ABSTRACT
The optimal surgical management of patients with leiomyosarcoma of inferior vena cava remains a controversy. From 1975 and 2009, five patients with leiomyosarcoma of inferior vena cava were treated at the Chinese PLA General Hospital and Beijing Shijitan Hospital. The age ranged 39-61 years and the duration of symptoms ranged from 18 to 36 months. Abdominal and back pain are the most common complaints. A combination of various imaging modalities is essential for treatment planning. R0, R1, R2, and biopsy only were accomplished in 2, 1, 1, and 1 case, respectively. Combined resections included inferior vena cava, right kidney, adrenal gland, psoas, colon, duodenal, gallbladder, liver, and/or aorta, without inferior vena cava reconstruction. No inferior vena cava-related postoperative complication was seen in our series.
Subject(s)
Leiomyosarcoma/pathology , Leiomyosarcoma/surgery , Vascular Neoplasms/pathology , Vascular Neoplasms/surgery , Vena Cava, Inferior/surgery , Beijing , Female , Humans , Leiomyosarcoma/diagnosis , Middle Aged , Tomography/methods , Treatment Outcome , Vascular Neoplasms/diagnosisABSTRACT
OBJECTIVE: To evaluate the methods of surgery for extraperitoneal pelvic neoplasms. METHODS: Clinical data related to surgery of 84 cases of extraperitoneal pelvic neoplasms were extracted and retrospectively analyzed. RESULTS: All 84 patients underwent operations, including one of them who received 4 operations within 6 months for resection of a single tumor. 58 abdominal, 16 buttock and 10 combined incisions were made in the series. Pelvic organs and structures were co-resected in 35 cases, including total pelvic exenteration in 2 cases and anterior pelvic exenteration in 2 cases. Common and/or external iliac vessels were resected and transplantations of artificial vessel were carried in 5 cases. Internal iliac arteries were ligated in 10 cases. The mean blood lose was 2 385 ml in our series and the largest was 15 000 ml. The complete resection rate of tumor was 81% for 84 operations and the largest resected tumor was 30 cm x 30 cm x 25 cm. There was no hospitalized death, and postoperative complication rate was 7% (6/84) in our series. Only 1 death were seen during the mean period of postoperative follow-up of 54 months, 22 operations were carried for 21 cases of recurrence, including 7 operations for 7 recurrences in a case within 12 years. CONCLUSIONS: Making adequate abdominal or/and buttock incisions, exenterations of involved pelvic organs and structures, total pelvic exenteration if necessary, appropriate management of iliac vessels, planned re-operation for one tumor, and re-operation for recurrences are important methods for the treatment of extraperitoneal pelvic neoplasms.
Subject(s)
Pelvic Exenteration/methods , Pelvic Neoplasms/surgery , Vascular Surgical Procedures/methods , Adolescent , Adult , Aged , Child , Child, Preschool , Female , Follow-Up Studies , Humans , Male , Middle Aged , Pelvic Neoplasms/pathology , Reoperation , Retrospective StudiesABSTRACT
Objective:To investigate the influence of Portulaca extracts on H1R,PAR-2 and TRPV1 in skins of rats and the regulation mechanism of H1R,PAR-2/TRPV1 itch signal pathway with atopic eczema.Methods:30 SD rats were randomly divided into normal control group,model group and Porulaca group,each group contained 10 rats.In addition to the normal group,2,4-dinitrochloro-benzene was used on the rest of group for making rat model with atopic eczema.After the success of the model manufacture,each group was given corresponding drugs.After the last administration,EASI was evaluated.The levels of H1R,PAR-2 and TRPV1 in rats skins were detected by immunohistochemical method.Ca2+concentration was analyzed by flow cytometry.Results: Compared with normal control group,EASI(P<0.01),the levels of H1R(P<0.05) and PAR-2(P<0.01),and Ca2+concentration(P<0.01) of rats in model group were significantly increased.The levels of TRPV1 were not increased obviously (P>0.05).Compared with model group,EASI (P<0.01),the levels of H1R(P<0.01) and PAR-2(P<0.01),and Ca2+concentration(P<0.05) of rats in Porulaca group were sig-nificantly reduced,and the levels of TRPV1 were not decreased obviously(P>0.05).Conclusion:Purslane could reduce the levels of H1R,PAR-2 and Ca2+concentration to treat the acute eczema.The mechanism may be to lose the activation of downstream molecule TRPV1 and reduce the inflow of Ca2+by reducing the levels of upstream molecules H1R and PAR-2,then to achieve the effect of anti itch.