Objective:To investigate the postoperative inflammatory reaction, stress reaction and immune response of laparoscopic surgery and laparotomy for acute gastric perforation. Methods: Forty-four patients with acute gastr...Objective:To investigate the postoperative inflammatory reaction, stress reaction and immune response of laparoscopic surgery and laparotomy for acute gastric perforation. Methods: Forty-four patients with acute gastric perforation receiving emergency surgery in our hospital from May 2012 to December 2015 were selected and retrospectively analyzed. Among these patients, there were 19 patients treated with laparoscopic surgery (LS group) and 25 patients treated with laparotomy (laparotomy group). At the first day after surgery, their serums were collected and the indexes of inflammatory reaction and stress reaction were detected. Mononuclear cells and red blood cells in peripheral blood were collected and detected for the immune function indexes. Results: At day 1 after surgery, the contents of serum interleukin-1β (IL-1β), IL-2, IL-6, IL-8, IL-10, cortisol, norepinephrine, epinephrine, renin and angiotensin-II of patients in the LS group were all significantly lower than those of the laparotomy group;fluorescence intensities of CD3, CD4, CD16 and CD56 of mononuclear cells in peripheral blood were all obviously higher than those of the laparotomy group;and the numbers of red blood cell C3bR and immune complex resette and the fluorescence intensities of complement receptor type 3, CD58 and CD59 were obviously higher than those of the laparotomy group. Conclusions: Emergency laparoscopic surgery used to treat acute gastric perforation shows slight postoperative inflammatory reaction and stress reaction and presents weak nonspecific immune response, specific immune response and erythrocyte immune response, which makes less trauma than laparotomy.展开更多
The purpose of this study was to investigate the clinical and therapeutic aspects of peritonitis by perforation of gastric and duodenal ulcer. This was a retrospective and descriptive study over 8 years (2010-2018) wh...The purpose of this study was to investigate the clinical and therapeutic aspects of peritonitis by perforation of gastric and duodenal ulcer. This was a retrospective and descriptive study over 8 years (2010-2018) which allowed to collect 54 cases of peptic ulcer. Included in the study were all patients with confirmed gastroduodenal perforation on histology or laparotomy. We collected 54 cases of peptic ulcer perforated s. The age group of 30 - 49 years was the majority. The male sex was dominant with 90.7% of cases;the clinical picture was dominated by abdominal contracture associated with pain in 74.07% of cases. X-ray of the abdomen without preparation (AWP) revealed in 87.03% of cases of pneumoperitoneum. The perforation was in 68.52% of cases on the gastric antrum and in 31.48% on the duodenum. The surgical procedure used was the bank of excision, and a suture reinforcement epiploic in 68.52% of cases, a simple suture made in 31.48% of cases, the disease was marked by a fistula (1.90%) and mortality was 5.55% of cases. The gastroduodenal ulcer perforation is potentially serious and responsible peritonitis whose surgical treatment involves the peritoneal toilet and sutures the puncture.展开更多
BACKGROUND Gastrointestinal stromal tumors(GISTs)originate from interstitial cells of Cajal.GISTs can occur anywhere along the gastrointestinal tract.Large lesions have traditionally been removed surgically.However,wi...BACKGROUND Gastrointestinal stromal tumors(GISTs)originate from interstitial cells of Cajal.GISTs can occur anywhere along the gastrointestinal tract.Large lesions have traditionally been removed surgically.However,with recent innovations in advanced endoscopy,GISTs located within the stomach are now removed endoscopically.We describe a new innovative endoscopic technique to close large and hard to access defects after endoscopic full-thickness resection of gastric GISTs.CASE SUMMARY We present a series of three patients who were diagnosed with a gastric GIST.All patients underwent full-thickness endoscopic resection.In all cases,for closure of the surgical bed,conventional endoscopic techniques including hemoclips,endoloop and suturing were unsuccessful.We performed a new technique in which we pulled omental fat into the gastric lumen and completely closed the defect using endoscopic devices.All patients performed well post-procedure and computed tomography was carried out one day after the procedures which showed no extravasation of contrast.CONCLUSION The omental plug technique may be used as an alternative to surgery in selected cases of gastric perforation.展开更多
SPONTANEOUS neonatal gastric perforation (SNGP) is a rare and life-threatening disease, which has a high mortality rate.This study retrospectively reported 23 cases of SNGP treated in the Department of Pediatric Surge...SPONTANEOUS neonatal gastric perforation (SNGP) is a rare and life-threatening disease, which has a high mortality rate.This study retrospectively reported 23 cases of SNGP treated in the Department of Pediatric Surgery of Shengjing Hospital of China Medical University from January 1993 to December 2003, and briefly discussed the diagnosis, treatment, and possible etiology.展开更多
目的探讨急诊胃癌穿孔手术方式的选择,为进一步优化治疗方案提供依据.方法选取行急诊胃癌手术治疗的38例胃癌穿孔患者,依据手术方式不同分为单纯穿孔修补组（修补组,18例）及胃癌根治术组（根治组,20例）.比较两组患者的术中出血量、手...目的探讨急诊胃癌穿孔手术方式的选择,为进一步优化治疗方案提供依据.方法选取行急诊胃癌手术治疗的38例胃癌穿孔患者,依据手术方式不同分为单纯穿孔修补组（修补组,18例）及胃癌根治术组（根治组,20例）.比较两组患者的术中出血量、手术时间、术后48h IL-6、TNF-α水平、术后住院时间、手术并发症发生率、术后生存率.结果修补组术中出血量明显少于根治组、手术时间明显短于根治组（P〈0.05）.两组患者术后48h IL-6及 TNF-α水平的差异均无统计学意义（均 P 〉0.05）.两组均无围手术期死亡患者,无二次手术患者.修补组并发肺部感染及切开感染的发生率均明显高于根治组（均 P〈0.05）,其他并发症发生率的差异均无统计学意义（均 P 〉0.05）.根治组患者生存率及中位生存时间均明显高于修补组（均 P〈0.05）.结论胃癌穿孔单纯修补术术后并发症较多且预后较差,对于一般情况尚可,穿孔时间短的患者应争取Ⅰ期手术,并强化围术期监护,有助于提高患者生存时间.展开更多
文摘Objective:To investigate the postoperative inflammatory reaction, stress reaction and immune response of laparoscopic surgery and laparotomy for acute gastric perforation. Methods: Forty-four patients with acute gastric perforation receiving emergency surgery in our hospital from May 2012 to December 2015 were selected and retrospectively analyzed. Among these patients, there were 19 patients treated with laparoscopic surgery (LS group) and 25 patients treated with laparotomy (laparotomy group). At the first day after surgery, their serums were collected and the indexes of inflammatory reaction and stress reaction were detected. Mononuclear cells and red blood cells in peripheral blood were collected and detected for the immune function indexes. Results: At day 1 after surgery, the contents of serum interleukin-1β (IL-1β), IL-2, IL-6, IL-8, IL-10, cortisol, norepinephrine, epinephrine, renin and angiotensin-II of patients in the LS group were all significantly lower than those of the laparotomy group;fluorescence intensities of CD3, CD4, CD16 and CD56 of mononuclear cells in peripheral blood were all obviously higher than those of the laparotomy group;and the numbers of red blood cell C3bR and immune complex resette and the fluorescence intensities of complement receptor type 3, CD58 and CD59 were obviously higher than those of the laparotomy group. Conclusions: Emergency laparoscopic surgery used to treat acute gastric perforation shows slight postoperative inflammatory reaction and stress reaction and presents weak nonspecific immune response, specific immune response and erythrocyte immune response, which makes less trauma than laparotomy.
文摘The purpose of this study was to investigate the clinical and therapeutic aspects of peritonitis by perforation of gastric and duodenal ulcer. This was a retrospective and descriptive study over 8 years (2010-2018) which allowed to collect 54 cases of peptic ulcer. Included in the study were all patients with confirmed gastroduodenal perforation on histology or laparotomy. We collected 54 cases of peptic ulcer perforated s. The age group of 30 - 49 years was the majority. The male sex was dominant with 90.7% of cases;the clinical picture was dominated by abdominal contracture associated with pain in 74.07% of cases. X-ray of the abdomen without preparation (AWP) revealed in 87.03% of cases of pneumoperitoneum. The perforation was in 68.52% of cases on the gastric antrum and in 31.48% on the duodenum. The surgical procedure used was the bank of excision, and a suture reinforcement epiploic in 68.52% of cases, a simple suture made in 31.48% of cases, the disease was marked by a fistula (1.90%) and mortality was 5.55% of cases. The gastroduodenal ulcer perforation is potentially serious and responsible peritonitis whose surgical treatment involves the peritoneal toilet and sutures the puncture.
文摘BACKGROUND Gastrointestinal stromal tumors(GISTs)originate from interstitial cells of Cajal.GISTs can occur anywhere along the gastrointestinal tract.Large lesions have traditionally been removed surgically.However,with recent innovations in advanced endoscopy,GISTs located within the stomach are now removed endoscopically.We describe a new innovative endoscopic technique to close large and hard to access defects after endoscopic full-thickness resection of gastric GISTs.CASE SUMMARY We present a series of three patients who were diagnosed with a gastric GIST.All patients underwent full-thickness endoscopic resection.In all cases,for closure of the surgical bed,conventional endoscopic techniques including hemoclips,endoloop and suturing were unsuccessful.We performed a new technique in which we pulled omental fat into the gastric lumen and completely closed the defect using endoscopic devices.All patients performed well post-procedure and computed tomography was carried out one day after the procedures which showed no extravasation of contrast.CONCLUSION The omental plug technique may be used as an alternative to surgery in selected cases of gastric perforation.
文摘SPONTANEOUS neonatal gastric perforation (SNGP) is a rare and life-threatening disease, which has a high mortality rate.This study retrospectively reported 23 cases of SNGP treated in the Department of Pediatric Surgery of Shengjing Hospital of China Medical University from January 1993 to December 2003, and briefly discussed the diagnosis, treatment, and possible etiology.
文摘目的探讨急诊胃癌穿孔手术方式的选择,为进一步优化治疗方案提供依据.方法选取行急诊胃癌手术治疗的38例胃癌穿孔患者,依据手术方式不同分为单纯穿孔修补组（修补组,18例）及胃癌根治术组（根治组,20例）.比较两组患者的术中出血量、手术时间、术后48h IL-6、TNF-α水平、术后住院时间、手术并发症发生率、术后生存率.结果修补组术中出血量明显少于根治组、手术时间明显短于根治组（P〈0.05）.两组患者术后48h IL-6及 TNF-α水平的差异均无统计学意义（均 P 〉0.05）.两组均无围手术期死亡患者,无二次手术患者.修补组并发肺部感染及切开感染的发生率均明显高于根治组（均 P〈0.05）,其他并发症发生率的差异均无统计学意义（均 P 〉0.05）.根治组患者生存率及中位生存时间均明显高于修补组（均 P〈0.05）.结论胃癌穿孔单纯修补术术后并发症较多且预后较差,对于一般情况尚可,穿孔时间短的患者应争取Ⅰ期手术,并强化围术期监护,有助于提高患者生存时间.
