RESUMO
BACKGROUND: Surgical resection with adequate lymphadenectomy is regarded the only curative option for gastric cancer. Regarding minimally invasive techniques, mainly Asian studies showed comparable oncological and short-term postoperative outcomes. The incidence of gastric cancer is lower in the Western population and patients often present with more advanced stages of disease. Therefore, the reproducibility of these Asian results in the Western population remains to be investigated. METHODS: A randomized trial was performed in thirteen hospitals in Europe. Patients with an indication for total gastrectomy who received neoadjuvant chemotherapy were eligible for inclusion and randomized between open total gastrectomy (OTG) or minimally invasive total gastrectomy (MITG). Primary outcome was oncological safety, measured as the number of resected lymph nodes and radicality. Secondary outcomes were postoperative complications, recovery and 1-year survival. RESULTS: Between January 2015 and June 2018, 96 patients were included in this trial. Forty-nine patients were randomized to OTG and 47 to MITG. The mean number of resected lymph nodes was 43.4 ± 17.3 in OTG and 41.7 ± 16.1 in MITG (p = 0.612). Forty-eight patients in the OTG group had a R0 resection and 44 patients in the MITG group (p = 0.617). One-year survival was 90.4% in OTG and 85.5% in MITG (p = 0.701). No significant differences were found regarding postoperative complications and recovery. CONCLUSION: These findings provide evidence that MITG after neoadjuvant therapy is not inferior regarding oncological quality of resection in comparison to OTG in Western patients with resectable gastric cancer. In addition, no differences in postoperative complications and recovery were seen.
Assuntos
Gastrectomia/métodos , Excisão de Linfonodo/métodos , Procedimentos Cirúrgicos Minimamente Invasivos/métodos , Neoplasias Gástricas/cirurgia , População Branca/estatística & dados numéricos , Povo Asiático/estatística & dados numéricos , Quimioterapia Adjuvante , Europa (Continente) , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Terapia Neoadjuvante , Complicações Pós-Operatórias/etiologia , Reprodutibilidade dos Testes , Neoplasias Gástricas/etnologia , Resultado do TratamentoAssuntos
Apendicite , Apêndice , Humanos , Apendicite/complicações , Apendicite/cirurgia , Apêndice/cirurgia , Apendicectomia , HérniaRESUMO
No disponible
Assuntos
Humanos , Masculino , Pessoa de Meia-Idade , Hérnia Hiatal/diagnóstico por imagem , Diverticulite/cirurgia , Mucosa Esofágica/fisiopatologia , Complicações Pós-Operatórias , Transtornos de Deglutição/etiologiaRESUMO
Inflammatory pseudotumor is a non-neoplastic process characterized by irregular growth of inflammatory cells. This type of tumor can arise in any part of the body; most are confined to a single site and are benign. We present the case of a 51-year-old man in whom a solitary pulmonary nodule was detected as an incidental finding. Right pulmonary lobectomy was performed and histopathological analysis led to a diagnosis of inflammatory pseudotumor. The patient subsequently developed tumors in the contralateral lung and cervix, the latter being highly aggressive. We found no reports of this association in the literature, prompting the present case report.
Assuntos
Granuloma de Células Plasmáticas Pulmonar/patologia , Anti-Inflamatórios/uso terapêutico , Humanos , Imageamento por Ressonância Magnética , Masculino , Pessoa de Meia-Idade , Granuloma de Células Plasmáticas Pulmonar/tratamento farmacológico , Granuloma de Células Plasmáticas Pulmonar/cirurgia , Nódulo Pulmonar Solitário/patologia , Nódulo Pulmonar Solitário/cirurgia , Procedimentos Cirúrgicos OperatóriosRESUMO
El seudotumor inflamatorio es un proceso no neoplásico caracterizado por un crecimiento irregular de células inflamatorias. Puede originarse en cualquier lugar del organismo y en la mayoría de los casos presenta un asentamiento local único y de características benignas. Presentamos el caso de un varón de 51 años en el que se objetivó de forma accidental un nódulo pulmonar solitario. Se llevó a cabo una lobectomía pulmonar derecha, y el estudio anatomopatológico llevó al diagnóstico de seudotumor inflamatorio. Posteriormente se desarrollaron tumores en el pulmón contralateral y a nivel cervical; este último se comportó de manera muy agresiva. En nuestra revisión bibliográfica no hemos encontrado dicha asociación, motivo de nuestra publicación (AU)
Inflammatory pseudotumor is a non-neoplastic process characterized by irregular growth of inflammatory cells. This type of tumor can arise in any part of the body; most are confined to a single site and are benign. We present the case of a 51-year-old man in whom a solitary pulmonary nodule was detected as an incidental finding. Right pulmonary lobectomy was performed and histopathological analysis led to a diagnosis of inflammatory pseudotumor. The patient subsequently developed tumors in the contralateral lung and cervix, the latter being highly aggressive. We found no reports of this association in the literature, prompting the present case report (AU)