Objective To summarize the research progress in antitumor mechanism of non-steroidal anti-inflam-matory drugs. Methods The domestic and international published literatures about antitumor mechanism of non-steroidal anti-inflammatory drugs in recent years were reviewed. Results The antitumor mechanism of non-steroidal anti-inflam-matory drugs was multistrata and multidigit. Conclusion Non-steroidal anti-inflammatory drugs can be used to prevent the development of colorectal cancer and also be a adjuvant therapy after radical operation for colorectal cancer.
ObjectiveTo summarize the functional outcomes of transanal total mesorectal excision (TaTME).MethodThe literatures about functional outcomes and existing problems secondary to TaTME in China and abroad were collected to make a review.ResultsNeither the TaTME or the laparoscopic TME (LTME) had few serious impact on the quality of life of patients. At present, only a few studies were involved in the postoperative sexual function, and no definite conclusion could be drawn. From the current data only, the TaTME had few serious impact on the sexual function and it didn’t show some advantages as compared with the LTME. The urinary and defecation functions showed no obvious differences between the TaTME and the LTME, which of the patients after the TaTME might be impaired to some extent. The defecation disorders mainly occurred in 1—6 months after the TaTME, but it would recover to a certain extent as time went on.ConclusionsAlthough TaTME has more advantages in protecting pelvic autonomic nerves, there is no obvious difference in postoperative organ function as compared with LTME surgery at present. Multi-center, large sample size, and long-term follow-up studies are still needed to validate long-term results.
目的 评价全直肠系膜切除术在直肠癌手术中的价值。方法 回顾性分析148例中下段直肠癌接受全直肠系膜切除术的情况。结果 148例平均失血150 ml（50～600 ml），平均手术时间4.3 h，保肛103例（69.6%），其中Dixon术96例，改良Bacon术7例。术后发生吻合口漏3例（2.9%），全组发生切口感染（包括会阴切口、造瘘口）5例（3.4%）。随访2年以上的病例117例，局部复发8例（6.8%），其中保肛86例中局部复发2例（2.3%），非保肛31例中局部复发6例（19.4%），无尿潴留及性功能丧失，无手术死亡。结论 全直肠系膜切除术使直肠癌患者更容易达到治愈，局部控制及保留括约肌，保留性功能和膀胱功能的标准，且出血少，不增加手术时间及吻合口漏和切口感染。
Objective To explore the feasibility and clinical effect of the nano-carbon particles in laparoscopic operation for adenocarcinoma of esophagogastric junction. Methods From 2008 to 2011， 119 patients with adenocar-cinoma of esophagogastric junction who underwent the laparoscopic operation were divided into study group （n=56） and control group （n=63）. The nano-carbon particle was injected into the subserosa around the tumor using the injection needle made by ourselves for lymphatic tracing before the laparoscopic operation in the study group， while no tracer was given in the control group. The indexes of lymph nodes， operation time， intraoperative blood loss， and postoperative hospital stay were compared in two groups. Results The nano-carbon particle was injected into the subserosa around the tumor successfully in the study group. The numbers of dissected lymph nodes and metastatic lymph nodes in the study group were significantly more than those in the control group （dissected lymph nodes：20.52±4.51 versus 16.44±3.80， t=5.341，P=0.000；metastatic lymph nodes：8.88±3.15 versus 6.49±2.49， t=4.602， P=0.000）. There were no statistical diff-erences in the intraoperative blood loss， operation time， and postoperative hospital stay in two groups 〔intraoperative blood loss：（97.50±27.52） ml versus （96.03±22.83） ml， t=0.318， P=0.751；operation time：（221.07±24.25） min versus （230.48±38.54） min， t=-1.570， P=0.119；postoperative hospital stay （10.82±1.67） d versus （10.29±1.33） d， t=1.945， P=0.054〕. Conclusions Injection of the nano-carbon particles using the injection needle made by ourselves is feasible in laparoscopic operation for adenocarcinoma of esophagogastric junction. It can increase number of dissected lymph nodes without increasing operation time， intraoperative blood loss， and postoperative hospital stay.
Objective To summarize the research progress of transanal total mesorectal excision (TaTME) for rectal cancer. Methods The literatures about current status, limitations, and prospects of TaTME in China and abroad were collected to make an reviewe. Results TaTME is conformed to the principle of total mesorectal excision (TME), by using the ‘bottom-up’ approach and assisting in the laparoscopic technique platform, to ensure an adequate oncological distal margin, and it could improve the quality of the mesorectum specimens, reduce the circumferential margin involvement rate, afford more precise autonomic nerve preservation rate, and increase sphincter preservation rate. But it is also facing new complications, oncological and functional outcomes problems. Conclusions Although the experience with TaTME remains limited, the safety, feasibility, and short-term outcomes are acceptable. Nevertheless, there is a need for multicenter, large sample size, and long-term follow-up clinical studies focusing on the long-term outcomes to further improve the oncological safety of TaTME, before widespread application can be recommended.
ObjectiveTo summarize the current commonly used anal function assessment methods after anorectal preservation surgery, and to discuss the current status of research and existing problems of anal function in patients after transanal total mesorectal excision (taTME) surgery.MethodBy searching the relevant literatures in domestic and international databases, the studies on anal function of patients after taTME and the studies on anal function assessment tools after anorectal preservation surgery were included to make an review.ResultsThere was little literatures on the recovery of anal function after taTME, especially the long-term recovery of anal function after taTME was still unclear. The anal function in the early stage after traditional anal preserving operation for rectal cancer may be superior to taTME, but the recovery of anal function in the middle and long term after operation was similar. In terms of research tools, most of the current studies tend to use scale assessment method to describe the recovery of anal function after taTME, while the objective quantitative index, such as anorectal manometry and anal ultrasound were rarely used.ConclusionAt present, there is a single and inconsistent research tool for the study of postoperative anal function after taTME, so further research is still needed to provide data reference for the postoperative anal function recovery curve of rectal cancer patients.
Objective To evaluate the effect of laparoscopy-assisted surgery for lymph node dissection in patients with carcinoma of gastric cardia. Methods The clinical data of patients with carcinoma of gastric cardia who underwent either laparoscopy-assisted or open gastrectomy between January 2004 and September 2009 in the Department of General Surgery, the Nanchong Central Hospital were analyzed retrospectively. The number of lymph node dissection was compared. Results Thirty-nine patients underwent laparoscopy-assisted gastrectomy (laparoscopy group) and 63 patients underwent open gastrectomy (open group). There was no significant difference in preoperative complications, type of pathology or pTNM stage between two groups (Pgt;0.05). The number of lymph node dissection was 16.44±6.25 in the laparoscopy group， of which the number of first station lymph node was 10.56±3.78 (metastasis rate was 74.4%), the second station was 3.82±1.82 (metastasis rate was 46.2%), the third station was 2.00±1.36 (metastasis rate was 5.1%); in the open group, the numbers of corresponding lymph node were 16.38±5.83, 10.94±3.91 (metastasis rate was 71.4%), 3.71±1.55 (metastasis rate was 42.9%), and 1.75±1.06 (metastasis rate was 3.2%), respectively. There was no significant difference between two groups (Pgt;0.05). Conclusion The effectiveness of lymph node dissection is satisfactory by laparoscopy-assisted surgery for patients with carcinoma of gastric cardia, but prospective efficacy is still being followed up.
目的 探讨局麻下经胸前入路行腔镜甲状腺手术的体会。方法 对2009年3月至2010年3月期间四川省南充市中心医院普外科收治的28例在局麻下行腔镜甲状腺手术患者术中及术后情况进行回顾性分析。结果 1例因术中冰冻检查发现为甲状腺癌而转开放性手术未纳入分析。视觉模拟镇痛评分（VAS）: 术中评分结果为0～5分，平均2.2分; 术后评分结果为0～3分，仅2例口服布洛芬缓释胶囊镇痛，其余25例未使用镇痛药物。手术时间为95～215 min，平均117 min; 术中出血量为50～150 ml，平均84 ml。术后引流量为25～70 ml，平均34 ml； 引流管放置时间为2～4 d。住院时间平均4.5 d。术后颈部及胸壁皮下无瘀血、肿胀，无声嘶、呛咳。经随访2~10个月（平均8个月），未见切口处明显瘢痕。结论 局麻下经胸前入路行腔镜甲状腺手术切实可行，并具有良好的美容效果。