During the course of anesthetic administration, appreciate volume of nitrous oxide can move into closed gas spaces. The use of nitrous oxide during abdominal surgery may cause distension of the intestine and make difficulty in operating procedure. We studied 29 patients undergoing elective colorectal surgery and they were classified into two groups -N2O group and Air group, N2O group was administered with air-oxygen-enflurane before peritoneal opening and administered with N2O- oxygen-enflurane after peritoneal opening. Air group was administered with air-oxygen-enflurane throughout the surgery. We measured N2O concentration in the terminal ileum, the degree of distension in the small and large intestine during anesthesia, and the time of postoperative flatulence and feces passage. The N2O concentration in the intestine increased throughout the time course in N2O group. The distension score of the small and large bowel had a tendency to increase in N2O group. There were no significant differences between the two groups in postoperative bowel motility. These results suggest that a long-term N2O administration in patients undergoing colorectal surgery may interfere surgical conditions of the intestine because of the bowel distension.
Anesthesia* ; Colorectal Surgery ; Feces ; Flatulence ; Humans ; Ileum ; Intestine, Large ; Intestines ; Nitrous Oxide

Adenocarcinoma ; metabolism ; pathology ; surgery ; Aged ; Humans ; Intestinal Neoplasms ; metabolism ; pathology ; surgery ; Intestine, Small ; Ki-1 Antigen ; metabolism ; Lymphoma, Large B-Cell, Diffuse ; metabolism ; pathology ; surgery ; Male ; Neoplasms, Multiple Primary ; metabolism ; pathology ; surgery ; Rectal Neoplasms ; metabolism ; pathology ; surgery

PURPOSE: We sought to evaluate the feasibility and safety of open or robotic radical prostatectomy (RP) after rectum, sigmoid, or colon surgery. MATERIALS AND METHODS: Sixty-four patients with a median age of 65 years (range, 46-73 years) who underwent RP after previous pelvic surgery were included. Twenty-four patients (38%) underwent robotic RP and 40 patients (62%) underwent open RP. Bilateral lymph node dissection and nerve preservation were performed in 50 patients (78%) and 35 patients (55%), respectively. Variables evaluated included demographic characteristics, perioperative complications, and functional and oncological outcomes. The median hospitalization and follow-up periods were 2 days (range, 1-12 days) and 21 months (range, 1-108 months), respectively. RESULTS: No conversions from robotic to open surgery were performed and there were no intraoperative complications. Surgical margins were positive in 13 patients (20%), seminal vesicle involvement was detected in 6 patients (9%), and lymph node involvement was found in 2 patients (3%). Postoperative complications included lymphocele in 1 patient, urethral stricture in 1 patient, and bowel obstruction and persistent bladder leakage in 2 patients. Eighty-eight percent of the patients were continent at 7 months and 80% of patients were able to achieve erection with or without medical aid. CONCLUSIONS: Open or robotic RP can be done safely and effectively in patients who have previously undergone pelvic surgery. Although prior pelvic surgery of the large intestine was associated with increased morbidity, it should not be considered a contraindication for robotic or open RP.
Aged ; Feasibility Studies ; Humans ; Intestine, Large/*surgery ; Lymph Node Excision ; Lymphatic Metastasis ; Male ; Middle Aged ; Prostatectomy/adverse effects/*methods ; Prostatic Neoplasms/*surgery ; Robotic Surgical Procedures/adverse effects/*methods ; Treatment Outcome

The effect of tumor necrosis factor-alpha (TNF-alpha) on endotoxin (ET)-mediated lung damage caused by incomplete ligation of large intestine and the influence of free Fu on the expression of TNF-alpha mRNA were explored. Forty SD rats were randomly divided into 4 groups: normal control group, model group, ligation group and treatment group (n =10 in each group). The models were made by the method of partly ligating the rectum outside the body. The plasma level of lipopolysaccaride was measured by dynamic nephelo metric method and the serum level of TNF-alpha was detected by the method of radioactive immunity. The expression of TNF-alpha mRNA in lung tissue was detected by RT-PCR method. The results were compared among the 4 groups. The results showed the plasma levels of ET and serum TNF-alpha in the model group and the expression of TNF-alpha mRNA in the lung tissues were remarkably higher than those in the normal control group (P<0.01). After the treatment of free Fu, all of the above indexes in the treatment group were all decreased as compared with model group (all P<0.01), and the damage to lung was alleviated. It was concluded that TNF-alpha might play a very important role in the ET-mediated lung damage caused by incomplete ligation of large intestine, free Fu could protect the lung from damage.
Animals ; Endothelins ; blood ; Endotoxins ; blood ; Female ; Intestine, Large ; surgery ; Ligation ; Medicine, Chinese Traditional ; RNA, Messenger ; biosynthesis ; genetics ; Random Allocation ; Rats ; Rats, Sprague-Dawley ; Respiratory Distress Syndrome, Adult ; etiology ; metabolism ; Tumor Necrosis Factor-alpha ; biosynthesis ; genetics

OBJECTIVETo investigate the clinicopathological features of primary diffuse large B-cell lymphomas (DLBCLs) of the small intestine, CD10 expression, and their relationship to prognosis.

METHODSTwenty-four cases of small intestinal DLBCLs were studied clinically and pathologically. All cases were staged according to the Ann Arbor classification of lymphoma.

RESULTSFifteen cases (62.5%) were at stages I and II, and nine cases (37.5%) at stages III and IV. The Karnofsky performance status ranged from 40% to 100% (mean 75.5%). Twenty cases (83.3%) received surgical resection, sixteen cases (66.7%) received chemotherapy, and no patient received radiotherapy. Seven of 19 cases (36.8%) were CD10+. Although there was no statistically significant difference(P = 0.28) in therapy result between the CD10+ and CDO1--groups, patients with CD10+ lymphoma more frequently presented with stages I compared with those with CD10 - lymphoma (P = 0.013). Follow-up information was available in 19 cases ranging from 1 to 111 months (mean 32.7 months). Five cases died of the disease. The mortality rate was 26.3%. The analysis of survival rate showed a longer overall survival duration in the stage I and II group compared with that of the stage III and IV group ( P = 0.0197 ) , but there was no significant difference between CD10+ and CD1- groups.

CONCLUSIONThe primary small intestnal diffuse large B cell lymphoma patients at stage I and II respond better to therapy including surgical resection and chemotherapy than those at stage III and IV. CD10+ expression is more common in stage I lymphomas.

Adult ; Aged ; Antineoplastic Combined Chemotherapy Protocols ; therapeutic use ; Combined Modality Therapy ; Cyclophosphamide ; therapeutic use ; Doxorubicin ; therapeutic use ; Female ; Follow-Up Studies ; Humans ; Intestinal Neoplasms ; immunology ; pathology ; therapy ; Intestine, Small ; pathology ; surgery ; Lymphoma, Large B-Cell, Diffuse ; immunology ; pathology ; therapy ; Male ; Middle Aged ; Neoplasm Staging ; Neprilysin ; metabolism ; Prednisone ; therapeutic use ; Remission Induction ; Survival Rate ; Vincristine ; therapeutic use