ObjectiveTo evaluate the safety and efficacy of single-layer seromuscular suture in ileocolonic anastomosis. MethodsFifty patients who needed ileocolonic anastomosis sugery were randomly divided into seromuscular anastomosis group (n=25) and two-layer anastomosis group (n=25). Intraoperative blood loss, perative time, postopreative complications, bowel function recovery time, and postoperative hospital stay time were recorded in each group. ResultsBlood loss, anastomotic leak, first passing gas time, first defecation time, and postoperative hospital stay time were (11.00±3.24) ml vs (10.28±2.99) ml (Pgt;0.05), 4.0% vs 8.0% (Pgt;0.05), (3.72±1.59) d vs (4.72±1.59) d (Pgt;0.05), (5.08±3.36) d vs (6.08±3.36) d (Pgt;0.05), and (8.47±2.32) d vs (10.26±2.61) d (Pgt;0.05), all the indexes above between the two groups had no significant difference. While a significant differnece in operative time was found between them 〔(11.74±2.02) min vs (16.44±2.06) min), Plt;0.01〕. ConclusionsSingle-layer seromuscular suture technique is safe and effective in ileocolonic anastomosis.
ObjectiveTo introduce the general situation about oval cells and the advance in research on relation between the hepatic oval cells and hepatocellular carcinoma (HCC). MethodRelevant literatures in recent years about oval cells in hepatocellular carcinoma were collected and analyzed. ResultsHepatic oval cells are progenies of the hepatic stem cells that are thought to reside in the terminal branches of the biliary tree, termed the canals of Hering.After severe liver injury resulting in hepatocyte and cholangiocyte necrosis/apoptosis, the dual-potential oval cells will proliferate and differentiate into hepatocytes or cholangiocytes to replace the respective lost cell types.Recent studies have found many new oval cell surface markers, and promoted the recognition of oval cells.The level of oval cells proliferation is positively correlated with the malignant and inflammatory level of chronic liver diseases.More importantly, oval cells is involved in the occurrence, development, recurrence, and metastasis of liver cancer, and closely related to the prognosis of HCC. ConclusionAn improved understanding of the biological behavior of hepatic oval cells may lead to the development of novel diagnosis, treatment regimens, and prevention for hepatocellular carcinoma.
【Abstract】Objective To evaluate the value of pTNM classification in predicting the prognosis of hepatic cell carcinoma after liver transplantation. Methods Fifty-nine HCC cases undergoing liver transplantation between April 1993 and January 2003 were retrospectively reviewed. Fiftynine cases were staged by using the pTNM classification. Results The 1-year survival rates were 66.67%, 66.67%, 40.91% and 31.75% for Ⅰ，Ⅱ，Ⅲa and Ⅳa stages，2-year survival rates were 66.67%, 66.67%, 21.29% and 31.75%, the difference was not statistically significant. Conclusion The pTNM classification is not good enough to predict the prognosis of hepatic cell carcinoma after liver transplantation.
Objective To investigate the effect of S-adenosylmethionine (SAM) on mitochondrial injury that was induced by ischemia-reperfusion in rat liver. Methods Fifty-four rats were randomly divided equally into 3 groups: control group, ischemia-reperfusion group (I/R group), and SAM-treated group (SAM group). Hepatic ischemia had been only lasted for 30 min by obstructing the blood stream of hepatic portal vena (the portal vena was only separated but not obstructed in control group). The rats of SAM group received SAM intraperitoneally 2 h prior to ischemia. Blood samples of each group were collected from the inferior cava vena at 0, 1 and 6 h after reperfusion and the serum levels of AST and ALT were detected. Mitochondrial super oxidedismutase (SOD), malondialdehyde (MDA), adenosine triphosphate (ATP) and energy charge (EC) in samples of liver tissue were detected, and the mitochondrial ultrastructure was observed with electronmicroscope. Results The serum levels of AST, ALT and mitochondrial MDA at 0, 1 and 6 h after reperfusion in the I/R group were significantly higher than those in the control group, whereas the levels of mitochondrial SOD, ATP and EC were significantly lower than those in the control group (P＜0.01). Except the value of 0 h, when it comes to SAM group, the levels of AST, ALT and mitochondrial MDA were significantly lower (P＜0.05) and the levels of mitochondrial SOD, ATP and EC were significantly higher (P＜0.05, P＜0.01) than those in the I/R group, respectively. The mitochondrial ultrastructure was injured obviously in I/R group when compared with that in control group. The number of mitochondria decreased and the mitochondria swelled, making the crista became obscure and the density of matrix became lower. The above changes in SAM group were less obvious when compared with those in I/R group. Conclusion SAM may protect mitochondrion against hepatic ischemia injury, since it may prevent mitochondrial lipid peroxidation, increase ATP, and eventually improve energy metabolism after ischemia-reperfusion.
Objective To analyze the surgical techniques for the procurement and back-table surgery of the graft in living-related small bowel transplantation. Methods Eligible donor was chosen according to the donor selection criteria of living-related small bowel transplantation, and preoperative plan was designed. A segment of ileum of 120 cm was procured 20 cm proximal to the ileocecal valve which was preserved in the donor. The techniques for the procurement and back-table surgery of the graft were summarized, which included measurement of entire small bowel length from Treitz to ileocecal valve, palpation and transillumination to identify the distal branch of the superior mesenteric artery， and transient blockage of isolated blood vessels with vascular clamps in order to observe the influence on the blood circulation of graft and residual ileum. The detailed manipulation techniques in processing the graft blood vessels were discussed. Results The operations were successful both on the donor and the recipient. The functions of implanted segment of bowel were well. The donor had no other complications, such as mesenteric thrombi and anastomosis leakage of intestine, except for transient moderate diarrhea. She was discharged 14 days after operation. In the next 8 months of following-up, the donor has not experienced significant alteration in bowel habits or weight loss. Now she is in good appetite, without any changes in the habit and amount on diet. No changes have been found in lifestyle, work habits, or psychosocial conditions after the small bowel donation. Conclusion The procurement of a segment of ileum as graft and preservation of 20 cm proximal to the donor ileocecal valve may be ideal protocol. Using a standardized technique with attention presents little recent or long-term risks for the donor and brings satisfied effect for the recipient.