Objective To evaluate DOG1 as an immunohistochemical marker for GIST.Methods From Jan 1987 to Sep 2008,210 consecutive cases including 137 GISTs as well as 73 non-GIST sarcoma were evaluated for clinicopathological characteristics and immunostained for DOG1 antibodies.Result Immunoreactivity for DOG1 was detected in 110 of 137 GIST cases (80.3%),3 out of 11 CD117negative GISTs were DOG1-positive.Only 1 of 73 non-GIST case was positive for DOG1.The expression of DOG1 in GIST is associated with the location of tumor,cell density,nuclear pleomorphism and Fletcher grading criteria.The postoperative 1-,3-,5-year overall survival for DOG1 negative and positive patients was 81.3%,74.5%,74.5% and 98.5%,85.9%,83.2%,respectively,P = 0.034.Conclusion DOG1 was a sensitive and specific marker for GIST in gastrointestinal mesenchymal tumors (GIMT).

Objective To evaluate the safety and feasibility of laparoscopie colorectal surgery in elderly patients.Methods The clinical data of 117 patients with colorechal cancer who had been admitted to People's Hospital of Peking University from January 2005 to December 2008 were analyzed retrospectively.Ail patients were divided into laparoscopic group(n=49)and open group(n=68).The postoperative conditions,incidence of complications and results of follow-up of patients in the 2 groups were compared.All data were analyzed via t test,chi-square test and Mann-Whitney U test,and the survival was analyzed via Kaplan-Meier method and Log-rank test.Results The mean operation time in laparoscopic group was(246±64)minutes,which was significantly longer than(218±50)minutes in open group(t=-2.677,P<0.05).The volume of blood loss,anal exsufflation time,postoperative hospital stay,ratio of patients who used analgesics and incidence of complications were (207±135)ml,3 days,12 days,45%(22/49)and 20%(10/49)in laparoscopic group,and were(296±178)ml,4 days,14 days,74%(50/68)and 44%(30/68)in open group,with significant difference between the 2 groups(t=2.920,U=770.5,1181.0,X~2=9.864,7.115,P<0.05).The length of bowel resected and number of lymph node dissected were(19±7)cm and 13±6 in laparoscopic group,and were(20±8)cm and 16±6 in open group,with no significant difference between the 2 groups(X~2=0.790,t=2.007,P>0.05).The 1-and 3-year accumulative survival were 95.4%and 85.2%in laparoscopic group,and were 94.7%and 82.3%in open group,with no significant difference between the 2 groups(X~2=0.581,P>0.05).Conclusion Laparoscopic surgery is safe and feasible for elderly patients with colorectal cancer.

Objective To explore the clinical outcomes of laparoscopic appendectomy in acute and chronic appendicitis,and sum up the surgical experiences of lapaproscopic appendectomy.Method In this study 129 cases of appendicitis at the Department of Gastroentrological Surgery,Peking University People's Hosptial were collected retrospectively from June 2008 to December 2009.The clinical results of laparoscopic and open procedures for acute appendicitis and the outcomes of laparoscopic operation for acute and chronic appendicitis were compared.Results For acute appendicitis,the length of hospitalization [(4.8 ± 2.6) d vs.(7.0 ± 1.3) d,t =0.679,P =0.006] was significantly shorter in laparoscopic group than that in open surgery group.In addition,the mean length of operation time [(77 ± 33) min vs.(55 ± 23) min,t =3.431,P ＜0.01] were longer,postoperative first passing flatus [(2.3 ± 1.2) d vs.(1.4 ±0.9) d,t =4.665,P ＜0.01] and oral intake [(2.3 ± 1.4) d vs.(1.2 ±0.6) d,t =4.517,P＜0.01] were later for acute appendicitis patients than for chronic appendicitis in laparoscopic group.Conclusions Laparoscopic appendectomy for acute appendicitis is a safe and effective procedure,though it might cause more postoperative complications such as intra-abdominal abscess and small intestinal obstruction in patients with acute appendicitis.

Objective To investigate the significance of preoperative Glasgow prognostic score (GPS) for postoperative prognosis in patients of resectable colon cancer. Recent studies have revealed that the GPS, an inflammation-based prognostic score that includes only C-reactive protein (CRP) and albumin, is a useful tool for predicting postoperative outcome in cancer patients. However, few studies have investigated the GPS in the field of colon surgery. Methods The GPS was calculated on the basis of admission data as follows; patients with an elevated level of both CRP ( ＞ 10 mg/L) and hypoalbuminemia (Alb ＜ 35 g/L) were allocated a score of 2, and patients showing 1 or none of these blood chemistry abnormalities were allocated a score of 1 or 0, respectively. Prognostic significance was analyzed by multivariate analyses. Overall survival and disease-free survival was estimated using the Kaplan-Meier method. Results A total of 282 patients were evaluated. Kaplan-Meier analysis and log-rank test revealed that a higher GPS predicted a higher risk of postoperative mortality and reccurence ( P ＜ 0.001 ). multivariate analyses revealed that postoperative TNM was the most sensitive predictor of postoperative mortality (OR, 0.210; 95% CI, 0.102-0.432; P＜0.01) and CEA(OR,0. 356;95% CI,0. 179 -0. 707; P = 0.003),CA19-9(OR,0. 260;95% CI,0. 120 -0. 564;P ＜ 0.01),CRP( OK,4. 503;95% CI, 1. 590 -12. 751 ;P =0.005) , GPS( OR, 0. 340 ;95% CI,0.181 -0.920;P＜0.01)were associated with postoperative mortality. Conclusions Preoperative GPS is considered to be a useful predictor of postoperative mortality in patients with colon cancer.

Objective This study was to investigate the relationship between the activities of thymidine phosphorylase (TP) and dihydropyrimidine dehydrogenase (DPD) and clinicopathological parameters in human colorectal cancer,and the relationship between TP and/or DPD activity in tumor tissue and efficiency of chemotherapy. MethodsSixty-eight patients undergoing surgery for primary colorectal cancer were enrolled including 40 patients receiving postoperative adjuvant chemotherapy with 5-FU plus leucovorin(de Gramont regimen). The activities of TP and DPD both in tumor tissue and in normal tissue were determined by enzyme-linked immunosorbent assay(ELISA). Results The TP activity was significantly higher in tumor than in normal tissues(P

Objective To explore the early predictive factors of intestinal necrosis in patients with acute superior mesenteric arterial occlusive disease and its significance for the decision of exploratory laparotomy.Methods This retrospective study enrolled 29 patients diagnosed with acute superior mesenteric artery embolism or thrombosis in Peking University People's Hospital between July 1995 and June 2015.Results 12 patients developed intestinal necrosis.Patients with intestinal necrosis had a poorer prognosis than those who did not develop intestinal necrosis (x2 =14.867,P =0.000).In univariate analysis,the early predictive factors for intestinal necrosis were D-Dimer ≥ 600 μg/L (x2 =11.455,P =0.002),INR≥1.2 (x2 =3.948,P =0.047),pH values ＜7.4 (x2 =8.191,P =0.004),BE ＜ -1.0 mmol/L (x2 =8.191,P =0.004),blood lactate ≥ 2.2 mmol/L(x2 =7.535,P =0.006),BUN ≥ 6 mmol/L (x2 =10.076,P =0.002),CK ≥ 80 U/L (x2 =8.191,P =0.004),LDH ≥ 210 U/L (x2 =13.079,P=0.000),AST ≥25 U/L (x2 =10.076,P =0.002),SIRS (x2 =10.076,P =0.002).Multivariate logistic regression analysis found no independent predictive factors of intestinal necrosis in patients with acute superior mesenteric arterial occlusive diseases.Conclusion Intestinal necrosis in acute mesenteric arterial occlusive diseases indicates a poor prognosis.Coagulation abnormalities,liver or kidney dysfunction,metabolic acidosis and SIRS necessitates an immediate exploration.

Objective To compare the therapeutic efficiency of laparoscopic and open radical colorectal surgery in the treatment of colorectal carcinoma. Methods Clinical data of 77 cases undergoing laparoscopic colorectal surgery from September 2004 to October 2007 were compared with 90 patients treated by open surgery. Results Mean operating time was longer in the laparoseopic group than that in the open group [248 minutes vs. 225 minutes (t = -2. 11 ,P =0. 036)], blood loss was less in laparoscopic group [210 ml vs. 315 ml (t = 2. 82, P = 0. 005)]. Laparoscopic surgery was associated with lower rate of analgesia use [48% vs. 80% (x2 = 18. 69 ,P < 0. 01)], earlier recovery of bowel function [2. 9 days vs. 4. 3 days(t =5.59,P <0. 01)]and shorter hospital stay [12. 5 days vs. 15.5 days (t =2. 32,P=0. 039)]compared with open surgery. The number of removed lymph nodes [14. 2 vs. 15.3 (t = 1.04, P = 0. 3)]and length of reseeted bowel [18. 9 cm vs. 20. 0 cm, (t = 0. 88,P = 0. 383)]were not different between the two groups. The mean follow-up time of the two groups were 28 months, local recurrence rate, metachronous metastases rate and 3-year cumulative survival rate were not statistically different between the two groups. Conclusion Laparoscopic surgery is as effective as conventional open surgery in the treatment of colorectal carcinoma.

OBJECTIVETo investigate the prevalence of depressive disorder in patients undergoing general surgical operations.

METHODSOne hundred and four patients who had undergone general surgical operations were investigated. Each patient filled in the self rating depression scale (SDS) as the baseline data.

RESULTSAmong these patients 40.4% of them had depressive disorder. The major factors for the prevalence of depression were sex, educational background and malignant diseases.

CONCLUSIONSA certain proportion of patients undergoing general surgical operations have depressive disorder. It is important to recognize and treat for this disorder.

Adult ; Aged ; Aged, 80 and over ; Depressive Disorder ; epidemiology ; etiology ; Female ; Humans ; Male ; Middle Aged ; Prevalence ; Surgical Procedures, Operative ; adverse effects ; psychology

Objective The purpose of this study is to investigate the factors associated with incisional surgical site infection (SSI) in colorectal cancer. Methods We retrospectively analyzed impacting factors of SSI including age, gender, BMI, diabetes mellitus, operation, albumin levels, hemoglobin levels, tumor staging, and length of stay post-operation in 327 colorectal patients from 2001 to 2005. Results The incidences of SSI and fat liquefaction were 2. 4%(8/327) and 12. 2%(40/327) respectively. The incidences of SSI in patients with obesity and diabetes mellitus increased significantly (16. 8% vs. 10. 0% ,28. 6% vs. 13. 7%). The length of stay in patients with SSI prolonged significantly (29.0 d vs. 15.8 d). Conclusion Obesity and diabetes mellitus are the most important factors associated with SSI in colorectal cancer patients.

OBJECTIVETo compare the safety and efficacy between extralevator abdominoperineal excision(ELAPE) and traditional abdominoperineal excision(APE) in patients with low rectal cancer.

METHODSFrom January 2011 to December 2013, 61 patients undergoing abdominoperineal excision for low rectal cancer at the Department of Gastrointestinal Surgery, Peking University People's Hospital were enrolled. The safety and efficacy of two procedure groups, ELAPE group (33 patients) and traditional APE group (28 patients) were reviewed retrospectively.

RESULTSLess intraoperative blood loss [(201 ± 147) ml vs. (343 ± 308) ml, P=0.022], shorter exhaust time [(3.8 ± 1.5) d vs. (4.6 ± 1.6) d, P=0.039] and lower perineal wound complication rate (9.1% vs. 25.0%, P=0.042) were observed in the ELAPE group as compared to the traditional APE group. However, longer operation time [(292 ± 46) min vs. (256 ± 28) min, P=0.008] and perineal drainage removal time [(11.1 ± 4.8) d vs. (7.1 ± 2.7) d, P<0.01] were noted in the ELAPE group than those in the traditional APE group. Number of lymph node retrieved and positive lymph node retrieved was not significantly different between two groups. The ELAPE group had lower rate of IOP (intraoperative perforation) (6.1% vs. 17.9%, P=0.055), but no significant difference was found. There were no significant differences in bowel movement, diet restoring time, average perineal drainage, postoperative hospitalization time and removing perineal stitches time between the two groups (all P>0.05).

CONCLUSIONELAPE possesses less intraoperative blood loss and lower perineal wound complication rate than traditional APE. ELAPE is associated with better safety and efficacy than traditional APE.

Digestive System Surgical Procedures ; Humans ; Operative Time ; Rectal Neoplasms ; surgery ; Retrospective Studies