Objective To investigate the significance and surgical skill for lymphadenectomy of No.12a lymph node around proper hepatic artery in gastric cancer. Methods Among data of stageⅣ gastric cancer patients who received curative R0 gastrectomy, sixty-eight patients performed gastrectomy with D2 lymph node dissection, including No.12a lymph node were identified. Experiences and understanding of No.12a lymphadenectomy for gastric cancer were concluded. Results The number of dissected No. 12a lymph node was 556 （5-11 per capita，mean 8.17 per capita） in 68 patients with stageⅣ gastric cancer, and the positive lymph node of No.12a was 33.27% （185/556）. There were no lymphadenectomy related complications： anastomotic leakage, lymphatic fistula， and postoperative hemorrhage in this series. Conclusions Being familiar with the anatomy around proper hepatic artery and intrathecal liberation of proper hepatic artery, ligation of left gastric vein and right gastric artery at its onset, and exposure of gastroduodenal artery’s root and anterior wall of portal vein are important to dissection of No.12a lymph nodes.
ObjectiveThe aim of this paper is to summarize the advantages and disadvantages of non-surgical treatments of the enterocutaneous fistula, in order to give some advice.MethodsPubmed, EMBASE, Medline, CNKI, and Wanfang databases were retrieved for the published article addressing the non-surgical treatments of enterocutaneous fistula between 2004 to 2018. The keywords were " enterocutaneous fistula” in English and Chinese, respectively. The non-surgical treatments of enterocutaneous fistula were reviewed.ResultsThe results of this search suggested that non-surgical treatments of the enterocutaneous fistula mainly include fibrin glue, endoscopic treatment, laser ablation, and somatostatin. Fibrin glue was widely used at domestic and abroad, but it needed repeated operations. Endoscopic treatment of enterocutaneous fistula required a certain professional foundation; laser ablation technology was still immature and required theoretical data support. Now, the use of somatostatin was controversial.ConclusionEach of measures have its advantages and disadvantages, we should determine according to the patient’s condition and economic situation.