ABSTRACT
OBJECTIVE: To explore the clinical value of three-dimensional visualization technology in the resection of retroperitoneal tumor.METHODS: A retrospective analysis was performed on 91 patients with retroperitoneal tumor who underwent surgical resection in Department of General Surgery,Affiliated Sixth People's Hospital of Shanghai Jiao Tong University from January 2014 to December 2018.The three-dimensional visualization technology was used to observe the relationship between retroperitoneal tumors and surrounding tissues and blood vessels,to assess the resectability of the tumor and guide the development of the surgical plan.RESULTS: The median operation time was 178 minutes,the median blood loss was 543 mL,and the average tumor size was 12.8 cm.Nine cases(9.9%) were with postoperative complications and 1 died of seizures,82 patients with pathological examination of tumor capsule integrity,and the rate of complete resection is 90%.CONCLUSION: Preoperative application of three-dimensional visualization technique in the resection of retroperitoneal tumor can improve preoperative assessment accuracy and guide the formulation of individualized precision surgical procedures,meanwhile,to enable patients to achieve better surgical results.
ABSTRACT
<p><b>OBJECTIVE</b>To evaluate the value and inadequacy in clinical practice of the concept of gastric high-grade intraepithelial neoplasia (HIN).</p><p><b>METHODS</b>Forty-five cases with gastric HIN diagnosed by the esophagogastroduodenoscopy (EGD) biopsy were treated from 2003 to 2009. The clinical and histopathological data were analyzed retrospectively.</p><p><b>RESULTS</b>Radical surgeries were successfully performed on all the patients, among whom 33 underwent distal subtotal gastrectomy, 3 proximal partial gastrectomy, 7 total gastrectomy, and 2 endoscopic mucosal resection. In postoperative pathological examination, only 15 cases (33.3%) were HIN, while 14 cases (31.1%) were found to be early gastric cancers, and 16 (35.6%) were advanced cancers. Twelve(40.0%) out of 30 cancers had regional lymph nodes metastasis. When the maximum diameter of the HIN lesion was greater than 3.0 cm, or when ulcer or the features of poorly-differentiated carcinoma or signet-ring cell carcinoma were present in preoperative biopsy, the likelihood of cancer in postoperative pathological examination was higher (P<0.05), and when malignancy was confirmed, the presence of the features above was associated with lymph nodes metastasis and advanced cancer.</p><p><b>CONCLUSIONS</b>Carcinoma is identified in a large proportion of patients with gastric HIN by the EGD biopsy. Lymph nodes metastasis or advanced cancer may be detected in these cases. Cautions must be taken when the new concept of HIN is widely used for diagnosing gastric lesion. Radical resection should be considered when the maximum diameter of the HIN lesion is greater than 3.0 cm, or when ulcer, or the feature of poorly-differentiated carcinoma or signet-ring cell carcinoma are present in the EGD biopsy.</p>