ABSTRACT
PURPOSE: There have been several comparative studies that have focused on elderly groups of patients with gastric cancer. However, new criteria are needed for this elderly group because of the longer life span of Korean people. The diagnosis of gastric cancer has sometimes been missed in the young age group. The perioperative risk is high in the elderly age group because of their combined diseases. This study was designed to determine the differences of the clinicopathologic features and the prognosis between young and elderly patients with gastric cancer. MATERIALS AND METHODS: Eighty patients were divided in two groups and these patients were selected for making comparison between young and elderly groups of patients with gastric cancer. The young age group consisted of 31 patients who were aged 35 years old or less. The elderly age group was made up of 49 patients who were aged 75 years old or above. RESULTS: For the clinicopathologic features, the young age group was characterized by a high incidence of the poorly differentiated type of adenocarcinoma and the diffuse type too, according to the Lauren classification. On the other hand, the elderly group was characterized by a high incidence of poorly to moderate differentiated adenocarcinoma and also the intestinal type according to the Lauren classification. The other clinical differences were unremarkable. Additionally, there was no survival advantage in the young age group compared to the elderly group. CONCLUSION: There were no clinicopathologic and prognostic differences between both extreme age groups. So, active surgical treatment is recommended even for the elderly patients group.
Subject(s)
Adult , Aged , Humans , Adenocarcinoma , Classification , Diagnosis , Hand , Incidence , Prognosis , Stomach NeoplasmsABSTRACT
Tuberculosis of the breast is an extremely rare disease. That needs to be differentiated from inflammatory breast cancer, acute or subacute breast abscess and actinomycosis of the breast in order for it to be treated effectively. However, tuberculosis of the breast is difficult to diagnose because of the diagnostic methods used. In addition, significant time is needed to identify tuberculosis by culture. We experienced a case of tuberculosis of the breast that developed during the anti-tuberculous medication. The patient was diagnosed quickly using tuberculosis PCR and treated with a combination of a surgical excision and anti-tuberculous medication.
Subject(s)
Humans , Abscess , Actinomycosis , Breast , Inflammatory Breast Neoplasms , Polymerase Chain Reaction , Rare Diseases , TuberculosisABSTRACT
PURPOSE: In treating carcinoma of the esophagus, a gastric drainage procedure seems to be necessary with esophago gastrostomies because of the inevitable incidental bilateral truncal vagotomy which occurs during the esophagectomy. There are potential hazards with a pyloroplasty such as jeopardizing the blood supply to the mobilized stmach, shortening its length for substitution, leakage, dumping syndrome, and bile reflux gastritis. The aims of the study are to compare the postoperative outcome of patients with and without pyloroplasty after an esophagectomy for esophageal cancer, and to evaluate the necessity of pyloroplasty in the vagotomized intrathoracic stomach after esophageal surgery. METHODS: During the years 1996 to 2001, 23 patients with carcinoma of the esophagus underwent an esophagectomy followed by esophagogastrostomy with or without pyloroplasty. The medical records of the patients were evaluated retrospectively. RESULTS: There were no statiscally significant differences between the pyloroplasty group and the no-pyloroplasty group with regards to the average hospital stay, resumption of oral feeding, removal of the nasogastric tube, and the daily gastric drainage. CONCLUSION: Postoperative symptomatic evaluation of patients who had esophageal cancer and underwent an esoph-agectomy and an esophagogastrostomy, with or without pyloroplasty supports the concept that the drainage procedure is unnecessary in the gastric replacement of the esophagus.
Subject(s)
Humans , Bile Reflux , Drainage , Dumping Syndrome , Esophageal Neoplasms , Esophagectomy , Esophagus , Gastritis , Gastrostomy , Length of Stay , Medical Records , Retrospective Studies , Stomach , Vagotomy, TruncalABSTRACT
PURPOSE: The proper reconstructive technique after a partial gastrectomy for an adenocarcinoma of the stomach is often debated, but few data exist to clarify the issue. The aim of this study was to compare retrospectively the early postoperative results and complications after different anastomoses used during a partial gastrectomy for a gastric adenocarcinoma. MATENRIALS AND METHODS: We reviewed the hospital records of 218 patients who had undergone a subtotal gastrectomy for gastric cancer at Chosun University Hospital between January 1997 and July 2000. Of the 218 subtotal gastrectomies performed with curative intent, 127 reconstructions were Billroth I gastrectomies and 91 were Billroth II gastrectomies. The following data were analyzed: age, sex, tumor size, gastric resection margin, timing of removal of the nasogastric tube, first bowel movement, resumption of oral feeding, and postoperative complications. RESULTS: The timing of removal of the nasogastric tube was significantly earlier in the Billroth Igroup than in the Billroth II group (27.9+/-13.9 hours and 69.7+/-68 hours, respectively)(P<0.05). Resumption of oral feeding was possible on day 4.6+/-1.5 in the Billroth I group and on dsy 5.2+/-1.5 in the Billroth II group (P<0.05). There were no anastomotic leakage, postoperative bleeding, and postoperative mortality among the patients in either group. CONCLUSION: the Billroth Igastrectomy should be considered for patients undergoing a partial gastric resection for gastric cancer due to its physiological benefits and acceptable rate of complication.