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Introduction: Although it was reported that serum zinc levels were lower in patients with various malignancies, serum zinc levels of patients with gastric cancer was not well documented. Objectives: This study aimed to evaluate the association between clinicopathologic features and serum zinc levels in preoperative patients with gastric cancer. Methods: The study enrolled 83 patients scheduled for gastric cancer surgery at the Kochi Medical School. Clinical data were obtained to investigate associations between clinicopathological features, including nutritional indicators and serum zinc levels. Serum zinc deficiency was defined as serum zinc level < 80 μg/dL. Results: The median zinc level of the 83 patients was 73 μg/dL (range, 20–152 μg/dL), and serum zinc deficiency was present in 66.3% of patients. Albumin was significantly lower in the zinc low level group than in the normal group (3.9 g/dL vs. 4.4 g/dL, P < 0.001), and the median serum zinc level was significantly lower in the albumin < 4.1 g/dL group than in the albumin ≥ 4.1 g/dL group (69 μg/dL vs. 82 μg/dL, P < 0.001). Lymphocyte count was significantly lower in the zinc low level group than in the normal group (1500 vs. 1810 years, P = 0.041). The median serum zinc level was significantly lower in the age ≥ 74 group than in the age < 74 (71 μg/dL vs. 76 μg/dL, P = 0.002). Serum zinc levels showed a significant positive correlation with serum albumin (r = 0.637, P = 0.009). Discussion/Conclusion: Serum zinc deficiency was found in 66.3% of preoperative patients with gastric cancer, which was highly correlated with serum albumin.

We present an unusual case of laparoscopic total gastrectomy with lymph node dissection in a 56-year-old woman with gastric cancer and agenesis of the dorsal pancreas (ADP). Esophagogastroduodenoscopy revealed erosive lesions with thickened gastric folds; biopsy specimens revealed a poorly differentiated adenocarcinoma. Abdominal contrast-enhanced computed tomography showed a thickened wall of the gastric body; the distal pancreas was not visualized. Under the clinical diagnosis of gastric cancer with ADP, the patient underwent laparoscopic total gastrectomy with standard lymphadenectomy. The absence of a pancreatic neck, body, and tail was confirmed; lymph nodes along the splenic artery were dissected. Pathological analysis demonstrated a poorly differentiated adenocarcinoma invading the serosa, with five lymph node metastases. The postoperative course was unremarkable; postoperative adjuvant chemotherapy was performed using S-1 plus oxaliplatin. No symptom recurrence was observed at the 6-month follow-up. Laparoscopic surgery, with careful preoperative anatomic evaluation, can be considered for concurrent gastric cancer and ADP.

Purpose Despite the widespread use of laparoscopic surgery, intracorporeal anastomosis remains a complicated procedure. This study aimed to investigate the efficacy of novel staple line reinforcement (SLR) during laparoscopic gastrectomy for gastric cancer. Methods This study included 30 patients who underwent laparoscopic gastrectomy for gastric cancer at Kochi Medical School between November 2021 and May 2022. A review of these patients was conducted, and perioperative outcomes were compared according to the use of SLR. Results The reconstruction time using SLR was significantly shorter than that for when SLR was not used (20.5 min vs. 32.0 min, P = 0.048). The incidence of hemostasis during anastomosis was significantly lower in the SLR group than in the non-SLR group (0 vs. 3 times, P = 0.041). There were no significant differences in the operating time and estimated blood loss after surgery between the two groups. Furthermore, there were no significant differences in postoperative complications or nutritional status between the two groups. Conclusions The results demonstrated the usefulness of SLR, which could reduce the time for intracorporeal reconstruction during laparoscopic gastrectomy for gastric cancer.

Purpose This study aimed to evaluate the association between clinicopathologic features and serum zinc levels in preoperative patients with gastric cancer. Methods The study enrolled 83 patients scheduled for gastric cancer surgery at the Kochi Medical School. Clinical data were obtained to investigate associations between clinicopathological features, including nutritional indicators and serum zinc levels. Serum zinc deficiency was defined as serum zinc level < 80 µg/dL. Results The median zinc level of the 83 patients was 73 µg/dL (range, 20–152 µg/dL), and serum zinc deficiency was present in 66.3% of patients. Albumin was significantly lower in the zinc low level group than in the normal group (3.9 g/dL vs. 4.4 g/dL, P < 0.001), and the median serum zinc level was significantly lower in the albumin < 4.1 g/dL group than in the albumin ≥ 4.1 g/dL group (69 µg/dL vs. 82 µg/dL, P < 0.001). Lymphocyte count was significantly lower in the zinc low level group than in the normal group (1500 vs. 1810 years, P = 0.041). The median serum zinc level was significantly lower in the age ≥ 74 group than in the age < 74 (71 µg/dL vs. 76 µg/dL, P = 0.002). Serum zinc levels showed a significant positive correlation with serum albumin (r = 0.637, P = 0.009). Conclusions Serum zinc deficiency was found in 66.3% of preoperative patients with gastric cancer, which was highly correlated with serum albumin.