Naoki Ikenaga | PubMed Health

PubMed2006

Long-term quality of life after laparoscopically assisted distal gastrectomy for gastric cancer.

OBJECTIVE: To investigate whether laparoscopically assisted distal gastrectomy (LADG) contributes to long-term quality of life as compared to open gastrectomy in patients with early-stage gastric cancer. MATERIALS AND METHODS: Quality of life was self-reported using a 15-item questionnaire with five options for each question. The responses obtained from 47 LADG patients and 33 conventional open gastrectomy patients were compared. All patients underwent Billroth I gastrectomy for early gastric cancer between September 1999 and October 2002. RESULTS: Patients who underwent LADG showed better results than those who underwent the open procedure with regard to satisfaction with the operation (87.2% vs. 57.6%; P < 0.01). However, the rate of late complications such as delayed gastric emptying was higher in the LADG group than in the open group (40.4% vs. 18.2%; P < 0.05). No differences were observed between the LADG and open groups with regard to appetite loss, heartburn, diarrhea, or difficulty in swallowing. CONCLUSION: LADG has an equivocal effect on long-term quality of life. Satisfaction with the surgical procedure was greater in patients who underwent the LADG method; however, complications that impaired the quality of life were also seen. The usefulness of LADG should be assessed in view of the immediate and relatively short-term outcomes and their effect on long-term quality of life.

Aged↗

PubMed2005

A minute nonfunctioning islet cell tumor demonstrating malignant features.

We report a patient with a minute nonfunctioning islet cell tumor, 8 mm in diameter, which demonstrated malignant features by histology. The patient was a 43-year-old Japanese woman, who had an elevated carbohydrate antigen (CA) 19-9 level, of 59 U/ml (normal range, <37 U/ml) identified on a health check to rule out malignancies. Ultrasonography and computed tomography demonstrated a well-defined pancreatic tumor, 8 mm in diameter, in the body of the pancreas. Serum levels of pancreatic hormones were within normal limits, and thus a tentative diagnosis was nonfunctioning islet cell tumor. The size of the tumor remained unchanged for 1 1/2 years, but, at this time, the serum level of CA19-9 was elevated to 253 U/ml. Segmental pancreatectomy was performed because malignancy could not be ruled out. The resected specimen showed an endocrine tumor invading both the pancreatic parenchyma and the perineural spaces outside the tumor. In general, minute nonfunctioning islet cell tumors have been considered to be completely benign, but the present tumor showed clear malignant features. We might have to take surgical resection into consideration even if the size of such an endocrine tumor is minute.

Adenoma, Islet Cell↗