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Objective To compare the efficacy of laparoscopic-assisted hemicolectomy with that of open hemicolectomy for right colon carcinoma and to explore the safety and effectiveness of the formor procedure. Methods The clinical data on 46 patients who had undergone laparoscopic-assisted hemicolectomy and 68 patients who had received open hemicolectomy between December 2009 and December 2013 in our department were retrospectively analyzed. Length of postoperative hospital stay, surgical duration, amount of intraoperative blood loss, number of lymph node dissection, time to postoperative anal exhaust, surgical costs, postoperative complications, and survival rate were compared between the two groups. Results There were no statistical differences between the two grounps in gender, age, body mass index, pathological typing, depth of invasion, and total number of lymph node dissection. Length of hospital stay was 6.84 days in the group of laparoscopic-assisted hemicolectomy and 11.72 days in the group of open hemicolectomy , with a statistical significance. Surgical duration and treatment costs did not differ significantly between the two groups; while amount of intraoperative blood loss (76.63 mL vs. 141.5 mL) and time to postoperative anal exhaust differed significanly. Conclusions Laparoscopic-assisted hemicolectomy is safe and effective for treatment of colon cancer , It has advantages of small trauma, rapid postoperative recovery, and a nice-looking surgical incision.
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Objective: Combined resection for locally advanced [T4] gastric cancer may result in high morbidity and mortality. The aim of this study was to evaluate the clinicopathologic characteristics to determine the prognostic factors for T4 gastric cancers
Methodology: A total of 463 consecutive patients with gastric cancers were enrolled in this study. Among them, 63 patients received combined resections. Various clinicopathologic factors influencing survival rates were evaluated. Survival rates were calculated according to the Kaplan-Meier method. Prognostic factors were evaluated by the univariate and multivariate analysis
Results: Thirty-one patients [49.2%] received one additional organ resection and 32 patients [50.8%] received two or more additional organ resections. Curative resection was performed in 49 patients [77.8%]. Multivariate analysis identified curative resection [hazard ratio 0.330; 95 percent confidence interval, 0.139-0.784; P = 0.012] and tumor diameter [> 7 cm] [hazard ratio, 3.589; the 95 percent confidence interval, 1.425-9.037; P = 0.007] as independent prognostic factor for patients with T4 gastric cancer undergoing combined resection
Conclusions: The use of aggressive multi-organ resection was recommended for patients with T4 gastric carcinoma, with tumor diameter as a useful indicator. Patients with relatively small tumor diameter [
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Objective To investigate the effect of xuebijing injection applied after abdominal operation on the inflammatory reaction,infection rate,length of stay and hepatorenal function. Methods Sixty patients received abdominal operations were randomly divided into therapeutic group (30 cases) and control group (30 cases). The inflammatory reaction indexes (temperature,heart rate,leucocyte) and hepatorenal function indexes(aminopherase, total bilirubin, creatinine, blood urea nitrogen) were observed in both groups before operation and after operation 3,7 days respectively. The infection rate and length of stay were compared in two groups. Results Temperature and leucocyte post operative 3 days [temperature:(37.0 ± 0.2) ℃ vs. (37.9 ± 0.4) ℃ ;leucocyte: (8.8 ± 1.1 ) × 109/L vs. ( 10.3 ± 1.7) × 109/L, P＜ 0.05] and length of stay in therapeutic group was obviously better than that in control group[ (8.7 ± 1.9 ) d vs. ( 10.9±1.6) d, P ＜ 0.05 ]. The hepatorenal function indexes and infection rate in both groups had no significant difference(P ＞ 0.05). Conclusion Xuebijing injection could significantly palliate the inflammatory reaction after abdominal operation, shorten the length of stay and has no hepatorenal toxicity in short term.
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AIM: To investigate mutations of oncogene k-ras in colorectal cancer tissues and the relationship between mutations of k - ras and biological behavior of colorectal carcinoma. METHODS:The specimens of 123 patients with colorectal cancer were collected. Real - time fluorescence quantitative PCR were performed to detect k-ras mutations at codon 12 and codon 13 of exon 1, and the results were analyzed with the corresponding clinical pathological data. RESULTS: Among 123 colorectal cancer cases, point mutations were detected in 53 cases (40.8% ) , point mutations at codon 12 were found in 42 (34.1 % ) cases, and 11(8.9% ) cases at codon 13.No closely relationship between mutations of k-ras and tumor size, location, invasive depth and differentiation extent was observed. The rate of k-ras mutation in the cases with more invaded lymph nodes was higher than that in the cases without invaded lymph nodes ( P < 0.05 ) , and the rate of k-ras gene mutation in the cases with hepatic metastases was higher than that in no hepatic metastases (P <0.05). The rate of k - ras gene mutation was higher in TNM staging Ⅲ/Ⅳ than that in Ⅰ/Ⅱ( P < 0.05 ). CONCLUSION: Mutation of oncogene k-ras plays an important role in the carcinogenesis and development of colorectal cancer, and it is closely associated with invaded lymph notes and hepatic metastases, suggesting that mutation of k- ras indicates a poor prognosis.
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Objective To explore the clinical effect of procedure for prolapse and hemorrhoids (PPH) treating for Ⅲand Ⅳ degree hemorrhoid under the local anesthesia.Methods One hundred and fifty patients with Ⅲ and Ⅳ degree hemorrhoid were divided into two groups randomly.One group was the local anesthesia group (LA group) which included 73 cases,the other one was the combined spinal epidural anesthesia group (CSE group) which included 77 cases.Compared the safety and efficacy of different procedure.Results The original symptom of the two groups were improved.There was a significant difference in the time of hospitalization time and the hospitalization expense between the two groups (P＜0.05).The LA group was(4.8±1.1)days with(3980±639)yuan,and the CSE group was(6.8±1.1) days with(5128±728)yuan.The rates of two groups of urine retention were 9.6% and 24.7% (P＜0.05) after the operation respectively,and there were no significant differences in recovery normal activity time,the pain index,copracrasia and pruritus,the bleed,the anal fistula,the prolapse of hemorrhoid,the skin tag (P ＞0.05).Conclusion PPH under the local anesthesia is safe,compare to the combined spinal epidural anesthesia,it excels in shortening the hospitalization time and reducing the hospitalization expense,also it can reduce significantly the rate of urine retention after operation.
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Objective To compare the clinical efficacy of tension-free hernioplasty with three operative methods, and analyze the reasons of complications. Methods All Chinese articles dealing with the tension-free hernioplasty included in CNKI from 1997 to 2004 were collected, and divided into three groups according to different operative methods, the clinical efficacy of which was compared. Results The frequecy of foreign matter feel in the Rutknow group was significantly higher than that in the other two groups (P