Short-term efficacy of da Vinci robotic surgical system on rectal cancer in 101 patients / 中华胃肠外科杂志

<p><b>OBJECTIVE</b>To investigate the feasibility and safety of da Vinci robotic surgical system in rectal cancer radical operation, and to summarize its short-term efficacy and clinical experience.</p><p><b>METHODS</b>Data of 101 cases undergoing da Vinci robotic surgical system for rectal cancer radical operation from March 2010 to September 2012 were retrospectively analyzed. Evaluation was focused on operative procedure, complication, recovery and pathology.</p><p><b>RESULTS</b>All the 101 cases underwent operation successfully and safely without conversion to open procedure. Rectal cancer radical operation with da Vinci robotic surgical system included 73 low anterior resections and 28 abdominoperineal resections. The average operative time was (210.3±47.2) min. The average blood lose was (60.5±28.7) ml without transfusion. Lymphadenectomy harvest was 17.3±5.4. Passage of first flatus was (2.7±0.7) d. Distal margin was (5.3±2.3) cm without residual cancer cells. The complication rate was 6.9%, including anastomotic leakage(n=2), perineum incision infection(n=2), pulmonary infection (n=2), urinary retention (n=1). There was no postoperative death. The mean follow-up time was(12.9±8.0) months. No local recurrence was found except 2 cases with distant metastasis.</p><p><b>CONCLUSION</b>Application of da Vinci robotic surgical system in rectal cancer radical operation is safe and patients recover quickly The short-term efficacy is satisfactory.</p>

Influence of CO2 pneumoperitoneum pressures on the expression of adhesion molecules of gastric cancer cells / 中华胃肠外科杂志

<p><b>OBJECTIVE</b>To study the effect of different CO2 pneumoperitoneum pressures on the expression of adhesion molecules of human gastric cancer cell line MNK-45.</p><p><b>METHODS</b>MKN-45 cells in the experimental groups were exposed to simulated CO2 environment maintained at different pressures (1.2, 1.6, 2.0 kPa) for 4 hours. Control groups were exposed to room air. At the 0, 24, 48, 72, 96 hours after treatment, CD44v6, ICAM-1 and E-cadherin were detected by flow cytometry method.</p><p><b>RESULTS</b>CD44v6 and ICAM-1 expressions showed pattern of firstly elevating, then descending to normal under the pressures of 1.2 kPa and 1.6 kPa. The expressions were different from control group significantly at 24 and 48 hours (P<0.01), while the 72 hours expression showed no difference compared with the controls (P>0.05). E-cadherin expression decreased significantly right after treatment compared to the control (P<0.01), but recovered to the level of control at 48 hours (P>0.05). In the 2.0 kPa group the expression changes of CD44v6, ICAM-1 and E-cadherin were more remarkable. CD44v6 and ICAM-1 expressions were increased significantly compared to control right after treatment (P<0.05). E-cadherin expression was significantly decreased even at 48 hours compared to the controls (P<0.01).</p><p><b>CONCLUSION</b>In vitro CO2 pneumoperitoneum pressures have transient influence on the adhesion molecules expression of gastric cancer cell MKN-45, then those expressions can recover in a short-time.</p>

Robotic-assisted radical gastrectomy using da Vinci robotic system: a report of 41 cases / 中华胃肠外科杂志

<p><b>OBJECTIVE</b>To investigate the feasibility and safety of da Vinci robotic-assisted radical gastrectomy for gastric cancer.</p><p><b>METHODS</b>Forty-one patients with gastric cancer from Southwest Hospital between March 2010 and December 2011 underwent da Vinci robotic-assisted radical gastrectomy including total gastrectomy(n=12) and distal gastrectomy (n=29).</p><p><b>RESULTS</b>Conversion was required in two patients. One was converted to open surgery, and the other to conventional laparoscopic surgery. The remaining thirty-nine patients underwent da Vinci robotic-assisted radical gastrectomy successfully. The mean operative time was (285±61) min for total gastrectomy, and (225±39) min for distal gastrectomy. The mean blood loss was (180±157) ml in total gastrectomy, and (150±127) ml in distal gastrectomy. The mean number of harvested lymph nodes was 34.2±18.5. The mean time for gastrointestinal function recovery was (3.1±1.2) days. The time to ambulation was (2.7±1.5) days. The time to oral liquid intake was (3.7±1.5) days. Two patients had complication including wound infection and pneumonia. After follow up ranging from 1 to 21 months (median 11 months), 4 patients died from peritoneal metastasis, 1 survived with tumor, and the remaining 36 patients survived without disease.</p><p><b>CONCLUSIONS</b>da Vinci robotic-assisted radical gastrectomy is a feasible and safe surgical procedure with clear operation field, precise dissection, minimal trauma and fast recovery.</p>

Effect of JAK2/STAT3/vimentin signaling pathway on proliferation and migration of human colon cancer cells / 中华胃肠外科杂志

<p><b>OBJECTIVE</b>To investigate the regulatory role of JAK2/STAT3/vimentin signaling pathway on the proliferation and migration of human colon cancer cells.</p><p><b>METHODS</b>The human colon cancer cell Lovo was treated with Janus kinase inhibitor AG490. The proliferation of Lovo cells was quantified by MTT assay. The migration of Lovo cells was measured with scratch assay. The intracellular phosphorylation STAT3 (P-STAT3) and vimentin protein was detected by Western blot and immunofluorescence.</p><p><b>RESULTS</b>After AG490 treatment, the proliferative ability of Lovo cells decreased as compared with control group (P<0.05). This suppression was dose-independent and time-independent. At 24 hrs after scratching, scratch width in the AG490 group recovered to 20%, lower than that in the control group (60%, P<0.05). After AG490 treatment, the expression of P-STAT3 and vimentin in Lovo cells decreased significantly (P<0.05).</p><p><b>CONCLUSION</b>JAK2/STAT3/vimentin signaling pathway participates in regulating the proliferation and migration of human colon cancer cells.</p>

Expression of Na+-H+ exchanger 1 in human gastric carcinoma tissue and its clinical significance / 中华胃肠外科杂志

<p><b>OBJECTIVE</b>To determine the expression of Na+/H+ exchanger 1(NHE1) in human gastric carcinoma tissue and to investigate the association between NHE1 expression and clinicopathological characteristics.</p><p><b>METHODS</b>The expressions of NHE1 mRNA and protein were detected in both gastric carcinoma tissue (n=60) and adjacent gastric mucosa tissue (n=30) by reverse transcription polymerase chain reaction (RT-PCR) and Western blot. The association between the expression and the clinicopathological characteristics was analyzed.</p><p><b>RESULTS</b>The relative expression levels of NHE1 mRNA and protein in gastric carcinoma tissue were 0.786+/-0.291 and 1.442+/-0.175, which were significantly higher than those in adjacent gastric mucosa tissue (0.369+/-0.052 and 0.348+/-0.029) (P<0.01). The expression of NHE1 mRNA was positively correlated with NHE1 protein in the gastric carcinoma tissue (r=0.264, P<0.05). The expressions of NHE1 mRNA and protein were associated with the depth of invasion, lymph node metastasis, and TNM staging (P<0.05). However, no statistical difference was found in age, gender, and tumor differentiation (P>0.05).</p><p><b>CONCLUSION</b>The expression levels of NHE1 mRNA and protein are significantly up-regulated in gastric carcinoma tissue, which may be involved in the development of gastric carcinoma.</p>

Effects of hypoxia-inducible factor-1α on human gastric cancer cell apoptosis under in vitro CO(2) pneumoperitoneum environment / 中华外科杂志

<p><b>OBJECTIVE</b>To study the effect of hypoxia-inducible factor-1α (HIF-1α) on human gastric cancer cells apoptosis in simulated CO2 pneumoperitoneum environment.</p><p><b>METHODS</b>Applied closed box to simulated CO2 pneumoperitoneum environment under the pressure of 0, 5, 10 and 15 mm Hg (1 mm Hg = 0.133 kPa). Compared HIF-1α mRNA and protein expression of MKN-45 cells before and after silencing HIF-1α by RT-PCR and Western blot. Study the changes of bcl-2/bax expression in MKN-45 cells before and after silencing HIF-1α by immunohistochemistry. The apoptosis ratio of MKN-45 was measured by using Annexin V-FITC/PI double labelled staining.</p><p><b>RESULTS</b>In 15 mm Hg group, HIF-1α mRNA and protein expression of MKN-45 cells (1.48 ± 0.22, 1.34 ± 0.09) and HIF-1α protein expression in 10 mm Hg group (1.25 ± 0.10) were significantly higher than those in control group (0.55 ± 0.17, 0.83 ± 0.04) (P < 0.05). But there was no significant differences among 0, 5, 10 mm Hg group and control group in HIF-1α mRNA (P > 0.05); and no obvious difference was found among 0, 5 mm Hg group and the control group in HIF-1α protein expression (P > 0.05). In 15 mm Hg CO2 pressure, bcl-2/bax expression (0.78 ± 0.05) was obviously lower than that in the control group (1.43 ± 0.15) (P < 0.05) and the apoptosis ratio (11.70 ± 0.12) was significantly higher than the control group (0.22 ± 0.07) (P < 0.01) before silencing HIF-1α. But once HIF-1α was silenced, HIF-1α mRNA (0.52 ± 0.11), HIF-1α protein expression (0.92 ± 0.02), bcl-2/bax ratio (1.57 ± 0.04) and apoptosis ratio (0.45 ± 0.11) in MKN-45 were not significantly different between 15 mm Hg group and the control group (P > 0.05).</p><p><b>CONCLUSIONS</b>The apoptosis ratios of MKN-45 under 0, 5, 10 mm Hg CO2 pneumoperitoneum are comparable with that in the control group before the silencing of HIF-1α. The apoptosis ratio of MKN-45 is increased under 15 mm Hg CO2 pneumoperitoneum environment and HIF-1α may be one of the important factor to improve the apoptosis of human gastric cancer cell.</p>

Changes of peritoneal free gastric cancer cells and its significance in patients after laparoscopic radical gastrectomy / 中华外科杂志

<p><b>OBJECTIVE</b>To evaluate the safety and feasibility of laparoscopic radical gastrectomy on gastric cancer through comparison of peritoneal free gastric cancer cells detecting rates between laparoscopic and open radical gastrectomy.</p><p><b>METHODS</b>Sixty-three patients received laparoscopic gastrectomy and 61 patients received open gastrectomy between April 2006 and June 2008 were included in this study. The peritoneal lavage fluid in those patients before and after the operation was collected. The cancer cell cytology and carcinoembryonic antigen (CEA) mRNA were detected with those samples. The relationship between peritoneal free gastric cancer cells and the area of cancer-invaded serosa was also observed.</p><p><b>RESULTS</b>The positive rate of cytology in laparoscopic surgery was 25.4% in the peritoneal fluid after the operation, while it was 29.5% in the open surgery, there was no significant difference between the two groups (P > 0.05). The positive rate of CEA mRNA in the peritoneal fluid after the operation in the laparoscopic group was 41.3%, and was 40.3% in the open group (P > 0.05). The area of cancer-invaded serosa in patients with positive cytology before and after the operation in the laparoscopic group was (16.2 +/- 2.2) cm(2), and it was (17.6 +/- 3.0) cm(2) in their counterparts in the open surgery group, while it was (5.3 +/- 0.8) cm(2) in patients with negative cytology before and after the operation. The area of cancer-invaded serosa was positively correlated with the positive rate of cytology(R(2) = 0.874, P = 0.000).</p><p><b>CONCLUSIONS</b>Laparoscopic radical gastrectomy is not associated with a greater risk for peritoneal dissemination of cancer cells than the open technique.</p>

Effects of different CO2 pressure pneumoperitoneum on the migration and cytoskeleton in gastric cancer cells / 中华胃肠外科杂志

<p><b>OBJECTIVE</b>To investigate the influence of CO(2) and He insufflation administered at different pressures on the migration and cytoskeleton of cultured human gastric cancer cells.</p><p><b>METHODS</b>The cultured gastric cancer cells MKN-45 were exposed to a CO(2) or He environment maintained at different pressures (12, 15 mm Hg). After 0, 2, 4, 6, 8 hours exposure to CO(2) or He environment, pH of the MKN-45 cells culture media was measured with blood gas analysis. The cell migration was detected with Transwell technology. The cell cytoskeleton was observed with laser confocal microscope.</p><p><b>RESULTS</b>The media pH was acid after exposure to CO(2) environment, while it was basic in the He group. The number of cells passing millipore in 12 mm Hg CO(2) or He insufflation pressure were not significantly different with control group (P>0.05), however in 15 mm Hg pressure CO(2) group, it was significantly decreased as compared to control group (P<0.01). The microfilament and microtubule in gastric cancer cell were ambiguous in 15 mm Hg pressure CO(2) group.</p><p><b>CONCLUSIONS</b>There are no obvious effects on the migration and cytoskeleton of MKN-45 cells under 12 mm Hg CO(2) insufflation pressure. The migration and cytoskeleton of MKN-45 cells can be inhibited in 15 mm Hg CO(2) pneumoperitoneum environment.</p>