ABSTRACT
<p><b>OBJECTIVE</b>To analyze the risk factors of postoperative complications in gastric carcinoma patients complicated with liver cirrhosis.</p><p><b>METHODS</b>A retrospective research of 41 gastric cancer patients with liver cirrhosis who underwent surgical therapy was performed. The multivariate Logistic regression analysis was carried out to determine risk factors of postoperative complications.</p><p><b>RESULTS</b>There were no postoperative death in this cohort. Twenty-seven(65.9%) patients developed postoperative complications. As determined by the Logistic regression analysis, Child-Pugh score(OR=27.96, 95% CI:1.16-672.23), albumin level(OR=17.98, 95% CI:1.28-253.36) and intraoperative blood loss(OR=10.60, 95% CI:1.21-92.82) were independent risk factors of postoperative complications.</p><p><b>CONCLUSION</b>As for gastric cancer patients with liver cirrhosis, positive perioperative management, adjustment of Child-Pugh classifications score, following damage control principle during operation and reducing the intraoperative bleeding may decrease the morbidity of postoperative complications.</p>
Subject(s)
Humans , Factor Analysis, Statistical , Liver Cirrhosis , Morbidity , Postoperative Complications , Retrospective Studies , Risk Factors , Stomach NeoplasmsABSTRACT
Objective To evaluate the treatment of acute cholecystitis patients through laparoscopic cholecystectomy (LC). Methods 387 cases of acute cholecystitis patients who underwent LC were studied retrospectively . Results Of the 387 cases, there were 359 cases of calculus incarcerated cholecystitis , 152 cases of cholecystitis with acute inflammatory symptoms for 72 h or more, 10 cases were converted to Laparotomy (2.6%).The operations lasted for 30~200 min(63.09 ±26.62 min on average),with blood loss about 10~500 mL(51.41 ±32.41 mL on average),and drainage was adopted in 183 cases.No complications developed fol-lowing the surgeries in 3 to 24 months, indicating a 100% cure rate. Conclusion If with good command of rules and techniques during LC operations , It is both safe and feasible to treat acute cholecystitis patients through LC operations .
ABSTRACT
Objective To compare the expression of mIFN-γ, replicative activities and anti-tumor activities of CNHK300-mIFN-γand Ad-mIFN-γin normal and gastric cancer cells. Methods The replicative activities of viruses in cells were measured by viral replication assay. CPE assay was used to detect the antitumor effect of viruses. The expression level of mIFN-γ in cancer cells was detected by ELISA. Results The infection of CNHK300-mIFN-γled to an obvious expression of mIFN-γin gastric cancer cells. The vector system CNHK300-mIFN-γpossessed more replicated potential than Ad-mIFN-γ, and could specifically kill most of BGC-823 cells at MOI value of 0.1, which was much better than that by the traditional adenoviral vector. Conclusion CNHK300-mIFN-γcan selectively replicate and effectively express mIFN-γ in tumor cells, and specifically kill gastric cancer cells, suggesting a splendid future as a new anticancer agent.
ABSTRACT
Objective To explore the operative procedure and perioperative management of gastric cancer with liver cirrhosis.Methods Clinical data of 28 cases of gastric cancer with liver cirrhosis who were surgically treated in our hospital during the last seven years were retrospectively analyzed.Preoperatively,a detailed examination,and improvement of their nutritional status,liver function,and prothrombin time were aggressively made,and the possibility of tumor removal was estimated.Seven patients underwent radical proximal subtotal gastrectomy,and 4 of these cases underwent splenectomy and pericardial devascularizaion simultaneously.Five cases underwent total gastrectomy,and 3 of them had splenectomy and pericardial devascularizaion simultaneously.Twelve patients underwent radical distal subtotal gastrectomy,and 5 of these cases had splenectomy and suture of pericardial varices simultaneously.Four patients had palliative distal subtotal gastrectomy.The support of liver function and intense monitoring and management of complications were carried out postoperatively.Results Varying degrees of ascites occurred in all the 28 patients postoperatively,and other complications such as early liver coma occurred in five patients,extensive wound bleeding in three patients,left subdiaphragmatic abscess in one patient and wound infection in two patients.The morbidity rate was 100%(28/28).However,all the complications were recovered by non-surgical treatment.There were no perioperative deaths in this series.Conclusions Gastric cancer patients with liver cirrhosis are at a significant risk of developing postoperative complications.The surgical procedure should the "individual" principle based on liver function,history of upper gastrointestinal bleeding and the location of gastric carcinoma.Good hepatic reserve and perioperative care,meticulous hemostasis during operation,and prevention and treatment of postoperative complications are the likely determinants of operative prognosis.