ABSTRACT
Objective:To compare and analyze the clinical efficacy of hand-assisted laparoscopic surgery (HALS) and laparoscopic assisted surgery (LAS) in the treatment of advanced gastric cancer.Methods:Articles of the efficacy comparison of HALS and LAS in D2 radical gastrectomy for gastric cancer from 2000 to 2019 published in PubMed, Cochrane library, EM-BASE, China National Knowledge Infrastructure (CNKI), Wanfang, Weipu, Chinese full-text database of Chinese Sci-Tech journals, Chinese biomedical literature database were retrieved, and the literatures were screened according to the pre-established inclusion and exclusion criteria. The quality of the two groups was evaluated, and the short-term indexes and complications for meta-analysis of the two groups were analyzed by using Revman 5.3 software.Results:A total of 1277 patients were included in 10 articles, including 629 in the HALS group and 648 in the LAS group. The results of the meta-analysis showed that compared with the LAS group, the operation time was shorter in the HALS group (WMD=24.02, 95% CI: -40.41--7.62, P=0.004), but the auxiliary incision was slightly longer (WMD=0.27, 95% CI: 0.06-0.47, P=0.01), and there were no statistically significant difference in the remaining number of lymph node dissections (WMD=0.58, 95% CI: -1.22-2.39, P=0.53), intraoperative blood loss (WMD=-7.94, 95% CI: -16.21-0.33, P=0.06), gastrointestinal tract recovery time (WMD=0.00, 95% CI: -0.03- 0.04, P=0.85), total length of hospital stay (WMD=-0.14, 95% CI0: -0.36-0.09, P=0.23) and postoperative complications ( OR=0.89, 95% CI: 0.58-1.37, P=0.61). Conclusions:Compared with the LAS for D2 radical surgery of advanced gastric cancer, HALS has significantly shorter operation time and is easier to perform than LAS, but the incision length is slightly increased. Physicians can choose the appropriate operation method according to the specific conditions of the operation and themselves.
ABSTRACT
Objective To explore the clinical efficacy of lnstaTrak3500 Plus with Fluoro Trak magnetic imaging guidance for spine surgery, Methods The construction and operation progress of the system were applied in thoracic-lumbar spine surgery, Results The electric-magnetic guided imaging system can improve success rate in thoracic-lumbar spine surgery,and all operative pedicle screw were inserted accurately with no related complications error. Conclusion The electric-magnetic imaging system can improve the accuracy of operations and guide mini-invasive surgery, which can significantly decrease X-ray irradiation dosage.
ABSTRACT
Objective To investigate changes of endothelin-1(ET-1) and endothelin-converting enzyme (ECE) in different time intervals after autograft vein implantation. Methods A model of autogenous vein graft was established by interposition of the jugular vein into abdominal aorta in 80 Wistar rats. RT-PCR and immunohistochemistry were employed to test mRNA and protein level of ECE, ET-1 and proliferating cell nuclear antigen (PCNA). Results Positive PCNA appeared at 6 hours after transplantation, with time reaching a peak at 1 to 2 week. ECE mRNA increased with time reaching a peak after 1-2 weeks and stabilizing around 8 weeks. ET-1 expression underwent similar tendence with ECE, reaching a peak after 1-2 weeks and stabilizing at 8 weeks at the protein level. Expression of ET-1 and ECE were closely related by the time pattern after vein autograft (r=0.975). Conclusions The process of intimal hyperplasia in its occurrence and pattern of change are related with dynamics of ET-1 and ECE. ECE may lead to intimal hyperplasia of the autografted vein through a passway of ECE to ET-1 to SMC.