Journal of surgical oncology
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CD44 and CD133 have been reported as putative stem cell markers. However, the clinicopathologic significance of CD44 and CD133 expression in patients with gastric carcinoma (GC) has not been clearly elucidated. ⋯ Our study introduces high expression of CD44 and CD133 as adverse independent prognostic factors in GC patients. The combined CD44 and CD133 expression may become a useful tool for identifying patients with different clinical outcomes.
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Combined pancreatic and liver resection for hepato-pancreatico-biliary disease is generally considered contraindicated since it is thought to provide little if any survival benefit with high risk of morbidity. Our goal was to review our experience with combined pancreatic and liver resections to better define characteristics that increase risk for perioperative complications after combined resections. ⋯ Combined pancreas and liver resection for metastatic disease should only be considered in highly selected patients. Tumor histology as well as BMI > 25 (overweight and obese patients) should be considered in the decision making process in an effort to minimize surgical morbidity while potentially improving survival.
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Comparative Study
An assessment of feeding jejunostomy tube placement at the time of resection for gastric adenocarcinoma.
Feeding jejunostomy tubes (J-tube) are often placed during gastrectomy for cancer to decrease malnutrition and promote delivery of adjuvant therapy. We hypothesized that J-tubes actually are associated with increased complications and do not improve nutritional status nor increase rates of adjuvant therapy. ⋯ J-tube placement after gastrectomy for gastric cancer may be associated with increased postoperative complications with no demonstrable advantage in receiving adjuvant therapy. Routine use of J-tubes after subtotal gastrectomy may not be justified, but may be selectively indicated in patients undergoing total gastrectomy. A prospective trial is needed to validate these results.
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Pancreatic surgery is associated with severe postoperative morbidity. Identification of patients at high risk may provide a way to allocate resources objectively and focus care on those patients in greater need. The Authors evaluate the prevalence of malnutrition and its effect on the postoperative morbidity of patients undergoing pancreatic surgery for malignant tumors. ⋯ Malnutrition is a relevant predictor of post-operative morbidity and mortality after pancreatic surgery. Patients underwent pancreatic resection for malignant tumors are usually malnourished. Preoperative malnutrition screening is mandatory in order to assess the risk and to treat the malnutrition.
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Comparative Study
Utilization of and charges for robotic versus laparoscopic versus open surgery for endometrial cancer.
To analyze the utilization and hospital charges associated with robotic (RS) versus laparoscopic (LS) versus open surgery (OS) in endometrial cancer patients. ⋯ In this statewide analysis of endometrial cancer patients, the utilization of robotic surgery increased and is associated with higher hospital charges compared to laparoscopic and open procedures.