Comparison of clinical efficacy between robotic and laparoscopic low anterior resection for rectal cancer:a Meta analysis / 重庆医学

Objective To compare the clinical efficacy of robotic low anterior resection (R-LAR) and laparoscopic low anterior resection(L-LAR) for rectal cancer.Methods The case-control studies for comparing the clinical efficacy of R-LAR and LLAR for rectal cancer were retrieved from databases,including PubMed,OVID,Springer,Wanfang and VIP,till June 2016.The studies were selected in accordance with inclusion and exclusion critera,and the data were extracted and evaluated by two researchers.The RevManS.3 software was used for Meta-analysis.Results A total of 7 studies including 1 126 patients with rectal cancer were included,592 cases in the R-LAR group and 534 cases in the L-LAR group.Compared with the L-LAR group,in the R-LAR group the operation time was longer (MD=33.84,95％ CI:4.25-63.43,P =0.03),the conversion rate was lower (OR =0.10,95％CI:0.03-0.36,P=0.000 5),and more lymph nodes were dissected (MD=1.24,95％CI:0.31-2.17,P=0.009).No statistically significant difference was found in length of hospital stay,intraoperative blood loss,distance from distal margin to tumor and incidence rate of postoperative anastomotic leakage between the two groups (P ＞ 0.05).Conclusion Compared with L-LAR,RLAR is characterized by longer operation time,lower conversion rate and more thoroughly removing lymph nodes.And the length of hospital stay,intraoperative blood loss,distance from distal margin to tumor and incidence rate of postoperative anastomotic leakage of R-LAR are similar to those of L-LAR.

Comparison of clinical efficacy between robotic and laparoscopic low anterior resection for rectal cancer:a Meta analysis / 重庆医学

Objective To compare the clinical efficacy of robotic low anterior resection (R-LAR) and laparoscopic low anterior resection(L-LAR) for rectal cancer.Methods The case-control studies for comparing the clinical efficacy of R-LAR and LLAR for rectal cancer were retrieved from databases,including PubMed,OVID,Springer,Wanfang and VIP,till June 2016.The studies were selected in accordance with inclusion and exclusion critera,and the data were extracted and evaluated by two researchers.The RevManS.3 software was used for Meta-analysis.Results A total of 7 studies including 1 126 patients with rectal cancer were included,592 cases in the R-LAR group and 534 cases in the L-LAR group.Compared with the L-LAR group,in the R-LAR group the operation time was longer (MD=33.84,95％ CI:4.25-63.43,P =0.03),the conversion rate was lower (OR =0.10,95％CI:0.03-0.36,P=0.000 5),and more lymph nodes were dissected (MD=1.24,95％CI:0.31-2.17,P=0.009).No statistically significant difference was found in length of hospital stay,intraoperative blood loss,distance from distal margin to tumor and incidence rate of postoperative anastomotic leakage between the two groups (P ＞ 0.05).Conclusion Compared with L-LAR,RLAR is characterized by longer operation time,lower conversion rate and more thoroughly removing lymph nodes.And the length of hospital stay,intraoperative blood loss,distance from distal margin to tumor and incidence rate of postoperative anastomotic leakage of R-LAR are similar to those of L-LAR.

Relationship between promoter methylation of Syk and Runx3 genes and postoperative recurrence and metastasis in gastric carcinoma / 中华肿瘤杂志

<p><b>OBJECTIVE</b>To investigate the relationship between aberrant methylation of Syk and Runx3 genes and recurrence and metastasis after resection of gastric cancer.</p><p><b>METHODS</b>Applying methylation-specific polymerase chain reaction technique, promoter methylation of Syk and Runx3 genes in the tumor tissues and adjacent normal tissues of gastric cancer patients were detected to investigate the relationship between methylation status of the promoter region of Syk and Runx3 genes and postoperative recurrence and metastasis.</p><p><b>RESULTS</b>In the 70 cases of gastric cancer, the frequencies of promoter methylation of Syk and Runx3 genes were 45.7% (32/70) and 55.7% (39/70) in gastric cancer, and 0 (0/70) and 7.1% (5/70), respectively, in the adjacent normal tissues. The rates of promoter methylation of Syk and Runx3 genes in the gastric cancers were significantly higher than that in the adjacent normal tissues (P < 0.001 for all). The promoter methylation of Syk and Runx3 genes was significantly correlated with the degree of tumor differentiation, depth of invasion, lymph node metastasis and pathological staging (P < 0.05 for all). The frequency of postoperative recurrence and metastasis in 32 patients with Syk promoter methylation was 65.6% (21/32) and that in 38 cases with Syk promoter unmethylation was 18.4% (7/38), showing a significant difference between the two subgroups (χ(2) = 16.13, P < 0.001). The rate of postoperative recurrence and metastasis in 39 patients with Runx3 promoter methylation was 61.5% (24/39) and that in 31 patients with Runx3 promoter unmethylation was 12.9% (4/31, P < 0.001).</p><p><b>CONCLUSIONS</b>The methylation of Syk and Runx3 promoters plays an important role in postoperative recurrence and metastasis of gastric cancer. Combined detection of promoter methylation of Syk and Runx3 genes is helpful for early diagnosis and evaluation of prognosis of gastric cancer.</p>

The clinical application of low-weight mesh for tension-free repair of inguinal hernia in the elders / 中华普通外科杂志

Objective To evaluate low-weight mesh for tension-free repair of inguinal hernia in the elders. Methods 120 old patients ( age at 60 -97 years) underwent tension-free repair of inguinal hernia by using low-weight mesh. The early complications, time of up and about, hospital stay, postoperative chronic pain,foreign body feelings and hernia recurrence were analyzed. Results The operations were successful in all cases and the average time of operation was (43 ± 12 ) min. 9 cases suffered from edema of the scrotum, 5 cases suffered urine retention, 4 cases suffered from incision hematoma. The average time of outof-bed was ( 17.4 ± 1.8 ) h, the average hospital days was ( 7.4 ± 1.9) d. However, there were 1.7%(2/120) patients suffering from slight chronic pain and 9. 1% (11/120) patients complaining foreign body feelings. There was no recurrence after follow-up for 6 to 48 months. Conclusions The clinical application of low-weight mesh for tension-free repair of inguinal hernia in old age is safe and effective, with an additional advantage of low occurrence of chronic pain and foreign body feelings.

Effect of CO_2 Pneumoperitoneum during Laparoscopy on Migration of GFP-labeled Living Cells into the Liver through Blood Route / 中国微创外科杂志

Objective To study the effect of CO2 pneumoperitoneum on migration of GFP-labeled living cells into the liver through blood route in rat model.Methods SD rats was inoculated intraportally with high-dose(5?106) GFP-labeled liver cells from C57BL/6 mice after cutting belly open.Pneumoperitoneum was established immediately after closing the abdominal wall.The rats were randomly divided into four groups(n=10 in each) to receive CO2 pneumoperitoneum at 5,10,or 15 mmHg,or no treatment other than cells inoculation(control).The pneumoperitoneum was maintained for 30 min.Afterwards,the rats were euthanized by cervical dislocation,and the liver of the rats was removed for fast frozen section biopsy.The expression of GFP-labeled living cells in rat livers was compared between the groups.Results No significant difference was detected in the positive expression of GFP-labeled cells between the groups(8 rats in the control group,9 in the 5 mm Hg group,9 in the 10 mm Hg group,and 10 in the 15 mm Hg group,?2=2.222,P=0.528).The mean number of GFP-positive cells in the four groups was 6.63?2.45(control),7.67?2.83(5 mm Hg),13.89?4.37(10 mm Hg),and 15.50?6.29(15 mm Hg).There was significant differences between the four groups(F=10.78,P=0.000).In addition,the numbers of GFP-positive cells in the high pressure groups(15 mm Hg and 10 mm Hg) were significantly higher than that in the low pressure group(5 mm Hg) and the control(P