Surgical treatment for cancer of the pancreatic head / 中华肿瘤杂志

<p><b>OBJECTIVE</b>To explore and evaluate the therapeutic efficacy of surgical treatment for cancer of the pancreatic head.</p><p><b>METHODS</b>The clinical data of 96 patients with cancer of the pancreatic head admitted in our hospital from January 2002 to December 2009 were retrospectively analyzed. pancreatoduodenectomy was performed in 48 cases, extended pancreatoduodenectomy in 30 cases, and Roux-Y cholangiojejunostomy in 18 cases.</p><p><b>RESULTS</b>The 1, 2 and 3-year survival rates were 59.2%, 41.8% and 13.2%, respectively, in the patients treated with pancreatoduodenectomy, and 73.2%, 58.2% and 24.1%, respectively, in the patients treated with extended pancreatoduodenectomy. The 1, 2 and 3-year survival rates were 36.8%, 15.8% and 5.3%, respectively, in the patients with unresectable tumor who received radiotherapy and (or) chemotherapy in Roux-Y cholangiojejunostomy. The postoperative morbidity was 29.2%, 30.0% and 27.8% in the patients treated with pancreatoduodenectomy, extended pancreatoduodenectomy and Roux-Y cholangiojejunostomy, respectively.</p><p><b>CONCLUSIONS</b>Pancreatoduodenectomy is the most effective treatment. Extended pancreatoduodenectomy can improve the surgical resection rate, reduce the recurrence rate and improve the survival rate. Internal drainage is an important palliative measure.</p>

Diagnosis and surgical treatment of esophageal leiomyoma / 中华肿瘤杂志

<p><b>OBJECTIVE</b>To study the characteristics of diagnosis and surgical treatment of esophageal leiomyoma.</p><p><b>METHODS</b>Preoperative radiology, esophagoscopy and results of surgical treatment were retrospectively analyzed in 141 patients with esophageal leiomyoma.</p><p><b>RESULTS</b>Dysphagia (64.5%) and chest or epigastric pain (20.6%) were the most common presenting symptoms with a mean duration of 15.7 months. Eleven patients had been misdiagnosed as malignant esophageal disease, mediastinal or retroperitoneal tumor before operation. Thirteen patents received partial esophageal resection, including 2 patients with gigantic tumor, 3 still misdiagnosed as malignancy in the operation theater and 8 accompanied with esophageal or gastric cardiac carcinoma. 128 patients were treated with tumor removal only, among whom the esophageal mucosa was ruptured and sutured in 13 patents. The tumor was single in 130 patients and multiple in 11 patients. The tumor shape was either oval, horseshoe-or ginger-like. Tumor surrounded the esophagus less than half circumference in 75 patients, more than half in 59 patients and involved the whole circumference in 7 patients. The tumor was polypoid and intraluminal in one patient. It was extraluminal in 2 patients and was intramural in all the others. The morbidity and 30-day mortality rates were 3.6% and 0%.</p><p><b>CONCLUSION</b>Preoperative differentiation of esophageal leiomyoma is important for it may be misdiagnosed as esophageal malignant disease or mediastinal tumor. Tumor removal only is indicated if possible. Biopsy is inadvisable if leiomyoma has been suspected by esophagoscopy. The incidence of esophageal carcinoma complicating esophageal leiomyoma is high, of which the reason needs further study.</p>

Sleeve gastrectomy model in DIO rat:establishment and evaluation / 中国普通外科杂志

Objective To investigate the weight loss mechanism of sleeve gastrectomy.Methods SD rats were fed with high-fat diet to induce obesity,and then the obesity rats were randomly divided into experimental group(underwent SG) and control group(underwent sham surgery).Eight weeks after operation,the body weight,food intake and peripheral blood concentration of Ghrelin,GLP-1,PYY3-36 of rats were checked.Results Compared with controll group,in experimental SG model,food intake was decreased(P 0.05).Conclusions The weight loss of sleeve gastrectomy in DIO rats's decline is lasting and obvious.The postoperative effect of decreased Ghrelin and increased GLP-1,PYY3-36 is the main mechanism for weight loss.