Effects of different gastrointestinal reconstruction techniques on nutrition, anemia, and quality of life in laparoscopic distal gastrectomy for gastric cancer.

PURPOSE: To explore the effect of different gastrointestinal reconstruction techniques on laparoscopic distal gastrectomy of gastric cancer on the nutritional and anemia status, and quality of life (QoL) of patients. METHODS: Eligible patients were randomly divided into three groups (n=36/group): Billroth I anastomosis group, Billroth II combined with Braun anastomosis group, and Roux-en-Y anastomosis group. Related indicators were compared and analyzed. RESULTS: The general data were comparable among the three groups (all P>0.05). Among the surgical-related indicators and postoperative recovery indicators, only the comparison of the operation time was statistically significant (P=0.004). The follow-up time was 5~36 months (average 27.9 months). In terms of nutritional and anemia indicators, only the differences in the levels of prealbumin, hemoglobin and serum ferritin in 24 months after operation showed significant differences (P=0.015, P=0.003, P=0.005, respectively). There were no significant differences in hospital readmission rate, overall survival, and QoL among the three groups (all P>0.05). CONCLUSIONS: In laparoscopic gastrectomy for stage II~III distal gastric cancer, Billroth I anastomosis has shorter operation time than Billroth II combined with Braun anastomosis and Roux-en-Y anastomosis and advantages in the improvement of nutritional status and anemia recovery.

Angio-Computed Tomograph-Guided Immediate Lipiodol Computed Tomograph for Diagnosis of Small Hepatocellular Carcinoma Lesions during Transarterial Chemoembolization / 中华医学杂志(英文版)

<p><b>Background</b>The diagnosis and treatment of small hepatocellular carcinoma (HCC) play a vital role in the prognosis of patients with HCC. The purpose of our study was to evaluate angio-computed tomography (angio-CT)-guided immediate lipiodol CT (a CT scan performed immediately after transarterial chemoembolization [TACE]) in the diagnosis of potential HCCs ≤1 cm in diameter.</p><p><b>Methods</b>This study retrospectively analyzed 31 patients diagnosed with HCCs after routine imaging (contrast-enhanced CT or magnetic resonance imaging) or pathologic examinations with undefined or undetermined tumor lesions (diameter ≤1 cm) from February 2016 to September 2016. After TACE guided by digital subtraction angiography of the angio-CT system, potential HCC lesions with a diameter ≤1 cm were diagnosed by immediate lipiodol CT. The number of well-demarcated lesions was recorded to calculate the true positive rate. The correlation between the number of small HCCs detected by immediate lipiodol CT and the size of HCC lesions (diameter >1 cm) diagnosed preoperatively was analyzed 1 month after TACE. A paired t-test was used to analyze differences in liver function. Pearson analysis was used to analyze correlation. Chi-square test was used to compare the rates.</p><p><b>Results</b>Fifty-eight lesions were detected on preoperative routine imaging examinations in 31 patients including 15 lesions with a diameter ≤1 cm. Ninety-one lesions were detected on immediate lipiodol CT, of which 48 had a diameter ≤1 cm. After 1 month, CT showed that 45 lesions had lipiodol deposition and three lesions had lipiodol clearance. Correlation analysis showed that the number of small HCCs detected by lipiodol CT was positively correlated with the size of HCC lesions diagnosed by conventional imaging examination (R = 0.54, P < 0.05).</p><p><b>Conclusion</b>Immediate lipiodol CT may be a useful tool in the diagnosis of potential HCC lesions with a diameter of ≤1 cm.</p>