ABSTRACT
Objective To explore the feasibility and clinical efficacy of serosal muscular layers incision and submucosal layers exfoliation technique in laparoscopic surgery for gastric gastrointestinal stromal tumors(GIST).Methods 28 patients with gastric GIST underwent serosal muscular layers incision and submucosal layers exfoliation technique under laparoscopic surgery.Patients' clinicopathologic characteristics,operative outcomes,postoperative complications,and follow up results were analyzed retrospectively.Results Surgery was successfully completed in all patients,and no one was converted to open surgery.The average operation time was (66 ± 15) min,and the intra operative blood loss was (16 ± 10) ml,the time of passage of gas by anus after operation was (20 ± 10)h,the time starting liquid diet was (2.5 ± 1.6) d,and the length of postoperative hospital stay was (7 ± 3) d.One patient had delayed gastric emptying,one had incisional infection.All the specimen had complete pseudocapsule and negative margin.pathology was all gastric GIST.After a median 22 months followed up,no recurrence or metastasis were found.Conclusion Serosal muscular layers incision and submucosal layers exfoliation under laparoscopic surgery is a safe and feasible procedure for treating gastric GIST.
ABSTRACT
Objective@#To explore the feasibility and clinical efficacy of serosal muscular layers incision and submucosal layers exfoliation technique in laparoscopic surgery for gastric gastrointestinal stromal tumors(GIST).@*Methods@#28 patients with gastric GIST underwent serosal muscular layers incision and submucosal layers exfoliation technique under laparoscopic surgery. Patients′clinicopathologic characteristics, operative outcomes, postoperative complications, and follow up results were analyzed retrospectively.@*Results@#Surgery was successfully completed in all patients, and no one was converted to open surgery.The average operation time was (66±15) min, and the intra operative blood loss was (16±10) ml, the time of passage of gas by anus after operation was (20±10)h, the time starting liquid diet was(2.5±1.6)d, and the length of postoperative hospital stay was (7±3)d. One patient had delayed gastric emptying, one had incisional infection. All the specimen had complete pseudocapsule and negative margin. pathology was all gastric GIST. After a median 22 months followed up, no recurrence or metastasis were found.@*Conclusion@#Serosal muscular layers incision and submucosal layers exfoliation under laparoscopic surgery is a safe and feasible procedure for treating gastric GIST.
ABSTRACT
Objective To explore the impact of abdominal situs inversus on the diagnosis and treatment of abdominal diseases.Methods Clinical data and course of 13 abdominal situs inversus cases from January 2012 to December 2016 were retrospectively analyzed.Results A total of 13 cases accounting for 1.5/10 000 of all cases who had abdominal CT were diagnosed situs inversus.6 of them were diagnosed for routine physical examination,4 of them for urinary tract symptoms,and the other 3 for digestive complaints.Conservative treatment or follow-up was prescribed for 8 patients who were asymptomatic and healthy;Five patients received operation,including 2 nephrecctomy,1 pancreatico duodenectomy,1 laparoscopic cholecystectomy,and 1 endoscopic retrograde cholangiopancreatography.All the cases recovered uneventfully.Conclusions Abdominal situs inversus is rare,non-disease entity,usually an incidental finding during clinical examination.It does not affect the therapeutic principle of concurrent primary disease.
ABSTRACT
Objective To evaluate the clinical characteristics,pathology,treatment and prognosis of gastrointestinal stromal tumors.Methods A retrospective analysis was made on clinical data of 469 patients with gastrointestinal stromal tumors (GIST) admitted between January 2010 and August 2016.Results There were 231 males and 238 females,the median age was 57 years old.The tumor was located in the esophagus in 6 cases (1.3％),in the stomach in 295 cases (62.9％),in the duodenum in 23 cases (4.9％),in the small intestine in 69 cases(14.7％),in the colorectum in 26 cases (5.5％).There were altogether 50 cases (10.6％) in this group with a final diagnosis of extra-gastrointestinal stromal tumors.Tumor invasion depth,risk of ulcer caused bleeding and NIH classification varied with its locations (all P ＜ 0.05).Conclusions The clinical characteristics of gastrointestinal stromal tumors can be used to preliminarily predict its malignant degree.Surgical resection is the treatment of choice,and postoperative recurrence or metastases of gastrointestinal stromal tumors can be treated by imatinib.
ABSTRACT
ObjectiveTo review surgical management of the complications caused by iatrogenic endoscopic sphincterotomy(EST).MethodsEleven patients with complications of EST were surgically treated, including 4 patients with hemorrhage, 3 patients with perforation, 3 patients with perforation plus hemorrhage, and one patient with perforation plus severe pancreatitis. ResultsTwo patients with perforation plus hemorrhage and the patient with perforation plus severe pancreatitis died, other patients survived.ConclusionEarly diagnosis and surgical intervention was very important to lower the mortality. For patients suffering from perforation and hemorrhage or pancreatitis, it′s very important to make an unobstructed peritoneal drainage as well as other maneuvers.