The experience on trocar layout method for robotic "3+2" mode gastrointestinal surgery / 中华普通外科杂志

Objective:Based on experience of robotic gastrointestinal surgery at the Department of General Surgery, Clinical Medicine Center of Gansu Provincial Hospital, this study explored the principles and methods of trocar layout for robotic "3+2" mode gastrointestinal surgery, suitable for beginners.Methods:From Apr 2017 to Oct 2022, the robotic gastrointestinal surgery team of Gansu Provincial Hospital completed 998 cases of robotic "3+2" mode gastrointestinal surgery, including 600 cases of gastric cancer, 100 cases of rectal cancer, 98 cases of descending colon and sigmoid colon cancer, 20 cases of transverse colon cancer, and 180 cases of right colon cancer. Through the continuous optimization and improvement of the problems encountered during the operation, combined with the operator's experience, and taking into account various aspects, we developed the robotic "3+2" mode trocar layout for gastrointestinal surgery.Results:Four principles of trocar layout were developed, namely, the principle of lens placement around the navel, the principle of symmetry in the main operation, the principle of 8-10cm distance between trocar holes, and the principle of symmetry in the auxiliary hole lens. Three trocar layout methods and principles applicable to robotic gastric surgery, and four applicable to robotic colorectal surgery were developed.Conclusion:The trocar layout method of robotic "3+2" mode gastrointestinal surgery is established based on a large number of robotic gastrointestinal surgery experiences. This method is simple and easy to learn, with strong repeatability and operability.

Research Progress of PD-L1 Expression in Circulating Tumor Cells in Malignant Tumors / 肿瘤防治研究

In recent years, with the in-depth study of PD-1 and PD-L1 and the development of immunotherapy, the first problem is how to screen the beneficiaries. Recent clinical studies have shown that the expression level of PD-L1 in circulating tumor cells (CTC) can be used as a potential biomarker to play a guiding role in immunotherapy of malignant tumors. This article reviews the latest clinical research progress on the expression of PD-L1 in circulating tumor cells in various solid tumors.

The safety and effectiveness of the Da Vinci robot "3+ 2" mode in radical gastrectomy / 中华普通外科杂志

Objective@#To explore the safety, feasibility and advantages of Da Vinci robot "3+ 2" mode in radical gastrectomy.@*Methods@#Clinical data of 30 patients received radical gastrectomy at our department under the "3+ 2" mode of Da Vinci robot from Jan. 2018 to Oct. 2018 were retrospectively analyzed. 30 patients who received classical robot mode in the same period were randomly selected as control group.@*Results@#Compared with the control group, the observation group had a shorter operative time (174±16)min vs.(197±19)min, t=-3.275, P<0.01) , a lower operation costs[(22 794±3 660)yuan vs.(29 307±3 220)yuan, t=-3.316, P<0.01; and inhospital costs (70 910±6 399)yuan vs.(78 180±6 636)yuan), t=-7.316, P<0.01].@*Conclusion@#The "3+ 2" mode of Da Vinci robot in radical gastrectomy is beneficial to enhance the exposure of the surgical field, improve the cooperation of assistants, reduce the costs of surgery, shorten the operative time and the learning curves. In addition, it has similar clinical efficacy to radical gastrectomy under the classical robot mode.

The safety and effectiveness of the Da Vinci robot "3 +2" mode in radical gastrectomy / 中华普通外科杂志

Objective To explore the safety,feasibility and advantages of Da Vinci robot "3 + 2" mode in radical gastrectomy.Methods Clinical data of 30 patients received radical gastrectomy at our department under the "3 + 2" mode of Da Vinci robot from Jan.2018 to Oct.2018 were retrospectively analyzed.30 patients who received classical robot mode in the same period were randomly selected as control group.Results Compared with the control group,the observation group had a shorter operative time (174 ± 16) min vs.(197 ± 19) min,t =-3.275,P ＜ 0.01),a lower operation costs [(22 794 ± 3 660)yuan vs.(29 307 ±3 220)yuan,t =-3.316,P ＜0.01;and inhospital costs (70 910 ±6 399) yuan vs.(78 180 ±6 636)yuan),t =-7.316,P ＜0.01].Conclusion The "3 +2" mode of Da Vinci robot in radical gastrectomy is beneficial to enhance the exposure of the surgical field,improve the cooperation of assistants,reduce the costs of surgery,shorten the operative time and the learning curves.In addition,it has similar clinical efficacy to radical gastrectomy under the classical robot mode.

The effect of interleukin-1 receptor antagonist on metastasis through inhibiting HGF secretion in human colon cancer cell lines / 中华普通外科杂志

Objective The aim of this study was to investigate the co-operative role of HGF and IL-1ra in metastatic processes by interactions between colon cancer cells and stromal cells in their microenvironment.Methods Expression of IL-1α,HGF and c-Met mRNA and proteins were determined by RT-PCR and Western blot.The effect of HGF on metastatic potential was evaluated by proliferation,invasion,and angiogenesis assays using an in vitro system consisting of co-cultured tumor cells and stromal cells.Results IL-1α expression was closely correlated with metastatic potential,and cancer cell-derived IL-1α significantly promoted HGF expression by fibroblasts (P ＜ 0.01).HGF enhanced the migration and proliferation of human umbilical vein endothelial cells (HUVECs),and angiogenesis (P ＜ 0.01).The high liver-metastatic colon cancer cell line (HT-29),which secretes IL-1 α,significantly enhanced angiogenesis compared to the low liver-metastatic cell line (CaCo-2),which does not produce IL-1 α (P ＜ 0.01).IL-1 ra significantly inhibit migration,proliferation and angiogenesis (P ＜ 0.01).Conclusions Autocrine IL-1α and paracrine HGF enhance the metastatic potential of colon cancer cells;IL-1ra inhibit the metastatic potential of colon cancer cells by blocking IL-1α and HGF signaling pathways.