Evaluation of the gastrointestinal decompression after gastrectomy: a prospective randomized controlled trial / 中华胃肠外科杂志

<p><b>OBJECTIVE</b>To evaluate the value of using nasogastric tube for patients after gastrectomy.</p><p><b>METHODS</b>One hundred and eight patients undergone gastrectomy were divided randomizely into nasogastric decompression group(n=53) and non-nasogastric decompression group (n=55). Gastrointestinal function and postoperative complications were compared between the two groups.</p><p><b>RESULTS</b>Between nasogastric decompression group and non-nasogastric decompression group, no significant differences in postoperative complications (20.8% vs 23.6%, P=0.719), postoperative time of flatus [(3.2+/-0.9) d vs (3.0+/-0.7) d, P=0.192], recovery time of drinking [(5.9+/-3.4) d vs (5.1+/-1.6) d, P=0.143], eating time of fluid food [(7.8+/-3.6) d vs (6.8+/-1.8) d, P=0.085] and eating time of semi-fluid food [(9.8+/-3.5) d vs (8.8+/-1.9) d, P=0.081] were found. While the recovery time of bowl sound [(1.8+/-0.7) d vs (2.2+/-0.9) d, (P=0.013)] and hospital stay [(10.2+/-2.1) d vs (11.7+/-4.3) d, (P=0.021)] were shorter in non-nasogastric decompression group.</p><p><b>CONCLUSION</b>It is not necessary to use nasogastric decompression for patients after gastrectomy.</p>

Clinical value of routine haematoxylin-eosin stain in diagnosing submucosal lymphatic vessel infiltration in early gastric cancer / 中华胃肠外科杂志

<p><b>OBJECTIVE</b>To evaluate the value of routine haematoxylin-eosin(HE) stain for submucosal lymphatic vessel infiltration in early gastric cancer.</p><p><b>METHODS</b>Four thousand four hundred and twenty early gastric cancer patients underwent D2 operation. Submucosal lymphatic vessel was detected by routine HE stain. The results were compared with pathological lymph node metastasis.</p><p><b>RESULTS</b>In early gastric cancer, the sensitivity, specificity, accuracy, positive predicting value (PPV), and negative predicting value (NPV) of routine HE stain for submucosal lymphatic vessel infiltration were 54.5%, 82.0%, 78.9%, 27.4%, and 93.5% respectively. In early gastric cancer limited in mucosa, these indexes were 14.5%, 98.0%, 95.8%, 15.8%, and 97.8% respectively. In early gastric cancer infiltrated to submucosa, they were 60.3%, 57.8%, 58.3%, 28.1%, and 84.2% respectively. There were significant differences of submucosal lymphatic vessel infiltration with lymph node metastasis (P< 0.001), but no significant difference with survival rate. The 5-year survival rates of submucosal lymphatic vessel infiltration positive and negative group were 84.4% and 87.3%, median survival time was 6998 d and 7237 d, and mean survival time was 6163.9 d and 6042.6 d respectively (P=0.2495).</p><p><b>CONCLUSION</b>The accuracy of routine HE stain is too low, thus it is not suitable for diagnosing submucosal lymphatic vessel infiltration in early gastric cancer.</p>

Clinical effect of intraoperative peritoneal hyperthermic chemotherapy for advanced gastric cancer / 中华胃肠外科杂志

<p><b>OBJECTIVE</b>To investigate the clinical effect of intraoperative peritoneal hyperthermic chemotherapy (IPHC) for advanced gastric cancer (AGC).</p><p><b>METHODS</b>A total of 118 AGC patients with serosal invasion were enrolled in this study from 1998 to 2001. Among these cases, 96 patients without macroscopic peritoneal metastases were selected for prophylactic study, including 42 cases with IPHC and 54 cases without IPHC as control. Other 22 patients with macroscopic peritoneal metastases were selected for therapeutic study, including 10 cases with IPHC and 12 without IPHC. Postoperative survival rate and peritoneal recurrence were compared.</p><p><b>RESULTS</b>For prophylactic study, the 1, 2 and 4 years survival rates were 85.7%, 81.0% and 63.9% respectively in the patients with IPHC,significantly higher than 77.3%, 61.0% and 50.8% in the patients without IPHC. Cox ratio hazard model revealed that IPHC procedure was an independent prognostic factor. More patients in the control group suffered from peritoneal recurrence than those in IPHC group (34.7% vs 10.3%). For therapeutic study,the median survival period of the patients with IPHC was 10 months, higher than 5 months in the patients without IPHC. The overall 1, 2, 4 year survival rates were 76.9%, 69.2%, 55.2% respectively in all cases with IPHC, higher than 66.2%, 49.7%, 41.4% in the cases without IPHC.</p><p><b>CONCLUSION</b>IPHC procedure can improve the prognosis of AGC patients with serosal invasion, reduce the risk for peritoneal recurrence, and is an independent prognostic factor.</p>