OBJECTIVETo explore the safety and feasibility of reduced-port laparoscopic-assisted resection for cancer at the sigmoid colon and upper rectum.

METHODSClinical data of 70 patients with sigmoid colon or upper rectal cancer undergoing laparoscopic-assisted resection in our department from February 2013 to July 2014 were retrospectively reviewed. Patients were divided into reduced-port group (44 cases, 3 or 4 ports) and conventional group (26 cases, 5 ports). The operative time, blood loss, retrieved lymph nodes, postoperative exhaust recovery, dietary recovery, hospital stay and morbidity of complication were compared between two the groups.

RESULTSNo significant differences were observed in operative time [(144.0 ± 40.1) min vs. (115.8 ± 30.8) min], blood loss [(72.9 ± 50.2) ml vs. (45.5 ± 52.4) ml], number of retrieved lymph nodes [(10.2 ± 8.4) vs. (12.0 ± 5.6)], time to bowel function return [(3.2 ± 0.7) d vs. (2.8 ± 0.8) d], time to liquid diet [(4.2 ± 1.1) d vs. (3.8 ± 0.9) d], time to semisolid diet [(8.6 ± 2.1) d vs (8.1 ± 1.7) d], and postoperative hospital stay [(13.0 ± 3.4) d vs. (12.8 ± 7.2) d] between two groups (all P>0.05). Complication rate of conventional group and the reduced-port group was 15.4% and 7.2% without significant difference (P=0.233).

CONCLUSIONSFor cancer at the sigmoid colon and upper rectum, reduced-port laparoscopic surgery is feasible, safe and radical as the five-port in terms of technical and oncologic issues. These two procedures have the same short-term outcome.

Humans ; Laparoscopy ; Length of Stay ; Lymph Node Excision ; Operative Time ; Rectal Neoplasms ; surgery ; Retrospective Studies ; Sigmoid Neoplasms ; surgery ; Treatment Outcome

Objective:To summarize the experience of laparoscopic transabdominal preperitoneal hernia repair (TAPP) and to discuss its safety and feasibility.Methods:Data of 26 consecutive cases from January 2015 to March 2018 in Ruijin Hospital, Shanghai Jiao Tong University School of Medicine were analyzed retrospectively. They were all males, aged (68.3±14.1) years, with a range from 57 to 86 years. Body mass index was (23.3±4.1) kg/m 2. Bathel indexwas 91.4±5.6. Intraoperative main procedures were done in accordance to Guideline of Standardized Operation for Laparoscopic Inguinal Hernia Repair. A drainage tube or catheter was not routinely placed intraoperatively. Patients were discharged but for any complaints. Observation data included intraoperative, postoperative and following-up data. The following-up period was more than 12 months by telephone or clinic. The long-term complications and the changes of Barthel index were observed. Paired sample t test was used to compare the changes of Barthel index before and after operation. Results:Of the 26 cases, none was converted to open procedure and no intra- or post-operative serious complications occurred. Occurrence of surgical site seroma was 17 (65.4%) cases. The operating time was (76.5±23.6) min. Intraoperative blood loss was (8.6±4.4) mL. The postoperative hospitalization was (2.3±1.2) d. Bathel index in 1 month postoperative was 96.9±3.2. It was higher statistically than that preoperative ( t=-6.968, P=0.000). Conclusions:TAPP in the treatment of huge inguinoscrotal hernia is safe and feasible. Mastering the anatomical characteristics and the according procedures is an important factor for successful operation.

Objective To explore the safety and feasibility of reduced-port laparoscopic-assisted resection for cancer at the sigmoid colon and upper rectum. Methods Clinical data of 70 patients with sigmoid colon or upper rectal cancer undergoing laparoscopic-assisted resection in our department from February 2013 to July 2014 were retrospectively reviewed. Patients were divided into reduced-port group (44 cases, 3 or 4 ports) and conventional group (26 cases, 5 ports). The operative time, blood loss, retrieved lymph nodes, postoperative exhaust recovery, dietary recovery, hospital stay and morbidity of complication were compared between two the groups. Results No significant differences were observed in operative time [(144.0±40.1) min vs. (115.8±30.8) min], blood loss [(72.9±50.2) ml vs. (45.5± 52.4) ml], number of retrieved lymph nodes [(10.2±8.4) vs. (12.0±5.6)], time to bowel function return [(3.2 ±0.7) d vs. (2.8 ±0.8) d], time to liquid diet [(4.2 ±1.1) d vs. (3.8 ±0.9) d], time to semisolid diet [(8.6 ±2.1) d vs (8.1 ±1.7) d], and postoperative hospital stay [(13.0 ±3.4) d vs. (12.8 ±7.2) d] between two groups (all P>0.05). Complication rate of conventional group and the reduced-port group was 15.4% and 7.2% without significant difference (P=0.233). Conclusions For cancer at the sigmoid colon and upper rectum , reduced-port laparoscopic surgery is feasible , safe and radical as the five-port in terms of technical and oncologic issues. These two procedures have the same short-term outcome.

Objective To explore the safety and feasibility of reduced-port laparoscopic-assisted resection for cancer at the sigmoid colon and upper rectum. Methods Clinical data of 70 patients with sigmoid colon or upper rectal cancer undergoing laparoscopic-assisted resection in our department from February 2013 to July 2014 were retrospectively reviewed. Patients were divided into reduced-port group (44 cases, 3 or 4 ports) and conventional group (26 cases, 5 ports). The operative time, blood loss, retrieved lymph nodes, postoperative exhaust recovery, dietary recovery, hospital stay and morbidity of complication were compared between two the groups. Results No significant differences were observed in operative time [(144.0±40.1) min vs. (115.8±30.8) min], blood loss [(72.9±50.2) ml vs. (45.5± 52.4) ml], number of retrieved lymph nodes [(10.2±8.4) vs. (12.0±5.6)], time to bowel function return [(3.2 ±0.7) d vs. (2.8 ±0.8) d], time to liquid diet [(4.2 ±1.1) d vs. (3.8 ±0.9) d], time to semisolid diet [(8.6 ±2.1) d vs (8.1 ±1.7) d], and postoperative hospital stay [(13.0 ±3.4) d vs. (12.8 ±7.2) d] between two groups (all P>0.05). Complication rate of conventional group and the reduced-port group was 15.4% and 7.2% without significant difference (P=0.233). Conclusions For cancer at the sigmoid colon and upper rectum , reduced-port laparoscopic surgery is feasible , safe and radical as the five-port in terms of technical and oncologic issues. These two procedures have the same short-term outcome.

Objective To analyze the serum PD-L1 levels of gastric cancer patients and its relationship with tumor stage and prognosis.Methods Serum of sixty patients with pathological diagnosis of gastric cancer in our hospital from August 2018 to December 2019 were collected,and the serum of 15 healthy adults as a control.The serum PD-L1 levels was measured by enzyme linked immunosorbent assay(ELISA).The serum PD-L1 levels between gastric cancer patients and healthy adults were compared.The relationship between the serum PD-L1 levels and prognosis of gastric cancer patients with different stages was analyzed.Finally,the PD-L1 expression in tumor tissues was detected by immunohistochemical staining,and its correlation with serum PD-L1 levels was analyzed.Results The serum PD-L1 levels of gastric cancer group was significantly higher than that of the control group.The serum PD-L1 levels in patients with stage Ⅲ and Ⅳ gastric cancer was significantly higher than that in stage Ⅰ and Ⅱ.The serum PD-L1 levels in gastric cancer patients with peritoneal metastasis was significantly elevated,indicating poor prognosis.Kaplan-Meier survival analysis showed that the survival time of gastric cancer patients with higher level of serum PD-L1 was shorter than those with lower ones.We further evaluated the PD-L1 expression in tumor tissues.There was no significant correlation between the serum PD-L1 levels and that in tumor tissues.Conclusions The serum PD-L1 levels of gastric cancer patients was higher than that of healthy adults,and which gradually increased with the progression of the disease.Gastric cancer patients with peritoneal metastasis had a much higher serum PD-L1 levels,and there was no significant correlation between serum PD-L1 levels and PD-L1 expression in tumor tissues.