目的 评价采用圆形吻合器治疗直肠黏膜脱垂的安全性和可行性. 方法 回顾性分析2002年10月至2006年1月我院手术治疗的42例直肠黏膜脱垂患者的临床资料,其中直肠内黏膜脱垂22例,直肠外黏膜脱垂20例,均经排粪造影诊断. 结果 42例均行经肛门直肠黏膜环切术(procedure for prolapse and haemorrhoids,PPH),术后随访2～40个月,2例术后半年少量便血,肠镜检查为吻合口丝线缝合处肉芽生长所致.总有效率为88.1%(37/42),其中直肠内黏膜脱垂有效率为81.8%(18/22),直肠外黏膜脱垂有效率达95.0%(19/20). 结论 PPH术治疗直肠外黏膜脱垂优于直肠内黏膜脱垂,手术简便.
We evaluated the surgical results in 32 patients with liver metastasis from colorectal carcinoma. Twenty four patients had 1-3 metastatic hepatic nodules and 20 patients had synchronous hepatic metastasis. Liver resection was carried out simultaneously with radical resection of the primary tumour in 15 patients, 5 patients experienced resection 2 to 4 weeks later. Liver and primary tumour were resected as a whole in 5 patients with infiltrating metastasis from colonic carcinoma.Other operative types included atypical resections, left lateral lobectom and right posterior lobectomy, and right hemihepatactomy, right trilobectomy.Hepatic metastasis were all documented by pathology. The 3year and 5year survival rate were 37.5% and 25.0%, with no operative death. The authors believed that the number of metastasis is the most important factor influencing the surgical result, and liver resection is an effective form of treatment for patients with resectable liver metastasis from colorectal carcinoma, but the type of surgery shall be choosed reasonably.
One hundred and twenty eight patients with intestinal obstruction due to cancer of left lemicolon are presented. In this series 71 patients suffered from partial intestinal obstruction and 57 patients from complete obstruction, the latter were in later Dukes stages, with lesser resectability of the tumor and higher mortality. The transition from partial obstruction to complete obstruction takes a slow course. Purgatives and coarse fibered food should not be given to the patients with partial obstruction, or else will induce acute obstruction. Several types of operation for partial and complete obstruction are discussed. Methods and results of intraoperative colonic irrigation are presented. The authors believe that intraoperative colonic irrigation is a good emergency management for cancer obstruction of the left colon. Complication of this disease are also discussed.
Gastrin(G) concentration in fasting blood, cancer tissues and its adjacent mucosas sampled from fourty-three patients with large intestine carcinoma (LIC) were measured. The results showed fasting G levels in patients with LIC were significantly higher than those in the normal surum controls (Ｐ＜0.05),and dropped to normal value after resection of the cancers. Surum G levels were correlated with cell differentiations of the cancer.The cancer tissues and its adjacent mucosas contained higher levels of G than the normal mucosas (Ｐ＜0.05). The results provided a laboratory evidence that the growth of LIC in vivo were regulated by G and G level might be an indicative parameter for selection of patients with LIC to be treated with hormone therapy and the study of biological character of LIC.
The effects of pentagastrin (PG) on the viable cell count (Α value) and the synthesis of DNA (CPM value) of primary cultured large bowel carcinoma cells in 25 patients were evaluated in vitro by MTT assay,3H-TdR incorporation. The results showed that Α value and CPM value in well， moderately and poorly-differentiated carcinoma cells were higher than normal control (Ｐlt;0.01，Ｐ＜0.05). The proliferative effect was significant at a dose of 0.3907 μg/ml in well-differentiated carcinoma cells, and at a dose of 6.2500μg/ml in moderately and poorly-differentiated carcinoma cells. These indicat that PG has the proliferative effect on large bowel carcinoma cells. These results provide an experimental foundation for the endocrine therapy for patients with large intestine carcinoma, especially by using gastrin receptor antagonists for well-differentiated carcinoma.