An Investigation Of The Metastasis V And Complete Mesentery Excision Surgery In Gastrointestinal Tumor

Background To investigate the distribution of metastatic cancer cells in the mesentery(referred to as metastasis V)and enrich the understanding of the metastasis of colorectal cancer.Methods A total of two hundred ninety-nine patients who received colorectal operations in our department between April 2018 and December 2018 were included.Samples were acquired from the dissected mesentery after the operation,and hematoxylin-eosin(HE)staining or immunohistochemistry(IHC)was used to detect metastatic cancer cells.Pathological factors,including tumor position,tumor size,invasion depth,tumor differentiation,lymph node involvement,local vessel invasion,and perineural invasion,were recorded.Results Metastatic cancer cells in the colorectal mesentery(metastasis V)were detected in 62 of 299 patients.Metastasis V was closely correlated with tumor invasion depth,lymph node metastasis,tumor differentiation,and perineural and vessel invasion by cancer cells.Metastasis V occurred more frequently in patients with p T3 stage(26.27%)and p T4 stage(40.00%)than in patients with p T1 and p T2 stage(0% and 2%,respectively).Metastasis V was frequently detected in patients with p N2 a and p N2 b stage tumors(51.72% and 61.54%,respectively).Metastasis V was more frequently detected in patients with perineural metastasis and local vessel invasion.In addition,metastasis V incidences in colon and rectal cancer were similar.Conclusion The incidence rate of metastasis V is correlated with tumor staging factors and occurs more frequently in advanced-stage patients.Background Our group have proposed the concept “metastasis V” for years,“metastasis V” is related to poor prognosis.The rationale of metastasis V was not clear and we have worked on it for a while,we would like to report our findings on the subject.Material and Method Mesentery specimens was obtained from gastric tumor patients,then sequential slices were generated for metastasis V detection.For suspected slices immunohistochemical staining slices were generated for further detection.The number and position of each metastasis V was recoded,and reconstructed on a reconstructed model.The migration trend of metastasis V were then calculated.Further,all relative positions of metastasis V to primary tumor were statistically recorded in a coordinate system,a regressive line was made to evaluate the migration trend of metastasis V.Results Fifty cases were enrolled in the study.39 metastasis Vs were detected in 8 cases.The lengthways migration distance of metastasis V can be as far as 5 cm.The crosswise migration distance of metastasis V can be as far as 3 cm.The migration trend of metastasis V was mainly towards root of the mesentery.Conclusion The occurrence rate of metastasis V was 16 percent.The migration trend of metastasis V was towards the root of mesentery,and the lengthways resection boundary of mesentery for gastric cancer patients should be carefully determined.Background For the purpose of en-bloc resection of mesogastrium during conventional D2 lymphadenectomy,we put forward to laparoscopic D2 gastrectomy plus complete mesogastric excision(D2+CME)in treatment of gastric cancer.Our previous results revealed that D2+CME exhibited advantages in decreasing intraoperative bleeding and reducing surgery-related tumor cells spreading in locally advanced gastric cancer.However,the efficiency,safety,and clinical outcome of D2+CME in patients with early gastric cancer(EGC)are still unknown.Material and method We collected 157 consecutive ECG patients in the Department of Gastrointestinal Surgery retrospectively,Tongji Hospital,Tongji Medical College of HUST between 2014 and 2017.Among them,141 who received laparoscopic distal gastrectomy(D2+CME)were enrolled in this study.Parameters including age,sex,comorbidity,BMI,surgery-related information,pathological characteristics,postoperative complications,and oncological outcomes were analyzed.Results Among the 141 EGC participants,60(42.55%)were diagnosed as submucosal infiltration and the remaining 81(57.45%)were intramucosal lesions.The average laparoscopic operation time of D2+CME was 132.48±23.81 minutes.Intraoperative bleeding of most participants was less than 20 ml,except for 4 patients received transfusions due to intraoperative trauma.Tumor size of the enrolled patients ranged from 0.6 cm to 6 cm.Eighteen patients(12.76%)had local lymph node metastasis.In postoperative recovery course,severe complications occurred in 2(1.42%)patients.The median follow-up time was 29.0 months.The overall cumulative survival rate of at 39 months was 98.1%.Conclusion Laparoscopic D2 gastrectomy with complete mesogastric excision appears to be efficient and effective in EGC treatment.Background: Complete mesenteric excision operation has been widely accepted for gastric/colorectal tumor diseases.There is no objective appraisal on the mesentery completeness.Raman spectrum is a method that used for material identification,and we applied the method to assess the completeness of mesentery.Method: Raman spectrum was used to test the surface of mesentery.The spectrum curves were analyzed and compared.The natural surface and the separated surface of mesentery were both tested and analyzed.Result: The spectrum curves of the natural and separated surface were similar but different to the raptured mesentery,indicating the method was stable for mesentery assessment.Conclusion: Raman spectrum can be applied in mesentery assessment,and further application during operation such as correct entrance confirmation may be expectant.