ABSTRACT

Background

Aims:

To evaluate the feasibility and safety of early removal of nasogastric tube after total gastrectomy for gastric cancer. Methodology: Data of 142 gastric cancer patients who underwent total gastrectomy from January 2011 to March 2012 were retrospectively collected and analyzed. Early removal ER group n=57 of nasogastric tube was defined as removal within postoperative 48h, and conventional placement CP group n=85 of nasogastric tube was defined as removal till flatus and less than 300cc gastric juice drainage. Outcome measures included postoperative temperature, hospital stay length, days to passage of flatus, days to semi-liquid diet, postoperative complications and mortality.

Results:

No statistically signi?cant difference was found between the ER group and the CP group in postoperative highest temperature p=0,456 the incidence of temperature over 38.5C p=0,772 postoperative hospital stay length p=0,102 and time to flatus p=0,163 There was no death or reoperation in patients of both groups. There were no significant differences in postoperative complications between the two groups 22,8% vs 30,6%, p=0,309 There was no anastomotic leakage, hemorrhage or stenosis. There was a trend of decreased risk of postoperative pneumonia in the ER group 10,5% vs 21,2% despite no significance p=0,097

Conclusions:

The early removal of nasogastric tube within postoperative 48h after total gastrectomy is feasible and safe in common practice and might also have a potential benefit in preventing postoperative pneumonia.

Background/Aims:

Predicting the severity of acute pancreatitis is limited to clinical, laboratory and radiological risk factors. Hepcidin levels increase in acute inflammation. We aimed to assess the relationship between hepcidin and C-reactive protein (CRP), white blood cells (WBC) and multi-detector computerized tomography (MDCT) in predicting the severity of pancreatitis. Methodology: We undertook a prospective review of 59 consecutive patients with acute pancreatitis admitted to our clinic. Biochemical values were measured from blood samples taken within 2 hours of admission and from between 2 and 72 hours related to the time of symptom onset.

Results:

In predicting severe acute pancreatitis, hepcidin was superior to CRP and WBC (Area Under the Curve (AUC)=0.79, p=0.003; AUC=0.69, p=NS; AUC=0.53, p=NS, respectively).

Conclusions:

In this study, hepcidin was found to be superior to CRP in predicting the severity of pancreatitis.

Background/Aims:

To compare the detection rate of 64-slice CT, digital subtraction angiography (DSA) and C-arm computed tomography (C-arm CT) in small lesions with a diameter <=3.0 cm of hepatocellular carcinoma (HCC). Methodology:Sixty-six patients with HCC underwent 64-slice CT, DSA, and C-arm CT, and were followed up by lipiodol CT two weeks after transcatheter arterial chemoembolization (TACE). Whose result was used as diagnostic reference. The number of detected lesions with diameter <=3.0 cm in each imaging modality was counted independently by 4 radiologists.

Results:

A total of 174 lesions out of the 66 patients were confirmed by lipiodol CT, among which 47.7% were detected by 64-slice CT, 82.2% by DSA, and 97.1% by C-arm CT. McNemar test showed the statistical difference in detection rate between each two methods of CT, DSA and C-arm CT (all p<0.0001). All lesions were further classified into 3 groups (group A, B, C) according to the diameter (<=1cm, 1-2cm, 2-3cm), where C-arm CT showed significantly higher diagnostic sensitivity in group A and B.

Conclusions:

Compared to 64-slice CT and DSA, C-arm CT has the best sensitivity by detecting small lesions of HCC, and thus may play a guiding role in TACE procedure.