ObjectiveTo investigate the reason, prevention, and treatment measures of gastrointestinal unplanned reoperation. MethodsClinical data of 21 patients who carried out gastrointestinal unplanned reoperation for various reasons from Jun. 2012 to Jun. 2013 in our hospital were retrospectively analyzed. ResultsTwenty-one of 2 492 patients with gastrointestinal tract surgery carried out gastrointestinal unplanned reoperation, and the incidence of reoperation was 0.8%. The causes of reoperation were intra-abdominal hemorrhage in 10 cases, gastrointestinal fistula in 7 cases, inflammatory intestinal obstruction with peritonitis in 1 case, and incision dehiscence in 3 cases. After undergoing suture hemostasis, colostomy, anastomotic fistula repair, debridement, and suture,20 cases were cured or improved, and 1 case died. The median of hospitalization expense was 76 000 yuan(46 000-116 000 yuan), and the median of hospital stay was 25-day(16-49 days). ConclusionsGastrointestinal unplanned reoperation can cause more serious economic and emotional burden to patients, standardizing surgical procedure and enhancing perioperative monitoring can reduce the incidence of unplanned reoperation. In addition, grasp legitimately the indications of reoperation, implement timely, and effective reoperation can avoid further deterioration of the disease.
Objective To summarize the research progress of the adenocarcinoma of esophago-gastric junction (AEG) in recent years, in order to improve the further understanding of this disease. Method The literatures about application and research progress of AEG were researched and reviewed. Results Siewert classification was a widely recognized classification for AEG, according to this classification, AEG was divided into typeⅠ, Ⅱ, and Ⅲ. Gastroesophageal reflux, Barrett’ sesophagus, and the infection of Helicobacter pylori may be the important pathogenic factors. For SiewertⅠAEG, thoracic approach was preferred commonly, and for SiewertⅡand Ⅲ AEG, total gastrectomy through abdominal approach and distal partial resection of esophagus through diaphragmatic hiatus approach were recommended. Endoscopic submucosal resection, neoadjuvant therapy, targeted therapy, and multidisciplinary team were becoming more and more important in the treatment of AEG. Conclusions The choice of surgical method and resection range should according to the types of AEG. Comprehensive assessment and comprehensive treatment would be performed, so that effect of treatment may be improved.