Effect of short-term recurrence of early stage colon cancer by laparoscopic colon cancer radical / 中国现代普通外科进展

Objective:Comparing the influence of colon cancer recurrence of laparoscopic and open operation to evaluate the safety and validity of operation.Methods:The cohort study includes 62 cases of laparoscopic and 83 cases of open colon cancer radical surgery from January 2010 to October 2012.The research aimed at comparing the effects of laparoscopic and open surgery for colon cancer recurrence by analyzing postoperative follow-up ending and GCC-mRNA & CEA.Results:There have no obvious differences in age,sex,BMI,tumor size,stage,grade,pathological types and resection range between laparoscopy and open group(P＞0.05).Postoperative 3-years recurrence of two groups have no difference (P＞0.05),but 1-year recurrence rate of laparoscopic was obviously lower than open operation (3.2％ vs 14.5％,P＜0.05).There have no obvious differences of postoperative overall survival rate and mortality(P＞0.05),but 1-year disease-free survival rate of laparoscopic group was obviously higher than laparotomy group (93.5％ vs 81.3％,P＜0.05).The postoperative GCC-mRNA and CEA positive rate of laparoscopic was significantly lower than laparotomy group.Univariable and Multivariable analysis reveals that laparoscopic colorectal cancer radical can obviously reduce the cancer recurrence within 1 year (P＜0.05).Addition,stage,aspirin and other amino acid drugs are independent risk factors of postoperative recurrence (P＜0.05).Conclusion:Laparoscopic colon cancer radical surgery is a safe and effective operation and can reduce short-term recurrence of colorectal cancer compared to open surgery.

Clinical analysis of laparoscopic combined with choledochoscope via the cystic duct for choledocholithiasis / 临床肝胆病杂志

Objective To explore the clinical application of laparoscopic transcystic common bile duct exploration.Methods From Jan 2014 to Dec 2015,laparoscopic transcystic common bile duct exploration was performed in 52 cases of cholecystolithiasis.The therapeutic effects of cases were studied.Results Among them,40 cases were performed operation successfully.The success rate of operation was 76.92％.7 cases were changed to laparoscopic common bile duct incision exploratory stone operation.5 cases were performed common bile duct incision nephrolithotomy,and the transfer rate was 9.62％.43 cases were toke stone success at a time in all of patients.The success removed rate was 82.69％.The last 9 patients included 8 cases performed laparoscopic transcystic common bile duct exploration and 1 case performed laparoscopic common bile duct incision exploratory stone operation.All cases were placed abdominal cavity drainage tube pulled out after 3-10 days.Biliary leakage occurred in 1 patients performed laparoscopic common bile duct incision exploratory stone operation,and it was cured after conservative treatment.No biliary tract infection,biliary tract bleeding complications occurred.The average hospitalization time was (8.24 ± 2.52) days.All patients were followed up 1 year.No extrahepatic bile duct stones were found by B-ultrasonic and MRCP,and bilirubin were normal.Conclusion Laparoscopic transcystic common bile duct exploration has positive clinical efficacy with small trauma,quick rever,less complications,safety and etfective.etc.But its indications must be grasped strictly in clinical promotion.

Therapeutic effect of transcatheter arterial chemoembolization combined with thalidomide or sorafenib in treatment of unresectable primary liver cancer: a comparative analysis / 临床肝胆病杂志

ObjectiveTo investigate the therapeutic effect and adverse effects of transcatheter arterial chemoembolization (TACE) combined with thalidomide or sorafenib in the treatment of unresectable primary liver cancer. MethodsA total of 102 patients who underwent TACE combined with thalidomide or sorafenib in 215 Hospital of Nuclear Industry of Shaanxi Province from January 2012 to August 2013 were enrolled and divided into TACE-thalidomide group (49 patients) and TACE-sorafenib group (53 patients). The short-term outcome, long-term outcome, changes in related indices, and adverse events were evaluated. The independent-samples t-test was applied for comparison of continuous data between groups, and the paired t-test was applied for comparison of continuous data within one group; the chi-square test was applied for comparison of categorical data between groups; the survival curve was used for survival analysis, and the log-rank test was applied for survival comparison. ResultsThe indices of short-term outcome, objective response rate and disease control rate, showed no significant differences between the two groups. The 2-year survival showed a significant difference between the two groups (χ2=4692, P=0.03). The log-rank test showed that overall survival time and median progression-free survival time showed significant differences between the two groups (χ2=8.267 and 6.896, P=0.004 and 0.009). After treatment, alpha-fetoprotein (AFP) and gamma-glutamyl transpeptidase (GGT) showed significant differences between the two groups (t=2.035 and 2.843, P=0.038 and 0.025). The incidence rates of nausea/vomiting, dizziness/headache, rash/desquamation, and increased blood pressure showed significant differences between the two groups (all P＜0.05). ConclusionTACE combined with thalidomide has the same short-term therapeutic effect as TACE combined with sorafenib and can improve the patient′s long-term outcome and significantly reduce the levels of AFP and GGT, but it has high incidence of nausea/vomiting and dizziness/headache.