RESUMO
Background: Postperitoneal tumors are diseases that are difficult diagnosis, vague and unspecific clinical signs. Objective: To take out experience for clinical practice based on clinical, imaging diagnosis, pathological characteristics and management for postperitoneal tumors. Subjects and method: A retrospective study included 93 cases that diagnosed and treated for postperitoneal tumors at Cho Ray Hospital from January 2000 to November 2006. Clinical, subclinical characteristics and theirs related factors; diagnosis, operation and prognosis for postperitoneal tumors were analysed. Results: The patients\ufffd?average age was 49.98\xb116.37 years (ranged 1-85 years); the ratio of male to female was 0.86. The average time from having pain symptom to admitting hospital was 4.49\xb110.01 months (ranged from 3 days to 60 months). Clinical symptoms were fatigue (51.5%), fever (15%), jaundice (45%), anemia (23.5%), weight loss (58%), abdominal pain (75%), abdominal distention (39%), digestive disorders (31%), touching tumor (50.5%)\ufffd?The diagnosis at admitting were right (32%), wrong (60%) and unclear (8%); the preoperative diagnosis were 70%, 22% and 8%, respectively. Pathologically, 39 of 93 cases (42%) were benign tumors, and 58% were malignant tumors. 61.3% of cases removed completely tumors, 2.15% removed partially tumors. The postoperative outcomes were good (62.6%), unimproved (28.57%), and bad (3.29%). There were some complications, included perioperative bleeding (2 cases - 2.19%), postoperative complication (3 cases - 3.29%), cracked colonic junction (1 case), renal bleeding (1 case) and peritonitis (1 case). Conclusions: The surgical treatment was main method for postperitoneal tumors. The complete tumor removing based on tumor\u2019s nature, stage and related structures.
Assuntos
Neoplasias Retroperitoneais , Terapêutica , Diagnóstico , EpidemiologiaRESUMO
The Aims of this study were to investigate to the role of Helicobacter pylori (H. pylori) eradication in cases of perforated peptic ulcer treated by simple surgical closure. In a large prospective study, these patients with H. pylori positive were evaluated before and after H. pylori eradication (>2 months and >1 year). Changes of gastric mocosal histopathology were assessed. Results: Improvement or resolution on the outcome of gastritis and atrophy (P<0.001) demonstrated the efficacy of eradication therapy but intestinal metaplasia did not change. Conclusions: After successful eradication of H. pylori, these lesions were restored significantly, but intestinal metaplasia is questionable
Assuntos
Helicobacter pylori , Úlcera PépticaRESUMO
170 patients with perforated peptic ulcer (90% perforated duodenal ulcer and 10% perforated gastric ulcer) were included in the study from 8/1998 to 8/1999 at the Cho Ray hospital, Ho Chi Minh city. 165 patients (97.05%) were treated by simple surgical closure (including by one laparoscopic repair) with a postoperative mortality of 4.84%. 4 of them were treated by subtotal gastrectomy and one by vagotomy+ pyloroplasty without mortality. In summary, simple surgical closure is a satisfactory operation for most patients.
Assuntos
Úlcera Péptica , Terapêutica , Cirurgia GeralRESUMO
98 patients with perforated peptic ulcer were treated by simple surgical closure followed by H.pylori eradication. Effect of H.pylori eradication was demonstrated by improvement or resolution of histopathological lesions of chronic gastritis 97.95% compared with 60.2% in pre and postreatment lesions (p<0.0001), atrophy 20.83% vs 4.16% (p<0.0001) and intestinal metaplasia 18.75% vs 9.37% (p < 0.005). After successful eradication of H.pylori, these lesions were restored and improved significantly in patients received a new triple therapy for 7 days (OCA-7).
Assuntos
Úlcera Péptica , Helicobacter pylori , Cirurgia GeralRESUMO
Of 115 patients with perforated peptic ulcer, 96,5% (111/115) were treated by simple surgical closure followed by Helicobacter pylori (H.pylori) eradication. 111 H.pylori positive patients received triple therapy including Omeprazole 20 mg b.d + Clarithromycine 500mg b.d + Amoxicillin 1,000 mg b.d for 7 days (OCA-7). Follow -up endoscopiy was performed over 2 month and over 1 year after hospital discharge for surveillance of ulcer healing and determination of H.pylori status. Of 107 patients who did underwent follow-up endoscopy, 95.3% (102/107) had H.pylori eradicated and initial ulcer healing rate was 92.5% (99/107). After over 1 year, H. pylori reinfection rate was 16.8% (16/95) and ulcer ralapse rate was 7.4% (7/95). The simple surgical closure followed by H.pylori eradication prevents ulcer recurrence in patients with H.pylori associated perforated peptic ulcers.