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"Five steps four quadrants" modularized en bloc dissection technique for accessing hepatic hilum lymph nodes in laparoscopic pancreaticoduodenectomy

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World Journal of Gastrointestinal surgery 2024年第2期16卷 503-510页

作者： Xiao-Si Hu Yong Wang Hong-Tao Pan Chao Zhu Shi-Lei Chen Hui-Chun Liu Qing Pang Hao Jin department of Hepatopancreatobiliary surgery Anhui No.2 Provincial People’s HospitalHefei 230041Anhui ProvinceChina

BACKGROUND Although en bloc dissection of hepatic hilum lymph nodes has many advantages in radical tumor treatment,the feasibility and safety of this approach for laparo-scopic pancreaticoduodenectomy(LPD)require further clinical evaluation and *** To explore the application value of the"five steps four quadrants"modularized en bloc dissection technique for accessing hepatic hilum lymph nodes in LPD *** A total of 52 patients who underwent LPD via the"five steps four quadrants"modularized en bloc dissection technique for hepatic hilum lymph nodes from April 2021 to July 2023 in our department were analyzed *** patients'body mass index(BMI),preoperative laboratory indices,intraoperative variables and postoperative complications were *** relationships between preoperative data and intraoperative lymph node dissection time and blood loss were also *** Among the 52 patients,36 were males and 16 were females,and the average age was 62.2±11.0 *** were 26 patients with pancreatic head cancer,16 patients with periampullary cancer,and 10 patients with distal bile duct *** BMI was 22.3±3.3 kg/m²,and the median total bilirubin(TBIL)concentration was 57.7(16.0-155.7)µmol/*** patients successfully underwent the"five steps four quadrants"modularized en bloc dissection technique without lymph node clearance-related complications such as postoperative bleeding or lymphatic *** analysis revealed significant associations between preoperative BMI(r=0.3581,P=0.0091),TBIL level(r=0.2988,P=0.0341),prothrombin time(r=0.3018,P=0.0297)and lymph node dissection ***,dissection time was significantly correlated with intraoperative blood loss(r=0.7744,P21.9 kg/m²and a TIBL concentration≥57.7μmol/L had significantly longer lymph node dissection times(both P<0.05).CONCLUSION The"five steps four quadrants

关键词： Five steps four quadrants Hepatic hilum lymph node Modularized en bloc clearance Laparoscopic pancreaticoduodenectomy

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Albumin–bilirubin grade as a predictor of survival in hepatocellular carcinoma patients with thrombocytopenia

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World Journal of Gastrointestinal Oncology 2024年第5期16卷 1763-1772页

作者： Zhong-Ran Man Xuan-Kun Gong Kang-Lin Qu Qing Pang Bin-Quan Wu department of Hepatobiliary surgery The First Affiliated Hospital of Bengbu Medical CollegeBengbu 233000Anhui ProvinceChina department of Hepatobiliary surgery Anhui No.2 Provincial People’s HospitalHefei 230041Anhui ProvinceChina

BACKGROUND The models for assessing liver function,mainly the Child–Pugh(CP),albuminbilirubin(ALBI),and platelet–ALBI(PALBI)classifications,have been validated for use in estimating the prognosis of hepatocellular carcinoma(HCC)***,thrombocytopenia is a common finding and may influence the prognostic value of the three models in *** To investigate and compare the prognostic performance of the above three models in thrombocytopenic HCC *** A total of 135 patients with thrombocytopenic HCC who underwent radical surgery were retrospectively *** scores on the CP,ALBI and PALBI classifications were estimated ***–Meier curves with logrank tests and Cox regression models were used to explore the significant factors associated with overall survival(OS)and recurrence-free survival(RFS).RESULTS The preoperative platelet counts were significantly different among the CP,ALBI and PALBI *** a median follow-up of 28 mo,39.3%(53/135)of the patients experienced postoperative recurrence,and 36.3%(49/135)*** analysis suggested thatα-fetoprotein levels,tumor size,vascular invasion,and ALBI grade were significant predictors of OS and *** to the multivariate Cox regression model,ALBI was identified as an independent prognostic ***,CP and PALBI grades were not statistically significant prognostic *** The ALBI grade,rather than CP or PALBI grade,is a significant prognostic indicator for thrombocytopenic HCC patients.

关键词： Hepatocellular carcinoma Thrombocytopenia Child-Pugh Albumin-bilirubin Platelet-albumin-bilirubin

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Prostate health index can stratify patients with Prostate Imaging Reporting and Data System score 3 lesions on magnetic resonance imaging to reduce prostate biopsies

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Asian Journal of Andrology 2024年第1期26卷 20-24页

作者： John Shung-Lai Leung Wai-Kit Ma Brian Sze-Ho Ho Stacia Tsun-Tsun Chun Rong Na Yongle Zhan Chi-Yuen Ng Chi-Ho Ip Ada Tsui-Lin Ng Yiu-Chung Lam Division of urology Department of SurgeryQueen Mary HospitalUniversity of Hong KongHong KongChina Division of urology Department of SurgeryPrincess Margaret HospitalHongKongChina

We aim to evaluate prostate health index as an additional risk-stratification tool in patients with Prostate Imaging Reporting and Data System score 3 lesions on multiparametric magnetic resonance *** with biochemical or clinical suspicion of having prostate cancer who underwent multiparametric magnetic resonance imaging in two tertiary centers(Queen Mary Hospital and Princess Margaret Hospital,Hong Kong,China)between January 2017 and June 2022 were ***-magnetic resonance imaging fusion biopsies were performed after prostate health index *** who only had Prostate Imaging Reporting and Data System score 3 lesions were further stratified into four prostate health index risk groups and the cancer detection rates were *** of the 747 patients,47.3%had Prostate Imaging Reporting and Data System score 3 lesions *** detection rate of clinically significant prostate cancer in this group was 15.0%.The cancer detection rates of clinically significant prostate cancer had statistically significant differences:5.3%in prostate health index25.0,7.4%in prostate health index 25.0-34.9,17.9%in prostate health index 35.0-54.9,and 52.6%in prostate health index≥55.0(P26.9%could have avoided a biopsy with a prostate health index25.0,at the expense of a 5.3%risk of missing clinically significant prostate *** health index could be used as an additional risk stratification tool for patients with Prostate Imaging Reporting and Data System score 3 *** could be avoided in patients with low prostate health index,with a small risk of missing clinically significant prostate cancer.

关键词： biopsy fusion biopsy magnetic resonance imaging prostate cancer prostate health index

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Incidence of urinary incontinence following endoscopic laser enucleation of the prostate by en-bloc and non-en-bloc techniques:a multicenter,real-world experience of 5068 patients

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Asian Journal of Andrology 2024年第3期26卷 233-238页

作者： Daniele Castellani Vineet Gauhar Khi Yung Fong Mario Sofer Moisés Rodríguez Socarrás Azimdjon N Tursunkulov Lie Kwok Ying Sarvajit Biligere Ho Yee Tiong Dean Elterman Abhay Mahajan Mark Taratkin Sorokin Nikolai Ivanovich Tanuj Pal Bhatia Dmitry Enikeev Nariman Gadzhiev Mohammed Taif Bendigeri Jeremy Yuen-Chun Teoh Marco Dellabella Fernando Gómez Sancha Bhaskar Kumar Somani Thomas Reinhard William Herrmann urology Unit IRCCS INRCAAncona 60127Italy urology Unit Marche University HospitalLe Marche Polytechnic UniversityAncona 60126Italy department of urology Ng Teng Fong General HospitalSingapore 609606Singapore Yong Loo Lin School of Medicine National University of SingaporeSingapore 117597Singapore department of urology Tel Aviv Sourasky Medical CenterAffiliated to the Sackler School of MedicineTel Aviv UniversityTel Aviv 6423906Israel department of urology and Robotic surgery ICUA-Clínica CEMTROMadrid 28701Spain urology Division Akfa Medline HospitalTashkent 100211Uzbekistan Advanced urology Gleneagles HospitalSingapore 258499Singapore department of urology National University HospitalSingapore 119228Singapore Divisionof urology Department of SurgeryUniversity of TorontoOntarioToronto M5G 2C4Canada department of urology Mahatma Gandhi Mission’s Medical College and HospitalAurangabad 431003India Institute for urology and Reproductive Health Sechenov UniversityMoscow119435Russian Federation department of urologyand Andrology Lomonosov Moscow State UniversityMoscow 119992Russian Federation department of urology Sarvodaya Hospital and Research CentreFaridabadHaryana 121006India department of urology Medical University of ViennaVienna 1090Austria department of urology Saint-Petersburg State University HospitalSaint-Petersburg 199034Russian Federation department of urology Asian Institute of Nephrology and UrologyHyderabad 500082India S.H.Ho urologyCentre Department of SurgeryFaculty of MedicineThe Chinese University of Hong KongHong Kong 96H2+Q9China department of urology University Hospitals Southampton NHS TrustSouthampton SO166YDUnited Kingdom department of urology Cantonal Hospital Thurgau AGFraunfeld 8500Switzerland

We aim to evaluate the incidence of incontinence following laser endoscopic enucleation of the prostate(EEP)comparing en-bloc(Group 1)versus 2-lobe/3-lobe techniques(Group 2).We performed a retrospective review of patients undergoing EEP for benign prostaticenlargement in 12 centers between January 2020 and January *** were presented as median and interquartile range(IQR).Univariable and multivariable logistic regression analysis was performed to evaluate factors associated with stress urinary incontinence(SUI)and mixed urinary incontinence(MUI).There were 1711 patients in Group 1 and 3357 patients in Group *** in Group 2were significantly younger(68[62–73]years vs 69[63–74]years,P=0.002).Median(interquartile range)prostate volume(PV)wassimilar between the groups(70[52–92]ml in Group 1 vs 70[54–90]ml in Group 2,P=0.774).There was no difference in preoperativeInternational Prostate Symptom Score,quality of life,or maximum flow ***,morcellation,and total surgical time weresignificantly shorter in Group *** 1 month,overall incontinence rate was 6.3%in Group 1 versus 5.3%in Group 2(P=0.12),and urge incontinence was significantly higher in Group 1(55.1%vs 37.3%in Group 2,P2.3%in Group 2(P=0.06),and SUI was significantly higher in Group 2(55.6%vs 24.1%in Group 1,P=0.002).At multivariable analysis,PV and IPSS were factors significantly associated with higher odds of transient SUI/***,surgical time,and no early apical release technique were factors associated with higher odds of persistent SUI/MUI.

关键词： benign prostatic hyperplasia en-bloc enucleation endoscopic enucleation of the prostate laser therapy stress urinaryincontinence urge urinary incontinence

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A prospective cohort of men with localized prostate cancer on active surveillance protocol in Hong Kong,China:what did we learn?

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Asian Journal of Andrology 2024年第3期26卷 245-249页

作者： Xiaobo Wu Ivan Ching-Ho Ko Cindy Yeuk-Lam Hong Samuel Chi-Hang Yee Jeremy Yuen-Chun Teoh Samson Yun-Sang Chan Ho-Man Tam Chi-Kwok Chan Chi-Fai Ng Peter Ka-Fung Chiu SH Ho urology Centre Department of SurgeryFaculty of MedicineThe Chinese University of Hong KongHong KongChina

This study aimed to report the outcomes of active surveillance(AS)in the management of low-risk prostate cancer(PCa).It recruited87 men who were prospectively followed up according to the Prostate Cancer Research International Active Surveillance(PRIAS)protocol with local adaptation at SH Ho urology Centre,Prince of Wales Hospital,Hong Kong,*** investigated the predictorsof disease progression and found that baseline prostate-specific antigen density(PSAD)and the presence of the highest ProstateImaging-Reporting and Data System(PI-RADS)score 5 lesion on magnetic resonance imaging(MRI)are significantly correlatedwith disease ***,men with PSAD>0.2 ng ml^(−2)or PI-RADS 4 or 5 lesions had significantly worse upgradingfree survival compared to those with PSAD≤0.2 ng ml−2 and PI-RADS 2 or 3 *** study concludes that AS is a safe andeffective management strategy for selected patients to defer radical treatment and that most disease progression can be detectedafter the first repeated *** combination of PSAD>0.2 ng ml^(−2)and PI-RADS 4 or 5 lesions may serve as a useful predictorof early disease progression and provide a guide to optimize follow-up protocols for men in different risk groups.

关键词： active surveillance cohort localized prostate cancer

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Intraplaque injections of hyaluronic acid for the treatment of stable-phase Peyronie’s disease:a retrospective single-center experience

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Asian Journal of Andrology 2024年第3期26卷 268-271页

作者： Simone Cilio Roberto La Rocca Giuseppe Celentano Claudio Marino Massimiliano Creta Gianluigi Califano Celeste Manfredi Giorgio Ivan Russo Afonso Morgado Marco Falcone Marco Capece YAU Working Group Sexual and Reproductive Health department of Neurosciences Reproductive Sciences and OdontostomatologyUrology UnitUniversity of Naples“Federico II”Naples 80131Italy urology Unit Department of WomenChild and General and Specialized Surgery“Luigi Vanvitelli”UniversityNaples 80131Italy urology Section Department of SurgeryUniversityof CataniaCatania 95131Italy department of urology Centro Hospitalar Universitário São JoãoPorto 4200-319Portugal urology Clinic-A.O.U.“Cittàdella Salute edella Scienza”-Molinette Hospital University of TurinTurin 10100Italy 不详

Peyronie’s disease(PD)is a condition of penile connective tissue affecting up to 10%of men *** the complexity ofits management,nonsurgical treatments,such as intraplaque injections,are gaining *** current literature shows dataon the efficacy of intraplaque injections of hyaluronic acid(HA)mainly in acute-phase ***,data on injections of HA instable-phase PD are *** for this retrospective study were derived from a prospectively maintained database of privatepatients presenting at a private medical practice affiliated to the University of Naples“Federico II”(Naples,Italy)with stable-phasePD between January 2020 and March *** underwent a standard protocol of three injections,each administered at atwo-week *** the intervals,patients performed vacuum device therapy,penile stretching,and modeling *** compiled the Peyronie’s Disease Questionnaire(PDQ)and Global Assessment of Peyronie’s Disease(GAPD)at baselineand 2 weeks after the third injection.A penile Doppler ultrasound was performed 2 weeks after the last injection to record thefinal ***,we recruited 62 patients with stable-phase PD and a mean(±standard deviation[s.d.])curvature of52.7°(±9.7°).After 6 weeks,eight(12.9%)patients did not experience any curvature *** remaining 54 patientshad a final mean(±s.d.)curvature of 40.3°(±9.1°)with P<0.001,compared to that before *** found improvement inall PDQ domains(all P≤0.01),and 50(80.6%)patients reported subjective improvement of the penile curvature according to *** conclusion,we demonstrated that after three injections of HA administered according to the adopted protocol,patientswith stable-phase PD could experience significant improvements in penile curvature,and physical and psychological consequencesof the disease without significantly relevant side effects.

关键词： hyaluronic acid intraplaque injection Peyronie’s disease stable-phase therapy

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Defining minimal invasive surgical therapy for benign prostatic obstruction surgery: Perspectives from a global knowledge, attitude, and practice survey

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Asian Journal of urology 2024年第1期11卷 55-64页

作者： Bryan Kwun-Chung Cheng Steffi Kar-Kei Yuen Daniele Castellani Marcelo Langer Wroclawski Hongda Zhao Mallikarjuna Chiruvella Wei-Jin Chua Ho-Yee Tiong Yiloren Tanidir Jean de la Rosette Enrique Rijo Vincent Misrai Amy Krambeck Dean S.Elterman Bhaskar K.Somani Jeremy Yuen-Chun Teoh Vineet Gauhar department of surgery United Christian HospitalHong KongChina S.H.Ho urology Centre Department of SurgeryPrince of Wales HospitalThe Chinese University of Hong KongHong KongChina department of urology University Hospital“Ospedali Riuniti”and Polytechnic University of Marche RegionAnconaItaly Hospital Israelita Albert Einstein Sao PauloSPBrazil BP—A Beneficencia Portuguesa de Sao Paulo Sao PauloSPBrazil Faculdade de Medicina do ABC Santo AndreSPBrazil department of urology Asian Institute of Nephrology and UrologyHyderabadTGIndia department of urology National University HospitalSingapore department of urology Marmara University School of MedicineIstanbulTurkey department of urology Medipol Mega University HospitalIstanbul Medipol UniversityIstanbulTurkey department of urology Hospital Quiron BarcelonaBarcelonaSpain department of urology Clinique PasteurToulouseFrance department of urology Indiana University School of MedicineIndianapolisINUSA Division of urology Department of SurgeryUniversity Health NetworkUniversity of TorontoTorontoCanada department of urology University Hospital Southampton NHS TrustSouthamptonUK department of urology Ng Teng Fong General HospitalNUHSSingapore

Objective:To scrutinize the definitions of minimal invasive surgical therapy(MIST)and to investigate urologists’knowledge,attitudes,and practices for benign prostatic obstruction ***:A 36-item survey was developed with a Delphi *** on definitions of MIST and attitudes and practices of benign prostatic obstruction surgeries were *** were invited globally to complete the online *** was achieved when more than or equal to 70%responses were“agree or strongly agree”and less than or equal to 15%responses were“disagree or strongly disagree”(consensus agree),or when more than or equal to 70%responses were“disagree or strongly disagree”and less than or equal to 15%responses were“agree or strongly agree”(consensus disagree).Results:The top three qualities for defining MIST were minimal blood loss(n=466,80.3%),fast post-operative recovery(n=431,74.3%),and short hospital stay(n=425,73.3%).The top three surgeries that were regarded as MIST were Urolift®(n=361,62.2%),Rezum®(n=351,60.5%),and endoscopic enucleation of the prostate(EEP)(n=332,57.2%).Consensus in the knowledge section was achieved for the superiority of Urolift®,Rezum®,and iTIND®over transurethral resection of the prostate with regard to blood loss,recovery,day surgery feasibility,and post-operative *** in the attitudes section was achieved for the superiority of Urolift®,Rezum®,and iTIND®over transurethral resection of the prostate with regard to blood loss,recovery,and day surgery *** on both sections was achieved for EEP as the option with the better symptoms and flow improvement,lower retreatment rate,and better suitable for prostate more than 80 ***:Minimal blood loss,fast post-operative recovery,and short hospital stay were the most important qualities for defining ***®,Rezum®,and EEP were regarded as MIST by most urologists.

关键词： Benignprostate hyperplasia Minimalinvasive surgical therapy surgery Bladderoutlet obstruction

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Oleanolic acid inhibits colon cancer cell stemness and reverses chemoresistance by suppressing JAK2/STAT3 signaling pathway

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BIOCELL 2024年第7期48卷 1037-1046页

作者： RUOYU CHEN YIMAN WU FENG WANG JUNTAO ZHOU HUAZHANG ZHUANG WEI LI department of Anus and Intestine surgery Shenzhen Longhua District Central HospitalShenzhenChina department of urology Shenzhen Longhua District Central HospitalShenzhenChina

Background:Oleanolic acid(OA),a pentacyclic triterpenoid exhibiting speciﬁc anti-cancer properties and highly effective antioxidant activity,was isolated from traditional Chinese medicinal ***,the OA that impacts colon cancer(CC)cells and its underlying mechanisms remain poorly ***:The cytotoxic effect of OA alone or OA-5-Fluorouracil(5-FU)combination on normal and CC cells was analyzed by methyl thiazolyl diphenyl-tetrazolium bromide(MTT).Then,the impact of OA on CC cell lines(LoVo and HT-29)proliferation and stemness were measured using colon formation and tumorsphere formation ***-binding transcription factor 4(Oct4),Prominin-1(CD133),Nanog,and transcription factor SOX-2(SOX2)are cell stemness-related indicators whose expression was assessed usingﬂuorescence qPCR assay,Western blotting,and *** effect of OA on the proliferative potency of CC cells was evaluated using an in vivo ***:The stem-like characteristics and clone production of colon cancer cells were markedly reduced by OA alone or in combination with ***,OA increases the susceptibility of CC cells to 5-FU by blocking the cell stemness-related markers(CD133,Nanog,SOX2,and Oct4)expression levels both in vitro and in vivo,as well as by inactivating the activator of transcription 3(STAT3 signaling)and Janus kinase 2/signal transducer(JAK2).Conclusion:Theseﬁndings imply that oleanolic acid,both in vitro and in vivo,suppresses the JAK2/STAT3 pathway,which in turn reverses chemoresistance and decreases colon cancer cell ***,by reducing the recommended amount of 5-FU,this strategy may improve chemotherapeutic effectiveness and minimize undesired side effects.

关键词： Colon cancer,Oleanolic acid,Stemness,5-FU JAK2/STAT3 signaling pathway

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“Hepatic hilum area priority,liver posterior first”:An optimized strategy in laparoscopic resection for type Ⅲ-Ⅳ hilar cholangiocarcinoma

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World Journal of Gastrointestinal surgery 2024年第7期16卷 2167-2174页

作者： Xiao-Si Hu Yong Wang Hong-Tao Pan Chao Zhu Shi-Lei Chen Shuai Zhou Hui-Chun Liu Qing Pang Hao Jin department of Hepatopancreatobiliary surgery Anhui No.2 Provincial People's HospitalHefei 230041Anhui ProvinceChina

BACKGROUND In recent years,pure laparoscopic radical surgery for Bismuth-Corlette type Ⅲ and Ⅳ hilar cholangiocarcinoma(HCCA)has been preliminarily explored and applied,but the surgical strategy and safety are still worthy of further improvement and *** To summarize and share the application experience of the emerging strategy of“hepatic hilum area dissection priority,liver posterior separation first”in pure laparoscopic radical resection for patients with HCCA of Bismuth-Corlette types Ⅲ and *** The clinical data and surgical videos of 6 patients with HCCA of Bismuth-Corlette types Ⅲ and Ⅳ who underwent pure laparoscopic radical resection in our department from December 2021 to December 2023 were retrospectively *** Among the 6 patients,4 were males and 2 were *** average age was 62.2±11.0 years,and the median body mass index was 20.7(19.2-24.1)kg/m^(2).The preoperative median total bilirubin was 57.7(16.0-155.7)μmol/*** patient had Bismuth-Corlette type Ⅲa,4 patients had Bismuth-Corlette type Ⅲb,and 1 patient had Bismuth-Corlette type Ⅳ.All patients successfully underwent pure laparoscopic radical resection following the strategy of“hepatic hilum area dissection priority,liver posterior separation first”.The operation time was 358.3±85.0 minutes,and the intraoperative blood loss volume was 195.0±108.4 *** of the patients received blood transfusions during the perioperative *** median length of stay was 8.3(7.0-10.0)*** bile leakage occurred in 2 patients,and all patients were discharged without serious surgery-related *** The emerging strategy of“hepatic hilum area dissection priority,liver posterior separation first”is safe and feasible in pure laparoscopic radical surgery for patients with HCCA of Bismuth-Corlette types Ⅲ and Ⅳ.This strategy is helpful for promoting the modularization and process of pure laparoscopic radical surgery for complicated HCCA,shortens the learning curve,and

关键词： Hilar cholangiocarcinoma Bismuth-Corlette types Ⅲ and Ⅳ Laparoscopy Radical resection Strategy

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M2 macrophage-related molecular subtypes and prognostic index for prostate cancer patients through integrating single-cell and bulk RNA sequencing analysis

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Genes & Diseases 2024年第4期11卷 131-133页

作者： Dechao Feng Xu Shi Dengxiong Li Ruicheng Wu Jie Wang Wuran Wei Ping Han department of urology Institute of UrologyWest China HospitalSichuan UniversityChengduSichuan 610041China

Prostate cancer(PCa)is considered as an age-related disease and accounts for the most prevalence of urinary malignancies in men.1 We previously analyzed the cellular landscape of tumor microenvironment in PCa patients,where we found that cancer-related fibroblasts might play an important role in tumorigenesis and the development of PCa and tumor-associated macrophage(TAM)could function synergistically with them.2 Thus,we further integrated single-cell and bulk RNA sequencing with meta-analysis to specify the prognostic effect of TAM on PCa and construct molecular subgroups and predictive index to guide clinical practice.

关键词： patients macrophage cancer

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