目的 探讨腹腔镜结肠癌根治术的临床效果。方法 应用腹腔镜外科技术对25例结肠癌患者实施腹腔镜结肠癌根治术。结果 本组25例手术时间110～310 min，平均195 min； 术中出血量约100～350 ml，平均约180 ml； 术后胃肠功能恢复时间1～4 d，平均 1.7 d。所有标本残端无肿瘤细胞残留、浸润。所有病例术后未出现出血、吻合口漏和狭窄并发症，仅有2例出现伤口感染。术后住院6～10 d，平均7.5 d； 术后19例随访2～38个月，平均13个月，其中2例于手术后第12个月和14个月因肿瘤广泛转移、衰竭而死亡； 余17例随访期间均未发现有转移复发及切口种植。结论 腹腔镜结肠癌根治术具有微创、安全、术后恢复快、肿瘤根治彻底等优点，值得临床推广应用。
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.