ABSTRACT
Background: Laparoscopy-assisted gastrectomy requires a lot of disposable products. So we compared the cost between laparoscopy-assisted gastrectomy and open surgery.Patients and methods: For comparison we used five cases each of open distal gastrectomy (ODG), laparoscopy-assisted distal gastrectomy (LADG), open total gastrectomy (OTG) and laparoscopy assisted total gastrectomy (LATG). In this study, we defined the profit of gastrectomy as below and we used the list price for all products. Profit of gastrectomy=Fee for gastrectomy-(Costs of all single use products-Demandable fee for single-use products)Results: Mean profits of ODG and LADG were 278,756.2 yen and 190,292.8 yen. The difference was 88,463.4 yen. Mean profits of OTG and LATG were 395,922.6 yen and 330,653.6 yen. The difference was 65,269 yen. Mean hospital charges, mean length of hospital stay, mean hospital charges per day of ODG, LADG, OTG and LATG were 1,390,464 yen, 21.4 days, 65,140.0 yen and 1,484,254.0 yen, 18.8 days, 80,805.4 yen and 1,956,664.0 yen, 24.4 days, 82,397.1 yen and 1,686,936.0 yen, 18.4 days, 91,894.8 yen, respectively.Conclusion: The turnover of laparoscopic gastrectomy was higher than open gastrectomy, but, the profit was lower because of high costs of disposable products. Hospital charges were not higher but the charge per day was higher because of a shorter hospital stay.
Subject(s)
Gastrectomy , Laparoscopy , HospitalsABSTRACT
Objective: The benefits of combining cancer screenings with clinical surveys have become increasingly obvious as cancer morbidity and mortality have steadily increased. This paper discusses a study on the current status of and issues surrounding breast cancer screening in a clinical survey. The study also investigated the patients' awareness of the benefits of breast cancer screening. A secondary aim of the study was to promote mammographic screening.;Subjects and Methods: During the 72 months between April 1999 and March 2005, a total of 36,505 women underwent clinical surveys in our hospital. In October 2002, mammographic examination was included as an optional part of the routine physical examination. We evaluated the results of breast cancer screening with or without mammographic examination and used a questionnaire to investigate the patients' awareness of the benefits of breast cancer screening.;Results: Compared with the pre-2001 results, the detection rate of breast cancer significantly increased after 2003 when physical examination was combined with mammographic examination. Our study also found that both elderly patients and those residing in the suburbs of Sapporo City tended to choose physical examination alone rather than combining it with mammographic examination. An analysis of the questionnaires collected from these patients indicates they had a poor understanding of and lacked awareness of the benefits of mammographic examinations during breast cancer screenings.;Conclusions: The inclusion of mammographic screenings with clinical surveys was found to be significantly useful in the detection of breast cancer. Further continued education is needed for women, particularly the elderly and residents in the suburbs, so they understand the benefits of breast cancer screening by mammographic examination for the early detection of breast cancer and, consequently, decreased mortality of the disease.
Subject(s)
Awareness , Surveys and QuestionnairesABSTRACT
Recently, in addition to standard surgical operations, reduction therapy (endoscopic mucosal resection and endoscopic gastrectomy) is indicated for early gastric cancer. However, the indication should be limited to the casesof early gastric cancer without lymph node metastases.<BR>During the past 25 years, we have surgically treated 2, 246 cases of early gastric cancer. The percentage of lymph node metastasis in 1, 242 mucosal cancer cases was 1.8% and that in 1, 004 submucosal cancer cases was 16.9%. In the mucosal cancer cases, lymph node metastasis did not occur in the depressedtumors with a diameter of less than 10mm and the elevated tumors with a diameted of less than 20mm. In the submucosal cancer cases, lymph node metastasis did not occur in the elevated tumors less than 10mm in diameter. So, the cases of gastric cancerof these types require the reduction therapy.<BR>However, in the mucosal cancers that have been diagnosed during the last 5 years, the percentage of preoperative correct diagnosis as for thedepth of invasion was 69.4%. In the submucosal cancers, the rate was 60.1%. Many of the cases diagnosed incorrectly had ulcers in the lesion. As for the infiltration type, INFβ and γ were noticeable in these cases. As for the histological type, most of the cases wereof the undifferentiated type.<BR>Moreover, if should be noted, the percentage that the histological type of preoperative ensoscopic biopsy specimens agrees with that of postoperative ones is 50-60% except for tubl of mucosal cancers.