RESUMO
PURPOSE: This study aims to compare the effectiveness of Billroth-II with Braun and Roux-en-Y reconstruction after laparoscopic distal gastrectomy. METHODS: From April 2010 to August 2012, 66 patients underwent laparoscopic distal gastrectomy (Billroth-II with Braun reconstruction, 26; Roux-en-Y, 40). The patients' data were collected prospectively and reviewed retrospectively. RESULTS: The mean operation and reconstruction times were statistically shorter for Billroth-II with Braun reconstruction than Roux-en-Y (198.1 ± 33.0 vs. 242.3 ± 58.1 min, p = 0.001). One case of postoperative stricture was observed in each group. One case each of intra-abdominal abscess and delayed gastric emptying occurred in the Billroth-II with Braun group. At 1 year postoperatively, gastric residue and reflux esophagitis were not significantly different between the groups. Gastritis and bile reflux were more frequently observed in the Billroth-II with Braun group (p = 0.004 and p < 0.001, respectively). At 2 years postoperatively, gastric residue was not significantly different, but gastritis, bile reflux, and esophagitis were more frequent in the Billroth-II with Braun group (p = 0.029, p < 0.001, and p = 0.036, respectively). CONCLUSION: The postoperative effectiveness of Roux-en-Y reconstruction may be superior to Billroth-II with Braun reconstruction after laparoscopic distal gastrectomy.
Assuntos
Anastomose em-Y de Roux , Gastrectomia/métodos , Gastroenterostomia , Complicações Pós-Operatórias/etiologia , Neoplasias Gástricas/cirurgia , Abscesso Abdominal/etiologia , Idoso , Anastomose em-Y de Roux/efeitos adversos , Refluxo Biliar/etiologia , Constrição Patológica/etiologia , Esofagite Péptica/etiologia , Feminino , Gastrectomia/efeitos adversos , Esvaziamento Gástrico , Gastrite/etiologia , Gastroenterostomia/efeitos adversos , Humanos , Laparoscopia , Masculino , Pessoa de Meia-Idade , Duração da Cirurgia , Estudos RetrospectivosRESUMO
Gastric epithelial neoplasia is a very common disease entity in Korea, encompassing gastric adenoma and adenocarcinoma. There are still discrepancies in pathologic diagnosis of gastric epithelial neoplasia between Western and Japanese pathologists after Vienna consensus classification. With increasing use of endoscopic therapy such as endoscopic mucosal resection and endoscopic submucosal dissection, it is very important to agree on the consensus criteria in the diagnosis of gastric epithelial neoplasia among pathologists in Korea. On this background, the current concepts, and contemporary issues of definition, diagnostic and classification criteria of gastric epithelial neoplasia were reviewed.
Assuntos
Adenocarcinoma/patologia , Adenoma/patologia , Neoplasias Gástricas/patologia , Terminologia como Assunto , Adenocarcinoma/classificação , Adenoma/classificação , Biópsia , Conferências de Consenso como Assunto , Endoscopia Gastrointestinal , Células Epiteliais/patologia , Humanos , Japão , Variações Dependentes do Observador , Neoplasias Gástricas/classificaçãoRESUMO
There had been no previous reports of ruptured pseudoaneurysm of inferior phrenic artery shortly after blunt abdominal trauma. Traumatic arterial pseudoaneurysms are either iatrogenic or the result of penetrating injuries and one of the sequelae of trauma. Post-traumatic pseudoaneurysm develops at varying time intervals after the initial insult. To our knowledge, this is the first report of massive hemoperitoneum caused by ruptured inferior phrenic artery pseudoaneurysm after blunt trauma. Pseudoaneurysm of inferior phrenic artery in patient with diaphragm injury is potentially a life-threatening condition and requires urgent management. Diagnosis of ruptured inferior phrenic artery pseudoaneurysm is based on clinical assessment combined with radiological investigations. We report a case of ruptured left inferior phrenic artery pseudoaneurysm as one aspect of massive hemoperitoneum caused by blunt abdominal trauma.
