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Objective:To investigate the clinical efficacy of three-dimensional (3D) laparos-copic radical resection of rectal cancer with left colic artery preservation and natural orfice specimen extraction surgery (NOSES).Methods:The retrospective and descriptive study was conducted. The clinicopathological data of 186 patients with rectal cancer who were admitted to Henan Provincial People's Hospital from December 2018 to December 2019 were colleted. There were 120 males and 66 females, aged from 30 to 81 years, with a median age of 59 years. Patients underwent 3D laparoscopic radical resection of rectal cancer. Observation indicators: (1) surgical and postoperative situations; (2) follow-up. Follow-up using outpatient examination or telephone interview was conducted to detect survival of patients and tumor recurrence up to January 2021. Measurement data with normal distribution were represented as Mean± SD, and measurement data with skewed distribution were represented as M(range). Count data were described as absolute numbers and percentages. Result:(1) Surgical situations: 186 patients with rectal cancer under-went 3D laparoscopic radical resection and postoperative with left colic artery preservation and NOSES. The operation time was (123±24)minutes, volume of intraoperative blood loss was (30±20)mL, the numer of lymph nodes dissected was 15±7. The time to postoperative first flatus, time to semiliquid food intake, time to postoperative out-of-bed activities were (2.3±0.7)days, (4.1±1.4)days, (2.9±1.0)days, respectively. The incidence of postoperative complications was 8.06%(15/186). The duration of postoperative hospital stay of 186 patients was (6.6±1.9)days and the treatment cost was (3.8±1.1) ten thousand yuan. Results of postoperative pathological examination showed 54 cases of low differentiated adenocarcinoma, 97 cases of moderate differentiated adenocarcinoma, 19 cases of high differentiated adenocarcinoma and 16 cases of mucinous adenocarcinoma. (2) Follow-up: 186 patients with rectal cancer were followed up for 13 to 24 months, with a median follow-up time of 13 months. During the follow-up, 18 patients had tumor recurrence or metastasis including 6 patients of death, 168 cases recovered well.Conclusion:3D laparoscopic radical resection of rectal cancer with left colic artery preservation and NOSES is safe and feasible.
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Objective To investigate the application value of parallel and cross-to-overlap anastomosis method (PCOA) in three-dimensional (3D) laparoscopic radical resection of right hemicolon cancer.Methods The retrospective cross-sectional study was conducted.The clinicopathological data of 138 patients who underwent 3D laparoscopic radical resection of right hemicolon cancer at Henan Provincial People's Hospital between July 2016 and July 2019 were collected.There were 83 males and 55 females,aged from 30 to 76 years,with a median age of 64 years.All the 138 patients with right hemicolon tumors were diagnosed as malignant tumors by enteroscopy and pathological examination before operation.The lymph node dissection and radical resection of right hemicolon cancer were performed according to the 9th edition of Japanese General Rules for Cancer of Colon,Rectum and Anus of the Japanese Colorectal Cancer Association.Observation indicators:(1) surgical situations;(2) postoperative conditions;(3) follow-up.Follow-up was conducted by outpatient examination or telephone interview to detect survival of patients and tumor recurrence and metastasis up to September 2019.Measurement data with normal distribution were represented as Mean ± SD.Measurement data with skewed distribution were represented as M (range).Count data were represented as percentages or absolute numbers.Results (1) Surgical situations:all the 138 patients underwent 3D laparoscopic radical resection of right hemicolon cancer using PCOA to reconstruct digestive tracts,without conversion to open surgery.The operation time,time for PCOA,and volume of intraoperative blood loss was (151.0±54.0)minutes,(20.1±2.0)minutes,and (60±21) mL.(2) Postoperative situations:the time to first flatus,time to semi-liquid food intake,length of auxiliary incision,and incidence rate of postoperative complications were (2.5±0.4)days,(4.0± 1.3)days,(3.0±0.2) cm,and 3.62％ (5/138),respectively.Of the 5 patients with postoperative complications,1 patient with intestinal obstruction was cured after conservative treatment including gastrointestinal decompression and nutritional support,1 patient with anastomotic leakage was cured after conservative treatment including gastrointestinal decompression,local patency drainage,infection control and nutritional support,1 patient with ascites and abdominal infection was cured after computed tomography-guided percutaneous catheter drainage,1 patient with incisional infection was cured by controlling infection,strengthening dressing changes,local irrigation and drainage,1 patient with pulmonary infection was cured after anti-infective treatment.The number of lymph nodes dissected after surgery,duration of postoperative hospital stay,and hospital expenses were 19±8,(7.2±4.1) days,and (4.8± 1.4) × 104 yuan.All the 138 patients were confirmed as colonic adenocarcinoma by postoperative pathological examination,including 27 cases of poorly differentiated adenocarcinoma,92 cases of moderately differentiated adenocarcinoma,10 cases of highly differentiated adenocarcinoma,and 9 cases of mucinous adenocarcinoma.(3) Follow-up:133 of 138 patients were followed up for 2-38 months,with a median follow-up time of 18 months.During the follow-up,2 patients died,1 of which was detected multiple liver metastases at postoperative 16 months and died at postoperative 21 months,and the other was detected multiple liver metastases at postoperative 20 months and died at postoperative 24 months.Eight patients had distant metastasis,including 5 cases of liver metastasis,1 case of lung metastasis,and 2 cases of abdominal metastasis.The 10 patients with death and tumor metastasis were confirmed as stage Ⅲ by postoperative pathological examination,and the other 123 patients were generally in good condition.Conclusion PCOA is safe and effective for 3D laparoscopic radical resection of right hemicolon cancer.
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Objective@#To investigate the application value of parallel and cross-to-overlap anastomosis method (PCOA) in three-dimensional (3D) laparoscopic radical resection of right hemicolon cancer.@*Methods@#The retrospective cross-sectional study was conducted. The clinicopathological data of 138 patients who underwent 3D laparoscopic radical resection of right hemicolon cancer at Henan Provincial People′s Hospital between July 2016 and July 2019 were collected. There were 83 males and 55 females, aged from 30 to 76 years, with a median age of 64 years. All the 138 patients with right hemicolon tumors were diagnosed as malignant tumors by enteroscopy and pathological examination before operation. The lymph node dissection and radical resection of right hemicolon cancer were performed according to the 9th edition of Japanese General Rules for Cancer of Colon, Rectum and Anus of the Japanese Colorectal Cancer Association. Observation indicators: (1) surgical situations; (2) postoperative conditions; (3) follow-up. Follow-up was conducted by outpatient examination or telephone interview to detect survival of patients and tumor recurrence and metastasis up to September 2019. Measurement data with normal distribution were represented as Mean±SD. Measurement data with skewed distribution were represented as M (range). Count data were represented as percentages or absolute numbers.@*Results@#(1) Surgical situations: all the 138 patients underwent 3D laparoscopic radical resection of right hemicolon cancer using PCOA to reconstruct digestive tracts, without conversion to open surgery. The operation time, time for PCOA, and volume of intraoperative blood loss was (151.0±54.0)minutes, (20.1±2.0)minutes, and (60±21)mL. (2) Postoperative situations: the time to first flatus, time to semi-liquid food intake, length of auxiliary incision, and incidence rate of postoperative complications were (2.5±0.4)days, (4.0±1.3)days, (3.0±0.2)cm, and 3.62%(5/138), respectively. Of the 5 patients with postoperative complications, 1 patient with intestinal obstruction was cured after conservative treatment including gastrointestinal decompression and nutritional support, 1 patient with anastomotic leakage was cured after conservative treatment including gastrointestinal decompression, local patency drainage, infection control and nutritional support, 1 patient with ascites and abdominal infection was cured after computed tomography-guided percutaneous catheter drainage, 1 patient with incisional infection was cured by controlling infection, strengthening dressing changes, local irrigation and drainage, 1 patient with pulmonary infection was cured after anti-infective treatment.The number of lymph nodes dissected after surgery, duration of postoperative hospital stay, and hospital expenses were 19±8, (7.2±4.1)days, and (4.8±1.4)×104 yuan. All the 138 patients were confirmed as colonic adenocarcinoma by postoperative pathological examination, including 27 cases of poorly differentiated adenocarcinoma, 92 cases of moderately differentiated adenocarcinoma, 10 cases of highly differentiated adenocarcinoma, and 9 cases of mucinous adenocarcinoma. (3) Follow-up: 133 of 138 patients were followed up for 2-38 months, with a median follow-up time of 18 months. During the follow-up, 2 patients died, 1 of which was detected multiple liver metastases at postoperative 16 months and died at postoperative 21 months, and the other was detected multiple liver metastases at postoperative 20 months and died at postoperative 24 months. Eight patients had distant metastasis, including 5 cases of liver metastasis, 1 case of lung metastasis, and 2 cases of abdominal metastasis. The 10 patients with death and tumor metastasis were confirmed as stage Ⅲ by postoperative pathological examination, and the other 123 patients were generally in good condition.@*Conclusion@#PCOA is safe and effective for 3D laparoscopic radical resection of right hemicolon cancer.
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Objective To evaluate PCOA + NOSES with 3D laparoscopy in the left colon cancer radical resection.Methods In this study 64 patients underwent PCOA + NOSES with 3D laparoscopic radical operation of the left colon cancer in He'nan Provincial People's Hospital from June 2016 to June 2019.Result The operation time was(146 ±53)min,time for anastomosis of PCOA was(30.3 ±2.5)min,intraoperative blood loss was (51 ±26)ml,the bowel function recovered in (2.1 ± 1.3)d,the time to semiliquid diet was (4.1 ± 1.4) d,time to being up and about was (1.3 ±0.6) d,the mean postoperative hospital stay was (5.4 ± 1.4) d,the number of lymph nodes dissection was (22 ± 9.5),the inhospital cost was (4.1 ± 1.2) ten thousand yuan.Complications developed in 4 patients (6％),one of intestinal obstruction,one of anastomotic leakage,one patient had ascites and infection,one suffred from pulmonary infection.Conclusion The PCOA + NOSES with 3D laparoscope in the left colon cancer radical resection was safe and feasible.
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The Rad1 gene is evolutionarily conserved from yeast to human. The fission yeast Schizosaccharomyces pombe Rad1 ortholog promotes cell survival against DNA damage and is required for G(2)/M checkpoint activation. In this study, mouse embryonic stem (ES) cells with a targeted deletion of Mrad1, the mouse ortholog of this gene, were created to evaluate its function in mammalian cells. Mrad1 (-/-) ES cells were highly sensitive to ultraviolet-light (UV light), hydroxyurea (HU) and gamma rays, and were defective in G(2)/M as well as S/M checkpoints. These data indicate that Mrad1 is required for repairing DNA lesions induced by UV-light, HU and gamma rays, and for mediating G(2)/M and S/M checkpoint controls. We further demonstrated that Mrad1 plays an important role in homologous recombination repair (HRR) in ES cells, but a minor HRR role in differentiated mouse cells.