目的:探讨在不同温度下进行体腔恒温循环热灌注化疗(Coelom Continued Circulatory HyperthermiaPerfusion,CCCHP)对实验动物生命体征和腹腔各脏器的影响,以寻求治疗的最适温度和有效控温的途径。方法:应用TRL型体腔循环灌注热化疗系统...目的:探讨在不同温度下进行体腔恒温循环热灌注化疗(Coelom Continued Circulatory HyperthermiaPerfusion,CCCHP)对实验动物生命体征和腹腔各脏器的影响,以寻求治疗的最适温度和有效控温的途径。方法:应用TRL型体腔循环灌注热化疗系统建立CCCHP动物模型,选用健康杂种家犬16只分别用41℃(分为单纯生理盐水组和顺铂组),42℃(生理盐水组),43℃(生理盐水组)腹腔温度对每组动物CCCHP 3次(临床治疗一个疗程),每次1h,间隔2d。记录犬的生命体征和治疗的各项参数。在每次CCCHP前及最后一次CCCHP 24h后抽取外周血备检肝肾功。CCCHP3次24h后及2周后时每组分别处死2只犬,开腹观察内脏器官的形态学改变,并切取肝、肾等脏器进行病理检查。结果:41℃腹腔温度下3次CCCHP对犬的生命体征及肝肾功无明显影响,肝、肾、脾和肠组织损伤轻微;41℃腹腔温度联合顺铂3次CCCHP也未对犬的正常生理功能造成明显影响;42℃,43℃腹腔温度行3次CCCHP后均对犬的生命体征及肝肾功有不同程度的影响,肝、肾、脾及肠组织均有不同程度的损伤,损伤程度随温度上升而加重。结论:41℃腹腔温度CCCHP 3次,每次1.0h是安全可行的,可以作为CCCHP联合化疗的安全治疗温度。展开更多
AIM:To study the short-term outcome of patients treated with laparoscopic right colectomy and how intracorporeal anastomosis has improved the outcome.METHODS:We retrospectively examined all patients affected by colore...AIM:To study the short-term outcome of patients treated with laparoscopic right colectomy and how intracorporeal anastomosis has improved the outcome.METHODS:We retrospectively examined all patients affected by colorectal cancer who underwent a laparoscopic right colectomy between January 2006 and December 2010 in our department.Our evaluation criteria were:diagnosis of colorectal carcinoma at presurgical biopsy,elective surgery,and the same surgeon.We excluded:emergency surgery,conversions from laparotomic colectomy,and other surgeons.The endpoints we examined were:surgical time,number of lymph nodes removed,length of stay(removal of nasogastric tube,bowel movements,gas evacuation,solid and liquid feeding,hospitalization),and major complications.Seventy-two patients were divided into two groups:intracorporeal anastomosis(39 patients)and extracorporeal anastomosis(33 patients).RESULTS:Significant differences were observed between intracorporeal vs extracorporeal anastomosis,respectively,for surgical times(186.8 min vs 184.1 min,P < 0.001),time to resumption of gas evacuation(3 d vs 3.5 d,P < 0.001),days until resumption of bowel movements(3.8 d vs 4.9 d,P < 0.001),days until resumption of liquid diet(3.5 d vs 4.5 d,P < 0.001),days until resuming a solid diet(4.6 d vs 5.7 d,P < 0.001),and total hospitalization duration(7.4 d vs 8.5 d,P < 0.001).In the intracorporeal group,on average,19 positive lymph nodes were removed;in the extracorporeal group,on average,14 were removed P < 0.001).Thus,intracorporeal anastomosis for right laparoscopic colectomy improved patient outcome by providing faster recovery of nutrition,faster recovery of intestinal function,and shorter hospitalization than extracorporeal anastomosis.CONCLUSION:Short-term outcomes favor intracorporeal anastomosis,confirming that a less traumatic surgical approach improves patient outcome.展开更多
文摘AIM:To study the short-term outcome of patients treated with laparoscopic right colectomy and how intracorporeal anastomosis has improved the outcome.METHODS:We retrospectively examined all patients affected by colorectal cancer who underwent a laparoscopic right colectomy between January 2006 and December 2010 in our department.Our evaluation criteria were:diagnosis of colorectal carcinoma at presurgical biopsy,elective surgery,and the same surgeon.We excluded:emergency surgery,conversions from laparotomic colectomy,and other surgeons.The endpoints we examined were:surgical time,number of lymph nodes removed,length of stay(removal of nasogastric tube,bowel movements,gas evacuation,solid and liquid feeding,hospitalization),and major complications.Seventy-two patients were divided into two groups:intracorporeal anastomosis(39 patients)and extracorporeal anastomosis(33 patients).RESULTS:Significant differences were observed between intracorporeal vs extracorporeal anastomosis,respectively,for surgical times(186.8 min vs 184.1 min,P < 0.001),time to resumption of gas evacuation(3 d vs 3.5 d,P < 0.001),days until resumption of bowel movements(3.8 d vs 4.9 d,P < 0.001),days until resumption of liquid diet(3.5 d vs 4.5 d,P < 0.001),days until resuming a solid diet(4.6 d vs 5.7 d,P < 0.001),and total hospitalization duration(7.4 d vs 8.5 d,P < 0.001).In the intracorporeal group,on average,19 positive lymph nodes were removed;in the extracorporeal group,on average,14 were removed P < 0.001).Thus,intracorporeal anastomosis for right laparoscopic colectomy improved patient outcome by providing faster recovery of nutrition,faster recovery of intestinal function,and shorter hospitalization than extracorporeal anastomosis.CONCLUSION:Short-term outcomes favor intracorporeal anastomosis,confirming that a less traumatic surgical approach improves patient outcome.
