Application of posterior gastric mesentery in laparoscopic gastric surgery / 中华胃肠外科杂志

The posterior gastric mesentery is one of the six mesenteries of the stomach in the membrane anatomy theory. It locates in the upper area of the pancreas, surrounds the posterior gastric vessels, and is adjacent to the short gastric mesentery by the left side, and is adjacent to the left gastric mesentery by the right side, which fixes the fundus body to the posterior abdominal wall of the upper area of pancreas. Due to its anatomical structure, in complete mesentery excision (CME)+D2 surgery, it is a surgical approach to deal with gastric mesentery in the upper area of pancreas; the second step of the "Huang's three-step method" corresponds to the posterior gastric mesentery in the theory of membrane anatomy. In the surgery of benign diseases of the stomach, laparoscopic sleeve gastrectomy (LSG) and laparoscopic Nissen fundoplication, if the short gastric vessels are difficult to be exposed and safely divided, we can dissect the posterior gastric mesentery firstly, and then hoist the fundus of the stomach in order to help dissection of the short gastric vessels. The membrane anatomy theory, as a frontier theory, provides us the new surgical perspectives and paths in gastric surgery.

Comparison among three reconstruction techniques after distal radical gastrectomy / 中华胃肠外科杂志

<p><b>OBJECTIVE</b>To compare surgical efficacy after three different reconstruction techniques after radical resection of distal gastric cancer.</p><p><b>METHODS</b>Clinical data of 169 cases of distal gastric cancer operated in our hospital from 2007 to 2010 were retrospectively analyzed. The reconstruction techniques included Billroth I (anastomosis (n=60), Billroth II (anastomosis (n=41), and Roux-en-Y anastomosis (n=68). Efficacy among 3 groups was compared. Specific symptoms scale was used to evaluate the quality of life in three methods after three months.</p><p><b>RESULTS</b>Compared to Billroth I(anastomosis and Billroth II (anastomosis, Roux-en-Y anastomosis had longer operative time [(266.3±70.4) min vs. (196.2±54.3) min, and (228.5±67.7) min], more blood loss [(220.9±67.6) ml vs. (170.5±61.5) ml and (188.5±76.7) ml], and shorter time to gastric tube removal [(2.6±1.5) d vs. (3.1±1.3) d and (3.6±1.2) d], milder postoperative reflux and heartburn sensation(specific symptoms scale, 1.8±0.4 vs. 1.9±0.6 and 2.6±0.4, P<0.05).</p><p><b>CONCLUSIONS</b>Although Roux-en-Y anastomosis is not consistent with physiological route and the procedure is more complex to perform, it can effectively prevent reflux complications. Roux-en-Y anastomosis is a better reconstruction technique after radical resection of distal gastric cancer.</p>

Analysis for myeloperoxidase genetic polymorphism in gastric cancer / 中华胃肠外科杂志

<p><b>OBJECTIVE</b>To investigate the association of myeloperoxidase(MPO) genetic polymorphism and gastric cancer.</p><p><b>METHODS</b>A case-control study was performed including 62 patients with gastric cancer and 61 healthy controls. Peripheral blood was collected for genetic analysis of MPO-463.</p><p><b>RESULTS</b>There were no significant differences in gender, age, and smoking between the two groups(P>0.05). However, the two groups differed in drinking, family history of gastric cancer, and Helicobacter pylori(HP) infection(P<0.05). The frequencies of MPO-463GG, GA and AA were 87.1%, 11.3% and 1.6%in the study group, and were 72.1%, 23.0%, and 4.9% in the control group, respectively. Carriers of MPO-463 GA or AA had a significantly higher risk of gastric cancer than those of MPO-463 GG(χ(2)=4.253, P<0.05, OR=0.383, 95% CI: 0.151-0.972). Carriers of G allele had a significantly lower risk of gastric cancer compared to carriers of A allele(χ(2)=4.935, P<0.05, OR=0.399, 95% CI: 0.174-0.916).</p><p><b>CONCLUSION</b>MPO-463 G/A polymorphism is associated with gastric cancer with A being a protective gene.</p>