Two cuts are better than one.


Original image by Calvin Klein Inc. – Edited by Richard Kizzee

When told “you will need surgery,” many people feel helpless. If someone is going to look inside your body, you had better have some say in how they do it. Vrije Universiteit Amsterdam is home to a group of researchers who show why opting for minimally invasive gastric surgery may be a safer option than fully open surgery.

Stomach (gastric) cancer is the cause of 10% of cancer deaths worldwide. This type of cancer often calls for total gastrectomy, full removal of the stomach, to be stopped. Two methods generally exist for approaching the stomach to remove it. A single, long incision can be made allowing for surgery through a fist sized hole. Another approach is making multiple small incisions (about wide enough to poke a finger in) for surgery.

Researchers of this study compared open total gastrectomy (OTG) with minimally invasive total gastrectomy (MITG) for markers of surgical quality and patient outcome. This was done by analyzing the results of 12 studies involving a total of 1,360 patients, of whom 768 underwent OTG and 592 MITG. The results of their meta-study showed (average differences in parentheses):

Shorter operation time: OTG (48.06 minutes faster)
Lower blood loss: MITG (160.70 mL less)
Lower time to recovery: MITG (1.05 days sooner)
Shorter length of hospital stay: MITG (2.43 days less)
Less postoperative complications: MITG (32.72% less)
Completeness of procedure: Equal

Both techniques were equally excellent at removing cancer from the patients, however, the minimally invasive technique left people recovering faster and with less complications after surgery. The benefits of MITG seen here may also apply to da Vinci robotic surgery in general.

If you or a loved one need surgery, remember that techniques are improving every day. Whether opting for open or minimally invasive (or even robotic) surgery, you are in good hands.

Jennifer Straatman, Nicole van der Wielen, Miguel A. Cuesta, Elly S. M. de Lange – de Klerk, Elise P. Jansma, Donald L. van der Peet. Minimally Invasive Versus Open Total Gastrectomy for Gastric Cancer: A Systematic Review and Meta-analysis of Short-Term Outcomes and Completeness of Resection. World Journal of Surgery, 2016.
DOI: 10.1007/s00268-015-3223-1

Resveratrol Vs. Exercise

Photo provided by  Anthony L. Hall

Photo provided by Anthony L. Hall

Exercise proves itself yet again as a more powerful way to stay healthy than taking dietary supplements. The department of sport science at Chungnam National University is where research was done to study the effectiveness of exercise versus resveratrol on fighting fat.

Resveratrol is a nutrient found in many foods that has become famous in recent years for its benefits of reducing blood pressure, protecting the heart, and preventing neuro-degenerative diseases. Specifically related to this research, resveratrol can increase metabolism, reduce lipids in the body, and help weight loss. It has been touted as an alternative to exercise.

To test this, 30 obese mice were assorted into three groups of 10: (R) mice were given resveratrol five days per week (10mg/kg of body weight), (E) mice exercised (30-60 minutes of treadmill running for five days a week), (C) mice acted as the control. All mice were on a low fat diet for eight weeks along with their group’s regimen during the study. The concluding results showed an average weight loss of 15% for (E) mice and about 5% for (R) compared to the controls (C). The higher weight loss most likely resulted from increased fat breakdown and blockage of new fat creation seen from exercise.

Although resveratrol has many highly sought after health benefits, it cannot beat good ol’ fashioned exercise in the battle against obesity.

Jun Hyun Jeong, Hee Geun Park, Young Ran Lee, Wang Lok Lee. Moderate exercise training is more effective than resveratrol supplementation for ameliorating lipid metabolic complication in skeletal muscle of high fat diet-induced obese mice. The Journal of Exercise Nutricion & Biochemistry, 2015

Obesity regulator associated with pancreatic cancer risk

Human Pancreas Photo courtesy of  the Society for Endocrinology

Human Pancreas
Photo courtesy of the Society for Endocrinology

A recent study was done to find the link between circulating levels adiponectin and risk of developing pancreatic cancer. Adiponectin is a hormone associated with destroying fat derivatives, blocking endogenous glucose creation, and weight loss. A Boston based case-control study found varying levels of this hormone associated with pancreatic cancer incidence in cohorts.

Health Professionals Follow-up Study, Nurses’ Health Study, Physicians’ Health Study, Women’s Health Initiative, and Women’s Health Study were the five cohorts, resulting in 1080 subjects matched as the control against 468 pancreatic cancer case subjects. The subjects were matched by cohort, year of birth, smoking status, fasting status, and month of blood draw.

Analysis of the study revealed lower median levels of adiponectin in patients’ blood, 6.2 µg/mL, as opposed to control subjects, 6.8 µg/mL. These results were very significant with a statistical P-value of 0.009. This depicts lower levels of adiponectin as linked to higher risk of pancreatic cancer consistently across all studied cohorts and independent of other insulin resistance markers (type II diabetes, higher BMI, and normal to increased plasma C-peptide levels).

Compared with the bottom quintile (Q1) participants who had the lowest adiponectin, higher levels of adiponectin were associated with lower risk of cancer. Specifically, participants’ likelyhood of developing cancer vs. not (Odds Ratio) were:

Q2: Odds ratio of 0.61 for cancer, 95% confidence interval from 0.43 to 0.86.
Q3: Odds ratio of 0.58 for cancer, 95% confidence interval from 0.41 to 0.84.
Q4: Odds ratio of 0.59 for cancer, 95% confidence interval from 0.40 to 0.87.
Q5: Odds ratio of 0.66 for cancer, 95% confidence interval from 0.44 to 0.97.

Quintile analysis had a trend P-value of 0.04 indicating significance.

This shows that low prediagnostic levels of plasma adiponectin are indeed associated with higher risk of developing pancreatic cancer.

Although this is not the end all diagnostic result for early pancreatic cancer detection and treatment, it proves useful to have another marker to help in the fight.

Ying Bao, Edward L. Giovannucci, Peter Kraft, Meir J. Stampfer, Shuji Ogino, Jing Ma, Julie E. Buring, Howard D. Sesso, I-Min Lee, John Michael Gaziano, Nader Rifai, Michael N. Pollak, Barbara B. Cochrane, Virginia Kaklamani, Jennifer H. Lin, JoAnn E. Manson, Charles S. Fuchs and Brian M. Wolpin. 2012. A Prospective Study of Plasma Adiponectin and Pancreatic Cancer Risk in Five US Cohorts. Journal of the National Cancer Institute.