Objective To explore the safety, effectiveness, operation mode and clinical value of the laparoscopic colorectal resection. Methods The clinical data and experiences of laparoscopic resection for 18 cases with colorectal neoplasm from Jun. 2007 to Mar. 2008 were studied retrospectively. Results Among 18 cases, there were 5 cases of rectal cancer, 6 cases of sigmoid colon carcinoma, 2 cases of sigmoid colonic polyp, 2 cases of descending colon carcinoma, 2 cases of ascending colon carcinoma and 1 case of ascending colonic lipoma. Fifteen cases of laparoscopic colorectal resection were performed successfully, including Dixon procedure 4 cases, Miles operation 1 case, radical resection of sigmoid colon 5 cases, palliative resection of sigmoid colon 2 cases, left hemicolectomy 2 cases and right hemicolectomy 1 case. Three cases converted to laparotomy due to adiposity or advanced status of local disease. Average intraoperative blood loss was 110 ml. The average number of lymph nodes dissected was 13.5. It took about 40 hours to restore intestinal function. The average time of hospitalization was 9 days. No one died during operation and no complications such as anastomotic leakage and postoperative hemorrhage occurred. Conclusion Laparoscopic resection for colorectal neoplasms possesses less trauma and rapid postoperative recovery. Laparoscopic colorectal surgery is safe and effective with skill and indication.
Objective To explore the consultation model of multi-disciplinary team （MDT） for colorectal cancer (CRC). Methods Combined the characteristics of large public hospital, with recognized treatment pathway in international MDT for CRC and a comparison to the traditional consultation, to explore a consultation process model of multi-disciplinary team-working for colorectal cancer of West China Hospital (MDT-CRC-WCH) by own feature. Results Colorectal cancer MDT project team summarized the advantage of the consultation process of MDT-CRC-WCH and the drawback of the traditional consultation, descripted the purpose and characterisctics of MDT consultation by adopting creative whole-mode ideal of MDT-CRC-WCH, and descripted the present implementation of the consultation of MDT-CRC-WCH. Conclusion The consultation process of MDT has appeared distinctive features to the traditional, and it may direct the future evolving of the consultation model, however, advanced research is needed.
【摘要】 目的 探讨结直肠癌致肠梗阻的诊断和治疗。方法 回顾性分析2003年1月—2008年12月间72例结直肠癌致肠梗阻的外科诊治资料。结果 72例患者中肿瘤位于右半结肠23例,左半结肠29例,直肠16例,回盲部4例。其中63例手术治疗,一期切除吻合46例,Hartmann术7例,单纯造口10例。有9例因肿瘤全身广泛转移等因素自动放弃手术治疗。结论 重视对结直肠癌致肠梗阻的认识、合理选择手术方式、做好围手术期处理是减少并发症、提高疗效的重要措施。
Objective To further discuss the strategies for building the framework of team culture of multi-disciplinary team (MDT) for colorectal cancer. Methods By analyzing the present situation of volunteer team of MDT and exploring the problems existed, look for new strategies to develop the volunteer team. Results The new strategies, such as optimizing the framework of the volunteer team and introducing into systematic and standardized training program, together with the gradually enlarged propaganda for the volunteer team, promote the development of MDT effectively. Conclusion By the exploration and practice in early stage, the volunteer team of MDT is gradually working smoothly. It is necessary to improve the strategies for developing the volunteer team of MDT constantly to make it integrate the MDT.
目的 探讨新辅助化学疗法（化疗）对结直肠癌手术患者炎症因子水平的影响。 方法 回顾2008年1月－2009年12月诊断为结直肠癌的487例患者的临床资料，剔除不符合研究条件者后，共390例，以是否接受过新辅助化疗分为术前化疗组（化疗组）156例与对照组234例进行研究。分别比较两组在入院时、术前、术后的炎症因子水平。 结果 入院时两组外周血白细胞、C反应蛋白（CRP）、纤维蛋白原、血清淀粉样蛋白水平差异均无统计学意义（P＞0.05）；术后化疗组CRP水平[（64.09 ± 60.24）mg/L]低于对照组[（87.80 ± 61.54）mg/L]，差异有统计学意义（P＜0.05）；其余炎症因子组间差异无统计学意义（P＞0.05）。 结论 新辅助化疗不会刺激机体产生免疫反应，且有一定的安全性。
Objective To evaluate the diagnostic accuracy of the aberrant methylation of genes in stool for colorectal tumor. Methods Databases including The Cochrane Library, PubMed, EMbase, CBM, Web of Science, CNKI and WanFang Data were searched to collect the diagnostic trials on the aberrant methylation of genes in stool for colorectal tumor published from January 1990 to February 2012. QUADAS items were used to evaluate the quality of the included studies, and the meta-analysis was conducted using Meta-Disc 1.4 software. Results A total of 32 studies involving 3 951 patients were included. The results of meta-analysis showed that, for detecting the colorectal tumor, the weighted sensitivity, specificity, diagnostic odds ratio (DOR), area under the summary receiver operating characteristic (SROC) curve and Q were 92% (95%CI 91% to 93%), 63% (95%CI 61% to 65%), 20.79 (95%CI 15.13 to 28.57), 0.861 9 (SE=0.020 4), and 0.792 6 (SE=0.019 8), respectively. For detecting the colorectal cancer, the weighted sensitivity, specificity and area under the curve (AUC) were 91% (95%CI 89% to 92%), 75% (95%CI 73% to 77%), and 0.900 7, respectively. For detecting the colorectal adenoma, the weighted sensitivity, specificity and AUC were 79% (95%CI 76% to 83%), 75% (95%CI 73% to 77%), and 0.845 7, respectively. Conclusion With high sensitivity (92%) and moderate specificity (63%), aberrant methylation of genes in stool can be used as an optional noninvasive method for the diagnosis of colorectal tumor.
Objective To investigate the features of extracolonic carcinoma spectrum in Northeast Chinese with hereditary nonpolyposis colorectal cancer. Methods The extracolonic carcinoma spectrum’s characteristics of 85 families registered in strict conformity with the HNPCC Amsterdam criteriaⅡwere analyzed retrospectively. Results In the 85 HNPCC families， the tumorous patients were 509 cases，the primary tumors were 589 cases， among the total consisted of 219 cases of colon cancer， 91 cases of rectal cancer，and 279 cases of extracolonic cancer， the most common extracolonic carcinoma was lung cancer. Conclusions Extracolonic carcinoma is an important part of cancer spectrum in HNPCC family， and the common extracolonic carcinoma in Northeast of Chinese are lung cancer， gastric cancer， endometrial cancer， liver cancer， and esophagus carcinoma.
ObjectiveTo study the expression of c-Met in colorectal carcinoma cells and the effect of hepatocyte growth factor (HGF) on proliferation and invasion of colon carcinoma cells SW480. MethodsReal-time PCR and Western blot methods were respectively used to detect the expressions of c-Met mRNA and protein in the different colorectal carcinoma cells in order to screen the high c-Met expression cells. The SW480 cells were incubated with different concentrations (0, 20, 40, and 70 ng/mL) HGF. MTT assay and Transwell test were used to evaluate the effects of proliferation and invasion in the SW480 cells. Results①The c-Met was expressed in each colorectal carcinomar cells, especially highly expressed in the colon carcinoma cells SW480 in vitro.②MTT assay showed that the HGF could promote the proliferation of SW480 cells in a dose-dependent manner with some extent.③Transwell test showed that the HGF could increase the invasion of SW480 cells. ConclusionThe c-Met is highly expressed in colorectal carcinoma cells and HGF could promote proliferation and increase invasion of colorectal carcinoma cells in vitro.
目的:探讨结直肠癌KAI1/CD82与E－cadherin的表达与预后的关系。方法: 采用免疫组化S-P法检测105例结直肠癌中KAI1/CD82与E-cadherin的表达。结果: 74例中5年生存率为48.6%。生存5年以上的KAI1/CD82的阳性表达率(86.11%),明显高于生存5年以下者(57.89%)(Plt;0.01);而E－cadherin生存5年以上者的阳性表达率(6389%)亦明显高于生存5年以下者(31.58%)(Plt;0.01%)。结论:联合检测KAI1/CD82与E-cadherin的表达对临床判断结直肠癌的预后有重要价值。