Clinical analysis of laparoscopic D2 lymphadenectomy for distal gastric cancer / 中华胃肠外科杂志

<p><b>OBJECTIVES</b>To investigate the surgical approach, feasibility and surgical outcomes of laparascopic distal gastrectomy D2(LDGD2).</p><p><b>METHODS</b>Fifty-four patients who underwent LDGD2 were examined in terms of pathologic findings, operative outcomes, and complications. A simple and effective surgical procedure was as follows: gastrocolic ligament--transverse mesocolon anterior lobe--pancreatic capsule--4sb--4d--6--14v, 8a--12a--9--7--11p, 1--3--5--lesser omental bursa. Efficacy and feasibility of this procedure was analyzed.</p><p><b>RESULTS</b>The mean operative time was (236±51) minutes, the mean number of lymph nodes was(18±5), the mean positive lymph nodes were 0-14, the mean blood loss was(217±65) ml, and postoperative mean hospital stay was(15±4) days.</p><p><b>CONCLUSIONS</b>LDGD2 for lower and lower-middle gastric cancer is feasible and safe, and can meet the oncological demand.</p>

Impact of laparoscopic colorectal surgery on the peritoneal microstructural injury and expression of t-PA/PAI-1 / 中华胃肠外科杂志

<p><b>OBJECTIVE</b>To assess the influence of laparoscopic colorectal cancer resection on the peritoneal microstructure injury and expression of t-PA/PAI-1 molecules.</p><p><b>METHODS</b>A total of 50 patients with colorectal cancer were prospectively enrolled between June 2011 and February 2012 in the Shanxi Provincial Hospital and were assigned into laparoscopic group (LO, n=27) and conventional laparotomy group (CO, n=23) based on patients expectancy and surgeon decision. Optical microscope and scanning electron microscope were employed for comparison of the postoperative peritoneal injury between LO and CO. Before and after surgery, t-PA and PAI-1 of peritoneal tissue were determined by ELISA in both groups.</p><p><b>RESULTS</b>Optical microscope and scanning electronic microscopy scan indicated less serosal injury in LO group than that in CO group with regard to serosa integrity, continuity of covering adipocytes and mesothelial cells, and the aggregation level of inflammatory cells (P<0.01). The injury score was 38.22 in CO in and 14.67 in LO and the difference was statistically significant (P<0.01). No significant differences were found between LO and CO in terms of postoperative t-PA in the omentum, t-PA and PAI-1 in the intestinal serosa tissue (P>0.05), however PAI-1 in the omentum was significantly lower in LO group compared to CO group (P<0.05).</p><p><b>CONCLUSION</b>Laparoscopic radical resection for colorectal cancer causes less peritoneal structural injury and less influence on the fibrinolytic capacity, which may contribute to less postoperative adhesion.</p>

Peritoneal structural injury in laparoscopic versus open radical resection for colorectal cancer: a prospective controlled study / 中华胃肠外科杂志

<p><b>OBJECTIVE</b>To assess the differences in peritoneal microstructure injury between laparoscopic and open radical resection for colorectal cancer.</p><p><b>METHODS</b>A total of 50 patients with colorectal cancer were consecutively assigned into laparoscopic group (LO, n=27) and conventional laparotomy group (CO, n=23). Prospectively comparative analyses of operative time, intraoperative blood loss, number of lymph node harvest, positive rate of lymph nodes, length of specimen and resection margin involvement were performed. Optical microscope and scanning electron microscope were used to detect postoperative peritoneal injury between patients who received laparoscopic surgery or open surgery.</p><p><b>RESULTS</b>Compared with the CO group, operative time [(150.6+/-39.5) min vs (183.0+/-39.2) min, P<0.05] and intraoperative blood loss [(80.0+/-75.2) ml vs (234.5+/-235.3) ml, P<0.01] were significantly less in the LO group. No significant differences were found between two groups in length specimen, number of lymph nodes harvest, positive rate of lymph nodes, and all resection margins were negative (P>0.05). Optical microscope indicated less serosal injury in the LO group as compared to the CO group with regard to serosal integrity, continuity of covering adipocyte and mesothelial cell, and the aggregation level of erythrocytes and inflammatory cells (P<0.01). Scanning electronic microscopy showed more severe injury to colorectal serosa, mesothelium and basement membrane in the CO group as compared to the LO group.</p><p><b>CONCLUSION</b>With equal degree of radical resection, laparoscopic technique for colorectal cancer causes less peritoneal structural injury as compared with open surgery.</p>

The effect of local vibration on blood-lipids and whole blood viscosity / 中华劳动卫生职业病杂志

<p><b>OBJECTIVE</b>To study the effects of local vibration on blood-lipids and whole blood viscosity.</p><p><b>METHODS</b>The total cholesterol (TC), triglyceride (TG), high density lipoprotein (HDL), low density lipoprotein (LDL), whole blood viscosity, apolipoprotein (Apo-), red blood cell (RBC), platelet (PLT), mean corpuscular volume (MCV), serum-protein, postprandial blood sugar (PBS), and serum-protein of experimental and control workers were detected. The difference of the means and abnormal rates of two groups were compared.</p><p><b>RESULTS</b>The means of TG, TC, HDL in exposed group [(1.01 +/- 0.85), (3.25 +/- 0.61), (1.14 +/- 0.20) mmol/L respectively] were significantly lower than that of control group [(1.89 +/- 1.47), (3.87 +/- 0.82), (1.22 +/- 0.26) mmol/L, respectively, P < 0.01 or P < 0.05]. Apo-A was also decreased [(1.13 +/- 0.29) g/L vs (1.23 +/- 0.16) g/L, P < 0.01]. The mean of whole blood viscosity were significantly increased in exposed group [(2.76 +/- 0.42) mPa.s vs (2.54 +/- 0.33) mPa.s, P < 0.01]. The abnormal rate of Apo-A was significantly higher in exposed group (23.30%) than that in control (4.50%, P < 0.01).</p><p><b>CONCLUSION</b>Local vibration may induce decrease in blood lipids, increase in blood viscosity and changes in some other blood parameters.</p>