Operative blood loss ≥ 1% of body weight and type of resection were associated with an increased frequency of postoperative complications, while preoperative C-reactive protein levels and operative blood loss may be prognostic predictors for gastric cancer patients following laparoscopy-assisted gastrectomy.

We report a case involving a minimally invasive single-incision laparoscopic and endoscopic cooperative local excision of a duodenal gastrointestinal stromal tumor. A 59-year-old man presented with a 35-mm lesion located in the second portion of the duodenum. A local resection was performed via single-incision laparoscopic and endoscopic cooperative surgery. Intraluminal endoscopic dissection of the duodenal mucosa and submucosa was performed circumferentially around the tumor. The resection was then completed by laparoscopic dissection of the seromuscular layer around the tumor. The tumor was retrieved laparoscopically. After confirming that the resection achieved clear surgical margins, we closed the duodenal wall with a laparoscopic stapling device. There were no postoperative complications, including stenosis. Single-incision laparoscopic and endoscopic cooperative surgery can be safely and effectively performed for a duodenal submucosal tumor.

Background Neoadjuvant chemoradiotherapy (CRT) followed by surgery is the standard approach for locally advanced esophageal cancer. Recently, the microenvironment (including the host immune response) after conventional chemo-and/or radiotherapy has been highlighted. The aim of this preliminary study was to evaluate peritumoral mast cells (MCs) in esophageal squamous cell carcinoma (ESCC) after neoadjuvant CRT. Methods We obtained a total of twenty specimens from patients with ESCC who underwent neoadjuvant CRT (30-40 Gy; 5-fluorouracil plus cisplatin) followed by surgery. We evaluated the expression of tryptase by MCs, Foxp3 by regulatory T cells, CD8 by cytotoxic T cells, and microvessel density (MVD) using immunohistochemistry. We investigated the correlation between the sizes of these marker-positive cell populations surrounding residual tumor nests, MVD and CRP, and clinical outcome. Results Patients with a low number of peritumoral MCs more frequently had lymphatic invasion (P = 0.0191). There was no significant correlation among the sizes of the marker-positive cell populations. We observed a significant negative correlation between the number of MCs and preoperative CRP levels (P = 0.009). Low numbers of peritumoral MCs, high MVD, and a preoperative C-reactive protein of [0.5 mg/dL were significantly associated with poor overall survival (MCs: P = 0.0239; MVD: P = 0.0317; CRP: P = 0.0395). Conclusion Our results suggest that peritumoral MCs may be associated with prognosis in patients with ESCC after neoadjuvant CRT.

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