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Gastric schwannoma is a tumor originating from mesenchymal tissue. The clinical incidence is relatively rare, accounting for 6.3% of all gastric stromal tumors. The tumor is more likely to occur in the body of the stomach and usually originates from the gastric submucosal nerve. Most gastric schwannomas do not have any clinical symptoms. Imaging examination can play a diagnostic role, but the diagnosis still requires pathological examination, especially S-100 protein which is the gold standard for the diagnosis of gastric schwannomas. Gastric schwannoma usually needs to be distinguished from gastrointestinal stromal tumors and gastrointestinal autonomic nerve tumors. In terms of treatment, complete surgical resection is the first choice.
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ObjectiveTo investigate the surgical treatment and prognosis of T1b unsuspected gallbladder carcinoma (UGC). MethodsTwenty-two patients with T1b UGC admitted to our hospital were enrolled as subjects. The information on clinical pathology, radiological examination, laboratory tests, surgical treatment, and postoperative follow-up were analyzed in patients. The survival rate and recurrence were compared between patients treated with radical cholecystectomy and laparoscopic cholecystectomy. The Kaplan-Meier method was used to calculate survival rates, and the log-rank test was used for survival difference analysis. Comparison of categorical data was made by Fisher′s exact test. ResultsThe 1-, 3-, and 5-year accumulative survival rates in all patients with T1b UGC were 100%, 89.7%, and 82.8%, respectively; there was no significant difference in the 5-year accumulative survival rate between patients treated with laparoscopic cholecystectomy and radical cholecystectomy (84.6% vs 75.0%, χ2=0.000, P=0.991); two (15.4%) out of thirteen patients treated with laparoscopic cholecystectomy respectively; one (12.5%) out of eight patients treated with radical cholecystectomy had recurrence, there was no significant difference between the two groups(P＞005). ConclusionRadical cholecystectomy is a superior therapy for T1b UGC over laparoscopic cholecystectomy.
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Objective To evaluate surgical treatment for different types of tumor of the suprarenal infrahepatic segment of the inferior vena cava (IVC).Methods A retrospective analysis was made on 8cases of IVC leiomyosarcoma at the suprarenal infrahepatic IVC segment.According to the extent of tumor invasion and collateral circulations,operations included tumor resection plus inferior vena cava reconstruction or tumor resection plus right nephrectomy.Results Tumors were completly resected in all patients.Renal function recovered after operation.During a follow up of 24 mons,7 cases had no recurrence.One case with recurrence after 12 months underwent successful resection and is doing well after a follow-up of 12 months.Conclusion CT and inferior vena cavography can determine the extent of tumor invasion and collateral circulations helping select appropriate surgical aproach before the operation resulting in less renal injury.
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<p><b>OBJECTIVE</b>To analyze the surgical management of incidental gallbladder cancer (IGBC) discovered during or after laparoscopic cholecystectomy (LC) and to evaluate the associated factors of survival.</p><p><b>METHODS</b>A retrospective analysis of patients with IGBC between January 2002 and December 2013 was performed. A total of 10 080 consecutive patients underwent LC operation for presumed gallbladder benign disease in Chinese People's Liberation Army General hospital. And among them, 83 patients were histologically diagnosed as IGBC. Data covering clinical characteristics, surgery records, local pathological stage, histological features and factors for long term survival were reviewed. The survival analysis was performed using Kaplan-Meier method, and the results were examined using the log-rank test.For multivariate statistical analyses of prognostic factors, a Cox proportional hazards model was carried out.</p><p><b>RESULTS</b>A total of 83 patients with IGBC:68.7% females (57/83), median age of 61 years (range 34-83 years). There were 47 cases accepted the initial simple LC, 18 cases converted to open extended radical cholecystectomy, 16 cases with radical second resection, and 2 cases with re-laparotomy; the 5-year survival rates for each group were 89.4%, 38.9%, 87.5%, and 0, respectively. The 5-year survival rates in T1a, T1b, T2, and T3 stage patients were 95.7% (22/23), 90.0% (18/20), 75.0% (15/20), and 40.0% (8/20), respectively. Univariate analysis for prognostic factors associated with cancer-specific death showed that depth of invasion, lymph-node status, vascular or neural invasion, tumor differentiation, extent of resection, bile spillage during prior LC and type of surgery were statistically significant.In multivariate analysis, depth of invasion, extent of resection and bile spillage were the most important prognostic factors related to both cancer-specific mortality and disease relapse (P < 0.05).</p><p><b>CONCLUSIONS</b>Simple LC is appropriate for T1a patients with clear margin and unbroken gallbladder. An extended radical resection in patients with T1b or more is highly recommended, and provided as a potentially curative R0 resection only if it is necessary.</p>
Subject(s)
Female , Humans , Cholecystectomy , Cholecystectomy, Laparoscopic , Gallbladder Neoplasms , General Surgery , Laparoscopy , Multivariate Analysis , Neoplasm Staging , Proportional Hazards Models , Retrospective Studies , Survival Analysis , Survival RateABSTRACT
<p><b>BACKGROUND</b>The possible role of substance P (SP) during wound healing has been the primary research focus in recent years, but its effect on the healing process after bile duct injury is little understood. This study aimed to investigate the effects of SP on growth of fibroblast-like cells derived from rabbit bile duct.</p><p><b>METHODS</b>Fibroblast-like cells derived from rabbit bile duct were identified and divided randomly into control and experimental groups. SP-treated cells at different concentrations of 10(-9)-10(-5) mol/L and control group were incubated, respectively, for 48 hours. After incubating, the effects of SP on cell proliferation were assessed by cell counts and MTT test. Apoptosis rate (AR) of cells was measured by flow cytometry.</p><p><b>RESULTS</b>Cultured rabbit bile duct cells were fibroblast-like in morphology, and these cells were stained positively for vimentin and negatively for desmin. After SP was added to nonconfluent cells for 48 hours, cell numbers were significantly increased in experimental groups than in controls (P < 0.05). The maximum stimulation of cell proliferation was achieved at SP of 10(-5) mol/L. Bile duct fibroblast-like cells in the SP group showed a higher proliferating activity and lower AR than those in the control group or in the SP + Spantide group (P < 0.05). Spantide partly inhibited the effects of SP on fibroblast-like cells. Examination under transmission electron microscopy revealed rough endoplasmic reticulum and prominent Golgi complexes after SP treatment.</p><p><b>CONCLUSIONS</b>SP has a growth regulatory property on cultivated bile duct fibroblast-like cells in vitro, suggesting that SP may involve in wound healing after bile duct injury by promoting wound fibroblast proliferation and inhibiting apoptosis and participate in pathological scar formation.</p>