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<p><b>OBJECTIVE</b>To assess the effect of laparoscopic colectomy on the exfoliated cancer cells in peritoneal cavity, recurrence and metastasis of patients with colonic carcinoma.</p><p><b>METHODS</b>One hundred and fifty-nine patients with colonic cancer proven by colonoscopy and pathology were divided into two groups based on patient's preference: laparoscopic group (n=74) and open group (n=85). The positive rate of exfoliated cancer cells in peritoneal cavity was compared by cytological detection before and after cancer resection. Recurrence, metastasis rate and 3-year survival were compared between the two groups.</p><p><b>RESULTS</b>The positive rates of exfoliated cancer cells in peritoneal cavity were 12.2% (9/74) in the laparoscopic group and 15.3% (13/85) in the open group before cancer resection without significant difference (P=0.718); 20.3% (15/74) and 30.6% (26/85) after cancer resection without significant difference (P=0.138). The follow-up ranged from 4 to 45 months. The 3-year local recurrence rates were 13.6% (8/59) and 8.8% (6/68) (P=0.455), the 3-year distal metastasis rates were 11.9% (7/59) and 17.6% (12/68) (P=0.416) and the 3-year survival rates were 79.7% and 80.0% (P=0.998), and the differences were not statistically significant.</p><p><b>CONCLUSION</b>The laparoscopic operation does not increase the recurrence and metastasis rate and results in similar survival in patients with colonic cancer as compared to open procedure.</p>
Subject(s)
Adult , Female , Humans , Male , Middle Aged , Colonic Neoplasms , Diagnosis , General Surgery , Laparoscopy , Neoplasm Metastasis , Neoplasm Recurrence, Local , Peritoneal Cavity , Pathology , Prognosis , Survival RateABSTRACT
Objective To analyze the relationship between polymorphisms of EDNRB gene and Hubei provincial patients of Han ethnicity with sporadic Hirschsprung disease(sHD). Methods Peripheral blood samples from 104 patients with sHD and 84 parents of 42 patients, and 120 normal children(as controls) were collected. PCR-SSCP and direct DNA sequencing were used to detect mutations and polymorphisms of exon-4 in EDNRB gene. The differences of allele frequencies and genotype distribution in polymorphic sites were further analyzed between the three groups. Allele frequencies of SNPs in forty-two sHD trios were analyzed by transmission disequilibrium test(TDT), and the association between phenotype of HD and SNPs was analyzed. Results No mutant site was detected and one polymorphic site of c831 G→A(L277L) was observed in Hubei provincial patients of Han ethnicity with sHD. The allele frequency of A(68% vs 53%) and genotype frequency of AA(49% vs 30%) were significantly higher in sHD group than that in control group(P
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Objective To evaluate the feasibility,safety and short-term outcome of laparoscopic-assisted surgery for colorectal cancer.Methods From August 2001 to November 2004,laparoscopic resection of colorectal carcinoma were performed in 112 cases,including right hemicolectomy(n=23),left himicolectomy(n=7),radical resection of sigmoid cancer(n=15),Dixon procedure(n=49),and Miles procedure(n=18).Results One hundred and five patients underwent laparoscopic resection successfully,7 cases were converted to open surgery because of hemorrhage,obesity or adhesion with adjacent organ,6 of which were left colon or rectal cancer.The mean operating time was(161.2?48.6)min,and the mean operative blood loss was 78.5 mL.There were 8 cases occurred postoperative complications,and no mortality during perioperative period.The length of upper and lower segment of resection for colonic cancer was (14.5?3.2)cm and(11.0?2.6)cm respectively.The length of upper and lower segment of resection for rectal cancer was(15.3?2.7)cm and(2.8?1.6)cm,respectively.The mean number of lymph nodes dissected was(8.2?4.6),and lymph node metastases were found in 49 cases.One hundred and seven cases(95.5%) were followed up for 8-44 months,of which,7 cases had local recurrence and 6 cases had distant metastases.No case of trocar port tumor implantation was observed.Conclusions Laparoscopic surgery for colorectal cancer is feasible and safe,can result in the same outcome as open radical surgery,and has the advantages of mini-invasive procedure.
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Objective To sum up our experiences for the diagnosis and treatment of visceral pseudoaneurysms. Methods This study included 14 patients admitted from 1990 to 2000, consisting of 6 hepatic, 5 splenic, 3 gastroduodenal aneurysms. Results Thirteen cases experienced a rupture. Five cases received emergent surgery, which was successful in 2, and fatal in one. Transcatheter embolization was used in 11 cases which was successful in all without complications and recurrence after an average follow up of 2 years. Conclusions Digital substraction angiography has diagnostic value for rupture of visceral pseudoaneurysms. Transcatheter embolization is an effective treatment for the majority of patients with visceral pseudoaneurysms.
