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Expanded endoscopic therapy criteria should be cautiously used in intramucosal gastric cancer

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Chinese Journal of Cancer Research 2016年第3期28卷 348-354页

作者： Hongshan Wang Heng Zhang Cong Wang Yong Fang Xuefei Wang Weidong Chen Fenglin Liu Kuntang Shen Xinyu Qin Zhenbin Shen Yihong Sun department of general surgery Zhongshan HospitalGeneral Surgery Research InstituteFudan University

Objective： Accurate estimation of lymph node metastasis （LNM） in intramucosal gastric cancer is essential to select less invasive treatment options and even avoid surgery. The aim of this study was to evaluate combined clinicopathological features to predict the presence of LNM. Methods： A retrospective review of data from 386 intramucosaL gastric cancer patients who underwent gastrectomy with extended lymphadenectomy from 2003 to 2010 was conducted. The mutual relation between clinicopathological characteristics and LNM was analyzed. Results： LNM was detected in 40 （10.4%） of the 386 patients. Histological typeand vascular or lymphatic invasion presence showed a positive correlation with LNM occurrence by univariate analysis. Multivariate analysis revealed that histological type was the only factor associated with LNM. Combined clinicopathologic characteristics would be more predictable for LNM. We found no LNM when we used combined clinicopathological characteristics conforming to Japanese absolute indications for endoscopic therapy. The LNM rate was as high as 8.7% when Japanese expanded criteria were used. Univariate analysis in cancer conformity to expand endoscopic submucosal dissection （ESD） indication also revealed that the undifferential type was the only significant factor for LNM. Conclusions： It was possible to predict intramucosal gastric cancer cases without LNM using combined clinicopathological characteristic analysis. Extended indication for ESD should be cautiously used for intramucosal gastric cancer patients.

关键词： Lymph node metastasis early gastric cancer intramucosal cancer endoscopic therapy

Volvulus of Colon Sigmoide in the general surgery department of Chu Gabriel Toure

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Surgical Science 2022年第1期13卷 46-52页

作者： Maïga Amadou Diakité Ibrahima Bah Amadou Diallo Aly Boubacar Traoré Bathio Moussa Diassana Sidibé Boubacar Yoro Koné Tani Doumbia Arouna Adama Traoré Amadou Saye Zakari Diallo Mamadou Konaté Moussa Saadé Oumou Hélène Kanté Lassana Konaté Madiassa Dembélé Souleymane Samaké Moussa Dembélé Bakary Tientigui Traoré Alhassane Togo Adégné general surgery department University Hospital Bamako Mali general surgery department Sikasso Hospital Sikasso Mali Reference Center of Commune VI Bamako Mali

Introduction: Sigmoid colon volvulus is a medico-surgical emergency which represents a common cause of colonic occlusion, it is characterized by strangulation of the sigmoid loop around its meso colic axis producing low mechanical occlusion [1]. Apart from this form conventionally described, the volvulus of the sigmoid colon can occur along an organoaxial axis. This form has been highlighted in the literature thanks to the diagnostic contribution of multi-detector scanners [2]. Objective: To determine the hospital frequency of sigmoid colon volvulus;to write the clinical and para-clinical aspects of sigmoid colon volvulus;write down the different treatments used for the management of sigmoid colon volvulus.

关键词： Sigmoid Volvulus general surgery department

Robotic total gastrectomy for carcinoma in the remnant stomach:a comparison with laparoscopic total gastrectomy

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Gastroenterology Report 2021年第6期9卷 583-588页

作者： Zheng-Yan Li Jia-Jia Liu Pei-Wu Yu Yong-Liang Zhao Yan Shi Zi-Yan Luo Bin Wu Jun-Jie Wang Feng Qian department of general surgery Center for Minimally Invasive Gastrointestinal SurgerySouthwest HospitalThird Military Medical UniversityChongqingP.R.China

Background Total gastrectomy for carcinoma in the remnant stomach(CRS)remains a technically demanding *** robotic surgery is superior,equal,or inferior to laparoscopic surgery in patients with CRS is *** study was designed to compare the efficacy and safety of robotic total gastrectomy(RTG)and laparoscopic total gastrectomy(LTG)for the treatment of *** In this cohort study,we retrospectively analysed the data from patients who underwent RTG or LTG for CRS at Southwest Hospital(Chongqing,China)between May 2006 and October *** surgical outcomes,post-operative complications,and survival outcomes between the two groups were *** Compared with LTG,RTG was associated with similar effective operation time(272.0 vs 297.9 min,P=0.170),higher total costs(105,967.2 vs 81,629.5 RMB,P0.05).The 3-year disease-free survival and 3-year overall survival rates were comparable between the two groups(65.5%vs 57.5%,P=0.918;69.0%vs 60.0%,P=0.850,respectively).Conclusions RTG is a safe and feasible procedure for the treatment of CRS and could serve as an optimal treatment for CRS.

关键词： robotic gastrectomy laparoscopic gastrectomy total gastrectomy carcinoma in the remnant stomach

Collagenous nodule mixed simple cyst and hemangioma coexistence in the liver

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World Journal of Gastroenterology 2015年第14期21卷 4419-4422页

作者： Zhen-Jiang Zheng Shu Zhang Yang Cao Guang-Chun Pu Hong Liu department of general surgery The Third People’s Hospital of Chengdu The Second Affiliated Hospital of Chengdu Chongqing Medical University department of Radiology The Third People’s Hospital of Chengdu

A 20-year-old female patient presented with two masses located in the left *** this patient, a computed tomography(CT) scan revealed a hypodense mass and a second well-defined mass with a calcified nodule in the left hepatic *** enhancements were apparent in or around the masses.A laparotomy was performed due to the patient's symptoms, namely, the atypical CT findings and a risk of rupture of the subcapsular *** operation revealed two masses in the left hepatic lobe and a left liver resection was subsequently *** of the masses involved segment Ⅲ and the other mass was located in segment Ⅳ.The histopathologic findings supported a diagnosis of collagenous nodule mixed simple cyst and hemangioma.A diagnosis of collagenous nodule mixed simple hepatic cyst is extremely rare and radiologically mimics a teratoma, hepatolithiasis, parasitic cyst, or *** hepatic hemangiomas are the most common benign tumors found in the liver, the present case showed atypical radiographic features.

关键词： Collagenous nodule Hepatic hemangioma Liver Mass S

Endoscopic ablation of Barrett's esophagus using high power setting argon plasma coagulation: A prospective study

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World Journal of Gastroenterology 2005年第12期11卷 1872-1875页

作者： Corrado Pedrazzani Filippo Catalano Mara Festini Germana Zerman Anna Tomezzoli Andrea Ruzzenente Alfredo Guglielmi Giovanni de Manzoni First department of general surgery

AIM: This prospective study evaluated the effectiveness of 90 W argon plasma coagulation (APC) for the ablation of Barrett's esophagus (BE) that is considered to be the main risk factor for the development of esophageal ***: The results from 25 patients, observed at the First department of general surgery, University of Verona, Italy, from October 2000 to October 2003, who underwent APC for histologically proven BE were prospectively ***: The ablation treatment was completed in all the patients but one (96%). The mean number of APC sessions needed to complete ablation was 1.6 (total number: 40). The eradication was obtained in the majority of cases by one session only (60%), two sessions were required in 24% of the cases and three or more in 16%.About 43% of the sessions were complicated. Retrosternal pain (22.5%) and fever (17.5%) were the most frequent symptoms. Only one major complication occurred, it was an hemorrhage due to ulcer formation on the treated esophagus that required urgent endoscopic sclerosis and admission. The follow-up was accomplished in all the patients with a mean period of 26.3 mo and 20 patients (84%) with a follow-up period longer than 24 mo. Only one patient showed a relapse of metaplastic mucosa 12 mo after the completion of ablation. The patient was hence re-treated and now is free from recurrence 33 mo ***: High power setting (90 W) APC showed to be safe and effective. The effects persist at a mean follow-up period of two years with a comparable cost in term of complications with respect to standard power settings. Further studies with greater number of patients are required to confirm these results and to assess if ablation reduces the incidence of malignant progression.

关键词： Barrett's esophagus Argon plasma coagulation Endoscopic treatment

Biliopleural fistula: A rare complication of percutaneous transhepatic gallbladder drainage

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World Journal of Gastroenterology 2007年第23期13卷 3268-3270页

作者： Ming-Tsung Lee Sheng-Chuan Hsi Philip Hu Kuang-Yi Liu Division of general surgery Department of Surgery Armed Forces Taoyuan General Hospital

A 79-year-old previously healthy man presented with acute acalculous cholecystitis with obstruction of the biliary tract. He was successfully treated with antibiotics and percutaneous transhepatic gallbladder drainage, but returned to the hospital two days after discharge with a rare complication of this technique, biliopleural fistula. A thoracostomy tube was inserted to drain the pleural effusion, and the patient’s previous antibiotics reinstated. After two weeks of drainage and antibiotics, the fistula healed spontaneously without the need for further intervention.

关键词： Biliopleural fistula Percutaneous transhepatic gallbladder drainage Cholecystitis Complications Biliary drainage

Relationship between intestinal microbiota and colorectal cancer

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World Journal of Gastrointestinal Oncology 2015年第10期7卷 233-240页

作者： Gokhan Cipe Ufuk Oguz Idiz Deniz Firat Huseyin Bektasoglu department of general surgery Fatih University department of general surgery Bezmialem Vakif University

The human gastrointestinal tract hosts a complexand vast microbial community with up to 1011-1012 microorganisms colonizing the colon. The gut microbiota has a serious effect on homeostasis and pathogenesis through a number of mechanisms. In recent years, the relationship between the intestinal microbiota and sporadic colorectal cancer has attracted much scientific interest. Mechanisms underlying colonic carcinogenesis include the conversion of procarcinogenic diet-related factors to carcinogens and the stimulation of procarcinogenic signaling pathways in luminal epithelial cells. Understanding each of these mechanisms will facilitate future studies, leading to the development of novel strategies for the diagnosis, treatment, and prevention of colorectal cancer. In this review, we discuss the relationship between colorectal cancer and the intestinal microbiota.

关键词： Sporadic Colorectal Cancer Intestinal Microbiota

Treatment of Helicobacter pylori in surgical practice:A randomised trial of triple versus quadruple therapy in a rural district general hospital

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World Journal of Gastroenterology 2008年第24期14卷 3855-3860页

作者： Siok Siong Ching Sivakumaran Sabanathan Lloyd R Jenkinson Clinical Research Fellow in general surgery Leeds General Infirmary department of surgery Ysbyty Gwynedd

AIM: To compare a lansoprazole-based triple versus quadruple therapy for Helicobacter pylori (H pylori) eradication with emphasis on side effect prof ile,patient compliance and eradication rate at a rural district general hospital in Wales,United Kingdom. METHODS: One hundred one patients with H pylori infection were included in the study. Patients were randomised to receive triple therapy comprising of lansoprazole 30 mg,amoxycillin 1 g,clarithromycin 500 mg,all b.d. (LAC),or quadruple therapy comprising of lansoprazole 30 mg b.d.,metronidazole 500 mg t.d.s.,bismuth subcitrate 240 mg b.d.,and tetracycline chloride 500 mg q.d.s. (LMBT). Cure was defi ned as a negative 13C urea breath test 2 mo after treatment. RESULTS: Seven patients were withdrawn after randomisation. Fifty patients were assigned to LAC group and 44 to LMBT group. The intention-to-treat cure rates were 92% and 91%,whereas the per-protocol cure rates were 92% and 97%,respectively. Side effects were common,with 56% experiencingmoderate to severe symptoms in the LAC group and 59% in the LMBT group. Symptoms of vomiting,diarrhoea and black stools were significantly more common in the LMBT group. Patient compliance was 100% for triple therapy and 86% for quadruple therapy (P third of patients in both groups were still taking acid-reducing medications at six-month follow-up. CONCLUSION: One-week triple and quadruple therapies have similar intention-to-treat eradication rates. Certain side effects are more common with quadruple therapy,which can compromise patient compliance. Patient education or modifi cations to the regimen are alternative options to improve compliance of the quadruple regimen.

关键词： Helicobacter pylori Triple therapy Quadruple therapy Side effects Treatment compliance Eradication rate

Pathogenetic effects of platelet activating factor on enterogenic endotoxemia after burn

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World Journal of Gastroenterology 2000年第3期6卷 451-453页

作者： Pei Wu Yu Guang Xia Xiao Wei Ling Fu Jian Cheng Yuan Li Xin Zhou Xiao Jian Qin department of general surgery Southwest HospitalThird Military Medical UniversityChongqing 400038China Institute of Burn Research Southwest HospitalThird Military Medical UniversityChongqing 400038China

INTRODUCTION Previous clinical and experimental studies haveindicated that an early endotoxemia occurred after amajor *** is unlikely that burn wound sepsis isthe source of circulating endotoxin in less than 12hour after *** evidence demonstratesthat the bacteria and endotoxin in thegastrointestinal tract can pass through the gutbarrier into blood circulation to form enterogenicendotoxemia following ***。

关键词： Platelet activating factor burn endotoxemia intestinal permeability