Surgical treatment for right colon cancer directly invading the duodenum.

Right colon carcinoma with duodenal invasion is rare, and optimal management remains controversial. Twenty patients demonstrating right-colon carcinoma directly invading the duodenum presented at the Second Xiangya Hospital between 1990 and 2006. Different surgical management strategies were selected based on duodenal involvement, and patient outcomes were evaluated. There was no perioperative death in this series, but three major complications presented during the perioperative period: one case of duodenal stenosis and two duodenal leaks due to gastric or duodenal drainage. Eight of 13 patients treated by en bloc resection survived more than 3 years, including one 10-year survivor and four 5-year survivors. Of the seven patients treated with palliative resection, no patients survived more than 18 months. In conclusion, duodenal invasion by a right-sided colon carcinoma does not necessarily represent incurable disease. If carefully applied based on the extent of duodenal invasion, active surgical management is very useful for improving patient prognosis without increasing the risks associated with surgery.

Exploration of the Diagnosis for 102 Cases of Pancreatic Carcinoma / 中国医师杂志

Objective To study the cause of misdiagnosis of pancreatic carcinoma(PC) in order to obtain the final diagnosis as early as possible,and increase the rates of early diagnosis and resection of PC.Mothods We petrospectively reviewed 102 cases of PC from 1991 to 1997,and analyzed the diagnostic accuracy of prehospitalized and admitted for PC.Results The average time from initial symptoms and jaundices to admision was 197 days and 60 days,respectively.The misdiagnostic rates of the first consult and multicosult or hospitalized in other hospitals were 100% and 85%,respectively.The most frequently misdiagnostic disease was peptic ulcer(25 cases),the rest were cholelithiasis(14 cases),hepatitis(11 cases),biliary tract ascarides(5 cases).Osteophyte proliferation(3 cases),colilis(3 cases) and others(3 cases).8 cases underwent surgery in other hospitals while 7 cases of them misdiagnosis in operation.The diagnostic rates of B-U and CT after admison were 85% and 95%,respectively.According to operative findings,60% cases had wide-ranging celiac metastasis in which 40% had hepatic metastasis simultaneously,alse 75% had local invasion and lymphatic metastasis.Only 10% and 2% patients underwent radical resection and palliative surgery respectively, while 10% patients had conservative treatment.Conclusion We demonstrated that there are high misdiagnositic rate,low radical rate and delaying final diagnosis for PC.It is urgent to increase its initial diagnostic rate and apply for CT in early stage would be the best device.

Study on the expressions of chemotactic proteins and their significance in pancreatic carcinoma and chronic pancreatitis / 中国普通外科杂志

Objective To investigate the expressions of IL-8,MCP-1 and MIP-1? and their biological significance in pancreatic carcinoma and chronic pancreatitis, and investigate the relationships of their expressions in pancreatic cancer tissues.Methods Immunohistochemical method of avidin-biotin complex was used to examine surgically removed specimens from 51 cases of pancreatic carcinoma and 10 cases of chronic pancreatitis. Results The positive rates of expression and the scorings of IL-8,MCP-1,MIP-1? were significantly higher in pancreatic carcinoma than that in chronic pancreatitis(P

The prevention and treatment of parastomal hernia: report of 44 cases / 中国普通外科杂志

Objective To investigate prevention and treatment of parastomal hernia. Methods Clinical data of parastomal hernia of 44 cases were analyzed respectively with special respect to clinical features and repair methods. Result Simple sutures were used in 23 cases, mesh repair in 16 cases, stoma relocation plus mesh repair in 5 cases. Postoperative recovery was satisfactory in 39 cases. Incisional infection occurred in 5 cases, and hernia recurrence developed in 3 cases (6.8%) during a follow-up of 6 to 108 months (average 49 months) in 41 patients. Conclusion The causes of parastomal hernia are miscellaneous especially incisional infection; Perioperative malnutrition must be corrected companying diseases properly controlled, and operative technique improved to prevent the incidence of parastomal hernia; Surgery is the only cure for parastomal hernia. Mesh repair and/or stoma relocation is sometimes necessary.