Journal of gastrointestinal surgery : official journal of the Society for Surgery of the Alimentary Tract
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J. Gastrointest. Surg. · Mar 2012
Comparative StudyAccumulation of pro-cancer cytokines in the plasma fraction of stored packed red cells.
Perioperative blood transfusion has been linked to decreased survival in pancreatic cancer; however, the exact causal mechanism has not been elucidated. Allogeneic transfusions are known to expose patients to foreign cells and lipid mediators. We hypothesize that stored packed red cells (pRBCs) contain pro-cancer cytokines that augment tumor progression. We analyzed the plasma fraction of stored pRBCs for pro-cancer cytokines and evaluated the affect of both storage time and leukocyte reduction on these mediators. ⋯ Pro-cancer cytokines that can augment tumor progression were identified in pRBCs. Some of these factors are present in fresh blood. The soluble factors identified herein may represent possible therapeutic targets to offset negative effects of transfusion. These data stress the need for efforts in cancer patients to reduce transfusion requirements if needed.
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J. Gastrointest. Surg. · Mar 2012
ReviewPostoperative adjuvant chemotherapy for stage II colorectal cancer: a systematic review of 12 randomized controlled trials.
The impact of postoperative adjuvant chemotherapy on the oncological outcomes for stage II colorectal cancer remains controversial. ⋯ Postoperative adjuvant chemotherapy for stage II colorectal cancer appears to be associated with improved 5-year overall survival and 5-year disease-free survival, and reduction in risk of recurrence.
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J. Gastrointest. Surg. · Mar 2012
Comparative StudyInternal hernia after gastric bypass: a new and simplified technique for laparoscopic primary closure of the mesenteric defects.
Bowel obstruction due to internal hernia is a well-known complication of laparoscopic Roux-en-Y gastric bypass (LRGB). Increasing evidence supports primary closing of the mesenteric defects, but controversy continues about surgical technique of systematic closure. This paper reviews our experience with internal hernia after LRGB and describes a new method of preemptive closure of the mesenteric defects. ⋯ Internal hernia should be ruled out in patients with previous LRGB and abdominal pain. Our technique for primary closing of the mesenteric defects seems to be safe and is so far promising.
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J. Gastrointest. Surg. · Mar 2012
Comparative StudyClinical significance of indefinite for dysplasia on pouch biopsy in patients with underlying inflammatory bowel disease.
"Indefinite for dysplasia" (IND) on pouch mucosal biopsy is occasionally reported during routine histopathological evaluation. The natural history and implication of this histologic entity in ileal pouch-anal anastomosis (IPAA) has not been studied. ⋯ Subsequent dysplasia was uncommon in pouch patients with IND. Natural history of pouch IND warrants further long-term investigation.
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J. Gastrointest. Surg. · Mar 2012
Comparative StudyLaparoscopic ventral rectopexy for internal rectal prolapse using biological mesh: postoperative and short-term functional results.
Laparoscopic ventral mesh rectopexy is a novel procedure to correct internal and external rectal prolapse. Several authors have shown that this approach is safe and improves obstructive defaecation symptoms and faecal incontinence, without inducing new-onset constipation, possible after posterior rectopexy. Over the last decade, as for other procedures, biological meshes are used to correct pelvic floor disorders. Literature data are scant. In this study, we present our experience with this procedure using biological mesh. ⋯ Laparoscopic ventral mesh rectopexy using biological mesh for internal rectal prolapse is safe and effective in ameliorating symptoms of obstructed defaecation and faecal incontinence.