ABSTRACT
OBJECTIVE@#To investigate the long-term outcome of laparoscope-assisted transanal total mesorectal excision (taTME) for rectal cancer.@*METHODS@#Clinicopathological data of 29 patients with mid-low rectal cancer undergoing laparoscope-assisted taTME at Department of Gastrointestinal Surgery, the First Affiliated Hospital of Guangzhou Medical University from May 2010 to December 2015 were collected for the retrospective case-series study. All the operations were performed with transabdominal and transanal procedure simultaneously or sequentially. Perioperative presentations, pathological examinations, and oncologic outcomes were retrospectively analyzed. Long-term recurrence, metastasis and survival were assessed during follow-up. Outpatient clinic and telephone survey were used for follow-up. The follow-up time ended in December 2018. The overall survival (OS) rate and disease-free survival (DFS) rate were calculated by the Kaplan-Meier method.@*RESULTS@#The average intra-operative blood loss was (75.9±9.5) ml (range,20 to 200). The average operating time was (223.6±4.1) minutes (range, 165 to 280). The average number of harvested lymph node was 22.3±2.0. The average length of pathological specimen was (13.1±0.6) cm. The average distal resection margin was (2.9±0.2) cm. 89.7% (26/29) of specimens was complete and 10.3% (3/29) near complete. Two cases (6.9%) had positive cutting circumferential margin. Median follow-up was 56 (range, 22 to 91) months. Local recurrence rate, distant metastasis rate, 3-year OS rate, 3-year DFS rate, 5-year OS rate, 5-year DFS rate were 10.3% (3/29), 20.7%(6/29), 96.6%, 83.2%, 87.6% and 79.6%, respectively. No incisional hernia or adhesive intestinal obstruction was found.@*CONCLUSION@#Long-term outcomes of mid-low rectal cancer patients undergoing laparoscope-assisted taTME are satisfactory.
Subject(s)
Humans , Laparoscopes , Neoplasm Recurrence, Local , Rectal Neoplasms , General Surgery , Rectum , Retrospective Studies , Transanal Endoscopic SurgeryABSTRACT
Objective To observe the preliminary effect and safety of perioperative hyperthermic intraperitonral chemotherapy to treat gastrointestinal cancer. Methods The clinical data of 60 patients with progressed gastric or colorectal carcinoma who underwent perioperatively HIPEC in our hospital from May, 2012 to October, 2013 were retrospectively analyzed. The incision healing, complications, KPS scores and serum CEA levels were observed. Results The vital signs of all patients were normal during HIPEC. There was no perioperative death. No patients underwent serious complications like diffuse peritonitis, intestinal obstruction, gastrointestinal perforation or intraperitoneal bleeding. There was no anastomotic leakage in 28 patients who underwent Stomach-jejunum anastomosis or intestinal anastomosis. After HIPEC, the life quality was improved;increase in KPS score and reduction in serum CEA levels were noted in all patients (P < 0.01). Of 29 patients with malignant ascites, 20 cases achieved complete mitigation and 8 cases achieved partial mitigation, 1 case was in stable condition, thus yielding effective rate of 96.5%. Conclusions It is safe and feasible for HIPEC to treat gastrointestinal cancer. HIPEC can improve the patients’ life qualities, without theincrease in perioperative complications. The short-term effect of HIPEC is confirmed in alleviating ascites.
ABSTRACT
Objective To evaluate the effect of discussion-based teaching pattern in clinical noviciate of general surgery. Methods Two hundred and ten students majoring in clinical medicine were randomly divided into the trial group and the control group during clinical noviciate of general surgery.There were 105 students in each group. The discussion-based teaching pattern and traditional teaching pattern were performed in the trial and control groups,respectively. After the clinical novici-ate of general surgery was completed,the teaching effects of both groups were evaluated by the exam-ination performance analyses and the questionnaire-based survey. Student's t-test andχ22 test were used in statistical analysis. Reults The rate of satisfaction with the teaching pattern was 88.6%in the trial group and 70.5%in control group(P<0.05). The mean scores in the trial group and control group were 80.3±9.2 and 74.5±11.3,respectively (P<0.05). The pass rate of examination in the trial group and control group were 97.1% and 88.6%,respectively (P<0.05). The excellence rate in the examination was 24.8%in the trial group and 12.4%in control group (P<0.05). The overwhelming majority of stu-dents in the trial group thought that the discussion-based teaching pattern had more advantages in im-proving students' learning initiative and enthusiasm,ability to analyze and solve problems,etc.,acord-ing to the questionnaire-based survey. Conclusions Discussion-based teaching is an effective teach-ing pattern and superior to the traditional teaching pattern.