Journal of gastrointestinal surgery : official journal of the Society for Surgery of the Alimentary Tract
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J. Gastrointest. Surg. · Sep 2017
Liver Stiffness Assessed by Shear Wave Elastography Predicts Postoperative Liver Failure in Patients with Hepatocellular Carcinoma.
Cirrhosis increases a patient's risk of developing postoperative liver failure (PLF). Liver stiffness (LS), assessed by two-dimensional shear wave elastography (SWE), indicates liver fibrosis with high accuracy. Whether LS is superior to portal hypertension (PHT) in predicting PLF remains to be studied. ⋯ LS measured by SWE can predict risk of PLF with greater accuracy than PHT.
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J. Gastrointest. Surg. · Sep 2017
Comparative Quantitative Lymph Node Assessment in Localized Esophageal Cancer Patients After R0 Resection With and Without Neoadjuvant Chemoradiation Therapy.
The effects of neoadjuvant chemoradiation therapy on lymph node retrieval during esophagectomy for patients with esophageal cancer are unclear. The aim of this study was to quantify lymph node retrieval after R0 esophagectomy and to assess its impact on overall survival in induction therapy patients. ⋯ Total lymph node counts were significantly lower in the induction therapy group, while positive lymph node counts and lymph node ratios did not differ from the upfront surgery group. Although overall survival was not different between groups, it was decreased within the induction therapy cohort among those who had any positive lymph nodes retrieved at surgery. This study confirms that unstratified gross lymph node counts do not substantially relate to prognosis in the heterogeneous population of locally advanced esophageal cancer patients who may or may not have had neoadjuvant chemoradiation.
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J. Gastrointest. Surg. · Jul 2017
Laparoscopically Assisted Proximal Gastrectomy with Esophagogastrostomy Using a Novel "Open-Door" Technique : LAPG with Novel Reconstruction.
Laparoscopy-assisted proximal gastrectomy (LAPG) with esophagogastrostomy using a novel "open-door" technique was introduced recently, with the aim of preventing gastroesophageal reflux. However, quantitate assessment of gastroesophageal reflux after this surgery has not been performed till date. The aims of the current study were to investigate the safety and feasibility of this operation and to elucidate the postoperative reflux status. ⋯ Our results showed that esophagogastrostomy using the "open-door" technique is a safe and feasible procedure for LAPG. The degree of gastroesophageal reflux was acceptable using this technique. Randomized controlled trials with long-term follow-ups are required to confirm that this technique would be superior to the others.
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J. Gastrointest. Surg. · Jun 2017
Randomized Controlled TrialEffect of Adding Dexmedetomidine to Ropivacaine on Ultrasound-Guided Dual Transversus Abdominis Plane Block after Gastrectomy.
Transversus abdominis plane (TAP) block is an analgesic technique. Adding dexmedetomidine can enhance regional anesthesia. This study's aim was to evaluate whether dexmedetomidine prolonged analgesic time of TAP block after gastrectomy. ⋯ TAP block can provide analgesia and improve the quality of recovery. Adding dexmedetomidine does not significantly improve the quality or duration of TAP block.
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J. Gastrointest. Surg. · Jun 2017
Postoperative Complications and Functional Outcome after Esophageal Atresia Repair: Results from Longitudinal Single-Center Follow-Up.
Esophageal atresia (EA) and tracheoesophageal fistula (TEF) represent major therapeutic challenges, frequently associated with serious morbidities following surgical repair. The aim of this longitudinal study was to assess temporal changes in morbidity and mortality of patients with EA/TEF treated in a tertiary-level center, focusing on postoperative complications and their impact on long-term gastroesophageal function. ⋯ Postoperative complications after EA/TEF repair are common and should be expertly managed to reduce the risk of long-term morbidity. Regular multidisciplinary surveillance with transitional care into adulthood is recommended in all patients with EA/TEF.