ABSTRACT
Objective To investigate the feasibility of application of anterograde tubular ileal fistula in Ⅰ stage anastomosis of colon cancer with acute obstruction. Method Eighty patients of colon cancer with acute obstruction who treated with anterograde tubular ileal fistula in Ⅰ stage anastomosis were analyzed restropectively. Result Clinical observation showed that 80 patients were cured and discharged,no one did occur anastomotic leakage, abdominal abscess,and other serious complications. Conclusion If correctly graspe the timing of operation for colon cancer with acute obstruction,irrigation methods,good perioperative management,select the anterograde tubular ileal fistula, Ⅰ stage resection and anastomosis is safe and feasible.
ABSTRACT
Objective To investigate the surgical strategy of recurrent rectuvaginal fistula. Methods Retrospectivly analyzed the clinical data of 13 patients with recurrent rectovaginal fistula from December 2001 to December 2008. The etiopathogenisis and the ways of treatment were analyzed. Results All the 13 patients with a transverse colostomy surgical repaired with Mason operation in the secondary intention,and recepted closure of colostomy in the third intention for treatment, all patients were cured. No recurrent fistula was identified with postoperative follow-up 4 - 84 months. Conclusions After recurrent rectovaginal fistula with multiple surgical treatment,the blood supply of local tissue is poor,the scar is serious. Selecting the appropriate timing of operation, adequate preoperative preparation, the application of transverse colostomy and Mason operation in different period could significantly enhance the successful operation rate.
ABSTRACT
Objective To discuss the diagnosis and surgical treatment of insulinoma. Methods The clinical data of 32 patients with insulinoma were analyzed retrospectively. Of the 32 patients, 19 patients were performed with simple tumor enucleation, 10 patients with pancreatic body and tail resection, 3 patients with pancreaticoduodenectomy. Results In this study, 20 cases were diagnosed and localized the tumor by type-B abdominal ultrasonic and enhanced spiral CT before operation and 12 cases by intraoperative type-B ultrasonic. Within all patients,9 tumors located in the head of pancreas, 15 tumors in the neck , 8 tumors in the tail. The clinical symptoms in 32 cases disappeared after operation with 2 cases followed by pancreatic leakage. Of all 32 cases with insulinoma,28 tumors were diagnosed as benign and the other 4 as malignant. Conclusions The mainly clinical manifestation of insulinoma is typical whipple triad. Preoperative qualitative diagnosis is practicable according to the clinical symptom and laboratory examination. Combined imaging examinations might be helpful in improving the positive test rates. Intraoperation exploration and ultrasonography are the chief methods for the tumor localization. Site, size, number and depth of the tumor are the key points determining the surgical method style.
ABSTRACT
Objective: To investigate the expression of human telomerase reverse transcriptase (hTERT)in benign and malignant gastric diseases and its clinical significance. Methods: The expression of hTERT in 126 gastric tissue specimens obtained by surgery and endoscopy were studied by SP immunohistochemical method. The specimens included 10 cases of nomal mucosa,26 of chronic gastritis, 22 of benign ulcer,5 of leiomyoma, 3 of hyperplastic polyps, 50 of gastric cancer, 2 of maligmant lymphoma and 8 of sarcoma. In precancerous lesions,there was 54 cases of atypical hyperplasia,including 18 low grade, 25 of intermediate and 11 high grade. The positive expression rates and relations of clinical characters were analyzed. Results: hTERT was not or seldom expressed in normal and benign gastric diseases, while it was highly expressed in malignant lesions.There was a significant difference between them(P
ABSTRACT
Objective:To investigate the effect of transcatheter arterial chemoembolization (TACE) on cell proliferation in hepatocellular carcinoma(HCC).Methods:Expression of proliferating cell nuclear antigen (PCNA) was detected immunohistochemically in paraffinmbedded specimen of 65 HCCs.Results:PCNA labeling index was significantly lower in the group of HCCs who underwent TACE preoperatively (35.83?12.23% vs 59.92?23.57%,P