Application of small intestine double stoma and succus entericus reinfusion in the patients with severe intra-abdominal infection / 中华胃肠外科杂志

<p><b>OBJECTIVE</b>To evaluate the application of small intestine double stoma and succus entericus reinfusion in the patients with severe intra-abdominal infection.</p><p><b>METHODS</b>Ten patients with high intestinal perforation from February 2005 to November 2014 were enrolled in the study. All the cases received emergency operation. Small bowel with intestinal perforation was resected, and double stoma was applied in the proximal and distal small intestine. When abdominal infection under control, total enteral nutrition was successfully administered from nasogastric tube. The succus entericus from the proximal intestine was collected and transfused back to the distal intestine. Stool was collected and fecal nitrogen, fat and carbohydrate contents were determined. Related serum protein levels were measured.</p><p><b>RESULTS</b>As compared to pre-reinfusion, the absorption rate of carbohydrate [(90.9±7.8)% vs. (82.7±15.2)%], fat [(87.6±6.4)% vs. (59.1±10.8)%], and nitrogen [(82.4±9.8)% vs. (67.2±15.4)%] increased after succus entericus reinfusion (P<0.05). The serum protein levels increased significantly as well[fibronectin: (285.6±3.6) vs. (157.0±22.6) mg/L, P<0.01; transferrin: (4.86±0.21) vs. (3.60±0.25) g/L, P<0.05; pre-albumin: (291.3±112.5) vs. (199.1±53.3) mg/L, P<0.05].</p><p><b>CONCLUSION</b>Small intestine double stoma and succus entericus reinfusion are effective in improving the absorption of carbohydrate, fat and nitrogen in the patients with severe intra-abdominal infection.</p>

Choice of surgical approach for Siewert II and III adenocarcinomas of the esophagogastric junction / 中华胃肠外科杂志

<p><b>OBJECTIVE</b>To explore the optimal surgical approach for Siewert II and III adenocarcinoma of esophagogastric junction (AEG).</p><p><b>METHODS</b>Clinical data of 135 patients with Siewert II and III AEG treated in our hospital from August 2007 to August 2012 were analyzed retrospectively. Of 135 patients, 57 received transthoracic path for the stomach and proximal gastrectomy, second station lymph node resection (transthoracic group), and 78 cases received transabdominal hiatal approach (transabdominal group). The intraoperative lymph node harvested, postoperative complications and 5-year survival rate were compared between the two groups.</p><p><b>RESULTS</b>There were no significant differences in the residual tumor positive margin and anastomotic leakage rate between the two groups (both P>0.05). Compared with transthoracic group, transabdominal group had more lymph node dissected (11.1±0.2 vs. 10.4±0.3, P=0.033], less postoperative cardiac [2.6% (2/78) vs. 19.3% (11/57), P<0.01] and pulmonary [7.7% (6/78) vs. 21.1% (12/57), P<0.05] morbidity, and short postoperative hospital stay [(13.4±0.1) d vs. (16.4±0.3) d, P<0.01]. A total of 128 cases were followed up for median 38 months (6 to 72 months). The 5-year survival rate in transthoracic group and transabdominal group was 29.8% and 34.6% respectively, without significant difference (P>0.05).</p><p><b>CONCLUSION</b>For the treatment of patients with Siewert II and III AEG, transabdominal hiatal approach can remove more lymph nodes, reduce postoperative cardiopulmonary morbidity and shorten hospital stay.</p>

Survival benefit of an herbal formula for invigorating spleen for elderly patients with gastric cancer / 中西医结合学报

Gastric cancer is one of the most common malignant tumors. Traditional Chinese medicine (TCM) has been widely used in treatment of gastric cancer, but still lacking large sample controlled trial to evaluate its efficacy.