AIM： TO re-evaluate the recent clinicopathological fea- tures of remnant gastric cancer （RGC） and to develop desirable surveillance programs.METHODS： Between 1997 and 2008, 1149 patients underwent gastrectomy for ...AIM： TO re-evaluate the recent clinicopathological fea- tures of remnant gastric cancer （RGC） and to develop desirable surveillance programs.METHODS： Between 1997 and 2008, 1149 patients underwent gastrectomy for gastric cancer at the Department of Digestive Surgery, Kyoto Prefectural Uni- versity of Medicine, Japan. Of these, 33 patients un- derwent gastrectomy with lymphadenectomy for RGC. Regarding the initial gastric disease, there were 19 patients with benign disease and 14 patients with gas- tric cancer. The hospital records of these patients were reviewed retrospectively. RESULTS： Concerning the initial gastric disease, the RGC group following gastric cancer had a shorter in- terval [P 〈 0.05; gastric cancer vs benign disease： 12 （2-22） vs 30 （4-51） years] and were more frequently reconstructed by Billroth- I procedure than those fol- lowing benign lesions （P 〈 0.001）. Regarding recon- struction, RGC following Billroth-]_l reconstruction showed a longer interval between surgical procedures [P 〈 0.001; Billroth-11 vs Billroth- I ： 32 （5-51） vs 12 （2-36） years] and tumors were more frequently associated with benign disease （P 〈 0.001） than those following Billroth- I reconstruction. In tumor location of RGC, after Billroth- I reconstruction, RGC occurred more fre- quently near the suture line and remnant gastric wall. After Billroth- 1I reconstruction, RGC occurred more fre- quently at the anastomotic site. The duration of follow- up was significantly associated with the stage of RGC （P 〈 0.05）. Patients diagnosed with early stage RGC such as stage Ⅰ-Ⅱ tended to have been followed up almost every second year. CONCLUSION： Meticulous follow-up examination and early detection of RGC might lead to a better prognosis. Based on the initial gastric disease and the procedure of reconstruction, an appropriate follow-up interval and programs might enable early detection of RGC.展开更多
Objective To investigate the changes of hipbone biomechanics after the resection of ischiopubic tumors and their relationships with the complications in the convalescent stage, and directing the postoperative pelvic r...Objective To investigate the changes of hipbone biomechanics after the resection of ischiopubic tumors and their relationships with the complications in the convalescent stage, and directing the postoperative pelvic reconstruction. Methods DICOM data were used to create an intact hipbone finite element model and postoperative model. The biomechanical indices on the same region in the two models under the same boundary condition were compared. The differences of displacement, stress, and strain of the two models were analyzed with statistical methods. Results The distribution areas of the hipbone nodes' displacement, stress, and strain were similar before and after the simulated operation. The sacroiliac joint nodes' displacement (P=0.040) and strain (P=0.000), and the acetabular roof nodes' stress (P=0.000) and strain (P=0.005) of two models had significant differences, respectively. But the sacroiliac joint nodes' stress (P=0.076) and the greater sciatic notch nodes' stress (P=0.825) and strain (P=0.506) did not have significant differences. Conclusions The resection of ischiopubic tumors mainly affect the biomechanical states of the homolateral sacroiliac joint and acetabular roof. The complications in the convalescent stage are due to the biomechanical changes of the sacroiliac joint and the acetabular roof and disappearances of the stabilization and connection functions of the pubic symphysis and superior ramus of pubis.展开更多
文摘AIM： TO re-evaluate the recent clinicopathological fea- tures of remnant gastric cancer （RGC） and to develop desirable surveillance programs.METHODS： Between 1997 and 2008, 1149 patients underwent gastrectomy for gastric cancer at the Department of Digestive Surgery, Kyoto Prefectural Uni- versity of Medicine, Japan. Of these, 33 patients un- derwent gastrectomy with lymphadenectomy for RGC. Regarding the initial gastric disease, there were 19 patients with benign disease and 14 patients with gas- tric cancer. The hospital records of these patients were reviewed retrospectively. RESULTS： Concerning the initial gastric disease, the RGC group following gastric cancer had a shorter in- terval [P 〈 0.05; gastric cancer vs benign disease： 12 （2-22） vs 30 （4-51） years] and were more frequently reconstructed by Billroth- I procedure than those fol- lowing benign lesions （P 〈 0.001）. Regarding recon- struction, RGC following Billroth-]_l reconstruction showed a longer interval between surgical procedures [P 〈 0.001; Billroth-11 vs Billroth- I ： 32 （5-51） vs 12 （2-36） years] and tumors were more frequently associated with benign disease （P 〈 0.001） than those following Billroth- I reconstruction. In tumor location of RGC, after Billroth- I reconstruction, RGC occurred more fre- quently near the suture line and remnant gastric wall. After Billroth- 1I reconstruction, RGC occurred more fre- quently at the anastomotic site. The duration of follow- up was significantly associated with the stage of RGC （P 〈 0.05）. Patients diagnosed with early stage RGC such as stage Ⅰ-Ⅱ tended to have been followed up almost every second year. CONCLUSION： Meticulous follow-up examination and early detection of RGC might lead to a better prognosis. Based on the initial gastric disease and the procedure of reconstruction, an appropriate follow-up interval and programs might enable early detection of RGC.
基金Supported by Medical Scientific Research Foundation Item of Guangdong Province(A2008800)Science and Technology ProgramItem of Zhongshan City(20082A071and20113A049)
文摘Objective To investigate the changes of hipbone biomechanics after the resection of ischiopubic tumors and their relationships with the complications in the convalescent stage, and directing the postoperative pelvic reconstruction. Methods DICOM data were used to create an intact hipbone finite element model and postoperative model. The biomechanical indices on the same region in the two models under the same boundary condition were compared. The differences of displacement, stress, and strain of the two models were analyzed with statistical methods. Results The distribution areas of the hipbone nodes' displacement, stress, and strain were similar before and after the simulated operation. The sacroiliac joint nodes' displacement (P=0.040) and strain (P=0.000), and the acetabular roof nodes' stress (P=0.000) and strain (P=0.005) of two models had significant differences, respectively. But the sacroiliac joint nodes' stress (P=0.076) and the greater sciatic notch nodes' stress (P=0.825) and strain (P=0.506) did not have significant differences. Conclusions The resection of ischiopubic tumors mainly affect the biomechanical states of the homolateral sacroiliac joint and acetabular roof. The complications in the convalescent stage are due to the biomechanical changes of the sacroiliac joint and the acetabular roof and disappearances of the stabilization and connection functions of the pubic symphysis and superior ramus of pubis.
