AIM To investigate the effect of gastroenteric reconstruction on the nutritional status of patients with gastric cancer after total gastrectomy. METHODS From 1989 1994, nutritional status was studied in 24 patient...AIM To investigate the effect of gastroenteric reconstruction on the nutritional status of patients with gastric cancer after total gastrectomy. METHODS From 1989 1994, nutritional status was studied in 24 patients, including 12 patients with the gastric reservoir and pyloric sphincter reconstruction (GRPS), 7 with Braun′s esophago jejunostomy (EJ) and 5 with Lawrance′s Roux en Y reconstruction (RY). The ability of these patients to ingest and absorb the amount of nutrients was examined and compared, and metabolic balance test was performed to compare the efficiency of those patients to accumulate and use the absorbed nutrients. RESULTS In the controlled hospital situation, the amount of food ingested by all the patients was greater than that required for maintenance of ideal body weight. In direct contrast, food intake in most patients with EJ or RY reconstruction significantly decreased when the patients returned home and that in EJ patients it was the lowest. The overgrowth of anaerobic bacteria was found in the jejunum in the patients with EJ and RY, due mainly to food stasis in the duodenum or in the Roux limb, caused by the operative procedure itself. In patients with GRPS, because of restoring of the alimentary continuity according to the normal digestive physiologic characters, all the nutritional parameters could fall in the normal range. CONCLUSION The most common mechanism responsible for postoperative malnutrition was inadequate food intake. Having solved the problem of alkaline reflux esophagitis, it is imperative to preserve the duodenal food passage to reduce malabsorption and other complications after total gastrectomy.展开更多
AIM:To study the relationship between ABO blood groups and carcinoma of esophagus and cardia in Chaoshan inhabitants of China, which is a unique Littoral high-risk area of esophageal carcinoma in China. The poor commu...AIM:To study the relationship between ABO blood groups and carcinoma of esophagus and cardia in Chaoshan inhabitants of China, which is a unique Littoral high-risk area of esophageal carcinoma in China. The poor communication and transportation in the past has made Chaoshan a relatively closed area and kept its culture and custure of old China thousand years ago. METHODS: Data on age, sex, ABO blood type and X-ray or pathological diagnose of the patients with carcinoma of esophagus or cardia were collected from the Tumor Hospital. First Affiliated Hospital, Second Affiliated Hospital of Shantou University Medical College; and the Central Hospital of Shantou and the Central Hospital of Jieyang. A total of 6685 patients with esophageal carcinoma (EC) and 2955 patients with cardiac cancer (CC) in Chaoshan district were retrospectively assessed for their association with ABO blood groups. RESULTS: The distribution of ABO blood groups in patients with EC or CC was similar to the normal local population in Chaoshan. However, blood group B in male patients with CC and in the patients with carcinoma in the upper third esophagus was 2.3% and 4.7% higher than the corresponding controls. The relative risk B O was 1.1415 (P【0.05) and 1.2696 (P【0.05), respectively. No relationship was found between ABO blood groups and tumor differentiation. CONCLUSION: ABO blood group B is associated with the incidence of CC in male individuals and carcinoma in the upper third esophagus. The distribution of ABO blood groups varies in the different geographical and ethnic groups. As a result, proper controls are very important for such studies.展开更多
Objective:To investigate the value of spleen and pancreatic tail thorax translocation on the residual stomach esophagus anastomosis.Methods:10 patients with esophageal carcinoma after gastrectomy were enrolled in this...Objective:To investigate the value of spleen and pancreatic tail thorax translocation on the residual stomach esophagus anastomosis.Methods:10 patients with esophageal carcinoma after gastrectomy were enrolled in this study. Lesions were removed through left thoracotomy and residual stomach was fully mobilized,with short gastric artery being re- served.Spleen and pancreatic tail were dissected from the back of peritoneum and transposed into thorax.Residual stomach esophagus anastomosis was performed.Results:All the operation went favorably.Patients were recovered rapidly and a relatively good prognosis was acquired.Late leakage and pleural effusion happened in one case respectively,but these com- plications were cured through conservative management without operation death.Conclusion:Residual stomach is an ideal candidate for the replacement of esophagus and residual stomach esophagus anastomosis is a simple operative alternative with few trauma and good results for the treatment of esophageal carcinoma after gastrectomy.展开更多
目的:检测食管鳞癌(esophageal squamous cell cancer,ESCC)和贲门腺癌(gastric cardia adenocarcinoma,GCA)中分泌型卷曲相关蛋白4(secreted frizzled related protein 4,SFRP4)的基因甲基化状态,探讨其与食管鳞癌和贲门腺癌发生的关...目的:检测食管鳞癌(esophageal squamous cell cancer,ESCC)和贲门腺癌(gastric cardia adenocarcinoma,GCA)中分泌型卷曲相关蛋白4(secreted frizzled related protein 4,SFRP4)的基因甲基化状态,探讨其与食管鳞癌和贲门腺癌发生的关系。方法:应用甲基化特异性PCR(methylation-specific PCR,MSP)及RT-PCR的方法检测49例食管鳞癌及58例贲门腺癌中SFRP4基因的甲基化状态及其mRNA表达情况,应用免疫组织化学法检测Wnt通路中心因子β-catenin蛋白的表达情况,并分析其与临床病理参数间的关系。结果:在食管鳞癌及贲门腺癌中,SFRP4基因的甲基化率分别为42.6%(21/49)和72.4%(42/58),均明显高于癌旁非肿瘤组织(P<0.01)。在贲门腺癌中SFRP4基因的高甲基化与肿瘤患者的临床分期相关,与病理分级无关;而在食管鳞癌中,该基因的甲基化与各临床病理指标均无关(P>0.05)。SFRP4基因在食管鳞癌及贲门腺癌中mRNA阳性表达率分别为69.3%(34/49)和44.8%(26/58),均明显低于癌旁非肿瘤组织(P<0.05),且肿瘤组织中mRNA表达与该基因的甲基化状态明显相关(P<0.01)。通路中心因子β-catenin蛋白在食管鳞癌及贲门腺癌中的异质表达率分别为65.3%(32/49)和86.2%(50/58),均明显高于癌旁非肿瘤组织(P<0.01),且其异质表达与SFRP4基因的甲基化状态相关(P<0.05)。结论:SFRP4基因的高甲基化状态可能是引起贲门癌及食管癌发生的共同分子机制之一,并有可能通过Wnt/β-catenin信号转导通路发挥作用。检测SFRP4基因甲基化状态对于贲门腺癌的预后评估有一定参考价值。展开更多
文摘AIM To investigate the effect of gastroenteric reconstruction on the nutritional status of patients with gastric cancer after total gastrectomy. METHODS From 1989 1994, nutritional status was studied in 24 patients, including 12 patients with the gastric reservoir and pyloric sphincter reconstruction (GRPS), 7 with Braun′s esophago jejunostomy (EJ) and 5 with Lawrance′s Roux en Y reconstruction (RY). The ability of these patients to ingest and absorb the amount of nutrients was examined and compared, and metabolic balance test was performed to compare the efficiency of those patients to accumulate and use the absorbed nutrients. RESULTS In the controlled hospital situation, the amount of food ingested by all the patients was greater than that required for maintenance of ideal body weight. In direct contrast, food intake in most patients with EJ or RY reconstruction significantly decreased when the patients returned home and that in EJ patients it was the lowest. The overgrowth of anaerobic bacteria was found in the jejunum in the patients with EJ and RY, due mainly to food stasis in the duodenum or in the Roux limb, caused by the operative procedure itself. In patients with GRPS, because of restoring of the alimentary continuity according to the normal digestive physiologic characters, all the nutritional parameters could fall in the normal range. CONCLUSION The most common mechanism responsible for postoperative malnutrition was inadequate food intake. Having solved the problem of alkaline reflux esophagitis, it is imperative to preserve the duodenal food passage to reduce malabsorption and other complications after total gastrectomy.
基金Supported ty the Key Teacher Fund,Ministry of Education of China and Sir Li Ka-Ching Foundation.
文摘AIM:To study the relationship between ABO blood groups and carcinoma of esophagus and cardia in Chaoshan inhabitants of China, which is a unique Littoral high-risk area of esophageal carcinoma in China. The poor communication and transportation in the past has made Chaoshan a relatively closed area and kept its culture and custure of old China thousand years ago. METHODS: Data on age, sex, ABO blood type and X-ray or pathological diagnose of the patients with carcinoma of esophagus or cardia were collected from the Tumor Hospital. First Affiliated Hospital, Second Affiliated Hospital of Shantou University Medical College; and the Central Hospital of Shantou and the Central Hospital of Jieyang. A total of 6685 patients with esophageal carcinoma (EC) and 2955 patients with cardiac cancer (CC) in Chaoshan district were retrospectively assessed for their association with ABO blood groups. RESULTS: The distribution of ABO blood groups in patients with EC or CC was similar to the normal local population in Chaoshan. However, blood group B in male patients with CC and in the patients with carcinoma in the upper third esophagus was 2.3% and 4.7% higher than the corresponding controls. The relative risk B O was 1.1415 (P【0.05) and 1.2696 (P【0.05), respectively. No relationship was found between ABO blood groups and tumor differentiation. CONCLUSION: ABO blood group B is associated with the incidence of CC in male individuals and carcinoma in the upper third esophagus. The distribution of ABO blood groups varies in the different geographical and ethnic groups. As a result, proper controls are very important for such studies.
文摘Objective:To investigate the value of spleen and pancreatic tail thorax translocation on the residual stomach esophagus anastomosis.Methods:10 patients with esophageal carcinoma after gastrectomy were enrolled in this study. Lesions were removed through left thoracotomy and residual stomach was fully mobilized,with short gastric artery being re- served.Spleen and pancreatic tail were dissected from the back of peritoneum and transposed into thorax.Residual stomach esophagus anastomosis was performed.Results:All the operation went favorably.Patients were recovered rapidly and a relatively good prognosis was acquired.Late leakage and pleural effusion happened in one case respectively,but these com- plications were cured through conservative management without operation death.Conclusion:Residual stomach is an ideal candidate for the replacement of esophagus and residual stomach esophagus anastomosis is a simple operative alternative with few trauma and good results for the treatment of esophageal carcinoma after gastrectomy.
