ABSTRACT
Objective To investigate the effect of short-term complications after D2 radical gastrectomy on long-term survival rate of gastric cancer patients. Methods A retrospective case-control study was conducted on 421 patients with gastric cancer who underwent D2 radical gastrectomy. According to the short-term postoperative complications, they were divided into experimental group (complication group, n=76) and control group (without complication group, n=345). In order to reduce the selection bias, the long-term survival rate of the two groups was tested by Kaplan-Meier survival analysis method after balancing the variables by propensity score matching (PSM). Log rank method was used for univariate analysis and Cox multivariate analysis was used for prognostic factors. Results There was no significant difference in long-term survival rate between the experimental group and the control group (P > 0.05). Histological type, lymph node metastasis rate and pTNM stage were independent risk factors for long-term survival. Conclusion The short-term complications after D2 radical gastrectomy have no significant impact on the long-term survival rate of gastric cancer patients, but it has certain clinical significance to actively prevent and control complications.
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Objective To explore the influencing factors and timing of acute cholecystitis laparoscopic surgery.Methods One hundred and sixty acute cholecystitis patients treated with laparoscopic surgery were divided into group A (56 cases,performed treatment within 24 h),group B (42 cases,performed treatment at 24 -48 h),group C ( 40 cases,performed treatment at 49 -72 h),group D (22 cases,performed treatment after 72 h).The operation time,rate of conversion to laparotomy,length of stay and average costs were compared among four groups and analyzed the impact of laparoscopic surgery conversion to laparotomy.Results The rate of conversion to laparotomy of group D [ 59.09％(13/22) ] was significantly higher than that in group A [ 19.64％(11/56) ] (P ＜ 0.01 ).The operation time of group A was the shortest and group D was the longest.The length of stay of group D was significantly longer than other groups (P ＜ 0.05 ).The costs of the four groups had no significant difference(P ＞ 0.05 ).Single factor analysis showed that white blood cell (WBC) count,body temperature,timing of surgery,gallbladder neck calculi incarceration were correlated with conversion to laparotomy(P ＜ 0.05 ).Multifactor analysis showed that WBC count,timing of surgery were independent risk factors of conversion to laparotomy (P ＜ 0.05 ).Conclusions WBC count,body temperature,timing of surgery,gallbladder neck calculi incarceration are correlated with acute cholecystitis laparoscopic surgery conversion to laparotomy.While WBC count and timing of surgery are independent risk factors.The best time of laparoscopic surgery is within 72 h and WBC count ＜ 15 x 109/L.
ABSTRACT
Objective To explore clinical effect of dinoprostone in premature rupture of the membranes at term cervical ripening.Methods 42 cases with premature rupture of the membranes at term cervical ripening were selected.All patients were randomly divided into two groups.The dinoprostone group had 21 cases,which applied the treatment of dinoprostone belt the posterior fornix of vagina medicine induced abortion.The oxytocin group had 21 cases,which applied the treatment of intravenous drip oxytocin.The time of induction labor,6h,12h cervical Bishop score after using the medication,drugs acting time,labor conditions and perinatal situation,pregnancy outcome and some other index were observed.Results It taken (6.18 ± 4.48 ) h until parturient and ( 12.62 ± 8.03 ) h until the cervical mouth full open in the dinoprostone group,which were shorter than the oxytocin group,that taken( 10.21 ±5.42) h,( 18.87 ± 9.14) h.( t =2.62,2.35,all P ＜ 0.05 ).There was no significant difference about cervical Bishop score before using the medication.It's(7.52 ± 2.44 ) point 6h after using the medication and( 9.03 ± 1.96 ) point 12h after in the dinoprostone group.They were better than the oxytocin group,which were(5.97 ± 1.95 )point,(7.13 ±2.12 )point.It was significantly different( t =2.27,3.02,all P ＜0.05 ).The average incubation period of dinoprostone group wss (9.91 ± 1.73 )h.It's longger than the oxytocin group,which was( 8.72 ± 1.34)h.The active period of dinoprostone group was(4.36 ± 0.66 ) h.It's shortter than the oxytocin group,which was( 5.84 ± 1.02 ) h.The difference was significant( t =2.49,5.58,all P ＜ 0.05 ).There was no significant difference in the second and third stage of laber between the two groups( t =0.56,0.33,all P ＞ 0.05 ).There was also no significant difference about intrauterine distress,amniotic fluid contamination,cesarean section,intestinal bleeding,the Apgar score of newborns and some other index in the two groups ( x2 =0.00,0.00,0.52,t =0.84,1.04,all P ＞ 0.05 ).Conclusion Dinoprostone had good promoting effect on cervical ripening for preterm premature rupture of membranes pregnant woman.Its effect was better than oxytocin and it was safe to use.