Adenocarcinoma/surgery* ; Esophageal Neoplasms/surgery* ; Esophagogastric Junction/surgery* ; Gastrectomy ; Humans ; Margins of Excision ; Neoadjuvant Therapy ; Retrospective Studies ; Stomach Neoplasms/surgery*

Objective To analyze retrospectively the clinico-pathological features that influencing the occurrence of anastomotie leakage after low anterior resection of rectal cancer, as well as its management and outcome of patients. Methods The data of 513 patients underwent anterior resection for low rectal cancer from june 1999 to June 2007 were reviewed. Results The incidence of anastomotic leakage was 4.5 %(23/ 513). 20 patients underwent conservative therapy,while 3 patients underwent reoperation, all patients were cured without ileostomy or colostomy.Conclusion The occurrence rate of anastomotie leakage is closely re- lated to the type of operation,the Dukes staging,Diabetes Mellitus and Diarrhea. Local irrigation via the drainage tube is the main strategic point to manage the leakage.

OBJECTIVETo explore a better operative approach to resect complicated pelvic retroperitoneal tumors.

METHODSA total of 28 patients with complicated pelvic retroperitoneal tumors who received surgical resection in our hospital from 2006 to 2010 were included in this study. The surgical operation was assisted with an arc-shaped transperineal incision in front of the apex of coccyx. The operation time, intraoperative blood loss, death toll and length of hospital stay of the patients were retrospectively analyzed.

RESULTSThe median operation time was 122.5 minutes. The median blood loss was 420 ml, and the median length of hospital stay of the patients was 17.5 days. There was no postoperative death in this group of patients.

CONCLUSIONWith the assistance of this arc-shaped transperineal incision in front of the apex of coccyx, the resection of pelvic retroperitoneal tumors can be effectively improved and the surgery risk is reduced.

Adult ; Aged ; Blood Loss, Surgical ; Coccyx ; surgery ; Epidermal Cyst ; pathology ; surgery ; Female ; Gastrointestinal Stromal Tumors ; pathology ; surgery ; Humans ; Length of Stay ; Male ; Middle Aged ; Neurilemmoma ; pathology ; surgery ; Pelvic Neoplasms ; pathology ; surgery ; Retroperitoneal Space ; Retrospective Studies ; Teratoma ; pathology ; surgery

OBJECTIVETo investigate long-term survival after multivisceral resection in patients with locally advanced right colon cancer.

METHODSThe clinical data and survival of 13 patients with locally advanced right colon cancer were retrospectively analyzed.

RESULTSThere were 8 males and 5 females with a mean age of 58.6 years. Location of the primary tumor included hepatic flexure(n=6), transverse colon(n=2), and ascending colon(n=5). Three patients had duodenal invasion alone, 9 had involvement of duodenum and other organs, and 1 had pancreas and stomach involvement. Right colectomy and pancreaticoduodenectomy and(or) resection of other organs were performed. The 1-, 3-, and 5-year survival rates were 69%, 54%, and 30%, respectively.

CONCLUSIONRight colectomy combined with multivisceral resection is a promising procedure for selected patients with locally advanced colon cancer.

Adult ; Aged ; Colonic Neoplasms ; surgery ; Female ; Humans ; Male ; Middle Aged ; Retrospective Studies ; Treatment Outcome

OBJECTIVETo evaluate the association of early diarrhea(postoperative day 1 to 7) and anastomotic leakage after low anterior resection for rectal cancer.

METHODSClinical data of 192 cases (group A, tumor from the anal verge 4-7 cm) from May 2004 to May 2007 and 236 cases(group B) from July 2007 to May 2010 in our hospital who received low anterior resection of rectal cancer were analyzed retrospectively.

RESULTSIn group A, the incidence of early postoperative diarrhea was 19.3%(37/192), of which 9 cases were treated with anti-diarrhea drugs. The morbidity of anastomotic leakage in patients with diarrhea was significantly higher than those without early diarrhea(16.2% vs. 5.2%, P<0.05). In group B, the incidence of early postoperative diarrhea was 16.5%(39/236). All the patients were treated with anti-diarrhea drugs. There was no difference in the morbidity of anastomotic leakage between patients with diarrhea and those without early diarrhea(16.2% vs. 5.2%, P<0.05). There was no difference in early diarrhea between groups A and B(P>0.05). However, the incidence of anastomotic leakage in patients with early diarrhea was lower in group B(P<0.05).

CONCLUSIONSEarly diarrhea after the low anterior resection of rectal cancer may indicate anastomotic leakage. Treatment of early postoperative diarrhea may reduce the risk of anastomotic leakage.

Adult ; Aged ; Anastomotic Leak ; etiology ; Diarrhea ; complications ; etiology ; Female ; Humans ; Male ; Middle Aged ; Postoperative Complications ; etiology ; Rectal Neoplasms ; surgery ; Retrospective Studies

OBJECTIVETo evaluate the therapeutic effects of trans-abdominal-mediastinal drainage tube on the prevention of esophagogastric or esophago-jejunal anastomotic leakage.

METHODSA total of 79 patients underwent thoraco-abdominal radical resection for gastric cardia cancer, with high risk of leakage of the anatsomosis, from Aug. 2007 to Aug. 2011 were included in this study. They were assigned into 2 groups. Forty one patients had trans-abdominal-mediastinal drainage tube (improvement group) and 38 patients were without the mediastinal drainage tube (control group). The clinical data of all the 79 patients were reviewed and the therapeutic effects of the two treatment approaches were compared.

RESULTSThere was anastomotic leakage in four patients of the improvement group. They were with stable vital signs and the median hospital stay was 29.3 days. There was anastomotic leakage in five cases of the contol group and all of them had high fever and chest tightness. One among those five patients had transdermal placement of thoracic drainage tube and was cured, and four among those five patients had second debridement operation, with 3 cured and one death case. Except the one death case, the median hospital stay of the control group was 53.4 days, significantly longer than that of the improvement group (P < 0.05).

CONCLUSIONSAlthough putting trans-abdominal-mediastinal drainage tube can not prevent the leakage of esophagogastric or esophago-jejunnal anastomosis, it can reduce the systemic inflammatory responses, death and painful suffering of the patients caused by anastomotic leakage.

Aged ; Anastomosis, Surgical ; adverse effects ; Anastomotic Leak ; etiology ; prevention & control ; Cardia ; Drainage ; methods ; Esophagus ; surgery ; Female ; Humans ; Jejunum ; surgery ; Length of Stay ; Male ; Middle Aged ; Stomach ; surgery ; Stomach Neoplasms ; surgery

OBJECTIVEThe purpose of this study was to evaluate the in vitro cytotoxicity of novel Comfort denture adhesive (Comfort-DA), which was developed by the authors, to human oral fibroblasts (HOFs).

METHODSA sample of Comfort-DA was prepared and extracted in culturing medium to prepare the eluate. Then the eluate was diluted by culturing medium to 50% and 75% concentration for the assessment of cytotoxicity by tetrazolium bromide (MTT) colorimetric assay. Wells containing fresh medium alone were served as control. Cell viability was recorded by optical density after culturing in an atmosphere of 5% CO2 and 95% air at 37 degrees C for 2, 3 and 4 days, respectively. The viability of HOF cells was evaluated by MTT assay to investigate cell proliferation. Optical density (OD) was measured by a spectrophotometer at 490 nm. Then evaluating the cytotoxicity grade in test groups according to the means of cell proliferation. ANOVA was used to test the statistical significance.

RESULTSThe statistical analysis of the results of MTT cytological assay indicated significant difference (P < 0.05) in OD (indicate cell viability) between all concentrations of Comfort-DA and the control at all incubation times. The results of cell proliferation percentage also showed that the cytotoxicity grade of tested material only displayed "0-2".

CONCLUSIONThe generally favorable in vitro cytotoxicity of the Comfort-DA formulations indicates that this product may be an efficacious denture adhesive.

Adhesives ; toxicity ; Adolescent ; Biocompatible Materials ; chemistry ; toxicity ; Cell Division ; drug effects ; Cell Survival ; drug effects ; Cells, Cultured ; Denture Retention ; Fibroblasts ; cytology ; drug effects ; Humans ; Male ; Periodontium ; cytology ; drug effects ; Tetrazolium Salts ; Thiazoles ; Toxicity Tests ; methods

Objective To investigate a shorter and safer route for contralateral C_7 nerve root transfer. Methods Eight male patients were treated from Dec2005 to Nov.2006Their range of age was from 22 to 43 years with an average of 30 yearsFive cases had total brachial plexus avulsion.The operative delay was from 2 to 6 months(mean:4 months).The sealenus anterior muscle was transected before a prespinaJ & ret- ropharyngeal tunnel was madeThe contralateral C_7 nerve root was used to repair the upper trunk or the infra- clavicular lateral cord and posterior cord of injured side via this routeusing direct anastomosis or nerve graft- ing.Results The length of the harvested contralateral C_7 nerve root was(4.67?0.52em in the early 5 casesThe nerve graft was6.25?0.35)em long for repairing supraclavicular brachial plexus and(8.56?0.45cm long for repairing infraclavicular brachial plexusThe length of the harvested contralateral C_7 nerve root averaged 6.85cm in the other 3 cases2 of which had direct anastomosis to the residual nerve C_5 and C_6 nerve roots and the other used nerve graft of 3 cm in lengthTransient contralateral sensory symptoms were re- ported in most patientsAt 3 months followups6 patients had tingling sensation on the contralateral fingers with percussion on the injured cervical areaIpsilateral SSEP could be recorded by stimulating at 2 cm above sternoclavicular joint on the injured sideAt 7 months follow ups of 5 patientsCMAP could be recorded in bi- cepsdeltoids and infraspinatus or triceps with stimulation at Erb's pointHoweverno clinical movements was noticedAt 12 months follow ups of 3 patientswe could observe early motor and sensory function recovery of those patients to different extent.Conclusion Transection of anterior scalenus muscle shortens the length of the transfer route and allows more efficient neurotizationThe procedure is convenient and safeprovided certain precautions being usedThe principal of contralateral C_7 nerve transfer are reconstruct the anterior divi- sions of upper trunkposterior divisions of upper trunk and suprascapular nerve when repairing the supraclavic- ula brachial plexusReconstruct the lateral cord and posterior cord when repairing the infraclavicula brachial plexusPostsurgical fasting for 4 days included foods and liquids will benefit of healing of anastomosed nerves and regenerationaud avoid complications.

OBJECTIVETo investigate the approach and efficacy of dealing the rectal ligament in resection of rectal cancer in obese male patients.

METHODSA total of 92 patients (BMI>25 kg/m(2)) undergoing resection of rectal cancer from December 2008 to December 2010 in Henan Tumor hospital were assigned into 2 groups according to the surgical technique, the modified group (paralleled clipping of rectal ligament, 48 patients) and traditional group (44 patients). Operative time, intra-operational bleeding, rectal ulceration, ureteral injury, mesorectal integrity, and positive rate of lateral margin of pelvic wall were compared between two groups.

RESULTSThe operative time was (66.9±99.8) min in modified group, which was significantly shorter than that in traditional group [(125.4±12.2) min, P=0.000]. Intra-operative bleeding was (160.3±27.2) ml in modified group and (150.5±28.5) ml in traditional group (P=0.093). Rectal ulceration rated were 0 and 18.2% (8/44), mesorectal disintegrity rates were 6.2% and 22.7%, pelvic infection rates were 2.1% (1/48) and 20.4 (9/44) in modified and traditional groups respectively, whose differences were all significant (all P<0.05). No ureteral injury and positive margin were found in both two groups.

CONCLUSIONThe approach of paralleled clipping of rectal ligament around the rectum meets the principle of TME, which is simple, safe and effective.

Adult ; Aged ; Humans ; Ligaments ; surgery ; Male ; Middle Aged ; Obesity ; complications ; Rectal Neoplasms ; complications ; surgery ; Rectum ; surgery

OBJECTIVETo investigate the diagnosis, treatment and prognosis of colorectal neuroendocrine carcinoma.

METHODSClinical data of 39 patients with colorectal neuroendocrine carcinoma from Jan 1995 to Jan 2010 were analyzed retrospectively and the related literatures were reviewed.

RESULTSThere were 27 males and 12 females. No patients presented endocrinal dysfunction symptoms. Fourteen patients were diagnosed as neuroendocrine cancer by preoperative pathological examination. All the patients received postoperative adjuvant chemotherapy including cis-platinum and etoposide. Twenty-two patients underwent curative resection, while 14 underwent palliative resection and 3 underwent biopsy alone. Of the 36 surgical resection specimens, vascular invasion was found in 27 patients (75.0%) and regional lymph node metastasis was found in 29 patients (80.6%). Length of follow-up ranged from 4 to 67 months. The 1-year, 3-year and 5-year survival rates were 48.2%, 16.5% and 6.8%, respectively. Statistically significant differences in survival were observed and associated with tumor staging, vascular invasion and surgery type (P<0.05), but not related to gender, age, tumor location, or diameter (P>0.05).

CONCLUSIONSClinical symptoms and signs of colorectal neuroendocrine carcinoma are nonspecific with poor prognosis. Tumor staging, vascular invasion and surgical type have potential impact on survival.

Carcinoma, Neuroendocrine ; diagnosis ; therapy ; Cisplatin ; therapeutic use ; Colorectal Neoplasms ; diagnosis ; therapy ; Etoposide ; therapeutic use ; Female ; Humans ; Male ; Neoplasm Staging ; Prognosis ; Retrospective Studies ; Survival Rate