Objective To summarize the research progress of preoperative staging diagnosis for gastric cancer. Methods Both the domestic and international literatures involving the preoperative staging diagnosis of gastric cancer in recent years were collected and reviewed. Results Transabdominal ultrosonography, EUS, CT, MRI, PET and diagnostic laparoscopy could provide objective evidences, and enhanced the accuracy of preoperative staging diagnosis for gastric cancer. Conclusion With the development of examination methods, the assessment of preoperative staging diagnosis of gastric cancer has been improved, and operation strategy can be made according to the correct preoperative staging.
Objective To summarize recent progress of three types of basic digestive tract reconstruction methods after distal gastrectomy for gastric cancer. Methods Recent domestic and international literatures about three types of basic digestive tract reconstruction methods after distal gastrectomy for gastric cancer were collected and analyzed. Results Of the three types of basic digestive tract reconstruction methods, BillrothⅠanastomosis had the most obvious advantage compared to BillrothⅡanastomosis and Roux-en Y anastomosis, but it was limited by tumor' size. The performance of BillrothⅡanastomosis was relatively easier but its complication risk was higher. Roux-en-Y anastomosis was superior in body weight control and treatment of type 2 diabetes mellitus, and had a wider indication than the other two types of methods. The modified uncut Roux-en-Y anastomosis was easier to perform under laparoscopic surgery. Conclusions Each method of the three types of basic digestive tract reconstruction methods after distal gastrectomy has its own superiority and indication. Therefore, the choice of digestive tract reconstruction method after distal gastrectomy should be case by case.
Objective To determine whether regional arterial infusion (RAI) of 5-Fu and imipenem could decrease infection and mortality of acute necrotic pancreatitis (ANP) or not. Methods Fifty three patients with ANP were devided into three groups, group A, 16 patients who received intravenous 5-Fu and imipenem, group B, 22 patients who received 5-Fu by RAI and imipenem intravenously, and group C, 15 patients who received both 5-Fu and imipenem by RAI. Results The incidence of infection of ANP in group C (0%) was significantly lower than that in group A (50.0%) and B (27.2%), and the mortality rates in group B (18.1%) and C (13.3%) were significantly reduced as compared with group C (43.8%). Conclusion RAI of 5-Fu and imipenem was effective in reducing ANP infection and mortality rates.
ObjectiveTo evaluate the influence of pathological differentiation in the effect of preoperative chemo-therapy for patients with locally advanced gastric cancer (LAGC). MethodsThirty-two patients with LAGA received preoperative chemotherapy with oxaliplatin and capecitabine (XELOX regimen).According to the pathological examina-tion, patients were classified into better (well and moderate, 16 cases) and poorly (16 cases) differentiated groups, and the clinical response rate, type of gastrectomy, and negative tumor residual rate were compared between the two groups.Morphological changes and toxic reactions were monitored after chemotherapy. ResultsThe results showed that the clinical response rate in the better differentiated group was significantly higher than that in the poorly differentiated group (100% vs.6.4%, P=0.000).The partial gastrectomy rate in the better differentiated group was significantly higher than that in the poorly differentiated group (87.5% vs.25.0%, P=0.000).A significant shrinking of tumor size and necrosis of tumor tissues caused by chemotherapy could be observed. ConclusionThe better differentiated group with locally advanced gastric cancer is suitable for preoperative chemotherapy with XELOX regimen, and as a result of effective preoperative chemotherapy, much more gastric tissue can be preserved for better differentiated group.
Objective To evaluate the role of preoperative 64 multi-detector spiral CT (MDCT) in predicting the extent of radical resection for advanced gastric cancer (AGC)． MethodsThe imaging data of 70 patients with AGC were collected and analyzed. The N2 lymph node metastasis was predicted by the MDCT indications, and compared with that postoperative pathological results. Results Sixty-two patients were treated with surgical intervention. The sensitivity, specificity, and accuracy of N2 positive prediction by MDCT was 92.0% (46/50), 75.0% (9/12) and 88.7% (55/62), respectively. Extended resection was performed in 81.6% (40/49) patients who were predicted as N2 positive, and D2 resection was performed in 92.3% (12/13) patients who were predicted as N2 negative.Conclusion The MDCT is a valuable technique to predict N2 lymph node metastasis, and to determine the extent of resection for AGC.
Objective To evaluate short-term effect of laparoscopic and open Miles operations for lower rectal carcinoma. Methods A total of 119 patients with lower rectal carcinoma were retrospectively collected from March 2012 to March 2017 in this hospital, among which 65 were in the laparoscopic operation group and 54 in the open operation group. The perioperative data, pathological results, recovery courses, and complications were compared between the two groups. Results Compared with the open operation group, the laparoscopic group showed a longer operation time (t=6.035, P=0.002), quicker bowel function recovery (t=4.919, P<0.001), faster off-bed activity (t=2.221, P<0.001), and shorter hospital stay time (t=3.795, P=0.025). The intraoperative blood loss (t=0.154, P=0.698) and the number of harvested lymph nodes (t=0.532, P=0.595) were similar between the two groups. The laparoscopic operation group showed a significant lower total complication rate (χ2=7.174, P=0.009) as compared with the open operation group, but the incision infection, urinary tract injury, lung infection, thrombosis of lower extremities, etc. had no significant differences between the two groups (P>0.050). Conclusion Laparoscopic Miles operation improves postoperative recovery and reduces postoperative complications as compared with open approach in treatment of lower rectal cancer, with similar oncological and short-term results.
ObjectiveTo analyze the related risk factors of influencing on postoperative severe complications (PSC) in elderly patients with gastric cancer. MethodsAltogether 202 cases of elderly patients with gastric cancer who received surgical treatment between January 2003 and December 2008 in this hospital were analyzed. On the basis of the degree of complications, the patients were divided into the group with PSC and the group without PSC. The relevant clinical and laboratory data were evaluated, and compared with statistical analysis. ResultsClinically the preoperative comorbidity, total gastrectomy, more than 800 ml intraoperative blood loss, intraoperative transfusion, and combined organ resection were significantly correlated with PSC (Plt;0.05). In laboratory data, the lower preoperative serum albumin and the blood glucose level on the first day after operation were significantly correlated with PSC (Plt;0.05). ConclusionThe preoperative comorbidity, lower serum albumin, and extended radical resection are the danger factors leading to PSC.