00:00
abstract:BACKGROUND:The impact of preoperative enteral nutrition (EN) on postoperative complications and recurrence in Crohn's disease (CD) has not been investigated to date. The purpose of the present study was to determine the effect of preoperative exclusive EN on postoperative complications and recurrence after bowel resect...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/s00268-016-3488-z
更新日期:2016-08-01 00:00:00
abstract:BACKGROUND:This study aimed to evaluate the clinical relevance of hepatectomy for Barcelona Clinic Liver Cancer (BCLC) stages B and C advanced hepatocellular carcinoma (HCC). METHODS:A total of 314 patients (149 and 165 BCLC stages B and C, respectively) who underwent hepatectomy were included. Complete hepatectomy (w...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/s00268-019-05052-5
更新日期:2019-10-01 00:00:00
abstract:BACKGROUND:The efficacy and the indications of resection of synchronous or metachronous hepatic and pulmonary metastases from colorectal cancer (CRC) are controversial. This study retrospectively reviewed the cases of CRC patients who underwent both liver and lung resection to define the appropriate indications for sur...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/s00268-012-1708-8
更新日期:2012-11-01 00:00:00
abstract::It is difficult to evaluate precisely the effects of one individual on an entire discipline such as surgery. Indeed, it is impossible to do so when such a discipline spans so vast a country as the United States of America. Nevertheless, as a mountain peak can be seen from afar, so may one perceive the influence of man...
journal_title:World journal of surgery
pub_type: 传,历史文章,杂志文章
doi:10.1007/s002689900357
更新日期:1998-01-01 00:00:00