ABSTRACT
Objective To explore the safety and feasibility of vagus nerve-preserving Da Vinci robotassisted radical gastrectomy for gastric cancer.Methods The retrospective cross-sectional study was conducted.The clinicopathological data of 12 gastric cancer patients who underwent vagus nerve-preserving Da Vinci robotassisted radical gastrectomy at the Southwest Hospital of the Third Military Medical University from January 2015 to November 2016 were collected.All patients underwent vagus nerve-preserving Da Vinci robot-assisted radical gastrectomy for gastric cancer.During operation,lymph node dissection of the pyloric region,the right side of the cardia and the superior margin of the pancreas were noticed,and other surgical procedures were the same as the traditional Da Vinci robot-assisted radical gastrectomy.Observation indicators:(1) intra-and post-operative situations:surgical methods,digestive tract reconstruction,operation time,volume of intraoperative blood loss,number of lymph node dissected,results of postoperative pathological examination,recovery time of gastrointestinal function,time for liquid diet intake,duration of postoperative hospital stay,short-term surgery-related complications (postoperative bleeding,anastomotic fistula,obstruction and intra-abdominal infection);(2)follow-up situations:postoperative long-term complications (gastric retention,alkaline reflux gastritis,dumping syndrome,gallbladder disease and cholelithiasis),postoperative quality of life (diet,upper abdominal discomfort,nausea,vomiting and diarrhea),postoperative nutritional status [body weight,hemoglobin (Hb),total protein (TP),albumin (Alb)] and tumor recurrence.Follow-up using telephone interview and outpatient examination was performed up to December 2016.Telephone interview included detecting diet of patients,digestive tract symptoms and body weight.Routine blood test,liver and kidney functions,tumor markers,chest X-ray,abdominal computed tomography (CT) or color Doppler ultrasound and gastroscopy of outpatient examinations were performed to detect tumor recurrence and metastasis.Measurement data with normal distribution were represented as x±s and measurement data with skewed distribution were described as M (range).Results (1) Intra-and post-operative situations:all the 12 patients underwent successful vagus nerve-preserving Da Vinci robot-assisted radical gastrectomy for gastric cancer,without conversion to laparoscopic surgery or open surgery,including 2 patients with D1 lymphadenectomy,2 patients with extended D1 lymphadenectomy and 8 patients with D2 lymphadenectomy.Five and 7 patients underwent respectively Billroth Ⅰ anastomosis and Billroth Ⅱ anastomosis of digestive tract reconstruction.Operation time,volume of intraoperative blood loss and number of lymph node dissected of 12 patients were (247± 34) minutes,(94 ± 23) mL and 27 ± 7,respectively.Results of postoperative pathological examination showed that distal and proximal surgical margins of 12 patients were negative and achieved R0 resection;326 lymph nodes were dissected,6 patients didn't have lymph node metastasis and 18 positive lymph nodes were detected in 6 patients.Recovery time of gastrointestinal function,time for liquid diet intake and duration of postoperative hospital stay in 12 patients were (57±14)hours,(64± 14)hours and (7.3±0.9)days,respectively.There was no occurrence of short-term surgery-related complications.(2) Follow-up situations:12 patients were followed up by telephone interview (10 receiving outpatient exaninations) for 9 months (range,1-20 months).Of 12 patients with long-term complications,2 had loss of appetite,1 had diarrhea,without occurrence of cholelithiasis,cholecystitis,gastric retention and dumping syndrome.Of 10 patients receiving outpatient examinations,body weight,Hb,TP and Alb were (56± 12) kg,(126± 10) g/L,(69.9±5.1) g/L,(43.2±3.3)g/L at 1 month postoperatively and (52±13)kg,(126±10)g/L,(72.1±2.4)g/L,(45.2±1.6)g/L at 3 months postoperatively,respectively,with negative carcinoembryonic antigen.There was no tumor recurrence and metastasis in 12 patients.Conclusion Vagus nerve-preserving Da Vinci robot-assisted radical gastrectomy is safe and feasible for gastric cancer,which has not affected the lymph node dissection and incidence of surgeryrelated complications,and it also can improve the postoperative quality of life and maintain good nutritional status.
ABSTRACT
Objective To investigate the safety and feasibility of totally Da Vinci robotic surgical system in the radical gastrectomy of gastric cancer.Methods The retrospective cross-sectional study was conducted.The clinical data of 30 patients who underwent radical gastrectomy of gastric cancer via totally Da Vinci robotic surgical system in the Southwest Hospital of Army Medical University between June 2016 and August 2017 were collected.Surgical methods were selected according to Expert consensus on enhanced recovery after gastrectomy for gastric cancer (2016 edition).Observation indicators:(1) surgical and postoperative situations;(2) follow-up.Followup using outpatient examination and telephone interview was performed to detect the patients' postoperative survival and tumor recurrence and metastases up to September 2017.Measurement data with normal distribution were represented as (x)±s and measurement data with skewed distribution were represented as median (range).Results (1) Surgical and postoperative situations:30 patients underwent radical gastrectomy of gastric cancer using totally Da Vinci robotic surgical system,without conversion to laparoscopic or open surgery.Of 30 patients,21 underwent distal subtotal gastrectomy including 1 with Billroth Ⅰ anastomosis and 20 with Billroth Ⅱ anastomosis,9 underwent total gastrectomy with Roux-en-Y anastomosis.Of 30 patients,1 underwent D1 radical gastrectomy,24 underwent D2 radical gastrectomy and 5 underwent D2+ radical gastrectomy.The number of lymph node detected,length of abdominal incision,operation time and time of digestive tract reconstruction were 34±12,(4.1 ±0.5)cm,(269±52) minutes and (49±9) minutes in 30 patients,including 31 ±21,(4.0±0.9) cm,(253±61) minutes,35 minutes (1 with Billroth Ⅰ anastomosis) and (38 ± 10) minutes (20 with Billroth Ⅱ anastomosis) in 21patients undergoing distal subtotal gastrectomy and 46± 12,(4.0±0.5) cm,(325±30) minutes,(64± 12) minutes in 9 patients undergoing total gastrectomy.The volume of intraoperative blood loss,postoperative pain score,time for out-of-bed activity,time of gastrointestinal function recovery,time for fluid food intake and time of drainage tube removal were (78±43) mL,2.5±0.5,(33±8) hours,(59± 13) hours,(66± 32) hours and (64±21) hours,respectively.Of 30 patients,2 with postoperative complications were cured by conservative treatment,including 1 of left lower lobe infection and 1 of abdominal abscess.Duration of postoperative hospital stay was (7± 5)days.(2) Follow-up:30 patients were followed up for 1.0-15.0 months,with a median time of 7.5 momths.During follow-up,2 patients died of tumor recurrence at postoperative half year and 1 year,1 patient still survived with tumor recurrence and other 27 patients had tumor-free survival.Conclusion The totally Da Vinci robotic surgical system is safe and feasible in the radical gastrectomy of gastric cancer,with good short-term outcomes.
ABSTRACT
Objective To investigate the safety and feasibility of totally Da Vinci robotic surgical system in the radical gastrectomy of gastric cancer.Methods The retrospective cross-sectional study was conducted.The clinical data of 30 patients who underwent radical gastrectomy of gastric cancer via totally Da Vinci robotic surgical system in the Southwest Hospital of Army Medical University between June 2016 and August 2017 were collected.Surgical methods were selected according to Expert consensus on enhanced recovery after gastrectomy for gastric cancer (2016 edition).Observation indicators:(1) surgical and postoperative situations;(2) follow-up.Followup using outpatient examination and telephone interview was performed to detect the patients' postoperative survival and tumor recurrence and metastases up to September 2017.Measurement data with normal distribution were represented as (x)±s and measurement data with skewed distribution were represented as median (range).Results (1) Surgical and postoperative situations:30 patients underwent radical gastrectomy of gastric cancer using totally Da Vinci robotic surgical system,without conversion to laparoscopic or open surgery.Of 30 patients,21 underwent distal subtotal gastrectomy including 1 with Billroth Ⅰ anastomosis and 20 with Billroth Ⅱ anastomosis,9 underwent total gastrectomy with Roux-en-Y anastomosis.Of 30 patients,1 underwent D1 radical gastrectomy,24 underwent D2 radical gastrectomy and 5 underwent D2+ radical gastrectomy.The number of lymph node detected,length of abdominal incision,operation time and time of digestive tract reconstruction were 34±12,(4.1 ±0.5)cm,(269±52) minutes and (49±9) minutes in 30 patients,including 31 ±21,(4.0±0.9) cm,(253±61) minutes,35 minutes (1 with Billroth Ⅰ anastomosis) and (38 ± 10) minutes (20 with Billroth Ⅱ anastomosis) in 21patients undergoing distal subtotal gastrectomy and 46± 12,(4.0±0.5) cm,(325±30) minutes,(64± 12) minutes in 9 patients undergoing total gastrectomy.The volume of intraoperative blood loss,postoperative pain score,time for out-of-bed activity,time of gastrointestinal function recovery,time for fluid food intake and time of drainage tube removal were (78±43) mL,2.5±0.5,(33±8) hours,(59± 13) hours,(66± 32) hours and (64±21) hours,respectively.Of 30 patients,2 with postoperative complications were cured by conservative treatment,including 1 of left lower lobe infection and 1 of abdominal abscess.Duration of postoperative hospital stay was (7± 5)days.(2) Follow-up:30 patients were followed up for 1.0-15.0 months,with a median time of 7.5 momths.During follow-up,2 patients died of tumor recurrence at postoperative half year and 1 year,1 patient still survived with tumor recurrence and other 27 patients had tumor-free survival.Conclusion The totally Da Vinci robotic surgical system is safe and feasible in the radical gastrectomy of gastric cancer,with good short-term outcomes.
ABSTRACT
Objective To investigate the effect of interleukin-17 (IL-17) in the gastric cancer cell migration and invasion via regulating epithelial-mesenchymal transition (EMT) and its potential function.Methods (1) Human gastric cancer cell MGC-803 lines in the logarithmic growth phase were stimulated by 0, 1 ng/mL, 10 ng/mL,100 ng/mL and 1μg/mL of IL-17 for 48 hours, and the phenotypic changes were observed.The concentration of IL-17 was selected for follow-on experiments based on the most obvious phenotypic changes.Gastric cancer cell MGC-803 which were stimulated by 100 ng/mL of IL-17 and PBS for 48 hours were allocated into the experimental group and control group, respectively.(2) The expressions of E-cadherin and Vimentin mRNA in gastric cancer cells were assayed through real-time PCR (RT-PCR).(3) The relative expressions of E-cadherin and Vimentin proteins in gastric cancer cells were assayed by the Western blot.(4) The scratch test and Transwell detection were also utilized to study the migration and invasion of gastric cancer cell MGC-803 in vitro.Measurement data with normal distribution were presented as-x ± s and comparison between groups was analyzed using the t test.Results (1) There were significant phenotypic changes in the gastric cancer cell after the different concentration of IL-17 stimulated gastric cancer cell MGC-803 for 48 hours.Cells were changed from polygonal and tight junction to spindle and loosely junction with a deterioration of cell adhesion.Cell phenotypes were gradually changed as the concentration of IL-17 was changed from 0 to 100 ng/mL.Phenotypic changes were the most obvious when 100 ng/mL of IL-17 was used, but these were non-significant as the concentration of IL-17 increased to 1 μg/mL with the death and floating of some cells.(2) The relative expressions of E-cadherin mRNA and Vimentin mRNA in RT-PCR were 0.45 ±0.13 and 1.06 ±0.23 in the experimental group and 2.39 ±0.55 and 1.23±0.41 in the control group, respectively, with significant differences (t =3.811, 2.923, P ＜0.05).(3) The results of Western blot showed the relative expressions of E-cadherin and Vimentin proteins were 0.86 ± 0.17 and 1.56 ± 0.29 in the experimental group and 1.01 ± 0.12 and 0.56 ± 0.17 in the control group, respectively, with significant differences (t =3.551, 3.601, P ＜ 0.05).(4) Cell migration in the 2 groups were detected by the scratch test at 36 hours after scratch test, and the width of scratch in the experimental and control groups were (0.76 ± 0.13) mm and (0.40 ± 0.15) mm, showing a significant difference (t =3.095, P ＜ 0.05).Transwell detection showed number of transmembrane cell in the experimental and control groups were 159 ±28 and 94 ± 18, respectively, with a significant difference (t =3.307, P ＜ 0.05).Conclusion IL-17 can promote the migration and invasion of gastric cancer cells via stimulating alteration of EMT.
ABSTRACT
@#Objective To explore the effects of strength training on aging muscular atrophy and inflammatory factors levels in old men.Methods 11 old men participated in 12 weeks of strength training. Muscle strength/muscle thickness and serum levels of tumor necrosis factor (TNF)-α, interleukin (IL)-6, high sensitivity C-reactive protein (hsCRP) and adiponectin were measured before and after training. Results After training, the muscle thickness increased, but there was no significantly difference (P>0.05); the levels of hsCRP decreased (P<0.001) and adiponectin increased (P<0.05). Conclusion Strength training may assist in maintaining or improving muscle strength/muscle mass and reducing inflammatory factors levels.
