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Clinical effect and safety of surgical operation in treating benign tumor of the stomach and duodenum by laparoscopic combined gastroscope positioning

Zhiyong SHAO

Chinese Journal of Current Advances in General Surgery.2017;20(5):355-357,361. doi:10.3969/j.issn.1009-9905.2017.05.006

Objective:To analyze the clinical effect and safety of surgical operation in treating benign tumor of the stomach and duodenum by laparoscopic combined gastroscope positioning.Methods:47 cases of stomach and duodenum patients with benign tumorour in the hospital from September 2013 to December 2015 were chosen,32 cases were only used laparoscopy to treat gastric and duodenal benign tumor,the other 15 patients were difficult to locate by laparoscopy.Results:The operation time,blood loss,length of hospital stay,the rate of conversion to abdominal surgery and the incidence of postoperative complications were lower in the combined group than in the laparoscopic group,the difference was statistically significant(P＜0.05).All patients were followed up for 6～18 months,no recurrence occurred in the combined group,7 cases of recurrence in the laparoscopic group,the recurrence rate of the comparison between the two groups,the difference was statistically significant (x 2=0.049,P＜0.05).Conclusion:The laparoscopic combined gastroscope to treat gastric and duodenal tumor can be accurately and quickly locate,significantly shorten the operation time,reduces the operation caused by trauma,and has the advantage of less postoperative pain and recover rapidly,which has good clinical application value.

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Feasibility and safety of laparoscopic radical gastrectomy:a Meta-analysis

Gang CHEN ; Hezhao ZHAO ; Xiufeng CHEN ; Zhenzong TAN ; Miao HE

Chinese Journal of Current Advances in General Surgery.2017;20(5):350-354. doi:10.3969/j.issn.1009-9905.2017.05.004

Objective:To explore the feasibility and safety of laparoscopic radical gastrectomy for gastric cancer through analysising the laparoscopic radical gastrectomy and open radical gastrectomy.Methods:Retrieval the Cochrane Library,PubMed,EMBASE,CBM,VIP,CNKI,WANFANG DATA,the time is from January 2010 to August 2015.Bring into the comparative studies about laparosopic radical gastrectomy and laparotomye.Processing data using the revman 5.2 to reaserch the feasibility and safety of laparoscopic radical gastrectomy.Results:7 clinical comparative studies were included in this study.The observation group was the group of laparoscopic radical gastrectomy and the control group was the group of laparotomye.Results showed that the length of incision of the observation group was shorter[MD=-12.93,95％ CI (-13.16,-12.70),P＜0.00001];The observation group bleeding was lesser[MD=-129.98,95％C1(-220.54,-39.42),P=0.005];The number of lymph node of the two groups had no significant difference [MD=0.77,95％ CI (-2.56,3.60),P=0.56];The operation time of the observation group was longer [MD=49.17,95％ CI (25.32,73.02),P＜0.0001];The hospitalization time of the observation group is shorter [MD=-2.27,95％ CI (-3.77,0.77),P=0.003].Conclusion:Laparoscopic radical gastrectomy is feasible and it is superior to laparotomye within the thoroughness,minimally invasiving and safety.

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Value of the fine liver surgery concept in the treatment of HCC

Da ZHANG

Chinese Journal of Current Advances in General Surgery.2017;20(5):362-364,370. doi:10.3969/j.issn.1009-9905.2017.05.008

Objective:To investigate the value of fine liver surgery concept in the treatment of HCC.Methods:Retrospective analysis of 121 cases of HCC with liver resection in our hospital from September 2010 to September 2015,according to the operation method,they were divided into the fine liver resection group and the traditional liver resection group,the two groups of operation conditions,postoperative conditions,complications and follow-up results were compared.Results:The operation time of the fine liver resection group was longer than that of the traditional liver resection group,the amount of blood loss,blood transfusion,blood transfusion rate,hepatic portal occlusion rate,and the length of stay in the fine liver resection group were lower than those in the traditional liver resection group,and the difference was statistic:-.significant (P＜0.05);The ALT and TB in the patients with fine liver resection group postoperative 1 days,3 days and 5 days were lower than those in the traditional liver resection group,and the difference was statistically significant(P＜0.05);The incidence of postoperative complications in the fine liver resection group (7 cases,15.56％) was lower than that in the conventional liver resection group (25 cases,32.89％),and the difference was statistically significant (P＜0.05);The residual rate of resection margins and recurrence rate (4.44％,11.11％) in the fine liver resection group were lower than that of conventional liver resection group (17.11％,48.68％),and the difference was statistically significant (P＜0.05);The survival rate after precise liver resection 1 year and 2 years in the fine liver resection group (92.17％,85.31％) was higher than that of traditional liver resection group(90.58％,72.45％),and the difference was statistically significant (x 2=7.715,P=0.005).Conclusion:The efficacy and safety of fine liver resection in the treatment of HCC was superior to that of conventional liver resection.

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Clinical features and prognostic factors of elderly patients with liver failure complicated with fungal infection

Aibin GUO ; Haiyan GONG ; Mingmin HUANG ; Jingtao SHEN ; Hao WANG

Chinese Journal of Current Advances in General Surgery.2017;20(5):358-361. doi:10.3969/j.issn.1009-9905.2017.05.007

Objective:To observe the clinical characteristics of elderly patients with liver failure complicated with fungal infection,and to analyze the factors influencing the prognosis.Method:117 cases of elderly patients with liver failure,who were treated in our hospital from May 2013 to May 2015,were selected as object,according to whether combined with fungal infection,the patients were divided into Fungal infection group (57 cases) and non fungal infection group (60 cases).The differences of liver function index,treatment effective rate and mortality were observed between the two groups;To compare the prognosis of patients with different clinicopathological features,and to explore the factors influencing the prognosis of patients.Results:The scores of ALT,AST and DBIL in patients with fungal infection were significantly higher than those without fungal infection,and the difference was statistically significant (P＜0.05);The effective rate of the treatment group was significantly lower than that of the non fungal infection group,the mortality rate was higher than that of the non fungal infection group,the difference was statistically significant (P＜0.05);The death rate of patients with age was more than or equal to 70 years of age,with diabetes,with fungal infection were higher (P＜0.05);Logistic regression analysis showed that combined with diabetes mellitus,combined with fungal infection was an independent prognostic factor for elderly patients with liver failure (OR=2.982,4.817,P＜0.05).Conclusion:Liver function injury is severe in elderly patients with liver failure,the mortality rate is high,and fungal infection is more serious,and diabetes and fungal infection are risk factors for mortality.

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Correlation between serum homocysteine and the staging of gastric cancer

Xiangchao ZHU ; Kexin WANG ; Mingxin JIN ; Chunhui CUI ; Fengjun LIU

Chinese Journal of Current Advances in General Surgery.2017;20(5):346-349. doi:10.3969/j.issn.1009-9905.2017.05.003

Objective:To study the correlation between serum homocysteine (Hcy) and the staging of gastric cancer,by comparing the concentrations of patients with gastric cancer at different pathological staging.Methods:90 patients with benign gastric diseases and 138 patients with gastric cancer were selected and admitted by Shandong University Qilu Hospital during the date from Mar 2014 to Jun 2015.The patients with gastric cancer were divided into 4 groups,according to the 7th AJCC Cancer Staging.To compare the difference of the concentration levels of Hcy and Tumor marks in different groups and analyze the relationship between benign disease and gastric cancer,and analyze it correlation with different pathological stagings of gastric cancer.Enzymatic cycling assay was used for detecting serum Hcy.Results:The serum Hcy concentration level in benign disease was (1 2.31 ± 3.22) μ mol/L,and significantly lower than cancer group(1 6.19 ± 4.84) μ mol/L,the difference was statistically significant (P＜0.05):The serum Hcy concentration levels increased gradually from staging I to staging Ⅳ,and the concentration level in staging Ⅰ was (13.94 ± 4.07) μ mol/L,in staging Ⅱ was (15.49 ± 4.09) μ mol/L,in staging Ⅲ was (17.10 ± 4.79) μ mol/L,in stagingⅣ was (19.81 ± 5.77) μ mol/L,the differences among the four groups were statistically significant(P＜0.05).Spearman Rank Correlation analysis confirmed that,the Hcy concentration level was positively related with pathological staging(r=0.503,P＜ 0.001).Logistic regression analysis showed that,the serum Hcy concentration level is significantly correlated with gastric cancer,after the adjustment of other risk factors (OR=1.208,P=0.003).Conclusions:The serum Hcy concentration level is closely correlated with gastric cancer staging,and increase significantly with the cancer staging (from staging Ⅰ to staging Ⅳ),so itcan be used to evaluate the severity of gastric cancer.

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Application of total parathyroidectomy without autotransplantation in refractory secondary hyperparathyroidism

Meng YANG ; Ling ZHANG ; Linping HUANG ; Xiaoliang SUN ; Jun LIU ; Haoyang JI ; Yao LU

Chinese Journal of Current Advances in General Surgery.2017;20(5):342-345. doi:10.3969/j.issn.1009-9905.2017.05.002

Objective:To analyze the clinical outcome and feasibility for patients who underwent total parathyroidectomy without autotransplantation (TPTX) for secondary hyperparathyroidism (SHPT).Methods:From April 2012 to December 2015,220 SHPT patients underwent TPTX in the department of Breast and Thyroid Surgery of China-Japan Friendship Hospital.The clinical data and effect were assessed retrospectively.Results:All the 220 patients were on permanent dialysis with mean duration of dialysis (7.93 ± 3.75) years.A durable reduction in mean PTH,Ca and P were observed after TPTX (P＜0.01).The mean hospital stay was (7.8 ± 2.8) days.TPTX produced a rapid improvement in clinical symptoms.Incidence of hypocalcemia was 73.46％.Severe complications such as recurrent laryngeal nerve palsy or inactive dynamic osteopathia,haven't been observed postoperatively.The rate of persistent status (PTH≥300 pg/mL) was 9.1％.One (0.45％) died of infectious shock perioperatively.Conclusions:TPTX was a safe and feasible surgical procedure for patients with SHPT.It was worth of being applied.Not missing the parathyroid during operation was the key point for successful TPTX.Intensive monitoring and maintaining stable normocalcemia were the key point to reduce complication.

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Expression of P2X7 receptor in pancreatic carcinoma and the mechanisms in cell migration and invasion

Yong WANG ; Honglong WEI ; Tao LI ; Zongzhen XU ; Feng LIU ; Peng XIU ; Jie LI

Chinese Journal of Current Advances in General Surgery.2017;20(5):337-341. doi:10.3969/j.issn.1009-9905.2017.05.001

Objective:The aim of this study was to detect the P2X7 receptor (P2X7R) protein expression in pancreatic carcinoma and to analyze its association with clinicopathology features of pancreatic carcinoma.And furtherly to explore the effects and underlying mechanisms of P2X7R on invasion and migration of PANC-1 cell line.Methods:P2X7R expression was determined by immunohistochemistry in specimens of primary cancer and adjacent noncancerous tissues respectively,and analyzed the relationship between P2X7R expression and clinicopathology features of pancreatic carcinoma.The transwell assay and wound healing assay were used for investigating cell invasion and migration ability of PANC-1,and western blotting was performed to measure the expresions of MMP2 and MMP9.Results:P2X7R protein was highly expressed in both PANC-1 cell line and tumor tissue,and associated positively with the histological differentiation and lymph node staging.The active P2X7R could increase the cell migration and invasion ability of PANC-1 cell line through up-regulated MMP2 and MMP9.Conclusions:The overexpression of P2X7R plays crucial roles in the migration and invasion of pancreatic carcinoma,and may represent a novel molecular target in pancreatic carcinoma therapy.

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Role of RNF87 in predicting the prognosis of human hepatocellular carcinoma patients

kun Jian BI ; 山东大学齐鲁医学部山东济南250012 ; ru Zhao DONG ; Dong SUN ; ze Hong SUN ; Chuang LIU ; gang Fa GUO ; Tao LI ; qiang Zhi CHEN ; Tao LI ; ting Xu ZHI

Chinese Journal of Current Advances in General Surgery.2017;20(8):623-626. doi:10.3969/j.issn.1009-9905.2017.08.010

Objective:To investigate the level and prognostic significance of RNF87 in human hepatocellular carcinoma.Methods:Detected the expression of RNF87 in 98 HCC tissues by immunohistochemistry and Western Blot.According to the clinical data of the patients,we analyzed the relationship between RNF87 level and the prognosis of the HCC patients.Results:The level of RNF87 in HCC tissues is down-regulated,compared with the adjacent tissues.And the expression of RNF87 was significantly related to the prognosis of HCC patients.Besides,the lower level of RNF87 was also obviously related with microvascular invasion.Conclusions:The down-regulated level of RNF87 may be one of the risk factors of human hepatocellular carcinoma progression;RNF87 maybe one of potential tumor suppressors;the level of RNF87 can be used as an indicator to predict the prognosis of HCC patients.

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Prevention effect of specimen skin transplantation for skin flap necrosis after breast cancer surgery

dong Xing WANG ; Yong LI

Chinese Journal of Current Advances in General Surgery.2017;20(8):607-610. doi:10.3969/j.issn.1009-9905.2017.08.006

Objective:To study the prevention effect of specimen skin transplantation for skin flap necrosis after breast cancer surgery.Methods:A retrospective analysis of 116 patients with breast cancer treated by surgery from January 2015 to November 2015 was reviewed,with skin graft in 58 cases,recorded as the observation group;skin graft was not accepted in 58 cases,as the control group,compared skin flap necrosis rate between the two groups after the operation,the operation index (operation time,hospitalization time,follow-up time and two times the proportion of skin graft),and before and after the operation of the IL-1 β,IL-6 and TNF-α levels.Resultes:The observation group of full-thickness skin flap necrosis of skin flap necrosis ratio was 0,the total incidence rate was 8.62％,which were significantly lower than the control group of 8.62％ and 25.86％,the differences were statistically significant(P＜0.05).Hospitalization time of the observation group and two skin graft ratio were significantly less than the control group,the differences were statistically significant (P＜0.05).The two groups after the IL-1 β,IL-6 and TNF-α respectively was significantly lower than that before treatment,the difference was statistically significant (P＜0.05).The patients in the observation group of IL-1 β,IL-6 and TNF-α respectively was significantly lower than the control group,the difference was statistically significant (P＜0.05).Conclusions:For large masses of breast cancer patients,under the premise of clear skin edge there is no residual cancer,through specimen skin transplantation can better prevention of skin flap necrosis after,at the same time,can promote the rehabilitation of patients,the effect is good,it is worth to give recommendation.

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Role and significance of PANP in laparoscopic surgery for low rectal cancer

dong Lian SHEN ; hai Wen QI ; cai Guang CAO ; ling Xin ZONG

Chinese Journal of Current Advances in General Surgery.2017;20(8):639-641,672. doi:10.3969/j.issn.1009-9905.2017.08.014

Objective:To investigate the clinical significance of preserving autonomic nerve (PANP) in patients with low rectal cancer.Methods:The clinical data of 68 cases of patients with low rectal cancer who underwent laparoscopic surgery in our hospital from March 2014 to January 2016 were retrospectively analyzed.According to the surgical methods,the patients were divided into PANP group and non PANP group.Two groups of patients with postoperative micturition function,sexual function and quality of life were observed,compared with the two groups of patients with postoperative satisfaction differences.Results:In retention of PANP group of patients with postoperative ultrasonic residual urine volume was lower than that in non retention in PANP group were less and recovery of automatic micturition time is short retention in PANP group,IPSS score was lower than that in non low retention in PANP group,the difference is statistically significant(P＜0.05);The female and male patients with retention of PANP group were better than those of non retention PANP group,and the difference was statistically significant (P＜0.05);There was no significant difference in quality of life between the two groups before surgery.After surgery,the quality of life of the two groups was lower than before treatment,and the decrease of PANP group was more obvious than that of the non retention group (P＜0.05).Conclusions:The autonomic nerve preservation in the operation of low rectal cancer has a good protective effect on the urinary function and sexual function,and can obviously improve the quality of life of patients after operation.

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