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Objective To explore the clinical value of a new scoring system for gastric cancer screening in hospital visits.Methods A new scoring system for gastric cancer screening was used to retrospectively analyze data of patients who visited Wenzhou Central Hospital for various digestive symptoms from April 2017 to August 2018 and met the screening requirements.All patients were divided into three groups according to the grading results of the new scoring system:low-risk group (0-11 points),medium-risk group (12-16 points) and high-risk group (17-23 points).A comparative analysis was performed on the detection of gastric cancer and gastric precancerous conditions among the three groups.Results A total of 2 674 patients were included in this study,1 694(63.35％) in the low-risk group,833(31.15％) in the medium-risk group,and 147(5.50％) in the high-risk group.The total detection rate of gastric cancer was 2.73％ (73/2 674).The detection rates were 1.06％ (18/1 694),4.32％ (36/833) and 12.93％ (19/147) in the three groups,respectively.There were significant differences in the detection rate of gastric cancer between any two of the three groups (all P ＜ 0.05).The detection rates of early gastric cancer in medium-risk group [2.04％ (17/833)] and high-risk group [4.08 ％ (6/147)] were significantly higher than that in the low-risk group[0.35％(6/1 694),all P＜0.05].Conclusion The new gastric cancer screening scoring system can not only significantly improve the detection rate of gastric cancer in hospital visits,but also improve the diagnostic rate of early gastric cancer.
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Objective To investigate the clinical effects of the stent-laparoscopy approach in treatment of elderly patients with malignant colorectal obstruction.Methods Clinical data of 55 elderly hospitalized patients with colorectal cancer-induced bowel obstruction in Wenzhou Central Hospital from January 2009 to January 2014 were evaluated retrospectively.All patients were treated with expandable metallic stents for remission of bowel obstruction.Patients were divided to laparoscopy surgeryobservation group (n =14) receiving laparoscopic surgery after decompression and the laparotomy surgery-control group (n=41) receiving conventional open colorectal cancer operation.The intraoperative information,postoperative complications and long-term curative effect were compared between the laparoscopy surgery-observation vs laparotomy surgery-control group.Results During laparoscopy surgery period,two patients operated by laparoscopy surgery were converted to laparotomy surgery.Surgical time was significantly longer in the laparoscopy surgery-observation group than in laparotomy surgery-control group[(178 ± 33) min vs.(145 ± 31) min,t =3.384,P =0.001],and bowel function recovery and postoperative hospital stay were significantly shorter in the laparoscopy surgery-observation group than in laparotomy surgery-control group[3.1 ± 0.9) d vs.(4.3 ± 1.3) d and (7.1±1.3) d vs.(12.6±5.7) d,t=3.193 and t=2.911,P=0.002 and P=0.005].Intraoperative blood loss was less in the laparoscopy surgery-observation group than in the laparotomy surgery-control group[(63 ± 29) ml vs (86 ± 37) ml,t =2.11,P =0.04],with no significant differences in postoperative complications between the two groups (0.0 vs 9.76 ％,x2 =1.47,P=0.225).Fifty-five patients were followed up for 2 years.All patients survived in the laparoscopy surgery-observation group,but one patient died from the cerebrovascular accident in the laparotomy surgery-control group.Conclusions The stent-laparoscopy approach to treat colorectal cancer (CRC) patients with acute colorectal obstruction is a safe,effective,recovery quick and minimally invasive option for elderly patients.Emergency surgery may be converted to a limited operation by this method.Laparoscopic radical surgery with one-stage anastomosis is feasible.