【Abstract】ObjectiveTo detect the spreading scope of rectal cancer to mesorectum by RT-PCR using carcinoembryonic antigen (CEA) mRNA as a marker and to investigate the excision scope of mesorectum in resection of rectal cancer. MethodsForty specimens from 40 rectal cancer patients who underwent curative operation was employed to detect the metastatic deposits scattered in the mesorectum by RT-PCR using CEA as a marker. ResultsNine of 40 (22.5%) specimens contained metastatic deposits scattered in the mesorectum. The metastasis was just within the range of 4cm mesorectum under the verge of tumor. The tumor spreading to mesorectum is correlated with Dukes stages，the infiltrated depth of bowel wall, tumor differentiation and tumor type(P＜0.05), and is not correlated with the size of tumor and the level of CEA(Pgt;0.05). ConclusionThe excision of mesorectum should be within the range of 5cm under the verge of tumor in surgical management of rectal cancer.
【摘要】目的探讨十二指肠憩室的诊断与治疗。方法对南方医院1982～2002年20年期间收治的110例十二指肠憩室患者的临床资料作回顾性分析。结果憩室分布于十二指肠球部10例，降部77例，水平部15例，升部8例； 憩室合并炎症28例，合并出血14例，合并急、慢性胆胰疾病35例，无合并症33例。手术治疗47例，其中行十二指肠憩室切除术10例，憩室内翻缝合术5例，胃大部切除术13例，胃大部切除+胆肠RouxenY吻合术10例，Oddi氏括约肌成形术2例，胃大部切除+胆囊切除术5例，胰十二指肠切除术2例。术后发生十二指肠瘘1例，手术治疗47例全部治愈，无一例死亡。结论十二指肠憩室以降部多发，无症状者可行保守治疗，若合并炎症、出血、胆胰疾病，则需根据憩室部位合理选择手术方式。