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Objective:To investigate the regularity of lymph node metastasis of gastrocolic ligament in colon cancer at hepatic flexure,and to explore the feasibility and necessity of the dissection.Methods:The dissection number and the metastasis number of gastrocolic lymph nodes in 96 patients with colon cancer on the hepatic flexure were analyzed retrospectively.The related factors affecting the lymph node metastasis of gastrocolonic ligament were analyzed.Results:Lymph node metastasis of gastrocolic ligament was found in 7 of 96 patients, and the metastasis rate was 7%. Metastasis was found in all three parts of gastrocolic lymph node. Gastrocolic lymph nodes metastasis were related to perineural invasion,tumor budding, N stage and intestinal obstruction (all P<0.05). Conclusion:The dissection of gastrocolic lymph node of hepatic flexure colon cancer is safe and feasible, and can provide more accurate pathological staging, which provides a basis for follow-up adjuvant therapy.
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Objective:To compare the results of lymph node dissection boundaries along the right or left sides of SMA in laparoscopic radical resection for right colon cancer.Methods:One hundred and two patients with advanced right colon cancer were selected for retrospective analysis, the patients were divided into study group (48 cases) and control group (54 cases) according to the extent of lymph node resection. The medial boundary of lymph node dissection in the study group was on the left side of SMA, and the control group was on the right side of SMA. The operation duration, hospital stays, CRP(postoperative day 1), the number of dissected lymph nodes and the complications were compared.Results:The operation duration of the study group was longer than that of the control group[(169±24)min vs.(138±28)min, t=4.827, P<0.05], but there was no statistically significant difference in hospital stays[(10.5±1.7)d vs.(9.7±2.0)d, t=1.172, P>0.05], CRP(postoperative day 1) [(110±44)mg/L vs.(100±39)mg/L, t=1.287, P>0.05], incidence of postoperative complication(12 cases vs. 9 cases, P>0.05) between the two groups.The number of lymph nodes removed in the study group was more than that in the control group[(23.8±8.2) vs.(19.7±6.8), t=2.191, P<0.05], though the number of positive lymph nodes removed in the two groups was not significantly different[(2.2±4.9) vs.(1.4±2.8), t=0.863, P>0.05]. Conclusions:Laparoscopic radical resection for right colon cancer along the left sides of SMA removed more lymph nodes without significant increase of the surgical complications.
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Objective To explore the factors related to the tolerance to enteral nutrition (EN) in gastric carcinoma patients undergoing surgical treatment and the implementation strategy of EN.Methods Fifty-four patients with gastric carcinoma undergoing surgery from November 2011 to September 2012 in the Affiliated Hospital of Medical College of Qingdao University were enrolled.EN were applied with sequential and gradual strategies.The tolerance status to EN was recorded.Factors related to the patient tolerance to EN were analyzed using single-factor and multiple-factor Logistic regression analysis.The incidences of gastrointestinal symptoms during EN application were recorded.Results Among the 54 patients,49 (90.74％) patients could tolerate EN.Single-factor analysis and multiple-factor Logistic regression analysis both showed that tumor staging (single-factor analysis:x2 =7.287,P =0.007 ; multiple-factor analysis:t =2.559,P =0.014) and surgical approach (singlefactor analysis:x2 =7.825,P =0.005 ; multiple-factor analysis:t =2.254,P =0.043) were major factors affecting patient tolerance to EN.Among the patients tolerant to EN,abdominal distension (19/49,38.8％) was the major gastrointestinal symptom of EN.Conclusion The sequential and gradual EN application strategy is suitable for the patients with gastric cancinoma after surgery,and can be widely used in clinical practice.
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Objective To explore 18F-FDG PET-CT in the detection of malignant tumors of the gastrointestinal tract.Methods 39 patients with gastrointestinal tumors who was diagnosed with operation,pathological examination,clinical and imaging follow-up undertake the whole-body 18F-FDG PET-CT.Results The sensitivity and specificity were both 100.0 ％ for primary malignant tumors.Gastric metastases sensitivity,specificity and accuracy were 80.0 ％ (4/5),90.9 ％ (10/11),87.5 ％ (14/16),and the colorectal metastases sensitivity,specificity,accuracy of diagnostic results were 88.9 ％ (8/9),92.9 ％ (13/14),91.3 ％ (21/23).The gastric cancer lymph node metastasis sensitivity,specificity and accuracy were 50.0 ％ (3/6),90.0 ％ (9/10),75.0 ％ (12/16),in the diagnosis of colorectal local lymph node metastasis the sensitivity,specificity and accuracy were 71.4 ％ (5/7),93.8 ％ (15/16),87.0 ％ (20/23).Conclusion The 18F-FDG PET-CT imaging for gastrointestinal malignant tumor diagnosis and residual lesions recurrence or lesions metastases of detection is of important value and better than traditional examination methods.