Cystic meconium peritonitis with jejunoileal atresia:Is it associated with unfavorable outcome?

AIM To compare the outcome between patients with jejunoileal atresia(JIA) associated with cystic meconium peritonitis(CMP) and patients with isolated JIA(JIA without CMP).METHODS A retrospective study was conducted for all neonates with JIA operated in our institute from January 2005 to January 2016.Demographics including the gestation age,sex,birth weight,age at operation,the presence of associated syndrome was recorded.Clinical outcome including the type of operation performed,operative time,the need for reoperation and mortality were studied.The demographics and the outcome between the 2 groups were compared.RESULTS During the study period,53 neonates had JIA underwent operation in our institute.Seventeen neonates(32%) were associated with CMP.There was no statistical difference on the demographics in the two groups.Patients with CMP had earlier operation than patients with isolated JIA(mean 1.4 d vs 3 d,P = 0.038).Primaryanastomosis was performed in 16 patients(94%) with CMP and 30 patients(83%) with isolated JIA(P = 0.269).Patients with CMP had longer operation(mean 190 min vs 154 min,P = 0.004).There were no statistical difference the need for reoperation(3 vs 6,P = 0.606) and mortality(2 vs 1,P = 0.269) between the two groups.CONCLUSION Primary intestinal anastomosis can be performed in94% of patients with JIA associated with CMP.Although patients with CMP had longer operative time,the mortality and reoperation rates were low and were comparable to patients with isolated JIA.

Effects of Sleeve Gastrectomy Surgery with Modified Jejunoileal Bypass on Body Weight, Food Intake and Metabolic Hormone Levels of Rats

This study examined the effects of a combined surgery of sleeve gastrectomy （SG） and modified jejunoileal bypass （JIB） on the body weight, food intake, and the plasma levels of active glucagon-like peptide-1 （GLP-1） and total ghrelin of rats. Rats were divided into 3 groups in terms of different surgical protocol： SG-JIB （n=12）, SG （n=12）, JIB （n=12） and sham surgery groups （n-10）. In SG-JIB group, rats was subjected to sleeve gastrectomy and end to side anastomosis of part of the jejunum （25 cm from the ligament of Treitz） to the ileum 25 cm proximal to the cecum. The body weight and food intake were evaluated during 10 consecutive weeks postoperatively. The levels of active GLP-1 and total ghrelin in the plasma of the rats were measured by ELISA assay. The results showed that the SG-JIB treated rats relative to SG- or JIB-treated ones produced a sustained reduction in food intake and weight gain. The level of active GLP-1 was elevated and total ghrelin level decreased in SG-JIB-treated rats as compared with SG- or JIB-treated ones. It was concluded that SG-JIB could efficiently reduce the body weight and food intake, alter obesity-related hormone levels of the rats, indicating that SG-JIB may be potentially used for the treatment of obesity.

Prognostic value of negative lymph node count in patients with jejunoileal neuroendocrine tumors

A negative lymph node(NLN)count has been shown to have a significant impact on the prognosis of many types of cancer.However,its prognostic value for jejunoileal neuroendocrine tumors(NETs)remains unclear.In this study,we investigated the prognostic value of NLN count in patients with resected jejunoileal NETs diagnosed between 1988 and 2014.The data were retrieved from the Surveillance,Epidemiology and End Results database.The X-tile program was used to determine the cutoff value of the NLN count.Univariate and multivariate Cox proportional hazards models were used to assess the prognostic value of NLN count on survival.Harrell concordance index was used to compare the prognostic validity of NLN count with 2 current prognostic systems.The optimal cutoff point of the NLN count was 8.Kaplan-Meier analysis revealed a progressively worse overall survival(OS)with an NLN count≤8 compared with an NLN count>8(P<0.001).Univariate analysis showed that the NLN count,age,tumor site,tumor size and T classification were significant prognostic factors for the OS of jejunoileal NETs,while the number of positive lymph nodes had no significant impact on OS(P=0.513).Multivariate analysis indicated that the NLN count was an independent prognostic factor for OS of jejunoileal NETs.A higher NLN count was associated with better OS(hazards ratio:0.641;95%confidence interval:0.519-0.793;P<0.001).Compared with 2 other prognostic systems,the NLN counts in this study had similar prognostic value in patients with jejunoileal NETs.Our findings suggest that the NLN count is an important independent prognostic factor for patients with jejunoileal NETs,and that it is a good adjunct for disease staging.