ObjectiveTo evaluate the efficacy of XiaochengqiMixture (XM) on promoting healing of colonic stoma. MethodsForty Wistar rats were divided into two groups randomly after colonectomy: experimental group (n=20) and control group (n=20). In early postoperatively stage rats were given gastric administration of XM in the experimental group and pure water in the control group. On day 3, 7, and 14 after establishment of animal models, laparotomy was performed in two groups of rats, respectively. Anastomotic stoma and surrounding tissues were harvested to detect the context of hydroxyproline and collagen fiber proportion by Masson dying. ResultsOn day 3 after establishment of animal models, hyperplastic collagen with small fiber was observed while no fasciculus was found. Hydroxyproline context and collagen fiber proportion of rats were higher in experimental group than those in control group (Plt;0.05). On day 7 after operation, many fasciculuses were found in two groups of rats, hydroxyproline context and collagen fiber proportion of rats were higher in experimental group than those in control group (Plt;0.01). On day 14 after operation, fasciculuses became bigger and more regular in arrangement, but there was no significant difference between the two groups (Pgt;0.05). ConclusionXM is capable of promoting healing of colonic stoma and might prevent the occurrence of anastomotic fistula.
目的對單層吻合在消化道手術中臨床應用的安全性和實用性進行評價。方法對該院1 600例消化道單層吻合術的臨床資料進行回顧性分析，并結合國內外文獻進行討論。結果全組1 600例消化道單層吻合手術均順利完成，發生吻合口漏25例（1.56%），吻合口狹窄3例（0.19%），無一例發生吻合口大出血。結論消化道單層吻合不會增加吻合口漏的發生率，并能減少吻合口狹窄、梗阻和出血，是安全、實用且有效的吻合方法。
ObjectiveTo investigate the association between the preoperative nutritional risk and anastomotic leakage following anterior resection for the rectal cancer. MethodsA total of 321 patients with rectal cancer underwent anterior resection in our hospital between January 2008 and December 2013 were retrospectively analyzed. Preoperative nutritional status was evaluated using NRS 2002. Correlation of clinicopathologic characteristics with postoperative anastomotic leakage was evaluated using single factor analysis and Logistic regression model. ResultsAmong the 321 patients, the incidence of postoperative anastomotic leakage was 5.6% (18/321). Single factor analysis showed that the NRS2002 score≥3, clinicalpathologic stage (Ⅲ-Ⅳstage) and distance of tumor from the anal verge were the risk factors of anastomotic leakage after anterior leakage following anterior resection for rectal cancer. Logistic regression analysis revealed that the NRS2002 score (OR=4.125, 95% CI=2.062-7.004), clinicalpathologic stage (OR=3.334, 95% CI=2.062-7.004) and the distance of tumor from the anal verge (OR=2.341, 95% CI=2.559-15.838) were the independent risk factors for anastomotic leakage after anterior leakage following anterior resection for rectal cancer. Conciusions Preoperative NRS2002 score is helpful to predict the risk of anastomotic leakage after anterior resection of rectal cancer. Nutrition education should be strengthened to decrease the morbidity of the anastomotic leakage following anterior resection for the patients who's NRS2002 score≥3.
目的評價雙吻合器在中、低位直腸癌保肛手術應用中的安全性和實用性。方法分析 38 例應用雙吻合器行結、直腸吻合治療中、低位直腸癌的經驗。結果本組病例在使用雙吻合器中閉合和吻合過程順利、簡捷，術后無1 例發生吻合口漏; 發生吻合口狹窄1例,發生率為2.6%, 經肛門指法擴肛后即痊愈; 局部復發2例,復發率為5.3%。結論雙吻合器吻合法可作為中、低位直腸癌保肛手術的一種安全可靠的術式選擇。
Objective To compare the effectiveness between a new hand-sewn intestinal anastomosis and stapled anastomosis during Roux-en-Y anastomosis of gastric cancer. Methods Retrospectively, we collected 200 gastric cancer patients who underwent radical distal or total gastrectomy from January 2014 to June 2017 in our hospital, and divided them into observation group (new hand-sewn anastomosis, n=100) and control group (stapled anastomosis, n=100) according to the type of anastomosis. The time and cost taken to perform the anastomosis, the incidence of postoperative complications (including anastomotic leakage, bleeding, and stenosis), and hospital stay were compared. Results The cost of anastomosis in the observation group was significantly lower than that of the control group [(194.1±13.5) RMB vs (5 270.3±852.7) RMB, P<0.001], and the time taken to perform was just slightly longer in the observation group [(8.34 ± 0.65) minvs (8.29±0.61 ) min, P=0.540], additionally the incidences between the observation group and the control group, in regards to anastomotic bleeding [0 (0/100) vs 3% (3/100), P=0.246], leakage [0 (0/100) vs 1% (1/100), P=1.000], stenosis [0 (0/100) vs 2% (2/100), P=0.497], and hospital stay [(18.8±7.4) d vs (19.2±6.2) d, P=0.175], showed no significant difference between the 2 groups. Conclusion The new hand-sewn anastomosis technology is safe and effective, easy to learn, and it can save money and time, which is worth promoting.
Objective To explore the changes of calcitonin gene-related peptide (CGRP) and substance P (SP) levels after end-toend and end-to-side neurorrhaphy. Methods Twenty female Wistar rats were divided into 4 experimental groups and control group. In the experimental groups, common peroneal nerves were transected on both sides. End-to-side coaptation was performed on the left, while end-to-end coaptation on the right. After 1, 2, 4 and 27 weeks, the rats were sacrificed, and immunoreactivities of CGRP and SP in suture sites, lumbar spine and dorsal root ganglia(DRGs) were evaluated respectively. Results The expression ofCGRP and SP decreased in dorsal horn and DRGs within 1 week postoperatively. After 4 -27 weeks, CGRP and SP in dorsal horn could return to almost normal level, but they had little recovery in DRGs. Although the trend of change between end-to-end and end-to-side was coincident, in most experimental groups, thereexisted differences in the dorsal horn between end-to-end and end-to-side. The sciatic nerve stained by acetylcholinesterase, SP, CGRP and PGP 9.5 showed that the fibers could pass through the suture site of either end-to-end or end-to-side. Conclusion Nerve regeneration can be achieved by end-to-side neurorrhaphy, andthe mechanism of sensory nerve recovery of these two methods is similar. But the recovery in end-to-side coaptation is insufficient to some degree.