Preliminary understanding of the development of laparoscopic radical gastrectomy in China / 中国实用外科杂志

China has gone through 30 years of laparoscopic gastric cancer from the first case to the widespread use of laparoscopic radical gastrectomy in various medical centers.During this period, China has developed rapidly in the field of laparoscopic lymph node dissection and anastomosis for gastric cancer and laparoscopic gastric cancer evidence-based research. Chinese physicians have completed the transition from the initial followers to the rational participants and researchers. Nowadays, new minimally invasive surgery techniques and new treatment concepts are emerging one after another. Individualized and precise minimally invasive surgery for gastric cancer is the future development direction. We should actively promote the development of new minimally invasive techniques and further improve the level of minimally invasive surgery in China.

Multimordality of cluster treatment strategy for early postoperative inflammatory small bowel obstruction / 中华胃肠外科杂志

<p><b>OBJECTIVE</b>To explore the application of multimordality of cluster treatment strategy in early postoperative inflammatory small bowel obstruction.</p><p><b>METHODS</b>Clinical data of 31 cases of early postoperative inflammatory small bowel obstruction in our department from July 2007 to July 2011 were analyzed retrospectively. Multimordality of cluster treatment strategy was used in 13 cases (treatment group), and other non-surgical treatment was applied in 18 cases (control group). Efficacy and prognosis were compared between the two groups.</p><p><b>RESULTS</b>Four-day improvement rate was 76.9% (10/13) and 44.4% (8/18), and 7-day cure rate was 92.3% (12/13) and 77.8% (14/18) in the treatment group and the control group, respectively. The differences were statistically significant (both P<0.05). The recovery time of bowel sounds and flatus, defecation time, bloating-free time, oral intake time, abdominal CT intestine improvement time, and hospital stay were all significantly shorter in the treatment group as compared to the control group (all P<0.05).</p><p><b>CONCLUSION</b>Multimordality of cluster treatment strategy can effectively shorten the healing time of early postoperative inflammatory small bowel obstruction, which possesses a good clinical application prospect.</p>

Thinking of laparoscopic anatomy of laparoscopic distal D2 radical gastrectomy / 中华外科杂志

<p><b>OBJECTIVE</b>To discuss laparoscopic assisted radical D2 resection of distal gastric anatomy application ideas.</p><p><b>METHODS</b>Collected the clinical data from January 2009 to January 2012 who underwent laparoscopic distal gastric resection in patients with D2 349 cases. There were 180 male and 169 female patients, and the age were (57 ± 3) years old (range 29-86 years), the body mass index of patients were (26.0 ± 2.0) kg/m(2) (range 20.5-32.8 kg/m(2)). The relevant surgical anatomy ideas had summarized.</p><p><b>RESULTS</b>In addition to 5 cases of obese patients with conversion to open, the remaining patients underwent laparoscopic distal gastric D2 resection. The operation is divided into 7 operating anatomical view. The operation time were 120-210 minutes and the blood loss were 50-200 ml. Postoperative complications occurred in 11 cases, including 5 cases of duodenal stump leakage, 2 cases of gastroparesis, 3 cases of small bowel obstruction, and abdominal bleeding in 1 case. All patients were discharged.</p><p><b>CONCLUSIONS</b>Use zoning, exterior to interior of the anatomy, more conducive to master the operation of laparoscopic radical gastrectomy and standardized cleaning, to improve the operation efficiency and shorten the surgical learning curve and improve the quality of surgery has an important role.</p>

Clinical application of real time-polymerase chain reaction in determining cytomegalovirus viral DNA load in renal transplant recipients / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>Cytomegalovirus (CMV) remains a significant clinical problem among immunosuppressed renal transplant patients. Quantitative PCR assays have become the most common methods in the determination of CMV infections in transplant patients. This study was to determine the relationship between CMV infection and the acute rejection of the transplanted kidney.</p><p><b>METHODS</b>Plasma samples from 77 renal transplant patients that were pre-transplant negative for CMV infection were tested using real-time quantitative PCR and CMV gene-specific primers. The detected viral loads were retrospectively compared with the acute rejection rate and the chronic or mild rejection rates of the renal transplant.</p><p><b>RESULTS</b>CMV-DNA was detected in 29 of 77 recipients, yielding a positive rate of detection of 37.7% for this procedure. Twelve of the 21 recipients (57.1%) who suffered acute rejection had positive CMV-DNA. Among the 56 recipients suffered from chronic or mild rejection, 17 (30.4%) had positive CMV-DNA plasma. Moreover, of the 29 recipients who had detectable CMV-DNA after transplant, 12 (41.4%) suffered from acute rejection; of the 48 recipients with undetectable CMV-DNA, only nine (18.8%) developed acute rejection. Post-transplant patients with acute rejection had a higher rate (57.1% vs. 30.4%, P = 0.03) of post-transplant CMV infection than those with chronic or mild rejection.</p><p><b>CONCLUSION</b>CMV infection is a risk factor of acute renal transplant rejection and CMV infection should be prevented and treated in renal transplant recipients.</p>

Use of laparoscope complete mesocolic excision in the surgical treatment of right colon cancer / 中华胃肠外科杂志

<p><b>OBJECTIVE</b>To investigate the efficacy of laparoscope complete mesocolic excision (CME) for right colon cancer.</p><p><b>METHODS</b>The clinical data of 49 cases of right colon cancer without metastasis and intestinal obstruction who underwent elective laparoscope CME by the same group of surgeons between October 2009 and June 2011 at the First Hospital of Jilin University were analyzed retrospectively.</p><p><b>RESULTS</b>Among the 49 cases with CME, the median number of total lymph node retrieved was 22. The positive rate of lymph node in patients with stage III disease was 16.3%. The median operative time of all the cases was 145 min. The mean intraoperative blood loss was 75 ml. The median time to flatus passage and defecation was 3 days and 6 days respectively. The median hospital stay was 12 days. The overall postoperative complication rate was 12.2% (6/49).</p><p><b>CONCLUSION</b>Laparoscope complete mesocolic excision for right colon cancer is safe and feasible.</p>