Background Gastric cancer recurrence includes: loco-regional recurrence (regional lymph nodes, perianastomotic region, gastric bed and stump, adjacent structure), peritoneal recurrence or distant metastasis. More than 90% of patients relapse within five years after surgery, and 70% relapse within two years. An isolated loco-regional recurrence is described in 11 % of Alvaro Diaz de Liano’s series. According to Watanabe is important to consider the clinicopathologic features of the primary tumor which predict loco-regional reccurence : proximal location, advanced stage (T3-4, N+), infiltrative growth, diffuse type. Surgical treatment of loco-regional recurrence can be performed by different surgical options: complete resection, incomplete resection, bypass, enterostomy or explorative laparotomy. We report 4 cases of loco-regional gastric cancer recurrence, treated by a radical surgical approach.

Aims: In the growing onco-geriatric surgical population, identifying patients at an increased risk for adverse outcome is crucial. Next to the severity of the surgical procedure, geriatric screening tools were found to predict the risk for major complications. The performance of these screening tools in patients undergoing major hepato-pancreato-biliary (HPB) surgery is unknown. The aim of this study was to analyze the predictive value of well-known screening tools regarding the risk for major postoperative complications in onco-geriatric surgical patients undergoing HPB-resective surgery. Methods: In an international cohort, patients >=70 years undergoing elective surgery for solid tumours were prospectively recruited. A subanalysis of HPB patients was performed. Primary endpoint was the incidence of major complications during the first 30 days after surgery. Preoperatively Timed Up and Go (TUG) was administered to assess mobility. ASA-classification, nutritional status (NS) and performance status (PS) were assessed as well. Results: Data of 58 HPB-patients with a mean age of 74 years (3 SD) were analyzed. Ten patients experienced major complications (18.2%). The vast majority of patients was diagnosed with stage 4 disease (n=48; 39.6%). The mean duration of anesthesia was five hours (2.7 SD). No statistical significant differences were found between patients with normal and with deranged results on the screening tools. Conclusions: Analysis didn't show a prognostic ability of TUG with respect to 30-day postoperative morbidity in our HPB subgroup. These results need to be carefully interpreted in light of the small number of patients. Furthermore, it is possible that the complexity of such surgery might play a role as the event of grade 3–4 complications and related mortality are more often unpredictable. Other studies with larger population are needed to validate these results and other screening tools could be considered for the preoperative assessment of oncogeriatric patients undergoing major surgery.

Background: With the expanding geriatric population, cancer prevalence in the elderly has increased accordingly. Within the oncogeriatric surgical population, it is very important to differentiate between fit and non-fit patients in order to effectively implement preventive measures and to improve outcome in this population. Therefore, it is necessary to find a time-saving and efficient screening tool to assess the probability of developing postoperative complications in elderly cancer patients, and to anticipate the postoperative outcome. The aim of this study was to determine the prognostic ability of timed 'Up & Go' (TUG) versus the American Society of Anesthesiologists (ASA Score) in hepato-pancreato-biliary (HPB) oncogeriatric surgical patients.

Background: With the expanding geriatric population, cancer prevalence in the elderly has increased accordingly. Within the oncogeriatric surgical population, it is of paramount importance to differentiate between frail and non-frail patients in order to tailor to each individual, the appropriate treatment, and to offer a more precise informed consent on risks and prognoses. The Comprehensive Geriatric Assessment (CGA) is extremely time consuming when administrated to each patient. Therefore, it is necessary to find a time-saving and efficient screening tool to assess the probability of developing postoperative complications in elderly cancer patients, and to anticipate the postoperative outcome. The aim of this study was to determine the prognostic ability of timed "Up & Go" (TUG) , Vulnerable Elders Survey (VES13) and Groningen Frailty Indicator (GFI) , with regard to short term postoperative complications in hepato-pancreato-biliary(HPB) oncogeriatric surgical patients.

Pancreatic trauma without injuries to other organs is uncommon, as reported in the reviewed literature. Diagnosis of pancreatic trauma might be difficult, due to unspecific signs and symptoms. The integrity of the main pancreatic duct is the crucial point in the management and outcome of patients with pancreatic trauma.The authors report a case of delayed diagnosis after a complete traumatic rupture of the main pancreatic duct, successfully managed by surgical treatment. The authors performed a laparotomy with complete removal of necrotic pancreatic tissue at the site of rupture. The proximal pancreatic stump was hand-sewn with detached stitches and a disposable catheter was positioned into Wirsung's duct, a diversion of the distal stump with a Roux-en-y pancreato-jejunal anastomosis was performed. The postoperative course was uneventful.Traumatic injuries of the pancreas occur after blunt abdominal traumas or penetrating wounds with a ratio of 3:1. Isolated traumatic injuries of the pancreas are uncommon; and they are usually associated with injuries to other organs. Surgical solutions for the treatment of pancreas lesions vary and it is well known that a surgical procedure performed after a delayed diagnosis is associated with high mortality and morbidity, especially in pancreatic duct rupture.Pancreatic trauma is a diagnostic and therapeutic challenge for the trauma surgeon. The integrity of the main pancreatic duct is the most important determinant of outcome after injury to the pancreas and, in Wirsung's duct rupture, early surgery may improve it.