ObjectiveTo explore the correlation between multiple clinicopathologic factors and perineural invasion in patients with pancreatic carcinoma.MethodsThe clinical data of 90 patients with pancreatic carcinoma in the Department of General Surgery of Shanghai Ninth People’s Hospital of Shanghai JiaoTong University School of Medicine from January 2012 to January 2020 were retrospectively collected. We collected clinical data such as patient medical records, surgical records, nursing records, examination reports, pathological reports, and studied the parameters that affect the occurrence of perineural invasion in patients with pancreatic carcinoma.ResultsAmong 90 patients with pancreatic carcinoma, 47 cases had perineural invasion and 43 cases had no perineural invasion. The univariate analysis results showed that perineural invasion was associated with abdominal pain and low back pain, levels of fasting blood glucose, glycosylated hemoglobin, CA19-9, carcinoembryonic antigen (CEA), and bilirubin, as well as tumor location, TNM stage, differentiation degree, lymph node metastasis, vascular cancer thrombus, peripheral invasion, and expression of p53 (P<0.05). Binary logistic regression analysis showed that abdominal or lower back pain, increased fasting blood glucose, tumor with invasion of surrounding tissues, and p53-positive expression were the independent risk factors for perineural invasion of pancreatic carcinoma (P<0.05).ConclusionPatients with pancreatic carcinoma have abdominal or lower back pain, elevated fasting blood glucose before surgery, tumor with surrounding tissue invasion, and p53-positive expression are independent risk factors for perineural invasion, which should be paid attention to.
ObjectiveTo explore risk factors and prognosis of unplanned reoperation in patients with malignant tumors of digestive tract. MethodsThe clinical data of patients with malignant tumors of digestive tract underwent unplanned reoperation who treated in the Department of General Surgery, the Northern District of the Shanghai Ninth People’s Hospital from January 2014 to December 2017 were retrospectively collected, and each operation was matched in a ratio of 1∶3 as a case-conontrol study object. The risk factors and prognosis of unplanned reoperation were analyzed by the basic information, surgical related informations, and postoperative relevant informations. ResultsThere were 33 cases of unplanned reoperation in the 588 patients with malignant tumors of digestive tract treated surgically, 8 cases died after the unplanned reoperation. The analysis results showed that the basic diseases, history of previous abdominal surgery, preoperative anemia, the first operative time >4 h and intraoperative blood loss ≥400 mL were the independent risk factors of the unplanned reoperations (P<0.050); the basic diseases, unplanned preoperative hemoglobin <90 g/L and intraoperative blood loss ≥400 mL were the independent factors of death for patients with unplanned reoperation (P<0.050). ConclusionsEffective intervention on independent risk factors associated with unplanned reoperation in patients with digestive tract malignant tumors can reduce incidence of unplanned reoperation in future and improve prognosis.