AIM:To investigate the current status of peritoneal carcinomatosis(PC) management,as well as the usage of cytoreductive surgery(CRS) and hyperthermic intraperitoneal chemotherapy(HIPEC) in China's Mainland.METHODS...AIM:To investigate the current status of peritoneal carcinomatosis(PC) management,as well as the usage of cytoreductive surgery(CRS) and hyperthermic intraperitoneal chemotherapy(HIPEC) in China's Mainland.METHODS:A potentially curative therapeutic strategy for selecting patients with PC,known as "Techniques",consists of CRS in combination with HIPEC.A systemic search of published works and clinical trials was performed.Additional papers were retrieved by crosschecking references and obtaining information from Chinese oncologists and relevant conferences.One hundred and one papers and one registered clinical trial on HIPEC were included.RESULTS:A literature review identified 86 hospitals in 25 out of all 31 areas of China's Mainland that perform HIPEC.The earliest report included in our survey was published in 1993.Different approaches to HIPEC have been utilized,i.e.palliative,prophylactic,and possiblycurative treatment.Only one center has consistently performed HIPEC according to the "Sugarbaker Protocol",which involves evaluating the extent of PC with peritoneal cancer index and the results of CRS with the completeness of cytoreduction.Positive preliminary results were reported:7 of 21 patients with PC survived,free of tumors,during an 8-43-mo follow-up period.Hyperthermic strategies that include HIPEC have been practiced for a long time in China's Mainland,whereas the "Sugarbaker Protocol/Techniques" has been only rarely implemented in China.The Peritoneal Surface Oncology Group International hosts a biannual workshop with the intent to train more specialists in this field and provide support for the construction of quality treatment centers,especially in developing countries like China,whose population is huge and has a dramatically increased incidence of cancer.CONCLUSION:To popularize Sugarbaker Protocol/Techniques in China's Mainland in PC management arising from gastric cancer or colorectal cancer will be the responsibility of the upcoming Chinese Peritoneal Surface Oncology Group.展开更多
Purpose: To investigate and analyze the clinical and etiological characteristics of community-acquired intraabdominal infections (CIAIs) and hospital-acquired or nosocomial intraabdominal infections (NIAIs) in a ...Purpose: To investigate and analyze the clinical and etiological characteristics of community-acquired intraabdominal infections (CIAIs) and hospital-acquired or nosocomial intraabdominal infections (NIAIs) in a comprehensive hospital, to understand the characteristics, pathogen composition, and drug resistance of CIAls as well as NIAIs, and to provide a reference for clinical treatment. Methods: We collected the clinical data of patients with intraabdominal infections admitted to our hospital from June 2013 to June 2014. In vitro drug sensitivity tests were conducted to separate pathogens, and the data were analyzed using the WHONET 5.4 software and SPSS 13.0 software. Results: A total of 221 patients were enrolled in the study, including 144 with CIAls (55 mild-moderate and 89 severe) and 77 with NIAIs. We isolated 322 pathogenic strains, including 234 strains of gramnegative bacteria, 82 strains of gram-positive bacteria, and 6 strains of fungi. Based on clinical features, NIAIs and severe ClAls presented significantly higher values in age, length of hospital stay, mortality, and the incidence of severe intra-abdominal infection than mild-moderate CIAIs (p 〈 0.05). There was no significant difference in the prognosis between NIAIs and severe CIAIs. Primary diseases leading to CIAIs and NIAIs mostly were hepatobiliary diseases and gastrointestinal diseases respectively. Bacteria isolated from various types of IAls mainly were Enterobacteriaceae; mild-moderate CIAIs mostly were mono-infection of gram-negative bacteria; NIAIs mostly were mixed infections of gram-negative and grampositive bacteria; and severe CIAls were from either type of infection. The rate of Extended Spectrum β-Lactamase-producing Escherichia coil and Klebsiella pneurnoniae was much higher in NIAIs than in CIAIs (p 〈 0.05). The antimicrobial drug sensitivity of gram-negative bacteria isolated from NIAIs was significantly lower than that of CIAIs. Conclusion: CIAIs and NIAIs have their own unique clinical featur展开更多
文摘AIM:To investigate the current status of peritoneal carcinomatosis(PC) management,as well as the usage of cytoreductive surgery(CRS) and hyperthermic intraperitoneal chemotherapy(HIPEC) in China's Mainland.METHODS:A potentially curative therapeutic strategy for selecting patients with PC,known as "Techniques",consists of CRS in combination with HIPEC.A systemic search of published works and clinical trials was performed.Additional papers were retrieved by crosschecking references and obtaining information from Chinese oncologists and relevant conferences.One hundred and one papers and one registered clinical trial on HIPEC were included.RESULTS:A literature review identified 86 hospitals in 25 out of all 31 areas of China's Mainland that perform HIPEC.The earliest report included in our survey was published in 1993.Different approaches to HIPEC have been utilized,i.e.palliative,prophylactic,and possiblycurative treatment.Only one center has consistently performed HIPEC according to the "Sugarbaker Protocol",which involves evaluating the extent of PC with peritoneal cancer index and the results of CRS with the completeness of cytoreduction.Positive preliminary results were reported:7 of 21 patients with PC survived,free of tumors,during an 8-43-mo follow-up period.Hyperthermic strategies that include HIPEC have been practiced for a long time in China's Mainland,whereas the "Sugarbaker Protocol/Techniques" has been only rarely implemented in China.The Peritoneal Surface Oncology Group International hosts a biannual workshop with the intent to train more specialists in this field and provide support for the construction of quality treatment centers,especially in developing countries like China,whose population is huge and has a dramatically increased incidence of cancer.CONCLUSION:To popularize Sugarbaker Protocol/Techniques in China's Mainland in PC management arising from gastric cancer or colorectal cancer will be the responsibility of the upcoming Chinese Peritoneal Surface Oncology Group.
文摘Purpose: To investigate and analyze the clinical and etiological characteristics of community-acquired intraabdominal infections (CIAIs) and hospital-acquired or nosocomial intraabdominal infections (NIAIs) in a comprehensive hospital, to understand the characteristics, pathogen composition, and drug resistance of CIAls as well as NIAIs, and to provide a reference for clinical treatment. Methods: We collected the clinical data of patients with intraabdominal infections admitted to our hospital from June 2013 to June 2014. In vitro drug sensitivity tests were conducted to separate pathogens, and the data were analyzed using the WHONET 5.4 software and SPSS 13.0 software. Results: A total of 221 patients were enrolled in the study, including 144 with CIAls (55 mild-moderate and 89 severe) and 77 with NIAIs. We isolated 322 pathogenic strains, including 234 strains of gramnegative bacteria, 82 strains of gram-positive bacteria, and 6 strains of fungi. Based on clinical features, NIAIs and severe ClAls presented significantly higher values in age, length of hospital stay, mortality, and the incidence of severe intra-abdominal infection than mild-moderate CIAIs (p 〈 0.05). There was no significant difference in the prognosis between NIAIs and severe CIAIs. Primary diseases leading to CIAIs and NIAIs mostly were hepatobiliary diseases and gastrointestinal diseases respectively. Bacteria isolated from various types of IAls mainly were Enterobacteriaceae; mild-moderate CIAIs mostly were mono-infection of gram-negative bacteria; NIAIs mostly were mixed infections of gram-negative and grampositive bacteria; and severe CIAls were from either type of infection. The rate of Extended Spectrum β-Lactamase-producing Escherichia coil and Klebsiella pneurnoniae was much higher in NIAIs than in CIAIs (p 〈 0.05). The antimicrobial drug sensitivity of gram-negative bacteria isolated from NIAIs was significantly lower than that of CIAIs. Conclusion: CIAIs and NIAIs have their own unique clinical featur