Performing robot-assisted pylorus and vagus nerve-preserving gastrectomy for early gastric cancer: A case series of initial experience.

BACKGROUND: Pylorus and vagus nerve-preserving gastrectomy (PPG) is a function-preserving surgery for early gastric cancer (GC) that has gained considerable interest in the recent years. The operative technique performed using the Da Vinci Xi robot system is considered ideal for open and laparoscopic surgery. AIM: To introduce Da Vinci Xi robot-assisted PPG (RAPPG)-based operative procedure and technical points as well as report the initial experience based on the clinical pathology data of eight cases of early GC. METHODS: Da Vinci Xi robot-assisted pylorus and vagus nerve-preserving gastrectomy (RAPPG) was performed for 11 consecutive patients with middle GC from December 2020 to July 2021. Outcome measures were postoperative morbidity, operative time, blood loss, number of lymph nodes harvested, postoperative hospital stay, time to first flatus, time to diet, and resection margins. RESULTS: Eight of the 11 patients who were pathologically diagnosed with early GC were enrolled in a retrospective study to assess the feasibility and safety of RAPPG. The mean operative time, mean blood loss, mean number of lymph nodes harvested, length of preserved pylorus canal, distal margin, and proximal margin were 330.63 ± 47.24 min, 57.50 ± 37.70 mL, 18.63 ± 10.57, 3.63 ± 0.88 cm, 3.50 ± 1.31 cm, and 3.63 ± 1.19 cm, respectively. None of the cases required conversion to laparotomy. Postoperative complications occurred in two (25.0%) patients. Postoperative complications were hyperamylasemia and gastric stasis in one case and incision infection in the other. Time to first flatus was 3.75 ± 2.49 d after the operation, and postoperative hospital stay was 10.13 ± 4.55 d. CONCLUSION: The core technique in the Da Vinci Xi RAPPG is lymph node dissection and the anatomic method of the nerve. Robotic surgical procedures are feasible and safe. With the progress of surgical technology, optimization of medical insurance structure, and emergence of evidence-based medicine, automated surgery systems will have a broad application in clinical treatment.

Long non-coding RNA HULC interacts with miR-613 to regulate colon cancer growth and metastasis through targeting RTKN.

Colon cancer is one of the leading causes of cancer death worldwide. Long non-coding RNA highly up-regulated in liver cancer (HULC) is an essential cancer-associated long non-coding RNA (lncRNA), contributing to the development and progression of several cancers. However, the exact effects of HULC in colon cancer progression and the underlying molecular mechanism are still unknown. In the study, we explored the detailed role of HULC in human clinical tumor tissue samples and colon cancer cell lines. The results indicated that lncRNA-HULC was markedly increased in colon cancer cell lines and accelerated colon cancer cell growth by targeting miR-613. HULC knockdown suppressed the proliferation, DNA synthesis and metastasis of human colon cancer cells in vitro. Additionally, the modulation of rhotekin (RTKN) by miR-613 was necessary in HULC-induced colon cancer cell proliferation and metastasis. The findings in the study suggested that HULC might inhibit the tumor growth through miR-613 dependent RTKN modulation. Together, our data suggested that HULC might be an oncogenic lncRNA, promoting the progression of colon cancer and could be considered as an effective therapeutic target in human colon cancer.

[Clinical observation of the role of Chenxia Sijunzi decoction in promoting the recovery of gastrointestinal function in critically ill patients].

OBJECTIVE: To observe the clinical effects of Chenxia Sijunzi decoction on promoting gastrointestinal function recovery in severe patients. METHODS: A prospective randomized controlled study was conducted. Eighty severe patients feeding with enteral nutrition from September 2011 to March 2012 were divided into three groups according to the method of random number table. The traditional Chinese medicine group and western medicine group were consisted of 35 cases respectively, and 10 cases were control group. Control group was routine symptomatically treated without any medicines for promoting gastrointestinal power function, helping the lower extremities to move and enhancing the turn over, letting the gastrointestinal function recover by its self. Chinese medicine group was tube fed with Chenxia Sijunzi decoction on the basis of control group, western medicine group was tube fed with the multienzyme tablets and mosapride dispersible tablets on the basis of control group. Then the differences in bowel sound recovery time and the time for passage of gas by anus and the bowel movement time and length of stay in hospitals within three groups were observed. RESULTS: The time of bowel sound recovery (41.02±7.52 hours, 44.02±6.23 hours), gas passage time by anus (49.90±6.95 hours, 51.32±5.12 hours) and the bowel movement time (58.22±6.71 hours, 60.91±3.72 hours) in both traditional Chinese medicine and the western medicine group were significantly reduced compared with the control group (54.62±5.51 hours, 64.68±9.47 hours, 78.20±7.11 hours, all P<0.01), and the days in hospital (5.1±1.7 days, 5.0±1.5 days) were shortened significantly compared with the control group (8.9±1.4 days, both P<0.01). However, results did not demonstrate any significant differences in each testing index between traditional Chinese medicine and western medicine group (all P>0.05). CONCLUSION: Chenxia Sijunzi decoction can promote severe patient's gastrointestinal function recovery and reduce hospitalization days.