Objective To explore the influence of modified Lawrence's reconstuction procedures following total gastrectomy for gastric cancer to alimentation of patients. Methods Retrospective analysis of nutritional status and symptoms of digestive tract in 76 patiens of total gastrectomy for gastric cancer while 3 and 6 month after modified Lawrence's reconstuction procedure. Results Examination was given in 48 patients 3 month after operation. Emptying time of barium was 60-100 min, barium meal backflowing to esophagus was not observed in all patients when they were in erect or decubitus position, no sign of narrow of anastomotic stoma. The hemoglobin, total protein, body weight and food-intake of patients 3 or 6 months after operation was as same as them before operation. Conclusion The patients undergoing this reconstuction procedure will recover normal food habits soon after operation, Lawrence's reconstuction procedures is a satisfactory choice in patients of total gastrectomy for gastric cancer because of its safety and convenient.

Objective To summarize surgical experience for the treatment of substernal goiter.Methods 102 cases of substernal goiter underwent surgical resection,in 74 by low collar incision,12 cases by larger low collar incision and pillowing the shoulder pad about 20 degrees for neck hyperextension,8 cases by unilateral or bilateral infrahyoid muscles transection,8 cases by low collar and up-mid-sternal incision plus horizontal sawing in 2 and 3 ribs.Results Resection was performed successfully in all cases.Hoarseness occurred in 7 cases,4 cases recovered after one month,3 cases did not improve because of tumor invasion of laryngeal recurrent nerve.Postoperative transient hypocalcemia in 9 cases recovered after 2 to 3 months.102 patients were followed up for 1 to 3 years without recurrence.Conclusions Substernal goiter can be resected successfully through a transcervical approach or mid-sternal incision.CT scanning and chest X radiograph are decisive for the surgical approach.