Journal of the American College of Surgeons
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Comparative Study
Sentinel lymph node mapping for gastric cancer using a dual procedure with dye- and gamma probe-guided techniques.
Increasing evidence supports the sentinel lymph node (SN) concept for melanoma and breast cancers. SN biopsy may replace routine lymph node dissection in the treatment of these cancers. But there are little data evaluating this concept in patients with gastric cancer. The objective of this study was to test the feasibility of SN mapping in gastric cancers by using the dual-mapping procedure with dye and radioactive colloid. ⋯ SN mapping is feasible in gastric cancer, but the dye-guided and gamma probe-guided techniques are complementary. So we recommend the dual-mapping procedure.
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Extramammary Paget's disease (EMPD) is a rare clinical entity and can be associated with other malignancies. We analyzed our experience for prognosis and impact of therapy on outcomes. ⋯ EMPD is an infrequently diagnosed disease that is preferably managed with complete local excision and reexcisions if needed. A thorough search for frequently occurring secondary malignancies might be beneficial to provide the best outcomes for these patients.
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We conducted an objective followup of 181 patients after laparoscopic Nissen fundoplication during a 5-year period after surgery. ⋯ Laparoscopic Nissen fundoplication remains an effective antireflux procedure at 5 years.