Pub Date : 2020-01-25DOI: 10.3760/CMA.J.ISSN.1007-631X.2020.01.014
Qian Fan, Yi Lin, Jia Ma, Senlin Zhu, Yu-wei Wu, Xingyi Mou, Bo Deng, Shiran Kang, Fan Min, Feng Ma, Y. Lyu, Xiaopeng Yan
Objective To verify the feasibility and safety of stomach tumor marker localization based on magnetic tracer technique in dogs. Methods Six male Beagle dogs were examined by gastroscopy. Then tracer magnets were sent to the "tumor" locations assumed in advance and fixed near the "tumors" by endoscopic soft tissue clamp. Laparoscopic gastric tumor localization was performed under general anesthesia 24 hours later. The tracer magnet was placed near the tumor on the surface of the stomach through the operating hole after the conventional establishment of laparoscope puncture parallel mirror to explore the tracer magnet. After the two magnets were attracted, the location of the tracer magnet seen under the laparoscope was the location of the gastric tumor, so as to complete the labeling and positioning of the lesion. Results All the 6 Beagle dogs were successfully implanted with tracer magnets under gastroscopy .Twenty-four hours after the gastroscopy, the pursuit magnet was successfully implanted during laparoscopic surgery. The two magnets automatically attracted each other and formed a sandwich structure of "tracer magnet-gastric wall-pursuit magnet" , which completed the location and identification of gastric tumor under the laparoscopy. Conclusion Gastroscopy combined with laparoscopy based on magnetic tracer technique is simple, accurate, safe and feasible. Key words: Stomach neoplasms; Magnetosomes; Gastroscopes; Laparoscopy
{"title":"Experimental study of stomach tumor localization based on magnetic tracer technique","authors":"Qian Fan, Yi Lin, Jia Ma, Senlin Zhu, Yu-wei Wu, Xingyi Mou, Bo Deng, Shiran Kang, Fan Min, Feng Ma, Y. Lyu, Xiaopeng Yan","doi":"10.3760/CMA.J.ISSN.1007-631X.2020.01.014","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1007-631X.2020.01.014","url":null,"abstract":"Objective \u0000To verify the feasibility and safety of stomach tumor marker localization based on magnetic tracer technique in dogs. \u0000 \u0000 \u0000Methods \u0000Six male Beagle dogs were examined by gastroscopy. Then tracer magnets were sent to the \"tumor\" locations assumed in advance and fixed near the \"tumors\" by endoscopic soft tissue clamp. Laparoscopic gastric tumor localization was performed under general anesthesia 24 hours later. The tracer magnet was placed near the tumor on the surface of the stomach through the operating hole after the conventional establishment of laparoscope puncture parallel mirror to explore the tracer magnet. After the two magnets were attracted, the location of the tracer magnet seen under the laparoscope was the location of the gastric tumor, so as to complete the labeling and positioning of the lesion. \u0000 \u0000 \u0000Results \u0000All the 6 Beagle dogs were successfully implanted with tracer magnets under gastroscopy .Twenty-four hours after the gastroscopy, the pursuit magnet was successfully implanted during laparoscopic surgery. The two magnets automatically attracted each other and formed a sandwich structure of \"tracer magnet-gastric wall-pursuit magnet\" , which completed the location and identification of gastric tumor under the laparoscopy. \u0000 \u0000 \u0000Conclusion \u0000Gastroscopy combined with laparoscopy based on magnetic tracer technique is simple, accurate, safe and feasible. \u0000 \u0000 \u0000Key words: \u0000Stomach neoplasms; Magnetosomes; Gastroscopes; Laparoscopy","PeriodicalId":66425,"journal":{"name":"中华普通外科杂志","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2020-01-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45197020","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2020-01-25DOI: 10.3760/CMA.J.ISSN.1007-631X.2020.01.013
Bao Yuan, Jing Yang, Hong Gu, Jiong Ma, J. Miao, Wanjin Shao, Yunfei Gu, Chaoqun Ma
Objective To study the surgical treatment of the pilonidal disease. Methods The clinical data of 33 cases of the pilonidal disease were retrospectively analyzed from Jul 2007 to Feb 2014. 18 cases were treated with Excision and Marsupialization, and 15 cases were treated with Rhomboid excision and Limberg flap. Results All 18 cases in the excision and marsupialization group, were cured by surgery.all 15 cases in the rhomboid excision and Limberg flap group were cured, five of these cases were delayed healing dehiscence or necrosis, all this cases were healed after dressing drainage.The average healing time of the Limberg flap group was shorter than that of the Marsupialization group[(19±7) d vs. (37±12) d, t=6.556, P 0.05). Conclusion The excision and marsupialization and the rhomboid excision and Limberg flap are effective in the treatment of the pilonidal disease, and the Limberg flap transfer is recommended in complicated and recurrence cases. Key words: Pilonidal disease; Surgical procedures, operative
目的探讨毛鞘疾病的外科治疗方法。方法回顾性分析2007年7月至2014年2月收治的33例毛鞘病患者的临床资料。切除+有袋化18例，菱形切除+ Limberg皮瓣15例。结果本组18例患者均经手术治愈。菱形切除+ Limberg皮瓣组15例均治愈，其中5例出现延迟愈合的裂裂或坏死，均经敷料引流后愈合。Limberg皮瓣组的平均愈合时间短于有袋化组[(19±7)d比(37±12)d, t=6.556, P < 0.05]。结论毛鞘病变的切除带袋化及菱形切除+ Limberg皮瓣是治疗毛鞘病变的有效方法，对于复杂和复发的病例，建议采用Limberg皮瓣转移。关键词:毛线虫病;外科手术
{"title":"Surgical treatment of pilonidal disease","authors":"Bao Yuan, Jing Yang, Hong Gu, Jiong Ma, J. Miao, Wanjin Shao, Yunfei Gu, Chaoqun Ma","doi":"10.3760/CMA.J.ISSN.1007-631X.2020.01.013","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1007-631X.2020.01.013","url":null,"abstract":"Objective \u0000To study the surgical treatment of the pilonidal disease. \u0000 \u0000 \u0000Methods \u0000The clinical data of 33 cases of the pilonidal disease were retrospectively analyzed from Jul 2007 to Feb 2014. 18 cases were treated with Excision and Marsupialization, and 15 cases were treated with Rhomboid excision and Limberg flap. \u0000 \u0000 \u0000Results \u0000All 18 cases in the excision and marsupialization group, were cured by surgery.all 15 cases in the rhomboid excision and Limberg flap group were cured, five of these cases were delayed healing dehiscence or necrosis, all this cases were healed after dressing drainage.The average healing time of the Limberg flap group was shorter than that of the Marsupialization group[(19±7) d vs. (37±12) d, t=6.556, P 0.05). \u0000 \u0000 \u0000Conclusion \u0000The excision and marsupialization and the rhomboid excision and Limberg flap are effective in the treatment of the pilonidal disease, and the Limberg flap transfer is recommended in complicated and recurrence cases. \u0000 \u0000 \u0000Key words: \u0000Pilonidal disease; Surgical procedures, operative","PeriodicalId":66425,"journal":{"name":"中华普通外科杂志","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2020-01-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43742426","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2020-01-25DOI: 10.3760/CMA.J.ISSN.1007-631X.2020.01.003
Bin Zhang, G. Zhuo, Yu-juan Zhao, K. Zhao, Yongcheng Zhao, Jun Zhu, G. Ni, Zhan Chen, J. Ding
Objective To investigate the risk factors for anastomotic leakage (AL) after laparoscopic intersphincteric resection (Lap-ISR) for patients with low-lying rectal cancer. Methods This retrospective study was conducted in the Characteristic Medical Center of PLA Rocket Force from Jun 2011 to Nov 2018. 151 patients undergoing Lap-ISR were enrolled for this study. Results All patients in this series had a defunctioning ileostomy. The overall leakage rate was 17.2% (26/151), including peri-operative AL (n=20) and delayed AL (n=6). In accordance with the grading system of the International Study Group of Rectal Cancer, there were 24 patients (15.9%) with AL Grade B (requiring active therapeutic intervention) and two patients (1.3%) with AL Grade C (requiring re-laparotomy). Univariate analysis showed that BMI (≥ 25 kg/m2), tumor annularity (≥ 3/4) and operation time (≥ 240 min) were associated with AL (P<0.05). Multivariate analysis showed that operation time (≥ 240 min, OR=7.390, 95% CI: 2.483-21.988, P=0.000), tumor annularity (≥ 3/4, OR=6.233, 95% CI: 1.932-20.107, P=0.002) and higher BMI (≥ 25 kg/m2,OR=3.523, 95% CI: 1.275-9.738, P=0.015) were independently predictive of AL. Conclusion Tumor annularity, operation time and higher BMI are independently associated with symptomatic AL after Lap-ISR. Key words: Rectal neoplasms; Anastomotic leakage; Risk factors; Laparoscopy
{"title":"Risk factors for anastomotic leakage after laparoscopic intersphincteric resection for low-lying rectal cancer","authors":"Bin Zhang, G. Zhuo, Yu-juan Zhao, K. Zhao, Yongcheng Zhao, Jun Zhu, G. Ni, Zhan Chen, J. Ding","doi":"10.3760/CMA.J.ISSN.1007-631X.2020.01.003","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1007-631X.2020.01.003","url":null,"abstract":"Objective \u0000To investigate the risk factors for anastomotic leakage (AL) after laparoscopic intersphincteric resection (Lap-ISR) for patients with low-lying rectal cancer. \u0000 \u0000 \u0000Methods \u0000This retrospective study was conducted in the Characteristic Medical Center of PLA Rocket Force from Jun 2011 to Nov 2018. 151 patients undergoing Lap-ISR were enrolled for this study. \u0000 \u0000 \u0000Results \u0000All patients in this series had a defunctioning ileostomy. The overall leakage rate was 17.2% (26/151), including peri-operative AL (n=20) and delayed AL (n=6). In accordance with the grading system of the International Study Group of Rectal Cancer, there were 24 patients (15.9%) with AL Grade B (requiring active therapeutic intervention) and two patients (1.3%) with AL Grade C (requiring re-laparotomy). Univariate analysis showed that BMI (≥ 25 kg/m2), tumor annularity (≥ 3/4) and operation time (≥ 240 min) were associated with AL (P<0.05). Multivariate analysis showed that operation time (≥ 240 min, OR=7.390, 95% CI: 2.483-21.988, P=0.000), tumor annularity (≥ 3/4, OR=6.233, 95% CI: 1.932-20.107, P=0.002) and higher BMI (≥ 25 kg/m2,OR=3.523, 95% CI: 1.275-9.738, P=0.015) were independently predictive of AL. \u0000 \u0000 \u0000Conclusion \u0000Tumor annularity, operation time and higher BMI are independently associated with symptomatic AL after Lap-ISR. \u0000 \u0000 \u0000Key words: \u0000Rectal neoplasms; Anastomotic leakage; Risk factors; Laparoscopy","PeriodicalId":66425,"journal":{"name":"中华普通外科杂志","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2020-01-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47128055","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2020-01-25DOI: 10.3760/CMA.J.ISSN.1007-631X.2020.01.010
Jianping Cai, Xiang-feng Zhou, Haibo Yu, Lian-cai Wang, Deyu Li
Objective To study the effects of different parenteral nutrition on acute inflammatory response, immune cells and lipid metabolism in patients after pancreaticoduodenectomy. Methods Eighty patients after pancreaticoduodenectomy were divided into study group and control group, with 40 cases in each group. Structural fat emulsion was used in study group and medium/long chain fat emulsion in control group. The changes of acute inflammation, immune cells and lipid metabolism were compared between the two groups. Results (1)The levels of C-reactive protein (CRP) and serum prostaglandin E2 (PGE2) in the two groups were significantly higher on the first day after operation than those before operation. The difference between the two groups was statistically significant (P<0.05). The level of CRP and PGE2 decreased to the preoperative level on the seventh day after operation, but the decline rate in the study group was significantly faster than that in the control group (P<0.05). (2)The levels of CD3+ , CD4+ , CD8+ , CD4+ /CD8+ in the study group were significantly higher than those in the control group (P<0.05). (3)After 3-7 days of intravenous parenteral nutrition infusion, the blood lipid level was significantly lower in study group (P<0.05). Conclusion Structural fat emulsion alleviates the inflammatory reaction in patients after pancreaticoduodenectomy, promotes the recovery of immunity, significantly reduces the level of blood lipids. Key words: Pancreaticoduodenectomy; Parenteral nutrition; C-reactive protein
{"title":"Effects of enteral nutrition on acute inflammation, immune cells and lipid metabolism in patients after pancreaticoduodenectomy","authors":"Jianping Cai, Xiang-feng Zhou, Haibo Yu, Lian-cai Wang, Deyu Li","doi":"10.3760/CMA.J.ISSN.1007-631X.2020.01.010","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1007-631X.2020.01.010","url":null,"abstract":"Objective \u0000To study the effects of different parenteral nutrition on acute inflammatory response, immune cells and lipid metabolism in patients after pancreaticoduodenectomy. \u0000 \u0000 \u0000Methods \u0000Eighty patients after pancreaticoduodenectomy were divided into study group and control group, with 40 cases in each group. Structural fat emulsion was used in study group and medium/long chain fat emulsion in control group. The changes of acute inflammation, immune cells and lipid metabolism were compared between the two groups. \u0000 \u0000 \u0000Results \u0000(1)The levels of C-reactive protein (CRP) and serum prostaglandin E2 (PGE2) in the two groups were significantly higher on the first day after operation than those before operation. The difference between the two groups was statistically significant (P<0.05). The level of CRP and PGE2 decreased to the preoperative level on the seventh day after operation, but the decline rate in the study group was significantly faster than that in the control group (P<0.05). (2)The levels of CD3+ , CD4+ , CD8+ , CD4+ /CD8+ in the study group were significantly higher than those in the control group (P<0.05). (3)After 3-7 days of intravenous parenteral nutrition infusion, the blood lipid level was significantly lower in study group (P<0.05). \u0000 \u0000 \u0000Conclusion \u0000Structural fat emulsion alleviates the inflammatory reaction in patients after pancreaticoduodenectomy, promotes the recovery of immunity, significantly reduces the level of blood lipids. \u0000 \u0000 \u0000Key words: \u0000Pancreaticoduodenectomy; Parenteral nutrition; C-reactive protein","PeriodicalId":66425,"journal":{"name":"中华普通外科杂志","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2020-01-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47798023","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2020-01-25DOI: 10.3760/CMA.J.ISSN.1007-631X.2020.01.016
Zhou Shicheng, Qinhu Sun, Hongxia Zhang, G. Lian, Hongjun Liu, Leping Li, Xiao-bo Guo
Objective To verify that lncRNA-C21orF96 regulates the expression of miRNA-875-5p and USF2 genes and promotes the invasion and metastasis of gastric cancer. Methods RT-PCR was used to measure the expression of lncRNA-C21orF96 related miRNA in gastric cancer cells. pcDNA3. 1 plasmid was used to over-express lncRNA-C21orF96 in KATO-Ⅲ and siRNA was used to knockdown the expression of lncRNA-C21orF96 in SGC-7901, and RT-PCR was used to measure the expression of miRNA-875-5p and USF2 genes; By overexpressing lncRNA-C21orF96 in MKN45, transwell was used to observe changes of cells invasion and migration. Results LncRNA-C21orF96 showed a significant inverse relationship with miR-875-5p, (SGC-7901: 21.19 ±1.09 vs. 3.28 ±0.06, P<0.01; SNU-16: 24.76±2.09 vs. 8.16 ±0.07, P<0.01). In KATO-Ⅲ over-expressing lncRNA-C21orF96, miR-875-5p expression decreased significantly while USF2 expression increased (P<0.01); In SGC-7901 with lncRNA-C21orF96 knockdown, miR-875-5p expression increased significantly while USF2 expression decreased (P<0.05). The number of cells passing through the artificial basement membrane in the experimental group was significantly different from that in the control group (migration: 216.19 ± 2.30 vs. 89.19 ± 4.60, P<0.001; invasion: 146.18 ±5.3 vs. 59.18 ± 2.60, P<0.001). Conclusions The overexpression of lncRNA- C21orF96 significantly reduces the expression of miR-875-5p and promotes the expression of USF2, hence promoting the invasion and metastasis of gastric cancer. Key words: Stomach neoplasms; Gene expression regulation; Neoplasm metastasis; Neoplasm invasiveness
{"title":"LncRNA C21orF96 promotes the invasion and metastasis of gastric cancer by regulating the expression of miR-875-5p and USF2 genes","authors":"Zhou Shicheng, Qinhu Sun, Hongxia Zhang, G. Lian, Hongjun Liu, Leping Li, Xiao-bo Guo","doi":"10.3760/CMA.J.ISSN.1007-631X.2020.01.016","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1007-631X.2020.01.016","url":null,"abstract":"Objective \u0000To verify that lncRNA-C21orF96 regulates the expression of miRNA-875-5p and USF2 genes and promotes the invasion and metastasis of gastric cancer. \u0000 \u0000 \u0000Methods \u0000RT-PCR was used to measure the expression of lncRNA-C21orF96 related miRNA in gastric cancer cells. pcDNA3. 1 plasmid was used to over-express lncRNA-C21orF96 in KATO-Ⅲ and siRNA was used to knockdown the expression of lncRNA-C21orF96 in SGC-7901, and RT-PCR was used to measure the expression of miRNA-875-5p and USF2 genes; By overexpressing lncRNA-C21orF96 in MKN45, transwell was used to observe changes of cells invasion and migration. \u0000 \u0000 \u0000Results \u0000LncRNA-C21orF96 showed a significant inverse relationship with miR-875-5p, (SGC-7901: 21.19 ±1.09 vs. 3.28 ±0.06, P<0.01; SNU-16: 24.76±2.09 vs. 8.16 ±0.07, P<0.01). In KATO-Ⅲ over-expressing lncRNA-C21orF96, miR-875-5p expression decreased significantly while USF2 expression increased (P<0.01); In SGC-7901 with lncRNA-C21orF96 knockdown, miR-875-5p expression increased significantly while USF2 expression decreased (P<0.05). The number of cells passing through the artificial basement membrane in the experimental group was significantly different from that in the control group (migration: 216.19 ± 2.30 vs. 89.19 ± 4.60, P<0.001; invasion: 146.18 ±5.3 vs. 59.18 ± 2.60, P<0.001). \u0000 \u0000 \u0000Conclusions \u0000The overexpression of lncRNA- C21orF96 significantly reduces the expression of miR-875-5p and promotes the expression of USF2, hence promoting the invasion and metastasis of gastric cancer. \u0000 \u0000 \u0000Key words: \u0000Stomach neoplasms; Gene expression regulation; Neoplasm metastasis; Neoplasm invasiveness","PeriodicalId":66425,"journal":{"name":"中华普通外科杂志","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2020-01-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49589048","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Objective To investigate the effect of enhanced recovery after surgery(ERAS) on immune function and postoperative recovery in gastric cancer patients undergoing total laparoscopic radical gastrectomy. Methods Patients were randomly divided into ERAS group and control group. Blood CD4+ , CD8+ , CD4+ CD25+ , C-reactive protein , postoperative recovery and complications were compared between the two groups. Results On day1, CD4+ , CD8+ , CD4+ CD25+ in the two groups were significantly lower than those before surgery (t=9.070, 7.297, 5.830, 12.870, 3.529, 10.547, all P 0.05) while the other indexes in the two groups raised but still were lower than preoperative level (t=3.322, 5.015, 3.418, 9.912, all P<0.05); CD4+ , CD8+ , CD4+ CD25+ in ERAS group were higher than control group (t=2.804, 2.040, 2.210, allP<0.05). On day5, CD4+ , CD4+ CD25+ in the two groups and CD8+ in ERAS group returned to the preoperative level, while CD8+ of the control group was still lower than the preoperative level (t=6.862, P<0.05). On day1, 3 and 5, the C-reactive protein levels of the two groups were higher than those before surgery(t=-13.338, -13.715, -11.319, -12.286, -13.182, -15.076, all P<0.05), and ERAS group were lower than the control group (t=-3.246, -2.100, -2.211, all P<0.05). There was no mortality in neither groups. The time of passage gas by anus, defecation, getting out of bed, oral feeding, and postoperative hospital stay in the ERAS group were less than those in the control group[(2.8±1.0)d vs. (3.9±0.9)d, t=-5.974; (3.8± 0.9)d vs.(4.3±1.0)d, t=-2.700; (19.1±4.0)h vs. (35.9±6.6)h, t=-16.045; (9.9±1.6)d vs. (11.5±2.0)d, t=-4.479, all P<0.05]. Conclusions ERAS in the perioperative period of patients with total laparoscopic radical gastrectomy mitigates the stress on the cellular immune system, reduces inflammatory response, and help fast recover the postoperative gastrointestinal function. Key words: Stomach neoplasms; Immunity, cellular; C-reaction protein; Enhanced recovery after surgery
{"title":"Enhanced recovery after surgery in total laparoscopic radical gastrectomy","authors":"Yu Yu, Moucheng Zhang, Kaijun Gao, Liangwei Yang, Jiaming Zhou, Zhilong Yan","doi":"10.3760/CMA.J.ISSN.1007-631X.2020.01.007","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1007-631X.2020.01.007","url":null,"abstract":"Objective \u0000To investigate the effect of enhanced recovery after surgery(ERAS) on immune function and postoperative recovery in gastric cancer patients undergoing total laparoscopic radical gastrectomy. \u0000 \u0000 \u0000Methods \u0000Patients were randomly divided into ERAS group and control group. Blood CD4+ , CD8+ , CD4+ CD25+ , C-reactive protein , postoperative recovery and complications were compared between the two groups. \u0000 \u0000 \u0000Results \u0000On day1, CD4+ , CD8+ , CD4+ CD25+ in the two groups were significantly lower than those before surgery (t=9.070, 7.297, 5.830, 12.870, 3.529, 10.547, all P 0.05) while the other indexes in the two groups raised but still were lower than preoperative level (t=3.322, 5.015, 3.418, 9.912, all P<0.05); CD4+ , CD8+ , CD4+ CD25+ in ERAS group were higher than control group (t=2.804, 2.040, 2.210, allP<0.05). On day5, CD4+ , CD4+ CD25+ in the two groups and CD8+ in ERAS group returned to the preoperative level, while CD8+ of the control group was still lower than the preoperative level (t=6.862, P<0.05). On day1, 3 and 5, the C-reactive protein levels of the two groups were higher than those before surgery(t=-13.338, -13.715, -11.319, -12.286, -13.182, -15.076, all P<0.05), and ERAS group were lower than the control group (t=-3.246, -2.100, -2.211, all P<0.05). There was no mortality in neither groups. The time of passage gas by anus, defecation, getting out of bed, oral feeding, and postoperative hospital stay in the ERAS group were less than those in the control group[(2.8±1.0)d vs. (3.9±0.9)d, t=-5.974; (3.8± 0.9)d vs.(4.3±1.0)d, t=-2.700; (19.1±4.0)h vs. (35.9±6.6)h, t=-16.045; (9.9±1.6)d vs. (11.5±2.0)d, t=-4.479, all P<0.05]. \u0000 \u0000 \u0000Conclusions \u0000ERAS in the perioperative period of patients with total laparoscopic radical gastrectomy mitigates the stress on the cellular immune system, reduces inflammatory response, and help fast recover the postoperative gastrointestinal function. \u0000 \u0000 \u0000Key words: \u0000Stomach neoplasms; Immunity, cellular; C-reaction protein; Enhanced recovery after surgery","PeriodicalId":66425,"journal":{"name":"中华普通外科杂志","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2020-01-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43929473","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2020-01-25DOI: 10.3760/CMA.J.ISSN.1007-631X.2020.01.012
Jinkai Li, J. Kong, Mei Huang, Jianpeng Cao, S. Yin, B. Dai, Nan Zhang, Song Zhang, Wen-tao Zhao
Objective To compare the effect and safety of stenting versus directional atherectomy(DA) in the treatment of TASCII A and B superficial femoral artery lesions. Methods 100 patients with TASCⅡ A and B lesions were divided into percutaneous transluminal stenting(PTS) group (n=50) and DA group (n=50). Patients were compared in terms of technical success rate, treatment success rate, first operation cost, postoperative ankle brachial index (ABI), limb salvage rate, survival, and patency. Results The technical success rate in both PTS and DA group was 100%.The treatment success rate was 98% vs. 86%, P>0.05. Postoperative ABI: 0.82±0.19 vs. 0.80±0.27, P>0.05. First operation cost: (34 820±1 051) yuan vs. (45 635±1 358) yuan, P 0.05). Limb salvage rate was 97.9% vs. 93.8 %, P>0.05. Conclusion There were no significant differences in the effect and safety of PTS versus DA in the treatment of TASCII A and B superficial femoral artery lesions. Key words: Peripheral artery disease; Claudication; Superficial femoral artery; Stents; Directional atherectomy
目的比较支架植入术与定向动脉粥样硬化切除术(DA)治疗TASCII A、B型股浅动脉病变的疗效和安全性。方法将100例TASCⅡA、B病变患者分为经皮腔内支架置入术组(PTS)和DA组(DA)。比较技术成功率、治疗成功率、首次手术费用、术后踝肱指数(ankle brachial index, ABI)、残肢保留率、生存率、通畅度。结果PTS组和DA组技术成功率均为100%。治疗成功率98% vs. 86%， P < 0.05。术后ABI: 0.82±0.19 vs. 0.80±0.27,P < 0.05。首次手术费用:(34 820±1 051)元vs(45 635±1 358)元，P < 0.05)。残肢保留率97.9%比93.8%，P < 0.05。结论PTS与DA治疗TASCII A、B型股浅动脉病变的疗效和安全性无显著差异。关键词:外周动脉疾病;跛行;股浅动脉;支架;定向atherectomy
{"title":"Percutaneous transluminal stenting versus directional atherectomy for lower limb artery TASC II Class A and B superficial femoral artery lesions","authors":"Jinkai Li, J. Kong, Mei Huang, Jianpeng Cao, S. Yin, B. Dai, Nan Zhang, Song Zhang, Wen-tao Zhao","doi":"10.3760/CMA.J.ISSN.1007-631X.2020.01.012","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1007-631X.2020.01.012","url":null,"abstract":"Objective \u0000To compare the effect and safety of stenting versus directional atherectomy(DA) in the treatment of TASCII A and B superficial femoral artery lesions. \u0000 \u0000 \u0000Methods \u0000100 patients with TASCⅡ A and B lesions were divided into percutaneous transluminal stenting(PTS) group (n=50) and DA group (n=50). Patients were compared in terms of technical success rate, treatment success rate, first operation cost, postoperative ankle brachial index (ABI), limb salvage rate, survival, and patency. \u0000 \u0000 \u0000Results \u0000The technical success rate in both PTS and DA group was 100%.The treatment success rate was 98% vs. 86%, P>0.05. Postoperative ABI: 0.82±0.19 vs. 0.80±0.27, P>0.05. First operation cost: (34 820±1 051) yuan vs. (45 635±1 358) yuan, P 0.05). Limb salvage rate was 97.9% vs. 93.8 %, P>0.05. \u0000 \u0000 \u0000Conclusion \u0000There were no significant differences in the effect and safety of PTS versus DA in the treatment of TASCII A and B superficial femoral artery lesions. \u0000 \u0000 \u0000Key words: \u0000Peripheral artery disease; Claudication; Superficial femoral artery; Stents; Directional atherectomy","PeriodicalId":66425,"journal":{"name":"中华普通外科杂志","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2020-01-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46513851","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2020-01-25DOI: 10.3760/CMA.J.ISSN.1007-631X.2020.01.002
He Wang, Xiao-long Zhu, Zhi-Song Liu, Xinlong Shi, B. Du, Wei-sheng Zhang, Xiong-Fei Yang
Objective To compare effectiveness and short-term outcomes between robotic-assisted and laparoscopic surgery for radical resection of rectal cancer. Methods A total of 410 patients diagnosed with rectal cancer, undergoing robotic-assisted surgery(RAS) for rectal cancer (215 cases) and conventional laparoscopic surgery(CLS) for rectal cancer (195) from Jan 2016 to Dec 2018 were included into the present study. Operative characteristics, postoperative complications and pathologic parameters were evaluated between RAS and CLS group. Results The RAS group had less intraoperative blood loss[(107±46) ml vs. (147±35)ml, t=3.695, P<0.05], longer operation time[(209±55)min vs. (195±55)min, t=2.508, P<0.05], earlier first flatus[(3.4±1.4)d vs.(5.3±1.6)d, t=-14.952, P<0.05], and first liquid diet time[(4.3±1.5)d vs. (6.2±2.6)d, t=-9.109, P<0.05], more number of dissected lymph nodes[(12.6±4.3) vs. (10.6±4.5), t=4.468, P<0.05]compared with those in the CLS group. But more expensive total hospitalization costs[(71 775±45 089) yuan vs. (66 789±16 721) yuan, t=4.224, P<0.05]. Conclusion Compared with laparoscopic surgery, robotic-assisted surgery has less blood loss, shorter time of first flatus, more lymph nodes yield. Key words: Rectal neoplasms; Robots; Laparoscopy; Proctectomy
{"title":"Short-term outcomes comparison between robotic-assisted versus laparoscopic radical resection of rectal cancer","authors":"He Wang, Xiao-long Zhu, Zhi-Song Liu, Xinlong Shi, B. Du, Wei-sheng Zhang, Xiong-Fei Yang","doi":"10.3760/CMA.J.ISSN.1007-631X.2020.01.002","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1007-631X.2020.01.002","url":null,"abstract":"Objective \u0000To compare effectiveness and short-term outcomes between robotic-assisted and laparoscopic surgery for radical resection of rectal cancer. \u0000 \u0000 \u0000Methods \u0000A total of 410 patients diagnosed with rectal cancer, undergoing robotic-assisted surgery(RAS) for rectal cancer (215 cases) and conventional laparoscopic surgery(CLS) for rectal cancer (195) from Jan 2016 to Dec 2018 were included into the present study. Operative characteristics, postoperative complications and pathologic parameters were evaluated between RAS and CLS group. \u0000 \u0000 \u0000Results \u0000The RAS group had less intraoperative blood loss[(107±46) ml vs. (147±35)ml, t=3.695, P<0.05], longer operation time[(209±55)min vs. (195±55)min, t=2.508, P<0.05], earlier first flatus[(3.4±1.4)d vs.(5.3±1.6)d, t=-14.952, P<0.05], and first liquid diet time[(4.3±1.5)d vs. (6.2±2.6)d, t=-9.109, P<0.05], more number of dissected lymph nodes[(12.6±4.3) vs. (10.6±4.5), t=4.468, P<0.05]compared with those in the CLS group. But more expensive total hospitalization costs[(71 775±45 089) yuan vs. (66 789±16 721) yuan, t=4.224, P<0.05]. \u0000 \u0000 \u0000Conclusion \u0000Compared with laparoscopic surgery, robotic-assisted surgery has less blood loss, shorter time of first flatus, more lymph nodes yield. \u0000 \u0000 \u0000Key words: \u0000Rectal neoplasms; Robots; Laparoscopy; Proctectomy","PeriodicalId":66425,"journal":{"name":"中华普通外科杂志","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2020-01-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41695640","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2020-01-25DOI: 10.3760/CMA.J.ISSN.1007-631X.2020.01.008
Sheng-long Zhang, Xianwei Yang, Wentao Wang
Objective To analyze the risk factors of bile leakage after operation of hepatic alveolar echinococcosis. Methods The clinical manifestations, laboratory examination, imaging features and operative data of 137 patients with hepatic alveolar echinococcosis were retrospectively analyzed. The clinical characteristics of bile leakage group (n=22) and non-bile leakage group (n=115) were compared and analyzed, and the Logistic regression model was used to explore the related factors of bile leakage. Results Preoperative liver function (AST, ALP, LDH), blood loss, blood transfusion, hepatic hilum invasion, preoperative PTCD, and regular resection were significantly different between the two groups. Logistic regression analysis showed that regular hepatectomy was a protective factor to avoid bile leakage. Hepatic hilum invasion was a risk factor for bile leakage. Conclusion The invasion of the hepatic hilum is an important factor of postoperative bile leakage. Regular hepatectomy can reduce the incidence of postoperative bile leakage. Key words: Echinococcosis; Hepatectomy; Postoperative complications; Risk factors
{"title":"Risk factors leading to bile leakage after hepatectomy for hepatic alveolar echinococcosis","authors":"Sheng-long Zhang, Xianwei Yang, Wentao Wang","doi":"10.3760/CMA.J.ISSN.1007-631X.2020.01.008","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1007-631X.2020.01.008","url":null,"abstract":"Objective \u0000To analyze the risk factors of bile leakage after operation of hepatic alveolar echinococcosis. \u0000 \u0000 \u0000Methods \u0000The clinical manifestations, laboratory examination, imaging features and operative data of 137 patients with hepatic alveolar echinococcosis were retrospectively analyzed. The clinical characteristics of bile leakage group (n=22) and non-bile leakage group (n=115) were compared and analyzed, and the Logistic regression model was used to explore the related factors of bile leakage. \u0000 \u0000 \u0000Results \u0000Preoperative liver function (AST, ALP, LDH), blood loss, blood transfusion, hepatic hilum invasion, preoperative PTCD, and regular resection were significantly different between the two groups. Logistic regression analysis showed that regular hepatectomy was a protective factor to avoid bile leakage. Hepatic hilum invasion was a risk factor for bile leakage. \u0000 \u0000 \u0000Conclusion \u0000The invasion of the hepatic hilum is an important factor of postoperative bile leakage. Regular hepatectomy can reduce the incidence of postoperative bile leakage. \u0000 \u0000 \u0000Key words: \u0000Echinococcosis; Hepatectomy; Postoperative complications; Risk factors","PeriodicalId":66425,"journal":{"name":"中华普通外科杂志","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2020-01-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48334872","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2020-01-25DOI: 10.3760/CMA.J.ISSN.1007-631X.2020.01.001
Yong Cheng, G. Han, Yan-hui Gu, Shijia Zhang, K. Hua, Wang Zhenlei
Objective To explore the safety and efficacy of middle line approach identified with superior mesenteric vein in the right hemicolectomy combined with pancreaticoduodenectomy for colonic carcinoma involing liver and duodenun. Methods Clinical data of 13 patient′s with right colonic cancer(T4b) undergoing right hemicolectomy combined with pancreaticoduodenectomy from Jan 2016 to Jul 2019 in He′nan Provincial Tumor Hospital were retrospectively analyzed. The superior mesenteric vein was used to mark the medial border of tumor resection. Vertical cutline was made to transverse mesocolon and all the way done to the root of superior mesenteric vein, the pancreas was cut in front of superior mesenteric vein, superior mesenteric artery and the affiliated lymph nodes were dissected. The stomach and pancreas were transected, the specimen was removed. Then the GI tract was reconstructed. Results Surgery was successful in all 13 patients . The operation time was (249±27) min, blood loss was (442±129)ml, 2 cases suffered pancreatic fistula, there was no biliary fistula, and 1 case of delayed gastric emptying. There were no other major complications. The number of lymph node dissection was (20±4) and hospital stay was (23.2±9.4) d. Conclusions It is safe and feasible to use the superior mesenteric vein-identified middle line approach in patients of right colonic cancer undergoing right hemicolectomy plus pancreaticoduodenectomy. Key words: Colonic neoplasms; Mesenteric veins; Pancreaticoduodenectomy; Colectomy
{"title":"Superior mesenteric vein-identified middle line approach in patients of colonic cancer(T4b) undergoing right hemicolectomy combined with pancreaticoduodenectomy","authors":"Yong Cheng, G. Han, Yan-hui Gu, Shijia Zhang, K. Hua, Wang Zhenlei","doi":"10.3760/CMA.J.ISSN.1007-631X.2020.01.001","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1007-631X.2020.01.001","url":null,"abstract":"Objective \u0000To explore the safety and efficacy of middle line approach identified with superior mesenteric vein in the right hemicolectomy combined with pancreaticoduodenectomy for colonic carcinoma involing liver and duodenun. \u0000 \u0000 \u0000Methods \u0000Clinical data of 13 patient′s with right colonic cancer(T4b) undergoing right hemicolectomy combined with pancreaticoduodenectomy from Jan 2016 to Jul 2019 in He′nan Provincial Tumor Hospital were retrospectively analyzed. The superior mesenteric vein was used to mark the medial border of tumor resection. Vertical cutline was made to transverse mesocolon and all the way done to the root of superior mesenteric vein, the pancreas was cut in front of superior mesenteric vein, superior mesenteric artery and the affiliated lymph nodes were dissected. The stomach and pancreas were transected, the specimen was removed. Then the GI tract was reconstructed. \u0000 \u0000 \u0000Results \u0000Surgery was successful in all 13 patients . The operation time was (249±27) min, blood loss was (442±129)ml, 2 cases suffered pancreatic fistula, there was no biliary fistula, and 1 case of delayed gastric emptying. There were no other major complications. The number of lymph node dissection was (20±4) and hospital stay was (23.2±9.4) d. \u0000 \u0000 \u0000Conclusions \u0000It is safe and feasible to use the superior mesenteric vein-identified middle line approach in patients of right colonic cancer undergoing right hemicolectomy plus pancreaticoduodenectomy. \u0000 \u0000 \u0000Key words: \u0000Colonic neoplasms; Mesenteric veins; Pancreaticoduodenectomy; Colectomy","PeriodicalId":66425,"journal":{"name":"中华普通外科杂志","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2020-01-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44591607","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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