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Objective To study the safety and short-term clinical outcome of different body mass index (BMI) patients with rectal cancer undergoing laparoscopic total mesorectal excision (TME). Methods The clinical data of 179 rectal cancer patients who had underwent laparoscopic TME from November 2016 to November 2017 were retrospectively analyzed. The patients were divided into 3 groups according to the BMI:leanness group (BMI<18.5 kg/m2, 15 cases), normal group (BMI 18.5 to 22.9 kg/m2, 89 cases) and overweight/obesity group (BMI ≥23.0 kg/m2, 75 cases). The general clinical data and the operation-related situation were compared. Results The rate of preoperative complications in overweight/obesity group was significantly higher than that in leanness group and normal group: 45.33％(34/75) vs. 4/15 and 28.09％(25/89), the preoperative albumin level in leanness group was significantly lower than that in normal group and overweight/obesity group:(36.3 ± 2.8) g/L vs. (38.6 ± 3.2) and (39.1 ± 3.7) g/L, and there were statistical differences (P<0.05). The operation time and blood loss in overweight/obesity group were significantly higher than those in leanness group and normal group: (149.2 ± 32.9) min vs. (129.3 ± 28.7) and (133.5 ± 23.6) min, (135.5 ± 29.0) ml vs. (117.5 ± 22.6) and (122.5 ± 25.9) ml, and there were statistical differences (P<0.05). There were no statistical differences in sex, age, tumor location, tumor maximum diameter, depth of tumor invasion, lymph node metastases, surgical approach, circumferential margin, number of lymph node dissections, length of resected specimens, incidence of postoperative complications, surgical site infection, postoperative urinary retention, postoperative exhaust time and postoperative hospitalization among 3 groups (P>0.05). Conclusions The differences of BMI mean different complications and nutritional status of patients. Overweight and obesity can lead to difficult operation of laparoscopic TME, but do not affect the radical cure of operations and the safety of clinical outcomes.
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ObjectiveTo study the expression level of HER-2 gene in the same pathological stage gastric cancer,and discuss the feasibility of HER-2 gene being the prognostic indicator.MethodsThe expression of HER-2 in gastric cancer was detected by immunohistocehmical technique and analyzed in relation with the pathological stage and prognosis of the patients.ResultsThe total positive rate of HER-2 in gastric cancer was 33.64％ (37/110).In stage Ⅱ,the weakly and strongly positive rates of gastric cancer were 21.31％ ( 13/61 ) and 9.84％ (6/61).In stage Ⅲ,the weakly and strongly positive rates of gastric cancer were 20.41％ (10/49) and 16.33％ (8/49).In the same pathological stage,the survival rate of patients with negative HER-2 expression was higher than weakly positive ones.And the survival rate of patients with strongly positive HER-2 expression was the lowest.The difference had statistical significance (P ＜ 0.01).ConclusionThe prognosis of patients in the same stage was correlated with the expression level of HER-2,which can be used to evaluate the biological behavior and prognosis of gastric cancer.
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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.
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Objective To explore the clinical significance and safety in hemihepatectomy for hepatoma without inflow occlusion.Methods A total of 62 patients with liver cancer were divided into 2 groups.The inflow was occluded in group A (n = 28) and not occluded in group B (n = 34) during hepatectomy.Subsequently,the influence of the two approaches on the parameters including intraoperative blood loss,postoperative hepatic function and complications incidence rate was comparatively analyzed.Results Hepatectomy was successfully performed in the two groups.There was no significant difference between the two groups in intraoperative blood loss (P ＞ 0.05).Significant difference existed between the two groups in postoperative hepatic function and complications incidence rate (P ＜ 0.05).Conclusions The hemihepatectomy for hepatoma without inflow occlusion can reduce complications incidence rate and profit the recovery of postoperative hepatic function parameters.
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Objective: To investigate the role of expression of Caspase-9 in megalosplenia of cirrhotic portal hypertension. Methods: Using SP immunohistochemistry method to examine theexpression of Caspase-9 in the specimens of 50 cases of megalosplenia with cirrhotic portal hypertension and 15 cases of traumatic spleen of normal man. Results: The Caspase-9 positive rates in the traumatic spleen and megaloplenia were 26.7% and 76.0%, respectively. There was a significant difference between the groups(P