Serous cystadenoma of the pancreas is a rare disease and is usually benign. Mucinous cystadenoma, another cystic neoplasm of the pancreas, has a malignant potential. Serous cystadenoma is usually composed of many small cysts lined by small, cuboidal or flattened cells containing abundant glycogen. With the finding of endoscopic retrograde pancreatography, a communication between the cyst and pancreatic duct is observed occasionally in the mucinous cystadenoma, but rarely in the case of serous cystadenoma of the pancreas. We experienced a case of serous cystadenoma of the pancreas that had a communication between a cyst and the pancreatic duct.
Adult ; Cystadenoma, Serous/*complications ; Digestive System Fistula/*complications ; Female ; Humans ; Pancreatic Diseases/complications ; *Pancreatic Ducts ; Pancreatic Neoplasms/*complications

Surgery is a definite treatment for rectal cancer by resecting the tumor. Surgeon not only aims to cure the patient but aims to relieve distressing symptoms as well. Unfortunately, patients may suffer adverse consequences from such surgery. The operative dissection of the rectum may damage the pelvic autonomic nerves disturbing bladder and sexual function. The construction of a permanent colostomy following an abdominoperineal resection may be associated with one or more physical problems as well as clinically significant psychosocial problems as well. The advances in knowledge of tumor biology and the improvements of surgical techniques and devices result in an increasing number of sphincter saving procedures such as low anterior resection. Although avoiding permanent stoma is generally regarded as a favorable outcome measure, patients undergoing sphincter-saving surgery may develop a number of unpleasant symptoms, typically fecal soiling and urgency, especially with low anastomosis. It is evident that the consequences of rectal surgery have an important bearing on quality of life. Although differences in definition exist, quality of life may be regarded as representing an individual's ability to carry out daily activities, as well as satisfaction with personal performance and with balance between disease control and adverse effects of treatment. In addition to traditional endpoints, such as survival and disease recurrences, assessing quality of life is necessary to provide a proper, comprehensive understanding of the outcome of surgery and other forms of treatment.
Digestive System Surgical Procedures/adverse effects ; Humans ; Postoperative Complications ; *Quality of Life ; Rectal Neoplasms/*surgery

The postoperative 30-day mortality and morbidity of gastric cancer surgery has markedly improved over the past years due to minimally invasive techniques, perioperative rehabilitation programs and centralization of care. However, there is still need for improvement as postoperative complications may have a serious negative impact on the efficacy of surgical treatment of gastric cancer. High-quality clinical research is a very important tool to analyze treatment outcomes and evaluate new treatment strategies. The meticulous registration of gastric cancer patient data is the basis of high-quality surgical research. In the past 11 years, the Dutch upper gastrointestinal cancer audit (DUCA) database has vast experience in data registration and maintenance of patients with upper gastrointestinal cancer. The effective measures it has taken in data registration, data quality control, data application and use, and data security have maintained quality at a high level. These data has been used for medical care quality monitoring and scientific research leading to a positive impact on the postoperative short-term outcomes of patients with upper gastrointestinal cancer. The work of DUCA may be a good incentive for the setup of population-based databases and clinical research in other countries.
Humans ; Stomach Neoplasms/surgery* ; Digestive System Surgical Procedures ; Treatment Outcome ; Postoperative Complications

Fast track surgery is referred as the integration of different medical intervention actively during peri-operative period to accelerate the rehabilitation of patients undergoing operation. The propose of fast track surgery has brought about great changes in the treatment mode of many diseases, and the concept has been used in a variety of operations, especially the gastrointestinal surgery. Fast track surgery covers the preoperative appropriate preparation and assessment, sophisticated operative manipulation, and the standardization of postoperative treatment and nursing care. According to clinical trials, fast track surgery is associated with reduced post-operative complications, hospital stay and cost in patients with gastric cancer undergoing surgery. However, some problems exist in the application of fast track surgery in clinical practice, including the multidisciplinary coordination and higher readmission rates etc. A large number of evidence-based clinical trials have confirmed the efficacy of fast track, so we believe that the fast track surgery will be applied more widely.
Digestive System Surgical Procedures ; Humans ; Length of Stay ; Postoperative Complications ; Postoperative Period ; Stomach Neoplasms

Gastrointestinal cancers include gastric cancer, small intestinal cancer and colorectal cancer. In China, the majority of hospitals at central cities even at county hospitals are providing surgical intervention for patients with gastrointestinal cancer. However, the complications after gastrointestinal cancer surgery pose significant burden to the patients and their relatives because of increased hospital cost and law suit. Acute bleeding, obstruction, anastomotic leakage are major complications after gastrointestinal surgery. Therefore it is important to deal with complications after gastrointestinal surgery.
Digestive System Surgical Procedures ; adverse effects ; Gastrointestinal Neoplasms ; surgery ; Humans ; Postoperative Complications ; prevention & control ; therapy

Conformal sphincter-preservation operation (CSPO) is considered the effective surgical technique for preserving the sphincter in cases of low rectal cancer. Accurate preoperative diagnosis and staging, reasonable selection of surgical approaches and technique, standardized perioperative management, and postoperative rehabilitation are the keys to ensuring the oncological clearance and functional preservation of CSPO. However, there is currently a lack of standardized surgical procedure for implementing CSPO in China. Therefore, the Colorectal Surgery Group of Surgery Branch of the Chinese Medical Association,along with the Colorectal Cancer Committee of the Chinese Medical Doctor Association and the Anorectal Branch of Chinese Medical Doctor Association, gathered experts in colorectal surgery to discuss and establish this standardized surgical procedure of CSPO. This standard, based on the latest evidence from literature, expert experiences, and China national condition, focuses on the definition, classification, pelvic anatomy, surgical techniques, postoperative complications, and perioperative care of CSPO. It aims to guide the standardized clinical practice of CSPO in China.
Humans ; Anal Canal/surgery* ; Rectal Neoplasms/surgery* ; Digestive System Surgical Procedures/methods* ; Pelvis ; Postoperative Complications

In Ivor Lewis operation, anastomosis site leakage is a critical complication. Interventional approach utilizing covered metal stent has been introduced for the management of this complication. This patient was diagnosed as esophageal cancer and underwent robot-assisted Ivor Lewis operation. Due to symptoms suggesting anastomosis site leakage, video-assisted thoracoscopic surgery exploration was performed without identification of gross leakage site. On esophagogastroduodenoscopy, anastomosis site leakage was detected and esophageal stent was placed. Four weeks later, the stent was removed, and the patient could intake all his diet orally without discomfort. Esophageal stent insertion can be an option to manage postesophagectomy leakage problem.
Anastomotic Leak ; Diet ; Endoscopy, Digestive System ; Esophageal Neoplasms ; Esophagectomy ; Humans ; Postoperative Complications ; Stents* ; Thoracic Surgery, Video-Assisted

OBJECTIVETo evaluate the efficacy of endoscopic purse-string suture (EPSS) with metallic clips and endoloop for the gastric wall defect after postoperative perforation.

METHODSClinical data of 25 patients with gastric tumors(1 of gastric adenocarcinoma, 24 of gastric gastrointestinal stromal tumor, GIST) undergoing EPSS in Jiangsu Province People's Hospital and The Second Affiliated Hospital of Nanjing Medical University from January 2013 to May 2014 were retrospectively analyzed. During the procedure, EPSS was performed in 8 cases with perforation after endoscopic submucosal dissection(ESD), and in 17 cases with active perforation after endoscopic full-thickness resection.

RESULTSTwenty-five patients underwent EPSS successfully. The procedure time was 35.0-75.0(49.8±10.1) min. No severe operational and postoperative complications occurred. Tumor resection margin were all negative. Time to withdraw gastrointestinal decompression drainage tube was 1-3(1.3±0.8) d. Postoperative hospital stay was 2-10(4.8±2.1) d and total cost was 10-31(19±0.5) thousand Yuan. One month after the procedure, all the patients received follow-up with no complaint of discomfort, and endoscopy confirmed that all the lesions healed.

CONCLUSIONEPSS with metallic clips and endoloop is effective and safe to close the gastric wall defect after full-thickness resection.

Adenocarcinoma ; Digestive System Surgical Procedures ; Gastrointestinal Stromal Tumors ; Gastroscopy ; Humans ; Postoperative Complications ; Postoperative Period ; Retrospective Studies ; Stomach Neoplasms ; Sutures

OBJECTIVETo investigate the influence of non-diabetic hyperglycemia on postoperative complications following laparoscopic colorectal cancer resection.

METHODSClinical data of 636 patients undergoing laparoscopic colorectal cancer resection in The Affiliated Nanhai Hospital of Southern Medical University between 2009 and 2013 were analyzed retrospectively. After excluding cases with diabetes mellitus, the patients were divided into the hyperglycemia group (blood glucose level>7.8 mmol/L at any time during hospitalization period, n=161) and the non-hyperglycemia group (n=309).

RESULTSCompared to non-hyperglycemia group, hyperglycemia group had more intraoperative blood loss [(186±80) ml vs. (158±74) ml, P=0.007] and longer postoperative hospital stay [(14.0±6.8) d vs. (11.2±5.5) d, P=0.013]. The overall rate of postoperative complication was 24.8% and 16.5% respectively (P=0.030), in the hyperglycemia and the non-hyperglycemia groups, and the mortality was 1.2% and 0.6% respectively (P=0.541). Multivariable analysis showed hyperglycemia was an independent risk factor of postoperative complication (RR=2.425, 95% CI:1.210-4.226, P=0.006).

CONCLUSIONSNon-diabetic hyperglycemia may increase the risk of postoperative complications following laparoscopic colorectal cancer resection. Perioperative blood glucose monitoring should be performed, regardless of patients with or without diabetes.

Colorectal Neoplasms ; Diabetes Mellitus ; Digestive System Surgical Procedures ; Humans ; Hyperglycemia ; Laparoscopy ; Postoperative Complications ; Postoperative Period ; Retrospective Studies ; Risk Factors

OBJECTIVETo evaluate the efficacy and safety of covered self-expanding metallic stents (CSEMS) implantation as a treatment option in patients with anastomotic leakages after colorectal cancer surgery.

METHODSShort-term outcomes of 12 patients with anastomotic leakage after colorectal cancer surgery undergoing CSEMS implantation between May 2013 and November 2014 were analyzed retrospectively.

RESULTSThe mean time to diagnosis of anastomotic leakage was 6.3 days (range 2-13). The median time of CSEMS implantation after anastomotic leakage was 8 days (range 2-55). Clinical success without reoperation was achieved in 10 of 12 cases (83.3%) and there was no mortality. The median time to healing of the anastomotic leakage after CSEMS implantation was 13 days (range 10-33). The complications were stent migration (66.7%, 8/12), anorectal pain (58.3%, 7/12), fecal incontinence (25.0%, 3/12) and enterocolic fistula (8.3%, 1/12).

CONCLUSIONStent implantation one week after relief of peritonitis of postoperative colorectal anastomotic leakages, combined with other conservative therapy (early indwelling of transanal double catheterization cannula and pelvic double catheterization cannula with persistent bathe and negative pressure aspiration) in the management of patients with early diagnosed anastomotic leakages is safe and effective.

Anastomotic Leak ; Colonoscopy ; Colorectal Neoplasms ; Digestive System Surgical Procedures ; Humans ; Metals ; Postoperative Complications ; Reoperation ; Retrospective Studies ; Stents