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Preoperative carcinoembryonic antibody is predictive of distant metastasis in pathologically T1 colorectal cancer after radical surgery

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World Journal of Gastroenterology 2013年第3期19卷 389-393页

作者： Zheng Lou Rong-Gui Meng Wei Zhang En-Da Yu chuan-Gang Fu Department of Colorectal Surgery Changhai Hospital

AIM:To identify the predictors of distant metastasis in pathologically T1(pT1)colorectal cancer(CRC)after radical resection. METHODS:Variables including age,gender,preoperative carcinoembryonic antibody(CEA)level,tumor location,tumor size,lymph node status,and histological grade were *** with and without metastasis were compared with regard to age,gender,CEA level and pathologic tumor characteristics using the independent t test orχ 2 test,as *** factors were determined by logistic regression analysis. RESULTS:Metastasis occurred in 6(3.8%)of the 159 patients during a median follow-up of 67.0(46.5%) *** rates of distant metastasis in patients with pT1 cancer of the colon and rectum were 6.7%and 2.9%, respectively(Pchemotherapy may be necessary in such patients,even if they have pT1 colorectal cancer.

关键词： Colorectal cancer Risk factor Metastasis Pathologically T1 Carcinoembryonic antigen

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Appropriate treatment of acute sigmoid volvulus in the emergency setting

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World Journal of Gastroenterology 2013年第30期19卷 4979-4983页

作者： Zheng Lou En-Da Yu Wei Zhang Rong-Gui Meng Li-Qiang Hao chuan-Gang Fu Department of Colorectal Surgery Changhai Hospital

AIM:To investigate an appropriate strategy for the treatment of patients with acute sigmoid volvulus in the emergency ***:A retrospective review of 28 patients with acute sigmoid volvulus treated in the Department of Colorectal Surgery,changhai Hospital,Shanghai from January 2001 to July 2012 was *** the diagnosis of acute sigmoid volvulus,an initial colonoscopic approach was adopted if there was no evidence of diffuse ***:Of the 28 patients with acute sigmoid volvulus,19(67.9%)were male and 9(32.1%)were *** mean age was 63.1 ± 22.9 years(range,21-93 years).Six(21.4%)patients had a history of abdominal surgery,and 17(60.7%)patients had a history of *** radiography or computed tomography was performed in all *** detorsion was performed in all 28 patients with a success rate of 92.8%(26/28).Emergency surgery was required in the other two *** the 26 successfully treated patients,seven(26.9%)had recurrent ***:Colonoscopy is the primary emergency treatment of choice in uncomplicated acute sigmoid *** surgery is only for patients in whom nonoperative treatment is unsuccessful,or in those with peritonitis.

关键词： Sigmoid colon Volvulus Emergency Colonoscopy

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Massive presacral bleeding during rectal surgery: From anatomy to clinical practice

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World Journal of Gastroenterology 2013年第25期19卷 4039-4044页

作者： Zheng Lou Wei Zhang Rong-Gui Meng chuan-Gang Fu Department of Colorectal Surgery Changhai Hospital

AIM: To investigate control of two different types of massive presacral bleeding according to the anatomy of the presacral venous system. METHODS: A retrospective review was performed in 1628 patients with middle or low rectal carcinoma who were treated surgically in the Department of Colorectal Surgery, changhai Hospital, Shanghai, china from January 2008 to December 2012. In four of these patients, the presacral venous plexus (n = 2) or basivertebral veins (n = 2) were injured with massive presacral bleeding during mobilization of the rectum. The first two patients with low rectal carcinoma were operated upon by a junior associate professor and the source of bleeding was the presacral venous plexus. The other two patients with recurrent rectal carcinoma were both women and the source of bleeding was the basivertebral ***: Two different techniques were used to con-trol the bleeding. In the first two patients with massive bleeding from the presacral venous plexus, we used suture ligation around the venous plexus in the area with intact presacral fascia that communicated with the site of bleeding (surrounding suture ligation). In the second two patients with massive bleeding from the basivertebral veins, the pelvis was packed with gauze, which resulted in recurrent bleeding as soon as it was removed. Following this, we used electrocautery applied through one epiploic appendix pressed with a long Kelly clamp over the bleeding sacral neural foramen where was felt like a pit Electrocautery adjusted to the highest setting was then applied to the clamp to "weld" closed the bleeding point. Postoperatively, the blood loss was minimal and the drain tube was removed on days 4-7. CONCLUSION: Surrounding suture ligation and epiploic appendices welding are effective techniques for controlling massive presacral bleeding from presacral venous plexus and sacral neural foramen, respectively.

关键词： Massive presacral bleeding Rectal surgery Suture ligation Welding

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