目的 探討腹腔鏡結腸癌根治術的臨床效果。方法 應用腹腔鏡外科技術對25例結腸癌患者實施腹腔鏡結腸癌根治術。結果 本組25例手術時間110～310 min，平均195 min； 術中出血量約100～350 ml，平均約180 ml； 術后胃腸功能恢復時間1～4 d，平均 1.7 d。所有標本殘端無腫瘤細胞殘留、浸潤。所有病例術后未出現出血、吻合口漏和狹窄并發癥，僅有2例出現傷口感染。術后住院6～10 d，平均7.5 d； 術后19例隨訪2～38個月，平均13個月，其中2例于手術后第12個月和14個月因腫瘤廣泛轉移、衰竭而死亡； 余17例隨訪期間均未發現有轉移復發及切口種植。結論 腹腔鏡結腸癌根治術具有微創、安全、術后恢復快、腫瘤根治徹底等優點，值得臨床推廣應用。
ObjectiveTo investigate the changes of diamine oxidase(DAO) and endotoxin(ET) during the treatment of systemic inflammatory response syndrome with human growth hormone and the relationship between human growth hormone and intestinal mucosal barrier injury. MethodsOne hundred and fortysix patients with systemic inflammatory response syndrome were randomly divided into operative group and nonoperative group, which were again randomly divided into the study group and control group.Plasma concentration of DAO and ET were determined before the treatment and 1 week after the treatment.ResultsPlasma concentration of DAO and ET in study group decreased after treatment with significant difference (P＜0.05，P＜0.01).ConclusionHuman growth hormone can protect intestinal mucosa barrier.
ObjectiveTo summarized the clinical experience on laparoscopic radical surgery in patients with advanced distal gastric cancer. MethodsThe clinical data of 26 patients with advanced distant gastric cancer undergoing laparoscopic gastrectomy were retrospectively analyzed. ResultsLaparoscopic distal gastrectomy was performed successfully in all patients. The operation time was (283.2±27.6) min (270-450 min) and the blood loss was (178.4±67.4) ml (80-350 ml). The time of gastrointestinal function recovery was (2.8±1.2) d (2-4 d), out of bed activity time was (1.5±0.4) d (1-3 d) and liquid diet feeding was (3.5±1.4) d (3-4 d). The hospital stay was (10.0±2.6) d (7-13 d). The number of harvested lymph nodes was 11 to 34 (17.8±7.3). The distance from proximal surgical margin to tumor was (7.0±2.1) cm (5-12 cm) and the distance from distal surgical margin to tumor was (5.5±1.8) cm (4-8 cm), thus surgical margins were negative in all samples. All patients were followed up for 3-48 months (mean 18.5 months), two patients with poorly differentiated adenocarcinoma died of extensive metastasis in 13 and 18 months, respectively, and other patients survived well. ConclusionsLaparoscopic radical gastrectomy with D2 lymphadenectomy for advanced gastric cancer is safe and feasible. However, the advantage of laparoscopic technique over the conventional open surgery requires further study.