1.Clinical efficacy of single-port Da Vinci robotic surgical system in the radical resection of rectal cancer
Bo TANG ; Chuan LI ; Ping'ang LI ; Peiwu YU ;
Chinese Journal of Digestive Surgery 2017;16(8):813-817
Objective To explore the clinical efficacy of single-port Da Vinci robotic surgical system in the radical resection of rectal cancer.Methods The retrospective descriptive study was conducted.The clinical data of one patient with rectal cancer who was admitted to the Southwest Hospital of the Third Military Medical University in June 2017 was collected.The patient underwent the first case of radical resection of rectal cancer with the single-port la Vinci robotic surgical system,and intraoperatively received laparoscopy-assisted digestive tract reconstruction.Observation indicators:(1) intra-and post-operative situations;(2) follow-up and survival.Follow-up using outpatient examination and telephone interview was performed to detect patients' survival up to July 2017.Results (1) Intra-and post-operative situations:the patient underwent successful single-port Da Vinci robotic radical resection of rectal cancer.The operation time and volume of intraoperative blood loss were 145minutes and 20 mL,without blood transfusion.The using time of nonsteroidal analgesic drug,time for out-of-bed activity,time to anal exsufflation,time of fluid diet intake and time of pelvic drainage tube removal were 1 day,24hours,48 hours,72 hours and 4 days after operation,respectively.No postoperative complication was detected.Results of postoperative pathological examination:moderate-differentiated rectal adenocarcinoma invaded serosal layer,with negative circumferential margin,negative distal margin of rectum and mesenteric lymph node metastasis (1 of 16 harvested lymph nodes was positive).Pathologic staging was T4aN1M0 (stage Ⅲb).The patient was discharged from hospital at postoperative day 6.(2) Follow-up and survival:the patient was followed up for 1month,with a good survival.Conclusion Single-port Da Vinci robotic surgical system in the radical resection of rectal cancer is safe and feasible,with good short-term outcomes.
2.Effect of interleukin-17 in the migration and invasion of gastric cancer cell via regulating epithelial-mesenchymal transition
Ping'ang LI ; Yuxing JIANG ; Shiwei YANG ; Yingxue HAO ; Peiwu YU ;
Chinese Journal of Digestive Surgery 2015;14(11):948-952
Objective To investigate the effect of interleukin-17 (IL-17) in the gastric cancer cell migration and invasion via regulating epithelial-mesenchymal transition (EMT) and its potential function.Methods (1) Human gastric cancer cell MGC-803 lines in the logarithmic growth phase were stimulated by 0, 1 ng/mL, 10 ng/mL,100 ng/mL and 1μg/mL of IL-17 for 48 hours, and the phenotypic changes were observed.The concentration of IL-17 was selected for follow-on experiments based on the most obvious phenotypic changes.Gastric cancer cell MGC-803 which were stimulated by 100 ng/mL of IL-17 and PBS for 48 hours were allocated into the experimental group and control group, respectively.(2) The expressions of E-cadherin and Vimentin mRNA in gastric cancer cells were assayed through real-time PCR (RT-PCR).(3) The relative expressions of E-cadherin and Vimentin proteins in gastric cancer cells were assayed by the Western blot.(4) The scratch test and Transwell detection were also utilized to study the migration and invasion of gastric cancer cell MGC-803 in vitro.Measurement data with normal distribution were presented as-x ± s and comparison between groups was analyzed using the t test.Results (1) There were significant phenotypic changes in the gastric cancer cell after the different concentration of IL-17 stimulated gastric cancer cell MGC-803 for 48 hours.Cells were changed from polygonal and tight junction to spindle and loosely junction with a deterioration of cell adhesion.Cell phenotypes were gradually changed as the concentration of IL-17 was changed from 0 to 100 ng/mL.Phenotypic changes were the most obvious when 100 ng/mL of IL-17 was used, but these were non-significant as the concentration of IL-17 increased to 1 μg/mL with the death and floating of some cells.(2) The relative expressions of E-cadherin mRNA and Vimentin mRNA in RT-PCR were 0.45 ±0.13 and 1.06 ±0.23 in the experimental group and 2.39 ±0.55 and 1.23±0.41 in the control group, respectively, with significant differences (t =3.811, 2.923, P <0.05).(3) The results of Western blot showed the relative expressions of E-cadherin and Vimentin proteins were 0.86 ± 0.17 and 1.56 ± 0.29 in the experimental group and 1.01 ± 0.12 and 0.56 ± 0.17 in the control group, respectively, with significant differences (t =3.551, 3.601, P < 0.05).(4) Cell migration in the 2 groups were detected by the scratch test at 36 hours after scratch test, and the width of scratch in the experimental and control groups were (0.76 ± 0.13) mm and (0.40 ± 0.15) mm, showing a significant difference (t =3.095, P < 0.05).Transwell detection showed number of transmembrane cell in the experimental and control groups were 159 ±28 and 94 ± 18, respectively, with a significant difference (t =3.307, P < 0.05).Conclusion IL-17 can promote the migration and invasion of gastric cancer cells via stimulating alteration of EMT.
3.Clinical efficacy of single-port Da Vinci robotic surgical system in the radical gastrectomy of gastric cancer
Yingxue HAO ; Chunyang LIU ; Ping'ang LI ; Peiwu YU ;
Chinese Journal of Digestive Surgery 2017;16(8):808-812
Objective To explore the clinical efficacy of single-port Da Vinci robotic surgical system in the radical gastrectomy of gastric cancer.Methods The retrospective descriptive study was conducted.The clinical data of the first patient in China who underwent single-port radical gastrectomy of gastric cancer using Da Vinci robotic surgical system in the Southwest Hospital of the Third Military Medical University in June 2017 were collected.Patient underwent radical gastrectomy of gastric cancer using single-port Da Vinci robotic surgical system +D2 lymph node dissection + Billroth Ⅱ anastomosis.Observation indicators:(1) intra-and post-operative situations;(2) follow-up and patients' survival.Follow-up using outpatient examination and telephone interview was performed to detect the patients' postoperative survival up to July 2017.Results (1) Intra-and postoperative situations:patient underwent radical distal subtotal gastrectomy of gastric cancer using single-port Da Vinci robotic surgical system.Operation time and volume of intraoperative blood loss were respectively 303 minutes and 100 mL.There was no intraoperative complication.The distances from tumor to proximal margin and distal margin were 5 cm and 6 cm.Number of lymph node dissected and length of abdominal incision were 51 and 3 cm.Time of gastric tube removal,time for out-of-bed activity,time of gastrointestinal function recovery,time of drainage tube removal and postoperative pain score were 17 hours,24 hours,36 hours,36 hours and 3,respectively.Patient took a little fluid diet after gastric tube removal.There was no occurrence of postoperative complication.Results of pathological examination showed that tumor invaded deep muscular layer,with 2 positive lymph nodes in No.3 and negative proximal and distal margins.Pathological staging was pT2N1M0 (Ⅱa staging).Duration of hospital stay was 6 days.(2) Follow-up and patients' survival:patient was followed up for 1 month,with a good survival.Conclusion The single-port Da Vinci robotic surgical system is safe and feasible in the radical gastrectomy of gastric cancer,with good short-term outcomes.