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Objective To investigate the effect of breast conserving surgery in early triple negative breast cancer (TNBC). Methods Data of 56 early (stage and Ⅱ) TNBC patients in the Eighth Medical Center of PLA General Hospital from January 2010 to January 2015 were analyzed retrospectively, and they were divided into breast-conserving surgery group (n=27) and modified radical surgery group (n=29) who chose the modified radical surgery due to their own willingness and economic factors. Patients in both groups received adjuvant chemoradiotherapy and were followed up for 5 years. Postoperative local recurrence rate, distal metastasis rate, 5-year survival rate, operative time, amount of bleeding, hospital stays, postoperative complications, Symptom Check List 90 (SCL90) were compared between the two groups. Results There were no significant differences in local recurrence rate, distant metastasis rate, operative time and survival rate between the breast-conserving surgery group and the modified radical surgery group (P>0.05). The postoperative complications, amount of bleeding, hospital stays in the breast-conserving surgery group were significantly lower than those in the modified radical surgery group (P<0.05). The SCL90 total score, total symptom index, positive items, and average of positive items of the patients who survived 5 years after the operation were also significantly lower than those of the modified radical surgery group (P<0.05). Conclusion Breast-conserving surgery for early TNBC patients is safe and effective. There was no significant difference in operation time between breast-conserving surgery and modified radical surgery, but breast-conserving surgery can shorten the postoperative recovery time, reduce surgical complications, and improve the postoperative quality of life.
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Objective To summarize the experiences in surgical treatment of abdominal tuberculosis and intestinal obstruction. Methods The clinical data were retrospectively analyzed of surgically treated 112 cases of abdominal tuberculosis and intestinal obstruction from Jan. 2010 to Dec. 2015. Results Of the 112 cases, 96 were diagnosed with complete intestinal obstruction, including 29 cases of ileocecal tuberculosis (12 cases of ileum perforation), 39 cases of severe adhesions, and 28 cases of strangulated ileus caused by adhesive band; 16 cases were incomplete ileus, including 6 cases of ileocecal tuberculosis, 6 cases of part adhesions caused by mesenteric lymph node tuberculosis, and 4 cases of angulation adhesion. A hundred and six cases were cured surgically. Six cases were obstructed again and cured after antituberculotic treatment. Five cases were with intestinal fistula after surgery, of whom 2 cases died of MODS induced by aggravation of infection, and 3 cases were cured and recovered after antituberculotic and nutritional support treatment through thorough drainage. Conclusions The surgical treatment as early as possible is recommended for the patients with abdominal tuberculosis and intestinal obstruction. Preoperative formulation through full multidisciplinary team (MDT) consultation of reasonable anti-tuberculosis treatment and nutritional support scheme is the key to complete recovery and reduce of postoperative complications.
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Objective To investigate the clinical efficacy of neoadjuvant chemotherapy combined with breast-conserving surgery for locally advanced breast cancer. Methods Eighty-one patients with locally advanced breast cancer were selected from those who were admitted into 309 Hospital of PLA from January 2009 to October 2013, consisting of 65 patients in stage III a and 16 in stage III b, and they were treated with neoadjuvant chemotherapy combined with breast-conserving surgery. The clinical efficacy [complete response (CR), partial response (PR), stable disease (SD) and progress disease (PD)] was observed during follow-up. Results All the patients were followed-up for 12-60 months with a median of 34 months. There were 12 CR patients (14.8%), including 4 with pathological complete response (4.9%), and 52 PR patients (64.2%), 17 SD patients (21.0%). No PD was observed. The overall response rate(ORR) was 79.0%(64/81). After follow-up for 12-60 months (median 34 months), distant metastasis to the lung, liver, meninges and bone occurred in 3 patients (3.7%, 3/81) and 1 of them died. Forty-eight patients received breastconserving surgery. The local recurrence rate was 6.3% (3/48). Assessment of cosmetic result was carried out in 48 patients who received breast-conserving surgery and comprehensive treatment for one year, and excellent results were obtained in 14.6% (7/48), good in 43.8% (21/48), and poor in 41.7% (20/48). Conclusions The therapeutic efficacy of locally advanced breast cancer is satisfactory by neoadjuvant chemotherapy and breast-conserving surgery. Standardization of excision and postoperative radiotherapy, systemic comprehensive treatment is the key to the success of the treatment.
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Objective To evaluate the clinical efficacy of imatinib mesylate as an adjuvant therapy in combination with surgery for advanced gastrointestinal stromal tumors. Methods A total of 92 patients with advanced gastrointestinal stromal tumors, which were confirmed by pathological examination, were enrolled in this study from Jan. 2007 to Jan. 2012. There were 57 male and 35 female patients with age range of 21-85 years, and disease courses from one month to 2.5 years. The lesion was located in the stomach in 41 patients, jejunum in 11, ileum in 9, colon in 17, and rectum in 14. All of them received imatinib mesylate at a dose of 400mg/d for 3-9 months. According to Choi's efficacy evaluation criteria, therapeutic efficacy and adverse reactions were recorded. Results All of the patients were followed up for 9-50 months. Two patients achieved complete response (CR), 45 partial response (PR), 31 stable disease (SD) and 14 had disease progression (PD). Six patients died. The overall response rate (ORR) was 51.1% and disease control rate(DCR) was 84.6%. The adverse reactions were mainly facial and lower extremity edema to varying degrees, neutropenia, nausea and vomiting. Fifty-four patients received surgery after adjuvant therapy, the resection rate was 58.7%. The overall survival rates at 1 and 3 years were 100% and 93.4% respectively. Conclusions Imatinib mesylate as adjuvant therapy has good therapeutic efficacy for middle-late gastrointestinal stromal tumor. It can prolong patient life and improve the resection rate. Only mild adverse reactions occur and its toxicity is acceptable.
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<p><b>BACKGROUND</b>Roux-en-Y gastric bypass (GBP) is the main surgical procedure used in type 2 diabetes. The objective of this study was to evaluate the different types of GBP in treatment of type 2 diabetes.</p><p><b>METHODS</b>Patients with type 2 diabetes were randomly divided into two groups: those who underwent gastrojejunal loop anastomosis bypass and those who underwent gastrojejunal Roux-en-Y bypass. Blood glucose alterations, operation time, and operation complications were observed.</p><p><b>RESULTS</b>Gastrojejunal loop anastomosis bypass and gastrojejunal Roux-en-Y bypass were both effective in the treatment of selected patients with type 2 diabetes. Compared with gastrojejunal Roux-en-Y bypass, gastrojejunal loop anastomosis bypass had the advantages of easier implementation, shorter operation time, and fewer operation complications.</p><p><b>CONCLUSIONS</b>Gastrojejunal loop anastomosis is effective in treatment of type 2 diabetes. It is safe, easy to implement, and worthy of clinical popularization.</p>