Objective: To evaluate the effects of surgical trauma of open surgery on the patients with gastric carcinoma who underwent different lymph node dissection. Methods:Total 30 patients with gastric carcinoma were divided...Objective: To evaluate the effects of surgical trauma of open surgery on the patients with gastric carcinoma who underwent different lymph node dissection. Methods:Total 30 patients with gastric carcinoma were divided into three groups (D1, D2, and D3) according to the extent of lymph node dissection. Peripheral blood samples were taken to measure the levels of interleukin-6 (IL-6), interleukin-8 (IL-8), C-reactive protein (CRP) and polymorphonuclear elastase (PMNE). Ad- ditionally, leucocytes and lymphocytes counts in peripheral serum were also detected. Results: All the three groups showed a significant increase of the levels of IL-6, IL-8, CRP and PMNE after operation. There was no significant difference between D1 and D2 groups. When the comparison was made between D3 group and the other two groups, it showed higher concentration of IL-6, IL-8, CRP and PMNE in serum of D3 group. Leucocytes count showed no difference among the three groups. After operation, the patients in three groups had transient lymphocytes decrease on the second and third postoperative days, the lymphocytes count in D3 group was still lower while those in D1 and D2 groups began to increase. Conclusion: IL-6, IL-8, CRP and PMNE can be used to monitor surgical stress. Using these parameters, we found that extended lymph node dissec- tion of D3 group led to more postoperative stress than D1 and D2 groups.展开更多
The treatment of gastric carcinoma consists of neoadjuvant chemoradiation,partial gastrectomy,subtotal gastrectomy,total gastrectomy,extended resection,and postoperative chemotherapy.Currently,gastrectomy and extended...The treatment of gastric carcinoma consists of neoadjuvant chemoradiation,partial gastrectomy,subtotal gastrectomy,total gastrectomy,extended resection,and postoperative chemotherapy.Currently,gastrectomy and extended lymphadenectomy is the optimal choice for late gastric carcinoma.Postoperative complications are common after total gastrectomy including hemorrhage,anastomotic leakage,f istula,and obstruction.However,deep venous thrombosis(DVT) is an uncommon complication after gastrectomy for gastric carcinoma.We describe a case of a 68-year-old female patient with DVT after gastrectomy for gastric carcinoma.The patient was treated with anticoagulants and thrombolytics and subjected to necessary laboratory monitoring.The patient recovered well after treatment and was symptom-free during a 3-mo follow-up.We conclude that correct diagnosis and treatment of DVT are crucial.展开更多
Objective： To explore the feasibility and clinical value of secondary sentinel lymph node （SSLN） tracing technique in radical gastrectomy for advanced gastric cancer （AGC）. Methods： From January 2009 to June 201...Objective： To explore the feasibility and clinical value of secondary sentinel lymph node （SSLN） tracing technique in radical gastrectomy for advanced gastric cancer （AGC）. Methods： From January 2009 to June 2011,247 patients who suffered from gastric angle cancer with metastasis in No. 3 group lymph nodes were divided randomly into groups A and B. Methylthioninium chloride was injected into the peripheral tissue of the metastatic No. 3 group lymph nodes of 138 patients in group A before tumor resections. SSLNs were traced and individual lymphadenectomies were carried out based on the biopsy results of the SSLNs. Standard D2 radical gastrectomies were carried out directly on 109 patients in group B. Postoperative follow-up and survival analysis were carried out for patients in both groups. Results： SSLNs were found in 114 （82.6%） patients in group A. Ninety of those patients （78.9%） demonstrated existing metastasis in SSLNs. According to Kaplan-Meier＇s method, the postoperative 3-year cumulative survival rates were 63.5% and 47.5%, and the median survival time were 40 and 36 months for the patients of groups A and B, respectively （P〈0.05）. Conclusions： The SSLN tracing technique is feasible in radical gastrectomy for AGC. It gives surgeons important information about the terminal status of lymph node metastasis and provides some scientific basis for individual lymphadenectomy.展开更多
文摘Objective: To evaluate the effects of surgical trauma of open surgery on the patients with gastric carcinoma who underwent different lymph node dissection. Methods:Total 30 patients with gastric carcinoma were divided into three groups (D1, D2, and D3) according to the extent of lymph node dissection. Peripheral blood samples were taken to measure the levels of interleukin-6 (IL-6), interleukin-8 (IL-8), C-reactive protein (CRP) and polymorphonuclear elastase (PMNE). Ad- ditionally, leucocytes and lymphocytes counts in peripheral serum were also detected. Results: All the three groups showed a significant increase of the levels of IL-6, IL-8, CRP and PMNE after operation. There was no significant difference between D1 and D2 groups. When the comparison was made between D3 group and the other two groups, it showed higher concentration of IL-6, IL-8, CRP and PMNE in serum of D3 group. Leucocytes count showed no difference among the three groups. After operation, the patients in three groups had transient lymphocytes decrease on the second and third postoperative days, the lymphocytes count in D3 group was still lower while those in D1 and D2 groups began to increase. Conclusion: IL-6, IL-8, CRP and PMNE can be used to monitor surgical stress. Using these parameters, we found that extended lymph node dissec- tion of D3 group led to more postoperative stress than D1 and D2 groups.
文摘The treatment of gastric carcinoma consists of neoadjuvant chemoradiation,partial gastrectomy,subtotal gastrectomy,total gastrectomy,extended resection,and postoperative chemotherapy.Currently,gastrectomy and extended lymphadenectomy is the optimal choice for late gastric carcinoma.Postoperative complications are common after total gastrectomy including hemorrhage,anastomotic leakage,f istula,and obstruction.However,deep venous thrombosis(DVT) is an uncommon complication after gastrectomy for gastric carcinoma.We describe a case of a 68-year-old female patient with DVT after gastrectomy for gastric carcinoma.The patient was treated with anticoagulants and thrombolytics and subjected to necessary laboratory monitoring.The patient recovered well after treatment and was symptom-free during a 3-mo follow-up.We conclude that correct diagnosis and treatment of DVT are crucial.
基金supported by the Projects of Sichuan Provincial Health Department Scientific Research(Nos.050182 and 090250),China
文摘Objective： To explore the feasibility and clinical value of secondary sentinel lymph node （SSLN） tracing technique in radical gastrectomy for advanced gastric cancer （AGC）. Methods： From January 2009 to June 2011,247 patients who suffered from gastric angle cancer with metastasis in No. 3 group lymph nodes were divided randomly into groups A and B. Methylthioninium chloride was injected into the peripheral tissue of the metastatic No. 3 group lymph nodes of 138 patients in group A before tumor resections. SSLNs were traced and individual lymphadenectomies were carried out based on the biopsy results of the SSLNs. Standard D2 radical gastrectomies were carried out directly on 109 patients in group B. Postoperative follow-up and survival analysis were carried out for patients in both groups. Results： SSLNs were found in 114 （82.6%） patients in group A. Ninety of those patients （78.9%） demonstrated existing metastasis in SSLNs. According to Kaplan-Meier＇s method, the postoperative 3-year cumulative survival rates were 63.5% and 47.5%, and the median survival time were 40 and 36 months for the patients of groups A and B, respectively （P〈0.05）. Conclusions： The SSLN tracing technique is feasible in radical gastrectomy for AGC. It gives surgeons important information about the terminal status of lymph node metastasis and provides some scientific basis for individual lymphadenectomy.
