A preliminary study of stenting followed by laparoscopic surgery for obstructing left-sided colon cancer / 中华胃肠外科杂志

<p><b>OBJECTIVE</b>To study the efficacy of stenting followed by laparoscopic surgery in the treatment of obstructing left-sided colon cancer.</p><p><b>METHODS</b>Forty-nine patients with obstructing left-sided colon cancer were prospectively randomized into two groups. Twenty patients received emergent open surgery, while 15 underwent laparoscopic surgery 3 days after placement of the self-expanding metal stent (SEMS) and 14 of them received laparoscopic surgery 10 days after placement of SEMS. Outcomes evaluated included 1-stage operation rate, conversion rate, operative time, length of hospital stay, blood loss, postoperative pain score and use of analgesics, rates of permanent stoma, and postoperative complications.</p><p><b>RESULTS</b>Compared with emergent open surgery, patients undergoing laparoscopic surgery had significantly less blood loss(P=0.000), lower permanent stoma rate (P=0.024), less pain(P=0.000), and lower incidence of postoperative complications. Laparoscopic surgery was associated with a significantly higher rate of 1-stage operation(P=0.004). Compared with patients undergoing laparoscopic surgery 3 days after SEMS placement, patients who underwent laparoscopic surgery 10 days after SEMS placement had a significantly higher 1-stage operation rate(P=0.001) and a lower conversion rate(P=0.046).</p><p><b>CONCLUSIONS</b>Self-expanding metal stenting is a safe and effective bridge to laparoscopic surgery in patients with obstructing left-sided colon cancer. Laparoscopic surgery 10 days after SEMS placement may be more appropriate.</p>

Study on No.7 lymph nodes micrometastasis in patients with node- negative gastric carcinoma by routine examination / 中华胃肠外科杂志

<p><b>OBJECTIVE</b>To investigate the micrometastatic characteristics in the gastric cancer patients with negative lymph node invasion by routine pathological examination and evaluate the relationship between micrometastasis and clinicopathological features.</p><p><b>METHODS</b>One hundred and thirty-eight lymph nodes from No. 7 group in 46 patients with node-negative gastric cancer by routine examination were examined by consecutive sections. Telomerase activity was determined by RT-PCR and ELISA. Clinicopathological data were analyzed by statistical method.</p><p><b>RESULTS</b>Micrometastasis was found in 32 lymph nodes (23.2%) from 13 cases (28.3%) by consecutive sections. Telomerase activity was positive in 49 lymph nodes (35.5%) from 20 cases (43.5%). The sensitivity, specificity, positive and negative predictive value and diagnostic accuracy of TRAP-ELISA was 100%, 84%, 65%, 100% and 88% respectively. The micrometastasis in lymph node was correlated with age, sex, primary tumor location, histological classification and metastatic lymph node type (P> 0.05), but correlated with the gross type of the primary tumor, size and serosa invasion (P< 0.05).</p><p><b>CONCLUSIONS</b>It is necessary to discern the micrometastasis in gastric cancer with negative lymph node by routine examination in order to objectively evaluate the clinicopathological classification and prognosis. TRAP-ELISA can be a complementary method to traditional histological examination.</p>