OBJECTIVETo assess the advantage and disadvantage of laparoscopic abdomino-perineal resection and open abdominoperineal resection for low rectal cancer.

METHODSPatients with low rectal cancer, collected from July 2003 to April 2006, were randomly divided into laparoscopic abdominoperineal resection group (37 cases) and open abdominoperineal resection group (37 cases). Operation time, number of lymph node removed, intra-operative blood loss, time to pass flatus, time to ambulate, time to discharge, complications, early recurrence, and economical cost were compared between the 2 groups.

RESULTSAll patients were performed successfully. For the first 10 patients, operation time of laparoscopic group was significantly longer than that of open group, but there was no significant difference between the 2 groups. Intra-operative blood loss of laparoscopic group was significantly less than that of open group, but it was reverse for the first 10 patients. There was no significant difference in time to pass flatus between the 2 groups. Time to ambulate in laparoscopic group was significantly earlier than that in open group. There was no significant difference in time to discharge between the 2 groups, but it was earlier for perineum closure in laparoscopic group. Relative complications of laparoscopic group, including pulmonary infection, abdominal wound infection or split, were significantly less than those of open group. There was no significant difference in number of lymph nodes removed, early recurrence between the 2 groups. Operation cost of laparoscopic group was significantly higher than that of open group, but there was no significant difference.

CONCLUSIONAdvantages of laparoscopic abdominoperineal resection were characterized for not only minimal invasion and good cosmetic outcome but also less blood loss, complications, and earlier postoperative recovery. The operation time, total costs and oncological clearance of laparoscopic abdominoperineal resection patients were comparable with those of open procedure patients.

Abdomen ; surgery ; Aged ; Female ; Humans ; Laparoscopy ; Male ; Middle Aged ; Perineum ; surgery ; Rectal Neoplasms ; pathology ; surgery ; Rectum ; pathology ; surgery ; Treatment Outcome

Abdomen, Acute ; diagnosis ; Adult ; Female ; Humans ; Laparoscopy ; methods ; Omentum ; pathology ; surgery ; Torsion Abnormality ; diagnosis ; surgery

The application of pelviscopic surgery for the management of ovarian tumors has increased dramatically in the last few years. Of particular concern is the pelviscopic excision of malignant ovarian tumors. One of the important potential problems with this approach is disseminating malignant cells to peritoneal surface. The aim of this report is to draw attention to the possibility of the occurrence of a tumor implantation at the pelviscopic port site in patients with malignant ovarian tumors. A case is presented here in which a localized tumor implant occurred in the abdominal trocar site after pelviscopic removal of ovarian mass subsequently found to be squamous cell carcinoma arising in mature cystic teratoma with brief review of literatures.
Abdomen ; Adult ; Carcinoma, Squamous Cell/*pathology/surgery ; Case Report ; Female ; Human ; *Neoplasms, Second Primary ; Ovarian Neoplasms/*pathology/surgery ; Pelvis

Esophageal duplication cysts are congenital anomalies of the foregut that are rarely found in the abdomen. An accurate preoperative diagnosis is not always possible, so the definitive diagnosis can be made by histologic examination of the surgical specimen. We experienced a case of Intra-abdominal esophageal duplication cyst in a 52-year-old female, who initially presented with an esophageal submucosal tumor on upper gastrointestinal endoscopy. She did not have any gastrointestinal symptoms. Barium esophagography, chest computed tomography scan and endoscopic ultrasonography demonstrated the cystic lesion in the intra-abdominal esophagus. Transhiatal enucleation of the lesion was performed successfully via the abdominal approach with no postoperative complications. Histologic study showed that the cyst wall contained a two-layered muscle coat and the surface of the lumen was lined by pseudo-ciliated columnar epithelium. The patient has been doing well without any complaints for 3 months of follow-up period.
Tomography, X-Ray Computed ; Radiography, Abdominal ; Middle Aged ; Humans ; Female ; Esophageal Cyst/*diagnosis/pathology/*surgery ; *Abdomen

OBJECTIVETo summarize the clinical management of abdominal compartment syndrome (ACS) in burn patients with severe burn injury.

METHODSTwelve serious burn patients with abdominal compartment syndrome hospitalized in our center from January 2001 to April 2005 were enrolled in the study. Among them 3 patients were treated with conservative method, 4 with escharectomy of abdominal wall, 5 with laparotomy for decompression. The clinical results were analyzed statistically. Bladder pressure, central venous pressure, systolic blood pressure and arterial blood oxygen partial pressure (PaO2 ) were measured and compared before and after operation.

RESULTSAmong these 12 patients, 5 died with the overall mortality of 41.67%. But only 3 died among 9 patients undergone operation. Most of patients were oliguric,with abnormal bladder pressure, central venous pressure, and systolic blood pressure 24 hours before operation. But these parameters were significantly improved after operation ( P <0. 01).

CONCLUSIONEarly abdominal escharectomy and timely abdominal decompression are vital for the management of ACS in burn patients.

Abdomen ; pathology ; Adult ; Aged ; Burns ; complications ; therapy ; Compartment Syndromes ; etiology ; surgery ; Female ; Humans ; Male ; Middle Aged

No abstract available.
Abdomen/pathology/surgery ; Adult ; Endometrial Neoplasms/complications/*pathology/radiography/surgery ; Endometriosis/complications/*pathology/radiography/surgery ; Female ; Humans ; Image Enhancement/*methods ; Imaging, Three-Dimensional/*methods ; Pelvis/pathology/radiography/surgery ; Radiography, Abdominal ; Sarcoma, Endometrial Stromal/complications/*pathology/radiography/surgery ; *Software ; Specimen Handling

Abdomen ; pathology ; surgery ; Anemia ; complications ; Castleman Disease ; complications ; diagnosis ; Child ; Humans ; Lymph Nodes ; pathology ; Male ; Treatment Outcome

Abdomen ; physiopathology ; Biomarkers ; Female ; Humans ; Immunoglobulin E ; blood ; Mesothelioma ; diagnosis ; pathology ; Middle Aged ; Outcome Assessment (Health Care) ; Peritoneal Neoplasms ; diagnosis ; pathology ; surgery ; Pruritus ; physiopathology ; surgery ; Radiography, Abdominal

Congenital cysts of the gallbladder are extremely rare, hence only a few ciliated foregut cysts of gallbladder have been reported. We report a case of a 20-year-old woman presenting with mild right upper quadrant abdominal discomfort, with normal levels of serum bilirubin and liver function tests. Abdominal ultrasonography revealed a well-defined cystic mass measured about 2 cm attached to the neck of gallbladder, with internal echogenic debris suggesting a complicated cyst, such as a hemorrhagic cyst. Abdominal computed tomography and magnetic resonance cholangiopancreatography revealed similar findings. Laparoscopic cholecystectomy showed a slightly distended gallbladder. The size of cyst on the neck was 1.6x1.2 cm, and it contained mucosa lined by ciliated pseudostratified columnar epithelium and underlying smooth muscle layers. Histopathology identified a ciliated foregut cyst of gallbladder.
Abdomen/diagnostic imaging ; Cholangiopancreatography, Magnetic Resonance ; Cholecystectomy, Laparoscopic ; Cysts/diagnostic imaging/pathology/surgery ; Female ; Gallbladder/pathology/surgery ; Gallbladder Diseases/*diagnosis ; Humans ; Tomography, X-Ray Computed ; Ultrasonography ; Young Adult

BACKGROUND AND OBJECTIVETransthoracic and transabdominal approaches are commonly used for the surgical treatment of adenocarcinoma of the cardia. Which approach is better has been controversial for quite a long time. Our study aimed to compare the surgical trauma, range of lymph node dissection, and the prognosis of the transthoracic and transabdominal approaches for the treatment of adenocarcinoma of the cardia.

METHODSThe medical records of 331 patients with adenocarcinoma of the cardia treated in our hospital between 1994 and 2003 were analyzed. Of the 331 patients, 284 underwent operation via transthoracic approach and 47 via transabdominal approach. Surgery-related status, postoperative complications, range of removed lymph nodes and prognosis of the two groups were compared.

RESULTSThere was no significant difference in surgery-related status and postoperative complications between the two groups (P >0.05). The mean number of removed lymph nodes from the thoracic cavity was much higher in transthoracic group than in transabdominal group (P < 0.001), while that from the abdominal cavity was similar in both groups (P = 0.404). The thoracic lymph node metastasis rate was 18.8% in transthoracic group and 13.3% in transabdominal group. The median survival time was 29 months in transthoracic group and 28 months in transabdominal group, and the 5-year survival rates were 34.9% and 40.1% (P= 0.599).

CONCLUSIONSFor the surgical treatment of adenocarcinoma of the cardia, the surgical trauma of the transthoracic approach is similar with that of transabdominal approach. The transthoracic approach has the advantage in thoracic lymph node dissection. The two approaches have no obvious effect on the prognosis.

Abdomen ; surgery ; Adenocarcinoma ; pathology ; surgery ; Blood Loss, Surgical ; Cardia ; pathology ; surgery ; Female ; Gastrectomy ; methods ; Humans ; Length of Stay ; Lymph Node Excision ; Lymphatic Metastasis ; Male ; Middle Aged ; Postoperative Complications ; Stomach Neoplasms ; pathology ; surgery ; Survival Rate ; Thoracotomy