Pathophysiological disorders, quality of life evaluation and recommendations after total resection of the stomach

In recent years, attention has been paid to the quality of life of patients after resection of the stomach as an additional factor of the therapeutic procedure. However, the consequences of total resection of the stomach (especially distant ones) and the influence of different methods of reconstruction of the alimentary tract on patients' quality of life are still controversial.This article sums up the current state of knowledge of patients' quality of life after total resection of the stomach. The first part discusses the pathophysiological disorders which occur after such operations. This will allow the reader to better understand the symptoms which may possibly occur and then decide on the appropriate procedure to improve the patient's everyday function. The subsection on the evaluation of the quality of life on the basis of literature discusses the following problems: questionnaire research, laboratory investigations, endoscopic examinations, and morphological/his-tological examinations.The final part of the paper is a collection of available recommendations to patients after total resection of the stomach. They refer to: optimisation of the diet, prevention of deficiencies, and follow-up examinations, all of which may influence the quality of life

Untargeted metabolomics in gastric and colorectal cancer patients – preliminary results

IntroductionRecent years, microbiota-associated aspects have been analysed in multiple disorders regarding cancers. Existing evidence pints that gut microorganisms might take part in tumour origin and therapy efficacy. Nevertheless, to date, data on faecal metabolomics in cancer patients is still strongly limited. Therefore, we aimed to analyse gut untargeted metabolome in gastrointestinal cancer patients (i.e., gastric and colorectal cancer).Patients and methodsThere were 12 patients with either gastric (n=4) or colorectal cancer (n=8) enrolled and 8 analysed (n=4 each). Stool samples were collected prior to anti-cancer treatments. Untargeted metabolomics analyses were conducted by means of mass spectrometry.ResultsA plethora of metabolites in cancer patients we analysed were noted, with higher homogenity in case of gastric cancer patients. We found that the level of Deoxyguanosine,m/z 266.091,[M-H]-, Uridine,m/z 245.075,[M+H]+, Deoxyguanosine,m/z 268.104,[M]+, 3-Indoleacetic acid,m/z 176.07,[M+H]+, Indoxyl,m/z 132.031,[M-H]-, L-Phenylalanine,m/z 164.073,[M-H]-, L-Methionine,m/z 150.058,[M+NH4]+, was significantly higher in colorectal cancer patients and Ethyl hydrogen malonate,m/z 133.031,[M+H]+ in gastric cancer.ConclusionThe overall insights into untargeted metabolomics showed that most often higher levels of analysed metabolites were detected in colorectal cancer patients compared to gastric cancer patients. The link between gut metabolome and both local and distal metastasis might exist, however it requires confirmation in further multi-centre studies regarding larger sample size

Quality of life assessment in patients with a stoma due to rectal cancer

The AimThe aim of the study was to assess the quality of life in patients with a stoma, created for various reasons in the course of rectal cancer treatment.Material and MethodsThe study included 50 patients in the early post-surgery follow-up period, visiting the Stoma Outpatient Clinic in the Great Poland Centre in Poznań. All patients underwent surgery due to rectal cancer. Quality of life was assessed using anonymous questionnaires. Participation in the study was voluntary, and patients were informed about the proceedings. Standardized EORTC QLQ-C30 questionnaire for quality of life assessment in cancer patients and QLQ-CR38 module for colorectal cancer patients were used.ResultsIn all domains assessed, stoma patients showed significant impairment of functioning, which negatively influenced their quality of life. In our study group scores in all functional scales (physical – 70.6, role – 71.0, emotional – 61.8, cognitive – 75.6, social – 65) differed significantly from the reference values for the healthy population. QLQ-CR38 questionnaire was used to assess which symptoms were most disturbing for the patients. Negative influence of stoma on sexual functioning in men (mostly erectile and ejaculation dysfunctions) turned out to be the most significant (54.6). In women sexual dysfunctions were significantly less expressed (26.8). Another large group of symptoms having an unquestionable influence on level of functioning comprised direct stoma-related symptoms (47.8).ConclusionsCreation of a stoma still has a large negative impact on patients' quality of life. Influence of the stoma is most pronounced in the area of social functioning. In spite of improvement in support, the problems pertaining directly to the fact of having a stoma bag remain significant for this group of patients

Plasma total antioxidant status in breast cancer women in relation to lymph node involvement and HER-2/neu expression

BackgroundOxidants can act at several stages of malignant transformation. To protect against toxic effects of oxidants and to modulate physiological effects of their action organisms have developed antioxidant defence systems. Plasma total antioxidant activity (TAS) measures peroxyl-scavenging capacity of the extracellular antioxidant system.AimThe goal of this pilot study was to evaluate the plasma total antioxidant status in breast cancer women in relation to lymph node metastases and HER-2/neu expression.Materials/MethodsNewly diagnosed consecutive breast cancer patients (n=26) were recruited before any treatment and matched with controls (n=24) randomly selected from benign breast disease patients. Cancer progress was established according to lymph node involvement: No or N+. HER-2/neu was considered as either negative (0 or 1+) or positive (2+ or 3+). The plasma total antioxidant status (TAS) was measured by colorimetric test (RANDOX). HER-2/neu oncogene expression was determined in breast cancer tissue using the immunohistochemical method (Hercep Test).ResultsThe study demonstrated a significant decrease in the mean TAS level (mmol/L) in the breast cancer group (1.42±0.22) in comparison to the control group (1.56±0.18;

Insights into oral microbiome and colorectal cancer – on the way of searching new perspectives

Microbiome is a keystone polymicrobial community that coexist with human body in a beneficial relationship. These microorganisms enable the human body to maintain homeostasis and take part in mechanisms of defense against infection and in the absorption of nutrients. Even though microbiome is involved in physiologic processes that are beneficial to host health, it may also cause serious detrimental issues. Additionally, it has been proven that bacteria can migrate to other human body compartments and colonize them even although significant structural differences with the area of origin exist. Such migrations have been clearly observed when the causes of genesis and progression of colorectal cancer (CRC) have been investigated. It has been demonstrated that the oral microbiome is capable of penetrating into the large intestine and cause impairments leading to dysbiosis and stimulation of cancerogenic processes. The main actors of such events seem to be oral pathogenic bacteria belonging to the red and orange complex (regarding classification of bacteria in the context of periodontal diseases), such as Porphyromonas gingivalis and Fusobacterium nucleatum respectively, which are characterized by significant amount of cancerogenic virulence factors. Further examination of oral microbiome and its impact on CRC may be crucial on early detection of this disease and would allow its use as a precise non-invasive biomarker

Pathophysiological disorders, quality of life evaluation and recommendations after total resection of the stomach

SummaryIn recent years, attention has been paid to the quality of life of patients after resection of the stomach as an additional factor of the therapeutic procedure. However, the consequences of total resection of the stomach (especially distant ones) and the influence of different methods of reconstruction of the alimentary tract on patients' quality of life are still controversial.This article sums up the current state of knowledge of patients' quality of life after total resection of the stomach. The first part discusses the pathophysiological disorders which occur after such operations. This will allow the reader to better understand the symptoms which may possibly occur and then decide on the appropriate procedure to improve the patient's everyday function. The subsection on the evaluation of the quality of life on the basis of literature discusses the following problems: questionnaire research, laboratory investigations, endoscopic examinations, and morphological/his-tological examinations.The final part of the paper is a collection of available recommendations to patients after total resection of the stomach. They refer to: optimisation of the diet, prevention of deficiencies, and follow-up examinations, all of which may influence the quality of life

Complete Mesogastric Excisions Involving Anatomically Based Concepts and Embryological-Based Surgeries: Current Knowledge and Future Challenges

Surgeries for gastrointestinal tract malignancies are based on the paradigm that we should remove the tumour together with its lymphatic drainage in one block. This concept was initially proposed in rectal surgery and called a total mesorectal excision. This procedure gained much interest and has improved oncological results in rectal cancer surgery. The same idea for mesogastric and complete mesogastric excisions was proposed but, because of the complexity of the gastric mesentery, it has not become a standard technique. In this review, we analysed anatomical and embryological factors, proposed technical aspects of this operation and incorporated the available initial results of this concept. We also discussed analogies to other gastrointestinal organs, as well as challenges to this concept

Complete Mesogastric Excisions Involving Anatomically Based Concepts and Embryological-Based Surgeries: Current Knowledge and Future Challenges

Surgeries for gastrointestinal tract malignancies are based on the paradigm that we should remove the tumour together with its lymphatic drainage in one block. This concept was initially proposed in rectal surgery and called a total mesorectal excision. This procedure gained much interest and has improved oncological results in rectal cancer surgery. The same idea for mesogastric and complete mesogastric excisions was proposed but, because of the complexity of the gastric mesentery, it has not become a standard technique. In this review, we analysed anatomical and embryological factors, proposed technical aspects of this operation and incorporated the available initial results of this concept. We also discussed analogies to other gastrointestinal organs, as well as challenges to this concept