ABSTRACT
OBJECTIVE:To observe the efficacy and safety of neoadjuvant chemotherapy in advanced gastric carcinoma patients before laparoscopic minimally invasive resction.METHODS:In retrospective analysis,93 patients with advanced gastric carcinoma were divided into single group (55 cases) and combined group (38 cases).Single group received laparoscopic minimally invasive operation.Combination group was given Tetrahydrofolate injection 400 mg/m2+Oxaliplatin injection 85 mg/m2,i.v.,2 h,d1+ Fluorouracil injection 2 400 mg/m2,i.v.,46 h,d2.A treatment course lasted for 2 weeks,both received 2-4 courses of treatment and 4 weeks later received laparoscopic minimally invasive resection.Both groups received routine treatment as parenteral nutrition and preventive anti-inflammation.They were given oxaliplatin+capecitabine or gimeracil oteracil potassium capsule+oxaliplatin chemotherapy for 6 courses.Clinical efficacies and ADR of combination group were observed.Operation time,intraoperative blood loss,intraoperative blood transfusion,resection range,conversions to laparotomy,the number of lymph node dissection,complete resection and postoperative first exhaust time,the time of fluid feeding recovery,the length of hospital stay and complications were observed in 2 groups.RESULTS:The objective remission rate and disease control rate of combination group were 44.8％ and 92.2％;there were 23 case time of grade Ⅰ ADR,13 case time of grade Ⅱ ADR and 3 case time of grade Ⅲ ADR.Complete resection rate of combination group was significantly higher than that of single group,with statistical significance (P＜0.05).There was no statistical significance in operation time,intraoperative blood loss,intraoperative blood transfusion,resection range,conversions to laparotomy,the number of lymph node dissection,postoperative first exhaust time,the time of fluid feeding recovery,the length of hospital stay or the incidence of complications between 2 groups (P＞0.05).CONCLUSIONS:For advanced gastric carcinoma patients before laparosapic minimally invasive resection,tetrahydrofolate,oxaliplatin and fluorouracil neoadjuvant chemotherapy show therapeutic efficacy and can improve the rate of complete resection without increasing the incidence of ADR.
ABSTRACT
OBJECTIVE:To observe the efficacy and safety of neoadjuvant chemotherapy in advanced gastric carcinoma patients before laparoscopic minimally invasive resction.METHODS:In retrospective analysis,93 patients with advanced gastric carcinoma were divided into single group (55 cases) and combined group (38 cases).Single group received laparoscopic minimally invasive operation.Combination group was given Tetrahydrofolate injection 400 mg/m2+Oxaliplatin injection 85 mg/m2,i.v.,2 h,d1+ Fluorouracil injection 2 400 mg/m2,i.v.,46 h,d2.A treatment course lasted for 2 weeks,both received 2-4 courses of treatment and 4 weeks later received laparoscopic minimally invasive resection.Both groups received routine treatment as parenteral nutrition and preventive anti-inflammation.They were given oxaliplatin+capecitabine or gimeracil oteracil potassium capsule+oxaliplatin chemotherapy for 6 courses.Clinical efficacies and ADR of combination group were observed.Operation time,intraoperative blood loss,intraoperative blood transfusion,resection range,conversions to laparotomy,the number of lymph node dissection,complete resection and postoperative first exhaust time,the time of fluid feeding recovery,the length of hospital stay and complications were observed in 2 groups.RESULTS:The objective remission rate and disease control rate of combination group were 44.8％ and 92.2％;there were 23 case time of grade Ⅰ ADR,13 case time of grade Ⅱ ADR and 3 case time of grade Ⅲ ADR.Complete resection rate of combination group was significantly higher than that of single group,with statistical significance (P＜0.05).There was no statistical significance in operation time,intraoperative blood loss,intraoperative blood transfusion,resection range,conversions to laparotomy,the number of lymph node dissection,postoperative first exhaust time,the time of fluid feeding recovery,the length of hospital stay or the incidence of complications between 2 groups (P＞0.05).CONCLUSIONS:For advanced gastric carcinoma patients before laparosapic minimally invasive resection,tetrahydrofolate,oxaliplatin and fluorouracil neoadjuvant chemotherapy show therapeutic efficacy and can improve the rate of complete resection without increasing the incidence of ADR.
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Objective To explore the impact of combined laparoscopic and choledochoscopic treatment on bile leak in hepatic hydatid disease at a high attitude region.Methods The clinical data of 50 patients who underwent combined laparoscopic and choledochoscopic treatment were compared with 50 patients who underwent laparoscopic surgery alone for hepatic hydatid internal capsule excision surgery.Results In the combined laparoscopic and choledochoscopic group,the incidence of biliary fistula after surgery was 15％,the incision infection rate was 13％,the length of hospitalization was (11.6 ± 3.8) days and the postoperative time to take off drain was (14.3 ± 7.9) days.These were significantly better than those in the laparoscopic alone group.The operation time in the former group was (108.2 ± 28.4)min,which was slightly longer than the laparoscopy group.Conclusion The combined laparoscopic and choledochoscopic treatment is a safer therapeutic option in treating hepatic hydatid disease with less trauma,faster recovery and shorter hospital stay than laparoscopic surgery alone in a high attitude region.
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Objective To explore the express of P-selectin in liver-tissue,on the model of HIRI in rats,we explored the pathogenesy of HIRI. Methods 32 female Sprague-Dawley rats were divided into four groups randomly ( n = 8 in each group): sham operation group ( group SO ), ischemia 30 min without repe- rfusion group ( group Ⅰ),30 min reperfusion following ischemia 30 min group ( group IR30 min), one hour reperfusion following ischemia 30min group( group IR1h). The model of HIRI was maded by Pringle's hepatic vascular occlusion. The contents of P-selectin in hepatic tissue were measured by kit of SP. Results After ischemia 30 min,the content of P-selectin in hepatic tissue increased less obviously than group SO; After 1 h reperfusion, the content of P-selectin in hepatic tissue vascular endothelial and hepatocyte express more broadly than group SO. Conclusion The content of P-selectin in hepatic tissue was increased gradually in the process of hepatic ischemia reperfusion injury(HIRI) in rats.