ABSTRACT
Objective To observe the clinical effects of chimney technique combined with thoracic endovascular aortic repair(TEVAR) in the treatment of type B aortic dissection.Methods The clinical datas of 56 patients with type B aortic dissection in our hospital were analyzed retrospectively.According to the surgical intervention method,they were divided into observation group (22 cases,TEVAR + chimney technique) and control group (34 cases,TEVAR alone).Surgery related indicators,incidence of postoperative short-term complications and mortality between the two groups were compared.Results The success rates in both groups were 100％,and the surgical time in observation group was longer than that in control group (P ＜ 0.05).There were no significant differences in blood loss,eating time,off-bed time and hospitalization time between the two groups(P ＞ 0.05).The incidence of complications of observation group and control group within 2 weeks after operation were 18.2％ and 5.8 ％ respectively,the difference was not significant(P ＞ 0.05),as well as mortality and incidence of longterm complications during the followed period (P ＞ 0.05).Conclusion The perioperative indexes of single endovascular repair and its combination with chimney technique for the treatment of type B aortic dissection are similar.Chimney technique can reconstruct important branch flows,especially for patients with insufficiency of landing zone.However,particular attention needs to be paid to postoperative complications to avoid negative effect on the prognosis of patients.
ABSTRACT
Objective To evaluate the effect of neoadjuvant chemotherapy on advanced gastric cancer before laparoscopic radical gastrectomy.Methods 46 advanced gastric cancer cases in our hospital from January 2010 to January 2013 were included in experimental group who were given two courses of neoadjuvant chemotherapy with FOLFOX regimen prior to surgery,the responsives (38 cases) received two more courses of neoadjuvant chemotherapy before surgery,and those in whom the chemotherapy was judged as ineffective (8 cases),received radical gastrectomy 21 days later.As a control,36 diseasematched cases went on upfront surgery without neoadjuvant chemotherapy.All these 82 cases underwent successful laparoscopic gastrectomy.Results The overall effective rate of neoadjuvant chemotherapy was 59％.Before the operation,the differences of pathological staging between the two groups were significantly different; The difference in operation time,the intraoperative blood loss and harvested lymph node number between the experimental group and control group was not statistically different (P ＞ 0.05).The R0 resection rate in experimental group (63％) was higher than in the control group (36％),P ＜0.05.The recurrence rate and mortality rate in experimental group was lower than that in the control group,P ＜ 0.05.Conclusions In advanced gastric carcinoma preoperative neoadjuvant chemotherapy significantly improved the resection rate and reduced postoperative recurrence and mortality rate.