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<p><b>OBJECTIVE</b>To evaluate laparoscopic radical gastrectomy for early gastric cancer.</p><p><b>METHODS</b>A total of 204 patients with early gastric cancer undergoing laparoscopic-assisted radical gastrectomy or open radical gastrectomy between October 2004 and December 2009 were retrospectively reviewed and analyzed. Patients were divided into laparoscopic group(LAP, n=78) and open group (OPEN, n=126). Operative time, blood loss, time to passage of flatus, postoperative hospital stay, complications and pathologic findings were compared between the two groups.</p><p><b>RESULTS</b>Compared to the OPEN group, operative time in the LAP group was significantly shorter[(202.9±45.6) min vs.(219.8±45.2) min, P<0.05], blood loss was less[(144.5±146.5) ml vs. (245.0±146.4) ml, P<0.05], time to passage of flatus was shorter[(3.1±1.1) d vs.(4.5±1.6) d, P<0.05], postoperative hospital stay was shorter[(10.8±1.2) d vs. (12.4±3.8) d, P<0.05]. However, the two groups were comparable with regard to postoperative complication rate(10.3% vs. 12.7%, P>0.05), proximal resection margin[(4.0±1.9) cm vs. (4.2±1.7) cm, P>0.05], distal resection margin [(3.6±1.7) cm vs. (3.5±1.8) cm, P>0.05], number of harvested lymph node(13.1±6.5 vs. 14.5±8.2, P>0.05). The median follow up was 22(2-64) months. There were no tumor recurrences or metastases in the LAP group. In the OPEN group, only 1 patient died from peritoneal metastasis. Total hospital costs between the two groups were similar(P>0.05).</p><p><b>CONCLUSION</b>Laparoscopic radical gastrectomy is a safe, feasible, effective, and less invasive surgery for early gastric cancer.</p>
Subject(s)
Adult , Aged , Aged, 80 and over , Female , Humans , Male , Middle Aged , Follow-Up Studies , Gastrectomy , Methods , Laparoscopy , Laparotomy , Lymph Node Excision , Retrospective Studies , Stomach Neoplasms , General Surgery , Treatment OutcomeABSTRACT
Objective To investigate the pathological diagnosis of high-grade intraepithelial neoplasia in gastric biopsy.MethodsOne hundred and forty-three cases diagnosed by gastric biopsy as high-grade intraepithelial neoplasia were analyzed by light microscopy,and were compared with the pathological findings of surgical specimens in 60 cases and a second biopsy in 13 cases.Results Among the sixty cases treated surgically following the gastric biopsies,no carcinoma was found in 6,while the other 54 were diagnosed as gastric adenocarcinoma,27 in advanced stage and 27 in early stage,respectively.Fifteen cases were well-differentiated,24 moderately-differentiated,12 poorly-differentiated and 3 were of mucinous type.Four of the 13 cases with a second biopsy were diagnosed as well-differentiated adenocarcinoma,8 low-grade intraepithelial neoplasia and 1 chronic inflammation.The colorectal adenomas-like changes were morphologically found in 6 surgically-treated cases without carcinoma,5 of whom mucous muscles were not found by biopsy.Fibroblastic reactions were found in 9 cases,all of which were diagnosed as adenocarcinoma in surgical specimens.Conclusion Ninety percent of the cases who are diagnosed as high-grade intraepithelial neoplasia by biopsy may have already been complicated with adenocarcinoma.The location and depth of the specimen in gastric biopsy have a considerable influence on pathological diagnosis.The fibroblastic reaction may be considered as an important marker for gastric adenocarcinoma in pathological diagnosis of gastric biopsy.
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Objective CT angiography (CTA) of the portal vein system by 16 detector spiral CT was performed to determine etiopathogenisis, collateral and gastro-renal shunt in the patients with portal hypertension. MethodsThirty-two patients suspected of portal hypertension were examined and reconstructed by arterial-venous double-phase scan. Results Twenty-seven patients with portal hypertension were revealed by CT scan and reconstruction, with spleen vein thrombosis in 4 cases, congenital cavernous transformation of portal vein in 3 cases, gastro-renal shunt in 9 cases, and simply liver cirrhosis and portal hypertension in 11 cases. Conclusion Portal CTA is a significantly important and useful examination method for portal hypertension patients, it could help to determine not only the range, degree and variation of esophageal and gastric varices, but also the etiopathogenisis of non-cirrhotic portal hypertension.
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<p><b>OBJECTIVES</b>To study the value of enteroscopy in determining bleeding lesion of small intestine.</p><p><b>METHODS</b>Clinical data of ten cases with small intestinal bleeding diagnosed by enteroscopy were analyzed retrospectively from June 2003 to June 2004.</p><p><b>RESULTS</b>Bleeding sites disclosed by enteroscopy were consistent with those confirmed by operation in 10 patients,but qualitative diagnosis was not consistent in 2 patients.</p><p><b>CONCLUSIONS</b>Enteroscopy is a safe,reliable and valuable modality for diagnosing bleeding lesion of small intestine.</p>
Subject(s)
Adolescent , Adult , Aged , Female , Humans , Male , Middle Aged , Young Adult , Endoscopy, Gastrointestinal , Gastrointestinal Hemorrhage , Diagnosis , Intestine, Small , Pathology , Retrospective StudiesABSTRACT
Objective To explore the changes of nitric oxide(NO) and superoxide dismutase(SOD) in the serun and intestine mucosal and the treatment of ulcerative colitis(UC) with tanshinon in rats,Methods 30 mg of trinitro-benzene-sulfonic acid (TNBS) dissolved in 0.85ml of 50% ethanol was administrated intrarectally in Sprague-Dawley female rats to induce experimental colitis.After 7 days,the rats were divided into normal control, 0.9% saline and treatment group tanshinon 2ml?kg~(-1)?d~(-1) were intravenously.The therapeutic effect was evaluated by measuring the ponderal index,the surface area of the ulcers,macroscopical and histological score,activity of NO and SOD were measured in colonic tissue and serum all rats.Results Compared with the saline group,the ponderal index,the surface area of the ulcers,macroscopical and histological score,activity of NO level in the serum and intes- tine mucosal was decreased and the SOD increased of significantly in the treatment group(P
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Objective To investigate the expression of normal epithelial cell-specific-1(NES1) gene in normal gastric epithelial cells and different gastric cancer cell lines and the effects of 5-aza-2-de- oxycytidine(5-aza-dC)on the expression of NES1 gene.Methods Expression of NES1 mRNA in five gastric cancer cell lines(MKN-28,SGC-7901,AGS,MKN-45 and HGC-27)and normal human gastric epithelial cells were detected by real-time PCR.After treatment with 5-aza-dC,a DNA methyltransferase inhibitor,the expression of NES1 mRNA in gastric cancer cell lines was detected by real-time PCR. DNA methylation status of NES1 gene was assayed by methylation-specific PCR(MSP).Results The expression of NES1 mRNA was decreased in all gastric cancer cell lines.A strong correlation between ex on 3 hypermethylation and loss of NES1 mRNA expression in gastric cancer cell lines was noted.5-aza dC treatment of NES1-nonexpressing tumor cell lines resulted in a dose-dependent induction(SGC-7901, MKN-45,MKN-28 and AGS)and increase (HGC-27) of NES1mRNA expression in gastric cancer cells. Conclusions The study suggested that hypermethylation was a responsible factor for tumor-specific loss of NES1 gene expression in gastric cancer cells.Treatment of gastric cancer cell lines with a demethylating agent led to reexpression of NES1 suggesting an important role of hypermethylation in loss of NES1 gene expression.