SEARCH · Search PubMed

Results for “Gastrectomy”

Search indexed PubMed citations on genomics, clinical trials, systematic reviews and public health. Explore titles, authors and supplied subject terms, then open the PubMed record.

SourceResearch connectionFrom yearThrough year

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 775 records · Page 43Linked to original sources

PubMed2000

[Complication rate after gastrectomy and pouch reconstruction with Longmire interposition].

BACKGROUND/AIMS: To determine whether a Longmire-Interposition with or without a pouch used for reconstruction after gastrectomy influences the postoperative complication rate. METHODOLOGY: 49 patients who underwent gastrectomy with Longmire-Interposition with (n = 33) or without (n = 16) an additional pouch and 46 patients with a Roux-en-Y-reconstruction were analysed retrospectively. Complication rate and mortality were studied. RESULTS: There were no significant differences between the reconstruction groups for postoperative complications (Roux-en-Y vs. Longmire-Interposition with and without pouch: 30.4% vs. 28.6% for the morbidity; 4.3% vs. 4.1% for the mortality). CONCLUSION: These findings suggest that a Longmire-Interposition with or without a pouch for reconstruction after total gastrectomy is not connected with a higher morbidity or mortality in comparison to a Roux-en-Y-reconstruction.

Adult↗

PubMed1984

Effects of gastrectomy on insulin secretion in rats.

To examine the relative importance of the stomach for the enteroinsular axis, the portal insulin secretion was measured in the rats with gastrectomy, after intraduodenal (I.D.) infusion of 0.5 g/kg glucose and after intravenous (I.V.) infusion of the same deal of glucose, respectively. Portal plasma gastrin was decreased from 100 pg/ml to 5 pg/ml by gastrectomy. Blood sugar level after I.D. and I.V. infusion of glucose in the rats with gastrectomy was similar to controls. Insulin release to I.D. infusion of glucose was slightly lower at 30 minutes in the gastrectomized rats compared with controls, while insulin secretion to I.V. infusion of glucose was similar to controls. These results suggest that endogenous gastrin has no insulinotropic effect and that the stomach has no direct effect on glucose-induced insulin release.

Animals↗

PubMed2006

Time-related improvement of survival in resectable gastric cancer: the role of Japanese-style gastrectomy with D2 lymphadenectomy and adjuvant chemotherapy.

BACKGROUND: We investigated the change of prognosis in resected gastric cancer (RGC) patients and the role of radical surgery and adjuvant chemotherapy. METHODS: We retrospectively analyze the outcome of 426 consecutive patients from 1975 to 2002, divided into 2 time-periods (TP) cohort: Before 1990 (TP1, n = 207) and 1990 or after (TP2; n= 219). Partial gastrectomy and D1-lymphadenectomy was predominant in TP1 and total gastrectomy with D2-lymphadenectomy it was in TP2. Adjuvant chemotherapy consisted of mitomycin C (MMC), 10-20 mg/m2 i.v. 4 courses or MMC plus Tegafur 500 mg/m2 for 6 months. RESULTS: Positive nodes were similar in TP2/TP1 patients with 56%/59% respectively. Total gastrectomy was done in 56%/45% of TP2/TP1 respectively. Two-drug adjuvant chemotherapy was administered in 65%/18% of TP2/TP1 respectively. Survival at 5 years was 66% for TP2 versus 42% for TP1 patients (p < 0.0001). Survival by stages II, IIIA and IIIB for TP2 versus TP1 patients was 70 vs. 51% (p = 0.0132); 57 vs. 22% (p = 0.0008) and 30 vs. 15% (p = 0.2315) respectively. Multivariate analysis showed that age, stage of disease and period of treatment were independent variables. CONCLUSION: The global prognosis and that of some stages have improved in recent years with case RGC patients treated with surgery and adjuvant chemotherapy.

Journal Article↗

PubMed1991

Biliopancreatic Diversion with Gastrectomy as Surgical Treatment of Morbid Obesity.

The best procedure for the treatment of morbid obesity has not yet been defined. Biliopancreatic diversion is one of the techniques available, but its results have not been sufficiently documented and the addition of a subtotal gastrectomy to the diversion so as to avoid leaving a blind non-functioning stomach, is still questionable. The purpose of this paper is to report our experience with our first 149 consecutive patients who were treated by biliopancreatic diversion with subtotal gastrectomy for morbid obesity. Operative mortality was 3% and morbidity 12%. The weight loss was marked during the first 6 months and decreased during the following 12 months. The weight stabilized at 2 years and there was subsequently a small increase. In only two out of 48 cases was the weight loss less than 25% of the initial weight at 2 years. The undesirable side-effects were diarrhea in 6%, vomiting in 9% and dyspepsia in 4%. The intervention leads to a malabsorption of carotene, iron, albumin and calcium. Except for carotene the deficiencies were corrected by oral supplement. In two patients, with resistant deficiencies, the diversion was reversed. Eighty-eight percent of the patients are satisfied with this intervention. At 2 years, 70% have reached their weight loss objective without any major side-effects or nutritional deficiencies, but in 14% the outcome of the procedure must be considered unsatisfactory. Biliopancreatic diversion with subtotal gastrectomy is a major operation, but it gives encouraging results so far.

Journal Article↗

PubMed1999

Gastroduodenal ulcer treated by pylorus and pyloric vagus-preserving gastrectomy.

AIM:To evaluate the curative effect of pylorus and pyloric vagus-preserving gastrectomy (PPVPG) on peptic ulcer.METHODS:Treating 132 cases of GU and DU with PPVPG, and comparative studies made with 24 cases treated with Billroth II (B II ) and 20 cases with Billroth I(BI); advantages and shortcomings evaluated.RESULTS:Not a single death after PPVPG. No recurrence of the disorder in the subsequent follow-up for an average of 6.5 years. Curative effect (visik II & I) 97.7%. Acidity reduction similar to that found in B II and BI, but 97.7% of the B II and all BIcases having more than second degree intestinal fluid reflux, in contrast to 7.1% in PPVPG cases. Dumping syndrome occurred in the B II and BI cases, none in PPVPG cases. With regard to gastric emptying, food digestion, absorption, body weight and life quality, PPVPG proved to be superior to Billroth procedure.CONCLUSION:PPVPG has the advantages of conventional Billroth gastrectomy in reducing acid, removing ulcer focus, and at the same time preserves the pylorus and pyloric vagus for maintaining the normal gastric physiological function.Dumping syndrome,intestinal fluid reflux and other complications of conventional gastrectomy may be avoided.

Journal Article↗

PubMed1976

[Main clinical syndromes after gastrectomy for cancer].

The immediate and late results of 219 gastrectomies performed for cancer were analysed. The postoperative mortality was 13.2%, the survival over 5 years--23.7% to the number of operated patients, and 34.7% to the number of those followed up. A functional estimation of the sequelae of 169 gastrectomies, performed by different technics, enabled the authors to reveal pathological changes on the part of the liver, gallbladder, esophagus, pancreas and intestine. The clinical picture of some major pathological syndromes after gastrectomy for cancer of the stomach are described. A certain dependence between the type of surgical intervention and the character of postgastrectomy disorders was noted.

Adult↗

PubMedDate not supplied

Second malignancies after a gastrectomy for gastric cancers: the effects of adjuvant therapies.

Second malignancy after gastrectomy has become one of the important issues in the management of gastric cancer patients. However, the effect of adjuvant therapies has never been surveyed, although there have been many reports on second malignancy after chemotherapy of other malignancies. Between 1979 and 1995, 574 patients with gastric cancer underwent gastrectomies in our department. 563 patients (98.1%) were completely followed-up, and the incidence of second malignancy after gastrectomy was assessed with special emphasis on the effect of adjuvant therapies, namely benefits versus carcinogenesis. The overall postsurgical survival rate was 62.5%, and the survival rate of patients with stage 2-4 cancer was significantly higher in the adjuvant therapy groups than in the surgery alone group. The overall incidence rate of a second malignancy was 3.20% (18/563), including 4 colorectal, 3 liver, 3 head and neck, and 8 other malignancies, and 3.90% (9/231) for the surgery alone group, 1.94% (3/155) for the chemotherapy group, 3.68% (6/163) for the chemoimmunotherapy group, and 0% (0/14) for the immunotherapy alone group. There were no statistical differences in the incidence rates between these 4 groups. The mean duration until the occurrence of second malignancy was 5.1 years for the surgery alone group, 8.6 years for the adjuvant therapy group (9.3 years for chemotherapy and 8.1 years for chemoimmunotherapy; p < 0.1, surgery alone vs. adjuvant therapy). The overall mean actuarial risk of developing a second malignancy was 6% at 5 years and 18% at 10 years. Multivariate analysis demonstrated that chemotherapy decreased the risk of death due to gastric cancer (risk ratio = 0.67, p = 0.017) and the risk of a second malignancy (risk ratio = 0.52, p = 0.261). Oral fluoropyrimidines were found to be particularly effective at decreasing the risk of death due to gastric cancer (risk ratio = 0.66, p = 0.012) and a second malignancy (risk ratio = 0.38, p = 0.136). However, intravenous chemotherapy was demonstrated to have no influence on survival (risk ratio = 0.93, p = 0.692) or a second malignancy (risk ratio = 0.58, p = 0.500). There was no evidence of an increased risk for a second malignancy following adjuvant chemotherapy. Adjuvant chemotherapy with oral fluoropyrimidines was suggested to contribute to the improved survival of patients with stage 2-4 gastric cancer, and to have a decreased the risk of a second malignancy.

Adult↗

PubMedDate not supplied

Indications for pylorus-preserving gastrectomy for gastric cancer based on lymph node metastasis.

BACKGROUND/AIMS: It is necessary to study the relation between lymph node metastasis in the suprapyloric or lesser curvature regions and clinicopathologic findings in order to determine the indications for pylorus-preserving gastrectomy. METHODOLOGY: We reviewed all pertinent data from the cases of 109 patients with gastric cancer located mainly in the middle third of the stomach focusing particularly on status of lymph node metastasis and clinicopathologic findings. All patients had been treated by conventional gastrectomy with regional lymph node dissection (D2 or D3). RESULTS: Lymph node metastases were found in the lesser curvature or suprapyloric regions in 18 patients. Primary tumors were located in the lesser curvature side in 15 of these 18 patients and in the greater curvature side in only 3. Primary tumors in the greater curvature side with involvement in the lesser curvature or suprapyloric lymph nodes were greater than 4.0 cm in diameter, whereas primary tumors in the lesser curvature side with such metastasis were greater than 1.3 cm. CONCLUSIONS: Indications for pylorus-preserving gastrectomy with preserving of the pyloric branch of the vagal nerve perhaps can be expanded to middle stomach cancer located in the greater curvature side that is less than 4.0 cm in diameter.

Adenocarcinoma↗

PubMed2004

Ileocecal interpositional graft for gastric replacement after total gastrectomy.

PURPOSE: The aim of this study is to evaluate the technique of ileocecal segment interpositional graft after total gastrectomy for gastric cancer with assessment of its advantages and disadvantages. PATIENTS AND METHODS: This is a prospective study carried out at the National Cancer Institute, Cairo University. Twenty four patients with gastric carcinoma were identified from December 1998 to February 2003. All of them were submitted to surgery after preoperative clinical, radiological and endoscopic diagnosis. Total gastrectomy with ileocecal interpositional graft were done (19 subdiaphragmatic reconstruction and 5 intrathoracic reconstruction). Patients were followed up for at least 12 months for postoperative morbidity, body weight, reflux and dumping symptoms. Gastrografin swallow, barium swallow, upper GIT endoscopy were routinely done in all patients and pouch emptying time by Tc-99m sulpher colloid was done in 11 patients only. RESULTS: Perioperative mortality was 8.3% (2/24). No patient reported reflux symptoms or showed endoscopic findings of reflux esophagitis in the subdiaphragmatic reconstruction group and mild reflux was noted in only one patient in the intrathoracic reconstruction group. No patient reported dumping symptoms. Emptying time showed good capacity as a reservoir of food. Postoperative decrease in body weight averaged less than 10% of preoperative weight. CONCLUSIONS: Ileocecal interposition graft after total gastrectomy has the advantages of preventing reflux esophagitis and providing functional replacement of the stomach as a reservoir for ingested food. It can be done with acceptable morbidity and mortality. It is simpler than some of the pouch reconstructions and deserves more attention.

Journal Article↗

PubMed1987

[Dietary treatment following gastrectomy].

A number of nutritional complications occur after total gastrectomy, such as protein malnutrition, dumping syndrome, diarrhoea, weight loss, iron deficiency and osteomalacia. Lack of appetite, absence of the sensation of hunger, oesophagitis, dysphagia and the limited capacity for food in most cases are the causes of suboptimal dietary intake after total gastrectomy. To avoid underweight and symptoms after gastrectomy it is necessary that all patients are seen soon after operation and at regular intervals thereafter not only by physicians but by dietitians additionally.

Deficiency Diseases↗

PubMedDate not supplied

A new approach for the surgical treatment of late post-total gastrectomy syndromes.

The value of a new reconstructive procedure after total gastrectomy is assessed in 79 patients who underwent this operation between 1964 and 1979. The results obtained in terms of mortality and of early and late morbidity have been most satisfactory. The new method offers to the patient an elimination of his post-total gastrectomy symptoms, a sense of well-being, a satisfactory nutritional status and a potentially reasonable working capacity, without added risk of mortality or morbidity. Postoperative studies are presented which demonstrate that the reservoir created does not dilate but retains active peristalsis and controls emptying time in a nearly normal manner. A hypothesis is put forward to explain this. Thus from the results of this paper it may well be recommended in dealing with patients who are submitted to total gastrectomy.

Adult↗

PubMed1981

[Radionuclide methods in evaluating the sequelae of gastrectomy for cancer].

The fat, protein and B12 absorption by the liver, kidney and small intestine was studied by radionuclide methods in gastric cancer patients during the preoperative period as well as within 15-30 days, 3-12 months and for more than a year following gastrectomy. It was observed that the function of the kidney, liver and B12 absorption was disturbed during the preoperative period. Gastrectomy caused a marked depression of the renal, hepatic and small intestinal function. During later periods following gastrectomy, these functions improved but were not restored to normal.

Follow-Up Studies↗

PubMed1962

The case for total gastrectomy in multiple polyposis of the stomach.

There is a considerable risk that a patient with multiple polyposis of the stomach will develop carcinoma of the stomach and this risk is greater than that of total gastrectomy when performed for benign conditions. Total gastrectomy is therefore sound treatment for this disease, regardless of the distribution of the lesions over the gastric mucosa, and a patient successfully treated in this way is reported. Reference is also made to a patient who died untreated and was found to have both multiple polyposis and gastric carcinoma.

Carcinoma↗

PubMed2025

Transcriptome atlases of rat brain regions and their adaptation to diabetes resolution following gastrectomy in the Goto-Kakizaki rat.

Brain regions drive multiple physiological functions through specific gene expression patterns that adapt to environmental influences, drug treatments and disease conditions. To generate a detailed atlas of the brain transcriptome in the context of diabetes, we carried out RNA sequencing in hypothalamus, hippocampus, brainstem and striatum of the Goto-Kakizaki (GK) rat model of spontaneous type 2 diabetes, which was applied to identify gene transcription adaptation to improved glycemic control following vertical sleeve gastrectomy (VSG) in the GK. Over 19,000 distinct transcripts were detected in the rat brain, including 2794 which were consistently expressed in the four brain regions. Region-specific gene expression was identified in hypothalamus (n = 477), hippocampus (n = 468), brainstem (n = 1173) and striatum (n = 791), resulting in differential regulation of biological processes between regions. Differentially expressed genes between VSG and sham operated rats were only found in the hypothalamus and were predominantly involved in the regulation of endothelium and extracellular matrix. These results provide a detailed atlas of regional gene expression in the diabetic rat brain and suggest that the long term effects of gastrectomy-promoted diabetes remission involve functional changes in the hypothalamus endothelium.

Animals↗

PubMed1998

Feasibility of pylorus-preserving gastrectomy with a wider scope of lymphadenectomy.

OBJECTIVE: To demonstrate the feasibility and safety of pylorus-preserving gastrectomy (PPG) accompanied by complete suprapyloric and infrapyloric lymph node dissection. DESIGN: Retrospective review. SETTING: A university hospital in Japan. PATIENTS: Fifteen patients underwent PPG, and 28 patients underwent conventional distal gastrectomy (CDG) with Billroth I anastomosis. All patients had early gastric cancer, with either limited invasion in the mucosal layer or invasion into the submucosal layer. INTERVENTIONS: In the PPG procedure, the distal part of the stomach was resected while retaining a 1.5-cm pyloric cuff. The right gastroepiploic artery, the right gastric artery, and hepatic and pyloric branches of the vagus nerve were divided, and the infrapyloric artery was preserved. A modified D1 or D2 lymphadenectomy accompanied the PPG. MAIN OUTCOME MEASURES: Patients undergoing the PPG and CDG procedures were assessed 1 year after their surgical procedure. Changes in body weight, serum total protein levels, and serum albumin levels, the incidence of dumping syndromes, and endoscopic findings in the gastric remnant were compared between the 2 groups. RESULTS: Weight loss was significantly less in the PPG group than in the CDG group (P=.02). The incidences of early dumping syndromes, especially vasomotor symptoms, were significantly lower in the PPG group than in the CDG group (P=.03 and P=.02, respectively). The pyloric sphincter function was preserved, and there was no anastomotic leakage in the PPG group. CONCLUSIONS: The PPG procedure with complete D2 lymphadenectomy can be performed safely with a low incidence of major complications and a better postoperative outcome than the CDG procedure. The PPG procedure can be recommended for the treatment of early gastric cancer with broader indications.

Aged↗

PubMed1999

Regular scintigraphic measurements of food transit following different types of reconstruction after total gastrectomy.

HYPOTHESIS: Ideal reconstruction after gastrectomy should ensure that the patient has a sufficiently large enteric reservoir to accommodate normal meals. Little is known about the transit of food after different methods of stomach reconstruction. The hypothesis of this trial was that food transit after gastrectomy is delayed by a pouch reconstruction compared with reconstructions without a pouch. DESIGN: Prospective. SETTING: University hospital. PATIENTS AND METHODS: A total of 27 patients underwent an interposition of a jejunal loop between the esophagus and the duodenum with (n = 19) or without (n = 8) a 7- or 15-cm proximal pouch reconstruction. Standardized scintigraphic measurements were performed to evaluate the food transit at fixed postoperative times. MAIN OUTCOME MEASURE: Scintigraphically measured food transit time. RESULTS: The food transit time 1 year postoperatively was significantly prolonged in patients with the 15-cm pouch in comparison with those with the 7-cm pouch and those without a pouch reconstruction (P = .005, P = .012). Patients with a pouch reconstruction tended to have better eating habits. CONCLUSIONS: Our results confirm the hypothesis and suggest that interposition of a large 15-cm jejunal pouch can lead to a prolonged food transit time with enteric reservoir function resulting in better patient nutritional status.

Adult↗

PubMed1976

Postresectional anemia. A preventable complication of total gastrectomy.

The incidence of anemia after total gastrectomy has not received sufficient clinical emphasis. During a follow-up period averaging 32 months, postresectional anemia developed in seven of ten patients without evidence of malignant neoplasm; all but one of these patients had received parenterally administered cyanocobalamin. Despite low levels of circulating erythrocytes and proportionately increased erythropoietin levels, reticulocytosis was not evident. This observation suggests an uncharacterized failure of marrow erythyroid precursors. Multiple deficits in intake of constituents necessary for the production of erythrocytes were demonstrated. With the possible exception of iron, malabsorption of these constituents is not an important factor in the production of anemia. Postresectional anemia is multicausal, but is primarily nutritional. As total gastrectomy becomes more commonly employed in the treatment of nonmalignant conditions, recognition of the frequency and causes of postresectional anemia should assist both diagnostic anticipation and therapy.

Adult↗

PubMed1981

Comparison of stapled and hand-sutured gastrectomies.

We reviewed 585 Billroth II gastrectomies to compare the results of stapled and hand-sutured cases. In 385 patients who had the duodenal stump handled by conventional methods, 18 (4.7%) leaked, compared with four (2.5%) leaks in 160 patients who had the duodenal stump stapled. In 474 hand-sutured anastomoses, there were 12 complications (leaks, hemorrhage, or obstruction), whereas there were no complications in 71 stapled anastomoses. We conclude that stapling provides an expedient way of performing gastrectomies that is at least as safe if not safer than conventional hand suture.

Adolescent↗