Surgery today
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The goal of this retrospective study was to evaluate the effects of perioperative administration of sivelestat sodium hydrate, a selective neutrophil elastase inhibitor, on the clinical course after radical surgery for esophageal cancer. ⋯ The early administration of sivelestat to patients receiving radical surgery for esophageal cancer can inhibit postoperative systemic inflammatory reactions and it might also have a beneficial effect on the prognosis.
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Comparative Study
Emergency versus elective living-donor liver transplantation: a comparison of a single center analysis.
We studied the risk factors for postoperative mortality between patients who underwent emergency or elective living-donor liver transplantation (LDLT). ⋯ Careful perioperative management, including preoperative investigation of aspergillosis and empiric antibiotic therapy, should be considered for emergency LDLT patients who fulfill IPA risk factors.
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Delayed gastric emptying (DGE) is a leading cause of complication after pylorus-preserving pancreaticoduodenectomy (PPPD). Its incidence has been reported to range from 5 to 57%. We describe a modified reconstruction method, which resulted in a low rate of DGE. ⋯ Straight stomach reconstruction with a twisted anastomosis could reduce the incidence of DGE after PPPD reconstruction.
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Despite recent improvements in surgical techniques and chemotherapy, advanced cancers of the stomach and gastroesophageal junction (GEJ) continue to have poor clinical outcomes. However, molecules intimately related to cancer cell proliferation, invasion, and metastasis have been studied as candidates for molecular targeted agents. Target molecules, such as the epidermal growth factor receptor, vascular endothelial growth factor receptor, and P13k/Akt/mTor pathway, as well as the insulin-like growth factor receptor, c-Met pathways, fibroblast growth factor receptor, and other pathways are considered to be promising candidates for molecular targeted therapy for gastric and GEJ cancer. In this review we focus on the recent developments in targeting relevant pathways in these types of cancer.
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Comparative Study
Systemic inflammatory response syndrome as a predictor of anastomotic leakage after esophagectomy.
Esophageal anastomotic leakage is still a major cause of morbidity and mortality after esophagectomy. We conducted this study to elucidate how anastomotic leakage affects the systemic inflammatory response syndrome (SIRS) criteria. ⋯ The SIRS scoring system is valuable for evaluating the severity of systemic inflammatory response caused by anastomosis leakage, and may serve as an indicator for prompt management.