[Ginsenosides affect the system of Toll-like receptors in the brain of rats under conditions of long-term alcohol withdrawal]. / Ginzenozidy vliiaiut na sistemu Toll-podobnykh retseptorov v strukturakh golovnogo mozga krys v usloviiakh otmeny dlitel'noi alkogolizatsii.

Long-term alcohol consumption causes the development of neuroinflammation in various brain structures. One of the mechanisms involved in this process is the increased activity of TLR-signaling intracellular pathways. Studies confirm the ability of ginseng extract or its individual ginsenosides to reduce the increased activity of TLR-signaling pathways. The aim of our study was to study the effect of the amount of ginsenosides obtained from the extract of the Panax japonicus cell line on the state of the TLR-signaling system in the nucleus accumbens and hippocampus of the rat brain in a model of long-term alcohol consumption during alcohol withdrawal. The results of the study showed that ginsenosides were able to make changes in the TLR signaling system, which has been altered by long-term alcohol consumption. A significant effect of ginsenosides on the level of TLR3 and TLR4 mRNA in the nucleus accumbens was found, while in the hippocampus, ginsenosides significantly affected the level of TLR7 mRNA. The effect of ginsenosides on the level of mRNA of transcription factors and cytokines involved in TLR-signaling was evaluated. Thus, results of our study confirm that ginsenosides are able to influence the state of TLR-signaling pathways, but this effect is multidirectional in relation to different brain structures. In the future, it seems interesting to evaluate the role of individual ginsenosides in relation to genes of TLR-signaling, as well as the effect of ginsenosides on other brain structures.

[Diagnostic significance of clinical and laboratory indices in predicting non-alcoholic fatty liver disease during screening studies].

AIM: To study the significance of clinical and laboratory non-invasive indexes along with the insulin resistance index when carrying out diagnostic assessment of non-alcoholic fatty liver disease (NAFLD) during screening examinations. MATERIALS AND METHODS: The study involved 348 employees working at oil-production enterprises. An ultrasound scanning of the liver was carried out to assess the criteria of NAFLD. The following indexes were calculated: fatty liver index (FLI), hepatic steatosis index (HSI), lipid accumulation products (LAP), and homeostasis model assessment of insulin resistance (HOMA1-IR). The prognostic significance of these indexes in relation to the probability of NAFLD diagnosis based on ultrasound data was studied using single-factor and multi-factor logistic regression models followed by ROC-analysis. RESULTS: The FLI, HSI, and HOMA1-IR indexes in single-factor logistic regression models showed a high statistical significance when carrying out diagnostic assessment the NAFLD with good model calibration capability. The percentage of correct binary classification regards the presence/absence of NAFLD amounted to 82.4% for FLI, 79.7% for HSI, and 72.7% for HOMA1-IR (p0.001). According to the ROC-analysis, the area under the curve (AUC) by the NAFLD diagnostic assessment was 0.917 (95% CI 0.8890.945); 0.880 (95% CI 0.8460.915) and 0.849 (95% CI 0.7640.934), respectively. The multi-factor logistic regression model with the inclusion of FLI and HOMA1-IR 72.7% enabled us to achieve the correct binary classification in terms of NAFLD in 84.2% of cases. When it comes to the ROC-analysis, considering the probabilities predicted in the multi-factor logistic model as the test variable and NAFLD in ultrasound examination as the state variable, it was possible to set the value of AUC 0.933 (95% CI 0.8820.985). CONCLUSION: The studied clinical and laboratory indexes (FLI, HSI, HOMA1-IR) have a high diagnostic significance regarding NAFLD diagnosed using ultrasonographic criteria. The application of the proposed two-factor logistics model makes it possible to predict the presence of NAFLD when examining a large number of patients, without involving additional ultrasound diagnostics specialists in order to use medical resources rationally.

[Prognostic significance of arterial stiffness parameters in the identification of very high-risk patients].

Over the past few decades, much attention has been paid to the study of the properties of the vascular wall and its role in predicting cardiovascular events. The testing of new indicators characterizing cardiovascular risk is being actively conducted. The study included 288 men aged 40 to 60 years (mean age 51.6 ± 6.2 years). Among the examined 133 people belonged to the category of very high cardiovascular risk (they suffered myocardial infarction for no more than 5 years before inclusion in the study), and 155 patients did not have a history of cardiovascular complications. Using the Fukuda denshi VS-1500 VaSera sphygmograph, a cardio-ankle vascular index (CAVI) and augmentation index (AI) were obtained. A model of multivariate logistic regression was constructed for the probability of assigning the patient to a group of very high risk, as well as ROC analysis. The study demonstrated the statistically significant role of CAVI in predicting the assignment of patients to a group of very high cardiovascular risk (after myocardial infarction). An increase in the odds ratio of assigning a patient to this group with an increase in CAVI per unit is 1.417. According to the results of ROC analysis, the prognostic role of CAVI (AUC 0.70) is slightly inferior to age (AUC 0.75), but exceeds AI (AUC 0.641). The share of variability in the probability of classifying patients as a very high risk group from the influence of the studied factors is 31%. The overall quality of the predictive model can be rated as good (AUC = 0.77).

Detection of Taxuyunnanin C in Suspension Cell Culture of Taxuscanadensis.

This is the first study to isolate the taxoid taxuyunnanin C (group of 14-hydroxylated taxoids) from the biomass of suspension cell culture of the Canadian yew (Taxus canadensis). According to available data, this is the first report of the presence of nonpolar (polyacylated) forms of 14-hydroxylated taxoids, including taxuyunnanin C, in T. canadensis.

[Analysis of the results of ERAS protocol in real-life clinical practice AFTER radical cystectomy (the first prospective multicenter study in Russia)].

AIM: to carry out a multicenter prospective analysis of the results of the ERAS protocol in patients undergoing radical cystectomy in real-life clinical practice. The aims of the study were to assess the complication and mortality rate after radical cystectomy using the ERAS protocol and to assess how often ERAS protocol was imple- mented. MATERIALS AND METHODS: a multicenter study was carried out in 4 clinics in Russia. A total of 134 patients who underwent radical cystectomy in 2017 were prospectively analyzed. Open and laparoscopic radical cystectomy was performed in 35 (26.1%) and 99 (73.9%) patients, respectively. Bricker procedure prevailed as a method for urine derivation (91.7%). Complication and mortality rate, and each principle of ERAS protocol was analyzed both in the general sample of patients and separately for open and laparoscopic radical cystectomy. RESULTS: length of hospitalization before the radical cystectomy was 1 (1-2) day. The median duration of surgery was 260 (205-300) minutes, median blood loss was 300 (200-400) ml. The median of the patients time in ICU was 1 (0-2) day. A total of 95 (70%) complications were recorded in the 90-day period after the surgery, including Clavien I-II category in 52 (38.8%) cases and Clavien III-IV in 43 (32%) cases. Of these, gastrointestinal tract complications were predominated. Gastroparesis requiring a nasogastric tube was observed in 16 (11.9%) patients. Ileus developed in 43 (32.1%) cases, and 22 patients (16.4 %) were managed conservatively; however, 21 patients (15.7%) undergone to reoperation. A 90-days mortality reached 5.2% and the main causes included multiple organ failure as a complication of peritonitis, acute heart failure after myocardial infarction and massive bleeding. Re-hospitalization rate was 9.7% (n=13). Length of stay was 12 (9-16) days. According to univariate and multivariate analysis, an absence of antibacterial prophylaxis, a history of coronary heart disease and the patients age more than 75 years were predictors of an increased complication rate. A 30-days mortality rate is 5.2%, and re-hospitalization was required in 9.7% (n=13) cases. An average length of stay was 12 (9-16) days. Frequency of implementation of ERAS protocol in each of the participating clinic varied. Open and laparoscopic radical cystectomy have insignificant differences in some intra- and postoperative parameters, but, in general, both approaches are comparable in terms of complications, mortality, and length of stay. CONCLUSION: 1. Despite the use of the ERAS protocol, radical cystectomy has a high frequency of complications (up to 70%); most of them are Clavien I-II. A 30-days mortality rate is 5.2%, and re-hospitalization is required in 9.7% cases. 2. Univariate and multivariate analysis showed that an absence of antibacterial prophylaxis, a coronary heart disease and the patients age more than 75 years are predictors of an increased complication rate. 3. Open and laparoscopic radical cystectomy have insignificant differences in some intra- and postoperative parameters, but, in general, both approaches are comparable in terms of complications, mortality, and length of stay. 4. To obtain more convincing data on the ERAS protocol after radical cystectomy, long-term studies are required.

[Informativity of Indicators of the Arterial Wall Stiffness for Screening Studies].

OBJECTIVE: comparative assessment of informativity of parameters of arterial wall stiffness - the cardio-ankle vascular index (CAVI), the augmentation index (AI) - for solution of problems of screening patients being under threat of realization of complex impact of metabolic syndrome (MS) and elevated vessel wall stiffness, both creators and markers of high risk of severe cardiovascular complications. MATERIALS AND METHODS: We examined mining industry employees (n=206) with cardiac risk factors (arterial hypertension, abdominal obesity, and smoking). Comparative group comprised 75 employees of the same enterprise without above-mentioned risk factors. Studies of arterial wall stiffness included determination of CAVI and AI. The sensitivity, specifcity and accuracy of the screening method were calculated. RESULTS: CAVI and AI parameters had different sensitivity, specifcity and accuracy for identifying patients at risk of cardiovascular complications. AI was 2 times more sensitive than CAVI during examination of patients with only clinical and anamnestic cardiovascular risk markers and patients with clinical-anamnestic and laboratory risk markers. Specifcity of AI was lower than specifcity of CAVI and atained only 34.4% in patients with clinical-anamnestic and laboratory risk factors. At the same time, specifcity of CAVI in these patients reached 86.2%. Accuracy of AI for screening study was 1.4 times higher than that of CAVI in patients with only clinical-anamnestic risk markers, and 1.6 times higher in patients with both clinical-anamnestic and laboratory risk markers. Moreover, after comparing patient groups with individually high and normal CAVI and AI, we found the differences in metabolic laboratory risk factors (glucose, total cholesterol, triglycerides and the Atherogenic Index) only for AI. CONCLUSION: Parameters of arterial stiffness have different informative value for screening of patients with clinical-anamnestic or laboratory risk factors. AI compared with CAVI is 2 times more sensitive and 1.6 times more accurate but has lower specifcity for risk factor screening among patients being under threat of realization of complex impact of MS and elevated vessel wall stiffness.

Analysis of the Role of Carriership of Polymorphic Genotypes of ESR1, eNOS, and APOE4 Genes in the Development of Arterial Hypertension in Men.

We studied the role of the carrier status for polymorphic loci of genes encoding estrogen receptors (ESR1), endothelial NO synthase (eNOS), and apolipoprotein E (APOE4) and products of their expression nitrogen oxide (NO) and apolipoprotein (ApoE) in the development of arterial hypertension in men. Conventionally healthy volunteers and 149 men with clinical manifestations of stage I-II arterial hypertension were examined. In men with arterial hypertension, the frequency of minor allele A of ESR1 gene was higher (27.5 vs. 9.5% in the reference group; χ2=4.43, p=0.04). The level of NO in the peripheral blood was also higher in the main group (χ2=3.93, p=0.047). The increase in NO concentration did not depend on the presence of polymorphic genotypes (GG and GT) of eNOS gene, but the decrease in ApoE level in blood serum was associated with TC genotype of APOE4 gene (p=0.04). Our results suggest that minor allele A of ESR1 gene is associated with the development of arterial hypertension in men. Reduced content of ApoE in blood serum of men with arterial hypertension was associated with APOE4 gene polymorphism. However, increased level of NO did not depend on polymorphic genotypes GG and GT of eNOS gene. These polymorphisms are of specific interest as additional markers of genetic predisposition to the development of arterial hypertension in middle-age men.

Spin Hall-induced auto-oscillations in ultrathin YIG grown on Pt.

We experimentally study nanowire-shaped spin-Hall nano-oscillators based on nanometer-thick epitaxial films of Yttrium Iron Garnet grown on top of a layer of Pt. We show that, although these films are characterized by significantly larger magnetic damping in comparison with the films grown directly on Gadolinium Gallium Garnet, they allow one to achieve spin current-driven auto-oscillations at comparable current densities, which can be an indication of the better transparency of the interface to the spin current. These observations suggest a route for improvement of the flexibility of insulator-based spintronic devices and their compatibility with semiconductor technology.

Occurrence of 14-hydroxylated taxoids in the plant in vitro cell cultures of different yew species (Taxus spp.).

This is the first study to show that the formation of 14ß-hydroxylated derivatives of taxa-4(20),11-diene is a specific feature of in vitro cultured dedifferentiated yew cells that distinguishes them from intact plant cells. This may be due to a lower toxicity of the 14-OH taxoids for proliferating plant cells compared to the 13-OH derivatives.

[Arterial bed stiffness in patients with different cardiovascular risk factors]. / Zhestkost' arterial'nogo rusla u patsientov s razlichnymi faktorami riska razvitiya serdechno-sosudistykh zabolevanii.

AIM: To investigate the specific features of changes in the arterial wall stiffness (AWS) parameters obtained by sphygmomanometry in patients with different risk factors (RFs) for cardiovascular events (CVEs). MATERIALS AND METHODS: A total of 208 mining enterprise workers who had cardiovascular RFs, such as hypertension, abdominal obesity, and smoking, were examined. A comparison group consisted of 75 workers of this enterprise who had no these RFs. AWS was examined using a VaSera VS-1500 (Fukuda Denshi, Japan) to determine CAVI, ABI, UT, %МАР, AI, tb, and tba. RESULTS: The group of patients with a combination of RFs versus the comparison group showed a statistically significant prevalence of virtually all sphygmomanometric indices characterizing AWS, which is suggestive of a less favorable long-term prognosis in this category of patients. CONCLUSION: The patients having abnormal AWS parameters should be included in a group at risk for cardiovascular diseases and CVEs and their existing RFs be further assessed in detail for a preventive purpose. It is appropriate to incorporate volumetric sphygmomanometry in screening examination programs.

[Use of the tactics of multistage surgical treatment on the model of combined radiation-and-mechanic injury].

Use of the tacticts of multistage surgical treatment on the model of combined radiation-and-mechanic injury. The article provides information on the use of the tactics of multistage surgical treatment (MST), which allows increasing survival value in patients with polytrauma. There are no descriptions of possibility of the use of this tactics in case of combined radiation-and-mechanic injuries in available literature. During an experimental research underwent on 25 sheep it was found that in case of MST implementation there is a significant decrease of intraoperative and postoperative lethal outcome in comparison with traditional tactics. In animals, underwent MST, were defined more laudable course of radiation syndrome. Analysis of laboratory peripheral blood indexes allowed making conclusion, that conducting final surgical intervention (3'd stage of MST) during the first 24 hours after abbreviated surgical intervention allows finishing surgical treatment and intensive care before the beginning of acute radiation syndrome and doesn't counter classic recommendations concerning the treatment of combined radiation-and-mechanic injuries.

Formation of metabolic syndrome as a risk factor of circulatory diseases in drivers.

The authors considered systemic approaches to disclosing factors that promote metabolic syndrome formation and associated risk of ciculatory system diseases in drivers. Examination covered drivers with metabolic syndrome and without it. Findings are that metabolic disorders developing in drivers are occupationally conditioned. Length of service can determine cases numbers of cardiovascular disorders, diabetes mellitus manifestations, more frequent combination of hyperglycemia and/or hyper-, dyslipidemia with abdominal obesity. The drivers with length of service over 15 years, aged over 35, demonstrated arterial hypertension in 35% of cases, postinfarction cardiosclerosis in 43% of cases, disorders of cardiac rhythm and conductivity in 55% of cases, and the number increases with length of service and reaches 80% of total examinees number by 55 years of age. Diabetes mellitus was diagnosed in 37% of cases (in 75% of the workers first diagnosed) with over 20 years of service, average age of 50 years.

On occupational fitness examination of workers exposed to occupational hazards after coronary artery bypass grafting.

Myocardium revascularization in coronary heart disease patients is one of the most important treatment modalities. Considerable improvement of somatic state after surgery for IHD is seen in 82-83% of patients in average, whereas only hardly more than a half return to occupational activity without decrease in preoperative level of qualification and performance. In occupational therapy and industrial medicine clinic with FBSI <>, examination covered 68 workers of Perm' area enterprises, derected for occupational fitness study after coronary artery bypass grafting and 100 workers at various terms after myocardium infarction, with verified IHD. Risk factors evaluation demonstrated that after coronary artery bypass grafting 75% of patients are motivated to maintain healthy lifestyle and compliance to treatment over 5 years; positive changes in a year according to functional study were seen in 75% of cases; level of blood pressure in office 127.8±9.4 mm Hg; dyslipidemia, hypercholesterolemia remain in 11.7% of cases. At first stage, criteria of permit-to-work are: decrease in functional class of chronic cardiac failure to 0-II degrees from initial one; absence of exertional stenocardia or exertional stenocardia less than II degree, absence of ventricular arrhythmias of high grade.

[Forecasting a risk of occupationally related diseases in workers engaged into titanium-magnesium production].

Workers of titanium and magnesium production, under occupational exposure to complex of chemical (chlorine, hydrochloride, sulfur dioxide) and physical factors (industrial noise, work hardiness), have arterial hypertension as occupationally related disease, when length of service over 15 years (EF = 71,5%), and nasopharyngitis for length of service over 10 years (EF = 65%). Arterial hypertension risk is mostly associated with increased industrial noise level (F = 1621; R2 0.95; p < 0,001; noise 70,1 dB). Mathematic modelling of nasopharyngitis development probability demonstrated dependence of concentration of chlorine, hydrochloride, sulfur dioxide, chlorine and hydrochloride combination (F = 37-281; R2 = 0,37-0,73; p < 0.001; chlorine 0,63 mg/m3). Complex of parameters (leucocytosis, eosinophilia, increased IgA level), activated cellular immunity (increased CD 16+56+, CD3+CD25+) and absolute phagocytosis characterized nonspecific inflammatory reaction, immunity tension as a response to a complex of chemical factors of titanium and magnesium production. Markers of endoihelial dysfunction and cardiovascular risk (uric acid, VEGF, homocystein, LDLP) and stress marker (cortisol) demonstrate potential effect of occupational factors on vascular wall, metabolic processes and central nervous system, with involvement of

[State of vegetative nervous system in workers engaged into multiple shifts work with night shifts].

Occupational activity with night shifts and length of service over 5 years is characterized by prevalent sympathetic influence on cardiac activity, vagosympathetic interaction index (LF/HF) is considerably higher than in workers with lower length of service and 1.5 times exceeding upper normal value. VLF indicator exceeds physiologic normal value due to increased activity of ergotropic and humoral metabolic mechanisms of cardiac rhythm regulation. Sympathetic regulation activity level (LF parameter) is also reliably higher than in workers with lower length of service (p = 0.024). Parasympathetic regulation activity level (HF parameter) is below normal value - that indicates decreased influence of parasympathetic vegetative system on cardiac activity (depression of defence mechanisms). Comparative analysis of vegetative regulation spectrum at rest, in accordance with length of service, demonstrated the most marked changes in workers with length of service over 5 years: lower total spectral capacity (TP, msz), lower share of high-frequency waves (HF, %), increase of average vagosympathetic interaction index (LF/HF) and higher share of very low waves (VLF, %) in the spectrum structure. Ihe data prove intensified ergotropic, humoral, sympathetic influences on cardiac activity and, as a result, higher risk of dysmetabolic processes and cardiovascular diseases.

[The role of laparoscopic salvage lymphadenectomy in patients after initial extended lymphadenectomy for prostate cancer].

This work presents results of the analysis of safety and efficacy of laparoscopic superextended lymphadenectomy, which was performed in patients with clinical progression (the presence of lesions in the lymph nodes of the pelvis and beyond) after undergoing prostatectomy. A feature of the work is that these patients initially extended lymphadenectomy was performed. Clinical detection of foci was carried out by 11C-PET/ CT. Laparoscopic salvage lymphadenectomy appears to be the safe method of performing surgery. When monitoring patients there was evaluated the effectiveness of the operation - the percentage of patients with marked regression and stabilization of markers (PSA), duration of remission. The analysis of the data attempted to determine the predictors of non-response patients after salvage lymphadenectomy.

[Formation of protodioscin and deltoside isomers in suspension cultures of Nepal yam (Dioscorea deltoidea Wall.) cells].

Changes in the content of the furostanol glycosides protodioscin and deltoside, particularly that of the (25S)-isomers of the glycosides, during suspension cultivation of different lines of Nepal yam (Dioscorea deltoidea Wall.) cells of the strain IFR-DM-0.5 has been investigated. The composition of furostanol glycosides has been characterized, and the dynamics of the accumulation of individual glycosides during lengthy subcultivation of cells maintained in flasks or in a barbotage bioreactor has been analyzed. A positive correlation between the growth and accumulation of substances that belonged to the class of furostanol glycosides has been demonstrated for cultured dioscorea cells, whereas the content of some of the individual glycosides varied considerably between the lines of the strain, cultures maintained under different conditions, and even between cells in different phases of the growth cycle. The increased content of (25R)-forms of the glycosides (protodioscin and deltoside) was correlated with a decrease in the cellular growth rate, whereas an increase in culture growth intensity occurred concomitantly to an increase of the amount of (25S)-isomers. This may be indicative of the specific stimulatory effect of (25S)-glycosides, but not the (25R)-forms, on cell proliferation in vitro. Thus, the concentration of (25S)-forms may increase due to the autoselection of cells capable of intensive division during prolonged cultivation.

PHYSIOLOGICAL, CYTOLOGICAL AND BIOCHEMICAL STABILITY OF Medicago sativa L. CELL CULTURE AFTER 27 YEARS OF CRYOGENIC STORAGE.

BACKGROUND: The efficiency of long-term cryogenic storage to prevent somaclonal variations in plant cell cultures and retain their major cytogenetic and biochemical traits remains under debate. In particular, it is not clear how stress conditions associated with cryopreservation, such as low temperature, dehydration and toxic action of some cryoprotectants (DMSO in particular), affect post-storage regrowth and genetic integrity of cell samples. OBJECTIVE: We assessed growth, cytogenetic and biochemical characteristics of the peroxidase-producing strain of Medicago sativa L. cell culture recovered after 27 years of cryogenic storage as compared to the same culture before cryopreservation. MATERIALS AND METHODS: In 1984, M. sativa L. cell culture was cryopreserved using programmed freezing and 7% DMSO as a cryoprotectant. In 2011, after rewarming in a water bath at 40 degree C for 90 s, cell culture was recovered and proliferated. Viability, growth profile, mitotic index, ploidy level, peroxidase activity and cell response to hypothermia and osmotic stress were compared between the recovered and the initial cell cultures using the records available from 1984. RESULTS: Viability of alfalfa cell culture after rewarming was below 20% but it increased to 80% by the 27th subculture cycle. Recovered culture showed higher mitotic activity and increased number of haploid and diploid cells compared to the initial cell line. Both peroxidase activity and response to abiotic stress in the recovered cell culture were similar to that of the initial culture. CONCLUSION: Cryopreservation by programmed freezing was effective at retaining the main characteristics of M. sativa undifferentiated cell culture after 27 years of storage. According to available data, this is longest period of successful cryopreservation of plant cell cultures reported so far. After storage, there was no evidence that DMSO had any detrimental effect on cell viability, growth or cytogenetics.

[Minimally invasive surgery with therapeutic effect in cancer patients].

During recent years ablative technologies have become very popular in tumor treatment. They are used in treatment for inoperable primary and metastatic tumors of the liver and the lung and also localized renal tumors of small sizes. The most studies on thermoablation in oncology are focused on the evaluation of tissue destruction and optimization of physical mechanisms, while potential mechanisms of immune response in thermoablation are still far from understanding. This study shows that with thermoablation of tumor within one month after the procedure the formation of a protective immune response is observed by increasing the content of activated T-helpers and cytotoxic T-lymphocytes.

[LAPAROSCOPIC AND OPEN RADICAL CYSTECTOMY FOR BLADDER CANCER].

Radical cystectomy is the standard method for treatment of muscle-invasive and locally advanced bladder cancer. Several less invasive approaches have been suggested recently, including totally laparoscopic radical cystectomy and robotic cystectomy. However despite significant improvements in surgical techniques the overall occurrence of perioperative complications is still high. Analysis of the literature data and comparison of these data with the results of our study was performed with respect to perioperative complications after radical cystectomy and oncological outcomes. In most of the studies, operating time during laparoscopic cystectomy was longer than that of open approach. Despite that, there was no influence of type of surgery on intraoperative complications. Major complication rates were similar between all groups. However laparoscopic cystectomy had lower rate of minor complications compared to open cystectomy. Laparoscopic cystectomy is safe and associated with lower blood loss, decreased postoperative ileus and lower length of stay compared with open radical cystectomy. Laparoscopic surgery for bladder cancer decreased minor complications (mainly due to lower bleeding and gastrointestinal complication rate) and had no impact on major complications. Moreover, if performed following the oncologic principles of open surgery, our results and literature data suggest that LRC is safe and determines non-inferior long-term cancer control compared with open surgery.