Segmental resection of the liver by Glissonean pedicle transection for primary liver cancer / 南方医科大学学报

<p><b>OBJECTIVE</b>To study the clinical effect of segmental resection of the liver using Glissonean pedicle transection for primary liver cancer.</p><p><b>METHODS</b>The clinical data of 55 primary liver cancer patients admitted from January 2006 to October 2008 were analyzed retrospectively. Twenty-five of the patients underwent segmental resection of the liver by Glissonean pedicle transection (group A), and 30 underwent routine hepatectomy (group B). The positivity rate of the resection margin, micrometastasis in the hepatic parenchyma surrounding the lesions and postoperative recurrence rates were investigated.</p><p><b>RESULTS</b>The positivity rate of the resection margin was 4.0% in group A, significantly lower than that of group B. The number of histological micrometastasis was significantly higher in group A than in group B (16 vs 8). The median distance of histological micrometastasis was 6.8 mm (2.7-25.6 mm) in group A and 4.2 mm (2.4-9.0 mm) in group B. The one-year recurrence rate was significantly lower in group A than in group B (16% vs 26.7%).</p><p><b>CONCLUSION</b>Glissonean pedicle transection for segmental liver resection is a simpler procedure than routine hepatectomy for primary liver cancer and can reduce the number of histological micrometastasis and recurrence rate.</p>

Clinical application of curve-type stapler in lower rectal cancer reserving anus / 临床外科杂志

Objective To evaluate the effect of Curve-t ype Stapler applied in lower rectal cancer reserving anus. Method The experiences were summarized and analyzed in 31 patients underwent re serving anus from January 2000 to April 2001.In 31 patients were performed end- to-side anastomosis for lower rectum cancer through abdomen.Result There were no complications including hemorrhage, stenosis and postope rative fistula in 31 cases lower rectum cancer end-to-side anastomosis.Conclutions The way of anastomosis is an effective, reliable, co nvenient method which lasts a short time.

Impact of mederate surgical trauma on substrate utilization / 肠外与肠内营养

The study was designed to observe the impact of moderate surgical trauma on substrate utilization in 39patients(men,n=1 9;women,n=2 0 ) undergoing elective cholecystectomy. The utilization rate of carbohydrate,fat and protein was estimated on the day before operation and on the1 st,4th and7th post operative day by indirect calorimetry.The result showed that the postoperative utilization rate of carbohydrate was declined,and that of fat elevated significantly when compared with the preoperative values(P0 .0 5 ) .It suggested that the main energy source after moderate surgical trauma be from the oxidation of fat,which might be related to the change of metabolic hormone and the insulin resistance.