Laparoscopia e lavado peritoneal no pré-operatório do adenocarcinoma gástrico: podemos modificar a conduta?

Carlotto, Jorge Roberto Marcante; Carlotto, Fernanda Marcante; Neto, Marcos Dal Vesco; Pastorello, Julia; Schmitz, Lucas Duda; Dal-Vesco, Juarez Antonio

doi:10.1590/0100-6991e-20192314

Rev. Col. Bras. Cir.

2019

DOI: 10.1590/0100-6991e-20192314

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Laparoscopia e lavado peritoneal no pré-operatório do adenocarcinoma gástrico: podemos modificar a conduta?

Jorge Roberto Marcante Carlotto

Fernanda Marcante Carlotto

Marcos Dal Vesco Neto

et al.

Abstract: RESUMO Objetivo: avaliar se a laparoscopia com lavado peritoneal é superior à tomografia computadorizada para o estadiamento do adenocarcinoma gástrico e se pode modificar a conduta cirúrgica do paciente. Métodos: estudo retrospectivo de 46 pacientes portadores de adenocarcinoma gástrico tratados pela equipe de cirurgia digestiva do Hospital de Clínicas de Passo Fundo (RS), de janeiro de 2015 a dezembro de 2018, e submetidos à laparoscopia com lavado peritoneal pré-operatório. Todos os pacientes foram submet… Show more

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Cited by 2 publications

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“…The main causes of prolonged hospital stay and high hospitalization costs for acute-care hospital patients are related to development of complications, such as an infectious disease 1 . It has also been shown that prolonged hospitalization of general internal medicine inpatients is associated with higher costs and complication rates because of nosocomial infections 2 , and that postoperative complications such as infection increased the cost of hospitalization for patients who underwent a simultaneous pancreas-kidney transplantation 3 . Additionally, a strong relationship among hospitalization costs, healthcare resource utilization, and postoperative complications following a lower anterior resection procedure for rectal cancer has been demonstrated 4 .…”

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confidence: 99%

Relationship of oral bacterial number with medical hospitalization costs in analysis of Diagnosis Procedure Combination database from single institution in Japan

Nishi,

Kajiya,

Ohta

et al. 2024

Sci Rep

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Oral bacteria are known to be associated with perioperative complications during hospitalization. However, no presented reports have clarified the relationship of oral bacterial number with medical costs for inpatients. The Diagnosis Procedure Combination (DPC) database system used in Japan provides clinical information regarding acute hospital patients. The present study was conducted to determine the association of oral bacterial numbers in individual patients treated at a single institution with length of hospital stay and medical costs using DPC data. A total of 2369 patients referred by the medical department to the dental department at Hiroshima University Hospital were divided into the low (n = 2060) and high (n = 309) oral bacterial number groups. Length of hospital stay and medical costs were compared between the groups, as well as the associations of number of oral bacteria with Charlson comorbidity index (CCI)-related diseases in regard to mortality and disease severity. There was no significant difference in hospital stay length between the low (24.3 ± 24.2 days) and high (22.8 ± 20.1 days) oral bacterial number groups. On the other hand, the daily hospital medical cost in the high group was significantly greater (US$1456.2 ± 1505.7 vs. US$1185.7 ± 1128.6, P < 0.001). Additionally, there was no significant difference in CCI score between the groups, whereas the daily hospital medical costs for patients in the high group treated for cardiovascular disease or malignant tumors were greater than in the low number group (P < 0.05). Multivariate regression analysis was also performed, which showed that oral bacterial number, age, gender, BMI, cardiovascular disease, diabetes, malignant tumor, and hospital stay length were independently associated with daily hospitalization costs. Monitoring and oral care treatment to lower the number of oral bacteria in patients affected by cardiovascular disease or cancer may contribute to reduce hospitalization costs.

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mentioning

confidence: 99%

Relationship of oral bacterial number with medical hospitalization costs in analysis of Diagnosis Procedure Combination database from single institution in Japan

Nishi,

Kajiya,

Ohta

et al. 2024

Sci Rep

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Techniques of staging laparoscopy and peritoneal fluid assessment in gastric cancer: a systematic review

Rawicz‐Pruszyński

Erodotou

Pelc

et al. 2023

International Journal of Surgery

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Background: Staging laparoscopy for gastric cancer is recommended to assess the tumor’s locoregional extension and exclude peritoneal disease. As there is no consensus on optimizing the procedure’s diagnostic accuracy, we aimed to systematically review the literature on operative techniques, followed by peritoneal lavage fluid assessment in gastric cancer patients. Specifically, we sought to indicate the most common characteristics of the procedure and cytological evaluation. Methods: This study was conducted according to the preferred reporting items for systematic reviews and meta-analyses (PRISMA). The protocol for this systematic review was registered on PROSPERO database (CRD: 42022306746). On September 2022, a search was carried out using Embase, Medline ALL, Cochrane Central Register of Controlled Trials and Web of Science Core Collection. Results: The search identified 1632 studies on staging laparoscopy and 2190 studies on peritoneal fluid assessment. Some 212 studies were included. Open Hasson was the method of choice in accessing the peritoneal cavity in 65% of the studies, followed by establishing a pneumoperitoneum at 10-12mmHg in 52% of reports. Most frequently, the patient was positioned supine (70%), while a 30° scope and three ports were used to assess the peritoneal cavity clockwise (72%, 77%, and 85%, respectively). Right and left upper abdomen quadrants were the predominant area of laparoscopic exploration (both 65%), followed by primary tumor region (54%), liver and pelvis (both 30%), small bowel and spleen (19% and 17%, respectively). Regions of peritoneal lavage and aspiration were limited to pelvis (50%), followed by right and left upper abdomen quadrants (37.5% and 50%, respectively). No studies compared different methods of operative techniques or analysis of ascites/fluid. Conclusions: This study indicates a high heterogeneity in the technique of staging laparoscopy and peritoneal fluid assessment in gastric cancer patients. Further research and initiatives to reach a consensus on the standardization of the procedure are warranted.

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Laparoscopia e lavado peritoneal no pré-operatório do adenocarcinoma gástrico: podemos modificar a conduta?

Cited by 2 publications

References 13 publications

Relationship of oral bacterial number with medical hospitalization costs in analysis of Diagnosis Procedure Combination database from single institution in Japan

Relationship of oral bacterial number with medical hospitalization costs in analysis of Diagnosis Procedure Combination database from single institution in Japan

Techniques of staging laparoscopy and peritoneal fluid assessment in gastric cancer: a systematic review

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