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Objective To evaluate transoral Orvil EEA stapler (OrVil) procedure in laparoscopic total gastrectomy for cardiac carcinoma compared with conventional anvil head method (purse-string suture).Methods From May 2014 to December 2014 20 cases were included into OrVil group,and 25 cases into purse-string suture group.Results The two groups had similar mean numbers of dissected lymph nodes [(25 ± 3) vs.(24 ± 4),t =1.067,P =0.292],the mean time of operation,intraoperative blood loss,and postoperative complications (5 vs.6,P =0.938).The length of incision was significantly shorter [(5 ±1) cm vs.(11 ± 2) cm,t =-10.724,P ＜ 0.0l] and the esophagojejunostomy time was significantly less [(28 ± 4) min vs.(39 ± 5) min,t =-7.996,P ＜ 0.01] with the use of OrVil.The time to first flatus and postoperative hospital stay were (3.7 ± 0.9) d vs.(4.4 ± 1.0) d,t =-2.485,P =0.017 and (13 ± 5) d vs.(16 ±4) d,t =-2.184,P =0.035.Conclusions OrVil is a technically safe and feasible surgical procedure for esophagojejunostomy in laparoscopy assisted total gastrectomy in the treatment of cardiac carcinoma.
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Objective There is close relationship between ubiquitin-specific protease 9X(USP9X) and the biological behav-ior of some tumor.The aim of this study is to investigate the expression and clinical significance of USP 9X in pancreatic carcinoma of elderly patients. Methods The expression of USP9X was detected in 30 pieces of surgically resected primary pancreatic carcinoma tissue and adjacent nontumorous pancreatic tissue of elderly patients by streptavidin -perosidase immunohistochemical method . Results The rate of USP9X positive expression was 56.7%, there was not positive expression in adjacent nontumorous pancreatic tissue .There was no relation between the expression of USP 9X with gender, age, the tumor positin, the tumor size and degree of differentiation (P>0.05), while it was significantly correlated with lymph node metastasis and TNM stages (P<0.05).By using Cox proportional haz-ards analysis, multivariable analysis revealed that TNM stages , lymph node metastasis and USP9X expression were independent risk factor(P<0.05). Conclusion The results indicated that USP9X may play a role in the pathogenesis and prognosis of pancreatic cancer of elderly patients .
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Objective To evaluate the safety and efficacy of the technique of transoral Orvil EEA stapler (OrVil) for laparoscopic gastrectomy of gastric cancer in our hospital.Methods Between Sep 2012 and Aug 2013,73 patients at our department underwent open (n =36) or laparoscopic (being reconstructed by OrVil,n =37) gastrectomy.Early surgical outcomes of the two groups were compared to assess the effectiveness,security and postoperative complications of OrVil procedure.Results The two groups had similar mean numbers of dissected lymph nodes (29 ± 10 vs.31 ± 14,t =-0.697,P =0.488),lengths of postoperative hospital stay (14 ± 5 vs.12 ± 3 d,t =1.933,P =0.057) and postoperative complications (11 vs.11,P =0.939).Intraoperative blood loss was significantly less (189 ± 79 vs.343 ± 90 ml,t =-7.782,P =0.000) and time to first flatus significantly shorter (2.9 ±0.5 vs.3.5 ±0.6 d,t =-4.714,P =0.000) with the use of OrVil.Operation time of laparoscopic group was significantly longer than that of open group (266 ± 97 vs.204 ± 39 min,t =3.607,P =0.001).There was one each anastomotic leakage in both groups.Conclusions With the suitable approach and skillful technique,OrVil is a technically safe and feasible surgical procedure for the treatment of gastric cancer.
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<p><b>OBJECTIVE</b>To scrutinize the immunohistochemical spectrum to differentiate hepatocellular carcinoma (HCC) from intrahepatic cholangiocarcinoma (ICC) and metastatic adenocarcinoma (MAC) in the liver.</p><p><b>METHODS</b>Seven antibodies including AFP, Hep Par 1, CK18, CK19, CA19-9, CD34 and pCEA were immunohistochemically stained in resected specimens of 300 HCC, 35 ICC and 30 MAC. The specificity and sensitivity of the antibodies were evaluated by comprehensive capability score (CCS), with only those with CCS > or = 8 considered as having highly diagnostic value.</p><p><b>RESULTS</b>Antibodies CCS > or = 8 were observed as Hep Par 1 and CD34 in HCC, and CK19 in ICC, but none in MAC. For HCC, CCS of Hep Par 1 was higher than that of AFP (9 vs. 7) with 83.7% in sensitivity and 96.7% in specificity.</p><p><b>CONCLUSION</b>For HCC, Hep Par 1 and CD34 can be used as the first line antibodies, AFP and pCEA as the second line ones. CK19 is the first line antibody for ICC, and CA19-9 as the second. Hep Par 1, CD34 and CK19 are definitely helpful for the routine immunohistochemical stain to differentiate HCC from ICC and MAC.</p>