The CHOLEGAS study: multicentric randomized, blinded, controlled trial of gastrectomy plus prophylactic cholecystectomy versus gastrectomy only, in adults submitted to Gastric cancer surgery with curative intent

<p>Abstract</p> <p>Background</p> <p>The incidence of gallstones and gallbladder sludge is known to be higher in patients after gastrectomy than in general population. This higher incidence is probably related to surgical dissection of the vagus nerve branches and the anatomical gastrointestinal reconstruction. Therefore, some surgeons perform routine concomitant cholecystectomy during standard surgery for gastric malignancies. However, not all the patients who are diagnosed to have cholelithiasis after gastric cancer surgery will develop symptoms or require additional surgical treatments and a standard laparoscopic cholecystectomy is feasible even in those patients who underwent previous gastric surgery. At the present, no randomized study has been published and the decision of gallbladder management is left to each surgeon preference.</p> <p>Design</p> <p>The study is a randomized controlled investigation. The study will be performed in the General and Oncologic Surgery, Department of Oncology – Azienda Ospedaliero-Universitaria Careggi – Florence – Italy, a large teaching institution, with the participation of all surgeons who accept to be involved in, together with other Italian Surgical Centers, on behalf of the GIRCG (Italian Research Group for Gastric Cancer).</p> <p>The patients will be randomized into two groups: in the first group the patient will be submitted to prophylactic cholecystectomy during standard surgery for curable gastric cancer (subtotal or total gastrectomy), while in the second group he/she will be submitted to standard gastric surgery only.</p> <p>Trial Registration</p> <p>ClinicalTrials.gov ID. NCT00757640</p

Conspecific injury raises an alarm in medaka

10.1038/srep36615Scientific Reports63661

Patterns of prey selection of Trypoxylon (Trypargilum) lactitarse Saussure (Hymenoptera: Crabronidae) in southern Brazil

This study was carried out in the Parque Municipal das Araucárias, in the municipality of Guarapuava, southern Brazil. A total of 449 T. lactitarse nests were collected using trap-nests of different diameters. Fifty three species of spiders belonging to 7 families were captured by T. lactitarse. Araneidae was the most captured family and has been strongly represented by the genus Eustala. Through Bray-Curtis's coefficient and the unweighted pair group method average (UPGMA), the spiders species can be divided into 3 groups: the smaller group includes the most abundant species (Eustala sp1, Eustala sp2, Acacesia villalobosi, Alpaida sp1 and Araneus corporosus), the second group includes species with intermediate abundance (Wagneriana iguape, Araneus omnicolor, Eustala sp4, Alpaida grayi, Eustala sp3, Larinia t-notata, Mangora sp1 and Wagneriana iguape), and the third and largest group includes the least abundant species (Aysha gr. brevimana 1, Eustala sp5, Wagneriana eupalaestra, Alpaida scriba, Alpaida veniliae, Araneus aff. omnicolor, Araneus sicki, Eustala sp8, Mangora sp2, Mangora sp3, Wagneriana juquia, Alpaida sp2, Araneus blumenau, Eustala sp6, Eustala sp7 and Ocrepeira galianoae). Of 2,029 identified spiders, 1,171 were captured in the Araucaria forest, 612 in grassland areas and 246 in the swamp. Grassland and swamp areas evidenced greater similarity between them than to the Araucaria Forest, regarding presence-absence of spider species in T. lactitarse's diet, as well as regarding species abundance in these habitats. The juvenile number (56%) was significantly higher than the female (38%) and male (6%) percentages

The Cholegas Study: safety of prophylactic cholecystectomy during gastrectomy for cancer: preliminary results of a multicentric randomized clinical trial

Abstract BACKGROUND: Cholelithiasis is more frequent in patients after gastrectomy, due to dissection of vagal branches and gastrointestinal reconstruction. METHODS: A randomized controlled trial was conducted from November 2008 to March 2012. Patients were randomized into two groups: prophylactic cholecystectomy (PC) and standard gastric surgery only (SS) for curable cancers. We planned three end points: evaluation of the number of patients who developed symptoms and needed further surgery for cholelithiasis after standard gastric cancer surgery, evaluation of the incidence of cholelithiasis overall after standard gastric cancer surgery and perioperative complications or costs of prophylactic cholecystectomy. The present study answers to the last end point only. RESULTS: After 40 months from the beginning of study, 172 patients were eligible from 9 Centers. Ten patients refused consent and 32 were excluded due to flawing of inclusion criteria (not confirmed adenocarcinomas and no R0 surgery). Therefore, final analysis included 130 patients: 65 in PC group and 65 in SS. Among PC group, 12 patients had surgical complications during the perioperative period; only 1 biliary leakage, conservatively treated, might have been caused by prophylactic cholecystectomy. 6 patients had surgical complications in SS group. One postoperative death occurred in PC group due to pulmonary embolism. Differences were not statistically significant. Similarly, no differences were significant in duration of surgery, blood loss, hospital stay. CONCLUSIONS: Concomitant cholecystectomy during standard surgery for gastric malignancies seemed to add no extra perioperative morbidity, mortality and costs to the sample included in the study