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find Keyword "结肠肿瘤" 13 results
  • Investigation of Diagnosis and Treatment for Colorectal Cancer with Intestinal Perforation

    目的 探讨结肠癌和直肠癌并发肠穿孔的外科诊治方法。方法 分析13例结直肠癌并发肠穿孔患者的临床资料。结果 13例患者中4例行肿瘤所在肠段一期切除吻合术; 4例行一期病灶切除吻合术,近端肠段行外置双管造瘘术; 2例切除肿瘤所在肠段,近端行端式结肠造瘘术,远端行封闭(Hartmann)术; 3例行单纯肠造瘘术。术后并发症发生率为46.15%(6/13),手术死亡率为15.38%(2/13)。结论 重视对结直肠癌并发肠穿孔的认识及选择合适的手术方式是减少并发症、提高疗效的重要措施。

    Release date:2016-09-08 10:58 Export PDF Favorites Scan
  • Understanding of Ideatifying Anatomical Planes in Right Radical Hemicolectomy ( Report of 36 Cases )

    【摘要】 目的 总结右半结肠癌根治切除术中寻找解剖平面的体会。方法 回顾性分析沧州市中心医院2002 年1 月至2006 年3 月期间36 例进展期右半结肠癌根治术的结果。结果 全部病例术中无一例副损伤。术后病理共检出淋巴结310 枚,平均8. 6 枚/ 例。围手术期无死亡病例。局部复发1 例且伴肝内转移及门静脉癌栓,肝转移3 例。随访过程中死亡3 例。结论 从易显露的固定解剖结构入手,采取上、下结合,寻找右Toldt 筋膜与肾前筋膜之间的解剖间隙平面简单、易行,极少发生副损伤。

    Release date:2016-09-08 11:45 Export PDF Favorites Scan
  • Treatment ofⅠ Stage Exeresis and Intestinal Anastomosis for Left Hemicolon Carcinoma Affiliating Obstruction

    摘要:目的:探讨左半结肠癌合并肠梗阻Ⅰ期手术切除肠吻合的方法和注意事项。〖HTH〗方法:〖HTSS〗分析36例左半结肠癌合并肠梗阻患者Ⅰ期行手术切除肠吻合手术及术后恢复情况。结果:36例左半结肠癌并肠梗阻患者,Ⅰ期手术切除、肠吻合无一例吻合口瘘,术后恢复良好。〖HTH〗结论:〖HTSS〗只要围手术期、术中处理得当,左半结肠癌合并肠梗阻患者选择Ⅰ期手术切除肠吻合,可以减少患者痛苦、节约医疗费用,同时也是安全的。

    Release date:2016-09-08 09:54 Export PDF Favorites Scan
  • Analysis on Prognosis Factors of Elderly Patients with Colon Cancer

    ObjectiveTo investigate the clinicopathological characteristics and prognosis of elderly patients with colon cancer. MethodsThe clinicopathological and followup data of patients with colon cancer were compared retrospectively between those older than 60 years (405 patients) and those younger than 40 years (146 patients). ResultsFamily history, comorbidities, preoperative intestinal obstruction, and differentiation grade were significantly different between two groups (P<0.05). The 5-year survival rate of patients in elder group and younger group was 64.9% and 56.8% respectively, and there was significant difference (P<0.05). The multivariate analysis indicated that the independent predictors of survival were comorbidities, perioperative CEA level, preoperative intestinal obstruction, tumor gross type, lymph node metastasis, hepatic metastasis, and TNM stage. ConclusionPatients older than 60 years with colon cancer have unique clinicopathological characteristics and better prognosis. The independent predictors of survival are comorbidities, perioperative CEA level, preoperative intestinal obstruction, tumor gross type, lymph node metastasis, hepatic metastasis, and TNM stage.

    Release date:2016-09-08 10:41 Export PDF Favorites Scan
  • Key issues in laparoscopic surgery for right-sided colon cancer and the experience of Peking Union Medical College Hospital

    The technique of laparoscopic radical right hemicolectomy is becoming mature, but there are still controversies on some key steps, including the extent of lymph node dissection, the scope of bowel resection, the choice of surgical access and anastomosis. The new function-preserving surgery and natural-orifice transluminal endoscopic surgery (NOTES) have further enhanced the minimally invasive nature of surgery. The author’s have reviewed the latest domestic and international literature, combined with the experience of the author’s center, and elaborated on the current focus issues of laparoscopic radical surgery for right-sided colon cancer.

    Release date:2024-05-28 01:54 Export PDF Favorites Scan
  • Analysis of risk factors and construction of a nomogram predictive model for anastomotic leakage after elective colectomy in elderly patients with colon cancer

    Objective To determine the risk factors of anastomotic leakage after elective colectomy in elderly patients with colon cancer, and to establish a model for predicting the risk of postoperative anastomotic leakage based on these factors. Methods The clinical data of 122 over 65 years old elderly patients who underwent colon cancer surgery in the First Hospital of Lanzhou University from January 2018 to December 2021 were analyzed retrospectively. Single factor analysis and multivariate logistic regression were used to analyze the potential risk factors for anastomotic leakage. A nomogram predictive model was established based on the determined independent risk factors, and the predictive performance of the model was evaluated by the receiver operating characteristic curve. Results Among the 122 patients included in this study, 10 had postoperative anastomotic leakage and 112 had no anastomotic leakage. Single factor analysis results showed that the occurrence of anastomotic leakage was associated with body mass index, smoking, combined diabetes, age-adjusted Charlson comorbidity index, intraoperative and postoperative blood transfusion within 2 days, preoperative hemoglobin, preoperative albumin, and preoperative prognostic nutritional index (P<0.05). The results of multivariate logistic regression analysis showed that smoking [OR=15.529, 95%CI (1.529, 157.690), P=0.020], age-adjusted Charlson comorbidity index [OR=1.742, 95%CI (1.024, 2.966), P=0.041], and intraoperative and postoperative blood transfusion within 2 days [OR=82.223, 95%CI (1.265, 5 343.025), P=0.038] were independent risk factors for anastomotic leakage. A nomogram predictive model was established based on three independent risk factors. The area under the receiver operating characteristic curve of the model was 0.897 [95%CI (0.804, 0.990)], and its corrected C-index value was 0.881, indicating that the model had good predictive ability for the risk of anastomotic leakage. Conclusions Smoking, higher age-adjusted Charlson comorbidity index, and intraoperative and postoperative blood transfusion within 2 days are important risk factors for anastomotic leak in elderly patients undergoing elective colon cancer resection. This nomogram predictive model based on the combination of the three factors is helpful for surgeons to optimize treatment decisions and postoperative monitoring.

    Release date:2023-08-22 08:48 Export PDF Favorites Scan
  • 两种机械吻合方式在腹腔镜辅助右半结肠癌术中的回顾性对照研究

    目的比较体外机械性侧侧吻合与端侧吻合在腹腔镜辅助右半结肠癌根治术中的应用效果。方法回顾性分析笔者所在医院 2015 年 6 月至 2018 年 6 月期间采用机械吻合进行消化道重建的 89 例腹腔镜辅助右半结肠癌根治术患者的临床资料,其中机械性侧侧吻合 32 例,机械性端侧吻合 57 例;比较 2 组患者的一般资料、手术时间、术中出血量、术后首次肛门排气时间、耐受流质饮食时间和术后住院时间;并比较术后并发症发生情况。结果2 组患者的一般资料、术中出血量、耐受流质饮食时间和术后住院时间的差异均无统计学意义(P>0.05);端侧吻合组手术时间短于侧侧吻合组 [160.0(150.0,177.5) min 比 170.0(156.3,203.8)min],差异有统计学意义(P=0.049);端侧吻合组首次肛门排气时间短于侧侧吻合组 [(2.5±0.9)d 比(3.0±1.0)d],差异有统计学意义(P=0.021);2 组患者术后各并发症发生率差异无统计学意义(P>0.05)。结论腹腔镜辅助右半结肠癌根治性切除手术中相比机械性侧侧吻合,机械性端侧吻合的手术时间及术后首次肛门通气时间较短,其并发症无统计学差异,提示机械性端侧吻合可能更具优势。

    Release date:2019-06-26 03:20 Export PDF Favorites Scan
  • Effects of Nimesulide on Expression of Matrix Metalloproteinase- 2 in Human Colonic Cancer Cell Lines

    【Abstract】Objective To investigate the effects of selective cyclooxygenase-2 (COX-2) inhibitor nimesulide on the proliferation of colon adenocarcinoma cells in vitro and the expression of matrix metalloproteinase-2 (MMP-2). Methods The human colon cancer cell lines HT-29 and HCT-116 were employed in the study, grouped as nimesulide group, DMSO control group and blank control group. After treatment with nimesulide, the inhibitory effect of nimesulide on the proliferation of cancer cells was quantified by MTT assay, and the expression of MMP-2 in the cells was detected by quantitative zymography. Results Nimesulide inhibited the proliferation of HT-29 and HCT-116 cells in time and dosedependent manners. The inhibitory effect on HT-29 cells was ber than that on HCT-116 cells. Nimesulide downregulated the MMP-2 expression in HT-29 cells, whereas the expression in HCT-116 cells remained unchanged. Conclusion Nimesulide can obviously inhibit the growth of colon cancer HT-29 cells with positive COX-2 protein, suggesting that nimesulide may downregulate the expression of MMP-2 by inhibiting the activity of COX-2.

    Release date:2016-08-28 04:28 Export PDF Favorites Scan
  • Expression of p53 and Vascular Endothelial Growth Factor and Its Correlation with Hematogenous Metastasis in Colorectal Cancer

    Objective To study the expression of p53 and vascular endothelial growth factor (VEGF) and its correlation with hematogenous metastasis in colorectal cancer. MethodsAvidinbiotin complex method was used to study the expression of p53 and VEGF in 79 cases of colorectal cancer.ResultsThe positive rates of p53 and VEGF were 48.1% and 58.2% respectively in 79 cases of colorectal cancer. p53 and VEGF expression were identical in 49 (62.0%) cases. There was significant association between p53 or VEGF expression and venous invasion or hematogenous metastasis (P<0.05). The incidence of hematogenous metastasis in the p53(+)/VEGF(+) subgroup was 66.7% and was significantly higher than that in the p53(-)/VEGF(-) or p53(+)/VEGF(-) subgroup (P<0.01). Neither synchronous nor metachronous hematogenous metastasis were found in the p53(-)/VEGF(-) subgroup.Conclusion The combination of p53 and VEGF expression is an important predictor for hematogenous metastasis in patients with colorectal cancer.

    Release date:2016-08-28 05:10 Export PDF Favorites Scan
  • Influence of Combinative Assessment of 64 Multi-Slice Spiral Computer Tomography and Serum Amyloid A Protein on Surgery Strategy of Colon Cancer

     Objective To discuss the influence of combination of 64 multi-slice spiral computer tomography (MSCT) and serum amyloid A protein (SAA) for preoperative assessment on colon cancer surgery strategy.  Methods The examination data of 110 patients diagnosed definitely as colon cancer in the West China Hospital of Sichuan University from Nov. 2007 to Nov. 2008 were studied prospectively, and randomly assigned into the MSCT+SAA group and MSCT group, respectively. Both MSCT and SAA combinative assessment were made for preoperative evaluation in MSCT+SAA group, while only MSCT was made preoperatively in MSCT group. Furthermore, the preoperative staging and prediction of operative procedures were compared with postoperative pathologic staging and practical of operative procedures, respectively.  Results According to the inclusion criteria, 99 colon cancer patients were actually included into MSCT+SAA group (n=49) and MSCT group (n=50). The baseline characteristics of two groups were statistically identical. For MSCT+SAA group, The accuracies of preoperative staging T, N, M and TNM were 81.6%, 79.6%, 100% and 77.6%, respectively. For MSCT group, the corresponding rates were 82.0%, 60.0%, 98.0% and 62.0%, respectively. The difference of accuracies on staging N between two groups was observed statistically (χ2=4.498, P=0.034). There was also a statistically significant difference of the accuracy of prediction of operative procedures in MSCT+SAA group and MSCT group (95.9% vs. 82.0%, χ2=4.854, P=0.028). The preoperative staging N (P=0.008), M (P=0.010), TNM (P=0.009) and level of SAA (P=0.004) were related to the selection of operative procedures when analyzed the relationship between the operative procedures and multiple clinicopathologic factors in colon cancer.  Conclusion The strategy of the combinative assessment of MSCT and SAA could advance the accuracy of preoperative staging, thus serve surgeon the more accurate prediction to surgery strategy in colon cancer.

    Release date:2016-09-08 10:57 Export PDF Favorites Scan
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