RÉSUMÉ
Objective To summarize the clinical characters of acute intestinal obstruction in elderly patient . Methods A retrospective analysis was performed in 183 cases of elderly patient with acute intestinal obstruction, who were operated on in our hospital between October 1992 and October 2001. Results Of the 183 elderly patients who underwent surgical operation, 43.2% was due to strangulated hernia, being a leading cause of the intestinal obstruction in the elderly people. The incidence of colon cancer increased in the elderly. In the same period of this retrospective study, 43 out of 106 elderly inpatients 40.6% (43/106) with colon cancer were admitted to the hospital due to acute intestinal obstruction. Out of the 19 patients with left semicolon cancers, Cancers of 17 cases were surgically removed. Twelve of them were operated on with one stage anastomosis and 2 were complicated with anastomosis fistulas (16.7%). The postoperative fatality rate was 3.3%(6/183), all were died of too late operation. Conclusions The operation intervention is effective in treating acute intestinal obstruction, and is capable of remitting most elderly patient.
RÉSUMÉ
Background and purpose:In China, incidence of gastric cancer is high but early diagnosis is low and treatment results remains poor.The role of neoadjuvant chemotherapy for patients has been explored.In this study, we evaluated the effects and safety of preoperative intra-arterial infusion chemotherapy(PAIC) for advanced gastric cancer.Methods:One hundred and five patients with clinic stage-Ⅱ above advanced gastric cancer were submitted to preoperative intra-arterial infusion chemotherapy using the Seldinger technique.The regimen consisted of 5-FU 750 mg/m2, MMC 10 mg/m2, and DDP 60 mg/m2.Seven to ten days after the PAIC, all 105 patients received operation.Other 95 patients underwent surgery directly as control group.The responses by the tumor lesion and chemotherapy toxicity were observed.The long term survival rate were also evaluated.Results:Pathological examination showed that the tumor cells had changed by chemothrapy.Common adverse effects of PAIC were grade Ⅰ-Ⅱ gastrointestinal discomfort and bone marrow depression.No gastric rupture had occurred.Ninety-one cases(86.6%) underwent curative resection.The 1, 3, and 5-year survival rate was 96.2%, 68.6%, and 52.4% respectively.Among 95 patients with control group, sixty-five cases(68.6%) underwent curative resection.1,3,and 5-year survival rates were 88.4%,38.9% and 28.4%,respectively.Conclusion:PAIC is an effective, and safety chemotherapeutic treatment for advanced gastric cancer.It can affer treatment downstage of disease and enhances resectability.It may also improve the prognosis of advanced gastric cancer.