Zhonghua wei chang wai ke za zhi = Chinese journal of gastrointestinal surgery
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Zhonghua Wei Chang Wai Ke Za Zhi · Apr 2019
[Analysis on efficacy and safety of total neoadjuvant therapy in patients with locally advanced rectal cancer with high risk factors].
Objective: To evaluate the safety and preliminary efficacy of total neoadjuvant therapy (TNT) in patients with locally advanced rectal cancer (LARC) with high risk factors. Methods: Data of 101 patients who were diagnosed with stage II-III rectal cancer with high risk factors and received TNT between March 2015 and January 2018 at West China Hospital of Sichuan University were analyzed retrospectively. Inclusion criteria: (1) patients were diagnosed with stage II-III rectal cancer by high-resolution MRI combined with CT and endorectal ultrasound; (2) at least one high risk factor: cT4a, cT4b, cN2, EMVI+, CRM+ and lateral lymph node+; (3) distance from tumor to anal verge was within 15 cm; (4) Eastern Collaborative Oncology Group (ECOG) performance status score was 0-1; bone marrow function, liver function and kidney function were suitable for chemoradiotherapy; (5) patients were treated with TNT strategy; (6) the follow-up data and postoperative pathological data were complete. ⋯ The morbidity of surgical complication was 16.1% (14/87), including pelvic infection or abscess in 6 cases (6.9%), anastomotic leakage in 3 (3.4%), hemorrhage in 2 (2.3%), and gastrointestinal dysfunction in 3 (3.4%). Pathological findings revealed that 24 cases (27.6%) had TRG 0, 20 (23.0%) had TRG 1, 30 (34.5%) TRG 2, and 13 (14.9%) TRG 3. Conclusion: TNT is safe and has good short-term efficacy for locally advanced rectal cancer patients with high risk factors.
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Zhonghua Wei Chang Wai Ke Za Zhi · Aug 2015
[Chinese consensus of enhanced recovery after surgery for colorectal surgery (2015)].
The Chinese consensus of enhanced recovery after surgery for colorectal surgery (2015) is the first guideline in the area of enhanced recovery after surgery (ERAS) in colorectal surgery in China, which is drafted by a committee organized by the China ERAS Group of GSPEN. The concept of ERAS is a series of evidence-based perioperative treatment to reduce the stress of the patients both physically and psychologically and then achieve rapid recovery. ⋯ There are a lot of benefits in ERAS: (1)More effective treatment; (2)Less postoperative complications; (3)Accelerating rehabilitation; (4)Shortening of hospital stay; (5)Reduction of medical expenses; (6)Relief of the financial burden both on the family hood and the social security system. With the successful application of ERAS in colorectal surgery, both literature and clinical experiences are reviewed by the committee to draft this consensus.
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Zhonghua Wei Chang Wai Ke Za Zhi · Jul 2015
[Effect of perioperative goal-directed fluid therapy on clinical outcome in elective colorectal resection].
To assess the effect of perioperative goal-directed fluid therapy (GDFT) on clinical outcomes in elective colorectal resection. ⋯ Patients undergoing elective colorectal resection do not benefit from intraoperative GDFT. Further studies should be carried out to investigate whether GDFT can be routinely used during colorectal resection.
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Zhonghua Wei Chang Wai Ke Za Zhi · Jan 2013
[Perioperative fluid therapy of gastrointestinal surgery].
Fluid therapy has been the focus of attention and dispute. In this paper, there are three aspects including postoperative bowel function, surgical prognosis, and acute diffuse peritonitis. ⋯ The different types of fluid in recent studies did not show a significant difference in the long term. The new evidence will be noted in fluid therapy among 2012 SSC Severe Sepsis and Septic Shock Guideline update (unpublished).