Objective:To retrospectively analyze related factors of subtype transformation and to identify prognostic factors for pa-tients with retroperitoneal liposarcoma (RPLS). Methods:This study retrospectively analyzed the clinical data of 92 patients with RPLS, which were confirmed by postoperative pathology from July 1997 to October 2014 in Henan Provincial Tumor Hospital. Related studies were reviewed, and the prognoses were followed up. The factors may affect subtype transformation or prognoses were applied to the statistical analysis. Results:A total of 74 patients with RPLS were included according to the recruiting standard. The 5-year survival rate was 48.65%. Lobulated tumors (P=0.013) were the correlative factors that influenced subtype transformation. The Log-rank test showed that the age at diagnosis (P=0.045), multi-visceral resection (P=0.042), tumor necrosis (P<0.001), subtype transformation (P<0.001), and malignant level of pathological subtypes of the first operation (P<0.001) influenced overall survival. Multivariate Cox re-gression analysis showed that tumor necrosis and the malignant level of the initial histological grade were independent factors of over-all survival. Conclusion:Lobulated tumors are likely to transform the subtype. The prognosis of patients with RPLS is correlated with multi-visceral resection, tumors necrosis, subtype transformation, and the malignant level of pathological subtypes of the first opera-tion. Multi-visceral resection could not improve the 5-year survival rate of RPLS, and adjuvant therapy could not improve the prognosis.

Objective To investigate the advantages of thoracoabdominal radical gastrectomy for advanced Siewert type Ⅱ adenocarcinoma of the esophagogastric junction. Methods Clinical data of 86 patients with Siewert type Ⅱ adennocarcinoma of the esophagogastric junction who received surgical treatment at the Henan Provincial Tumor Hospital from January 2015 to January 2016 were retrospectively analyzed. Among them, 44 patients underwent abdominal operation (abdominal group), and 42 patients underwent thoracoabdominal radical gastrectomy ( thoraco?abdominal group ) . The operation time, lymph node number, distance between the tumor and cutting edge, amount of intraoperational blood loss, postoperative pulmonary complications, and postoperative hospital stay in the two groups were compared. Results Comparing the thoracoabdominal group with the abdominal group, the number of removed lymph nodes was 41.57±9.22 vs. 35.09±10.61 (P<0.01), the number of removed mediastinal lymph nodes was 6.38±1.50 vs. 3.52±1.42 (P<0.01), the distance between the tumor and cut edge was (5.62±0.73) cm vs. (3.30±0.85) cm (P<0.01), whereas the operation time, intraoperative blood loss, postoperative pulmonary complications, occurrence of anastomotic leakage and hospital stay were statistically not significantly different ( P>0. 05 for all ) . Conclusions For patients with advanced Siewert type Ⅱ adenocarcinoma of the esophagogastric junction, radical gastrectomy through thoracoabdominal approach can resect a longer segment of the esophagus, dissect more mediastinal lymph nodes, and does not increase post?operative complications and extend hospital stay, thus, exhibits obvious advantages in the surgical treatment of Siewert Ⅱadenocarcinoma of the esophagogastric junction.

Objective To investigate the advantages of thoracoabdominal radical gastrectomy for advanced Siewert type Ⅱ adenocarcinoma of the esophagogastric junction. Methods Clinical data of 86 patients with Siewert type Ⅱ adennocarcinoma of the esophagogastric junction who received surgical treatment at the Henan Provincial Tumor Hospital from January 2015 to January 2016 were retrospectively analyzed. Among them, 44 patients underwent abdominal operation (abdominal group), and 42 patients underwent thoracoabdominal radical gastrectomy ( thoraco?abdominal group ) . The operation time, lymph node number, distance between the tumor and cutting edge, amount of intraoperational blood loss, postoperative pulmonary complications, and postoperative hospital stay in the two groups were compared. Results Comparing the thoracoabdominal group with the abdominal group, the number of removed lymph nodes was 41.57±9.22 vs. 35.09±10.61 (P<0.01), the number of removed mediastinal lymph nodes was 6.38±1.50 vs. 3.52±1.42 (P<0.01), the distance between the tumor and cut edge was (5.62±0.73) cm vs. (3.30±0.85) cm (P<0.01), whereas the operation time, intraoperative blood loss, postoperative pulmonary complications, occurrence of anastomotic leakage and hospital stay were statistically not significantly different ( P>0. 05 for all ) . Conclusions For patients with advanced Siewert type Ⅱ adenocarcinoma of the esophagogastric junction, radical gastrectomy through thoracoabdominal approach can resect a longer segment of the esophagus, dissect more mediastinal lymph nodes, and does not increase post?operative complications and extend hospital stay, thus, exhibits obvious advantages in the surgical treatment of Siewert Ⅱadenocarcinoma of the esophagogastric junction.

Objective: To evaluate surgical repair of vesicorectovaginal fistula using transvaginal pedicled omentum pull-through combined transanal colon pull-through. Methods: A total of 11 patients with postoperative vesicorectovaginal fistulas complicating female reproductive system malignant tumors undergoing repairement from Aug 2013 to Aug 2018 were retrospectively analyzed. In order to isolate, protect the bladder and eliminate residual vaginal cavity using transvaginal pedicled omentum pull-through, combined transanal colon pull-through to repair vesicorectovaginal fistula. Results: All the 11 patients in this group completed the operation successfully, and no air or stool passing from the vaginal after the operation. The fistula disappeared in five patients confirmed by cystography and enterograph. The average operation time was 115 min, the average blood loss was 260 ml.Incision fat liquefaction was found in two. Incision infection occurred in one. Urinary dysfunction in two. Anal stenosis was found in four patients which were healed by anal dilation. Conclusions Transvaginal pedicled omentum pull-through combined transanal colon pull-through can eliminate vesicorectovaginal fistula, improve life quality and avoid colostomy.