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Single-incision laparoscopic colorectal surgery for cancer: State of art

World Journal of Gastroenterology 2014年第20期20卷 6073-6080页

作者： Fabio Cianchi Fabio Staderini Benedetta Badii department of Surgery and Translational Medicine Center of Oncological Minimally Invasive Surgery University of Florence 50134 Florence Italy

A number of clinical trials have demonstrated that the laparoscopic approach for colorectal cancer resection provides the same oncologic results as open surgery along with all clinical benefits of minimally invasive surgery. During the last years, a great effort has been made to research for minimizing parietal trauma, yet for cosmetic reasons and in order to further reduce surgery-related pain and morbidity. New techniques, such as natural orifice transluminal endoscopic surgery (NOTES) and single-incision laparoscopy (SIL) have been developed in order to reach the goal of “scarless” surgery. Although NOTES may seem not fully suitable or safe for advanced procedures, such as colectomies, SIL is currently regarded as the next major advance in the progress of minimally invasive surgical approaches to colorectal disease that is more feasible in generalized use. The small incision through the umbilicus allows surgeons to use familiar standard laparoscopic instruments and thus, perform even complex procedures which require extraction of large surgical specimens or intestinal anastomosis. The cosmetic result from SIL is also better because the only incision is made through the umbilicus which can hide the wound effectively after operation. However, SIL raises a number of specific new challenges compared with the laparoscopic conventional approach. A reduced capacity for triangulation, the repeated conflicts between the shafts of the instruments and the difficulties to achieve a correct exposure of the operative field are the most claimed issues. The use therefore of this new approach for complex colorectal procedures might understandingly be viewed as difficult to implement, especially for oncologic cases.

关键词： Colorectal cancer Laparoscopic surgery Single-incision surgery Single-access surgery Scarless surgery Technical challenges

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Clinical efficacy and safety of selective trans-cystic intra-operative cholangiography in primary suture following three-port laparoscopic common bile duct exploration

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Chinese Medical Journal 2012年第19期125卷 3509-3513页

作者： SUN Dong-lin ZHANG Feng CHEN Xue-min JIANG Hong-yuan YANG Chun SUN Ya-ping YANG Bo YANG Yue CAI Hui-hua WANG Cao-ye WU Xin-quan department of minimally invasive Surgery the First People's Hospital of ChangzhouSuzhou UniversityChangzhouJiangsu 213003China

Background Intra-operative cholangiography has been shown to be a sensitive and specific method of demonstrating bile duct stones. This study investigated the feasibility, safety, and clinical value of selective trans-cystic intra-operative cholangiography in primary suture following three-port laparoscopic common bile duct exploration, and identified the factors that positively predict the presence of common bile duct stones. Methods From January 2008 to January 2011, 252 of 1013 patients undergoing laparoscopic cholecystectomy received selective trans-cystic intra-operative cholangiography and primary suture following three-port laparoscopic common bile duct exploration. Their clinical data were analyzed retrospectively. Results All operations were successful and none was converted to open surgery. The intra-operative cholangiography time was （8.3±2.5） minutes, and the operative duration was （105.4±23.1） minutes. According to selective intra-operative cholangiography, the positive predictive values of current jaundice, small gallstones （〈0.5 cm） and dilated cystic duct （〉0.3 cm）, dilated common bile duct （〉0.8 cm）, history of jaundice or gallstone pancreatitis, abnormal liver function test, and preoperative demonstration of suspected common bile duct stones on imaging were 87%, 25%, 42%, 15%, 32%, and 75% for common bile duct stones, respectively. Patients with several factors suggestive of common bile duct stones yielded higher numbers of positive cholangiograms. Unexpected stones were found in 13 patients （5.2%） by intra-operative cholangiography. The post-operative hospital stay was （4.7±2.2） days. Post-operative bile leakage occurred in two cases, and these patients recovered by simple drainage for 3-7 days without re-operation. Of the 761 patients who underwent laparoscopic cholecystectomy alone, 5 （0.7%） presented with a retained common bile duct stone requiring intervention. The median follow-up was 12 months, and only one patient who once suffered from bil

关键词： laparoscopy intra-operative cholangiography common bile duct exploration primary suture

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Neuroendocrine carcinoma of the endometrium concomitant with Lynch syndrome:A case report

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World Journal of Clinical Cases 2023年第21期11卷 5160-5166页

作者： Wing Yu Sharon Siu Mun-Kun Hong Dah-Ching Ding department of Obstetrics and Gynecology Hualien Tzu Chi HospitalHualien 970TaiwanChina minimally invasive Gynecology Surgery Center Department of Obstetrics and GynecologyHualien Tzu Chi HospitalHualien 970TaiwanChina department of Obstetrics and Gynecology Hualien Tzu Chi HospitalTzu Ch UniversityHualien 970TaiwanChina

BACKGROUND Large-cell neuroendocrine carcinoma(NEC)is an uncommon type of tumor that can occur in the *** aggressive cancer requires definitive ***,we describe the clinical characteristics and treatment of a postmenopausal woman with large cell NEC of the *** SUMMARY A 55-year-old Asian female presented with a 1-year history of postmenopausal vaginal *** ultrasound revealed a thickened endometrium(30.2 mm)and a hypervascular *** tomography revealed that the tumor had invaded more than half of the myometrium and spread to the pelvic lymph *** tumor marker,carcinoembryonic antigen,was elevated(3.65 ng/mL).Endocervical biopsy revealed high-grade endometrial *** underwent radical hysterectomy,bilateral salpingo-oophorectomy,omentectomy,and bilateral pelvic and para-aortic lymph node *** examination revealed mixed neuroendocrine and endometrioid adenocarcinoma,pT2N0M0,grade 3,and International Federation of Gynecology and Obstetrics stage *** showed moderate estrogen and progesterone receptor expressions(20%and 1%,respectively),focal CD56 expression(NEC marker),positive staining for vimentin,p53(wild type),and ki67(90%),and loss of expression of PMS2(Lynch syndrome marker).The patient received five cycles of cisplatin and etoposide after *** recurrence was noted after 5 *** We report the characteristics and successful management of a rare case of large cell endometrial NEC concomitant with Lynch syndrome.

关键词： Neuroendocrine carcinoma Endometrium Large cell carcinoma Immunohistochemistry Lynch syndrome Case report

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Association of matrix metalloproteinase-9 C1562T polymorphism and coronary artery disease： a meta-analysis

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Journal of Zhejiang University-Science B(Biomedicine & Biotechnology) 2014年第3期15卷 256-263页

作者： Xiao WANG Lei-zhi SHI department of Emergency Zhejiang Hospital Hangzhou 310013 China department of Thoracic minimally invasive Surgery Linyi People's Hospital Linyi 276000 China

Objective： Many investigations have studied the associations between matrix metalloproteinase-9 （MMP-9） C1562T polymorphisms and coronary artery disease （CAD）. However, the conclusions of these studies were incon- sistent. Therefore, this study was aimed at clarifying the association between MMP-9 C1562T polymorphisms and CAD in a large-scale meta-analysis. Methods： The PubMed and Embase databases were retrieved to collect all pub- lications on the association between MMP-9 C1562T polymorphisms and CAD. Then the odd ratios （ORs） and 95% confidence intervals （95% CIs） for C1562T TT＋TC versus CC genotype between CAD and the control groups were evaluated. Subgroup analysis was also performed according to different races. The meta-analysis was performed by Stata 10.0. Results： Sixteen case-control studies were included in our meta-analysis, involving 11032 CAD patients and 4628 non-CAD controls. Compared with C allele carriers, East Asian T allele carriers TT＋TC had a significantly higher risk of CAD （OR=1.43; 95% CI： 1.03-1.99; P=0.031）; however, there were no significant associations in Western populations （OR=1.06; 95% CI： 0.96-1.18; p=0.240） or West Asians （OR=1.13; 95% CI： 0.75-1.70; P=-0.565）. When further analyzing the association between C1562T polymorphisms and myocardial infarction （MI, the most serious type of CAD）, the risk of TT＋TC genotype versus CC genotype for MI was significantly higher for the overall （OR=1.21; 95% C1： 1.04-1.40; P=0.012） and for East Asians （OR=1.58; 95% C1： 1.26-1.97; P=0.000） but not in Western populations （OR=1.12; 95% CI： 0.99-1.26; P=0.078）. Conclusions： Our meta-analysis suggested an obvious ethnic difference in the association between MMP-9 C1562T polymorphisms and CAD. MMP-9 C1562T polymorphism was significantly related to CAD in East Asians. However, no significant associations were observed in either West Asians or Western populations.

关键词： Coronary artery disease Matrix metalloproteinase-9 Polymorphism Meta-analysis

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Efficacy of continuous arterial perfusion chemotherapy combined with transarterial chemoembolization regional arterial thermal perfusion in the treatment of pancreatic cancer with liver metastases

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Oncology and Translational Medicine 2023年第4期9卷 176-183页

作者： Zhuo Zhong Jian Yang Jing-Zi Luo Xiong Xie Zhi-Mei Huang De Long Oncology department Guangzhou Hospital of Integrated Traditional and West Medicine Hepatobiliary Surgery department Zhujiang Hospital Affiliated to Southern Medical University Clinical Laboratory department Guangzhou Hospital of Integrated Traditional and West Medicine minimally invasive intervention department Sun Yat-sen University Cancer Prevention Center

Background:The aim of the study was to investigate the efficacy of continuous transcatheter arterial infusion chemotherapy combined with transarterial chemoembolization(TACE)for the treatment of advanced pancreatic cancer with liver ***:Sixty patients with advanced pancreatic cancer and liver metastases were enrolled in this *** the treatment group,31patients underwent continuous transcatheter arterial infusion chemotherapy combined with TACE regional arterial thermal perfusion,whereas 29 patients included in the control group received intravenous chemotherapy with gemcitabine and *** patients received maintenance chemotherapy with S-1 after 4 cycles of the study *** efficacy,quality of life,survival,and toxicity were ***:Efficacy was better in the treatment group than in the control group,as reflected by the objective remission,partial remission,and disease progression rates(all P<0.05).The Eastern Cooperative Oncology Group and Numerical Rating Scale pain scores were also higher in the treatment group(both P<0.05).In survival analysis,the 1-year overall survival rates in the treatment and control groups were64.516%and 10.345%,respectively,whereas the median overall survival times were 16 and 6 months,respectively(both P<0.05).The6-month progression-free survival rates in the treatment and control groups were 77.419%and 13.790%,respectively,and the median progression-free survival times were 12 and 3 months,respectively(both P<0.05).The rates of hematological and nonhematological toxicological adverse effects were also lower in the treatment group(both P<0.05).Although the rate of liver dysfunction was higher in the treatment group,this finding had no adverse effects on ***:Continuous transcatheter arterial infusion chemotherapy combined with TACE regional arterial perfusion chemotherapy resulted in better efficacy and safety outcomes in patients with pancreatic cancer and liver metastasis,sugges

关键词： Advanced pancreatic cancer Liver metastasis Continuous transcatheter arterial infusion chemotherapy(cTAI) Transcatheter arterial chemoembolization(TACE) Arterial perfusion chemotherapy Efficacy

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Colorectal resections for malignancy: A pilot study comparing conventional vs freehand robot-assisted laparoscopic colectomy

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World Journal of Clinical Cases 2024年第3期12卷 488-494页

作者： Shamir O Cawich Joseph Martin Plummer Sahle Griffith Vijay Naraynsingh department of Surgery University of the West IndiesSt AugustineTrinidad and Tobago department of General Surgery and Consultant General and Colorectal Surgeon Department of SurgeryUniversity of the West IndiesKingstonKIN7Jamaica department of Surgery Queen Elizabeth HospitalBridgetownBarbados department of Surgery Port of Spain General HospitalPort of SpainTrinidad and Tobago

BACKGROUND Laparoscopic colectomy is widely accepted as a safe operation for colorectal cancer,but we have experienced resistance to the introduction of the FreeHandffrobotic camera holder to augment laparoscopic colorectal *** To compare the initial results between conventional and FreeHandffrobot-assisted laparoscopic colectomy in Trinidad and *** This was a prospective study of outcomes from all laparoscopic colectomies per-formed for colorectal carcinoma from November 29,2021 to May 30,*** following data were recorded:Operating time,conversions,estimated blood loss,hospitalization,morbidity,surgical resection margins and number of nodes *** data were entered into an excel database and the data were analyzed using SPSS ver *** There were 23 patients undergoing colectomies for malignant disease:8(35%)FreeHandff-assisted and 15(65%)conventional laparoscopic *** were no *** time was significantly lower in patients under-going robot-assisted laparoscopic colectomy(95.13±9.22 vs 105.67±11.48 min;P=0.045).Otherwise,there was no difference in estimated blood loss,nodal harvest,hospitalization,morbidity or *** The FreeHandffrobot for colectomies is safe,provides some advantages over conventional laparoscopy and does not compromise oncologic standards in the resource-poor Caribbean setting.

关键词： Laparoscopic Colectomy Robot Surgery minimally invasive

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Feasibility of laparoscopic total gastrectomy in overweight patients: Implications of less impact of overweight on laparoscopic versus open approach

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World Journal of Clinical Cases 2018年第16期6卷 1094-1100页

作者： Masatoshi Nakagawa Kazuyuki Kojima Mikito Inokuchi Kenta Kobayashi Toshiro Tanioka Keisuke Okuno Kentaro Gokita department of Gastric Surgery Tokyo Medical and Dental University Center for minimally invasive Surgery Tokyo Medical and Dental University

AIM To investigate safety and oncological feasibility of laparoscopic total gastrectomy(LTG) in overweight(OW) *** Patients who underwent total gastrectomy(110 laparoscopic, 211 open) for gastric cancer between January 1999 and July 2016 were included. Propensity score matching selected 152 patients(76 laparoscopic, 76 open), which were subsequently divided into the OW(≥ 25) or non-OW(< 25) group by body mass index. Postoperative outcomes of laparoscopic versus open approaches were compared between OW and non-OW groups. RESULTS In the propensity-matched population, baseline characteristics were comparable between the OW and nonOW groups for the laparoscopy and open groups. In the laparoscopy group, operative time was longer(P = 0.01) in the OW group, however, other perioperative results including complication rates were comparable between the non-OW and OW groups. In the open group, number of retrieved lymph nodes were less(P = 0.03) and local complication rate was more frequent(P = 0.03) in the OW group. CONCLUSION LTG in OW patients remains technically challenging but can be performed safely. Our findings imply that OW has a lesser effect on the laparoscopic versus open approach to total gastrectomy.

关键词： Gastric cancer Laparoscopy Overweight Total gastrectomy

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A rare case of easily misdiagnosed primary mucoepidermoid carcinoma of the liver

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Genes & Diseases 2022年第3期9卷 582-584页

作者： Fusheng Liu Bicheng Wang Zhonglin Zhang Yufeng Yuan Haitao Wang department of Hepatobiliary&Pancreatic Surgery Zhongnan Hospital of Wuhan UniversityWuhanHubei 430071PR China Clinical Medicine Research Center for minimally invasive Procedure of Hepatobiliary&Pancreatic Diseases of Hubei Province WuhanHubei 430030PR China department of Pathology Zhongnan Hospital of Wuhan UniversityWuhanHubei 430062PR China

To the editor,Mucoepidermoid carcinoma(MEC)is a common malignancy of the salivary glands,which account for approximately 30%of all malignant salivary gland neoplasms that originate in both the major and minor glands.1 But it is relatively rare at other organs,extremely rare in the hepatobiliary *** the best of our knowledge,since primary MEC of the liver was first reported in 1971,2 no more than 20 cases have been reported worldwide.

关键词： neoplasms organs liver

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Nanodrug enhances post-ablation immunotherapy of hepatocellular carcinoma via promoting dendritic cell maturation and antigen presentation

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Bioactive Materials 2023年第3期21卷 57-68页

作者： Zecong Xiao Tan Li Xinyao Zheng Liteng Lin Xiaobin Wang Bo Li Jingjun Huang Yong Wang Xintao Shuai Kangshun Zhu department of minimally invasive interventional Radiology And Laboratory of Interventional RadiologyThe Second Affiliated Hospital of Guangzhou Medical UniversityGuangzhou510260China Nanomedicine Research Center The Third Affiliated Hospital of Sun Yat-sen UniversityGuangzhou510630China College of Chemistry and Materials Science Jinan UniversityGuangzhou510632China department of Dermatology The Nanfang Hospital of Southern Medical UniversityGuangzhouGuangdong510515China

Thermal ablation(TA)as an effective method treating hepatocellular carcinoma(HCC)in clinics is facing great challenges of high recurrence and *** immune-checkpoint blockade(ICB)-based immuno-therapy has shown potential to inhibit recurrence and metastasis,the combination strategy of ICB and thermal ablation has shown little progress in HCC *** tremendous hurdle for combining ICB with thermal ablation lies with the insufficient antigen internalization and immaturity of tumor-infiltrating dendritic cells(TIDCs)which leads to an inferior immune response to distant tumor growth and ***,an antigen-capturing nanoplatform,whose surface was modified with mannose as a targeting ligand,was constructed for co-delivering tumor-associated antigens(TAAs)and m6A demethylases inhibitor(i.e.,fat mass and obesity asso-ciated gene(FTO)inhibitor)into *** vivo results demonstrate that the intratumoral injection of nanodrug followed by HCC thermal ablation promotes dendritic cells(DCs)maturation,improves tumor infiltration of effector T cells and generates immune memory,which synergize with ICB treatment to inhibit the distant tumor growth and lung ***,the antigen-capturing and FTO-inhibiting nanodrug holds potential to boost the ICB-based immunotherapy against HCC after thermal ablation.

关键词： Thermal ablation Tumor-infiltrating dendritic cells N6-methyladenosine modification Nanoplatform Tumor immunotherapy

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Theranostic nanosystem mediating cascade catalytic reactions for effective immunotherapy of highly immunosuppressive and poorly penetrable pancreatic tumor

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Science China Chemistry 2022年第7期65卷 1383-1400页

作者： Gengjia Chen Yujun Cai Bo Li Minzhao Lin Xiaobin Wang Zhiyong Wang Xintao Shuai Key Laboratory for Polymeric Composite&Functional Materials of Ministry of Education School of Materials Science and EngineeringSun Yat-sen UniversityGuangzhou 510275China Nanomedicine Research Center the Third Affiliated Hospital of Sun Yat-sen UniversityGuangzhou 510630China department of minimally invasive interventional Radiology Laboratory of Interventional Radiologythe Second Affiliated Hospital of Guangzhou Medical UniversityGuangzhou 510275China

The dense desmoplastic stroma and immunosuppressive microenvironment of pancreatic cancer hinder the penetration of drugs and induce a considerable resistance to conventional chemoradiotherapy. Although nanomedicine has recently shown attractive potential in cancer immunotherapy, it remains a great challenge to achieve efficient drug delivery and potent immune ***, a stimuli-responsive nanosystem, comprising superparamagnetic iron oxide nanocrystals and nitric oxide(NO) donors,was developed for in-situ triggered catalytic cascade reaction to produce abundant free radicals and remodel the anti-tumor immunity. The nanosystem was activated in the tumor microenvironment to produce NO which dilated the tumor vasculature for efficient drug delivery, and the iron oxide nanocrystals catalyzed the reaction of NO to generate reactive oxygen-nitrogen species(RONS) with high cytotoxicity. Moreover, owing to the catalytic cascade reactions mediated by the nanosystem, the tumor associated macrophages(TAMs) were converted to a proinflammatory M1 phenotype and tumor infiltration of effector T cells was promoted to result in potent anti-tumor immunotherapy which could be readily monitored with magnetic resonance imaging(MRI).

关键词： nanozyme catalytic cascade reactions macrophages tumor microenvironment nitric oxide

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