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課程表 - 中華民國癌症醫學會

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課程表 - 中華民國癌症醫學會 Powered By Docstoc
					                        一校三院          胃暨食道癌團隊聯合研討會

日期:2012年02月18日(星期六)

時間:08:00-12:40PM

                     地點:台北醫學大學附設醫院 第三醫療大樓11樓會議室

     時間                                             議程

 08:00-08:30                                        報到

 08:30-08:50                                      長官致詞

  Section I                             主持人:雙和醫院 吳志雄院長

     時間                             主題

 09:00-09:50            達文西機械手臂應用於胃癌手術

 09:50-10:40     Laparoscopic subtotal gastrectomy in TMUH

 10:40-10:50                                       Break


  Section II                     主持人:台北醫學大學附設醫院 邱仲峯副院長

               Guidelines for the management of esophageal and
 10:50-11:40
                                gastric cancer

 11:40-12:30              胃癌之標靶治療-Herceptin

 12:30-12:40                      綜合討論


                                                    歸賦
聯合研討會




大樓11樓會議室




詞

 吳志雄院長

             主講者

         臺北榮民總醫院 一般外科
            方文良醫師
     台北醫學大學附設醫院一般外科
         李泓家醫師




設醫院 邱仲峯副院長

        台北醫學大學附設醫院 放腫科
            郭嘉駿醫師
        台北醫學大學附設醫院 血腫科
            蔡佳叡醫師

             全體講師
課程屬性 課程分類 辦理單位   日 期     開始時間 結束時間 時數                        課 程 主 題
胃
暨
食
道
癌
相          癌
關          症
研          中   101/02/18  9:00 9:50 50分             達文西機械手臂應用於胃癌手術
究          心
與

臨
床
治
療
胃
暨
食
道
癌
             癌
相
             症
關                                                 Laparoscopic subtotal gastrectomy
             中   101/02/18   9:50   10:40   50分
研                                                              in TMUH
             心
究
與
臨
床
治
療
胃
暨
食
道
癌
        癌
相
        症                                     Guidelines for the management of
關
        中   101/02/18   10:50   11:40   50分     esophageal and gastric cancer
研
        心
究
與
臨
床
治
療
    胃
    暨
    食
    道
    癌   癌
    相   症
    關   中   101/02/18   11:40   12:30   50分      胃癌之標靶治療-Herceptin
    研   心
    究
    與
    臨
    床
    治
    療
    主講者          主講者職稱          地點




臺北榮民總醫院 一般外科    臺北榮民總醫院
                            台北醫學大學附設醫院
   方文良醫師        一般外科醫師




台北醫學大學附設醫院
               台北醫學大學附設醫院
   一般外科                     台北醫學大學附設醫院
                 一般外科醫師
  李泓家醫師
台北醫學大學附設醫院
             台北醫學大學附設醫院
   放腫科                    台北醫學大學附設醫院
              放腫科主治醫師
  郭嘉駿醫師




台北醫學大學附設醫院
             台北醫學大學附設醫院
   血腫科                    台北醫學大學附設醫院
              血液腫瘤科醫師
  蔡佳叡醫師
                                          100字大綱
The open group was associated with larger tumor size, more D2 dissection, more advanced
tumor stage, and more blood loss than the groups treated with laparoscopic and robotic
methods. Robotic gastrectomy was associated with female predominance, less blood loss,
shorter hospital stay, and longer operative time than open and laparoscopic gastrectomy. The
retrieved lymph node numbers were similar between the open and robotic groups. There is a
trend of decrease in operative time after 25 cases in robotic group. Postoperative morbidity
rates were similar among the three groups. However, there were two surgical mortalities
secondary to anastomotic leakage; one in laparoscopic group, and the other in robotic group.
Conclusion: Robotic gastrectomy could achieve extended lymph node dissection similar to
open surgery. Our results showed a significant learning curve effect in robotic group in the
initial 25 cases.

Laparoscopically assisted distal gastrectomy has been used for distal part early gastric
cancer resection. However, use of totally laparoscopic gastric cancer resection remains
limited because of technical problems, especially when standard D2 nodal dissection was
applied. We had reported the first totally laparoscopic Billroth II ( BII) subtotal gastrectomy
with lymphadenectomy for early gastric cancer in the year 1998 . In the laparoscopic group,
all the operations were completed by laparoscopic technique, but 1 patient required
secondary laparotomy for total gastrectomy owing to inadequate resection margin.Although
totally laparoscopic BII gastrectorny using the upper to lower technique required a longer
surgical time and was technically more demanding than conventional open surgery, it
resulted in shorter recovery time, less analgesic use, and lesssevere physical discomfort
without compromising the operative curability and oncologic outcomes.
These guidelines have developed as a joint project between the Association of Upper
Gastrointestinal Surgeons of Great Britain and Ireland, the British Society of
Gastroenterology, and the British Association of Surgical Oncology. They have been
produced as part of the wider initiative of the British Society of Gastroenterology to provide
guidance for clinicians in several areas of clinical practice related to the broad field of
gastroenterology. These guidelines have been written to emphasise these recent
developments and to place them in the context of established approaches to enable clinicians
to incorporate them into their clinical practice.However, they have been produced based on
careful review of the available evidence with the recommendations weighted according to the
strength of the evidence. As with other similar recommendations, much of the evidence is
based on consensus view as in many areas scientific evaluation has not taken place or is not
possible.
The humanized monoclonal antibody Herceptin, which specifically targets HER-2/neu,
exhibits growth inhibitory activity against HER-2/neu-overexpressing tumors and is approved
for therapeutic use with proved survival benefit in patients with HER-2/neu-positive breast
cancer. In the present study, we investigated whether Herceptin could affect the HER-2/neu-
overexpressing gastric cancer cells based on antibody-dependent cell-mediated cytotoxicity
(ADCC) and compared immune effector cells from gastric cancer patients with normal
individuals on ADCC. Thus, some modalities such as interleukin 2 treatment aimed at
reversing NK dysfunction may be necessary for successful Herceptin treatment of gastric
cancer.

				
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