Meta-analysis of laparoscopic and open repair of perforated peptic ulcer / 中华胃肠外科杂志

<p><b>OBJECTIVE</b>To assess the safety and feasibility of laparoscopic and open repair of perforated peptic ulcer.</p><p><b>METHODS</b>Studies on comparison between laparoscopic repair(LR) and open repair(OR) of perforated peptic ulcer were collected. Data of operating time, blood loss, time to first flatus, postoperative hospital stay, postoperative complications and mortality between LR group and OR group were meta-analyzed using fixed effect model and random effect model.</p><p><b>RESULTS</b>Nineteen studies including 1507 patients were selected for this study,including laparoscopic surgery(n=673) and open surgery(n=834). There were significant differences in blood loss, time to first flatus, postoperative hospital stay, wound infection rate and mortality between LR group and OR group. However, no significant differences existed in operative time, postoperative sepsis, pulmonary infection, abdominal abscess, and suture leakage between the two groups.</p><p><b>CONCLUSIONS</b>Laparoscopic repair of perforated peptic ulcer is associated with improved outcomes in terms of less blood loss, quicker recovery, and lower rates of wound infection and mortality. Laparoscopic repair of perforated peptic ulcer is safe and feasible.</p>

Radiotherapy of unicentric mediastinal Castleman's disease / 癌症

Castleman's disease is a slowly progressive and rare lymphoproliferative disorder. Here, we report a 55-year-old woman with superior mediastinal Castleman's disease being misdiagnosed for a long term. We found a 4.3 cm mass localized in the superior mediastinum accompanied with severe clinical symptoms. The patient underwent an exploratory laparotomy, but the mass failed to be totally excised. Pathologic examination revealed a mediastinal mass of Castleman's disease. After radiotherapy of 30 Gy by 15 fractions, the patient no longer presented previous symptoms. At 3 months after radiotherapy of 60 Gy by 30 fractions, Computed tomography of the chest showed significantly smaller mass, indicating partial remission. Upon a 10-month follow-up, the patient was alive and free of symptoms.

Necessity of splenectomy in radical resection of gastric cancer: a meta-analysis / 中华胃肠外科杂志

<p><b>OBJECTIVE</b>To evaluate the necessity of splenectomy in radical resection of gastric cancer.</p><p><b>METHODS</b>Twelve studies comparing outcomes after radical resection of gastric cancer with or without splenectomy were identified. Both fixed effect model and random effect model were used.</p><p><b>RESULTS</b>There were 2628 patients in total. There were significant differences in complications between splenectomy group and spleen-preserving group(OR=1.91, 95% CI:1.28-2.87, P<0.05), while no significant difference in 5-year survival rate was noticed(HR=0.90, 95% CI:0.73-1.11, P>0.05).</p><p><b>CONCLUSION</b>Radical resection of gastric cancer combined with splenectomy is not associated with improved survival but increased postoperative complications.</p>