Introduction: Although it was reported that serum zinc levels were lower in patients with various malignancies, serum zinc levels of patients with gastric cancer was not well documented. Objectives: This study aimed to evaluate the association between clinicopathologic features and serum zinc levels in preoperative patients with gastric cancer. Methods: The study enrolled 83 patients scheduled for gastric cancer surgery at the Kochi Medical School. Clinical data were obtained to investigate associations between clinicopathological features, including nutritional indicators and serum zinc levels. Serum zinc deficiency was defined as serum zinc level < 80 μg/dL. Results: The median zinc level of the 83 patients was 73 μg/dL (range, 20–152 μg/dL), and serum zinc deficiency was present in 66.3% of patients. Albumin was significantly lower in the zinc low level group than in the normal group (3.9 g/dL vs. 4.4 g/dL, P < 0.001), and the median serum zinc level was significantly lower in the albumin < 4.1 g/dL group than in the albumin ≥ 4.1 g/dL group (69 μg/dL vs. 82 μg/dL, P < 0.001). Lymphocyte count was significantly lower in the zinc low level group than in the normal group (1500 vs. 1810 years, P = 0.041). The median serum zinc level was significantly lower in the age ≥ 74 group than in the age < 74 (71 μg/dL vs. 76 μg/dL, P = 0.002). Serum zinc levels showed a significant positive correlation with serum albumin (r = 0.637, P = 0.009). Discussion/Conclusion: Serum zinc deficiency was found in 66.3% of preoperative patients with gastric cancer, which was highly correlated with serum albumin.
Purpose This study aimed to evaluate the association between clinicopathologic features and serum zinc levels in preoperative patients with gastric cancer. Methods The study enrolled 83 patients scheduled for gastric cancer surgery at the Kochi Medical School. Clinical data were obtained to investigate associations between clinicopathological features, including nutritional indicators and serum zinc levels. Serum zinc deficiency was defined as serum zinc level < 80 µg/dL. Results The median zinc level of the 83 patients was 73 µg/dL (range, 20–152 µg/dL), and serum zinc deficiency was present in 66.3% of patients. Albumin was significantly lower in the zinc low level group than in the normal group (3.9 g/dL vs. 4.4 g/dL, P < 0.001), and the median serum zinc level was significantly lower in the albumin < 4.1 g/dL group than in the albumin ≥ 4.1 g/dL group (69 µg/dL vs. 82 µg/dL, P < 0.001). Lymphocyte count was significantly lower in the zinc low level group than in the normal group (1500 vs. 1810 years, P = 0.041). The median serum zinc level was significantly lower in the age ≥ 74 group than in the age < 74 (71 µg/dL vs. 76 µg/dL, P = 0.002). Serum zinc levels showed a significant positive correlation with serum albumin (r = 0.637, P = 0.009). Conclusions Serum zinc deficiency was found in 66.3% of preoperative patients with gastric cancer, which was highly correlated with serum albumin.
We report a case of a 93‐year‐old woman with gastric cancer who presented with gastroduodenal intussusception and was treated with laparoscopic distal gastrectomy. Esophagogastroduodenoscopy showed a giant protruding lesion in the gastric antrum extending into the duodenal bulb, and biopsy confirmed a well‐differentiated adenocarcinoma. Abdominal contrast‐enhanced computed tomography (CT) revealed a well‐defined mass with homogeneous enhancement and a stalk arising from the distal stomach extending into the duodenal bulb. With a clinical diagnosis of gastric cancer with gastroduodenal intussusception, the patient underwent laparoscopic distal gastrectomy with regional lymph node dissection and reconstruction using the Billroth I method. Reduction of the intussusception was performed through a 4 cm incision under the xiphoid process in the epigastric region because it could not be laparoscopically reduced. Gross examination of the resected specimen showed a well‐circumscribed, elevated lesion measuring 11.2 × 4.7 × 3.6 cm in the antrum. Microscopic examination of the elevated tumor confirmed the diagnosis of well‐differentiated adenocarcinoma invading the gastric submucosal layer without lymph node metastasis. There was no lymphatic or venous invasion or lymph node metastasis. The postoperative course was uneventful, and her hemoglobin level improved to 11.9 g/dL. The patient has been postoperatively well without evidence of recurrence for 3 months. Part of the superficial spreading‐type tumor may be drawn into the duodenum under strong peristaltic movement because it does not infiltrate the muscle layer.
We present an unusual case of laparoscopic total gastrectomy with lymph node dissection in a 56-year-old woman with gastric cancer and agenesis of the dorsal pancreas (ADP). Esophagogastroduodenoscopy revealed erosive lesions with thickened gastric folds; biopsy specimens revealed a poorly differentiated adenocarcinoma. Abdominal contrast-enhanced computed tomography showed a thickened wall of the gastric body; the distal pancreas was not visualized. Under the clinical diagnosis of gastric cancer with ADP, the patient underwent laparoscopic total gastrectomy with standard lymphadenectomy. The absence of a pancreatic neck, body, and tail was confirmed; lymph nodes along the splenic artery were dissected. Pathological analysis demonstrated a poorly differentiated adenocarcinoma invading the serosa, with five lymph node metastases. The postoperative course was unremarkable; postoperative adjuvant chemotherapy was performed using S-1 plus oxaliplatin. No symptom recurrence was observed at the 6-month follow-up. Laparoscopic surgery, with careful preoperative anatomic evaluation, can be considered for concurrent gastric cancer and ADP.
Purpose Despite the widespread use of laparoscopic surgery, intracorporeal anastomosis remains a complicated procedure. This study aimed to investigate the efficacy of novel staple line reinforcement (SLR) during laparoscopic gastrectomy for gastric cancer. Methods This study included 30 patients who underwent laparoscopic gastrectomy for gastric cancer at Kochi Medical School between November 2021 and May 2022. A review of these patients was conducted, and perioperative outcomes were compared according to the use of SLR. Results The reconstruction time using SLR was significantly shorter than that for when SLR was not used (20.5 min vs. 32.0 min, P = 0.048). The incidence of hemostasis during anastomosis was significantly lower in the SLR group than in the non-SLR group (0 vs. 3 times, P = 0.041). There were no significant differences in the operating time and estimated blood loss after surgery between the two groups. Furthermore, there were no significant differences in postoperative complications or nutritional status between the two groups. Conclusions The results demonstrated the usefulness of SLR, which could reduce the time for intracorporeal reconstruction during laparoscopic gastrectomy for gastric cancer.
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