Objective To explore the feasibility and safety of laparoscopic total colectomy for familial adenomatous polyposis. Methods All 9 patients with familial adenomatous polyposis received laparoscopic total colectomy were analyzed. Results Laparoscopic total colecto-my was successfully performed in all the 9 patients. The operative time,blood loss,flatus and hospitalization were respectively 230~310 min, 80~210 mL,2~3 days and 12~14 days. All patients were followed up for 6~36 months. The postoperative recovery was good. Conclusion Total colectomy can be successfully perfomed with laparoscopic assisted in treating familial adenomatous poliposis. It is a feasible and safe surgical procedure and can significantly improve the quality life.

Objective:Study on proliferation of gastric cancer cells (GCCs) and expressions of VEGF under the CO2 pneumoperitoneum environment,and effect of Bcl-2 specific inhibitor on the expression of VEGF in GCCs/TAMs co-culture system.Methods:TAMs induced by PMA and IL-4 in vitro.TAMs and MKN-45 cells were co-cultured in Transwell chamber,in pseudo CO2 pneumoperitoneum environment.Proliferation activity of GCCs was detected by MTT assay,and ELISA method was used to detect VEGF concentration in the cell culture supernatant.Results:Co-culture system was divided into CO2 pneumoperitoneum group and control group.Proliferation activity of MKN-45 cell and expression of VEGF of 5mmHg,10mmHg and 15mmHg groups are no difference with the control group;25 mmHg group is opposite to the former.The cells in co-culture group and CO2 pneumoperitoneum group (15 mmHg) were added to ABT-737,VEGF expression of co-culture + ABT-737 group was significantly lower than that of in the control group(P=0.001).Co-cultured cells VEGF expression in pneumoperitoneum group was significantly lower than the control group without inhibitor (P=0.000).Conclusion:Normal laparoscopic pneumoperitoneum is no stimulation of tumor cell proliferation defects,And higher pneumoperitoneum pressure might increase the hypoxia status of tumor microenvironment,promote tumor malignant progression.The interaction between tumor cells and TAMs may be achieved by paracrine Bcl-2-VEGF loop.