Objective To explore the value of laparoscopy combined with gastroscopy in treatment for gastric stromal tumors. Method The clinical data of 45 patients with gastric stromal tumors performed laparoscopy combined with gastroscopy resection from June 2008 to June 2012 in this hospital were analyzed retrospectively. Results Forty-five patients with gastric stromal tumors were successfully excised by laparoscopy combined with gastroscopy， and the tumors were completely resected and no residual tumor at the edge. The length of surgical incision was about 4-6 cm with an average of 5.1 cm. The mean operation time was 75 min. Postoperative recovery was smooth， no surgery-related comp-lications occurred. The mean hospital stay was 6.8 d. No recurrence or metastasis happened within the follow-up with an average of 16.5 months. The immunohistochemical examination results：43 cases of CD117 was positive， 32 cases of CD34 was positive， 28 cases of SMA was positive， 2 cases of Desmin was positive， 22 cases of S-100 was positive. Conclusions The treatment of gastric stromal tumors through laparoscopy combined with gastroscopy is safe and effective. The benefits include minimal invasiveness， shorter operation time， and rapid postoperative recovery. The laparoscopy combined with gastroscopy can make more precise resection range， and avoid residual tumor and resection of excessive normal gastric tissue.
Objective To analyze the clinicopathologic characteristics of remnant gastric cancer （RGC）. Methods The clinical data of 114 patients with RGC treated in The Second Affiliated Hospital of Northern Sichuan MedicalCollege and The General Hospital of Chinese People’s Liberation Army from March 2000 to May 2008 were reviewed and analyzed retrospectively. The clinicopathologic characteristics between the patients with primary benign diseases and those with malignant diseases were evaluated. Results A total of 114 cases，the age was （62.6±11.3） years，and the males versus females was 4.7∶1.0. Most patients （76.2%，64/84） were diagnosed at advanced stages （consistent with pT），and the proportion of pT1 stage cases was only 23.8% （20/84），tumor invasion pT4 was 60.7% （51/84）. It was more common that tumor directly invaded adjacent organs or structures （27.4%，23/84），lymph nodes positive （42.9%，36/84），and distant metastasis （27.2%，31/114）. The location of distant metastasis was usually confined in the abdominal cavity （93.5%，29/31），and the peritoneum disseminated was the most commonly structures （67.7%，21/31）. Histologically，the incidence of poorly differentiated adenocarcinoma （76.7%，79/103） was the mostly histologic grade as well as the diffuse type （78.6%，81/103） was the mostly Laurén classification. Between the patients with primary benign diseases and those with initial malignant disease，the initial gastrectomy or the methods of reconstruction had significantly differences （both P=0.000）. The median time from initial resection to development of RGC was 30.0 years in the patients with original benign disease，contrary to 3.3 years in those with previous malignant disease （P=0.000）. Both primary diseases （benign or malignant） and the age at initial gastrectomy were the major influencing factors for the time of RGC developed （P＜0.05）. For pathohistology characters，except signet-ring cell carcinoma （P=0.045）， pT4b （P=0.049），pN stage （P=0.025），and Borrmann classification （P=0.005），there were no significant differences between the patients with previous benign diseases and those with original malignant disease，as well as the resectability rate，curative resection （R0） rate，and overall survival rate （P＞0.05）. Conclusions It is almost unaffected by originalbenign diseases or malignant diseases for clinicopathologic characteristics including the treatment option and prognostic factors.It is necessary and feasibility to form a pattern of endoscopic follow-up for RGC.
ObjectiveTo investigate the relationship between clinicopathological characteristics and invasion depth of early gastric cancer (EGC), in order to put forward suitable regimens for EGC with different clinicopathological characteristics. MethodsThe clinicopathological data of 18 patients with EGC diagnosed from January 2008 to January 2013 were retrospectively analyzed. Clinicopathologic variables such as age, gender, tumor size and location, Helicobacter pylori infection, melaena, macroscopic type, and histopathological type were investigated by using chi-square test for their possible relationship with the depth of invasion. ResultsLymph node metastasis was more common in patients with submucous cancer (3/9, 33.3%) than in those with mucous cancer (0/9, 0%). Submucosal invasion was found in 77.8% (7/9) of undifferentiated adenocarcinoma cases, whereas only 22.2% (2/9) of differentiated adenocarcinoma had submucosal invasion. TypeⅢ EGC had a significant association with submucosal invasion (P<0.05). ConclusionEndoscopic treatment is unsuitable for patients with Type Ⅲ EGC.
ObjectiveTo explore the clinical effect of lidocaine mucilage diluent and simethicone emulsion in gastroscopy examination, in order to provide effective drugs for gastroscopy. MethodsWe selected 201 outpatients and the inpatients who underwent gastroscopic examination between August and October 2014 as the research subjects. Based on the kind of drug, the patients were randomly divided into research group (n=100) and control group (n=101). Patients in the research group accepted lidocaine mucilage diluent, while those in the control group received simethicone emulsion. Then we observed and compared the definition of gastroscopy, adverse drug reactions, examination time and drug price between the two groups. ResultsThe frequencies of high, medium, and low definition of gastroscopy were respectively 63.00%, 34.00% and 3.00% among the patients in the research group, and 69.31%, 26.73% and 3.96% among patients in the control group; there was no significant differences between the two groups (Z=-0.854, P=0.393). The adverse reaction rates, testing time, and drug prices for the two groups were 0.99% vs.1.00% (P>0.05), (6.5±2.1) minutes vs.(6.6±2.0) minutes (t=0.458, P>0.05), and RMB (9.0±1.2) yuan vs.(42.8±2.8) yuan (t=227.644, P<0.05), respectively. ConclusionLidocaine mucilage diluent and simethicone emulsion both have good effect for gastroscopic examination, which can raise the gastroscopic definition, promote endoscopic operation and observation by doctors, shorten examination time, and reduce adverse drug reactions. Both are of great value in clinical application, and lidocaine hydrochloride mucilage diluent is cheaper, which can be widely used and promoted clinically.
ObjectivesTo systematically review the efficacy of dyclonine and lidocaine for preparation before gastroscopy.MethodsPubMed, CNKI, CBM, VIP and WanFang Data databases were electronically searched to collect randomized controlled trials (RCTs) of dyclonine vs. lidocaine for preparation before gastroscopy from inception to December 31st, 2017. Two reviewers independently screened literature, extracted data and assessed the risk of bias of included studies. Meta-analysis was then performed by using RevMan 5.3 software.ResultsA total of 11 RCTs were included. The results of meta-analysis showed that: dyclonine could improve anesthetic effect (RR=1.38, 95%CI 1.31 to 1.47, P<0.000 01), and was more capable to remove bubble (RR=1.40, 95%CI 1.28 to 1.52,P<0.000 01), and had superior textures (RR=1.43, 95%CI 1.18 to 1.74,P=0.000 3).ConclusionsOral dyclonine can improve the visual definition of gastric mucosa and anesthetic effect, and has superior textures. Thus, dyclonine can be regarded as a recommended option prior to gastroscopy. Due to limited quality and quantity of the included studies, more high quality studies are required to verify above conclusions.