ABSTRACT
Objective:To investigate the effect of CIRc_0000267 on proliferation, migration, invasion and apoptosis of gastric cancer cells in vitro.Methods:Gastric cancer cell lines with circ_0000267 knockdown and miR-661 overexpression were constructed in vitro, and the expressions of circ_0000267, miR-661 and NGAL mRNA in gastric cancer tissues and cells were detected by qRT-PCR. Cell proliferation, migration, invasion and apoptosis were detected by clonogenesis, Transwell chamber and flow cytometry, and related protein expression was detected by Western blot. Online prediction combined with double luciferase assay and RNA pull down assay was used to verify the targeting relationship between circ_0000267, miR-661 and NGAL. Tumogenesis assay in nude mice was used to observe the effect of circ_0000267 knockout on the growth of gastric cancer cells in vivo. Results:Circ_0000267 was highly expressed in gastric cancer tissues and cells. Knockdown circ_0000267 inhibited the proliferation, migration and invasion of gastric cancer cells and promote apoptosis. Circ_0000267 targeted miR-661, and inhibition of miR-661 partially reversed the effect of circ_0000267 on gastric cancer cells. NGAL was the target gene of miR-661, and overexpression of miR-661 regulated the proliferation, migration, invasion and apoptosis of gastric cancer cells by inhibiting NGAL. Knockdown circ_0000267 targeting miR-661 inhibited NGAL expression in gastric cancer cells; Knockdown circ_0000267 inhibited the growth of gastric cancer cells in vivo.Conclusions:Circ_0000267 may regulate the proliferation, migration, invasion and apoptosis of gastric cancer cells and inhibit the growth of tumors in vivo by regulating the expression of miR-661/NGAL.
ABSTRACT
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.
ABSTRACT
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.
ABSTRACT
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.
ABSTRACT
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.
ABSTRACT
Objective To investigate the clinical value of laparoscopic resection techniques in patients with gastric stump cancer.Methods From Oct 2012 to Oct 2015,the clinical data of 30 patients who had undergone laparoscopic resection for gastric stump cancer in the Department of Gastrointestinal Surgery of He'nan Province People's Hospital were analyzed retrospectively.Results Among the 30 patients,22 cases underwent laparoscopic radical gastrectomy,five cases did palliative gastrectomy and three cases were converted to open palliative resection.The average operation time of laparoscopic surgery was (200 ±55) min,average intraoperative blood loss was (110 ± 80) ml,average number of harvested lymph node was(19 ±7).The average time of first flatus was (3.0 ± 1.0) d.The average first time of semi liquid diet intake was (5.3 ±1.6) d.The average hospital stay was (8.0 ±2.8) d (7-15 d),and the cost of hospitalization was (5.9 ± 1.3) × 104 RMB.Postoperative complications occurred in 2 patients (7％),one with ascites and infection,one with pulmonary infection,all were cured.28 patients (93％) were followed up for a median time of 18 months (2-36 months).During the follow-up period,2 patients died of liver metastasis and 6 patients died of peritoneal metastasis.Conclusions Laparoscopic gastrectomy for gastric stump cancer is safe and feasible with satisfactory short-term outcome.
ABSTRACT
Objective To investigate the clinical efficacy of three-dimensional (3D) laparoscopic resection for gastric stump cancer.Methods The retrospective cross-sectional study was conducted.The clinicopathological data of 20 patients who underwent 3D laparoscopic resection for gastric stump cancer in the Henan Provincial People's Hospital between January 2015 and January 2018 were collected.All patients were diagnosed as malignant tumors through gastroscopy and pathological examination before operation,and underwent 3D laparoscopic resection for gastric stump cancer and lymph node dissection according to Japanese Classification of Gastric Carcinoma (ver.14).Observation indicators:(1) intra-and post-operative recovery situations;(2) follow-up and survival situations.Follow-up using outpatient examination and telephone interview was performed to detect postoperative survival and tumor recurrence up to March 2018.Measurement data with normal distribution were represented as (-x)±s.Measurement data with skewed distribution were described as M (range).Results (1) Intra-and post-operative recovery situations:of 20 patients with gastric stump cancer,14 underwent 3D laparoscopic radical resection for gastric stump cancer (R0 resection and negative resection margin),4 underwent 3D laparoscopic palliative resection for gastric stump cancer and 2 were converted to open palliative resection for gastric stump cancer.Operation time,volume of intraoperative blood loss,number of lymph node dissected,time for postoperative out-of-bed activity,time to initial anal exsufflation,time for postoperative semi-fluid diet intake,duration of hospital stay and treatment expenses in 18 patients were (195±60) minutes,(105±85) mL,20±8,(1.6±0.8) days,(3.0±1.0) days,(5.5±1.8)days,(8.0±2.8) days and (5.5± 1.5) ×104 yuan,respectively.There was no surgery-related complication.(2) Follow-up and survival situations:of 20 patients,18 were followed up for 2-36 months,with a median time of 18 months.During the follow-up,6 patients died,including 2 dying of liver metastases and 4 dying of peritoneal metastases,12 had good conditions.Conclusion 3D laparoscopic resection for gastric stump cancer is safe and effective.
ABSTRACT
Objective To explore the clinical effect of three-dimensional (3D) laparoscopic radical gastrectomy of gastric cancer.Methods The retrospective cross-sectional study was conducted.The clinical data of 65 patients with gastric cancer who underwent 3D laparoscopic radical gastrectomy of gastric cancer in the People's Hospital of Zhengzhou University from January 2015 to July 2016 were collected.There were the same surgical procedure and postoperative treatment between 3D and two-dimensional (2D) laparoscopic radical gastrectomy of gastric cancer.Observation indicators:(1) surgical situations:operation time,volume of intraoperative blood loss,number of lymph node dissected;(2) postoperative recovery situations:time to anal exsufflation,time for semiliquid diet intake,duration of hospital stay,treatment expenses and postoperative complications;(3) postoperative pathological situations:pathological classification of gastric cancer,T stage,lymph node metastasis,TNM stage,surgical margin;(4) follow-up situations.The follow-up using outpatient examination and telephone interview was performed to detect patients' survival and tumor metastasis and recurrence up to July 2016.Measurement data with normal distribution were represented as x±s.Measurement data with skewed distribution were described as M (range).Results (1) Surgical situations:all the 65 patients underwent successful 3D laparoscopic radical gastrectomy of gastric cancer and D2 lymph node dissection,without the occurrence of conversion to open surgery,intraoperative complications and perioperative death.Operation time,volume of intraoperative blood loss and number of lymph node dissected were (200± 55) minutes,(110± 80) mL and 32±7,respectively.(2) Postoperative recovery situations:time to anal exsufflation,time for semiliquid diet intake,duration of hospital stay and treatment expenses were (3.1 ± 1.0) days,(5.3 ± 1.6) days,(9.4± 3.0) days and (8.1 ± 1.3) × 104 yuan,respectively.Of 65 patients,5 had postoperative complications.One patient with anastomotic leakage underwent percutaneous endoscopic gastrostomy and abdominal drainage again and then was cured.One patient with peritoneal effusion and infection was cured after catheter drainage under CT guided.One patient with delayed gastric emptying was cured after symptomatic treatment.One patient with chylous fistula was cured after short-term fast and total parenteral nutrition treatment.One patient with pulmonary infection was cured after antibiotic therapy.(3) Postoperative pathological situations:① Pathological classification of gastric cancer:high-and moderate-differentiated adenocarcinoma was detected in 30 patients,poor-differentiated adenocarcinoma in 20 patients,signet ring cell carcinoma in 11 patients,mucinous adenocarcinoma in 3 patients and papillary adenocarcinoma in 1 patient.② T stage:27,15 and 23 patients were in T1,T2 and T3 stages.③ Twenty-five patients had lymph node metastases and 40 had no lymph node metastasis.④ TNM stage:19,17,15,12 and 2 patients were in Ⅰ A,Ⅰ B,Ⅱ,Ⅲ A and Ⅲ B,respectively.R0 resection was performed to all the 65 patients,with negative surgical margin under the microscope.(4) Follow-up situations:of 65 patients,61 were followed up for 3-18 months,with a median time of 9 months.During the follow-up,there was no occurrence of surgeryrelated complications,tumor metastasis and recurrence and death.Conclusion The 3D laparoscopic radical gastrectomy of gastric cancer is safe and feasible,with a good short-term outcome.
ABSTRACT
Objective To explore the clinical effect of three-dimensional (3D) and two-dimensional (2D) laparoscopic radical resection of colorectal cancer.Methods The retrospective cohort study was adopted.The clinical data of 83 patients who underwent laparoscopic radical resection of colorectal cancer at the People's Hospital of Zhengzhou University from March 2014 to November 2015 were collected.Forty-two patients undergoing 2D laparoscopic radical resection of colorectal cancer between March 2014 and December 2014 were allocated into the 2D group and 41 patients undergoing 3D laparoscopic radical resection of colorectal cancer between January 2015 and November 2015 were allocated into the 3D group.All the patients in the 2 groups underwent 2D or 3D laparoscopic radical resection of colorectal cancer based on the principles of lymph node dissection and tumor-free survival.Observation indicators included:(1) surgical situations:operation time,volume of intraoperative blood loss,number of lymph node dissected,(2) postoperative recovery:recovery time of gastrointestinal function,postoperative complications,duration of postoperative hospital stay,hospital expenses,(3) postoperative pathological situations:length of colorectal specimens,distance from tumor to distal incision margin,(4) follow-up.All the patients were followed up to detect postoperative survival,tumor metastasis and recurrence using outpatient examination and telephone interview up to March 2016.Measurement data with normal distribution were presented as x-± s and comparison between groups was analyzed using the t test.Count data were analyzed using chi-square test or Fisher exact probability.Results (1) Surgical situations:all the patients underwent successful laparoscopic radical resection of colorectal cancer,without conversion to open surgery and perioperative death.Operation time,volume of intraoperative blood loss and number of lymph node dissected were (171 ±18) minutes,(112±18)mL,14.0 ± 1.4 in the 2D group and (125 ± 13) minutes,(101 ± 16)mL,14.6 ± 0.9 in the 3D group,respectively,with statistically significant differences between the 2 groups (t =-13.091,-2.962,-3.623,P ＜0.05).(2) Postoperative recovery:recovery time of gastrointestinal function was (3.0 ± 0.6) days in the 2D group and (3.0 ± 0.6) days in the 3D group,respectively,with no statistically significant difference between the 2 groups (t =3.423,P ＞ 0.05).Incidence of postoperative complications in the 2D and 3D groups was 7.1％ (3/42) and 4.9％ (2/41),respectively,with no statistically significant difference between the 2 groups (P ＞0.05).One,1,1 patients in the 2D group were respectively complicated with anastomotic fistula,intra-abdominal hemorrhage and intra-abdominal infection,1 and 1 patients in the 3D group were respectively complicated with anastomotic fistula and intestinal paralysis,and they were improved by symptomatic treatment.Duration of postoperative hospital stay and hospital expenses was (10.0 ±0.8)days,(7.0 ± 1.4) × 104 yuan in the 2D group and (10.0 ±0.6)days,(7.3 ± 1.5) x 104 yuan in the 3D group,respectively,with no statistically significant difference between the 2 groups (t =15.716,0.941,P ＞ 0.05).(3)Postoperative pathological situations:length of colorectal specimens and distance from tumor to distal incision margin were (18 ± 7) cm,(4.7 ± 0.6) cm in the 2D group and (20 ± 8) cm,(4.9 ± 0.7)cm in the 3D group,respectively,with no statistically significant difference between the 2 groups (t =0.742,1.401,P ＞0.05).(4)Follow-up:of 83 patients,82 were followed up for 5-24 months with a median time of 12 months.During the follow-up,there was no occurrence of tumor-related death and recurrence and metastasis of sites of puncture.Intra-abdominal tumor recurrence,recurrence of anastomotic tumor and tumor distant metastasis were detected in 3,2,1 patients in the 2D group and 2,1,1 patients in the 3D group,with no statistically significant difference between the 2 groups (P ＞ 0.05).Conclusion Compared with 2D laparoscopic radical resection of colorectal cancer,3D laparoscopic radical resection of colorectal cancer is safe and feasible,and it can also reduce intraoperative blood loss and increase the rate of lymph node dissected,with a good short-term outcome.