BACKGROUND Emergency pancreaticoduodenectomy(EPD)is a rare event for complex periam-pullary etiology.Increased intraoperative blood loss is correlated with poor post-operative outcomes.CASE SUMMARY Two patients underw...BACKGROUND Emergency pancreaticoduodenectomy(EPD)is a rare event for complex periam-pullary etiology.Increased intraoperative blood loss is correlated with poor post-operative outcomes.CASE SUMMARY Two patients underwent EPD using a no-touch isolation technique,in which all arteries supplying the pancreatic head region were ligated and divided before manipulation of the pancreatic head and duodenum.The operative times were 220 and 239 min,and the blood loss was 70 and 270 g,respectively.The patients were discharged on the 14^(th) and 10^(th) postoperative day,respectively.Thirty-two patients underwent EPD for the treatment of neoplastic bleeding.The mean operative time was 361.6 min,and the mean blood loss was 747.3 g.The comp-lication rate was 37.5%.The in-hospital mortality rate was 9.38%.CONCLUSION The no-touch isolation technique is feasible,safe,and effective for reducing intraoperative blood loss in EPD.展开更多
目的:探讨原发性肝细胞癌应用非接触分离技术切除的临床效果效。方法:回顾性分析2011年1月—2013年1月70例应用非接触分离技术行手术切除的原发性肝细胞癌患者(观察组),以及同期70例行传统手术方式切除的原发性肝细胞癌患者(对照组)临...目的:探讨原发性肝细胞癌应用非接触分离技术切除的临床效果效。方法:回顾性分析2011年1月—2013年1月70例应用非接触分离技术行手术切除的原发性肝细胞癌患者(观察组),以及同期70例行传统手术方式切除的原发性肝细胞癌患者(对照组)临床资料,比较两组相关手术指标及术后发率、生存情况。结果:与对照组比较,观察组手术时间有所延长[(238.9±44.8)min vs.(132.8±25.4)min,P<0.05]、术中出血量及输血率差异无统计学意义[(461.0±112.6)m L vs.(464.6+109.0)m L;31.4%vs.28.5%,均P>0.05]、肝门阻断率降低(7.14%vs.32.9%,P<0.05);两组的并发症发生率差异无统计学意义(18.6%vs.22.9%,P>0.05);观察组1年复发率明显低于对照组(24.3%vs.44.3%,P<0.05),但1年生存率两组无统计学差异(88.6%vs.81.2%,P>0.05)。结论:非接触分离技术用于原发性肝细胞癌手术治疗对于减少术后肿瘤复发有着积极的作用,较传统手术方式有一定优势。展开更多
Surgical resection is the only curative treatment modality for colorectal cancer limited locally.Evidence for the kind of resection procedure that is effective for improving prognosis is insufficient.Prognosis improve...Surgical resection is the only curative treatment modality for colorectal cancer limited locally.Evidence for the kind of resection procedure that is effective for improving prognosis is insufficient.Prognosis improvement is expected with the no-touch isolation technique(NTIT),making it the most important resection procedure.We are conducting a multicenter randomized controlled trial(RCT) to confirm the efficacy of NTIT in patients with colorectal cancer.The present review serves as a preface to our trial,as it focuses on basic and clinical studies that support the efficacy of NTIT.The detection ratios of circulating tumor cells(CTCs) of peripheral blood indicate the progress and prognosis of colorectal cancer.In a rabbit liver tumor model,metastases increased after surgical manipulation.Also,CTCs increased during the radical excision of colorectal cancer.However,NTIT decreased the detection of CTCs of intraoperative portal vein blood in patients with colorectal cancer.Although these aforementioned results support the use of NTIT,a previous controlled prospective trial was not able to confirm the clinical benefit of NTIT,as it had an insufficient sample size and many patients were lost to follow-up.Therefore,we initiated a large-scale highquality RCT to confirm the efficacy of NTIT for colorectal cancer.展开更多
文摘BACKGROUND Emergency pancreaticoduodenectomy(EPD)is a rare event for complex periam-pullary etiology.Increased intraoperative blood loss is correlated with poor post-operative outcomes.CASE SUMMARY Two patients underwent EPD using a no-touch isolation technique,in which all arteries supplying the pancreatic head region were ligated and divided before manipulation of the pancreatic head and duodenum.The operative times were 220 and 239 min,and the blood loss was 70 and 270 g,respectively.The patients were discharged on the 14^(th) and 10^(th) postoperative day,respectively.Thirty-two patients underwent EPD for the treatment of neoplastic bleeding.The mean operative time was 361.6 min,and the mean blood loss was 747.3 g.The comp-lication rate was 37.5%.The in-hospital mortality rate was 9.38%.CONCLUSION The no-touch isolation technique is feasible,safe,and effective for reducing intraoperative blood loss in EPD.
文摘目的:探讨原发性肝细胞癌应用非接触分离技术切除的临床效果效。方法:回顾性分析2011年1月—2013年1月70例应用非接触分离技术行手术切除的原发性肝细胞癌患者(观察组),以及同期70例行传统手术方式切除的原发性肝细胞癌患者(对照组)临床资料,比较两组相关手术指标及术后发率、生存情况。结果:与对照组比较,观察组手术时间有所延长[(238.9±44.8)min vs.(132.8±25.4)min,P<0.05]、术中出血量及输血率差异无统计学意义[(461.0±112.6)m L vs.(464.6+109.0)m L;31.4%vs.28.5%,均P>0.05]、肝门阻断率降低(7.14%vs.32.9%,P<0.05);两组的并发症发生率差异无统计学意义(18.6%vs.22.9%,P>0.05);观察组1年复发率明显低于对照组(24.3%vs.44.3%,P<0.05),但1年生存率两组无统计学差异(88.6%vs.81.2%,P>0.05)。结论:非接触分离技术用于原发性肝细胞癌手术治疗对于减少术后肿瘤复发有着积极的作用,较传统手术方式有一定优势。
基金Supported by National Cancer Research and Development Fund,No.26-A-4
文摘Surgical resection is the only curative treatment modality for colorectal cancer limited locally.Evidence for the kind of resection procedure that is effective for improving prognosis is insufficient.Prognosis improvement is expected with the no-touch isolation technique(NTIT),making it the most important resection procedure.We are conducting a multicenter randomized controlled trial(RCT) to confirm the efficacy of NTIT in patients with colorectal cancer.The present review serves as a preface to our trial,as it focuses on basic and clinical studies that support the efficacy of NTIT.The detection ratios of circulating tumor cells(CTCs) of peripheral blood indicate the progress and prognosis of colorectal cancer.In a rabbit liver tumor model,metastases increased after surgical manipulation.Also,CTCs increased during the radical excision of colorectal cancer.However,NTIT decreased the detection of CTCs of intraoperative portal vein blood in patients with colorectal cancer.Although these aforementioned results support the use of NTIT,a previous controlled prospective trial was not able to confirm the clinical benefit of NTIT,as it had an insufficient sample size and many patients were lost to follow-up.Therefore,we initiated a large-scale highquality RCT to confirm the efficacy of NTIT for colorectal cancer.
