Obstructive colorectal cancer (OCC) often has a poor prognosis. The traditional TNM stage does not effectively predict disease prognosis, so there is an urgent need to establish a more suitable prognostic staging system for patients with OCC. This study analyzed 164 patients treated for OCC at a single center between February 1, 2010, and January 31, 2020. The integrative two-step cluster (TSC) stage was used to self-classify OCCs into two groups on the basis of postoperative clinicopathological features. The Kaplan‒Meier method was subsequently used to compare the 3-year overall survival (OS) and disease-free survival (DFS) of patients grouped by TNM stage and integrative TSC stage. Machine learning classifiers were then applied to predict the integrative TSC stage using preoperative clinical features and radiomics. To evaluate the performance of the classifiers, we used the receiver operating characteristic (ROC) curve and the area under the receiver operating characteristic curve (AUC). After the integrative TSC stage was constructed, 164 patients with OCC were divided into an integrative superior group (iSG, n = 99) and an integrative inferior group (iIG, n = 65). In the integrative TSC staging system, lymphovascular invasion (1.00) was identified as the most valuable risk factor. The iSG outperformed the iIG in both OS and DFS (OS-months: 31.42 (27.96–34.88) vs. 19.30 (15.43–23.17), p < 0.001; DFS-months: 31.15 (27.49–34.82) vs. 18.12 (14.32–21.92), p < 0.001). Compared with the TNM stage, the integrative TSC stage was more effective in discriminating OS (integrative TSC stage, p < 0.001; TNM stage, p = 0.036) and DFS (integrative TSC stage, p < 0.001; TNM stage, p = 0.011). To predict the integrative TSC stage, the linear discriminant analysis (LDA) classifier based on carcinoembryonic antigen (CEA) and 15 radiomics features performed best (testing dataset: AUC 0.85, 95

To summarize the key operational points for super-low placement of intestinal decompression tubes and compare the short-term outcomes between super-low placement and traditional placement in elderly patients with incomplete small bowel obstruction. Seventy-eight elderly patients (aged ≥ 60 years) with incomplete small bowel obstruction following abdominal surgery admitted to Fujian Medical University Union Hospital between January 2014 and December 2024 were retrospectively enrolled. The super-low group comprised 55 patients treated with the super-low placement of an intestinal decompression tube. The traditional group comprised 23 patients treated with the traditional placement of intestinal decompression tubes. Short-term outcomes were compared between the two groups. The key operational points for super-low placement of the intestinal decompression tube involve three steps: (1) simultaneous insertion of the catheter and guidewire through the cardia; (2) advancement of the guidewire as deeply as possible; and (3) advancement of the catheter over the guidewire. No significant differences were observed in the baseline clinical characteristics between the two groups. The conservative treatment success rate was significantly greater in the super-low group than in the traditional group (89.1

This study aimed to evaluate the clinical application and efficacy of a super-low-positioned intestinal decompression tube in the treatment of intestinal obstruction. A total of 130 patients with postoperative small bowel obstruction were included in this study. The patients were divided into a super-low-positioned intestinal decompression group and a conventional intestinal decompression group. The clinical data, treatment outcomes, and complications were compared between the two groups. The technical success rate of placing the super-low-positioned intestinal decompression tube was 100

To compare the short-term outcomes of a new gastrointestinal decompression tube combined with conservative treatment in patients with esophagojejunal anastomotic leakage (EJAL) after total gastrectomy. We retrospectively analyzed the data of 81 patients with EJAL who had undergone total gastrectomy and Roux-en-Y reconstruction at Fujian Medical University Union Hospital between January 2014 and December 2021. The patients were divided into experimental (12 patients with new gastrointestinal decompression tube plus conservative treatment) and control (69 patients with conservative treatment) groups, according to the different treatment methods they received. Anatomic defect size linearly correlated with time to clinical success, hospital stay, and hospital cost in the control group. The two groups showed no significant differences in anastomotic defect size, time of defect after surgery, hospitalization cost, and time of antibiotic use. However, the time to clinical success was significantly shorter in the experimental group than in the control group (16.0 ± 8.3 vs. 23.6 ± 17.8, P = 0.04), as was the length of hospital stay (30.1 ± 6.3 vs. 36.8 ± 16.7, P = 0.017). Furthermore, when the defect size was ≥ 4 mm, the time to clinical success, hospital stay, and hospital cost in the experimental group were lower than those in the control group (P < 0.05). Placement of a new gastrointestinal decompression tube is a safe treatment. When the defect size is ≥ 4 mm, the time to clinical success, length of hospital stay, and hospital cost can be reduced.

Objective. To investigate the curative effect of a transnasal ileus tube in the treatment of small bowel obstruction caused by a phytobezoar. Methods. Seventy-one patients with small bowel obstruction caused by a phytobezoar who underwent treatment in three provincial tertiary grade A hospitals in Fujian Province from March 2011 to February 2020 were included in this study. Patients were divided into the following two groups according to the treatment received: (1) conservative group, comprising patients who received medical conservative treatment, and (2) combined group, including patients who received combined medical conservative treatment and transnasal ileus tube placement. The clinical symptoms, changes in abdominal imaging, tube depth of the first day, reduction of pressure volume on the first day after catheterization, length of hospital stay, and nonsurgical rate were compared between the combined and conservative groups. Results. There was no significant difference in age, sex, history of previous abdominal surgery and abdominal radiotherapy, symptoms at admission, duration of symptoms before admission, signs at admission, laboratory data, and obstruction position between the combined and conservative groups. There was a statistically significant difference in the nonsurgical rate (19/24 vs. 23/47, P = 0.014 ) between the combined and conservative groups. Logistic analysis showed that the duration of symptoms before admission, albumin level, and use of a transnasal ileus tube might be independent factors affecting the transition to surgery for patients with small bowel obstruction caused by a phytobezoar ( P < 0.05 ). Conclusion. Timely conservative medical treatment with transnasal ileus tube placement can effectively improve the nonsurgical rate of small bowel obstruction caused by a phytobezoar. The duration of symptoms before admission, albumin level, and use of a transnasal ileus tube were closely related to whether patients with small bowel obstruction caused by phytobezoar were transferred to surgery.

Objective To evaluate the technique of double intestinal loop in restraining reflux from jejunum to duodenum, caused by intrajejunal administration of enteral diet of acute pancreatitis.Methods A total of 182 patients suffering from acute pancreatitis were placed nasal jejunum catheter guided by X-ray.The 182 patients were divided into three groups according to different length of catheter in jejunum (A1:10-20 cm, A2:20-30 cm, A3:more than 30 cm), and divided into three groups according to different quantity of intestinal loop which the catheter went though in jejunum (B1:0 intestinal loop, B2:1 intestinal loop, B3:2 intestinal loops).The reflux rates of the different groups were contrasted.Results The reflux rate of A3 was lower than that of A1 and A2 (P<0.012 5); the reflux rate of B3 was lower than that of B1 and B2 (P<0.012 5); the reflux rate of B3 was lower than that of B2 (P<0.012 5).The reflux rate of B3 was the lowest of the former six groups.Conclusion By placing the catheter into jejunum to two intestinal loops, we can guard against and diminish the reflux from jejunum to duodenum effectively.

目的 探讨急性重症胰腺炎(SAP)患者肠道运动障碍对空肠-十二指肠反流的影响.方法 将200例SAP患者根据X线或数字减影血管造影技术(DSA)介入下经鼻空肠置管通过空肠的深度分为4组(10～20 cm L1组、20～30cm L2组、30～40 cm L3组、40～60 cm L4组).每组再根据肠道运动障碍程度分成4级.观察上述4组组内各级肠道运动障碍对空肠-十二指肠反流的影响.结果 L1组、L4组组内各级运动障碍的肠道反流率比较,差异均无统计学意义(P＞0.05).L2组、L3组组内各级运动障碍的肠道反流率比较,差异均有统计学意义(P＜0.05).结论 急性重症胰腺炎患者肠道运动障碍可影响空肠-十二指肠反流.

Objective To explore the efficient,safe and lower painful way of putting jejunal tube through nose guided by digital gastrointestinal machine,and to know its significance and advantages.Method There were 86 cases of severe acute pancreatitis(SAP) putted jejunal tube through nose guided by digital gastrointestinal machine.Compared that 86 cases′fluctuation of heart rate,blood pressure,respiratory with that of 25 cases which was instaled tube guided by gastroscope,and compared the former′s rate of nausea,vomiting,chest tightness,shortness of breath,dizziness with the later′s.Results Each group of contrastive tests contained in the 86 cases was significantly different(P0.05),86 cases′ fluctuation of heart rate,blood pressure,respiratory was weaker than that of the 25 cases,which was installed guided by gastroscope.The former′srate of nausea,vomiting,chest tightness,shortness of breath,dizziness was lower than the later′s(P0.05).Conclusion The new way of putting the jejunum tube guided by digital gastrointestinal machine is efficient,safe and lower painful method.And it will reduce the need of patients′ physical function level when we install the tube.Andenable the patients to be putted jejunal tube timely,to get jejunal nutrition early.At last,it reduces the rate of SAP′S complications,improves its prognosis

Objective To explain the phenomenon that there is a lump less than 2.0 cm in the caecum and a little gas came into small intestine after enforcing air enema for infant intussusception.Methods The 54 cases which could not reach replacement criterion after enforcing air enema for infant intussusception were divided into two groups as follows:the group containing 18 cases with a lump less than 2.0 cm in the caecum and a little gas coming into small intestine after enforcing air enema for intussusception(group A);the group containing 36 caces with a lump more than 3.0 cm in the caecum and no gas coming into small intestine after enforcing air enema for intussusception(group B).Their intussusceptions rate comfirmed eventuall were compared.Results The formers intussusception replacement rate of group A was 88.9%.The formers intussusceptions replacement rate of group B was 0%.The replacement rate of group A was obviously higher than group B(P0.05).Conclusion The phenomenon that there is a lump less than 2.0 cm in the caecum and a little gas comes into small intestine after enforcing air enema for intussusception in children indacates that most of intussusception has been replaced,but there is a few caces remaining short intussusception.