In patients with dyspeptic symptoms who have been treated for gastric cancer, other medical conditions apart from cancer recurrence should be considered. A long small-bowel loop left after esophagogastric anastomosis, flaccid diaphragmatic crura, and several external factors such as hard physical exertion can promote the development of postoperative hiatus hernia. The authors of this paper present a rare case of hiatus hernia considered a late complication of primary surgery performed due to gastric cancer. The 63-year-old patient had undergone total gastrectomy with double tract reconstruction (DTR) six years earlier. Gastrectomy was performed with extended lymphadenectomy (>D2). Histopathologic examination of tumor specimens showed mucinous adenocarcinoma with no lymph node metastasis and no distant metastases (pathologic staging: pT2, pN0, pM0). After six years, the patient was admitted to the 2nd Department of General and Gastroenterologic Surgery with abdominal pains, malaise, weight loss and feeling of fullness after small meals. Diagnostic procedures performed showed the presence of hiatus hernia, a very rare complication after this particular surgery, with no features of cancer recurrence. The patient was underwent surgery and the hernia was successfully repaired.
Gallbladder cancer is a relatively rare cancer of the gastrointestinal tract, most commonly detected (approximately 95% of cases) in the most advanced clinical stage IV and burdened with high mortality rate. This is mainly due to the nonspecific symptoms in the early stages of the disease. The remaining cases of gallbladder cancer are usually detected after surgery due to gallstone disease. Gallstones, their size and pancreatic juice reflux into the gallbladder are risk factors in the development of gallbladder cancer. In this paper the authors carried out a retrospective research based on an evaluation of a group of 38 patients treated surgically due to the gallbladder cancer in the years 2005-2012 in the Second Department of General and Gastroenterological Surgery in Białystok Medical University Hospital. In this group there were 29 women and 9 men, in age between 48-86 years. Although women suffered from gallbladder cancer more often than men, their survival rate was significantly better after the surgery. The research showed some benefits of extended surgical procedures even in patients with advanced stages of the disease, while the effectiveness of surgical treatment depends mainly on the possibility of radical resection of the primary lesion and, eventually, the resection of lymph nodes and other infiltrated tissues.
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