Abstract:
BACKGROUND:Recently, detections of early gastric cancer (EGC) have been increasing, and the treatment strategies for gastric cancer have been changing. To demonstrate recent clinical experience of EGC in Japan and to assess modern strategies for the treatment of EGC, we investigated the English-language literature of the past 10 years through computer searches. METHODS:This article intends to provide gastric surgeons with recent Japanese experience of the treatment for EGC. In a search for modern treatments of EGC, we selected 100 papers published in well-known medical journals, and focused on the following items of EGC: (1) prognostic factors, (2) endoscopic treatment, (3) surgical procedures, and (4) Japanese guidelines. RESULTS:The most important factor influencing the survival of patients with EGC is the status of lymph node metastasis. The incidence of lymph node metastasis is 1-3% for mucosal cancers and 11-20% for submucosal cancers. Endoscopic mucosal resection (EMR) is a technique for the treatment of EGC, and the recent indication includes the tumors confined to the mucosa up to 3 cm in size or those invading the superficial submucosa. Surgical procedures include conventional Billroth I gastrectomy, limited resections, and laparoscopic surgery. Laparoscopic wedge resection using the lesion-lifting method and laparoscopy-assisted distal gastrectomy provide less pain, faster recovery and shorter hospital stay. Guidelines for the treatment of gastric cancer proposed by the Japanese Gastric Cancer Association show that patients with mucosal cancer can be managed by EMR or distal gastrectomy, whereas patients with submucosal cancer are candidates for distal gastrectomy with lymph node dissection. CONCLUSION:Although the prognosis of patients with EGC depends on the presence or absence of lymph node metastasis, most are successfully treated by modern endoscopic or surgical techniques. Laparoscopic surgery and limited resections will contribute to the better quality of life of patients with EGC.
journal_name
Dig Surgjournal_title
Digestive surgeryauthors
Adachi Y,Shiraishi N,Kitano Sdoi
10.1159/000065829subject
Has Abstractpub_date
2002-01-01 00:00:00pages
333-9issue
5eissn
0253-4886issn
1421-9883pii
65829journal_volume
19pub_type
杂志文章,评审abstract::Dysgerminomas of the ovary rarely metastasize to abdominal viscera and when they do, the involvement is a part of a disseminated disease. A 30-year-old woman developed isolated duodenopancreatic dysgerminoma 14 years after salpingo-oophorectomy. The clinical picture was complicated by the presence of tuberculous lesio...
journal_title:Digestive surgery
pub_type: 杂志文章
doi:10.1159/000050198
更新日期:2001-01-01 00:00:00
abstract:BACKGROUND:Vagus nerve injury (VNI) is a feared complication of antireflux surgery (ARS). The impact of VNI on the functional outcomes of ARS has not yet been evaluated systematically. The aim of this review was to evaluate the impact of VNI on functional and clinical outcome of ARS. METHODS:A systematic search was pe...
journal_title:Digestive surgery
pub_type: 杂志文章,评审
doi:10.1159/000444147
更新日期:2016-01-01 00:00:00
abstract:AIMS:To assess the safety and feasibility of minimally invasive esophagectomy and selected three-field lymphadenectomy with the right bronchial occlusion in left semi-prone position under artificial pneumothorax. METHODS:Thoracoscopic-laparoscopic subtotal esophagectomy and selected three-field lymphadenectomy were pe...
journal_title:Digestive surgery
pub_type: 杂志文章
doi:10.1159/000371747
更新日期:2015-01-01 00:00:00
abstract:BACKGROUND:Tata Memorial Centre (TMC) is a high-volume centre for pancreatic tumour resections. We found a continually increasing referral of pancreatic tumours for re-evaluation for surgery, after an initial unsuccessful attempt at resection. AIM:To evaluate reasons of initial in-operability, the feasibility of re-op...
journal_title:Digestive surgery
pub_type: 杂志文章
doi:10.1159/000489275
更新日期:2019-01-01 00:00:00
abstract:OBJECTIVE:To propose guidelines for treatment based on the study of early and late outcome after various surgical procedures for sclerosing encapsulating peritonitis (SEP). PRIMARY BACKGROUND DATA: SEP is rare. The main complication is intestinal obstruction. Ideal treatment is resection of the membrane, whenever possi...
journal_title:Digestive surgery
pub_type: 杂志文章,多中心研究,评审
doi:10.1159/000018681
更新日期:1998-01-01 00:00:00
abstract::Infectious complications in surgical patients often originate from the intestinal microflora. In the critically ill patient, small bowel motility is disturbed, leading to bacterial overgrowth and subsequent bacterial translocation due to dysfunction of the gut mucosal barrier. The optimal prophylactic strategy should ...
journal_title:Digestive surgery
pub_type: 杂志文章,评审
doi:10.1159/000088053
更新日期:2005-01-01 00:00:00
abstract::Local invasion of adjacent viscera by colorectal liver metastases (CRLM) is no longer considered an absolute contraindication to curative hepatic resection. A growing number of observational analyses have illustrated the feasibility of such resections; however, the evidence base is at best heterogeneous with a lack of...
journal_title:Digestive surgery
pub_type: 杂志文章
doi:10.1159/000485198
更新日期:2018-01-01 00:00:00
abstract:BACKGROUND:Pancreatic tuberculosis is usually unsuspected as it can present in various forms. Though an uncommon disease, once diagnosed it is potentially curable. PATIENTS AND METHODS:Retrospective review of the records of 9 patients with histologically proven tuberculosis of the pancreas. RESULTS:In none of the 9 p...
journal_title:Digestive surgery
pub_type: 杂志文章
doi:10.1159/000065832
更新日期:2002-01-01 00:00:00
abstract:BACKGROUND/AIMS:Oesophageal intubation remains one of the principal methods of palliation for an obstructing oesophageal carcinoma. We present a case which illustrates a rare but fatal complication of this procedure. METHODS:A 60-year-old female with oesophageal cancer presented with total dysphagia 9 months following...
journal_title:Digestive surgery
pub_type: 杂志文章
doi:10.1159/000018886
更新日期:2000-01-01 00:00:00
abstract:BACKGROUND/AIMS:Although the diagnostic value of fluorine-18 2-fluoro-2-deoxy-D-glucose (F-18-FDG) positron emission tomography/computed tomography (F-18-FDG-PET/CT) in patients with colorectal cancer (CRC) has been reported, the association between the F-18-FDG uptake in metastatic lymph nodes (FDGLN) and clinicopatho...
journal_title:Digestive surgery
pub_type: 杂志文章
doi:10.1159/000448222
更新日期:2017-01-01 00:00:00
abstract::Several methods for assessment of methodological quality in randomized controlled trials (RCTs) have been developed during the past few years. Factors associated with quality in laparoscopic surgery have not been defined till date. The aim of this study was to investigate the relationship between bibliometric and the ...
journal_title:Digestive surgery
pub_type: 杂志文章,评审
doi:10.1159/000381886
更新日期:2015-01-01 00:00:00
abstract:AIM:To prove further the safety of primary closure of the common bile duct. METHOD:Twenty patients among 99 common bile duct explorations underwent primary closure. Pre- and postoperative liver function test, ultrasound and intraoperative cholangiography data, operation time, postoperative complications and the length...
journal_title:Digestive surgery
pub_type: 临床试验,杂志文章
doi:10.1159/000018706
更新日期:1999-01-01 00:00:00
abstract::Hepatocellular adenomas (HCA) are rare benign tumours occurring mainly in women under oral contraceptives. HCA bleed frequently and transform rarely into hepatocellular carcinoma. Identification of genes recurrently mutated in HCA and good genotype/phenotype correlations provided the basis of a pathomolecular classifi...
journal_title:Digestive surgery
pub_type: 杂志文章
doi:10.1159/000268406
更新日期:2010-01-01 00:00:00
abstract::Ileal J-pouch-anal anastomosis is a commonly accepted surgical treatment for patients with ulcerative colitis. However, making a J-pouch anal anastomosis can be difficult due to anatomical variations of patients. We experienced an informative case of ulcerative colitis in which the ileal pouch was damaged when it was ...
journal_title:Digestive surgery
pub_type: 杂志文章
doi:10.1159/000105526
更新日期:2007-01-01 00:00:00
abstract::Tumour recurrence that obstructs the afferent limb, blocking outflow of bile and pancreatic juice, constitutes a major clinical problem after a Whipple procedure. The endoscopic route is often not a possible alternative. Surgery may be difficult and perhaps dangerous to the often very sick patient and decompression wi...
journal_title:Digestive surgery
pub_type: 杂志文章
doi:10.1159/000071760
更新日期:2003-01-01 00:00:00
abstract::Partial liver resections are the treatment of choice for patients with a malignant liver or bile duct tumor. The most frequent indications for partial liver resections are colorectal metastasis, hepatocellular carcinoma (HCC) and cholangiocarcinoma. Liver resection is the only therapy with a chance for cure in these p...
journal_title:Digestive surgery
pub_type: 杂志文章,评审
doi:10.1159/000103656
更新日期:2007-01-01 00:00:00
abstract:BACKGROUND:Since carcinoma of the esophagus is usually diagnosed at an advanced stage, many cases of esophageal cancer are beyond possible radical resection and only palliative treatment can be performed in such cases. Therefore, a great deal of discussion has taken place concerning indications for treatment modality, ...
journal_title:Digestive surgery
pub_type: 杂志文章
doi:10.1159/000018619
更新日期:1998-01-01 00:00:00
abstract:BACKGROUND/AIMS:Patients with postoperative pulmonary complications after esophagectomy often have increased mortality. The purpose of the study was to examine the efficacy of preventing postoperative pulmonary complications by an intensive preoperative respiratory rehabilitation (PR) program for esophageal cancer pati...
journal_title:Digestive surgery
pub_type: 杂志文章,随机对照试验
doi:10.1159/000434758
更新日期:2015-01-01 00:00:00
abstract:BACKGROUND:Although evidence is growing that most patients who need an operation for diverticular disease of the sigmoid colon can be treated by a single-stage procedure, a two-stage procedure will still be necessary in some patients because of significant sepsis or technical difficulties. The outcomes of 65 patients w...
journal_title:Digestive surgery
pub_type: 杂志文章
doi:10.1159/000091444
更新日期:2005-01-01 00:00:00
abstract:BACKGROUND/AIMS:Graft failure is a critical complication associated with vascular occlusion in esophageal reconstruction with a free jejunal graft following pharyngolaryngoesophagectomy. In this study, we evaluated the usefulness of intramucosal pH (pHi) measurement using a tonometer to assess the graft viability. MET...
journal_title:Digestive surgery
pub_type: 杂志文章
doi:10.1159/000102902
更新日期:2007-01-01 00:00:00
abstract:BACKGROUND:Proinflammatory cytokines like TNF-alpha and IL-8 have been thought to play a pivotal role in the propagation of severe acute pancreatitis (AP) and the development of its systemic complications, particularly acute lung injury. OBJECTIVE:To investigate the effects of pretreatment with hydrocortisone on the p...
journal_title:Digestive surgery
pub_type: 杂志文章
doi:10.1159/000018730
更新日期:1999-01-01 00:00:00
abstract::The introduction and widespread application of minimally invasive surgery has been one of the most important innovations that radically changed the practice of surgery during the last few decades. The application to pancreatic surgery of minimally invasive approach has only recently emerged: both laparoscopic distal p...
journal_title:Digestive surgery
pub_type: 杂志文章,评审
doi:10.1159/000445012
更新日期:2016-01-01 00:00:00
abstract:BACKGROUND:Chyle leaks are a rare complication following abdominal surgery. The aim of this study is to describe the management of chyle leaks following surgery for pancreatico-duodenal malignancy. METHODS:Data were collated from a consecutive series of 105 patients who had undergone a pancreatico-duodenectomy for mal...
journal_title:Digestive surgery
pub_type: 杂志文章
doi:10.1159/000108324
更新日期:2007-01-01 00:00:00
abstract:BACKGROUND:Pancreatic serous cystic tumors are considered to have a benign biological and clinical course with only few malignant cases. METHODS:We retrospectively analyzed data from 26 patients affected by serous cystic tumors consecutively observed in our Pancreas Unit. We explored the different clinical pictures in...
journal_title:Digestive surgery
pub_type: 杂志文章
doi:10.1159/000142947
更新日期:2008-01-01 00:00:00
abstract:BACKGROUND:Laparoscopic sigmoidectomy for diverticulitis has initially been confined to the elective setting. However, open acute sigmoidectomy for perforated diverticulitis is associated with high morbidity rates that might be reduced after laparoscopic surgery. The aim of this systematic review was to assess the feas...
journal_title:Digestive surgery
pub_type: 杂志文章,评审
doi:10.1159/000441150
更新日期:2016-01-01 00:00:00
abstract:INTRODUCTION:To elucidate the clinical presentation, diagnosis and management of primary hepatic carcinoid tumours, a literature search was conducted and summarized. MATERIALS AND METHODS:Published primary hepatic carcinoid tumour case reports and series were searched and selected in the Medline, EMBASE and Cochrane L...
journal_title:Digestive surgery
pub_type: 杂志文章,评审
doi:10.1159/000167021
更新日期:2008-01-01 00:00:00
abstract:AIMS:To describe the extremely rare case of an adenomyoma of the papilla of Vater. CASE REPORT:A 42-year-old woman was hospitalized for epigastralgia and high fever. The clinical presentation and endoscopic, biochemical, and radiologic findings led to the diagnostic impression of a dysfunction of the papilla of Vater....
journal_title:Digestive surgery
pub_type: 杂志文章
doi:10.1159/000050115
更新日期:2001-01-01 00:00:00
abstract:BACKGROUND:Mechanical stapling devices are widely used in all fields of surgery as they can cut and sew tissue in a quick and easy manner. However, complications like bleeding or leakage at the staple line are frequently encountered and can have devastating consequences. Recent developments have led to the introduction...
journal_title:Digestive surgery
pub_type: 杂志文章,评审
doi:10.1159/000096648
更新日期:2006-01-01 00:00:00
abstract:OBJECTIVE:Systemic and/or local interleukin-6 (IL-6) reportedly plays an active role in the progression and prognosis of thoracic esophageal squamous cell carcinoma (TESCC). We assessed the associations between IL-6 and IL-6 receptor (IL-6R) genetic polymorphisms, tumoral IL-6 expression and survival rates following su...
journal_title:Digestive surgery
pub_type: 杂志文章
doi:10.1159/000336952
更新日期:2012-01-01 00:00:00
abstract:AIM:We investigated the clinical significance of metastasis to the lymph node (LN) along the superior mesenteric vein (14v) in gastric cancer. METHODS:A retrospective study of 2,513 gastrectomy patients with a 14v dissection was done using the Ganken Igan Database. RESULTS:The incidence of 14v metastasis correlated w...
journal_title:Digestive surgery
pub_type: 杂志文章
doi:10.1159/000165382
更新日期:2008-01-01 00:00:00