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OBJECTIVE@#To observe the clinical effect of acupuncture for functional delayed gastric emptying after gastric cancer surgery on the basis of routine treatment.@*METHODS@#A total of 80 patients with functional delayed gastric emptying after gastric cancer surgery were randomly divided into an observation group (40 cases, 3 cases dropped off) and a control group (40 cases, 1 case dropped off). The control group was treated with routine treatment, e.g. continuous gastrointestinal decompression. On the basis of the treatment in the control group, the observation group was treated with acupuncture at Zusanli (ST 36), Shangjuxu (ST 37), Xiajuxu (ST 39), Gongsun (SP 4), Sanyinjiao (SP 6), 30 min each time, once a day, 5 days as a course, 1-3 courses were required. The first exhaust time, remove gastric tube time, liquid food intake time and hospital stay were compared in the two groups, and the clinical effect was evaluated.@*RESULTS@#The first exhaust time, remove gastric tube time, liquid food intake time and hospital stay in the observation group were shorter than the control group (P<0.001).@*CONCLUSION@#On the basis of routine treatment, acupuncture could accelerate the recovery of patients with functional delayed gastric emptying after gastric cancer surgery.
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Humans , Stomach Neoplasms , Gastroparesis , Acupuncture Therapy , Acupuncture PointsABSTRACT
Objective:To investigate the incidence of early enteral nutrition intolerance and related influencing factors in postoperative gastric cancer patients.Methods:90 gastric cancer patients who underwent radical gastric cancer surgery and received early enteral nutrition thereafter in our hospital were retrospectively enrolled from January 2019 to December 2020. Patients were divided into early enteral nutrition tolerance group ( n=30) and intolerance group ( n=60) according to whether they developed nausea, vomiting, abdominal distension, abdominal pain, diarrhea and other symptoms after early enteral nutrition. The general characteristics of the two groups were compared and the risk factors of early enteral nutrition intolerance in postoperative gastric cancer patients were analyzed using multivariate Logistic regression. Results:60 (66.67%) of the 90 postoperative gastric cancer patients experienced early enteral nutrition intolerance. Multivariate Logistic regression analysis showed that ≤4 hours of out-of-bed activity on the first postoperative day and nonuse of nutrition pump were independent risk factors for early enteral nutrition intolerance in these patients ( OR=2.998; 4.586, P<0.05). Conclusions:The risk factors of early enteral nutrition intolerance in postoperative gastric cancer patients were ≤4 hours of out-of-bed activity on the first postoperative day and nonuse of nutrition pump. Corresponding clinical interventions could be implemented to prevent the occurrence of early enteral nutrition intolerance in postoperative gastric cancer patients.
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With the approaches of artificial intelligence and big data, the development of cancer genomics and updating of imaging technology, gastric cancer surgery is facing great challenges and opportunities. The main focus is on laparoscopic surgery technology, enhanced recovery after surgery, multidisciplinary comprehensive treatment, and precision medicine. Considering the common de-mand for reduced complication rate among doctors and patients, laparoscopic surgery has become widely popular owing to its advan-tages of small incision and rapid recovery. Furthermore, the development of artificial intelligence and big data has raised a new chal-lenge in routine diagnosis and treatment. As a result, we encourage multicenter cooperation, and data standardization and sharing. At present, completion of the transition from empirical medicine to evidence-based medicine and promotion of the individualization and standardization of gastric cancer treatment are needed.
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Objective The Da Vinci single－site surgical platform (DVSSP) is an intelligent operation platform widely used worldwide. It possesses 3D vision ,flexible operation and other advantages, so in the field of gastrointestinal surgery, it has been gradually applied to radical gastrectomy, radical gastrectomy, radical resection of colorectal cancer, gastric fundus folding, Heller myotomy, weight loss surgery and small bowel surgery, and the satisfactory clinical effect has been achieved. For gastric cancer surgery, compared with traditional laparoscopy and laparotomy, the robot operation is more accurate, flexible, and has obvious minimally invasive advantages. The intraoperative treatment and postoperative curative effect are better than the traditional laparoscopy. With the support of a large number of clinical cases, DVSSP has been proven to be a new platform for minimally invasive surgery and has considerable value in the field of gastric cancer surgery. However, there is still a long operation time and a high cost of operation. The long－term effect of gastric cancer surgery needs further observation.
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Objective To explore the clinical effect of minimally invasive distal gastric cancer surgery combined with D2 lymph node dissection. Methods From September 2010 to September 2012,95 cases of gastric cancer surgically treated from our hospital were selected. Among them,2 cases were converted to laparotomy by abdominal cavity,and a total of 93 patients were included in the study. According to dif-ferent surgical methods,there were 43 cases in the observation group and 50 cases in the control group. The observation group was treated with minimally invasive distal gastric cancer surgery combined with D2 lymph node dissection,and the control group was treated with open surgery combined with D2 lymph node dissection. The bleeding volume,ambulation time,operative time,hospitalization time,lymph node dissection and postoperative complications were compared between the two groups. The recurrence,metastasis and mortality during 1 year,3 years and 5 years follow-up were also compared. Results The bleeding volume in the observation group was less than that in the control group,and the off-bed activity occurred earlier than that in the control group. The hospitalization time was shorter in the observation group than in the control group(P<0. 05),but there was no significant difference in operative time between the two groups(P>0. 05). There was no statistical differ-ence between the number of lymph nodes in the first station, the number of lymph nodes in second stations and the total number of lymph nodes in the two groups(P>0. 05). The incidence of postoperative complications in the observation group(6. 98％) was lower than that of the control group (22. 00％)(P<0. 05). The two groups were followed up for 1,3 and 5 years,and the recurrence rate and mortality rate were low(P>0. 05). Conclusion minimally invasive distal gastric cancer surgery combined with D2 lymph node dissection has significant clinical effect,less blood loss,quicker postoperative recovery and fewer complications,as well as less recurrence and metastasis and death in long-term follow-up.
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To evaluate the different anesthesia in elderly patients with gastric cancer surgery influence blood con-centrations of melatonin and its correlation with postoperative agitation. The agitation scroes were evaluated and re-corded,and the blood samples were taken twice:before induction as well as just at the end of surgery,then making correlation analysis. The agitation scroes were significantly lower in group ET than in group T(P<0.01);the level of postoperative blood concentrations of melatonin was higher in group ET than that in group T(P<0.01);the agi-tation scroes and the level of postoperative blood concentrations of melatonin were negatively correlated ( r =-0.429,P<0.05).
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ObjectiveTo investigate and analyze the factors affecting the quality of life of patients with gastric cancer after surgery. Methods120 cases of gastric cancer patients undergoing resection of gastric cancer from March 2009 to March 2010 in our hospital were chosen as the research object.100 cases of non-cancer patients with similar general information and without factors affecting quality of life at the same period were chosen as the control group.Quality of Life Questionnaire of Stomach 22 (QLQ-STO22) were used to investigated the quality of life of patients in the two groups.The factors affecting the quality of life for patients with gastric cancer were analyzed.Countermeasures to increase the quality of life of cancer patients were explored according to factors affecting the quality of life. ResultsThe study showed that quality of life of gastric cancer patients was significantly lower than the control group.The differences were significant.Multiple linear regression analysis showed that gender,age,personality,education degree,family economic status,cancer disease were the main factors affecting their quality of life. ConclusionsIn clinical care of patients with gastric cancer,the medical staff should take appropriate psychological care and health education based on individual circumstances of patients,try to eliminate the adverse fractors of patients in psychology,cognition and thought in order to enhance the quality of life of patients after surgery.
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PURPOSE: Traditionally, nasogastric decompression has been a routine procedure following major abdominal surgery or gastrointestinal surgery. This prospective, randomized controlled trial was performed in order to evaluate the usefulness of nasogastric decompression following elective gastric cancer surgery. METHODS: This study was carried out prospectively. A total of 95 patients were randomly divided into two groups, group I (45 patients with nasogatric tube) and group II (50 patients without nasogastric tube). Patients receiving emergency surgery due to gastric outlet obstruction were excluded from this study. The data was analysed by chi-square test, T-test and Mann-Whitney U test with the level of significance set at P<0.05. RESULTS: No significant differences were found between the two groups in regards to nausea, vomting, distension, anastomotic leak or wound dehiscence. However, longer hospital stay, delayed passage of flatus, delayed initiation of ambulation, delayed start of feeding and sore throat occurred more often in group I patients than in group II patients. CONCLUSION: The result showed that the routine prophylactic use of nasogastric decompression following gastric cancer surgery is an unnecessary procedure and does not offer any considerable advantage.
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Humans , Anastomotic Leak , Decompression , Emergencies , Flatulence , Gastric Outlet Obstruction , Length of Stay , Nausea , Pharyngitis , Prospective Studies , Stomach Neoplasms , Unnecessary Procedures , Walking , Wounds and InjuriesABSTRACT
PURPOSE: It is well known that the incidence of cholelithiasis and cholecystitis increases after a gastrectomy and vagotomy for peptic ulcer disease, but operations for ulcers have decreased due to improved medical therapy. However, there are not so many studies about cholelithiasis and cholecystitis after a gastric resection due to gastric cancer. Therefore, we investigated its incidence, the factors affecting it, and its natural course. METHODS: Six hundred eighty-four gastric patients who had received a gastric resection at the Korea University Guro Hospital from January 1992 to October 1999 and who had been followed regularly with abdominal ultrasonography or computed tomography were enrolled in this study. The incidence of gallstones and sludge was investigated according to age group (60), sex, extent of gastric resection (subtotal vs total), anastomotic methods (duodenal bypass vs duodenal passage of food), and degree of lymph node dissection ( or =D2+alpha). The clinical course of cholelithiasis was also followed up. RESULTS: Gallstones were discovered in 38 patients (5.6%) with a mean duration of 26.4+/-20.7 months, and sludge was found in 17 patients (2.5%) with a mean duration of 25.1+/-20.5 months. There were no significant differences of incidence of gallstones and sludge according to sex, age group, and other surgical options (p>0.05). Twenty- eight cases of gallstones (73.7%) were detected within 36 months, and 11 cases of sludge (64.7%) within 24 months. Among the 38 gallstones patient, only 7 patients (18.4%) developed acute cholecystitis; they received cholecystectomy during the follow-up period, and all removed stones were pigment stones. CONCLUSION: The incidences of cholelithiasis and chole-cystitis do not increased very much after a gastric resection with lymph-node dissection due to gastric cancer, and there are no specific factors affecting those incidences. A prophylactic cholecystectomy during the gastric cancer operation should be performed with caution.