Study on accuracy of endoscopic polyp size measurement by disposable graduated biopsy forceps / 中华胃肠外科杂志

<p><b>OBJECTIVE</b>To study the accuracy of endoscopic polyp size measurement by disposable graduated biopsy forceps (DGBF).</p><p><b>METHODS</b>Accurate gradation of 1 mm was made in the wire of disposable graduated biopsy forceps, which was used to measure the size of tumors under endoscopy. Fifty-eight polyps from 43 patients underwent endoscopy in our department from May to June 2013 were enrolled. Size of polyp was measured and compared among DGBF, routine estimation and direct measurement after resection. The accuracy of polyp size measurement was investigated by four colonoscopists who had finished at least 2000 procedures of colonoscopy.</p><p><b>RESULTS</b>The mean diameter of post-polypectomy measurement was (1.02±0.84) cm. Diameter was less than 1 cm in 36 polyps, 1 to 2 cm in 15, and over 2 cm in 7. The mean diameter of visual estimation was (1.29±1.07) cm, and the difference was significant as compared with actual size (P=0.000). The mean diameter measured by DGBF was (1.02±0.82) cm, and the difference was not significant as compared with actual size (P=0.775). The ratio of visual estimation to actual size was 1.29±0.31, and DGBF estimation to actual size was 1.02±0.11 with significant difference (P=0.000). The accurate rate of DGBF in estimating polyp size was 77.6% (45/58), which was obviously higher as compared to visual estimation [19.0% (11/58), P=0.000].</p><p><b>CONCLUSION</b>The accuracy of DGBF as a scale in the estimation of poly size increases as compared to visual estimation.</p>

Distribution characteristics of colorectal neoplasm in 4450 patients and implication for colorectal cancer screening / 中华胃肠外科杂志

<p><b>OBJECTIVE</b>To study the distribution characteristics of colorectal neoplasm and evaluate the implication for colorectal cancer screening.</p><p><b>METHODS</b>A total of 17,939 colonoscopies were performed in the National Center of Colorectal Surgery between October 2004 and June 2009. Characteristics of colorectal neoplasm including anatomical distribution, sex, and age were investigated.</p><p><b>RESULTS</b>Colorectal neoplasm was found in 24.8% (4450/17,939) of the patients during colonoscopy, including adenomatous polyp (n=3410, 19.0%) and adenocarcinoma (n=1040, 5.8%). The prevalence of colorectal neoplasm was higher in male and significantly increased in patients older than 40 years. 63.3% of the lesions located at the distal colon (sigmoid colon and rectum) and 36.7% at the proximal colon (36.7%). In patients with adenomatous polyp, 52.8% (1802/3410) of the lesions were at the distal colon, 30.8% (1049/3410) at the proximal colon, and 16.4% (559/3410) at both distal and proximal colon. In patients with carcinoma (n=1040), 921 (88.6%) lesions located at the distal colon, 118 (11.3%) at the proximal colon, and 1 (0.1%) at both segments.</p><p><b>CONCLUSION</b>Sigmoidoscopy is inadequate for colorectal cancer screening as compared to colonoscopy.</p>

Fast-track surgery in laparoscopic gastrectomy for gastric cancer / 肠外与肠内营养

Objective: The purpose of this study was to evaluate the safety and effectiveness of fast track surgery in laparoscopic gastrectomy for gastric cancer. Methods: All patients received elective gastric cancer resection, and were divided into three groups: group Ⅰ (open gastrecomy, n = 30) , group Ⅱ (open gastrecomy with fast track surgery, n = 30) , and group Ⅲ (laparoscopic gastrecomy with fast track surger-y ,n =30) . Clinical data and gut function were assessed in three groups. Results: There were no significant differences in postoperative complication and the number of lymph node harvest between 3 groups. Blood loss was less in group Ⅲ than group Ⅰ and group Ⅱ (P 0. 05). Conclusion: Postoperative hospital stay can be shorter and recovery of bowel function can be faster in laparoscopic gastrectomy with fast track surgery plan compared to traditional care group. But when using fast track surgery plan, laparoscopic gastrectomy was not superior to open surgery.

The impact of fast track surgery on host cell-mediated immunity and inflammatory responses for colorectal cancer patients / 肠外与肠内营养

Objective: The aim of this study was to evaluate the impact of fast track surgery on host cell-mediated immunology and inflammatory responses in colorectal cancer patients.Methods: Sixty colorectal cancer patients were prospectively divided into fast track surgery(FTS)group(n=30)and conventional perioperative care group(n=30).In addition to clinical parameters(recovery of gastrointestinal function,complication rates and postoperative length of stay), the parameters of perioperative cell-mediated immunology function,and the serum level changes of CRP and IL-6 were determined.Results: FTS group was associated with a significantly shorter postoperative hospital stay compared with conventional care group(P<0.05).Serum concentration of CRP and IL-6 in FTS group were lower(P<0.05) than in the conventional care group on postoperative day(POD) 1 and POD 3(P<0.05).CD4/CD8 ratio in FTS group were higher(P<0.05) than in the conventional care group on postoperative day(POD)1 and POD 3(P<0.05).Conclusion: Fast track surgery for colorectal cancer patients can preserve cell-mediated immunity and control inflammatory responses when compared with conventional postoperative care.