ABSTRACT
Objective@#To evaluate the efficacy and safety of Hong's pancreaticojejunostomy in laparoscopic pancreaticoduodenectomy.@*Methods@#A retrospective analysis was carried out on 184 patients who underwent laparoscopic pancreaticoduodenectomy using Hong's pancreaticojejunostomy (the Hong’s pancreaticojejunostomy group) compared with 100 patients who underwent laparoscopic pancreaticoduodenectomy using traditional pancreaticojejunostomy (the traditional pancreaticojejunostomy group) at Department of Second Hepatobiliary and Pancreatic Surgery, the First Bethune Hospital of Jilin University, from April 2016 to December 2018. The differences between the two anastomotic methods in operation time, pancreaticojejunostomy time, intraoperative blood loss, postoperative hospital stay, postoperative complications, and incidences of pancreatic fistula were compared.@*Results@#The operation time, pancreaticojejunostomy time and intraoperative blood loss of the Hong's pancreaticojejunostomy group were significantly less than the traditional pancreaticojejunostomy group [(278.2±49.3) min vs. (337.3±67.4) min, (33.7±6.6) min vs. (46.8±8.5) min, (123.1±44.7) ml vs. (203.8±138.6) ml], respectively, (all P<0.05). There were no significant differences in postoperative hospital stay and pancreatic fistula rates between the two groups (all P>0.05).@*Conclusions@#Hong's pancreaticojejunostomy was safe, rapid and effective compared with traditional pancreaticojejunostomy. It did not increase the incidence of pancreatic fistula.
ABSTRACT
Objective:To compare the three effects of lidocaine in the prevention of general anesthesia in elderly patients.Methods:A total of 120 elderly patients (65-85 years old) underwent anesthesia with general anesthesia (ASA) Ⅰ ～ Ⅱ were randomly divided into thyrocricocentesis group (group H),throat surface anesthesia group (Group Y),intravenous injection group (group J) and control group (group D).Group H was injected with lidocaine for surface anesthesia;group Y used laryngeal spray for laryngeal sprayed lidocaine for surface anesthesia;group J was anesthetized induction of intravenous lidocaine to prevent intubation reaction;group D the control group was not treated with lidocaine.(SBP) and heart rate (HR) were measured before and after induction (T0),tracheal intubation (T1) and 1 (T2),3 (T3) and 5 min (T4),the changes of hemodynamics related indexes were compared.Results:Compared with the same group of T0,the SBP and HR of four groups of T1 moments were significantly decreased (P ＜0.05);In the other three groups,SBP was significantly increased at T2 and T3 (P ＜0.05),HR ofT2 was significantly increased (P ＜0.05);Compared with group D,SBP and HR in group H,Y and J were significantly different at T2,T3 and T4,he difference was statistically significant (P ＜0.05);but there was no statistically significant difference between the three groups (P＞ 0.05).Conclusion:The three ways of lidocaine can be used to prevent the general anesthesia reaction in elderly patients,the effect of three ways is parallel.However,cricothyroid membrane puncture increased the patient's pain,throat spray method increased the cumbersome operation and enhanced the cost of the patient,and intravenous injection method is simple and worthy of popularization and application in clinic.
ABSTRACT
About 30%-50% of colorectal cancer patients would develop recurrence and metastasis. At present, there is still a lack of effective evaluation method for recurrence, metastasis and prognosis. In recent years, a great progress about circulating tumor cells (CTC) in diagnosis and treatment of colorectal cancer has been made. The most common CTC detection methods include immunocytochemistry, flow cytometry, PCR, immunomagnetic separation, optical fiber array scanning and CTC chip. Based on present studies, researchers reach the consensus that CTC is clinically valuable in the following aspects: detection of occult metastasis, monitor of disease progress and evaluation of response to treatment. With recent development of clinical specialization, multi-disciplinary treatment (MDT), gene detection and targeted therapy, individualized treatment may greatly improve overall survive and disease-free survival of colorectal cancer patients. However, the methods above depend on tumor tissues that are always impractical to obtain for late stage and non-surgery patients. Moreover, the size of specimen is always small, making gene expression and mutation detection difficult. CTC detection may solve such problems based on molecular biology with high plausibility and repeatability. Therefore, CTC detection can be used as a new diagnosis tool. It is believed that CTC detection will play an important role in early diagnosis, evaluating recurrence, metastasis, making individualized treatment and predicting prognosis.