Peritoneal carcinomatosis is the most frequent pattern of metastasis and recurrence in patients with gastric cancer, and the prognosis of those patients with peritoneal metastasis is extremely poor. Once peritoneal me...Peritoneal carcinomatosis is the most frequent pattern of metastasis and recurrence in patients with gastric cancer, and the prognosis of those patients with peritoneal metastasis is extremely poor. Once peritoneal metastasis is formed, it is extremely difficult to overcome. EIPL (extensive intraoperative peritoneal lavage) is a quite useful and practical adjuvant surgical technique for the gastric cancer patients who are likely to suffer from peritoneal recurrence. EIPL includes 10 times of an extensive shake and wash of abdominal cavity with saline followed by the complete aspiration of the fluid after potentially curative operation, which is supposed to have an amazing cyto-reduction power. The purpose of this article is to review the effect of EIPL on prevention of peritoneal recurrence in the patients with peritoneal free cancer cells and to evaluate its validity as a standard prophylactic strategy against peritoneal recurrence in gastric cancer.展开更多
Objective:Adhesion barriers have not traditionally been used during laparoscopic cholecystectomy(lapchole),and so there are no data confirming the safety of the dextrin hydrogel adhesion barrier(AdSpray®)for the ...Objective:Adhesion barriers have not traditionally been used during laparoscopic cholecystectomy(lapchole),and so there are no data confirming the safety of the dextrin hydrogel adhesion barrier(AdSpray®)for the use during lap-chole.The aim of this prospective study is to investigate the safety of AdSpray®for elective lap-chole.Methods:Between July 2019 and March 2021,we conducted a prospective study at Saiseikai Kumamoto Hospital to assess the safety of applying AdSpray®around the hepatoduodenal ligament,liver surface,and port area after extraction of the gallbladder during elective lap-chole.We assessed patient morbidity,mortality,and laboratory data on postoperative day 1 and at the outpatient follow-up visit.Results:A total of 100 patients(43 men,57 women)received AdSpray®application during elective lapchole at our institution.The mean patient age was 56.5±14.8 y,and the mean body mass index was 25.1±4.8 kg/m2.Preoperative gallbladder drainage was performed in 3(3.0%)patients as conservative treatment for acute cholecystitis.The mean operative time was 91.7±35.1 min,and the median blood loss was 5 mL(range,5e120 mL).Intraoperative gallbladder perforation was observed in 4.0%of patients(n=4).There was no intraoperative bile duct injury.One(1.0%)patient had a postoperative subhepatic fluid collection without bacterial infection.The mean white blood cell count and C-reactive protein level was significantly elevated on postoperative day 1 but returned to preoperative levels by the time of the follow-up visit.All patients were successfully discharged after surgery,and the median postoperative hospital stay was 2 d(range,2e9 d).Conclusion:Applying AdSpray®during elective lap-chole is safe,with an acceptable rate of postoperative complications.展开更多
文摘Peritoneal carcinomatosis is the most frequent pattern of metastasis and recurrence in patients with gastric cancer, and the prognosis of those patients with peritoneal metastasis is extremely poor. Once peritoneal metastasis is formed, it is extremely difficult to overcome. EIPL (extensive intraoperative peritoneal lavage) is a quite useful and practical adjuvant surgical technique for the gastric cancer patients who are likely to suffer from peritoneal recurrence. EIPL includes 10 times of an extensive shake and wash of abdominal cavity with saline followed by the complete aspiration of the fluid after potentially curative operation, which is supposed to have an amazing cyto-reduction power. The purpose of this article is to review the effect of EIPL on prevention of peritoneal recurrence in the patients with peritoneal free cancer cells and to evaluate its validity as a standard prophylactic strategy against peritoneal recurrence in gastric cancer.
文摘Objective:Adhesion barriers have not traditionally been used during laparoscopic cholecystectomy(lapchole),and so there are no data confirming the safety of the dextrin hydrogel adhesion barrier(AdSpray®)for the use during lap-chole.The aim of this prospective study is to investigate the safety of AdSpray®for elective lap-chole.Methods:Between July 2019 and March 2021,we conducted a prospective study at Saiseikai Kumamoto Hospital to assess the safety of applying AdSpray®around the hepatoduodenal ligament,liver surface,and port area after extraction of the gallbladder during elective lap-chole.We assessed patient morbidity,mortality,and laboratory data on postoperative day 1 and at the outpatient follow-up visit.Results:A total of 100 patients(43 men,57 women)received AdSpray®application during elective lapchole at our institution.The mean patient age was 56.5±14.8 y,and the mean body mass index was 25.1±4.8 kg/m2.Preoperative gallbladder drainage was performed in 3(3.0%)patients as conservative treatment for acute cholecystitis.The mean operative time was 91.7±35.1 min,and the median blood loss was 5 mL(range,5e120 mL).Intraoperative gallbladder perforation was observed in 4.0%of patients(n=4).There was no intraoperative bile duct injury.One(1.0%)patient had a postoperative subhepatic fluid collection without bacterial infection.The mean white blood cell count and C-reactive protein level was significantly elevated on postoperative day 1 but returned to preoperative levels by the time of the follow-up visit.All patients were successfully discharged after surgery,and the median postoperative hospital stay was 2 d(range,2e9 d).Conclusion:Applying AdSpray®during elective lap-chole is safe,with an acceptable rate of postoperative complications.
