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20 June 2006, Volume 26 Issue 06 Previous Issue    Next Issue
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Multivariate regression analysis of postoperative complications of resection of hepatocellular carcinoma. Huang Gengwen,Yang Lianyue,Lu Weiqun,et al. 2006, 26(06): 1-408.  Abstract ( 1214 )   PDF (268KB) ( 506 )   Objective:To study the factors associated with postoperative complications of resection of hepatocellular carcinoma. Methods:Consecutive 378 cases of hepatocellular carcinoma between June 1988 and April 2005 at Xiangya Hospital were summarized retrospectively.Singlevariant and multivariate stepwise regression model were used to analysis the factors associated with postoperative complications of resection of hepatocellular carcinoma. Results:The overall morbidity rate and mortality rate were 17.7% and 1.3% respectively.Singlevariant analysis showed that the age,pringle maneuver,intraoperative blood loss and blood transfusion were associated with postoperative complications.Furthermore,multivariate stepwise regression analysis revealed that the age,pringle maneuver,intraoperative blood loss and blood transfusion volume were the independent risk factors of morbidity rate of resections of hepatocellular carcinoma. Conclusion:The surgical excisions of hepatocellular carcinomas are safe and feasible only if the liver function reserve could be judged accurately before operation and the intraoperative hemorrhage and blood transfusion could be controlled effectively and the duration of portal clamping could be shortened during the operation.

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The causes and prevention of portal vein thrombosis after the Hassab’s operation. Liu Yu,Liang Tingbo,Zheng Shusen,et al. 2006, 26(06): 1-452.  Abstract ( 1124 )   PDF (291KB) ( 554 )   Objective:To discuss the pathogenesis,diagnosis,therapy,and precaution of the portal vein thrombosis (PVT) after Hassab’s operation. Methods:Two hundred patients who underwent Hassab’s operation because of liver cirrhosis with portal hypertension between 1999 and 2004 in the First Affiliated Hospital of Medical College of Zhejiang University were analyzed retrospectively. Results:Twentysix patients developed PVT after operation (13%),and all of them discharged smoothly after anticoagulant therapy. Conclusion:The definite cause of PVT after Hassab’s operation is still unclear.The peak value of plate which exceeded 300×109/L is a risk factor.The preventive anticoagulation can not decrease incidence of PVT.The key point of therapy is early diagnosis and early anticoagulant treatment.

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The study of relationship between intestinal permeability and C reactive protein in gastric cancer patients. Jia Yunhe,Jiang Zhiwei,Li Ning,et al. 2006, 26(06): 1-443.  Abstract ( 1216 )   PDF (445KB) ( 502 )   Objective:To observe the relationship between intestinal permeability and C Reactive Protein (CRP) in malnutrition gastric carcinoma patients. Methods:Thirty stomach cancer patients (fifteen malnutrition patients and fifteen normal nutrition patients) were enrolled in the study.Lactulose/mannitol test was performed on the day of hospitalization.The patients were retrospectively analyzed with automatic biochemistry analyzer for CRP. Results:L/M ratio of normal nutrition group was 0.049±0.010,and the malnutrition group was 0.161±0.141，respectively.Significant differences of L/M ratios were found between the two groups.The CRP changed significantly in high L/M ratio group (5.69 vs 17.40). Conclusion:The increase of intestinal permeability of malnutrition gastric carcinoma has great relation with inflammatory reaction.

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The use of different biliary suture mode in liver transplantation. Peng Chenhong,Wang Xiaoming,Shen Baiyong,et al. 2006, 26(06): 1-452.  Abstract ( 1289 )   PDF (305KB) ( 494 )   Objective:To study the use of different biliary suture modes in liver transplantation. Methods:The different biliary suture modes and biliary complications were analyzed retrospectively in 158 cases of liver transplantation performed between June 2002 and September 2005 in Rui Jin Hospital affiliated to Medical college of Shanghai JiaoTong University. Results:Among 158 cases,interrupted sutures were performed in 26 cases.Biliary complications were identified in 3 cases. Among them,2 cases were anastomotic biliary strictures.Continuous sutures were performed in 47cases.Biliary complications were identified in 5 cases.Among them,3 cases were anastomotic biliary strictures.Improved continuous sutures were performed in 85 cases and biliary complications were identified in 6 cases with no anastomotic biliary stricture identified.The results showed that the difference in the incidence of anastomotic biliary strictures among the three groups was significant（P<0.05）,and the incidence of anastomotic biliary strictures in the improved continous group was significantly lower than that in the other two groups. Conclusion:Improved continous suture is a kind of ideal suture mode which can reduce the incidence of anastomotic biliary strictures.

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Treatment of biliary stricture after orthotopic liver transplantation:a report of 43 cases. Wang Genshu,Chen Guihua,Lu Minqiang,et al. 2006, 26(06): 1-443.  Abstract ( 1167 )   PDF (461KB) ( 588 )   Objective:To investigate the treatment and its efficacy of biliary stricture (BS) after orthotopic liver transplantation (OLT). Methods:The treatment and efficacy of 43 patients with BS after OLT from October 2003 to October 2005 were analyzed retrospectively.The patients received interventional therapy through endoscopic retrograde cholangiography (ERC),percutaneous transhepatic cholangiography (PTC) or T tube,cholangioenterostomy,hepatic artery stent and liver retransplantation. Results:The total cure rate of 43 patients with BS was 48.8% (21/43),the improvement rate was 30.2% (13/43),and the total effective rate was 79.0%(34/43).The cure rate of interventional therapy of 41 patients with BS was 34.1% (14/41),the improvement rate was 31.7%(13/41),and the total effective rate was 65.8% (27/41).The total cure rate of anastomotic,extrahepatic,intrahepatic,and mixed type BS was 100%(5/5),64.3%(9/14),50.0%(1/2),and 28.6%(6/21) respectively.And that of interventional therapy was respectively 80.0%(4/5),64.3%(9/14),50.0%(1/2) and 0.The cure rate of liver retransplantation of 12 BS was 50%(6/12). Conclusion:The therapeutic efficacy of BS after OLT is not ideal nowadays.The therapeutic efficacy of interventional therapy of BS is related to its type.The therapeutic efficacy of anastomotic BS is the best,followed by extrahepatic BS,intrahepatic BS and mixed BS.Liver retransplantation is effective in refractory BS.The optimal timing is the key for a successful liver retransplantation.

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The evaluation of therapeutic effects of left external lobectomy of liver on hepatolithiasis. Deng Meihai,Tang Zhaofeng，Liu Bo,et al. 2006, 26(06): 1-443.  Abstract ( 1013 )   PDF (309KB) ( 448 )   Objective:To compare the therapeutic efficacy of left lateral lobectomy of liver with the section of common bile duct and calculus remove only on hepatolithiasis. Methods:Fortyfour patients with hepatolithiasis were performed by the section of common bile duct and calculus remove，left lateral lobectomy of liver and drainage with Ttube (the first group).Meanwhile,the procedure was performed for another 41 cases of hepatolithiasis with the section of common bile duct、calculus remove and drainage with Ttube (the second group ).The therapeutic efficacy of these two groups were summarized and analyzed. Results:In the first group,the rate of fine postoperative result in shortterm was 909%,but the second group was 80.5％.The second group was significantly fewer than the first group in the operative time,volume of surgical bleeding and blood transfusion. The first group was significantly better than the second group in the rate of residual calculus,cholangitis,and secondoperation. Conclusion:The left lateral lobectomy of liver is effective in the treatment of hepatolithiasis, and its longterm efficacy is significantly better than the procedure of section of common bile duct and calculus remove only.Section of common bile duct,calculus remove and drainage with Ttube is not a radical procedure for cases with more serious and complicated calculus and abnormality of intrahepatic duct.

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The pullthrough combined with double stapling technique for sphincter preservation operation in superlow rectal carcinoma. He Yuanxiang，Wang Weimin，Huang Hailin，et al. 2006, 26(06): 1-452.  Abstract ( 1042 )   PDF (305KB) ( 484 )   Objective:To evaluate the effect of pullthrough combined with double stapling technique for sphincter preservation operation in superlow rectal carcinoma. Methods:The resection through pullthrough combined with double stapling technique for sphincter preservation approach was performed on 38 patients with superlow rectal carcinoma from December 1997 to January 2005. Results:Fecal continences were preserved successfully in all patients.Only one got anastomosis leak after operation.At followup，two patients had postoperative recurrences. Conclusion:Pullthrough combined with double stapling technique for sphinceter preservation operation is useful and safe in superlow rectal carcinoma.

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Clinical experience in diagnosis and treatment of 12 cases of splenic tuberculosis. Li Minpeng,Li Lequn,Xiao Kaiyin. 2006, 26(06): 1-443.  Abstract ( 969 )   PDF (304KB) ( 520 )   Objective:To explore methods for diagnosis and treatment of splenic tuberculosis. Methods:The clinical data of 12 patients with splenic tuberculosis treated between 1995 and 2005 in the First Affiliated Hospital of Guangxi Medical University were analyzed retrospectively.Twelve patients (7 males and 5 females) were enrolled in the study.The main clinical features included longterm fever,anepithymia,weight loss,pain of left upper quadrant,splenomegalia,and anemia.Splenomegalia was discovered by abdominal ultrasonography and CT.Six of 12 underwent splenectomy and received antituberculosis treatment after surgery,and the rest were given normal antituberculosis therapy. Results:The recovery of all 12 cases was satisfactory. Conclusion:Splenomegalia and longterm fever,anepithymia,weight loss,pain of left upper quadrant,and anemia are significant for diagnosis of splenic tuberculosis,especially with other organic tuberculosis simultaneous.Image examinations have value in diagnosis of splenic tuberculosis but no specificity.Surgery is adopted as the available means of diagnosis and treatment for some diagnosis unknown splenic tuberculosis.Antituberculosis treatment is the main means of treatment and indispensable for splenic tuberculosis.

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A clinical study on nutritional supplementation of injectile fructose in surgical patients of gastrointestinal malignancies. Wu Xiaojiang,Zhao Jun,Zong Xianglong,et al. 2006, 26(06): 1-447.  Abstract ( 836 )   PDF (396KB) ( 540 )   Objective:To explore the efficiency of injectile fructose in postoperative nutritional supplementation and efficacy in stabilization of serum glucose and insulin levels in surgical patients of gastrointestinal malignancies. Methods:A randomized single blind parallel controlled prospective study was performed aiming at comparing the efficiency in stabilization of serum glucose and insulin levels between injectile fructose group and injectile glucose group as control in postoperative gastrointestinal malignancies patients. Results:No significant difference in morning serum glucose and insulin levels between two groups was observed;statistically significantly less fluctuation of serum glucose and insulin levels in injectile fructose group was observed compared to injectile glucose group. Conclusion:The injectile fructose has an advantage over injectile glucose in the stabilization of serum glucose and insulin levels.It can play a role in nutritional supplementation for postoperative gastrointestinal malignancies patients in replacement of injectile glucose for a short period.

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The treatment of giant abdominal incisional hernia with patch:a report of 26 cases. Zhu Xiaoqiang，Gong Dingquan. 2006, 26(06): 1-447.  Abstract ( 993 )   PDF (311KB) ( 450 )   Objective:To summarize the clinical experiences of patch repair on giant abdominal incisional hernia. Methods:The clinical data of 26 cases of giant abdominal incisional hernia treated between June 2001 and May 2005 in the Ninth People’s Hospital of Medical School of Shanghai Jiaotong University were retrospectively analyzed. Results:All cases were cured.No severe complication developed and no recurrence. Conclusion:Patch repair is an ideal surgical procedure for giant abdominal incisional hernia.

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Construction of the autogenous radialcephalic hemodialysis access assisted by the Fogarty catheter. Fan Longhua,Feng Gang,Zhu Yingchun,et al. 2006, 26(06): 1-408.  Abstract ( 1105 )   PDF (303KB) ( 460 )   Objective:To discuss the operative methods and the primary effect of the autogenous radialcephalic hemodialysis access use the Fogarty catheter. Methods:From August to December in 2005,12 patients with uremia received radialcephalic access assisted by the Fogarty catheter in the Department of Vascular Surgery of Zhongshan Hospital of Fudan University.The radial artery and cephalic vein of nondominant hand were sufficiently mobilizated,and the distal of the artery and vein were ligated.3F or 4F Fogarty catheter was inserted into the proximal vessels to dilate the cephalic vein and/or the radial artery.After modified the vessels,an endtoend anastomosis was performed with a running 7.0 polypropylene monofilament suture. Results:AVF patency was confirmed by palpation and auscultation just after operation,or 1 day,3 days and 7 days postoperatively.The mean length of followup was 3 months.The patency rate was 100%.There were five patients received hemodialysis used the autogenous radialcephalic access.The AVFs blood flow was larger than 150mL/min during hemodialysis. Conclusion:The method is convenience to overcome the stenosis of the vessels,and the patency rate is high.The patients get a quite good clinical effect in a short period.The long term effects need to be observed further more.

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The evaluation of electrocoagulation for treating varicose veins of the lower extremity. Wang Chenggang,Wu Danming,Zhou Yubin,et al. 2006, 26(06): 1-443.  Abstract ( 1077 )   PDF (459KB) ( 624 )   Objective:To evaluate the methods and efficacy of electrocoagulation for treating varicose veins of the lower extremity. Methods:Clinical data of 502 patients (595 legs) with varicose veins of the lower extremity were analyzed retrospectively after the electrocoagulation was used in the patients in the Department of Vascular Surgery of People’s Hospital of Liaoning Province from November 2000 to December 2004. Results:The majority of the patients recovered well except 10 cases developed skin burn,18 cases subcutaneous induration,and 4 cases recurrence.The average hospitalization time is 45 days. Conclusion:Electrocoagulation for treating varicose veins of the lower extremity is a good minimal invasive surgical method. In order to improve the effects and reduce the complications,It should firmly master the indications and operative method.