1,721,144 research outputs found
Possible impact of COVID-19 on gastric cancer surgery in Italy
No full textThe outbreak of SARS-CoV2 infection, responsible for
the clinical manifestations named Corona Virus Disease
2019 or COVID-19 by the World Health Organization,
became a pandemic on the 12th March 2020.
Italy suffered the deepest impact, and its Health System is currently being severely tested by COVID-19
Malnutrition and postoperative complications in abdominal surgery
No full textWe read with great interest the article by Hennessey et al 1 who studied retrospectively the relationship between preoperative serum albumin and surgical site infection(SSI) in a heterogeneous population of 524 patients undergoing gastrointestinal surgery.A total of 105 patients developed SSI and among them hypoalbuminemia (>30 mg/dL) was significantly associated, both at univariate and multivariate analysis, with the development of SSI, deeper SSI and prolonged inpatient stay. It is well known that malnutrition is a significant risk factor of postoperative complications in major abdominal surgery. Disclosure: The authors declare that they have nothing to disclose. DOI: 10.1097/SLA.0b013e3182306457
However, in the last 3 decades we have assisted to an impressive improvement of anaesthetic and surgical techniques and in an amelioration of postoperative patient management that have led to a reduction of postoperative morbidity and mortality.
At the same time, some recent evidence suggests that being overweight and obesity, rather than malnutrition, are significant risk factors of postoperative complications in major abdominal surgery.
Indeed, in 2008 we published the results of a prospective study that evaluated the incidence of mortality and major and minor postoperative complications in patients who underwent surgery for gastric cancer between 2000 and 2006. In this study, we stratified patients according to the preoperative percentage weight loss (0%–5%, 5.1%–10%, >10%) and serumalbumin levels < 3.0 g/dL; 3.0–3.4 g/dL; ≥ 3.5 g/dL). Interestingly, the rate of major infectious, major non-infectious and minor infectious (as SSI) postoperative complications was similar in patients with serum albumin 8.1%, respectively); between 3.0 and 3.4 (8.8%, 13.3%, 17.7%, respectively) or ≥ 3.5 g/dL (10.5%, 7.9%, 8.7%, respectively). It is difficult to explain the difference between our study and that of Hennessey et al Indeed, the study of Hennessey et al was retrospective and it is unknown if the surgeons or the attending doctors who made the diagnosis of SSI in each case were blinded to the status of serum albumin. In addition, the population studied by Hennessey et al was extremely heterogeneous, including patients who underwent elective or urgent operations on the gastrointestinal tract including stomach, duodenum, gallbladder, small intestine and colon and rectum, whereas we studied only patients undergoing gastric surgery. It has been shown that malnutrition does not re-enter in the risk factors predictive of postoperative morbidity in surgery for malignant gastric tumors.
It seems that role of hypoalbuminemia in the development of SSI varies according to the type of disease, to the type of surgery and to the characteristics of patients
Laparoscopic Gastrectomy after Neoadjuvant Chemotherapy: Still Far from Solid Conclusions
No full textN/
Parenteral nutrition does not stimulate tumor proliferation in malnourished gastric cancer patients
No full textThe present study evaluated the effects of preoperative parenteral nutrition (PN) on tumor cell proliferation in malnourished gastric cancer patients
Classification of nodal stations in gastric cancer
No full textThe lymphatic drainage from the stomach is anatomically elaborate and it is very hard to predict the pattern of lymph node (LN) metastases from gastric cancer (GC). However, there are LN stations metastases that are more frequently observed depending on the tumor location. Furthermore, the incidence of metastasis to various regional LN stations depends on the depth of gastric-wall invasion. The Japanese Gastric Cancer Association (JGCA) classifies the regional LNs draining the stomach into 33 regional lymphatic stations. These are distinguished into three (N1-N3) groups with respect to the location of the primary tumor. The aim of this classification is to provide a common language for the clinical, surgical, and pathological description of GC
Clinical nutrition in surgical oncology: Young AIOM-AIRO-SICO multidisciplinary national survey on behalf of NutriOnc research group
Full text link: Malnutrition is a common condition in cancer patients which is usually associated with functional limitations, as well as increased morbidity and mortality. Based on the support of the young sections of Italian Association of Medical Oncology (AIOM), Italian Association of Radiotherapy and Clinical Oncology (AIRO) and Italian Society of Surgical Oncology (SICO) merged into the NutriOnc Research Group, we performed a multidisciplinary national survey with the aim to define the awareness of nutritional issues among healthcare professionals delivering anticancer care. The questionnaire was organized in four sections, as follows: Knowledge and practices regarding Nutritional Management of cancer patients; Timing of screening and assessment of Nutritional Status; Nutritional Treatment and prescription criteria; Immunonutrition and educational topics. The modules focused on esophagogastric, hepato-bilio-pancreatic and colorectal malignancies. Overall, 215 physicians completed the survey. As regards the management of Nutritional Status of cancer patients, many responders adopted the ERAS program (49.3%), while a consistent number of professionals did not follow a specific validated nutritional care protocol (41.8%), mainly due to lack of educational courses (14.5%) and financial support (15.3%). Nearly all the included institutions had a multidisciplinary team (92%) to finalize the treatment decision-making. Cancer patients routinely underwent nutritional screening according to 57.2% of interviewed physicians. The timing of nutritional assessment was at diagnosis (37.8%), before surgery (25.9%), after surgery (16.7%), before radiochemotherapy (13.5%) and after radiochemotherapy (7%). Most of the responders reported that nutritional status was assessed throughout the duration of cancer treatments (55.6%). An important gap between current delivery and need of nutritional assessment persists. The development of specific and defined care protocols and the adherence to these tools may be the key to improving nutritional support management in clinical practice
Going Beyond Counting First Authors in Author Co-citation Analysis
Full text linkThe present study examines one of the fundamental aspects of author co-citation analysis (ACA) - the way co-citation
counts are defined. Co-citation counting provides the data on which all subsequent statistical analyses and mappings
are based, and we compare ACA results based on two different types of co-citation counting - the traditional type that
only counts the first one among a cited work's authors on the one hand and a non-traditional type that takes into
account the first 5 authors of a cited work on the other hand. Results indicate that the picture produced through this non-traditional author co-citation counting contains more coherent author groups and is therefore considerably clearer. However, this picture represents fewer specialties in the research field being studied than that produced through the traditional first-author co-citation counting when the same number of top-ranked authors is selected and analyzed. Reasons for these effects are discussed
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