Digestive System Surgical Procedures ; Humans ; Laparoscopy ; Robotic Surgical Procedures ; Robotics

Laparoscopic surgery for gastric cancer with the advantages of slight pain,micro-invasive trauma and fast recovery has been accepted gradually by most surgeons and increasingly used in the field of surgery.However,how to establish a standardized laparoscopic surgery procedure for gastric cancer and improve the operation skills need to be solved urgently.Meanwhile,a reliable technical support of laparoscopic surgery for gastric cancer should be provided by controlling strictly the operation indications,standardizing surgical procedures,building a standardized training system,improving perioperative management and applying enhanced recovery program in patients with gastric cancer,and it will provide greater benefits to more and more patients.

Objective To investigate the role of PAF, TNF, IL-8 on septic rats. Methods Made use of the model of cecum ligated and perforated, observed the mortality rate of septic rats and examined their level of blood PAF, serum TNF,IL-8 at several plastic points, analysizd the relationship between level of blood PAF and serum TNF, IL-8. Results (1)The level of blood PAF, and serum TNF,IL-8 elevated significantly. The blood PAF was positively related with serum TNF, IL-8. (2)Treated with PAF antagonist WEB2170 could reduced the level of blood PAF, serum TNF, IL-8. (3)The mortality rate of the severe infectious rats could be reduced by WEB2170. Conclusion The PAF antagonist can block the network relationship between PAF and TNF,IL-8 and has an important role on preventing MOF.

Surgical treatment is the treatment of choice for gastrointestinal stromal tumor (GIST).A consensus on the surgical principle of GIST has been made based on the 10-year experience,which effectively guided the standardized treatment of GIST.Laparoscopic and gastrointestinal endoscopic techniques were applied in the treatment of GIST,and promote the development of the diagnosis and treatment of GIST.Laparoscopic treatment has become one of the main treatment methods for GIST.Furthermore,multi-disciplinary treatment for GIST is gradually adopted in clinical practice.In this article,the prospect of surgical treatment of GIST is introduced based on a 10-year experience.

Laparoscopic surgery has been adopted for the treatment of gastric cancer in recent years around the world.New advances in these techniques have been achieved. This paper provides an overview of the clinical outcome of laparoscopic surgery for early gastric cancer and advanced gastric cancer,the application of laparoscopy-assisted pylorus-preserving gastrectomy,the technical characteristics of laparoscopy-assisted total gastrectomy,the values of single-incision laparoscopically assisted surgery and the application status and prospect of robotassisted laparoscopic gastrectomy for gastric cancer.

Da Vinci robotic surgical system have some advantages of defibrillation,three-dimensional (3D) view and flexible operation,and it has been gradually applied in radical gastrectomy,colorectal cancer radical resection,complex hepatic resection,biliary tract surgery,partial resection of pancreas and pancreaticoduodenectomy in the fiell of digestive surgery,with satisfactory clinical efficacy.Compared with traditional laparoscopic and open operations,Da Vinci robotic surgical system is more precise and flexible,with advantages of minimal invasion and good application value,however,longer operation time,expensive surgery cost and indefinite long-term efficacy of malignant tumor need to be further improved.

Objective To generally analyse the current situations and advances in the biotherapy of gastric cancer. Methods The published papers about the current situations and research advances in the biotherapy of gastric cancer were reviewed.Results The main research fields and treatments in the biotherapy of gastric cancer include immunomodulator therapy, guided therapy of monoclonal antibodies and their joint-bodies, cytokine therapy, adoptive immunotherapy and gene therapy, etc. Conclusion As a beneficial complement for surgery, chemotherapy and radiotherapy, biotherapy plays an important auxiliary role in the multiple treatments for gastric cancer.

As a guanine nucleotide dissociation stimulator (GDS) of Rho-like GTPases, T lymphoma invasion and metastasis inducing factor 1(Tiam 1)possesses such biological functions as regulating reconstruction of cytoskeletal structure and migratory potential of cells. Studies had shown that over-expression of Tiam 1 was able to induce invasion and metastasis of tumor cells, the molecular biological basis of which includes the interactions between Tiam 1 and trans-membrane system of cytoskeleton, adhesion molecules and extra-cellular matrix, the effect on proliferation and apoptosis of tumor cells exposed by Tiam 1, as well as the activities of Tiam 1 regulated by other invasion and meatstasis associated factors. Simultaneously, these experimental results suggested that much more work would be needed in Tiam 1 on the diversity of its activity regulation ,the specificity of its biological effect, the realationship among Tiam 1 with other invasion and metastasis associated factors, as well as their mechanisms of signal transduction.

Objective　To explore the correlation between the expression of p33/ING1 and the clinicopathological features in patients with colorectal cancer, and to understand the possible mechanism of p33/ING1 in the oncogenesis of colorectal neoplasms. Methods　All samples of normal mucosa and cancer tissues from 52 patients with colorectal cancer were detected for their expression levels of p33/ING1 by RT-PCR. Results　A significant decrease in p33/ING1 mRNA expression was found in 30 out of 52(57.7%) colorectal cancer tissues. The results also showed that repression of p33/ING1 expression markedly related to both the Duke's stage and metastasis. Conclusion　Down-regulation of p33/ING1 may play an important role in the oncogenesis and development of colorectal carcinoma.

Objective To compare the short-term efficacy between da Vinci robotic and laparoscopic radical gastrectomy for gastric cancer.Methods Database including PubMed,EMBASE,the Cochrane Library,Medline,the China National Knowledge Infrastructure (CNKI),Wanfang Database,VIP and China Biomedicine were searched with the key words of gastric cancer,gastrectomy,da Vinci surgical system,laparoscopic,laparoscopy,胃癌,胃切除术,达芬奇机器人手术系统and腹腔镜.Literatures published between May 2002 and March 2014 were retrieved.Related controlled trials containing the clinical efficacy of da Vinci robotic and laparoscopic radical gastrectomy for gastric cancer were enrolled in the study,and then the literatures were screened and the data were extracted by 2 independent reviewers.The quality of the literatures was assessed,and the data were analyzed using the RevMan 5.2 software.Patients receiving da Vinci robotic surgery and laparoscopic surgery were allocated into the robotic group and laparoscopy group,respectively.The count data were analyzed using the relative risk (RR) and 95％ confidence interval (95％ CI),and the measurement data were analyzed using weighted mean difference (WMD) and 95％ CI.The heterogeneity of the data was analyzed using the I2 test.Results Eleven literatures including 3 698 cases were enrolled in the study.There were 953 patients in the robotic group and 2 745 patients in the laparoscopic group.There were significant differences in the operation time,volume of intraoperative blood loss,time of postoperative flatus,time of first oral intake and duration of postoperative hospital stay between the 2 groups (WMD =51.23,-36.96,-0.24,-0.26,-1.11,95％ CI:28.01-74.46,-61.28--12.65,-0.42--0.06,-0.39--0.14,-1.92--0.29,P ＜ 0.05).There was no significant difference in the number of lymph nodes resected,the distance to proximal and distal resection margin and overall incidence of postoperative complications (WMD =1.63,0.21,0.06,RR =1.11,95％ CI:-0.49-3.76,-0.65-1.06,-0.13-0.25,0.90-1.37,P ＞ 0.05).Conclusion Da Vinci robotic radical gastrectomy for gastric cancer is safe and feasible,with the advantages of minimal invasion and rapid postoperative recovery.