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The morbidity and mortality of gastrointestinal malignancies are the highest in the world. For patients with poor response to conventional chemotherapy, new treatment methods are urgently needed. In recent years, under the background of precision medicine, antibody-drug conjugates (ADCs) with high tumor specificity and potent toxicity have become a hot research spot in the field of biomedicine. However, due to the complex structure and mechanism of ADCs, its pharmacokinetic research is facing great challenges which are the biggest resistance to the development of ADCs at present. In this case, it is of great significance to understand the pharmacokinetic properties of ADCs and make use of it to improve the efficacy of ADCs in the treatment of gastrointestinal malignancies. Based on the basic composition and mechanism of ADCs, this review summarizes the pharmacokinetic properties of ADCs, discusses its recent advances in the treatment of gastrointestinal malignancies, in order to provide more references for follow-up research on ADCs.
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Background: With so much burden of advanced incurable disease, the role of palliative surgery is paramount for gastrointestinal malignancies improving quality of life. Aim of the study was to study the indications, risks and outcome of palliative surgeries in gastrointestinal malignancies, the burden of disease requiring palliative surgery, and to describe strategies to improve end of life care.Methods: All the patients diagnosed with gastrointestinal malignancy and who underwent palliative surgery between January 2017 and December 2017 were analysed.Results: A total of 186 cases underwent palliative surgery. The most common age group affected was between 50-60 years and the mean age was 54.55 years. Stomach was the most common primary consisting of 58.60% followed by colorectal (23.66%), small intestine (9.68%), hepato-pacreatico-billiary (4.30%), and oesophageal (3.76%) primary. Major complications were seen in 4.84% of cases. Average symptomatic relief was observed for 5.5 months in cases of stomach and 7 months in case of colorectal malignancies. 35.48% cases were alive at the end of one year.Conclusions: Present study concludes that palliative surgery improves quality of life of the patient, provides them with time to accept death and live rest of the life in a dignified manner.
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Background: Gastrointestinal (GI) cancers are responsible for more deaths from cancer than any other cancers. These patients are at risk for disease-related malnutrition which has been linked to an increase in post operative complications. Despite research, guidelines for preoperative nutritional assessment are lacking. The study was aimed to assess the nutritional status of patients in gastrointestinal malignancy, impact of nutritional supplementation and its impact on outcome of surgery.Methods: This cross-sectional study was conducted on patients of gastrointestinal malignancy attending Dept. of Surgery, Dr. D.Y. Patil Medical College, and Hospital, Pimpri, Pune. Institute Ethics Committee clearance was obtained before starting the study. 45 newly diagnosed patients of gastrointestinal malignancy were included in the study after informed consent.Results: At the start of this study 26.66% were well nourished, 35.55% moderately nourished, and 37.77% poorly nourished. At 6 weeks after supplementation 60 % were well nourished, 24.4 % moderately nourished, and 7 % poorly nourished. Surgical site infection (SSI) occurred in 7 patients of which 57.14% were poorly nourished, 28.57 % were moderately nourished. Anastomotic leak occurred in 3 patients of which 66.66% patients were poorly nourished. Average number of days of hospital stay for well nourished patients was 6.23 and for poorly nourished patients 14.14.Conclusions: Malnutrition is a concern in gastrointestinal malignancies. Delay in surgery upto 6 weeks is permissible to enhance patients’ nutritional status. Proper nutritional supplementation significantly improves nutritional status. Complications like SSI and anastomotic leak; hospital stay are significantly reduced after improvement in nutritional status.
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Background: Gastrointestinal (GI) Malignancy is one of the commonest malignancies encountered in developing countries. The goal of this study was to analyze the haematological and coagulation profile- Complete Blood Count (CBC), Prothrombin time (PT), activated partial thromboplastin time (aPTT) among patients of gastrointestinal malignancies. Materials and Methods: Fresh blood samples were collected from the diagnosed patients with appropriate anticoagulant in proper proportion. Complete blood count was done by automated analyzer. Peripheral blood smear was seen in cases with abnormal results on CBC. Peripheral smears were stained with Leishman’s stain using standard procedures and then examined under light microscope. Results: A total of 30 patients with gastrointestinal malignancy were included in this study. There were 19 males and 11 females. Among all cases of gastrointestinal malignancy, stomach cancers constitute the maximum (50%) followed by rectal cancers accounting for 23.3%. GI malignancy had negative impact on haemoglobin profile, affecting 56.6% of cases. In peripheral smear study, microcytic hypochromic anaemia was most common comprising 63.3% of cases. Regarding leukocyte count, 16(53.3%) cases had leukocytosis,07 have normal leukocyte count,7 had leukopenia. Out of 30 cases, 56.6% had normal thrombocyte count, 30% had thrombocytopenia and 13.3% had thrombocytosis. Out of 30 cases, 60% cases had the normal prothrombin time and 40% cases had values higher than the reference value. Regarding activated partial thromboplastin time (aPTT), 63.3% cases had normal reports and 36.6% cases had values higher than the reference value. Conclusion: Reduced haemoglobin, increase in neutrophil count, change in coagulation profile are associated with poor prognosis in patients with GI malignancy. Hence close monitoring of haematological and coagulation profile in patients with gastrointestinal malignancy will help in reducing morbidity and mortality.
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The incidence of concomitant abdominal aortic aneurysm (AAA) combined with gastrointestinal malignancy is rare,but it still represents an issue of controversy regarding the optimal treatment.It is unclear whether to treat the AAA and gastrointestinal malignancy simultaneously or in a staged manner as both options offer advantages but also carry some substantial risks.This study attempts a historical review of the surgical practice during the past decades by reviewing the existing literatures on this topic.In general,the most symptomatic lesion or the most life threatening condition should be treated firstly.Large aneurysm should usually be resected in preference to gastrointestinal malignancy unless the tumor is locally advanced,perforated or likely to result in intestinal obstruction.If both lesions are complicated there may be a case for simultaneous treatment.The evolution of vascular stents and the reported efficacy of endovascular aortic repair (EVAR) provide an alternative method for treating high risk patients.If the anatomical criteria are satisfied,EVAR combined with laparoscopic operation could become the optimal solution for the concomitant AAA and gastrointestinal malignancy patients,especially those who require minimally invasive treatment.
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Objective: To investigate the effects of ω-3 fish oil fat emulsion on nutritional status and humoral immunity in postoperative patients suffering from gastrointestinal malignancy. Methods: Thirty patients of gastrointestinal malignancy were randomly divided into study group (n = 15) and control group (n = 15). All the patients were assigned to receive total parenteral nutrition with the equal nitrogen and calory,and those in study group received fish oil fat emulsion additionally. Liver and renal function, blood lipid, haemoglobin, albumin, transferrin, total lymphocyte count (TLC) , B lymphocyte subsets (B1, B2), immunoglobin(IgG, IgM, IgA) and complement(C3, C4) were determined preoperatively and 1, 6d postoperatively. Results: There were no significant differences in liver and renal function and blood lipid on postoperative day 6 versus preoperation in all the two groups. TLC, IgG, IgM, C3 on postoperative day 6 were siginificantly higher in the study group(P < 0. 05). Haemoglobin, albumin, transferrin and B lymphocyte subsets were not significantly different between the two groups. Conclusion: Fish oil fat emulsion treatment was safe and tolerated, and could improve the humoral immunity in patients.
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OBJECTIVE:To explore the clinical significance of water-soluble vitamins for injection in supportive care of postoperative tumor patients undergoing chemotherapy.METHODS:Water-soluble vitamins for injection was given to64post operative patients with gastrointestinal malignancy in treatment group for3days before chemotherapy and for7days after chemotherapy;adenosine triphosphate,coenzyme a and kalium chloratum were given to60patients in control group for the same period.Nutritional and oral mucosa condition,hemoglobin and hepatic function were observed before and after chemotherapy.RESULTS:Appetite increased in71.8%patients in treatment group,none was observed in control group(P
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Chyloperitoneum, also called chylous ascites, is a rarely reported complication of abdominal surgery. In most cases, the diagnosis and treatment is not difficult. The characteristic milky colored odorless fluid is easily detected by drainage or aspiration. With the help of diagnostic radiology and laboratory tests, it has become easier to detect the chyloperitoneum. Chyloperitoneum subsides spontaneously or responds well to medical treatment. Death from chyloperitoneum is extremely rare. However, 3 cases of medically intractable chyloperitoneum were encountered at our hospital after curative surgery for gastrointestinal malignancies (two colorectal cancers and one gastric cancer). Herein, the authors report these case and discuss their treatments.