Application of transanal ileus tube followed by laparoscopic surgery for malignant colorectal obstruction / 中华外科杂志

<p><b>OBJECTIVE</b>To evaluate the safety and efficacy of transanal drainage tube followed by laparoscopic surgery in management of malignant colorectal obstruction.</p><p><b>METHODS</b>From March 2007 to October 2010, 37 patients with colorectal cancer manifesting acute complete mechanical obstruction were treated by ileus tube drainage. After irrigation and drainage ranging from 4 to 10 days, the radical operations and anastomosis were performed by laparoscopy.</p><p><b>RESULTS</b>The drainage tubes were successfully implanted in 34 patients. The decompression time of patients was (5.8 ± 1.6) d, ranging from 4 to 10 d. The abdominal pain and bloating symptoms were faded away after (3.8 ± 1.3) d (1 to 7 d) drainage. And comparing to that of patients when admission, abdominal circumference significantly reduced from (92 ± 7) cm to (84 ± 6) cm (P = 0.013) before surgery. Thirty-one cases were performed radical resection and anastomosis by laparoscopy after decompression. Postoperative recovery was smooth, and there was no serious complication.</p><p><b>CONCLUSIONS</b>Laparoscopic surgery followed decompression by transanal ileus tube is effective and safe for acute lower colorectal obstruction. Emergency surgery may be converted to limit surgery by this method. After appropriate bowel preparation, laparoscopic radical surgery and anastomosis is feasible.</p>

Clinical observation on early intraperitoneal hyperthermic perfusion chemotherapy in the treatment of stomach carcinoma after operation / 肿瘤

Objective: To study the clinical effect of early intraperitoneal hyperthermic perfusion chemotherapy on stomach carcinoma after operation. Methods: A total of 78 patients with stomach carcinoma were randomly divided into two groups. The therapeutic group received an intraperitoneal hyperthermic perfusion chemotherapy combined with intravenous chemotherapy (n = 41). The control group were given the intravenous chemotherapy only (n = 37). Postoperative complications, adverse reaction, local recurrence, distant metastasis, and 1- and 3-year survival rate were compared between the two groups. Results: There was no significant difference in the postoperative complications and adverse reaction between the two groups. The local recurrence rate and distant metastasis rate in the therapeutic group were significantly lower than the control group (21.95% vs 40.54%, 17.07% vs 37.83%, P < 0.05). The 1-year and 3-year survival rate in the therapeutic group were higher than the control group (90.24% vs 81.68%, 68.29% vs 48.64%, P < 0.05). Conclusions: Early postoperative intraperitoneal hyperthermic perfusion chemotherapy, effectively decreased the rate of local recurrence and distant metastasis and increased the survival rate. It is safe and easy to operate.