ABSTRACT
Objective To investigate the safety and feasibility of not placing prophylactic drainage after colorectal anastomosis.Methods A total of 100 patients with colorectal cancer who were admitted to the Sichuan Provincial People's Hospital from July 2007 to March 2009 were randomly divided into drainage group (50 patients) and non-drainage group (50 patients) according to the random number table.A drainage tube was placed after colorectal anastomosis in the drainage group,while no drainage tube was placed in patients in the non-drainage group.The duration of postoperative hospital stay,mortality and morbidity of the 2 groups were compared.All data were analyzed by using the chi-square test or t test.Results Two patients(1 from each group) were excluded in the study,and no death or pulmonary infection were found in the remaining 98 patients.The numbers of patients whose course was complicated by anastomotic leakage and wound infection were 2 and 7 in the drainage group,and 1 and 5 in the non-drainage group.The duration of postoperative hospital stays were ( 11.5 ± 2.4)days in the drainage group and(10.6 ± 2.2)days in the non-drainage group.There were significant differences in the morbidity and duration of postoperative hospital stay between the 2 groups(x2 =0.00,0.38,t =1.428,P ＞ 0.05).Conclusion It is safe and feasible not to place a prophylactic peri-anastomotic drainage tube after colorectal anastomosis.
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Objective To investigate the feasibility and safety of laparoscopic-assisted gastrectomy for distant gastric cancer.Methods All 18 patients with distant gastric cancer receiving laparoscopic-assisted gastrectomy were analyzed.Results Laparoscopic-assisted distal gastrectomy was performed successfully in all patients.The mean operation time was(291.33?19.61) min.The mean blood loss was(151.32?71.78) ml.The mean numbers of harvested lymph node were 14.57?3.11.The mean time of gastrointestinal function recovery was(3.46?0.93) d,the mean out of bed activity time was(1.75?0.45) d.All patients were followed up for 1-24 months,mean 11 months.No local recurrence,trocar implant or distant metastasis happened.Conclusion Laparoscopic-assisted gastrectomy is a feasible and safe surgical procedure combined with minimal trauma and fast recovery.
ABSTRACT
Objective:To evaluate the effects of perioperatively administrated enteral immunonutrition in gastrointestinal cancer patients on immune and inflammatory responses,nutrition states and postoperative morbidity.Methods:Sixty patients with gastrointestinal cancer were divided randomly into two groups.Two groups perioperatively(from preoperative day 5 to postoperative day 7) received an supplemented diet with arginine,RNA,and ?-3fatty acids(immunonutrition group;n=30) or an isoenergetic and isonitrogenous standard diet (standard-nutrition group;n=30).All variables of immune and inflammatory responses,nutrition states and postoperative morbidity were measured on preoperative day 5 and postoperative day 1,4 and 8.Results:On postoperative day 4 and 8,most immune variables and prealbumin in the immuno-group were significantly higher than those in the standard-group(P0.05),and inflammatory variables as CRP in the immunonutrition group were significantly lower than those in the standard group.In the immunonutrition group,there were significantly fewer patients who experienced postoperative complications and shorter days of hospital stay compared with standard group(P0.05).Conclusion:The perioperative administration of enteral immunonutrition in gastrointestinal cancer patients can significantly modulate the postoperative immunosuppressive and inflammatory responses at the early postoperative day,can significantly decrease the occurrence of infectious and overall postoperative complications as well as the length of hospital stay.