ObjectiveTo investigate the feasibility of hand-assisted laparoscopic surgery in radical gastrectomy for gastric cancer. MethodsThe data of two cases undergoing hand-assisted laparoscopic radical gastrectomy for gastric cancer, including operative time, operation related complications, intraoperative bleeding volumes, number of harvested lymph nodes, postoperative complications, time to restoration of bowel function, and length of postoperative hospital stay, etc, were retrospectively analyzed. ResultsTwo patients had undergone the successful hand-assisted laparoscopic radical total gastrectomy and distal gastrectomy without operation related complications. The operative time was 310 min and 220 min, respectively. While, the intraoperative bleeding volume was 120 ml and 80 ml with the number of harvested lymph node being 38 and 52, respectively. There were no postoperative bleeding, intestinal fistula, and anastomotic leakage， etc. The patients were discharged with smooth and fully recovery. ConclusionThe application of hand-assisted laparoscopic surgery in radical gastrectomy for gastric cancer is feasible and safe. However, the effectiveness needs further exploring.
Objective To investigate the feasibility and safety of laparoscopic-assisted gastrectomy for distant gastric cancer. Methods All 18 patients with distant gastric cancer receiving laparoscopic-assisted gastrectomy were analyzed. Results Laparoscopic-assisted distal gastrectomy was performed successfully in all patients. The mean operation time was (291.33±19.61) min. The mean blood loss was (151.32±71.78) ml. The mean numbers of harvested lymph node were 14.57±3.11. The mean time of gastrointestinal function recovery was (3.46±0.93) d, the mean out of bed activity time was (1.75±0.45) d. All patients were followed up for 1-24 months, mean 11 months. No local recurrence, trocar implant or distant metastasis happened. Conclusion Laparoscopic-assisted gastrectomy is a feasible and safe surgical procedure combined with minimal trauma and fast recovery.
ObjectiveTo develop altering intake managing symptoms (AIMS) dietary intervention and evaluate its effects on nutritional status and dietary compliance for patients after gastrectomy.MethodsFrom April 2017 to July 2018, 176 patients underwent the gastrectomy in the Xijing Hospital of Air Force Military Medical University were selected, then were divided into an AIMS group and a control group by the Excel 2007 random function method. The AIMS group was intervened by the AIMS dietary intervention, the control group was given the routine diet management. The body mass, body mass index (BMI), albumin, and dietary intake at the admission, on the 2nd week and the 3rd month after the discharge were compared between the two groups. The nutritional status of the two groups was assessed by the PG-SGA scale. The diet-related symptoms and dietary compliance of the two groups were assessed by the dietary related symptoms scale and the dietary compliance scale.ResultsA total of 176 eligible patients were enrolled in this study, including 92 patients in the AIMS group and 84 patients in the control group. There were no significant differences in the baseline data such as the gender, age, educational level, occupation, disease type, surgical method, tumor TNM stage, and pathological differentiated type between the two groups (P>0.050). There were no significant differences in the body mass, BMI, and albumin between the AIMS group and the control group before and after the dietary intervention (P>0.050). The PG-SGA score, diet-related symptom score, and dietary compliance score had significant differences between on the 2nd week or the 3rd month after the discharge and at the admission in the AIMS group and the control group (P<0.050), which had significant differences on the 2nd week or the 3rd month after the discharge between the AIMS group and the control group (P<0.001). The dietary intake of the AIMS group was significantly higher than that of the control group on the 3rd month after the discharge (P<0.001). The complications incidences of total diet-related symptoms was 5.5% (5/91) and 14.6% (12/82) in the AIMS group and the control group, respectively, the difference was statistically significant (P=0.047).ConclusionUsing AIMS dietary intervention for patients after radical gastrectomy can significantly improve their overall nutritional status and improve dietary compliance.
ObjectiveTo investigate the research progress of assisted techniques for lymph node dissection in gastric cancer. Method The literatures on the applications of assisted techniques of lymph node dissection in the gastric cancer radical gastrectomy in recent years were reviewed. ResultsAt present, the assisted techniques used for lymph node dissection in the radical gastrectomy mainly included the lymphatic tracing technology and laparoscopic and robotic surgeries. The lymphatic tracing technology mainly included the use of dye tracers, indocyanine green, gamma probe, intraoperative radiation technology, etc. Among which gamma probe and intraoperative radiation technology were expensive and not suitable for clinical application, and intraoperative radiation technology had a radiation risk, so it was rarely used currently. At present, the dye tracers and indocyanine green were mainly used in the clinical lymph node tracing, both of which could improve the detection rate and increase the number of lymph node dissection, and improve the prognosis of patients. The laparoscopic radical gastrectomy was not inferior to traditional radical gastrectomy in terms of lymph node dissection, and had been more widely used in the clinical practice due to its advantages of visualization, minimally invasive, quickly postoperative recovery, and good short-term efficacy. Compared with the conventional laparoscopic system, the robotic surgical system was more precise, dexterous, stable, and had a better feedback feeling, which was more conducive to the lymph node dissection of special location. ConclusionUse of lymphatic tracers, laparoscopy and robotics could increase lymph node detection rate and improve prognosis of patients.