BACKGROUND Previously,some studies have proposed that total laparoscopic gastrectomy(TLG)is superior to laparoscopic-assisted gastrectomy(LAG)in terms of safety and feasibility based on the related intraoperative oper...BACKGROUND Previously,some studies have proposed that total laparoscopic gastrectomy(TLG)is superior to laparoscopic-assisted gastrectomy(LAG)in terms of safety and feasibility based on the related intraoperative operative parameters and incidence of postoperative complications.However,there are still few studies on the changes in postoperative liver function in patients undergoing LG.The present study compared the postoperative liver function of patients with TLG and LAG,aiming to explore whether there is a difference in the influence of TLG and LAG on the liver function of patients.AIM To investigate whether there is a difference in the influence of TLG and LAG on the liver function of patients.METHODS The present study collected 80 patients who underwent LG from 2020 to 2021 at the Digestive Center(including the Department of Gastrointestinal Surgery and the Department of General Surgery)of Zhongshan Hospital affiliated with Xiamen University,including 40 patients who underwent TLG and 40 patients who underwent LAG.Alanine aminotransferase(ALT),aspartate aminotransferase(AST),alkaline phosphatase(ALP),γ-glutamyltransferase(GGLT),total bilirubin(TBIL),direct bilirubin(DBIL)and indirect bilirubin(IBIL),and other liver function-related test indices were compared between the 2 groups before surgery and on the 1^(st),3^(rd),and 5^(th) d after surgery.RESULTS The levels of ALT and AST in the 2 groups were significantly increased on the 1st to 2nd postoperative days compared with those before the operation.The levels of ALT and AST in the TLG group were within the normal range,while the levels of ALT and AST in the LAG group were twice as high as those in the TLG group(P<0.05).The levels of ALT and AST in the 2 groups showed a downward trend at 3-4 d and 5-7 d after the operation and gradually decreased to the normal range(P<0.05).The GGLT level in the LAG group was higher than that in the TLG group on postoperative days 1-2,the ALP level in the TLG group was higher than that in the LAG group on postoperative days 3-4,and the TBIL,DBIL and IBIL levels in the TLG group were higher than those in the LAG group on postoperative days 5-7(P<0.05).No significant difference was observed at other time points(P>0.05).CONCLUSION Both TLG and LAG can affect liver function,but the effect of LAG is more serious.The influence of both surgical approaches on liver function is transient and reversible.Although TLG is more difficult to perform,it may be a better choice for patients with gastric cancer combined with liver insufficiency.展开更多
BACKGROUND Cutaneous metastasis is a rare event associated with poor prognosis for gastric cancer and has been rarely reported in the literature.CASE SUMMARY A 69-year-old male patient who had undergone salvage gastre...BACKGROUND Cutaneous metastasis is a rare event associated with poor prognosis for gastric cancer and has been rarely reported in the literature.CASE SUMMARY A 69-year-old male patient who had undergone salvage gastrectomy and a few courses of adjuvant chemotherapy 3 mo earlier for recurrent gastric cancer developed widespread cutaneous metastases.Due to the patient’s intolerance to further adjuvant chemotherapy,he was placed in hospice care and expired 1 mo later.In the literature,gastric cancers are rarely reported as the primary malignancies for cutaneous metastasis.We,thus,provide an update on a case review published in 2014 by reviewing 10 more case reports dated from 2014 to 2020.The average age for the new group of patients was 59.4±18.88-years-old.Thirty percent of the patients presented with cutaneous lesions and advanced gastric cancer synchronously while 70%developed cutaneous metastases 1.3 years to 14 years after the initial treatment for primary gastric cancer.Eighty percent of the patients received either local excision or chemo±radiation therapy to treat their cutaneous metastases.CONCLUSION This report highlights cutaneous metastasis as a late and untreatable metastasis of gastric cancer.展开更多
Umbilical cord(UC)embolism is a rare,life-threatening complication of pregnancy.The exact cause of this condition is not yet known.Women with more than one UC abnormality are at risk of UC obstruction;this condition c...Umbilical cord(UC)embolism is a rare,life-threatening complication of pregnancy.The exact cause of this condition is not yet known.Women with more than one UC abnormality are at risk of UC obstruction;this condition can lead to stasis,ischemia,and in some cases,thrombosis.However,many women with UC abnormalities remain undetected and may not be recognized until after birth.Here,we present a case involving the prenatal diagnosis and successful treatment of umbilical artery embolism in the third trimester with good maternal and fetal outcomes.The risk of UC embolism increases when more than one UC abnormality is identified in a single case.Ultrasound examination in the third trimester of pregnancy should be able to verify the existence of two arteries and one vein in the UC.If necessary,these results can be compared with ultrasound imaging acquired during the first trimester of pregnancy.展开更多
基金The study was reviewed and approved by the Institutional review board of Zhongshan Hospital Xiamen University(approval No.2022-257).
文摘BACKGROUND Previously,some studies have proposed that total laparoscopic gastrectomy(TLG)is superior to laparoscopic-assisted gastrectomy(LAG)in terms of safety and feasibility based on the related intraoperative operative parameters and incidence of postoperative complications.However,there are still few studies on the changes in postoperative liver function in patients undergoing LG.The present study compared the postoperative liver function of patients with TLG and LAG,aiming to explore whether there is a difference in the influence of TLG and LAG on the liver function of patients.AIM To investigate whether there is a difference in the influence of TLG and LAG on the liver function of patients.METHODS The present study collected 80 patients who underwent LG from 2020 to 2021 at the Digestive Center(including the Department of Gastrointestinal Surgery and the Department of General Surgery)of Zhongshan Hospital affiliated with Xiamen University,including 40 patients who underwent TLG and 40 patients who underwent LAG.Alanine aminotransferase(ALT),aspartate aminotransferase(AST),alkaline phosphatase(ALP),γ-glutamyltransferase(GGLT),total bilirubin(TBIL),direct bilirubin(DBIL)and indirect bilirubin(IBIL),and other liver function-related test indices were compared between the 2 groups before surgery and on the 1^(st),3^(rd),and 5^(th) d after surgery.RESULTS The levels of ALT and AST in the 2 groups were significantly increased on the 1st to 2nd postoperative days compared with those before the operation.The levels of ALT and AST in the TLG group were within the normal range,while the levels of ALT and AST in the LAG group were twice as high as those in the TLG group(P<0.05).The levels of ALT and AST in the 2 groups showed a downward trend at 3-4 d and 5-7 d after the operation and gradually decreased to the normal range(P<0.05).The GGLT level in the LAG group was higher than that in the TLG group on postoperative days 1-2,the ALP level in the TLG group was higher than that in the LAG group on postoperative days 3-4,and the TBIL,DBIL and IBIL levels in the TLG group were higher than those in the LAG group on postoperative days 5-7(P<0.05).No significant difference was observed at other time points(P>0.05).CONCLUSION Both TLG and LAG can affect liver function,but the effect of LAG is more serious.The influence of both surgical approaches on liver function is transient and reversible.Although TLG is more difficult to perform,it may be a better choice for patients with gastric cancer combined with liver insufficiency.
文摘BACKGROUND Cutaneous metastasis is a rare event associated with poor prognosis for gastric cancer and has been rarely reported in the literature.CASE SUMMARY A 69-year-old male patient who had undergone salvage gastrectomy and a few courses of adjuvant chemotherapy 3 mo earlier for recurrent gastric cancer developed widespread cutaneous metastases.Due to the patient’s intolerance to further adjuvant chemotherapy,he was placed in hospice care and expired 1 mo later.In the literature,gastric cancers are rarely reported as the primary malignancies for cutaneous metastasis.We,thus,provide an update on a case review published in 2014 by reviewing 10 more case reports dated from 2014 to 2020.The average age for the new group of patients was 59.4±18.88-years-old.Thirty percent of the patients presented with cutaneous lesions and advanced gastric cancer synchronously while 70%developed cutaneous metastases 1.3 years to 14 years after the initial treatment for primary gastric cancer.Eighty percent of the patients received either local excision or chemo±radiation therapy to treat their cutaneous metastases.CONCLUSION This report highlights cutaneous metastasis as a late and untreatable metastasis of gastric cancer.
基金This study was funded by the National Health and Family Planning Commission Science Foundation(2019-WJ-04)the Guide Fund for the Development of Local Science and Technology from the Central Government(2020L3019).
文摘Umbilical cord(UC)embolism is a rare,life-threatening complication of pregnancy.The exact cause of this condition is not yet known.Women with more than one UC abnormality are at risk of UC obstruction;this condition can lead to stasis,ischemia,and in some cases,thrombosis.However,many women with UC abnormalities remain undetected and may not be recognized until after birth.Here,we present a case involving the prenatal diagnosis and successful treatment of umbilical artery embolism in the third trimester with good maternal and fetal outcomes.The risk of UC embolism increases when more than one UC abnormality is identified in a single case.Ultrasound examination in the third trimester of pregnancy should be able to verify the existence of two arteries and one vein in the UC.If necessary,these results can be compared with ultrasound imaging acquired during the first trimester of pregnancy.
