Transumbilical single-port laparoscopic cholecystectomy for chronic cholecystitis with cholecystolithiasis / 中华肝胆外科杂志

Objective@#To study the feasibility, safety and aesthetics of laparoscopic cholecystectomy using a single-port through the umbilicus in patients with chronic cholecystitis with cholecystolithiasis.@*Methods@#From Jan 2007 to Jun 2017, the clinical data of 4790 patients who underwent single-port, 4 426 patients conventional three-ports, and 3 304 patients two-ports laparoscopic cholecystectomy were retrospectively studied.@*Results@#There were no death in all the three groups. There were no significant differences in the incidences of postoperative bleeding, bile leakage, biliary tract injury and other significant short-term complications (all P>0.05). The operation time of transumbilical single-port laparoscopic cholecystectomy was significantly longer than that of two-ports and three-ports laparoscopic cholecystectomy [(35.3±9.0)min vs. (28.4±7.2)min vs. (23.3±6.4)min, P<0.05]. Looking only in a single year, there was no significant difference in the operation time of the three groups in the year 2017 (P>0.05). There were no significant differences among the three groups in intraoperative blood loss, first postoperative passing of flatus, postoperative pain, and length of hospital stay (all P>0.05). The satisfaction score of surgical scar in the single-port group was higher than that in the two-ports and three-ports groups [(9.6±1.6) vs. (7.6±1.9) vs. (6.7±2.0), P<0.05].@*Conclusions@#Transumbilical single-port laparoscopic cholecystectomy was safe and feasible, with good aesthetics and other advantages. It was more difficult than the traditional laparoscopic technique. After the learning curve, the operation time could be comparable to the three-ports technique.

Transumbilical single-port laparoscopic cholecystectomy for chronic cholecystitis with cholecystolithi-asis / 中华肝胆外科杂志

Objective To study the feasibility, safety and aesthetics of laparoscopic cholecystectomy using a single-port through the umbilicus in patients with chronic cholecystitis with cholecystolithiasis. Methods From Jan 2007 to Jun 2017, the clinical data of 4790 patients who underwent single-port, 4426 patients conventional three-ports, and 3304 patients two-ports laparoscopic cholecystectomy were retrospec-tively studied. Results There were no death in all the three groups. There were no significant differences in the incidences of postoperative bleeding, bile leakage, biliary tract injury and other significant short-term complications (all P>0. 05). The operation time of transumbilical single-port laparoscopic cholecystectomy was significantly longer than that of two-ports and three-ports laparoscopic cholecystectomy [(35. 3 ± 9. 0) min vs. (28. 4 ± 7. 2)min vs. (23. 3 ± 6. 4)min, P<0. 05]. Looking only in a single year, there was no significant difference in the operation time of the three groups in the year 2017 (P>0. 05). There were no significant differences among the three groups in intraoperative blood loss, first postoperative passing of flatus, postoperative pain, and length of hospital stay (all P>0. 05). The satisfaction score of surgical scar in the single-port group was higher than that in the two-ports and three-ports groups [ ( 9. 6 ± 1. 6 ) vs. (7. 6 ± 1. 9) vs. (6. 7 ± 2. 0), P < 0. 05]. Conclusions Transumbilical single-port laparoscopic cholecystectomy was safe and feasible, with good aesthetics and other advantages. It was more difficult than the traditional laparoscopic technique. After the learning curve, the operation time could be comparable to the three-ports technique.

Regularity and predictors of weight loss during concurrent chemoradiotherapy for nasopharyngeal carcino- ma patients / 实用医学杂志

Objective To investigate the regularity and predictors of weight loss during concurrent chemo-radiotherapy for nasopharyngeal carcinoma patients. Methods A retrospective study was carried out on 82 patients with nasopharyngeal carcinoma ,with average age of 45 years ,who received concurrent chemoradiotherapy at the Affiliated Cancer Hospital of Guangzhou Medical University. Paired t-test was used to analyze the weight loss pattern during chemoradiotherapy. The Spearman′s rank correlation analysis was used to investigate the correlation between high weight loss(HWL)and the clinical factors. Results The paired t-test showed that the weight of the patients decreased continuously every week during chemoradiotherapy(P 10%). Spearman′s rank correlation analysis showed that HWL was associated with older age,female,higher T and TNM stage,3D-CRT technology,the higher dose of radiotherapy in nasopharynx and in neck lymph node,and decreases of leukopenia and hemoglobin over degree Ⅱ(P<0.05). Conlousions Weight may decrease continuously every week during chemoradiotherapy for nasopharyngeal carcinoma patients. Age,gender,T stage,TNM stage,radio-therapy dose,and leukopenia and hemoglobin decreases may be predictors for weight loss degree during concurrent chemoradiotherapy for nasopharyngeal carcinoma patients.

The role of pretreatment FDG standard uptake value in predicting for clinical outcome in locally advanced nasopharyngeal carcinoma / 中华放射肿瘤学杂志

ObjectiveTo explore the prognostic value of pretreated maximum standardized uptake value (SUVmax) using 18-fluorodeoxyglucose positron emission tomography with computed tomography (18FDG PET/CT) in locally-advanced nasopharyngeal carcinoma (NPC) treated by intensity-modulated radiotherapy (IMRT).MethodsOne hundred and forty previously untreated stage Ⅲ - Ⅳb ( UICC/AJCC 6th) patients with biopsy-proven nasopharyngeal carcinoma were examined.All of the enrolled patients accepted whole body/head-neck 18FDG PET/CT before radical IMRT. 18FDG uptakes were recorded as SUVmax of primary tumor (SUVmax-P) and SUVmax of cervical lymph nodes (SUVmax-N).The relationships between SUVmax and long-term clinical outcomes were analyzed.ResultsThe median SUVmax-P was 10.4,and the median SUVmax-N was 6.2.The SUVmax-P was weakly correlated with T-stage ( R =0.279,P =0.001 ).The SUVmax-N was weakly correlated with N stage ( R =0.334,P =0.000 ).There were no difference of the median SUVmax-P (9.2 vs.10.4,U =560.50,P =0.805 ) and the median SUVmax-N (4.0vs.5.0,U =576.00,P =0.908) between patients with and without local recurrence.The median SUVmax-P of patients with distant metastasis was significantly higher than those without metastasis (11.9 vs.9.8,U =987.50,P =0.014).The SUV of 10.2 was taken as a cut-off for high and low uptake tumors.For patients with SUVmax-P ＞ 10.2,the 5-year distant metastasis-free survival (DMFS) and 5-year overall survival (OS)were significantly higher than those with SUVmax-P ≤ 10.2 (69.1％ vs.95.5％,x2 =15.88,P =0.000;68.4％ vs.94.0％,x2 =15.56,P =0.000,respectively).Multivariate analysis showed that SUVmax-P was the only independent risk factor of 5-year DMFS and OS ( HR =7.87,P =0.001 and HR =5.14,P =0.003). Conclusion SUVmax-P is a useful biomarker predicting long-term clinical outcomes in newly diagnosed locally-advanced NPC patients.