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Objective To explore the efficacy of different surgeries for gastrointestinal stromal tumors (GIST) and their effects on perioperative indexesand prognosis. Methods 60 cases of GIST patients admitted in our hospital from October 2006 to November 2016 were selected and were divided into the study group (n =35, given the laparoscopic surgery) and the control group (n =25, given the laparotomy). The perioperative indexes, gastrointestinal function before and after operation [ (gastrin (GAS), motilin (MTL), vasoactive intestinal peptide (VIP) ], postoperative recurrence risk grade and complications were recorded in the two groups. Results There was no significant difference between the two groups in the operation time (P＞0.05), and the intraoperative blood loss volume and postoperative 3 d pain score in the study group were lower than those in the control group, and the postoperative exhaust time, eating time and hospital stay were shorter than those in the control group (P＜0.05). The levels of plasma GAS, MTL and VIP in the study group were higher than those in the control group after operation (P＜0.05). There was no significant difference in the postoperative recurrence risk grade and the incidence rate of complications between the two groups (P＞0.05). Conclusions Compared with the conventional laparotomy, laparoscopic surgery has better efficacy for GIST and has advantages of small trauma, mild pain and fast postoperative gastrointestinal function recovery, and it will not increase the risk of long-term recurrence and complications, therefore it has a good application prospect.
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<p><b>OBJECTIVE</b>To evaluate safety and efficacy of preoperative administration of enteral nutrition support in gastric cancer patients at risk of malnutrition.</p><p><b>METHODS</b>A single center randomized controlled clinical trial was performed in 60 gastric cancer patients in West China Hospital from May to October 2012. Thirty patients were given enteral nutrition support(Ensure(R)) manufactured by Abbott Laboratories for ten consecutive days before surgical operation in the treatment group, and 30 patients were given an isocaloric and isonitrogenous homogenized diet in the control group for 10 days as well. The laboratory parameters of nutritional status and hepatorenal function were observed and compared between the two groups on admission, preoperative day 1 and postoperative day 3, respectively. Clinical observations, such as nausea and vomiting, were carried out until patients were discharged.</p><p><b>RESULTS</b>Before the intervention, there were no significant differences in the baseline characteristics between the two groups. The levels of serum albumin [(33.9±5.6) g/L vs. (31.0±5.3) g/L, P<0.05], and hemoglobin[(103.4±7.7) g/L vs.(96.6±10.5) g/L, P<0.01] were significantly improved in the treatment group on postoperative day 3. However, the levels of body mass index, lymphocyte count, liver and renal function, serum glucose, sodium, and potassium were not significantly different between the two groups(all P>0.05). Moreover, two patients with nausea and one with vomiting in each group were found. In clinical observation period, no severe treatment-related adverse event were observed.</p><p><b>CONCLUSION</b>The enteral supplement with Ensure(R) in gastric cancer patients at risk of malnutrition during preoperative period is effective and safe, which is superior to homogenized diet and an appropriate choice for gastric cancer patients with nutritional risk.</p>