Extended multi-organ resection for cT4 gastric carcinoma: a retrospective analysis

Objective: Combined resection for locally advanced [T4] gastric cancer may result in high morbidity and mortality. The aim of this study was to evaluate the clinicopathologic characteristics to determine the prognostic factors for T4 gastric cancers

Methodology: A total of 463 consecutive patients with gastric cancers were enrolled in this study. Among them, 63 patients received combined resections. Various clinicopathologic factors influencing survival rates were evaluated. Survival rates were calculated according to the Kaplan-Meier method. Prognostic factors were evaluated by the univariate and multivariate analysis

Results: Thirty-one patients [49.2%] received one additional organ resection and 32 patients [50.8%] received two or more additional organ resections. Curative resection was performed in 49 patients [77.8%]. Multivariate analysis identified curative resection [hazard ratio 0.330; 95 percent confidence interval, 0.139-0.784; P = 0.012] and tumor diameter [> 7 cm] [hazard ratio, 3.589; the 95 percent confidence interval, 1.425-9.037; P = 0.007] as independent prognostic factor for patients with T4 gastric cancer undergoing combined resection

Conclusions: The use of aggressive multi-organ resection was recommended for patients with T4 gastric carcinoma, with tumor diameter as a useful indicator. Patients with relatively small tumor diameter [

Analysis on the Antibiotic Rational Application in Department of Gastrointestinal Surgery / 中华医院感染学杂志

OBJECTIVE To realize the circumstances of the antibiotic application during perioperational period and evaluate the rational application of antimicrobial agents in department of gastrointestinal Surgery in a hospital.METHODS Retrospective study for 210 patients in the department of gastrointestinal Surgery form Jan 2007 to Dec 2008 was carried out randomly.RESULTS The antibacterial agents were used in all patients during perioperation.The antibacterial agents used most frequently were Metronidazole and Cephalosporins,The combined use cases accounted for 90.5%.The average period of treatment was 7 days.The incidence of surgical site infection was 8.6%.Only 55.6% patient′s samples were examined and drug susceptibility test were detected.CONCLUSIONS The irrational applications of prophylactic antibiotitcs during the perioperative period are serious,such as the average time of using antibiotics was too long,unreasonable frequently sort changing and low rate for samples detecting.