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Marco BARONE

San Camillo General Hospital
Trento, Italy
MD
158 likes
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Totally laparoscopic total gastrectomy for stage IIIA (cT3 cN1 cM0) advanced gastric carcinoma
A 66-year-old man was admitted to our hospital with complaints of epigastric pain. His hemoglobin level was 9.3g/dL. Endoscopy of the upper gastrointestinal tract (EGD) showed an advanced gastric carcinoma that had invaded the middle and lower third of the stomach. A biopsy specimen revealed a moderately differentiated adenocarcinoma. Abdominal computed tomography (CT) showed that the tumor had invaded the stomach wall. Enlarged lymph nodes were present only around the lesser curvature (regional lymph nodes No. 3). The patient was diagnosed with stage IIIA (cT3 cN1 cM0) advanced gastric carcinoma according to the Japanese classification of gastric carcinoma1. The patient was then taken to the operating room for exploratory laparoscopy and laparoscopic total gastrectomy with D2 lymphadenectomy. The operation time was 260 minutes. No further evidence of intra-abdominal disease or liver involvement was noted. The patient did well postoperatively and was subsequently discharged home on postoperative day 9. Four metastatic lymph nodes/twenty eight regional lymph nodes were found; so the pathological findings confirmed stage IIIA. The patient is disease-free at 10 months. Japanese Classification of Gastric Carcinoma - 2nd English Edition. Gastric Cancer 1998;1:10-24.
G Pignata, M Barone, U Bracale, E Gianetta, F Badessi
Surgical intervention
8 years ago
5279 views
33 likes
1 comment
26:02
Totally laparoscopic total gastrectomy for stage IIIA (cT3 cN1 cM0) advanced gastric carcinoma
A 66-year-old man was admitted to our hospital with complaints of epigastric pain. His hemoglobin level was 9.3g/dL. Endoscopy of the upper gastrointestinal tract (EGD) showed an advanced gastric carcinoma that had invaded the middle and lower third of the stomach. A biopsy specimen revealed a moderately differentiated adenocarcinoma. Abdominal computed tomography (CT) showed that the tumor had invaded the stomach wall. Enlarged lymph nodes were present only around the lesser curvature (regional lymph nodes No. 3). The patient was diagnosed with stage IIIA (cT3 cN1 cM0) advanced gastric carcinoma according to the Japanese classification of gastric carcinoma1. The patient was then taken to the operating room for exploratory laparoscopy and laparoscopic total gastrectomy with D2 lymphadenectomy. The operation time was 260 minutes. No further evidence of intra-abdominal disease or liver involvement was noted. The patient did well postoperatively and was subsequently discharged home on postoperative day 9. Four metastatic lymph nodes/twenty eight regional lymph nodes were found; so the pathological findings confirmed stage IIIA. The patient is disease-free at 10 months. Japanese Classification of Gastric Carcinoma - 2nd English Edition. Gastric Cancer 1998;1:10-24.
Totally laparoscopic subtotal gastrectomy with D2 lymphadenectomy for stage II (cT3 cN0 cM0) advanced gastric carcinoma
A 54-year-old female patient with a past medical history of hypertension presented with abdominal pain and an episode of coffee ground emesis. Symptoms of pain and vomiting started approximately two to three months before admission and began to worsen over the past month. The pain was relieved by food. The patient also admitted to unspecified weight loss over the same period of time. On physical examination, mild distension of the abdomen was observed with a mild to moderate tenderness to palpation involving epigastric tenderness. An endoscopy of the upper gastrointestinal tract (EGD) revealed a gastric ulcer extending to the lower part of the stomach. No active bleeding was observed at the site. Gastric outlet obstruction was also noted with an inflamed edematous pylorus. Biopsy revealed a moderately differentiated gastric carcinoma. Staging CT-scan imaging studies revealed no sites of metastasis. The patient was diagnosed with stage II (cT3 cN0 cM0) advanced gastric carcinoma according to the Japanese classification of gastric carcinoma. The patient was then taken to the operating room for laparoscopic subtotal gastrectomy with D2 lymphadenectomy. The operation time was 220 minutes. No further evidence of intra-abdominal disease or liver involvement was observed. The patient did well postoperatively and was subsequently discharged home on postoperative day 7. No metastatic lymph nodes / twenty-two regional lymph nodes were found; so the pathological findings confirmed stage II. The patient is disease-free at 12 months.
Japanese Classification of Gastric Carcinoma - 2nd English Edition. Gastric Cancer 1998;1:10-24.
G Pignata, U Bracale, M Barone, F Perna, P Becchi
Surgical intervention
8 years ago
6358 views
68 likes
1 comment
25:53
Totally laparoscopic subtotal gastrectomy with D2 lymphadenectomy for stage II (cT3 cN0 cM0) advanced gastric carcinoma
A 54-year-old female patient with a past medical history of hypertension presented with abdominal pain and an episode of coffee ground emesis. Symptoms of pain and vomiting started approximately two to three months before admission and began to worsen over the past month. The pain was relieved by food. The patient also admitted to unspecified weight loss over the same period of time. On physical examination, mild distension of the abdomen was observed with a mild to moderate tenderness to palpation involving epigastric tenderness. An endoscopy of the upper gastrointestinal tract (EGD) revealed a gastric ulcer extending to the lower part of the stomach. No active bleeding was observed at the site. Gastric outlet obstruction was also noted with an inflamed edematous pylorus. Biopsy revealed a moderately differentiated gastric carcinoma. Staging CT-scan imaging studies revealed no sites of metastasis. The patient was diagnosed with stage II (cT3 cN0 cM0) advanced gastric carcinoma according to the Japanese classification of gastric carcinoma. The patient was then taken to the operating room for laparoscopic subtotal gastrectomy with D2 lymphadenectomy. The operation time was 220 minutes. No further evidence of intra-abdominal disease or liver involvement was observed. The patient did well postoperatively and was subsequently discharged home on postoperative day 7. No metastatic lymph nodes / twenty-two regional lymph nodes were found; so the pathological findings confirmed stage II. The patient is disease-free at 12 months.
Japanese Classification of Gastric Carcinoma - 2nd English Edition. Gastric Cancer 1998;1:10-24.