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World Journal of Gastroenterology 2017年第32期23卷 6003-6006页

作者： Jun-Jun Su Ming Su Kai Xu Peng-Fei Wang Li Yan Shi-Chun Lu Wan-Qing Gu Yong-Liang Chen division of Gastroenterological surgery Department of Surgery Shanxi Provincial People’s Hospital Department of Hepatobiliary surgery Chinese People’s Liberation Army General Hospital

Portal vein thrombosis(PVT) is a rare but serious postoperative complication associated with irreversible electroporation(IRE). We report a case of postoperative PVT in a 54-year-old woman who underwent IRE for locally advanced pancreatic cancer. Drain removal and discharge of the patient from the hospital were scheduled on postoperative day(POD) 7; however, a magnetic resonance imaging scan revealed the presence of PVT. We suspected postoperative inflammation in the pancreas as the main cause of PVT. However, the patient did not undergo any medical treatment because she did not have any clinical symptoms, and she was discharged on POD 8.

关键词： Irreversible electroporation Portal vein thrombosis Locally advanced pancreatic cancer Safety

Minimal access liver surgery: from the escalation, to the boundaries, searching for the rules

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Hepatobiliary surgery and Nutrition 2019年第6期8卷 637-639页

作者： Guido Torzilli division of Hepatobiliary&general surgery Department of SurgeryHumanitas Research HospitalHumanitas UniversityMilanoItaly

Minimal access liver surgery(MALS),is now routinely performed worldwide,and procedures like limited resections of antero-inferior segments and left lateral sectionectomy could be retained as standard once performed laparoscopically(1).It is a common believe that MALS procedures mean shorter and better postoperative outcome,and essentially more safety compared to the open ***,MALS procedures facing with complex disease presentations are increasingly proposed(2).In this escalation of MALS in the panorama of the surgical offer available for patients with liver tumors open liver surgery(OLS)seems somehow passed *** this setting,the paper of Tong et *** to set clinically based criteria for allowing to foresee the risk of conversion and morbidity once a MALS is planned(3).At least the attempt is worth to be awarded while the results should be validated by means of further studies able to test the scoring system the authors *** sure there is the merit to investigate the burden of MALS,which implies the recognition of a limit and subsequently the need for its precise definition.A definition which,as anything in medicine,could not be considered definitive,since it will probably evolve with expertise and technology as it has been the case in the last 10-15 ***,pointing out the existence of a limit superimposes caution to any effort to get over the burden unless the attempt is based on a solid *** sure,in this sense,the authors have provided an instrument for the surgical community which conveys limits to which any surgeon has to face with.

关键词： routine instrument searching

Laparoscopic and robot-assisted gastrectomy for gastric cancer: Current considerations

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World Journal of Gastroenterology 2016年第25期22卷 5694-5717页

作者： Stefano Caruso Alberto Patriti Franco Roviello Lorenzo De Franco Franco Franceschini Andrea Coratti Graziano Ceccarelli Department of general surgery and Surgical Specialties Unit of General Surgery 'Santa Maria Annunziata' Hospital ASL Firenze 50012 Florence Italy Department of surgery General Minimally Invasive and Robotic Surgery 'San Matteo degli Infermi' Hospital 06049 Spoleto (PG) Italy Department of Medical Surgical and Neuroscience/ Unit of General and Minimally Invasive Surgery University of Siena 53100 Siena Italy division of Oncological and Robotic general surgery 'Careggi' University Hospital 50134 Florence Italy Department of Medicine and general surgery Unit of Minimally Invasive and General Surgery ASL8 Arezzo 'San Donato' Hospital 52100 Arezzo Italy

Radical gastrectomy with an adequate lymphadenectomy is the main procedure which makes it possible to cure patients with resectable gastric cancer (GC). A number of randomized controlled trials and meta-analysis provide phase III evidence that laparoscopic gastrectomy is technically safe and that it yields better short-term outcomes than conventional open gastrectomy for early-stage GC. While laparoscopic gastrectomy has become standard therapy for early-stage GC, especially in Asian countries such as Japan and South Korea, the use of minimally invasive techniques is still controversial for the treatment of more advanced tumours, principally due to existing concerns about its oncological adequacy and capacity to carry out an adequately extended lymphadenectomy. Some intrinsic drawbacks of the conventional laparoscopic technique have prevented the worldwide spread of laparoscopic gastrectomy for cancer and, despite technological advances in recent year, it remains a technically challenging procedure. The introduction of robotic surgery over the last ten years has implied a notable mutation of certain minimally invasive procedures, making it possible to overcome some limitations of the traditional laparoscopic technique. Robot-assisted gastric resection with D2 lymph node dissection has been shown to be safe and feasible in prospective and retrospective studies. However, to date there are no high quality comparative studies investigating the advantages of a robotic approach to GC over traditional laparoscopic and open gastrectomy. On the basis of the literature review here presented, robot-assisted surgery seems to fulfill oncologic criteria for D2 dissection and has a comparable oncologic outcome to traditional laparoscopic and open procedure. Robot-assisted gastrectomy was associated with the trend toward a shorter hospital stay with a comparable morbidity of conventional laparoscopic and open gastrectomy, but randomized clinical trials and longer follow-ups are nee

关键词： Gastric cancer Gastric resection Minimally invasive surgery Laparoscopic gastrectomy Robot-assisted gastrectomy

Complete response to multidisciplinary therapy in a patient with primary gastric choriocarcinoma

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World Journal of Gastroenterology 2013年第31期19卷 5187-5194页

作者： Kazuhiro Takahashi Shigeki Tsukamoto Ken Saito Nobuhiro Ohkohchi Katsu Hirayama division of Gastro-enterological and Hepatobiliary surgery and Organ Transplantation Department of Surgery University of Tsukuba Tsukuba 3058575 Japan Department of surgery Hiraka General Hospital Yokote 0138610 Japan

Primary gastric choriocarcinoma is a rapidly growing neoplasm with an average survival of several months in untreated *** with lymph node dissection followed by chemotherapy is the treatment of *** used for gastric adenocarcinoma are usually ***,median survival remains less than six *** this case report,we describe a case of primary gastric choriocarcinoma with a clinical complete response to multidisciplinary treatment including surgery,chemotherapy,and radiofrequency ablation(RFA).The patient was originally referred for general *** demonstrated a large tumor occupying the fornix,and total gastrectomy with lymph node dissection was *** days later,multiple liver metastatic recurrences with high serum levels of beta-human chorionic gonadotropin(β-hCG) were *** with a gonadal choriocarcinoma regimen consisting of etoposide,methotrexate,actinomycin D,cyclophosphamide,and vincristine(EMA/CO),was *** three cycles,serum β-hCG decreased markedly and the tumors *** months later,multiple lung metastatic recurrences were *** one cycle of EMA/CO,only one nodule *** tomography-guided RFA was performed for this oligometastatic *** patient has been alive with no evidence of disease for 10 years after the initial *** the best of our knowledge,this patient with recurrent primary gastric choriocarcinoma has achieved the longest *** present case is the first report of choriocarcinoma metastatic to the lung successfully treated with *** our retrospective analysis of recurrent or unresectable primary gastric choriocarcinoma,we propose that gonadal choriocarcinoma regimens can be considered as first-line for primary gastric choriocarcinoma.

关键词： Primary gastric choriocarcinoma Betahuman chorionic gonadotropin Etoposide,methotrexate,actinomycin D,cyclophosphamide,and vincristine Oligometastatic Radiofrequency ablation

Radiofrequency ablation-assisted liver resection a step toward bloodless liver resection

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Hepatobiliary & Pancreatic Diseases International 2015年第1期14卷 69-74页

作者： Athanasios Petrou Kyriakos Neofytou Constantinos Mihas Jessamy Bagenal Michael Kontos John Griniatsos Evangelos Felekouras Nicosia Surgical Department Division of Hepatobiliary Pancreatic Surgery Nicosia General Hospital First Department of surgery University of Athens Medical School LAIKO Teaching Hospital Bristol Heart Institute Severn School of Surgery

BACKGROUND： Liver resection is currently the most efficient curative approach for a wide variety of liver tumors. The application of modern techniques and new surgical devices has improved operative outcomes. Radiofrequency ablation is used more often for liver parenchymal transection. This study aimed to assess the efficacy and safety of radiofrequency ablation-assisted liver ***： A retrospective study of 145 consecutive patients who underwent radiofrequency ablation-assisted liver resection was performed. Intraoperative blood loss, need for transfusion or intraoperative Pringle maneuver, the duration of liver parenchymal transection, perioperative complications, and postoperative morbidity and mortality were all ***： Fifty minor and ninety-five major liver resections were performed. The mean intraoperative blood loss was 251 m L, with a transfusion rate of 11.7%. The Pringle maneuver was necessary in 12 patients（8.3%）. The mean duration for parenchymal transection was 51.75 minutes. There were 47 patients（32.4%） with postoperative complications. There is no mortality within 30 days after surgery. CONCLUSIONS： Radiofrequency ablation-assisted liver resection permits both major and minor liver resections with minimal blood loss and without occlusion of hepatic inflow. Furthermore it decreases the need for blood transfusion and reduces morbidity and mortality.

关键词： bleeding complications hepatectomy radiofrequency ablation Pringle maneuver

Is repeat wide excision plus radiotherapy of localized rectal melanoma another choice before abdominoperineal resection?A case report

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World Journal of Clinical Cases 2022年第15期10卷 5057-5063页

作者： Hao-Tse Chiu Ta-Wei Pu Hao Yen Tung Liu Chia-Cheng Wen Department of surgery Tri-Service General HospitalNational Defense Medical CenterTaipei 114Taiwan division of Colon and Rectal surgery Department of SurgerySongshan BranchTri-Service General HospitalNational Defense Medical CenterTaipei 10581Taiwan Department of Pathology Tri-Service General HospitalNational Defense Medical CenterTaipei 114Taiwan division of Colon and Rectal surgery Department of SurgeryTri-Service General HospitalNational Defense Medical CenterTaipei 114Taiwan

BACKGROUND Rectal melanoma is an uncommon neoplasm that accounts for approximately 1 percent of rectal cancer *** resection was regarded as the radical procedure for disease ***,it led to more postoperative complications than sphincter-sparing wide local excision(WLE)and reduced the patient’s quality of life(QOL)owing to creation of ***,in this study,WLE,radiotherapy(RT),and a second WLE were conducted on a patient who had been diagnosed with localized rectal *** SUMMARY The patient was a 79-year-old woman who had been experiencing anal pain and bloody stool for 1 ***,magnetic resonance imaging,positron emission tomography–computed tomography,and histological analysis of tissue biopsy using the histological markers Melan-A(+),S-100(+),and Ki-67(+,50%)lead to the diagnosis of localized rectal *** patient had initially undergone WLE to resolve problem of anal bleeding,followed by RT to treat the residual lesion with partial ***,the residual lesion was removed with margin-free resection by the second *** patient’s postoperative course was smooth and *** the 2-year follow-up,no local recurrence was ***,a good functional outcome and improved QOL were *** Combining WLE,RT,and repeat WLE is proposed as a viable alternative for treating rectal melanoma accompanied by bleeding symptoms that cannot be completely resected at the beginning.

关键词： Sphincter-sparing local wide excision Radiotherapy Rectal melanoma Case report

Isolated repeated anastomotic recurrence after sigmoidectomy

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World Journal of Gastroenterology 2014年第43期20卷 16343-16348页

作者： Giovanni Conzo Claudio Mauriello Claudio Gambardella Fabio Cavallo Ernesto Tartaglia Salvatore Napolitano Luigi Santini Department of Anaesthesiologic Surgical and Emergency ScienceⅦ Division of General SurgerySecond University of Naples80131 NaplesItaly

Repeated anastomotic recurrence(AR)of colonic cancer is *** report a case of a double-isolated AR after *** 2003,a 60-year-old woman underwent stapled sigmoid resection for a moderately differentiated *** rectal bleeding occurred after six months,and colonoscopy detected an ***,an additional stapled colorectal anastomosis was *** months later,a colonoscopy detected a circumferential AR that prompted the completion of a second colorectal resection,with a doublestapled colorectal ***-four hours after surgery,a massive pulmonary embolism occurred,and the patient died within a few *** present,onlysix cases of repeated isolated AR have been *** segmental colorectal resections are generally associated with a favourable prognosis,with a median survival rate of 45 mo(range,13-132 mo).Repeated isolated ARs are rare,and segmental colorectal resections are generally associated with long-term diseasefree survival.

关键词： Repeated Anastomotic Recurrence Stapled Anastomosis Viable Exfoliated Cells

Catheter tract implantation metastases associated with percutaneous biliary drainage for extrahepatic cholangiocarcinoma

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World Journal of Gastroenterology 2005年第44期11卷 7024-7027页

作者： Jun Sakata Yoshio Shirai Toshifumi Wakai Tatsuya Nomura Eiko Sakata Katsuyoshi Hatakeyama division of Digestive and general surgery

AIM： To estimate the incidence of catheter tract implantation metastasis among patients undergoing percutaneous transhepatic biliary drainage （PTBD） for extrahepatic cholangiocarcinoma, and to provide data regarding the management of this unusual complication of PTBD by reviewing cases reported in the literature. METHODS： A retrospective analysis of 67 consecutive patients who underwent PTBD before the resection of extrahepatic cholangiocarcinoma was conducted. The median follow-up period after PTBD was 106 too. The English language literature （PubMed, National Library of Medicine, Bethesda, MD, USA）, from .lanuary 1966 through December 2004, was reviewed. RESULTS： Catheter tract implantation metastasis developed in three patients. The cumulative incidence of implantation metastasis reached a plateau （6%） at 20 mo after PTBD. All of the three patients with implantation metastasis died of tumor progression at 3, 9, and 20 mo after the detection of this complication. Among the 10 reported patients with catheter tract implantation metastasis from extrahepatic cholangiocarcinoma （including our three patients）, two survived for more than 5 years after the excision of isolated catheter tract metastases. CONCLUSION： Catheter tract implantation metastasis is not a rare complication following PTBD for extrahepatic cholangiocarcinoma. Although the prognosis for patients with this complication is generally poor, the excision of the catheter tract may enable survival in selected patients with isolated metastases along the catheter tract.

关键词： Neoplasm seeding Extrahepatic cholangiocarcinoma Percutaneous transhepatic biliary drainage Malignant biliary obstruction surgery Prognosis

Tumor-infiltrating B cells come into vogue

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World Journal of Gastroenterology 2013年第1期19卷 8-11页

作者： Michael Linnebacher division of Molecular Oncology and Immunotherapy Department of General SurgeryUniversity of RostockD-18057 RostockGermany

Lymphocyte infiltration into solid tumors has been recognized as a main determinator of positive *** the most part this is attributed to cytotoxic T cells capable of directly destroying malignant ***,when considering the complex composition of the human immune system,recent findings of Nielsenet al on a potentially central role of tumor-infiltrating B cells is not really *** this commentary article,I want to highlight the enormous potential impact of this observation for basic and translational research,prognostic procedures and ultimately for the development of future therapeutic concepts.

关键词： CD20 + tumor-infiltrating lymphocytes Tumorinfiltrating B cells Prognosis Immunotherapy Functional immunology

Hepatic clearance measured with ^(99m)Tc-GSA single-photon emission computed tomography to estimate liver fibrosis

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World Journal of Gastroenterology 2014年第44期20卷 16714-16720页

作者： Masahiko Taniguchi Atsutaka Okizaki Kenji Watanabe Koji Imai Koichiro Uchida Takahiro Einama Noriyuki Shuke Naoyuki Miyokawa Hiroyuki Furukawa division of Gastroenterologic and general surgery Department of Surgery Asahikawa Medical College Department of Radiology Asahikawa Medical College Department of Pathology Asahikawa Medical College

AIM: To evaluate the clinical utility of hepatic clearance(HC) measured with technetium-99m-diethylenetriaminepenta-acetic acid-galactosyl human serum albumin(99mTc-GSA) single-photon emission computed tomography(SPECT) to estimate the degree of liver ***:Seventy-eight consecutive patients who underwent initial hepatectomy due to hepatocellular carcinoma were enrolled in this *** green clearance(ICG R15),quantitative indices estimated by 99mTc-GSA[the receptor index(LHL15 and HH15)and HC via SPECT analysis],and conventional liver function tests were performed before *** among the quantitative indices for liver functional reserve,conventional liver function tests,andthe degree of liver fibrosis were ***:The degree of liver fibrosis was correlated with ICG R15,HH15,LHL15,and *** showed the best correlation with conventional liver function *** to multivariate analysis,HC and LHL15 were significant independent predictors of severe *** was the most valuable index for predicting severe ***:HC measured with 99mTc-GSA SPECT is a reliable index for assessing liver fibrosis before hepatectomy.

关键词： Fibrosis Technetium-99m-diethylenetri-aminepenta-acetic acid-galactosyl human serum albu-min Single-photon emission computed tomography Hepatic clearance Liver resection