The results of 2389 patients exmained by colonofiverscope in past nine years are reported. Polyps were found in 561 cases, including 1256 polyps in the large intestine and 82 polyps in the terminal ileum. All 1299 polyps were removed with biopsy forceps. Pathology demonstrated that there were 406 adenomas, including 89 atypical hyperplasia and 23 cases with malignant change and 932 non-canerous polyps with 102 atypical hyperplasia. Since adenoma is seen to be a precancerous change, the polypectomy by colonofiberscope , ecpecially atypical hyperplastic polyps may decrease morbidity of large intestinal cancer. Cancer associated with adenoma may be as high as 51.28%, so the recrudescence of polyps may possibly be found even afer the cancer removal. These data showed that an early discovery of small malignant adenoma is key to improve efficiency.
In this study, the effect of neostigmine on the healing of colonic anastomoses has been investigated following onestage resection and anastomosis for complete leftsided colomic obstruction.It was found that neostingmine promoted colonic anastomotic healing either experimentally or clinically. Further, the authors discuss the pathogenesis of anastomotic leakage but suggest that neostigmine should be used in the first 5 hours after operation.
ObjectiveTo systematically review the effects of chewing gun on the promotion of intestinal function recovery after colorectal cancer surgery. MethodsWe searched PubMed, The Cochrane Library, CBM and CNKI databases from their inception to December 2014, to collect randomized controlled trials (RCTs) assessing chewing gun in patients after colorectal cancer surgery. References of included studies were also retrieved. Two reviewers independently screened studies according to inclusion and exclusion criteria, extracted data, and assessed the methodological quality of included studies. Then meta-analysis was performed using RevMan 5.2 software. ResultsNine RCTs involved 686 patients were included. The results of meta-analysis indicated that, compared with the control group, chewing gun could significantly reduce the time to first passage of flatus (MD=-17.33, 95%CI -23.96 to -10.70, P<0.000 01), the time to the first defecation (MD=-22.25, 95%CI -36.45 to -8.05, P=0.002) and postoperative hospital stay (MD=-1.37, 95%CI -2.25 to -0.49, P=0.002) after colorectal cancer surgery, and could also reduce the intestinal obstruction caused by intestinal paralysis (OR=0.33, 95%CI 0.14 to 0.77, P=0.01). However, no significant difference in the incidence of nausea and vomiting was found. ConclusionEarly chewing gum can promote the recovery of gastrointestinal function in patients after colorectal cancer operation.
Objective To analyse the clinico-pathological characteristics of young patients with colorectal cancer. Methods From January 1980 to January 2000, among 1 030 patients with colorectal cancer admitted for surgical treatment, 143 (13.9%) patients were ＜35 years of age. The clinicopathological data of these young patients were reviewed and compared with those of patients in the other age groups. Results In this series of young patients, males were predominat. Most of them were with poorly differentiated (37.8%) and muco-cellular (29.6%) adenocarcinoma. The mast common gross morphology was infiltrating type (56.6%) and colloid carcinoma type (31.5%). The majority of patients (89.5%) were in Dukes stage B and stage C. Conclusion The prognosis of young patients with colorectal cancer surgically treated is worse, due to the fact that most of them are in late stage and their cancers are worse in differentiation. To increase the awareness of cancer in the young is important for early diagnosis and treatment and better prognosis.
Esophageal reconstruction with interposition of transverse colon was performed in 24 children from 1971 to 1992. The results were evaluated from questionaire, clinical interview, barium swallowing, manometric and radioisotopic test. The complications and the functional status of the gastrointestinal tract were studied and discussed. The follow up showed the growth and developmenlt of the children were satisfactory, the results were good to excellent in 89.5 per cent. If necessary, pyloromyotomy should be chosen instead of other methods of pyloroplasty. Compairing the three routes of colon reconstruction, the esophageal bed route had an excellent clinical result.
Objective To study the feasibility and curative effect of laparoscopic vs. open radical rectectomy and colectomy for colorectal cancer. Methods Sixty-two cases who underwent laparoscopic operation (17， 2， 10， 23， 9 and 1 case underwent radical right colectomy， radical transverse colectomy， radical left colectomy， Dixon， Miles and Hartmann operation respectively) and 78 cases who underwent open operation (17， 4， 11， 27， 18 and 1 case underwent radical right colectomy， radical transverse colectomy， radical left colectomy， Dixon， Miles and Hartmann operation respectively) in our department from Aug. 2001 to Jun. 2008 were included. The clinical data of patients in two groups were compared. Results There were no severe complications and death occurred in both groups and 4 cases in laparoscopic group were converted to open operation during the procedure. The mean operation time of laparoscopic group and open group were (230.6±23.5) min and (145.5±17.6) min respectively, there was a statistical difference between them (P＜0.01). The intra-operative blood loss of laparoscopic group was obviously less than that in open group 〔(135.5±22.5) ml vs. (300.6±34.5) ml， P＜0.01〕. There was no statistical difference of the number of cleared lymph nodes between two groups 〔(11.8±1.5) pieces vs. (13.3±1.7) pieces， Pgt;0.05〕. The length of distal incision margin of rectal anterior resection in laparoscopic group was obviously longer than that in open group 〔(3.1±0.4) cm vs. (2.6±0.3) cm， P＜0.01〕. The gastrointestinal and urinary function of laparoscopic group recovered more quickly than those in open group 〔(2.3±0.7) d vs. (3.6±0.9) d for intake of liquid diet， P＜0.05； (3.5±1.1) d vs. (4.7±1.2) d for intake of solid diet， P＜0.05； (2.3±0.4) d vs. (4.4±1.2) d for duration of urethral catheterization， P＜0.01， respectively〕. The length of hospital stay in laparoscopic group was shorter than that in open group 〔(8.5±0.7) d vs. (12.8±0.9) d， P＜0.01〕. But the cost of hospitalization in laparoscopic group was higher than that in open group 〔(3.14±0.25)×104 yuan vs. (2.02±0.75)×104 yuan， P＜0.05〕. There was no statistical difference of the three-year survival rate between two groups (89.5% vs. 89.1%， Pgt;0.05). Conclusion Laparoscopic radical rectectomy and colectomy for colorectal cancer is feasible and safe with minimal invasiveness.
Objective To study the effects of long term application of cathartics on electromyography of rat colon, and to explore the role of interstitial cells of Cajal (ICC) in it. Methods Colonic slow waves of the rat was examined after 3-month feeding of phenolphthalein, and ICC in myenteric plexus was observed by ZIO method, and ultrastructure changes of nerves and ICC was observed. Results The frequency of slow waves of cathartic colon was reduced significantly(Ｐ＜0.05). The distribution of ICC in myenteric plexus was uneven, and the processes were mussily connected each other. Vacuolar degeneration of axon and ICC-like cells was revealed by electron microscope in myenteric plexus of cathartic colon. Conclusion Long term application of phenolphthalein could reduce the frequency of colonic slow waves, and the possible mechanism was degeneration of ICC and myenteric plexus nerves.
ObjectiveTo systematically evaluate the efficacy and safety of computer-aided detection (CADe) and conventional colonoscopy in identifying colorectal adenomas and polyps. MethodsThe PubMed, Embase, Cochrane Library, Web of Science, WanFang Data, VIP, and CNKI databases were electronically searched to collect randomized controlled trials (RCTs) comparing the effectiveness and safety of CADe assisted colonoscopy and conventional colonoscopy in detecting colorectal tumors from 2014 to April 2023. Two reviewers independently screened the literature, extracted data, and evaluated the risk of bias of the included literature. Meta-analysis was performed by RevMan 5.3 software. ResultsA total of 9 RCTs were included, with a total of 6 393 patients. Compared with conventional colonoscopy, the CADe system significantly improved the adenoma detection rate (ADR) (RR=1.22, 95%CI 1.10 to 1.35, P<0.01) and polyp detection rate (PDR) (RR=1.19, 95%CI 1.04 to 1.36, P=0.01). It also reduced the missed diagnosis rate (AMR) of adenomas (RR=0.48, 95%CI 0.34 to 0.67, P<0.01) and the missed diagnosis rate (PMR) of polyps (RR=0.39, 95%CI 0.25 to 0.59, P<0.01). The PDR of proximal polyps significantly increased, while the PDR of ≤5 mm polyps slightly increased, but the PDR of >10mm and pedunculated polyps significantly decreased. The AMR of the cecum, transverse colon, descending colon, and sigmoid colon was significantly reduced. There was no statistically significant difference in the withdrawal time between the two groups. Conclusion The CADe system can increase the detection rate of adenomas and polyps, and reduce the missed diagnosis rate. The detection rate of polyps is related to their location, size, and shape, while the missed diagnosis rate of adenomas is related to their location.
Objective To investigate the influence of colectomy on the expressions of 5-hydroxy tryptamine (5-HT) and chromogranin A (CgA) in colon mucosa of Chinchilla rabbits. Methods Colon (7-8 cm) upon colon-rectum junction (control group) of 15 Chinchilla rabbits was cut out. After two weeks, these rabbits were executed and the samples of colon at anastomotic stoma (study group) were taken. 5-HT positive cells and CgA positive cells in two groups were detected by immunohistochemical method. Results The number of 5-HT positive cells was 10.40±2.22 in control group， and 26.27±2.35 in study group; the number of CgA positive cells was 20.60±5.34 in control group, and 51.51±6.13 in study group. There were significant differences between two groups respectively (P＜0.01). Conclusion The increase of 5-HT positive cells and CgA positive cells can be caused by colectomy.
【Abstract】ObjectiveTo investigate the inhibitory effects of somatostatin analogue (SSTA) on the colonic carcinoma cell growth in vitro and in vivo and its possible mechanism. MethodsThe somatostatin receptor type Ⅱ (SSTR2) mRNA of colonic carcinoma cell line HCT116 was detected by using RTPCR and hybridization in situ. The effects of octreotide (Oct) or NC-8-12 (specific agonist of SSTR2 ) on the proliferation of HCT116 was measured with MTT after HCT116 stimulated by insulin or epidermal growth factor (EGF) and incubated with Oct or NC-8-12 simultaneously for 24 hours. The expression of cyclin D1 was detected with flow cytometry. The HCT116 were implanted in nude mice subcutaneously and treated with Oct or NC-8-12. The tumor volume and tumor weight were measured according to schedule. Results①SSTR2 mRNA was detected in HCT116 and the tumor implanted in nude mice; ②Insulin and EGF increased the proliferation of HCT116 significantly, and this proliferation could be inhibited by Oct and NC-8-12 partially; ③Insulin increased the Cyclin D1 expression of HCT116, its level decreased slightly when treated with Oct or NC-8-12 but not significantly (Pgt;0.05); ④The weight and volume of implanted tumor in nude mice treated with Oct or NC-8-12 showed no significant difference compared with the control group (Pgt;0.05). ConclusionBoth Oct and NC-8-12 could inhibit the proliferation of colonic carcinoma cell line HCT116 in vitro, which indicated that SSTR2 may mediated the inhibition. Oct and NC-8-12 have no effect on the growth of implanted HCT116 in nude mice in this experiment.