Simultaneous laparoscopy-assisted resection for rectal and gastric cancer.

Laparoscopy-assisted surgery for either rectal or gastric cancer has been increasingly performed. However, simultaneous laparoscopy-assisted resection for synchronous rectal and gastric cancer is rarely reported in the literature. In our study, 3 cases of patients who received simultaneous laparoscopy-assisted resection for synchronous rectal and gastric cancer were recorded. The results showed that all 3 patients recovered well, with only 253 minutes of mean operation time, 57 mL of intraoperative blood loss, 5 cm of assisted operation incision, 4 days to resume oral intake, 12 days' postoperative hospital stay, and no complication or mortality. No recurrence or metastasis was found within the follow-up period of 22 months. When performed by surgeons with plentiful experience in laparoscopic technology, simultaneous laparoscopy-assisted resection for synchronous rectal and gastric cancer is safe and feasible, with the benefits of minimal trauma, fast recovery, and better cosmetic results, compared with open surgery.

Enteral and parenteral nutritional support for gastric cancer patients undergoing laparoscopic radical gastrectomy / 中华消化外科杂志

Objective To compare the effect and safety of enteral and parenteral nutritional support for gastric cancer patients undergoing laparoscopic radical gastrectomy(LRG). Methods Sixty gastric cancer patients received nutritional support after LRG at The Third Affiliated Hospital of Sun Yat-sen University from December 2007 to April 2010. All patients were randomly divided into the enteral nutrition(EN) group (n = 30)and parenteral nutrition (PN) group (n = 30) according to the random number table. Anthropometry, nutritional indexes, complications and expenses of the two groups were compared after treatment. All data were analysed by using the t test and chi-square test. Results Body mass index, triceps skin fold, mid-upper arm muscle circumference, hemoglobin levels, transferrin levels, and albumin levels were ( 16.9 ± 2.4) kg/m2, ( 10.6 ± 2.5 ) mm,(24.2 ±2.5) cm, (106 ± 15) g/L, (2.2 ±0.4) g/L and (39 ±3) g/Lin the EN group, and they were (16.6 ±2.1) kg/m2, (9.2 ± 1.3) mm, (24.0 ±3.4) cm, (102 ± 18) g/L, (2.0 ±0.4) g/L and (38 ±3) g/L in the PN group, respectively, with no significant differences between the two groups (t =0. 52, 1.72, 0.05, 0.93, 1.94,1.29, P ＞ 0.05). Prealbumin levels, nitrogen balance, time of first flatus, and daily expenses in the EN group were (0.30 ±0.10) g/L,0.8 ±0.3, (29 ± 10) hours and (210 ±30) yuan, while they were (0.25 ±0.09) g/L,0. 4 ± 0.2, (38±6) hours and ( 700 ± 50) yuan in the PN group, respectively, with a significant difference between the two groups ( t = 2. 03, 6. 08, 2. 25, 10. 38, P ＜ 0.05 ). One patient had dysbacteriosis, two were glycometabolic and two had a hepatic disorder in the EN group, while the corresponding numbers in the PN group were 9, 12 and 15 patients, respectively, with a significant difference between the two groups ( x2 =7.68, 9.32,13.87, P ＜ 0.05). Conclusions Nutritional support can promote the recovery of gastric cancer patients undergoing LRG. The efficacy of EN is superior to that of PN, and EN is the method of choice for nutritional support.