Objective:To investigate the clinical efficacy of laparoscopic hepatic caudate lobectomy.Methods:The retrospective and descriptive study was conducted. The clinicopathological data of 5 patients with hepatic caudate lobe tumor who were admitted to the General Hospital of PLA Northern Theater Command from July 2018 to June 2021 were collected. There were 2 males and 3 females, aged 49(range, 26-55)years. All 5 patients underwent laparoscopic hepatic caudate lobectomy. Observation indicators: (1) intraoperative situations; (2) postoperative situations; (3) follow-up. Follow-up was conducted using telephone interview or outpatient examination to detect tumor recurrence. The follow-up was up to March 2023. Measurement data with skewed distribution were represented as M(range) and count data were described as absolute numbers. Results:(1) Intraoperative situations. All 5 patients underwent laparoscopic hepatic caudate lobectomy with the left approach, including 3 cases receiving laparoscopic partial resection of hepatic caudate lobe, 1 case receiving laparoscopic partial resection of hepatic caudate lobe+left lateral lobectomy and 1 case receiving laparoscopic partial resection of hepatic caudate lobe+cholecystectomy. Intraoperative hilar occlusion was performed in 3 patients. The operation time and volume of intraoperative blood loss of 5 patients was 240(range, 180-370)minutes and150(range, 100-200)mL, respectively. (2) Postoperative situations. On the first day after surgery, the levels of albumin, alanine aminotransferase, and aspartate aminotransferase in 5 patients was 32.9(range, 29.2-40.3)g/L, 104.09(range, 57.11-1 018.67)U/L, and 67.13(range, 58.00-852.66)U/L, respectively. Three of 5 patients showed no significant changes in prothrombin time (PT) on the first day after surgery, while two patients did not undergo PT test. On the third day after surgery, the visual analogue score of 5 patients was mild pain. Among the 5 patients, 1 case had anal exhaust on the postoperative 1st day, and 4 cases had anal exhaust on the postoperative 2nd day. The time to drainage tube removal for 5 patients was 6(range, 4-10)days. There was no postoperative complication such as bleeding, infection, bile leakage or liver failure in 5 patients. Results of postoperative histopathological examination showed that 2 cases with adenoma, 2 cases with cavernous hemangioma and 1 case with smooth myolipoma. The duration of postoperative hospital stay of 5 patients was 6(range, 5-11)days. (3) Follow-up. All 5 patients were followed up for 22 (range, 19-51)months, and there was no tumor recurrence.Conclusion:It is safe and feasible to selectively carry out laparoscopic hepatic caudate lobectomy by strictly gras-ping the indications.

【Objective】 To explore the efficacy and safety of thalidomide, arsenic trioxide, dexamethasone and ascorbic acid (TADA) regimen in the treatment of early relapsed multiple myeloma (MM) patients (tumor progression within 12 months after initial treatment). 【Methods】 This study retrospectively analyzed 62 patients on TADA chemotherapy regimen and 57 patients on bortezomib, lenalidomide, dexamethasone (velcade, revlimid, dexamethasone, VRD) chemotherapy regimen for multiple myeloma (MM) in early stage relapse, who visited the Department of Hematology of Yanbian University Hospital between 2008 and 2020. We collected the general data profile, follow-up data during 3 courses of treatment, and laboratory data of all patients before and after chemotherapy. The efficacy of the patients was assessed by overall response rate (ORR) and complete response rate (CRR), and the occurrence of adverse reactions was collected for statistical analysis. Kaplan-Meier curves were plotted for the TADA and VRD groups under different renal function conditions, cytogenetically different risk stratification, and different ISS scenarios; the prognosis of patients on the TADA chemotherapy regimen was analyzed. 【Results】 There were no statistical differences in age, gender, immunochemical subtypes, ISS staging and high-risk FISH indicators between the two groups (P>0.05). After chemotherapy, the haemoglobin and serum albumin of patients in the TADA group were significantly lower than those in the VRD group, whereas the percentage of blood calcium, blood β2 microglobulin, creatinine and bone marrow plasma cells were significantly higher than those in the VRD group (P<0.05). In addition, the incidence of peripheral neuropathy was significantly lower than that in the VRD group (P<0.05), and there was no statistically significant difference in other adverse reactions (P>0.05). Compared with those in the VRD group, the overall survival (OS) (χ²=8.201, P=0.004) and progression free survival (PFS) (χ²=7.568, P=0.006) survival curves were statistically significant in the TADA group. In the TADA group OS (χ²=3.924, P=0.048) in patients with normal and impaired renal function at the time of enrolment and PFS (χ²=9.008, P=0.003), OS (χ²=9.330, P=0.002) and PFS (χ²=16.090, P<0.001) in ISS stage Ⅰ/Ⅱ and ISS stage Ⅲ at enrolment, OS (χ²=10.149,P<0.001) in high-risk FISH and non-high-risk patients at enrolment and PFS (χ²=11.286, P<0.001) survival curve results showed statistically significant differences. 【Conclusion】 The TADA regimen has better efficacy and safety in patients with early recurrence of MM. Renal function, ISS staging and FISH stratification are important factors affecting patients’ prognosis.