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Objective To analyse the breast conserving surgery feasibility in patients with advanced breast cancer after neoadjuvant chemotherapy.Methods Sixty patients with advanced breast cancer were collect-ed from June 2010 to June 2011, and were divided into breast conserving surgery after neoadjuvant chemotherapy group and modified radical mastectomy group according to the intention,30 cases in each group.They were given breast conserving surgery after neoadjuvant chemotherapy and modified radical mastectomy respectively,with fol-lowing-up for 3 years.The treatment effect and contrast analysis of two groups of breast cancer CTCs positive of the two groups were compared,two groups of late follow-up of patients with local recurrence and distant metasta-sis rate,overall survival and disease free survival rate were recorded.Results Compared with the modified radi-cal mastectomy group,CTCs detection rate in breast conserving surgery group had no statistical differences(P>0.05).Two groups of patients in clinical complete remission rate,partial remission rate,disease stability factor and local recurrence and distant metastasis rate,overall survival and disease free survival rate had no statistical significances(P>0.05).Conclusion The application of breast conserving surgery after neoadjuvant chemother-apy for patients with advanced breast cancer can achieve similar effect as modified radical mastectomy surgery treatment,and can be used as a effective treatment for advanced breast cancer.
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Objective To Summarize experiences in the treatment of serious injury of pancreas using damage control laparotomy. Methods Retrospectively analyze the choice of surgical method and follow-up treatments on 38 patients cured by DCL,who were in serious injury of pancreas. Results 12 cases(32%) were stanched, surgical debrided and drainage quickly,6 cases(16%) were treated with improved Cogbill operation,and 20 cases(S3% ) were treated with pancreateduodenectomy without reconstruction of enteron. After recovery in SICU, all patients were treated with deterministic operation again. Totally 4 cases(11%) died,with no relation with surgical operation,and 34 cases (89%) were cured. Pancreatic fistula occurred in 4 patients(11% ) ,all of which have been cured with conservative treatment. Conclusion Patients with serious injury of pancreas in accordance with DCL, should choose proper method and take fractionated operation,based on different places and extent of the injury of pancreas.