Objective To assess the effectiveness of large-calibre (7.5#) transanal tube drainage and decompression on prevention from anastomotic leakage following anterior resection for rectal cancer. Methods Clinical data of 346 consecutive patients (M/F=1.39, age range 32-84 years, median age 58.5 years) undergone anterior resection for rectal cancer in this institute from January 2006 to December 2008 were analyzed retrospectively. Results The anastomotic leakage rate was 0 (0/185) and 5.59%(9/161) in patients with or without receiving large-calibre transanal tube drainage respectively. The anastomotic leakage rate was significantly decreased by large-calibre transanal tube drainage after anterior resection for rectal cancer (χ2=8.526, P=0.004). Eight cases of anastomotic leakage were treated conservatively and the other one required further surgical interventions. No perioperative death occurred in this series. Conclusion In this study, the large-calibre transanal tube drainage and decompression is effective in protecting rectal anastomosis and decreasing the rate of anastomotic leakage.
Objective To sum up the diagnosis, treatment, and prevention of postoperative complications of carotid body tumor. Methods The clinical data of 27 patients (30 aneurysms) with carotid body tumor who treated in our hospital from June 2005 to June 2016 were analyzed retrospectively. Results Of the 27 patients, 24 patients had unilateral lesions and 3 patients had bilateral lesions, with a total of 30 aneurysms. Three patients received color Doppler ultrasound, 18 patients received computed tomography angiography, 3 patients received magnetic resonance angiography, and 6 patients received digital subtraction angiography. According to Shamblin classification: 10 aneurysms belonged to typeⅠ, 16 aneurysms belonged to typeⅡ, 4 aneurysms belonged to type Ⅲ. Twenty aneurysms were treated with simple stripping, 6 aneurysms were treated with tumor resection and external carotid artery resection, 2 aneurysms were resected by resection, partial carotid artery resection plus external-internal carotid artery anastomosis, 2 aneurysms were resected by resection, resection of internal carotid artery, external carotid artery, and common carotid artery, as well as internal carotid artery-common carotid artery bypass. All patients underwent a successful operation with no death. After surgery,1 patient suffered from hemiplegia, 2 patients suffered from hoarseness, and 1 patient suffered from cough. Of the 27 patients, 24 patients were followed-up from 3 months to 4 years, with a median time of 2.3 years. During the follow-up procedure, the 1 patient with hemiplegic recovered to more than three levels of muscle strength after 6 months after rehabilitation, the 2 patients with hoarseness and 1 patient with cough returned to normal after 2 months after symptomatic treatment. There was no recurrence during follow-up procedure, and no other complications occurred. Conclusion Computed tomography angiography and magnetic resonance angiography are propitious to the definitive diagnosis of carotid body tumor, and actively surgical treatment should be performed once diagnosis of carotid body tumor.
Objective To observe the expressions of P53 and CD34 in rectal cancer and distal mucosa and to explore the safe distal margin of radical surgery for rectal cancer at molecular pathologic level. Methods Forty-five cases of rectal cancer were marked before operation， and then the cases were detected by PET/CT. P53 and CD34 expressions in rectal tissues were detected by immunohistochemistry technique. Results P53 expression and microvessel density (MVD) in rectal cancer were significantly higher than those in distal mucosa， which in distal mucosa were decreased along the anal direction. P53 and CD34 were still found in the normal rectal tissue. P53 expression and MVD were not significantly different between in more than 1.5 cm distal rectal mucosa and in normal rectal tissue. Besides MVD was related to size of tumor in rectal cancer and distal 0.5 cm rectal mucosa tissue, P53 and CD34 in rectal cancer and distal mucosa rectal tissue were not associated with tumor diameter, stage and differentiation of rectal cancer. Conclusion From the molecular pathologic view, the resection of 2.0 cm rectal distal tissue should be safe for excision of rectal cancer.