Clinical significance of serum ALP elevation in patients receiving chemotherapy after radical gastrectomy / 中华普通外科杂志

Objective To identify the influence of chemotherapy-induced serum alkaline phosphatase (ALP) elevation on the tumor-free survival (TFS) in patients of gastric carcinoma after radical gastrectomy.Methods The clinical data of 189 gastric carcinoma patients receiving radical surgery and postoperative adjuvant chemotherapy between Jan,2010 and Dec,2015 were reviewed and statistically analyzed.Results The TFS of patients with serum ALP elevation was obviously inferior than those without ALP elevation (x2 =5.717,P =0.017),serum ALP elevation was an independent risk factor influencing patients' TFS (HR =2.178,P =0.032),the degree of serum ALP elevation was associated with patients' TFS (x2 =4.627,P =0.031).Conclusion Serum ALP elevation during postoperative chemotherapy indicates the increases of recurrence or metastasis rate of gastric cancer patients after radical gastrectomy.

Perioperative risk factors for postoperative pancreatic fistula in patients with gastric cancer / 中国综合临床

Objective To explore perioperative risk factors for postoperative pancreatic fistu?la. Methods Six hundred and forty?three cases patients who underwent radical gastrectomy for gastric cancer from January 2010 to June 2015 in the NO. 309 Hospital of Chinese People’ s Liberation Army were selected and divided into Postoperative Pancreatic Fistula( POPF) group with 53 cases and Non?Postoperative Pancreatic Fis?tula( NPOPF) group with 590 cases. Preoperative,intraoperative and postoperative data were analyzed by statisti?cal analysis of two groups. Results POPF rate was 8. 24%(53/643). There were no significanct differences in terms of gender,age,preoperation with disease,preoperative serum albumin,TNM stage,abdominal surgery,sur?gical procedure,lymph node dissection,digestive tract reconstruction,surgical approach,blood loss and length of time between the POPF group and NPOP group(P>0. 05). The level of BMI of POPF group was higher than that of NPOPF group,the difference was statistically significant((25. 63±2. 54) kg/m2 vs. (21. 11±2. 44) kg/m2,t=2. 245,P=0. 025). The number of lymph node dissection in POPF group was (32. 25±5. 82),in NPOPF group was (27. 06±6. 79),there was significant difference between the two groups(t=2. 093,P=0. 037). The operation time in POPF group was (242. 50±52. 30) min,in NPOPF group was (229. 51±59. 21) min,the difference was statistically significant between the two groups( t=2. 398,P=0. 017) . The serum CRP of 1 d in POPF group was (85. 72±12. 05) mg/L,in NPOPF group was (76. 41±12. 52) mg/L,and there was significant difference between the two groups( t=1. 979,P=0. 048) . The serum albumin of 2?4 d after operation in POPF group was (26. 0±5. 9) g/L,in NPOPF group was (32. 6±6. 8) g/L,the difference between the two groups was statistically significant(t=-10. 185,P=0. 000). The drainage fluid amylase of 1 and 2 d after operation in POPF group was (2094+1444) U/L,in NPOPF group was (746+486) U/L,and there was significant difference be?tween the two groups( t=10. 400,P=0. 000) . Logistic regression analysis results showed that body mass index ( BMI) ,lymph node dissection number,time of operation,postoperative 1,2 d drainage fluid amylase and serum albumin of 2?4 d after operation were postoperative occurred pancreatic fistula risk factors( OR=1. 972,183. 6, 2. 004,0. 150,9. 809,P>0. 05). Conclusion BMI,number of dissected lymph node,duration of surgery,serum albumin of 2?4 d after operation and postoperative 1,2 d drainage fluid amylase have important clinical values for predicted POPF.

Double-pump implantation chemotherapy for hepatic metastasis from colorectal cancer / 中华肿瘤杂志

<p><b>OBJECTIVE</b>To evaluate the value of infusion chemotherapy by pump implantation via hepatic artery or portal vein or both (double-pump chemotherapy, DPC) for hepatic metastasis from colorectal cancer.</p><p><b>METHODS</b>Thirty patients with hepatic metastasis from colorectal cancer were divided into three groups: 1. Group I-DPC (12 patients). 2. Group II-hepatic artery implantation chemotherapy (10 patients) and 3. Group III-portal vein implantation chemotherapy (8 patients).</p><p><b>RESULTS</b>Response rate was 66.7% in group I, 60% in group II and 37.5% in group III. The 0.5-, 1-, 2-year survival rates were 100.0%, 75.0%, 41.7% in group I, 90.0%, 60.0%, 30.0% in group II and 87.5%, 50.0%, 25.0% in group III.</p><p><b>CONCLUSION</b>Double pump implantation chemotherapy is effective in treating hepatic metastasis from colorectal cancer. It is better than hepatic artery or portal vein pump-implantation chemotherapy alone.</p>

Diagnosis and treatment of postsurgical gastroparesis syndrome after radical operation of gastric carcinoma:report of 24 cases / 解放军医学杂志

Objective To explore the etiology,diagnosis and treatment of postsurgical gastroparesis syndrome(PGS)after radical gastrectomy for gastric carcinoma.Methods The data of 585 patients who had undergone radical gastrectomy for gastric carcinoma were retrospectively studied.The diagnosis was established with fiberoptic gastroscopy and biopsy before operation in all the patients,and radical subtotal gastrectomy was performed,with antero-colonic Billroth's Ⅱ anastomosis of the remnant stomach and jejunum.Results PGS occurred in 24 patients(age 46-81,mean 58.6 years)among 585 patients,the prevalence was 4.1%.In all the 24 patients,PGS occurred at the period when liquid diet was changed to semifluid diet,with the symptoms of epigastric fullness,nausea,vomiting and intractable hiccup.The vomitus contained large amount of gastric contents and a small amount of bile.The quantity of gastrointestinal decompression was 800-2000 ml/d.Upper gastrointestinal radiography using 38% meglucamine diatrizoate was performed in all the 24 patients,the contrast agent was taken orally or through gastric tube.It showed that the remnant stomach was atonic,gastric peristalsis was weak or absent,and evacuation of contrast agent was delayed.The anastomosis stoma was patent.Gastroscopy was performed in 18 patients,and a large amount of residual gastric content and anatomotic edema of anastomosis stoma were found.Howener,the gastroscope could be introenced into the duodenum or jejunal efferent loop through anastomotic stoma without difficulty,and no signs of mechanical obstruction were found.All the 18 patients were cured within10-38 days by conservative treatment.Conclusion The main causes of PGS may be the loss of gastrointestinal motility and anastomotic edema,while the risk factors may include old age,malnutrition,water-electrolyte imbalance,and peritoneal infection.Gastrointestinal radiography and gastroscopy are important diagnostic methods,and the patients can be cured by conservative treatment.

CHEMOTHERAPY VIA HEPATIC ARTERY AND PORTAL VEIN FOR THE PREVENTION OF LIVER METASTASIS OF COLORECTAL CANCER / 解放军医学杂志

Objective To evaluate the clinical effect of chemotherapy via both hepatic artery and portal vein on liver metastasis of colorectal cancer. Methods Forty-eight patients with colorectal cancer (admitted to our hospital from Jan, 1994 to Dec, 2000)were divided into group Ⅰ, in which 17 patients received chemotherapy via both hepatic artery and portal vein, group Ⅱ in which 16 patients received simple hepatic artery chemotherapy, and group Ⅲ in which 15 patients received simple portal vein chemotherapy. Chemotherapy was begun 2 weeks after operation. The drugs used in chemotherapy regime were 5-fluorouracil(5-FU) 500mg/m 2 + Mitomycin(MMC) 4mg/m 2 + Epirubicin(EPI) 60mg/m 2, once per week, 2-3 times as a course. The chemotherapy regime was the same for the 3 groups. Results The respective effective rate for liver metastasis was 76.5%, 62.5%, 46.7% in group Ⅰ, group Ⅱ, and group Ⅲ. The 0.5, 1 and 2 year survival rates were 100%, 82.4% and 52.9% respectively in group Ⅰ, 87.5%, 62.5% and 43.7% respectively in group Ⅱ, and 93.3%, 60% and 33.3% respectively in group Ⅲ. There were statistically significant differences between group Ⅰ and groups Ⅱ and Ⅲ (P

The double stapling technique for anus-saving in rectal cancer / 临床外科杂志

Objective To evaluate role of double stapling technique in anus-saving operations for patient with low rectal carcinoma.Method The double stapling technique was used for anus-saving in colorectal anastomosis after anterior resection in 52 patiens with rectal cancer from 1994 to 1999,and the results were evaluated.Results 2 cases were failed to close rectal.4 cases were failed to anastomose.2 cases had anastomotic fistula(3.8%).3 cases had anastomotic stenosis (5.8%).2 cases had waund infection.1 case had anastomotic bleeding.There was no operative death.Conclusion The double stapling technigue provided a safe alternative for anus-saving operation in patients with rectal cancer.

To study the free cancer cells in the surgical field and prevention of local recurrense of breact cancer with hyperthermic soaking chemocherapy / 临床外科杂志

Objective Through the qualitative study of surgical field free cancer cells of patients with breast cancer,to evaluate theprevention effects of intraoperative hot hypotonic solution soaking chemotherapy on cancer recurrence after resection of breast cancer.Methods 94 cases with breast cancer divided in to study group (n=48)and control group (n=46).Before the operation wound closed,both group surgical field washing solutions were collected for examination of free cancer cell,then the wounds of study group were treated with Hyperthermic soaking chemotherapy (41℃～42℃normal saline solutions 3000 ml+5-fluorouracil 1.0 g),once five minutes,total 3～4 times.While the wound of control group were soaked with normal saline solutions only.The soaking solutions were collected for examination of free cancer cell.The rates of free cancer cell in the surgical field and local recurrence rates in the both group were compared.Result The rates of washing solutions and the rates of soaking solution and the localy recurrent rates in the study group were 29.2%,8.3%,6.3%,which in the control group were 26.1%,19.6%,15.2%.Conclusions There are free cancer cells in the surgical field of breast cancer.Hyperthermic soaking chemotherapy can kill free cancer cell and reduce localy recurrent rate.

Preoperative regional infusion chemotherpy for advanced breast cancer / 中国普通外科杂志

Objective To investigate the pathological and clinical effects of preoperative intra arterial infusion chemotherapy for patients with advanced breast cancer.Methods The clinical data of 52 patients with advanced breast cancer were analyzed retrospectively.Twenty two patients were treated with preoperative intra arterial infusion chemotherapy (treatment group),and 30 were treated without preoperative intra arterial infusion chemotherapy (control group).Results In the treatment group,the tumour size reduced and symptoms relieved after intra arterial infusion chemotherapy in 86.4% of the patients.Pathological examination of the specimens showed that raryopyknosis,raryorrhexis,cytoplasm coagulation and necrosis in cancer cells around the vascular vessels were found in all patients.Interstitial edema,inflammatory cells infiltration ,fibroelastosis around the cancer cells,proliferous intima thrombus and inflammation of vessels were also found.But in the control group,the histological chang of cancer cell was not found yet.All patients were followed up for 2 to 7 years.Local recurrence rate in the treatment group was 13.6%, while that of the control group was 33.3% (P

Segmental mastectomy plus axialla dissection for early stage breast cancer / 中国普通外科杂志

Objective To evaluate the clinic effect of local resection plus axialla lympha nodes dissection on treating early stage breast cancer. Methods 112 cases of early stage breast cancer in PLA309 Hospital were divided into 2 groups: local resection plus axially dissection group (46 cases) and Halsted's operation group (66 cases). The survival rate,local recurrence rate,metastasis rate, and casmetic effect of breast were followed up for long time. Results In treatment group, the 3,5,8 years survival rates were 97.8%, 80.5%, 76.1% respectively. In control group 3,5,8 years survival rates were 97.0%, 87.9% and 71.2% respectively. The rate of local recurrence was 4.3% in treatment group and 4.6% in control group.The metastasis rate in treatment group was 19.6%, in control group was 16.7%. 93.2% of patients in treatment group kept good breast figure. Conclusions Local resection plus axially dissection, with the same effect as Halsted procedure, is an ideal method in treating early stage breast cancer.

Hyperthermic peritoneal perfusion and intraarterial infusion chemotherapy for the gastrointestinal neoplasms / 中国普通外科杂志

Objective To study the prevention and treatment of the local and hepatic recurrence after advanced gastrointestal(G1) carcinoma operation.Methods 282 patients were divided into treatment group and control group.The treatment group (hyperthemic peritoneal perfusion plus intraarterial infusion chemotherapy)had 169 patients.The control group (systemic chemtherapy)had 113 patients. The peritoneal and hepatic recurrence and 3 year survival rate were compared between the 2 groups.Results The local and hepatic recurrence and 3 year survival rate in the treatment group were 21.9%,12.4% and 74.6%;those in the control group were 46.0%,27.4% and 46.8%,respectively ( P

Clinical study of regional infusion chemotherapy for prevention of local recurrence and hepatic metastasis after radical resection of gastric carcinoma / 中国普通外科杂志

Objective To evaluate the value of regional infusion chemotherapy for prevention of local (recurrence) and hepatic metastasis after radical resection of gastric carcioma.Methods 352 patients with (gastric) carcinoma undergoing radical operation were preoperatively randomly divided into 2 groups:Regional (infusion) chemotherapy(treatment group,184 cases) and peripheral venous chemotherapy(control group,168 cases).Results 328 cases(93.2%) were followed-up for 3 to 6 years,and 24 cases were lost to follow up.The 1-,3- and 5-year survival rate was 95.7%,78.3% and 46.3%,respectively,in the (treatment) group,and 86.8%,48.2% and 22.0%,respectively in the control group.The local recurrence rate and hepatic metastasis rate was 9.2% and 12.5%,respectively,in the treatment group; and was (22.0)% and 26.8%,respectively,in the control group.Conclusions Regional infusion chemotherapy is (effective) for prevention of local recurrence and hepatic metastasis after radical operation for gastric carcinoma.It is better than peripheral venous chemotherapy and has less toxic side effects.

Surgical treatment for malignant colorectal mesenchymoma: a report of 17 cases / 解放军医学杂志

Objective To evaluate the surgical treatment for patients with malignant colorectal mesenchymoma, and to analyze the clinical data, pathological features and the common presenting symptoms and its immunohistochemical staining property. Methods The clinical data and the pathological findings, including immunohistochemical staining, of 17 patients with malignant colorectal mesenchymoma admitted from Jan 1990 to Mar 2005 were retrospectively analyeed. All the patients were followed up carefully. Results All the patients underwent operation, and all the tumors were proved malignant pathologically. In 6 cases left hemicolectomy was done, in 3 cases right hemicolectomy was done, in 2 cases the treatment was local resection from the rectum, and 6 patients received Mile's resection. The 1, 3 and 5-year overall survival rates for 17 patients with the total resection of tumor were 100%, 70.6% and 47.1%, respectively. The median survival time for 17 patients was 52 months. The final diagnosis of malignant GIST depended on the pathological examination, but the most worthwhile diagnostic criterion was the presence of CD117 and CD34 cells. Conclusion Since the prognosis is very poor, radical hemicolectomy is the principal treatment, and comprehensive treatment is necessary to improve clinical result.

PREVENTION OF HEPATIC METASTASIS AFTER RADICAL RESECTION OF COLONIC CARCINOMA WITH CHEMOTHERAPY VIA A PUMP IMPLANTED IN THE PORTAL VEIN / 解放军医学杂志

To evaluate the value of chemotherapy via portal vein pump implantation in preventing hepatic metastasis from colorectal cancer after a radical resestion. Patients after a radical resection were divided into two groups: the portal vein pump implantation chemotherapy group (Group A 32 cases), chemotherapy via peripheral vein(Grounp B 22 cases). The results showed that hepatic metastasis rate was 15 4% in group I and 36 4% in group 2. The survival rates of 1, 2, 3 years in group A were 98%, 83%, 61% respectively, while in group B they were 90%, 68%, 42%, respectively. The results suggested that portal vein pump chemotherapy was an effective treatment modality to prevent hepatic metastasis from colorectal cancer. Its clinical results were better than conventional chemotherapy via peripheral vein.