Pub Date : 2020-01-25DOI: 10.3760/CMA.J.ISSN.1007-631X.2020.01.015
Xin Wang, Yue Du, Zhao Li
Objective To investigate the effects and mechanisms of BMSCs on CP in rats. Methods 40 SD rats were divided into 4 groups with 10 in each: control group, model group, treatment group, and sham treatment group.The pancreatic fibrosis and pathological score were evaluated.The expression of α-SMA, collagen type I and III, IL-10 in pancreatic tissue were detected by ELASA. The expression of apoptosis genes BNIP3 in pancreatic tissue was assayed by qRT-PCR. The protein of TGF-β1, Smad2, Smad3 and Smad4 in TGF-β/Smad signal pathway in pancreatic tissue was determined by Western-blot method. The culture system of PSC was divided into 2 groups with 5 in each: control group and treatment group.The expression of α-SMA, collagen type I and III, IL-10 for PSC were detected by ELASA. The expression of apoptosis genes BNIP3 for PSC was assayed by qRT-PCR. The protein of TGF-β1, Smad2, Smad3 and Smad4 in TGF-β/Smad signal pathway for PSC was determined by Western-blot method. Results (1)The pancreatic fibrosis and pathological score in treatment group were lower than model group and sham treatment group (P<0.05). The expression of α-SMA, collagen type I and III in tissues were less in treatment group compared with model group and sham treatment group (P<0.05) while the level of BNIP3 and IL-10 in pancreatic tissue were higher in treatment group compared with model group and sham treatment group with significant group(P<0.05). The level of TGF-β1, Smad2, Smad3 and Smad4 were lower in treatment group compared with model group and sham treatment group (P<0.05). (2) The expression of α-SMA, collagen type I and III were less in treatment group compared with control group (P<0.05). The level of BNIP3 and IL-10 were higher in treatment group compared (P<0.05). The level of TGF-β1, Smad2, Smad3 and Smad4 were less in treatment group compared with control group (P<0.05). Conclusion BMSCs reduce the activation and proliferation of PSC and then lower pancreatic fibrosis degree in rats with chronic pancreatitis. Key words: Pancreatitis, chronic; Mesenchymal stem cells; Stellate cells
{"title":"The experimental study of bone marrow mesenchymal stem cells for the treatment of chronic pancreatitis in rats","authors":"Xin Wang, Yue Du, Zhao Li","doi":"10.3760/CMA.J.ISSN.1007-631X.2020.01.015","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1007-631X.2020.01.015","url":null,"abstract":"Objective \u0000To investigate the effects and mechanisms of BMSCs on CP in rats. \u0000 \u0000 \u0000Methods \u000040 SD rats were divided into 4 groups with 10 in each: control group, model group, treatment group, and sham treatment group.The pancreatic fibrosis and pathological score were evaluated.The expression of α-SMA, collagen type I and III, IL-10 in pancreatic tissue were detected by ELASA. The expression of apoptosis genes BNIP3 in pancreatic tissue was assayed by qRT-PCR. The protein of TGF-β1, Smad2, Smad3 and Smad4 in TGF-β/Smad signal pathway in pancreatic tissue was determined by Western-blot method. The culture system of PSC was divided into 2 groups with 5 in each: control group and treatment group.The expression of α-SMA, collagen type I and III, IL-10 for PSC were detected by ELASA. The expression of apoptosis genes BNIP3 for PSC was assayed by qRT-PCR. The protein of TGF-β1, Smad2, Smad3 and Smad4 in TGF-β/Smad signal pathway for PSC was determined by Western-blot method. \u0000 \u0000 \u0000Results \u0000(1)The pancreatic fibrosis and pathological score in treatment group were lower than model group and sham treatment group (P<0.05). The expression of α-SMA, collagen type I and III in tissues were less in treatment group compared with model group and sham treatment group (P<0.05) while the level of BNIP3 and IL-10 in pancreatic tissue were higher in treatment group compared with model group and sham treatment group with significant group(P<0.05). The level of TGF-β1, Smad2, Smad3 and Smad4 were lower in treatment group compared with model group and sham treatment group (P<0.05). (2) The expression of α-SMA, collagen type I and III were less in treatment group compared with control group (P<0.05). The level of BNIP3 and IL-10 were higher in treatment group compared (P<0.05). The level of TGF-β1, Smad2, Smad3 and Smad4 were less in treatment group compared with control group (P<0.05). \u0000 \u0000 \u0000Conclusion \u0000BMSCs reduce the activation and proliferation of PSC and then lower pancreatic fibrosis degree in rats with chronic pancreatitis. \u0000 \u0000 \u0000Key words: \u0000Pancreatitis, chronic; Mesenchymal stem cells; Stellate cells","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":"42359044","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.2020.01.011
Ying Wang, Hongpeng Zhang, Xiao-ping Liu, Li-jun Wang, Xin Jia, J. Xiong, XiaoHui Ma, W. Guo
Objective To investigate the safety and mid- term efficacy of percutaneous endovascular angioplasty(PTA) and stent implantation for transplantation renal arterial stenosis(TRAS) . Methods Retrospective analysis was performed on 18 patients with TRAS admitted to of department vascular surgery, PLA General Hospital from Jan 2011 to Dec 2018. Results PTA and stent implantation were performed in all 18 patients via ipsilateral or contralateral femoral artery including 4 cases of PTA alone, 8 cases of PTA plus stent, 6 cases of stent implanted directly.Three of the 18 patients underwent ipsilateral femoral artery catheterization and 15 underwent contralaterally.A total of 14 stents were implanted, all of were balloon expanding stents, of which 2 were drug-coated stents, and the technical success rate was 100%.The average dosage of contrast agent was 64 ml, the stenosis rate of renal artery before interventional treatment was 50%-99%, and that after interventional treatment reduced to 10%-30%.The systolic blood pressure decreased from (157.2±43.0) mmHg preoperatively to (129.8±8.6) mmHg postoperatively.The SCr level decreased from (258.8±214.7) μmol/L to (176.3±101.1) μmol/L. Preoperative urea nitrogen decreased from (15.7±1.6) mmol/L to (10.6±1.1) mmol/L postoperatively (P<0.05). Mean postoperative follow-up time was 42.4 months (3-93 months).17 cases were cured, 1 case was ineffective, 1 case suffered restenosis after 30 days, and was given remedy PTA plus stenting. Conclusions TRAS is a vascular factor leading to grafted renal failure, the endovascular treatment of TRAS is safe, effective and has good mid-term result. Key words: Kidney transplantation; Renal artery obstruction; Angioplasty; Stent
{"title":"Mid-term results of endovascular treatment for the transplanted renal arterial stenosis","authors":"Ying Wang, Hongpeng Zhang, Xiao-ping Liu, Li-jun Wang, Xin Jia, J. Xiong, XiaoHui Ma, W. Guo","doi":"10.3760/CMA.J.ISSN.1007-631X.2020.01.011","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1007-631X.2020.01.011","url":null,"abstract":"Objective \u0000To investigate the safety and mid- term efficacy of percutaneous endovascular angioplasty(PTA) and stent implantation for transplantation renal arterial stenosis(TRAS) . \u0000 \u0000 \u0000Methods \u0000Retrospective analysis was performed on 18 patients with TRAS admitted to of department vascular surgery, PLA General Hospital from Jan 2011 to Dec 2018. \u0000 \u0000 \u0000Results \u0000PTA and stent implantation were performed in all 18 patients via ipsilateral or contralateral femoral artery including 4 cases of PTA alone, 8 cases of PTA plus stent, 6 cases of stent implanted directly.Three of the 18 patients underwent ipsilateral femoral artery catheterization and 15 underwent contralaterally.A total of 14 stents were implanted, all of were balloon expanding stents, of which 2 were drug-coated stents, and the technical success rate was 100%.The average dosage of contrast agent was 64 ml, the stenosis rate of renal artery before interventional treatment was 50%-99%, and that after interventional treatment reduced to 10%-30%.The systolic blood pressure decreased from (157.2±43.0) mmHg preoperatively to (129.8±8.6) mmHg postoperatively.The SCr level decreased from (258.8±214.7) μmol/L to (176.3±101.1) μmol/L. Preoperative urea nitrogen decreased from (15.7±1.6) mmol/L to (10.6±1.1) mmol/L postoperatively (P<0.05). Mean postoperative follow-up time was 42.4 months (3-93 months).17 cases were cured, 1 case was ineffective, 1 case suffered restenosis after 30 days, and was given remedy PTA plus stenting. \u0000 \u0000 \u0000Conclusions \u0000TRAS is a vascular factor leading to grafted renal failure, the endovascular treatment of TRAS is safe, effective and has good mid-term result. \u0000 \u0000 \u0000Key words: \u0000Kidney transplantation; Renal artery obstruction; Angioplasty; Stent","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":"44861751","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 explore the safety and feasibility of robot splenectomy. Methods 65 patients undergoing robotic or laparoscopic splenectomy at No.940 Hospital of Chinese people′s Liberation Army Joint Service Support Force from Jan 2015 to Sep 2019 were analyzed retrospectively. Results The operation time and total hospitalization cost of robot spleen resection group and laparoscopic splenectomy group were[(167±34) min vs.(123±24) min, t=8.554, P=0.00]and (73 002±21 009) yuan vs. (42 095±9 999) yuan, (t=6.484, P=0.00), respectively. In laparoscopy group, 3 cases were converted to laparotomy. In the subgroup of splenic hilum thickness ≥5 cm, the intraoperative bleeding volume of robot group and laparoscopic group was (145±67) ml vs. (263±180) ml, (t=-2.195, P=0.04). There were significant differences in VAS score (3±1) vs. (4±1), (t=2.175, P=0.04). Conclusion Robotic splenectomy is safe and feasible. For patients with splenomegaly, robot surgery has more minimally invasive advantages than laparoscopy, but it is expensive and time-consuming. Key words: Splenectomy; Robotics; Laparoscopes
{"title":"Comparative study on safety and feasibility between robot splenectomy and laparoscopic splenectomy","authors":"Weikai Chen, Yanan Zhang, Jianping Yu, Wenwen Yu, Jing Wang, Hong-Bin Liu","doi":"10.3760/CMA.J.ISSN.1007-631X.2020.01.009","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1007-631X.2020.01.009","url":null,"abstract":"Objective \u0000To explore the safety and feasibility of robot splenectomy. \u0000 \u0000 \u0000Methods \u000065 patients undergoing robotic or laparoscopic splenectomy at No.940 Hospital of Chinese people′s Liberation Army Joint Service Support Force from Jan 2015 to Sep 2019 were analyzed retrospectively. \u0000 \u0000 \u0000Results \u0000The operation time and total hospitalization cost of robot spleen resection group and laparoscopic splenectomy group were[(167±34) min vs.(123±24) min, t=8.554, P=0.00]and (73 002±21 009) yuan vs. (42 095±9 999) yuan, (t=6.484, P=0.00), respectively. In laparoscopy group, 3 cases were converted to laparotomy. In the subgroup of splenic hilum thickness ≥5 cm, the intraoperative bleeding volume of robot group and laparoscopic group was (145±67) ml vs. (263±180) ml, (t=-2.195, P=0.04). There were significant differences in VAS score (3±1) vs. (4±1), (t=2.175, P=0.04). \u0000 \u0000 \u0000Conclusion \u0000Robotic splenectomy is safe and feasible. For patients with splenomegaly, robot surgery has more minimally invasive advantages than laparoscopy, but it is expensive and time-consuming. \u0000 \u0000 \u0000Key words: \u0000Splenectomy; Robotics; Laparoscopes","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":"44592539","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 : 2019-12-25DOI: 10.3760/CMA.J.ISSN.1007-631X.2019.12.003
Yafeng Chen, Xilin Du, Jianguo Lu, Jikai Yin, Dong Wang, L. Zang, R. Dong
Objective To evaluate the laparoscopic splenectomy and pericardial devascularization in patients with portal hypertension. Methods In this study, 205 patients who underwent splenectomy and pericardial devascularization in the Second Hospital of Air Force Medical University between Jan 2013 and Jan 2018 were divided into 135 patients undergoing laparoscopic surgery(LSD group) and 70 patients undergoing open surgery(OSD group). Results Operation time, intraoperative blood loss, intraoperative blood infusion, time of postoperative abdominal drainage-tube removal, time of gastrointestinal function recovery and duration of hospital stay were respectively (150±37)min, (223±129)ml, (91±138)ml, (4.0±1.0)d, (33±9)h, (5.6±1.0)d in the LSD group, (183±42)min, (346±131)ml, (214±182)ml, (5.5±1.3)d, (42±14)h, (7.5±1.4)d in the OSD group, with statistically significant differences between groups(t=-2.203, -4.980, -2.830, -5.553, -2.307, -6.635, all P<0.05). The main complications included pancreatic fistula, intra-abdominal bleeding, intra-abdominal infection, pulmonary infection, refractory ascites, portal vein system thrombosis and incision infection, and there were respectively 0, 1, 2, 2, 3, 13, 0 in the LSD group and 3, 4, 6, 6, 7, 14, 3 in the OSD group, with statistically significant differences between groups (χ2=5.872, 4.792, 6.179, 6.179, 6.010, 4.335, 5.872, all P<0.05). All the 205 patients received follow-up for a median time of 38 months(12-72 months). Gastroscopy showed improvement of esophageal and gastric varices in postoperative 6 months. Conclusion Laparoscopic splenectomy and pericardial devascularization for the treatment of portal hypertension is safe, feasible and effective. Key words: Hypertension, portal; Laparoscopy; Splenectomy
{"title":"Laparoscopic esophagogastric devascularization for portal hypertension","authors":"Yafeng Chen, Xilin Du, Jianguo Lu, Jikai Yin, Dong Wang, L. Zang, R. Dong","doi":"10.3760/CMA.J.ISSN.1007-631X.2019.12.003","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1007-631X.2019.12.003","url":null,"abstract":"Objective \u0000To evaluate the laparoscopic splenectomy and pericardial devascularization in patients with portal hypertension. \u0000 \u0000 \u0000Methods \u0000In this study, 205 patients who underwent splenectomy and pericardial devascularization in the Second Hospital of Air Force Medical University between Jan 2013 and Jan 2018 were divided into 135 patients undergoing laparoscopic surgery(LSD group) and 70 patients undergoing open surgery(OSD group). \u0000 \u0000 \u0000Results \u0000Operation time, intraoperative blood loss, intraoperative blood infusion, time of postoperative abdominal drainage-tube removal, time of gastrointestinal function recovery and duration of hospital stay were respectively (150±37)min, (223±129)ml, (91±138)ml, (4.0±1.0)d, (33±9)h, (5.6±1.0)d in the LSD group, (183±42)min, (346±131)ml, (214±182)ml, (5.5±1.3)d, (42±14)h, (7.5±1.4)d in the OSD group, with statistically significant differences between groups(t=-2.203, -4.980, -2.830, -5.553, -2.307, -6.635, all P<0.05). The main complications included pancreatic fistula, intra-abdominal bleeding, intra-abdominal infection, pulmonary infection, refractory ascites, portal vein system thrombosis and incision infection, and there were respectively 0, 1, 2, 2, 3, 13, 0 in the LSD group and 3, 4, 6, 6, 7, 14, 3 in the OSD group, with statistically significant differences between groups (χ2=5.872, 4.792, 6.179, 6.179, 6.010, 4.335, 5.872, all P<0.05). All the 205 patients received follow-up for a median time of 38 months(12-72 months). Gastroscopy showed improvement of esophageal and gastric varices in postoperative 6 months. \u0000 \u0000 \u0000Conclusion \u0000Laparoscopic splenectomy and pericardial devascularization for the treatment of portal hypertension is safe, feasible and effective. \u0000 \u0000 \u0000Key words: \u0000Hypertension, portal; Laparoscopy; Splenectomy","PeriodicalId":66425,"journal":{"name":"中华普通外科杂志","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2019-12-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45492729","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 : 2019-12-25DOI: 10.3760/CMA.J.ISSN.1007-631X.2019.12.011
Guotai Wang, Xingwu Yang, Qi Wang, Xin Wang, Ning Li
Objective To compare the clinical efficacy of one-stage laparoscopic cholecystectomy (LC) plus laparoscopic common bile duct exploration (LCBDE) with primary suture (PS) and two-staged endoscopic retrograde cholangiopancreatography (ERCP)/endoscopic sphincterotomy (EST) followed by LC in treatment of cholecystolithiasis complicated with choledocholithiasis. Methods Of these patients, 58 received one-staged LC+ LCBDE+ PS (the one-stage group), and 71 underwent two-staged ERCP/EST followed by LC (the two-stage group). Results The surgical success rate, residual stone rate, incidence of postoperative complications and operative time showed no significant difference (χ2=0.344, 0.344, 0.108, t=-0.240, all P>0.05) in both the one-staged and two-stage groups. Compared with the two-staged group, the hospital stay was shorter (4.1d vs. 6.9d) and the total hospitalization cost was lower (23 126 yuan vs. 32 982 yuan) in the one-staged group. Conclusion Both one-staged LC+ LCBDE+ PS and two-staged ERCP/EST+ LC are safe and effective in the treatment of cholecystolithiasis complicated with choledocholithiasis on base for base basis. Key words: Cholecystolithiasis; Choledocholithiasis; Cholecystectomy, Laparoscopic
{"title":"One-staged and two-staged minimally invasive surgical procedures in the treatment of cholecystolithiasis complicated with choledocholithiasis","authors":"Guotai Wang, Xingwu Yang, Qi Wang, Xin Wang, Ning Li","doi":"10.3760/CMA.J.ISSN.1007-631X.2019.12.011","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1007-631X.2019.12.011","url":null,"abstract":"Objective \u0000To compare the clinical efficacy of one-stage laparoscopic cholecystectomy (LC) plus laparoscopic common bile duct exploration (LCBDE) with primary suture (PS) and two-staged endoscopic retrograde cholangiopancreatography (ERCP)/endoscopic sphincterotomy (EST) followed by LC in treatment of cholecystolithiasis complicated with choledocholithiasis. \u0000 \u0000 \u0000Methods \u0000Of these patients, 58 received one-staged LC+ LCBDE+ PS (the one-stage group), and 71 underwent two-staged ERCP/EST followed by LC (the two-stage group). \u0000 \u0000 \u0000Results \u0000The surgical success rate, residual stone rate, incidence of postoperative complications and operative time showed no significant difference (χ2=0.344, 0.344, 0.108, t=-0.240, all P>0.05) in both the one-staged and two-stage groups. Compared with the two-staged group, the hospital stay was shorter (4.1d vs. 6.9d) and the total hospitalization cost was lower (23 126 yuan vs. 32 982 yuan) in the one-staged group. \u0000 \u0000 \u0000Conclusion \u0000Both one-staged LC+ LCBDE+ PS and two-staged ERCP/EST+ LC are safe and effective in the treatment of cholecystolithiasis complicated with choledocholithiasis on base for base basis. \u0000 \u0000 \u0000Key words: \u0000Cholecystolithiasis; Choledocholithiasis; Cholecystectomy, Laparoscopic","PeriodicalId":66425,"journal":{"name":"中华普通外科杂志","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2019-12-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46124211","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 : 2019-12-25DOI: 10.3760/CMA.J.ISSN.1007-631X.2019.12.001
Zhedong Zhang, Dafang Zhang, Wenyong Xie, Weihua Zhu, Jiye Zhu, X. Leng, Shu Li
Objective To investigate the clinical efficacy and prognostic factors for combined caudate lobectomy radical resection plus broad lymph node dissection in patients of hilar cholangiocarcinoma. Methods The clinical data and follow-up results of patients with hilar cholangiocarcinoma surgically treated from Feb 2008 to Feb 2017 were retrospectively analyzed. Result The R0 resection rate[72.2%(13/18)vs 43.9%(18/41)], operation time[(433±136)min vs(302±122)min], intraoperative blood loss [(1 789±1 091)ml vs(776±755)ml]and postoperative complication rate[66.7%(12/18)vs 36.6%(15/41)]were significantly higher in the hepatic lobe combined with caudate lobe resection group than that without caudate lobe resection group (P 1 000 U/ml, the degree of microscopic margin and tumor TNM stage were significantly correlated with the prognosis of the patients (P<0.05). Conclusion Combined with caudate lobe resection can improve R0 resection rate. Targeted lymph node dissection helps prolong survival. The degree of microscopic margin, preoperative CA199 and TNM staging are independent risk factors for the prognosis of patients with hilar cholangiocarcinoma. Key words: Bile duct neoplasms; Lymph node excision; Comparative effectiveness research
{"title":"Combined caudate lobectomy radical resection and lymph node dissection for hilar cholangiocarcinoma","authors":"Zhedong Zhang, Dafang Zhang, Wenyong Xie, Weihua Zhu, Jiye Zhu, X. Leng, Shu Li","doi":"10.3760/CMA.J.ISSN.1007-631X.2019.12.001","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1007-631X.2019.12.001","url":null,"abstract":"Objective \u0000To investigate the clinical efficacy and prognostic factors for combined caudate lobectomy radical resection plus broad lymph node dissection in patients of hilar cholangiocarcinoma. \u0000 \u0000 \u0000Methods \u0000The clinical data and follow-up results of patients with hilar cholangiocarcinoma surgically treated from Feb 2008 to Feb 2017 were retrospectively analyzed. \u0000 \u0000 \u0000Result \u0000The R0 resection rate[72.2%(13/18)vs 43.9%(18/41)], operation time[(433±136)min vs(302±122)min], intraoperative blood loss [(1 789±1 091)ml vs(776±755)ml]and postoperative complication rate[66.7%(12/18)vs 36.6%(15/41)]were significantly higher in the hepatic lobe combined with caudate lobe resection group than that without caudate lobe resection group (P 1 000 U/ml, the degree of microscopic margin and tumor TNM stage were significantly correlated with the prognosis of the patients (P<0.05). \u0000 \u0000 \u0000Conclusion \u0000Combined with caudate lobe resection can improve R0 resection rate. Targeted lymph node dissection helps prolong survival. The degree of microscopic margin, preoperative CA199 and TNM staging are independent risk factors for the prognosis of patients with hilar cholangiocarcinoma. \u0000 \u0000 \u0000Key words: \u0000Bile duct neoplasms; Lymph node excision; Comparative effectiveness research","PeriodicalId":66425,"journal":{"name":"中华普通外科杂志","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2019-12-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46646442","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 : 2019-12-25DOI: 10.3760/CMA.J.ISSN.1007-631X.2019.12.010
W. Su, Yuguang Sun, S. Xia, W. Shen
Objective To investigate the clinical value of lymphangiography in the diagnosis and treatment of cervical chylous fistula. Methods The clinical data of 7 patients with chylous fistula at Department of Lymph Surgery, Capital Medical University Affiliated Beijing Shijitan Hospital from Jul 2010 to Aug 2015 was retrospectively analyzed. Lymphangiography was performed to investigate the site of fistula and condition of thoracic duct. Results There were 1 male and 6 female patients aging from 22 to 59 years.All patients underwent lymphangiography successfully with dynamic imaging clearly, which accurately showed the location of the leakage and the anatomy of the thoracic duct. There was compensatory branch or trunk drainage in 2 cases which underwent successful conservative treatment, the other 5 cases with leak>500 ml a day without clear compensatory branch underwent surgical treatment and were cured with no major complications. Conclusion Lymphangiography not only clearly locates the leakage and anatomical relationship of the thoracic duct, but also guides the choice of treatment and precise surgery, avoiding the secondary injury. Key words: Lymphography; Thoracic duct; Chylous fistula
{"title":"Treatment of cervical chylous fistula under the guidance of lymphangiography","authors":"W. Su, Yuguang Sun, S. Xia, W. Shen","doi":"10.3760/CMA.J.ISSN.1007-631X.2019.12.010","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1007-631X.2019.12.010","url":null,"abstract":"Objective \u0000To investigate the clinical value of lymphangiography in the diagnosis and treatment of cervical chylous fistula. \u0000 \u0000 \u0000Methods \u0000The clinical data of 7 patients with chylous fistula at Department of Lymph Surgery, Capital Medical University Affiliated Beijing Shijitan Hospital from Jul 2010 to Aug 2015 was retrospectively analyzed. Lymphangiography was performed to investigate the site of fistula and condition of thoracic duct. \u0000 \u0000 \u0000Results \u0000There were 1 male and 6 female patients aging from 22 to 59 years.All patients underwent lymphangiography successfully with dynamic imaging clearly, which accurately showed the location of the leakage and the anatomy of the thoracic duct. There was compensatory branch or trunk drainage in 2 cases which underwent successful conservative treatment, the other 5 cases with leak>500 ml a day without clear compensatory branch underwent surgical treatment and were cured with no major complications. \u0000 \u0000 \u0000Conclusion \u0000Lymphangiography not only clearly locates the leakage and anatomical relationship of the thoracic duct, but also guides the choice of treatment and precise surgery, avoiding the secondary injury. \u0000 \u0000 \u0000Key words: \u0000Lymphography; Thoracic duct; Chylous fistula","PeriodicalId":66425,"journal":{"name":"中华普通外科杂志","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2019-12-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44412358","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 : 2019-12-25DOI: 10.3760/CMA.J.ISSN.1007-631X.2019.12.009
He Huang, Qiyu Chen, Lei Zhou, Zhichao Yao, Yigeng Wang, Zhong-lin Ni
Objective To evaluate the efficacy and safety of XELOX regimen combined with hepatic artery chemoembolization in the treatment of gastric cancer with liver metastasis. Methods 50 cases of gastric cancer with liver metastasis were randomly divided into two groups, the experimental group (25 cases) received chemotherapy regimen of XELOX first: Xeloda tablets 1 000 mg/m2, orally, twice a day, days1-14; Oxaliplatin 130 mg/m2, intravenous drip, day 1. Hepatic artery chemoembolization was performed one a week later, and a cycle consists of 4 weeks. The control group (25 cases) received chemotherapy regimen of XELOX, 3 weeks as a cycle. All patients were evaluated for efficacy and toxicity every 2 cycles. Results In the experimental group, the overall response rate was 56%, the tumor control rate was 80%, the increase rate of Karnofsky was 60%, and 10 patients got chance of tumor resection. In the control group, the overall response rate was 32%, the tumor control rate was 52%, the increase rate of Karnofsky was 48%, and 6 patients got chance of operation. The overall response rate, tumor control rate, surgical treatment rate and the increase rate of Karnofsky in the experimental group were significantly different from those in the control group (P<0.05). The median total survival time was 12.5 months in the experimental group and 10.5 months in the control group (P<0.05). There was no significant difference in toxicity and side effects between the two groups. Conclusion XELOX regimen combined with hepatic artery chemoembolization is effective and safe in the treatment of gastric cancer with liver metastasis. Key words: Stomach neoplasms; Embolization, therapeutic; Neoplasm metastasis; Combined chemotherapy regimen
{"title":"Efficacy and safety of XELOX regimen combined with transcatheter arterial chemoembolization in the treatment of gastric cancer with liver metastasis","authors":"He Huang, Qiyu Chen, Lei Zhou, Zhichao Yao, Yigeng Wang, Zhong-lin Ni","doi":"10.3760/CMA.J.ISSN.1007-631X.2019.12.009","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1007-631X.2019.12.009","url":null,"abstract":"Objective \u0000To evaluate the efficacy and safety of XELOX regimen combined with hepatic artery chemoembolization in the treatment of gastric cancer with liver metastasis. \u0000 \u0000 \u0000Methods \u000050 cases of gastric cancer with liver metastasis were randomly divided into two groups, the experimental group (25 cases) received chemotherapy regimen of XELOX first: Xeloda tablets 1 000 mg/m2, orally, twice a day, days1-14; Oxaliplatin 130 mg/m2, intravenous drip, day 1. Hepatic artery chemoembolization was performed one a week later, and a cycle consists of 4 weeks. The control group (25 cases) received chemotherapy regimen of XELOX, 3 weeks as a cycle. All patients were evaluated for efficacy and toxicity every 2 cycles. \u0000 \u0000 \u0000Results \u0000In the experimental group, the overall response rate was 56%, the tumor control rate was 80%, the increase rate of Karnofsky was 60%, and 10 patients got chance of tumor resection. In the control group, the overall response rate was 32%, the tumor control rate was 52%, the increase rate of Karnofsky was 48%, and 6 patients got chance of operation. The overall response rate, tumor control rate, surgical treatment rate and the increase rate of Karnofsky in the experimental group were significantly different from those in the control group (P<0.05). The median total survival time was 12.5 months in the experimental group and 10.5 months in the control group (P<0.05). There was no significant difference in toxicity and side effects between the two groups. \u0000 \u0000 \u0000Conclusion \u0000XELOX regimen combined with hepatic artery chemoembolization is effective and safe in the treatment of gastric cancer with liver metastasis. \u0000 \u0000 \u0000Key words: \u0000Stomach neoplasms; Embolization, therapeutic; Neoplasm metastasis; Combined chemotherapy regimen","PeriodicalId":66425,"journal":{"name":"中华普通外科杂志","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2019-12-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49659158","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 : 2019-12-25DOI: 10.3760/CMA.J.ISSN.1007-631X.2019.12.004
Hui Zhang, S. Lyu, B. Pan, Xing‐mao Zhang, Xin Zhao, R. Lang, H. Fan, Qiang He
Objective To analyze the application and effect of non-penetrating vascular and tubular tissue closure system in radical resection of adenocarcinoma of pancreatic head combined with venous resection and reconstruction. Methods A retrospective analysis was made on the clinical data of 78 patients with pancreatic head cancer who underwent radical resection of venous vessels from Feb 2014 to Feb 2018. According to the intraoperative venous resection and anastomosis, the patients were divided into vascular clip group (41 cases) and traditional suture group (37 cases). The preoperative data, intraoperative and postoperative recovery of the two groups were analyzed and compared. Results There were no perioperative deaths and no significant differences in perioperative complications between the two groups(P>0.05). The anastomotic time of the clip group was (18.6±3.3) min, which was significantly shorter than that of the traditional suture group (39.7±8.5) min, (P 0.05). Conclusion It is safe and feasible to use vascular clip in venous vascular reconstruction in radical resection of carcinoma of the head of the pancreas combined with venous vascular resection. Key words: Pancreaticoduodenectomy; Vascular surgical procedures; Complications
{"title":"Non-penetrating vascular and tubular tissue closure system in radical resection of adenocarcinoma of pancreatic head combined with major venous resection and reconstruction","authors":"Hui Zhang, S. Lyu, B. Pan, Xing‐mao Zhang, Xin Zhao, R. Lang, H. Fan, Qiang He","doi":"10.3760/CMA.J.ISSN.1007-631X.2019.12.004","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1007-631X.2019.12.004","url":null,"abstract":"Objective \u0000To analyze the application and effect of non-penetrating vascular and tubular tissue closure system in radical resection of adenocarcinoma of pancreatic head combined with venous resection and reconstruction. \u0000 \u0000 \u0000Methods \u0000A retrospective analysis was made on the clinical data of 78 patients with pancreatic head cancer who underwent radical resection of venous vessels from Feb 2014 to Feb 2018. According to the intraoperative venous resection and anastomosis, the patients were divided into vascular clip group (41 cases) and traditional suture group (37 cases). The preoperative data, intraoperative and postoperative recovery of the two groups were analyzed and compared. \u0000 \u0000 \u0000Results \u0000There were no perioperative deaths and no significant differences in perioperative complications between the two groups(P>0.05). The anastomotic time of the clip group was (18.6±3.3) min, which was significantly shorter than that of the traditional suture group (39.7±8.5) min, (P 0.05). \u0000 \u0000 \u0000Conclusion \u0000It is safe and feasible to use vascular clip in venous vascular reconstruction in radical resection of carcinoma of the head of the pancreas combined with venous vascular resection. \u0000 \u0000 \u0000Key words: \u0000Pancreaticoduodenectomy; Vascular surgical procedures; Complications","PeriodicalId":66425,"journal":{"name":"中华普通外科杂志","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2019-12-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45793598","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 evaluate the role of tumor budding in the prognostic value of intrahepatic cholangiocarcinoma(ICC) after radical resection. Methods The clinicopathological data of patients undergoing radical resection for intrahepatic cholangiocarcinoma between 2011 and 2016 were retrospectively analyzed. The number of tumor budding was counted in a ×200 microscopic field (0.785mm2). Based on receiver operation curve (ROC), the number of tumor budding≥15 was defined as high-grade group, and<15 was low-grade group. Multivariate analysis were performed on predictors of the tumor. Results Low-grade group was observed in 32 cases and high-grade group in 50. High-grade group appeared to develop tumors with higher CA199, poor differentiation, larger tumor diameter, advanced stage and high risks of lymphnode metastasis(respectively χ2=5.470, 4.359, 5.101, 4.696, 5.960, all P<0.05). Univariate analysis showed that tumor budding, CA199, differentiation, tumor diameter, T classification and lymphnode metastasis were related to the overall survival of patients with ICC(respectively χ2=11.704, 4.876, 5.056, 5.152, 8.442, 16.725, all P<0.05). On multivariable analysis, high-grade group was a significant independent predictor of worse OS(HR=2.707 95% CI 1.558-4.705, P<0.001). Conclusions High-grade tumor budding is an important negative prognostic factor for ICC. Key words: Bile duct neoplasms; Prognosis
{"title":"The prognostic value of tumor budding in intrahepatic cholangiocarcinoma","authors":"Xiaopei Hao, Zeyuan Qiang, Kunfu Dai, Shuai Ma, Yuting He, L. Tao, Zhen Li, Mei-rong Xu, Haibo Yu","doi":"10.3760/CMA.J.ISSN.1007-631X.2019.12.012","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1007-631X.2019.12.012","url":null,"abstract":"Objective \u0000To evaluate the role of tumor budding in the prognostic value of intrahepatic cholangiocarcinoma(ICC) after radical resection. \u0000 \u0000 \u0000Methods \u0000The clinicopathological data of patients undergoing radical resection for intrahepatic cholangiocarcinoma between 2011 and 2016 were retrospectively analyzed. The number of tumor budding was counted in a ×200 microscopic field (0.785mm2). Based on receiver operation curve (ROC), the number of tumor budding≥15 was defined as high-grade group, and<15 was low-grade group. Multivariate analysis were performed on predictors of the tumor. \u0000 \u0000 \u0000Results \u0000Low-grade group was observed in 32 cases and high-grade group in 50. High-grade group appeared to develop tumors with higher CA199, poor differentiation, larger tumor diameter, advanced stage and high risks of lymphnode metastasis(respectively χ2=5.470, 4.359, 5.101, 4.696, 5.960, all P<0.05). Univariate analysis showed that tumor budding, CA199, differentiation, tumor diameter, T classification and lymphnode metastasis were related to the overall survival of patients with ICC(respectively χ2=11.704, 4.876, 5.056, 5.152, 8.442, 16.725, all P<0.05). On multivariable analysis, high-grade group was a significant independent predictor of worse OS(HR=2.707 95% CI 1.558-4.705, P<0.001). \u0000 \u0000 \u0000Conclusions \u0000High-grade tumor budding is an important negative prognostic factor for ICC. \u0000 \u0000 \u0000Key words: \u0000Bile duct neoplasms; Prognosis","PeriodicalId":66425,"journal":{"name":"中华普通外科杂志","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2019-12-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48580807","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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