Influence of liver function after laparoscopy-assisted vs totally laparoscopic gastrectomy.

BACKGROUND: Previously, some studies have proposed that total laparoscopic gastrectomy (TLG) is superior to laparoscopic-assisted gastrectomy (LAG) in terms of safety and feasibility based on the related intraoperative operative parameters and incidence of postoperative complications. However, there are still few studies on the changes in postoperative liver function in patients undergoing LG. The present study compared the postoperative liver function of patients with TLG and LAG, aiming to explore whether there is a difference in the influence of TLG and LAG on the liver function of patients. AIM: To investigate whether there is a difference in the influence of TLG and LAG on the liver function of patients. METHODS: The present study collected 80 patients who underwent LG from 2020 to 2021 at the Digestive Center (including the Department of Gastrointestinal Surgery and the Department of General Surgery) of Zhongshan Hospital affiliated with Xiamen University, including 40 patients who underwent TLG and 40 patients who underwent LAG. Alanine aminotransferase (ALT), aspartate aminotransferase (AST), alkaline phosphatase (ALP), γ-glutamyltransferase (GGLT), total bilirubin (TBIL), direct bilirubin (DBIL) and indirect bilirubin (IBIL), and other liver function-related test indices were compared between the 2 groups before surgery and on the 1st, 3rd, and 5th d after surgery. RESULTS: The levels of ALT and AST in the 2 groups were significantly increased on the 1st to 2nd postoperative days compared with those before the operation. The levels of ALT and AST in the TLG group were within the normal range, while the levels of ALT and AST in the LAG group were twice as high as those in the TLG group (P < 0.05). The levels of ALT and AST in the 2 groups showed a downward trend at 3-4 d and 5-7 d after the operation and gradually decreased to the normal range (P < 0.05). The GGLT level in the LAG group was higher than that in the TLG group on postoperative days 1-2, the ALP level in the TLG group was higher than that in the LAG group on postoperative days 3-4, and the TBIL, DBIL and IBIL levels in the TLG group were higher than those in the LAG group on postoperative days 5-7 (P < 0.05). No significant difference was observed at other time points (P > 0.05). CONCLUSION: Both TLG and LAG can affect liver function, but the effect of LAG is more serious. The influence of both surgical approaches on liver function is transient and reversible. Although TLG is more difficult to perform, it may be a better choice for patients with gastric cancer combined with liver insufficiency.

[Transumbilical single-port access laparoscopic surgery for colorectal cancer].

OBJECTIVE: To evaluate the surgical outcomes after transumbilical single-port access laparoscopic surgery for colorectal cancer. METHODS: Patients undergoing transumbilical single-port access laparoscopic radical resection for colorectal cancer at the Zhongshan Hospital of Xiamen University were included. RESULTS: Three patients underwent transumbilical single-port access laparoscopic radical resection for sigmoid colon cancer and 1 for rectal cancer between August 2010 and September 2010. There were no intraoperative or postoperative complications. No conversion was required. The mean operative time was 206 min and the mean estimated blood loss was 75 ml. The mean number of harvested lymph nodes was 21. Patients were ambulatory in the same day of surgery or postoperative day 1. Length of hospital stay ranged from 7 to 10 days. CONCLUSIONS: Transumbilical single-port access laparoscopic surgery is safe for colorectal cancer. Long-term outcomes warrant further investigation.

[Expression of inductive nitric oxide synthase and vascular endothelial growth factor in colonic carcinoma, and their effects on tumor angiogenesis].

OBJECTIVE: To investigate the expression of inductive nitric oxide synthase (iNOS) and vascular endothelial growth factor (VEGF), and their relations with clinicopathological parameters in colonic carcinoma. METHOD: Immunohistochemistry (streptomycin avidin-biotin peroxidase complex, SP) was used to detect the expression of iNOS, VEGF, collagen IV, FVIII Ag in colonic adenocarcinoma, and micro vessel density (MVD) was counted. RESULTS: The positive rates of iNOS and VEGF in colonic carcinoma were 76% and 80% respectively. The MVD in iNOS-positive carcinoma and iNOS-negative carcinoma were 37.0+/- 5.7 and 30.5+/- 4.9. The MVD in VEGF-positive carcinoma and VEGF-negative carcinoma were 39.5+/- 8.5 and 30.7+/- 4.4. The expressions of iNOS and VEGF were positively correlated with MVD. The expression of VEGF was correlated with tumor invasion, differentiation and lymph no de metastasis, but not with patients age,sex and histologic type. CONCLUSION: The expression of iNOS and VEGF may play a role in the angiogenesis, metastasis and invasion of colonic carcinoma.