Objective To identify clinicopathological features of laterally spreading tumors (LST) and explore the cancera-tion risk factors related with LSTs .Methods A retrospective analysis of clinical and pathological data was made in the patients , who underwent colonoscopy from May 2011 to May 2017 in the Digestive Endoscopy Center of Changhai Hospital and were conformed to the diagnostic criteria of LST and protruded-type adenoma ( PA) .Clinical features and related canceration risk factors of LST and its sub-type were analyzed and compared with those of PA .Results In the LST group, there were 422 patients, with a total of 439 LST le-sions, and in the PA group, there were 432 patients with 465 lesions.Canceration rates of the LST-G group, the LST-NG group and the PA group were respectively 7.72%, 11.69%and 2.58%.Regression analysis indicated that the canceration risk factors of LST were associated with those of PA , and morphological classification , pathogenic sites and polyp size were related canceration risk factors in LST.Morphological typing was LST-NG and pathogenic site was located at the left half colon , and the larger its size , the greater the canceration risk.Patient age, pathogenic site and polyp size were 3 canceration related risk factors of PA .Old age, pathogenic location at the right half colon and larger polyp size were high canceration risk factors .Conclusion LST seems to have greater malignant poten-tial than PA, especially the LST-NG type.The canceration risk factors of LST and PA are obviously different , indicating that the can-ceration mechanism of LST and PA might be entirely different .

Objective To investigate the clinical manifestations of early postoperative internal hernia. Methods Patients who were diagnosed with early postoperative small bowel obstruction(EPSBO)within 30 days after operation and underwent laparotomy between 1994 and 2006 were included for study.Clinical and radiological findings were analyzed. Results Totally 38 EPSBO patients were identined.among those,9 patients(23.7%)had an internal hera ag the cause of the howel obstruction.Other causes included intestinal adhesions in 27 patients(71.1%),gallstone ileus in 1 patient(2.6%)and stoma obstruction in 1 patient(2.6%).In the internal hernia group,6 cases were male and 3 cases were female witIl a mean age of 53.6 years.The mean time from the primary operation to symptom development was 7.8 d(range,2～17 d)and the mean time of conservative treatment Was 3.4 d(range,1～8 d).The main clinical features included:complete mechanical obstruction with symptoms rapidly progressing and early bowel strangulation.Specific radiologic abnormalities misht be identified,especially by contrast-enhanced CT.In this series,intestinal strangulation was found in 6 patients with bowel necrosis in 4 eases,necessitating howel resection in 5 patients.Wound infection developed in one cage and there was no perioperative death.Conclusion Internal hernia can occur early postoperatively and it bears a high risk of strangulation and bowel necrosis.Prompt operative intervention should be carried out in highly suspicious patients in order to avoid complications and achieve good outcome.