Analysis of repair effect in 170 cases of adolescent inguinal hernia / 中国实用外科杂志

OBJECTIVE: To analyze the clinical characteristics of adolescent inguinal hernia, and to explore the reasonable repair methods. METHODS: The clinical data of 170 cases of adolescent aged between 14 to 18 years old with inguinal hernia admitted from January 2010 to January 2019 in West China Hospital of Sichuan University were analyzed retrospectively. The operation mode, anesthesia method, operation time, medical expenses, recurrence and complications were studied. RESULTS: Among the 170 patients, 16 patients were treated with traditional suture repairing Bassini method, 11 patients were treated with mesh plug repair, 3 patients were treated with plain film Lichtenstein method, 3 patients were treated with TAPP, and preperitoneal space repair was applied in 137 cases. Three patients with TAPP were treated with general anesthesia, 5 patients underwent continuous epidural anesthesia, and 162 patients underwent local infiltration anesthesia. The average operation time was(28.5±11.6)minutes. The median postoperative hospital stay was 1 day, including 159 cases(93.5%)of day surgery. The total cost of medical treatment was(7254.8±236.5)yuan per unilateral inguinal hernia, and the bilateral inguinal hernia was(13261.9±543.8)yuan. The follow-up rate was95%, and the follow-up time was 5 to 113 months. There was no recurrence. One patient with bilateral cryptorchidism developed fertility disorder, and two patients developed chronic pain. No serious complication occurred in remaining patients. CONCLUSION: Adolescent inguinal hernia should be selected from the individualized treatment plan.

Expression of phosphatase of regeneration liver-3 in human colorectal carcinoma and its prognosis value / 中华胃肠外科杂志

<p><b>OBJECTIVE</b>To investigate the expression of phosphatase of regeneration liver-3(PRL-3) protein and its relationship with tumor invasion and metastasis in human colorectal carcinoma,and elucidate prognostic value.</p><p><b>METHODS</b>Immunohistochemistry method was applied to detect the PRL-3 expression in the primary tumor specimens and paired paratumor normal tissues from 46 colorectal carcinoma patients, the adenoma tissues from 6 patients with colorectal adenoma, all the metastatic lymph nodes from 29 cases and the metastatic liver lesions from 6 cases. The relationship between PRL-3 expression and clinicopathologic parameters was analyzed and a survival curve was achieved according to Kaplan-Meier method.</p><p><b>RESULTS</b>No or weak PRL-3 protein expression was detected in normal colorectal mucosa and colorectal adenoma. In colorectal carcinoma tissues, PRL-3 expression was confirmed in 26 of 46 cases (56.5%) of primary colorectal carcinomas (with lymph node metastasis 63.0%, without lymph node metastasis 37.0%, P=0.001), 26 of 29 (89.7%) lymph node metastases, and 5 of 6 liver metastases. The expression of PRL-3 was assembled in the cytoplasm of carcinoma cells and more intensively on the cell membrane.Analysis of the relationship between PRL-3 expression and the clinicopathologic features showed that PRL-3 expression was closely associated with tumor stage (P=0.019), lymph node metastasis (P=0.026), but no relationship with age, sex, tumor size, degree of differentiation was founded (P<0.05). The mean follow-up time was 41.4 months and results showed that patients with positive expression of PRL-3 had a significantly poorer prognosis than those with negative PRL-3 expression group(P=0.032).</p><p><b>CONCLUSIONS</b>PRL-3 protein plays a novel role in tumor progression and metastasis of colorectal carcinoma. PRL-3 can be expected to be a potential predictive biomarker for identifying the prognosis in colorectal carcinoma patients.</p>

Lateral pelvic metastasis and micrometastasis in low rectal cancer / 中华外科杂志

<p><b>OBJECTIVE</b>To study lateral pelvic metastasis and micrometastasis of low rectal cancer and elucidate their prognostic value.</p><p><b>METHODS</b>Whole-mount slice and tissue microarray of dissected lateral pelvic specimen from 67 cases of low rectal cancer were examined, and the included cases were followed up.</p><p><b>RESULTS</b>Twelve specimens were diagnosed as lateral metastasis, while another 10 were proved to bear micrometastasis. Most of the involved metastatic lymph nodes (82.9%) were smaller than 5 mm in diameter. Internal iliac, obturator regions and middle rectal root were more likely to be involved by tumors. Patients with lateral metastasis suffered more recurrence and poorer survival.</p><p><b>CONCLUSIONS</b>Lateral pelvic metastasis could be observed in low rectal cancer and its incidence differed among lateral pelvic regions. Patients with lateral spread predisposed poor prognosis, thus underlies the value of pre/postoperative adjuvant therapy.</p>

Evaluation of clinical necessity of gastrointestinal decompression after excision and anastomosis of lower digestive tract / 中华胃肠外科杂志

<p><b>OBJECTIVE</b>To evaluate the clinical necessity of postoperative gastrointestinal decompression after operation on lower digestive tract.</p><p><b>METHODS</b>Three hundred and sixty-eight patients who required excision and anastomosis of lower digestive tract were randomly divided into two groups, with or without receiving gastrointestinal decompression after operation. Clinical therapeutic efficacy and complications were compared between two groups.</p><p><b>RESULTS</b>The volume of gastrointestinal suction ranged from 10 ml to 520 ml each day after operation, and was less on the first day than those on the second and the third day after operation in decompression group. There was no significant difference in the average girth between two groups before and after operation. The average girths were shorter before operation than those after operation in two groups (P< 0.001). There was no significant difference in postoperative defecation and urination time between two groups (P > 0.05). The complication rate was significantly higher in decompression group than that in non-decompression group (28% vs. 8.2%, P< 0.001). The incidence of pharyngolaryngitis was up to 23.1% in decompression group. There was no difference in hospital stay between the two groups after operation.</p><p><b>CONCLUSION</b>The recovery of patients who receive excision and anastomosis of lower digestive tract will benefit from non-gastrointestinal decompression.</p>

Expression of phosphatase of regenerating liver-3 mRNA and its clinical implications in human colorectal carcinoma / 中华胃肠外科杂志

<p><b>OBJECTIVE</b>To investigate the expression of phosphatase of regenerating liver-3 (PRL- 3) mRNA and evaluate its relationship with tumor invasion and metastasis in human colorectal carcinoma.</p><p><b>METHODS</b>The expression level of PRL-3 mRNA was examined semi-quantitatively in surgically resected tumor specimens, paired paratumor normal tissues from 46 CRC patients, metastatic lymph nodes and liver metastases from 18 cases with metastasis,adenoma tissues from 6 patients with colorectal adenoma (CRA). In addition,the mutation of PRL-3 gene was examined by PCR-SSCP.</p><p><b>RESULTS</b>The PRL-3 mRNA level was increased in primary CRC tissues as compared with paired paratumor normal tissues (1.6+/- 0.7 vs. 0.4+/- 0.1, P< 0.01), while no significant difference of its expression was found between CRA tissues and their adjacent normal mucosae (P> 0.05). However,the PRL-3 mRNA levels of liver metastases (2.1+/- 0.8) in 12 cases and metastatic lymph nodes (3.3+/- 1.0) in 6 cases were significantly higher compared with the matched primary lesions, normal tissues and negative-lymph nodes (P< 0.01). There was significant relation of the expression of PRL-3 mRNA with the clinicopathological features including Dukes stage, invasion depth and metastasis (P< 0.05), but no relation with sex,tumor size,degree of differentiation was found (P> 0.05). Abnormal electrolysis band was found in 1 of 6 cases with liver metastasis by PCR-SSCP analysis.</p><p><b>CONCLUSION</b>PRL-3 gene plays an important role in tumor invasion and metastasis and may associated with carcinogenesis and development of CRC. There might exist some unknown mechanisms of overexpression and mutation of PRL-3 gene in CRC.</p>

Clinical Study of Gastrointestinal Decompression after Excision and Anastomosis of Lower Digestive Tract / 中国普外基础与临床杂志

Objective To discuss the clinical significance of postoperative application of gastrointestinal decompression after anastomosis of lower digestive tract. Methods Three hundred and sixty-eight patients undergoing excision and anastomosis of lower digestive tract were divided into two groups: the group with postoperative gastrointestinal decompression and the group without it. The clinical therapeutic outcomes and incidences of complications were compared between the two groups. Results The volume of gastric juice in the decompression group was about 200 ml every day after operation. Both groups had a smaller abdomenal circumference before operation than after operation ( P