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  • Gastric carcinoma  (4)
  • Body composition  (2)
  • Total gastrectomy  (2)
  • 1
    Electronic Resource
    Electronic Resource
    Estimation of extracellular space and blood volume using bioelectrical impedance measurements (1992)
    Springer
    Journal of molecular medicine 70 (1992), S. 600-605 
    Details
    ISSN: 1432-1440
    Keywords: Body composition ; Bioelectrical impedance ; Blood volume ; Extracellular space ; Malnutrition
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary The bromide-82 dilution space (extracellular space, ECS) and blood volume (BV) were measured in 21 patients with esophageal and gastric cancer and in 27 patients 18–96 months after total gastrectomy. Resistance (R) and reactance (Xc) from bioelectrical impedance measurements were used to obtain multiple regression equations for ECS and BV. The variables weight, gender, and height 2/Xc were independent predictors of ECS (r = 0.767; P 〈 0.0001). Height 2/R and gender were predictors of blood volume (r = 0.856; P 〈 0.0001). The mean difference between the Br space and the ECS predicted from impedance measurements was 0 ± 1.54 (mean ± SD). The limits of agreement (± 2 SD) were therefore ±3.081 or 19.6% of the mean Br space of 15.71. The limits of agreement for BV were ±789 ml or ±19.7% of the average BV of 4008 ml. It is concluded that bioelectrical impedance plethysmography using a single frequency can be used for the estimation of ECS and BV The wide limits of agreement, however, may limit its used in clinical practice.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF00184802
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  • 2
    Electronic Resource
    Electronic Resource
    Perspectives of surgery and multimodality treatment in gastric carcinoma (1993)
    Springer
    Journal of cancer research and clinical oncology 119 (1993), S. 384-394 
    Details
    ISSN: 1432-1335
    Keywords: Gastric carcinoma ; Gastric surgery ; Multimodality treatment ; Chemotherapy
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Surgery still represents the therapy of choice for patients with primary gastric adenocarcinoma. The best survival results can be achieved if a potentially curative (R0) resection can be performed whatever the extent of resection of the primary tumor (total versus subtotal distal gastrectomy). Either procedure should be accompanied by systematic lymph node dissection since lymphadenectomy has relevant diagnostic (i.e. staging) and therapeutic implications (i.e. improved survival in stage II/IIIA disease). Since most gastric carcinomas are diagnosed in advanced tumor stages, the number of patients to be treated curatively by surgery alone remains limited. Multimodality treatment, consisting of chemotherapy and surgery, may be an encouraging alternative strategy. With actual chemotherapy protocols (i.e. 5-FU/doxorubicin/methotrexate, etoposide/doxorubicin/cisplatin) high remission rates in locally advanced irresectable lesions without distant metastases can be induced. Survival in these patients has been significantly improved after chemotherapy and second-look surgery. The effectiveness of these protocols in an adjuvant setting seems a worthwhile study for the future. In addition, immunological and somatic gene therapy may be of therapeutic impact in the next decade.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF01218419
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  • 3
    Electronic Resource
    Electronic Resource
    Expression ofHer2/neu oncogene product p185 in correlation to clinicopathological and prognostic factors of gastric carcinoma (1992)
    Springer
    Journal of cancer research and clinical oncology 118 (1992), S. 474-479 
    Details
    ISSN: 1432-1335
    Keywords: Her2/neu oncogene product p185 ; Gastric carcinoma ; Clinicopathological variables ; Prognosis
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary The expression of theHer2/neu gene product p 185 was retrospectively analyzed in 58 patients with gastric carcinoma. The results were correlated to various clinicopathological and prognostic factors. Positive membrane staining for p185 could be detected in 38% of the patients (22/58). Membrane staining was significantly greater in well and moderately differentiated tumors of the intestinal type when compared with poorly differentiated lesions and carcinomas of the diffuse type (P〈0.01). Positive membrane staining did not correlate with site and tumor stage, but T1 lesions had less membrane staining than more advanced primary tumors. Overall survival showed no difference between p185-positive and negative cases. Multivariate analysis defined a subgroup of curatively resected patients with stage III and IV disease that had a statistically significant poorer survival when p185 was overexpressed (P=0.005). Overexpression of theHer2/neu product p185 appears to be associated with intestinal-type gastric carcinoma and may sociated with intestinal-type gastric carcinoma and may help in identifying a subset of patients at increased risk for shorter survival.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF01629433
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  • 4
    Electronic Resource
    Electronic Resource
    “Conservative” treatment of intra-abdominal complications after total gastrectomy with interventional radiological techniques (1989)
    Springer
    Surgical endoscopy and other interventional techniques 3 (1989), S. 16-20 
    Details
    ISSN: 1432-2218
    Keywords: Total gastrectomy ; Intra-abdominal septic complications ; Interventional therapy ; Reduction in relaparotomies
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary Septic complications following total gastrectomy usually require relaparotomy, which is associated with a high operative mortality. Due to the improvement of percutaneous drainage of abdominal abscesses we prefer this therapy for septic complications after total gastrectomy. Among 141 total gastrectomies, 14 patients developed subphrenic abscesses. While 2 patients required relaparotomy, 12 had interventional therapy by sonographically guided drainage and insertion of a pigtail catheter. The catheters were irrigated daily, and the patients received systemic antibiotics. Complete resolution of the abscess cavity was achieved, even in 1 case with simultaneous duodenal stump insufficiency without increasing morbidity. The hospital stay was prolonged for an average of 20 days by this “conservative” treatment. The management of septic complications following total gastrectomy with interventional techniques may reduce the number of operative reinterventions. The indication for such a therapy, however, needs to be evaluated on an individual basis.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF00591310
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  • 5
    Electronic Resource
    Electronic Resource
    Bedeutung des präoperativen Gewichtsverlusts für die perioperative Stoffwechseladaptation und das Operationsrisiko bei Patienten mit Tumoren im oberen Gastrointestinaltrakt (1992)
    Springer
    Langenbeck's archives of surgery 377 (1992), S. 45-52 
    Details
    ISSN: 1435-2451
    Keywords: Esophageal carcinoma ; Gastric carcinomaCancer cachexia ; Malnutrition ; Body composition ; Metabolism
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Zusammenfassung Zur Frage des Einflusses des präoperativen Gewichtsverlusts auf die metabolische Adaptation an das Operationstrauma und auf die Häufigkeit postoperativer Komplikationen wurden 44 Patienten mit Karzinomen des oberen Gastrointestinaltrakts (23 Ösophagus-und 21 Magenkarzinome) 10–14 Tage prä- und postoperativ im Ernährungsstatus, der Körperzusammensetzung und der Stoffwechsellage untersucht. Die Patienten wurden entsprechend dem präoperativen Gewichtsverlust in den letzten 6 Monaten vor der stationären Aufnahme in 3 Gruppen unterteilt: I: Abnahme um 0–5% des Ausgangsgewichts, II: 5–10% und III: 〉 10%. 50% der Patienten wiesen präoperativ keinen oder nur einen geringen Gewichtsverlust auf. Auch bei hohem Gewichtsverlust wurde das jeweils errechnete ideale Körpergewicht nicht unterschritten. Körperzellund Fettmasse waren in Gruppe III signifikant (p 〈 0,05) niedriger als in Gruppe I. Da der Ruheenergieverbrauch bei den meisten Patienten nicht erhöht war, müssen als Ursache des Gewichtsverlusts Tumorstenose und Dysphagie, jedoch nicht ein Hypermetabolismus, angesehen werden. Mehr als 50% des Energiebedarfs wurden durch Lipidoxidation gedeckt. Insgesamt erfüllten selbst die Patienten in Gruppe III nicht die Kriterien einer Mangelernährung. Der perioperative Gewichtsverlust war in der Gruppe III am niedrigsten (1,6 ± 4,9 kg) im Vergleich zu den Gruppen I und II mit 2,9 ± 1,7 bzw. 5,0 ± 6,9 kg. In allen Gruppen wurde eine Erhöhung des Energieverbrauchs und der Fettoxidationsrate, einhergehend mit einer Hemmung der Glukoseoxidation, beobachtet. Dies resultierte in einer Verminderung der Körperzellmasse. Unabhängig vom präoperativen Gewichtsverlust kam es bei 8 Patienten zu schwerwiegenden Komplikationen mit Pneumonie in 6 und Anastomoseninsuffizienz in 2 Fällen. Kein Patient verstarb. Die metabolische Reaktion auf das Operationstrauma ist auch bei Patienten mit ausgeprägtem präoperativem Gewichtsverlust adäquat. Diese Patienten bleiben kompensiert und der präoperative Gewichtsverlust ist ohne signifikanten Einfluß auf die postoperative Komplikationsrate.
    Notes: Summary Body composition and energy expenditure were investigated before and 10–14 days after surgery in 44 patients with upper gastrointestinal cancer (23 esophageal and 21 gastric cancer) in order to assess the impact of preoperative weight loss on metabolic adaptation to the surgical trauma and on postoperative complications. Patients were divided in three groups with I: 0–5%, II: 5–10% and III: 〉 10% preoperative weight loss related to the usual body weight. 50% of the patients presented with no or just minor weight loss. Even in case of weight loss 〉 10% no decrease below the ideal body weight was observed. Body cell mass and fat mass were significantly (p 〈 0.05) reduced in group III when compared with I. Since energy expenditure and substrate oxidation rates were rather normal in most patients weight loss was considered to be due to tumor related stenosis and dysphagia. More than 50% of the energy requirements were gained from fat oxidation. General criteria of malnutrition were not fulfilled. Perioperative weight loss was lowest (1.6 ± 4.9 kg) in patients of group III related to group I (2.9 ± 1.7 kg) and II (5.0 ± 6.9 kg). Similar elevation of energy expenditure and lipid oxidation with concomitant reduction in glucose oxidation was observed in all groups of patients. This led to a similar decrease of body cell mass. Independant of preoperative weight loss major complications occurred in 8 cases — pneumonia in 6 and leakage of the anastomosis in 2 patients; no patient died. From this study can be concluded that with regard to perioperative weight loss the metabolic response to surgical trauma is adequate even in patients with marked preoperative weight loss. These patients remain compensated and preoperative weight loss is without major effect on postoperative complication rate.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF00186148
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  • 6
    Electronic Resource
    Electronic Resource
    247. Die Insuffizienz der oesophagojejunalen Anastomose als Komplikation der Gastrektomie bei malignen Magentumoren: Bilanz nach 539 Gastrektomien (1983)
    Springer
    Langenbeck's archives of surgery 361 (1983), S. 763-764 
    Details
    ISSN: 1435-2451
    Keywords: Malignant tumours of the stomach ; Total gastrectomy ; Proximal anastomotic failure ; Maligne Magentumoren ; Gastrektomie ; proximale Nahtinsuffizienz
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Zusammenfassmg Die Insuffizienz der oesophagojejunalen Anastomose nach Gastrektomie ist eine der häufigsten Komplikationen mit hoher Letalität. Als Ursache sind u. a. hauptsächlich operationstechnische Schwierigkeiten und Fehler anzuführen. Nach insgesamt 539 Gastrektomien kam es 55mal zur proximalen Nahtinsuffizienz, die in 38,2 % letal verlief. Seit Durchführung der Gastrektomie „ode principe” konnte sowohl die postoperative Letaktät wie auch die Frequenz der tödlichen Nahtinsuffizienzen deutlich gesenkt werden (20,6 bzw. 75 % auf 9,3 % bzw. 35,3 %). Vorteilhaft erwies sich die Anlage einer proximalen End/SeitAanastomose bei der Jejunuminterposition oder der Roux-Schlinge. Prävention dieser Komplikation nach Gastrektomie kommt entscheidende Bedeutung zu.
    Notes: Summary Failure of oesophageal anastomosis represents one of the most serious and highly lethal complication of total gastrectomy. Anastomotic disruption is mainly due to surgical difficulties or errors. Among a total of 539 total gastrectomies proximal anastomotic leakage was observed in 55 cases, of which 38.2 % proved lethal. By performing total gastrectomy de principe postoperative mortality and the incidence of lethal anastomotic failure were reduced considerably (from 20.6 % or 75 %, respectively to 9.3 % or 35.3 % respectively). Best results could be obtained with a proximal end-to-side oesophagojejunostomy (jejunal interposition and Roux-en-Y loop). Prevention of this complication by exact anastomotic technique is the crucial point.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF01276072
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  • 7
    Electronic Resource
    Electronic Resource
    233. Ansatzpunkte zur Verbesserung der Resektionsquote beim fortgeschrittenen Magencarcinom mit einem neuen präoperativen Chemotherapiekonzept (EAP) (1987)
    Springer
    Langenbeck's archives of surgery 372 (1987), S. 870-870 
    Details
    ISSN: 1435-2451
    Keywords: Gastric carcinoma ; Chemotherapy ; EAP ; Second-look operation ; Magencarcinom ; Chemotherapie ; EAP ; Sekundäreingriff
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Zusammenfassung Etoposid, Adriamycin und Cisplatin (EAP) führten bei 55 Patienten (Pat.) mit fortgeschrittenem Magencarcinom zu einer partiellen und kompletten Remission (PR + CR) von 70%. 16 Pat. hatten ein lokal fortgeschrittenes, primär irresektables Carcinom. Die PR + CR betrug hier 87% (14/16). 8 dieser Pat. wurden einem Sekundäreingriff zugeführt. Neben anderen Verfahren war in 4 Fällen eine Gastrektomie möglich. Die CR bestätigte sich bei 5 Pat. auch histologisch. Die Resektionsquote beim lokal fortgeschrittenen Magencarcinom mag durch präop. Gabe von EAP verbessert werden.
    Notes: Summary Etoposide, adriamycin, and cisplatin (EAP) led to partial or complete remission (PR + CR) in 70% in 55 patients with advanced gastric carcinoma. Sixteen patients had local advanced tumors for which primary resection was not possible. PR + CR was 87% (14/16) in this group. In eight patients, a second-look operation was performed. Among other procedures, gastrectomy was achievable in 4 cases. CR was confirmed histologically in 5 patients. The resectability rate in locally advanced gastric carcinoma may improve after preoperative application of EAR
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF01298017
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  • 8
    Electronic Resource
    Electronic Resource
    Ermöglichen immunologische Marker eine Differenzierung zwischen den histologischen Typen des Magenkarzinoms? (1990)
    Springer
    Langenbeck's archives of surgery 375 (1990), S. 135-140 
    Details
    ISSN: 1435-2451
    Keywords: Gastric carcinoma ; Keratin ; Villin ; Brush border hydrolases
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Zusammenfassung Siebzehn Magenkarzinome (intestinal n=12; diffus n=1; Mischtyp n=4) und ein BarrettKarzinom wurden prospektiv hinsichtlich der Expression verschiedener Keratinpolypeptide sowie der Bürsten-saummarker Villin, Sucrase Isomaltase and Aminopeptidase N immunfluoreszenzmikroskopisch untersucht. Unabhängig vom histologischen Typ exprimierten alle Karzinome die Keratinpolypeptide 8, 18 and 19 and reagierten mit dem breit spezifischen Keratinantikbrper KL1. Das Keratin 7 hingegen wurde nur in einem Karzinom von nahezu allen Tumorzellen and bei zwei weiteren Karzinomen nur von einigen Tumorzellen exprimiert. Die weitergehende Differenzierung der verschiedenen hi stologischen Typen des Magenkarzinoms ist mit Hilfe der Keratinantikörper nicht m6glich. Villin war in 80% aller Karzinome and Sucrase Isomaltase and Aminopeptidase N waren in je 67%, wiederum ohne histologiespezifische Unterschiede, positiv. Die Nachweisbarkeit der Bürstensaummarker, charakteristisches Kennzeichen des intestinalen Epithels, verdeutlicht das hohe Maß der intestinalen Differenzierung der Magenkarzinome, ohne daß eine Zuordnung zu bestimmten histologischen Typen möglich erscheint.[/p]
    Notes: Summary Seventeen gastric carcinomas (intestinal n=12; diffuse n=1; mixed type n=4) and one Barrett's carcinoma were prospectively studied by immunohistochemistry for the expression of different keratin polypeptides and of the brush border markers villin, sucrase isomaltase and aminopeptidase N. All carcinomas expressed the keratin polypeptides 8, 18, and 19 and were stained by the broad specific keratin antibody KL1, irrespective of histologic type. Keratin 7, however, was expressed in only one carcinoma in most tumor cells and in two further carcinomas in some tumor cells. Thus, specific differentiation of the various histologic types of gastric carcinoma does not seem to be aided by the use of keratin antibodies. Villin was positive in 80% of the tumors and sucrase isomaltase and aminopeptidase N were positive in 67% respectively with no obvious histologic difference. The frequent positivity of the brush border markers, usually typical for intestinal epithelium, reflects the high degree of intestinal differentiation of gastric carcinomas, but again does not seem to be associated with a particular histologic type.[/p]
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF00206805
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