A comparison of perioperative outcomes between extraperitoneal robotic single-port and multiport radical prostatectomy with the da Vinci Si Surgical System / 亚洲男科学杂志(英文版)

To evaluate outcomes between extraperitoneal robotic single-port radical prostatectomy (epR-spRP) and extraperitoneal robotic multiport radical prostatectomy (epR-mpRP) performed with the da Vinci Si Surgical System, comparison was performed between 30 single-port (SP group) and 26 multiport (MP group) cases. Comparisons included operative time, estimated blood loss (EBL), hospital stay, peritoneal violation, pain scores, scar satisfaction, continence, and erectile function. The median operation time and EBL were not different between the two groups. In the SP group, the median operation time of the first 10 patients was obviously longer than that of the latter 20 patients (P < 0.001). The median postoperative hospital stay in the SP group was shorter than that in the MP group (P < 0.001). The rate of peritoneal damage in the SP group was less than that in the MP group (P = 0.017). The pain score and overall need for pain medications in the SP group were lower than those in the MP group (P < 0.001 and P = 0.015, respectively). Patients in the SP group were more satisfied with their scars than those in the MP group 3 months postoperatively (P = 0.007). At 3 months, the cancer control, recovery of erectile function, and urinary continence rates were similar between the two groups. It is safe and feasible to perform epR-spRP using the da Vinci Si surgical system. Therefore, epR-spRP can be a treatment option for localized prostate cancer. Although epR-spRP still has a learning curve, it has advantages for postoperative pain and self-assessed cosmesis. In the absence of the single-port robotic surgery platform, we can still provide minimally invasive surgery for patients.

Value of serum AFP-L3 in predicting recurrence of hepatocellular carcinoma after hepatectomy / 第二军医大学学报

Objective To identify the changes of serum alpha-fetoprotein (AFP) and AFP-L3 levels after surgical resection of hepatocellular carcinoma (HCC), so as to evaluate the role of AFP-L3 in predicting post-operative HCC recurrence. Methods A total of 67 HCC patients who received surgical resection from Jan. 2007 to Dec. 2007 were enrolled in the present study. The detailed clinical data were obtained for each patient. Pre- and post-operative serum AFP and AFP-L3 levels were measured continuously, and patterns of their post-operative changes were followed up for a long-term period. Results The overall 1-, 2- and 3-year recurrence rates of the patients were 23. 9% (16/67), 38. 8% (26/67) and 50. 7% (34/67), respectively. There was no relationship between serum AFP and AFP-L3 level before operation Os = 0. 176, P = 0. 155). The pre-operation serum AFP-L3 level was significantly correlated with tumor recurrence (rs = 0. 327, P = 0. 007), but the relation between pre-operation serum AFP level and tumor recurrence was not clear yet(rs = 0. 240, P = 0. 051). Conclusion Serum AFP-L3 level is associated with HCC recurrence and therefore valuable for predicting HCC recurrence; it can provide clinicians with more information for judging the therapeutic efficacy of HCC patients.