west china medical publishers
Author
  • Title
  • Author
  • Keyword
  • Abstract
Advance search
Advance search

Search

find Author "卞邦健" 3 results
  • Study on Reconstruction of Digestive Tract Following Total Gastrectomy in Rats

    Objective To find out some ideal reconstructions after total gastrectomy in experimental study of rat. Methods Sixty male Sprague-Dawley rats were randomly and averagely divided into 6 groups: Roux-en-Y group (RY group), proximate jejunal pouch group (PJP group), distal jejunal pouch group (DJP group), two jejunal pouchs group (TJP group), duodenumjejunal pouch interposition group (DJPI group) and laparotomy group (L group). Body weight of rats, intestinal transit distance, adaptive changes in esophagojejunostomic mucosa and morphology changes of intestine after operation were observed and compared. Results At 2 weeks after operation, body weight in each group were significantly lower than that before operation (P<0.05). At 4 weeks postoperatively, body weight in PJP group, TJP group and DJPI group were significantly higher than that in RY group respectively (P<0.05), as well as at 8 weeks. Intestinal transit distance in PJP group was shorter than that in RY group (P<0.05). With regard to intestinal mucosa, TJP group and DJPI group were significantly different with RY group (P<0.05). Interestingly, there was no difference in each group as to refluxing esophagitis (P>0.05). Conclusion  Proximate and two jejunal pouchs Roux-en-Y esophagojejunostomy seem to be ideal procedures for digestive tract reconstruction after total gastrectomy. The jejunal pouch interposition procedure seems to be same effective to PJP and TJP, but there is no preponderance over the former.

    Release date:2016-09-08 11:47 Export PDF Favorites Scan
  • Clinical Significance of Lymphangiogenesis, Lymph Vessel Invasion and Lymph Node Micrometastasis in Gastric Cancer

    Objective To investigate the clinical meanings of lymphangiogenesis, lymph vessel invasion (LVI) and lymph node (LN) micrometastasis in gastric cancer. Methods The expression of D2-40 in 68 patients with gastric cancer of primary lesion and the expressions of CK20 and (or) CKpan in 791 lymph nodes from 51 cases which were detected by immunohistochemical staining were analyzed, as well as their clinicopathologic profiles. The relationship of lymph vessel density (LVD), LVI and LN micrometastasis with LN metastasis and other clinicopathologic parameters was analyzed respectively. Results Positive rate of LVI with HE (LVI-HE) and D2-40 (LVI-IM) staining was respectively 66.2%(45/68) and 76.5%(52/68), P=0.118. The positive rate of LVI-IM was related to deeper tumor invasion (P=0.044), later stage of TNM (P=0.003) and LN metastasis (P=0.000). Average LVD of 68 cases was (18.19±7.44)/HP. The increment of LVD was significantly associated with LVI-HE positive status (P=0.040), LVI-IM positive status (P=0.001), venous invasion (P=0.037), later stage of TNM (P=0.020) and LN metastasis (P=0.001). The survival rate of the group sharing ≥15/HP of LVD was significantly lower than that in the group sharing ≤14/HP of LVD in early period of follow-up (P=0.032). The incidence of nodal involvement in 51 patients was increased from 74.5%(38/51) by HE staining to 88.2%(45/51) by CK (CK20 or CKpan) immunostaining. The detection rate of metastasized LN was increased from 32.0%(253/791) by HE staining to 41.5%(328/791) by CK immunostaining (Plt;0.001). The significant difference of LN micrometastasis detection rate between CK20 (8.7%) and CKpan (12.3%) was also identified (P=0.003). The increased number of LN micrometastasis was related to larger diameter of tumor (P=0.001), higher LVI-HE positive rate (P=0.040), deeper invasion of tumor (P=0.018) and later stage of TNM (P=0.012). Both LN stage and TNM stage were changed according to the detection of LN micrometastasis: Seven patients of N0 should be recognized as N1 (N0→N1), 6 as N1→N2, 1 as N2→N3. Four patients of stage Ⅰb should be recognized as stage Ⅱ (Ⅰb→Ⅱ), 4 as Ⅱ→Ⅲa, 3 as Ⅲa→Ⅲb, 1 as Ⅲb→Ⅳ. Conclusion Detection of D2-40 and CK in diagnosis of LVI and LN micrometastasis is better than HE staining. The combined detection of CK20 and CKpan may be much easier to find out the LN with micrometastasis. Later stage of TNM the tumor is, more frequently the LN micrometastasis happens. The relationships of LVI-IM, LVD and LN micrometastasis with LN metastasis in gastric cancer has been demonstrated. Patients with higher LVD share a lower survival rate in early period of follow-up.

    Release date: Export PDF Favorites Scan
  • 腹腔镜阑尾切除术治疗急性穿孔性阑尾炎的临床疗效分析及经验体会

    目的总结腹腔镜阑尾切除术治疗急性穿孔性阑尾炎的临床疗效及经验体会。方法回顾性分析 2014 年 9 月至 2018 年 9 月期间上海交通大学医学院附属第九人民医院北部普外科收治的 48 例行腹腔镜阑尾切除的急性穿孔性阑尾炎患者的临床资料。收集患者的术前资料、手术资料和术后相关资料,分析腹腔镜阑尾切除术治疗急性穿孔性阑尾炎的临床疗效。结果48 例患者中,有 2 例因腔镜下缝合困难中转开腹(4.2%),46 例顺利完成腹腔镜手术(95.8%);手术时间(70±21)min,术中出血量(28±15)mL,术后肛门排气时间(33±15)h;术后腹腔引流管前 2 d 的引流量较多,拔管时间为术后 3~5 d,平均 4 d;出院时间为术后 3~10 d,平均 5 d。术后第 1 天所有患者均有发热,体温较术前高,3 d 后体温逐渐正常,白细胞计数也表现为同样的趋势。术后 15 例患者出现并发症,其中 10 例切口感染,4 例腹腔感染,1 例肠梗阻,通过保守治疗,所有患者均好转出院,无再次手术患者。术后 48 例患者的随访时间为 3~6 个月,均未出现腹痛、腹胀等症状。结论腹腔镜阑尾切除术治疗急性穿孔性阑尾炎是安全可行的,值得推广。

    Release date:2019-05-08 05:34 Export PDF Favorites Scan
1 pages Previous 1 Next

Format

Content