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Objective To evaluate the safety and effectiveness of enhanced recovery after surgery (ERAS) in laparoscopic radical gastrectomy for gastric cancer.Methods From May 2015 to July 2017,149 patients with gastric cancer in our department were prospectively enrolled and randomly divided into the ERAS group (n =75) and control group (n =74).Results In ERAS group compared to control group,the time to first passage of flatus was (51 ± 11)vs.(62 ± 11)h,first feeding time (46 ± 12) vs.(68 ±20)h,gastric tube removal time (13 ± 12)h vs.(70 ± 16) h,pain score on the first day after surgery (3.9 ±1.3) vs.(5.2 ±0.9),C-reaction protein level (8.5 ±2.6) mg/L vs.(10.1 ±3.0)mg/L,post-op hospital stay (6.9 ± 2.9) d vs.(11.2 ± 3.5) d,were all significantly different (all P ＜ 0.05).The postoperative complication rates was 25％ vs.28％ respectively,(x2 =0.101,P =0.750).Conclusions Enhanced recovery after surgery can promote the postoperative recovery and shorten the time of hospitalization in laparoscopic-assisted radical gastrectomy for gastric cancer.
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Objective To identify the risk factors for postoperative complications after radical resection of rectal cancer, and study the influence of high ligation of the inferior mesenteric artery on postoperative complications of rectal cancer. Methods Clinical data of the patients who underwent radical resection of rectal cancer in the Affiliated Hospital of North Sichuan Medical College from January 2011 to December 2015 were analyzed. The χ 2test and t test were used for all the data. Results A total of 431 patients with rectal cancer were included, of which 80 cases were excluded, and finally 351 cases met the standard. Among them, 196 cases were in high ligation group, and 155 cases were in low ligation group. The total incidence of postoperative complications was 20.4 %(40/196) in the high ligation group and 27.1 %(42/155)in the low ligation group respectively,the difference of which was not statistically significant(χ2=1.336, P= 0.245). The incidence of anastomotic leakage was 10.2 % (20/196) in the high ligation group and 7.7 % (12/155) in the low ligation group respectively, and there was no significant difference between them (χ2=0.529, P= 0.467). Logistic regression analysis revealed that gender (OR= 2.102, 95 % CI 1.278-3.459, P=0.003), body mass index (OR= 2.492, 95 % CI 1.070-5.800, P= 0.027), with or without anemia before surgery(OR=2.203,95 % CI 1.085-4.472,P=0.029), and location of tumor(OR=2.861, 95 % CI 1.288-16.007,P=0.019) were independent risk factors for postoperative complications. Conclusions High ligation of the inferior mesenteric artery does not increase the incidence of postoperative complications after radical resection of rectal cancer. Anastomotic leakage after rectal cancer resection is related to gender, body mass index,with or without anemia before surgery,and location of tumor.
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Objective To investigate the nursing knowledge of rural patients with rectal carcinoma after permanent colostomy.Methods Data were collected on 54 patients with rectal carcinoma after permanent colostomy using the self-designed questionnaire and analyzed by statistical methods.Results The rural patients with permanent colostomy showed low level of nursing knowledge.Scores of patients with different sexes and family income showed significant difference.Conclusions Medical security system and medical staff should provide with more welfare policy and specialty support for the patients in rural areas to promote their knowledge of self-care.
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BACKGROUND: Chemotherapy has been the very important adjunctive treatment for the patients with large intestine cancer. However, obvious individual difference exists in the sensitivity of the patients to the chemotherapeutic drugs, and the difference is related with the age and sex of the patients or not?OBJECTIVE: To make an exploratory discussion of that whether the difference of the sensitivity of chemotherapeutic drugs exists in different ages and different sexes of the patients with epidemiological investigation of the tumor cell survival rate.DESIGN: Controlled experimental study based on pathological samples.SETTING: General surgery department of an affiliated hospital of a medical college.PARTICIPANTS: Tumor cell samples of 169 cases of colorectal cancer tissue obtained from patients with colorectal cancer at the Department of General Surgery of the affiliated hospital of North Sichuan Medical College during the period from January 2001 to January 2003 were involved as subjects. The patients, 97 males and 72 females, were made a definite diagnosis of the large intestine cancer by operation and pathological examination and have not been treated with chemotherapy before operation.METHODS: The sensitivity of chemotherapy drugs were measured on the survival tumor specimens of 169 patients with colorectal carcinoma with Methyl thiazolyl tetrazolium(MTT) test method in vitro. The differences of different ages and different sexes were analyzed in patients.MAIN OUTCOME MEASURES: The absorbance values of tumor cell 72hours after treatment with chemotherapeutic drugs.RESULTS: There was no obvious significance of the tumor' s sensitivity to chemotherapeutic agents in different ages and sexes in patients with colorectal cancer( P ＞ 0.05).ONCLUSION: The individual difference of sensitivity for chemotherapeutic agents in patients with colorectal cancer is not related with the age and gender, needless to consider age and gender in selecting chemotherapeutic agents for different individuls.