Objective To describe the technique and characteristics of simple hand-assisted laparoscopic resection of renal and adrenal. Methods A total of 37 patients (22 males and 15 females) underwent simple hand-assisted laparoscopic resection of renal and adrenal from June 1999 to April 2004.Their mean age was 52 years (range,25～65 years).Renal resection group included 29 cases,including 13 of renal carcinoma and 2 of renal pelvic carcinoma.All these 15 cases were staged as T 1N 0M 0.The average tumor volume of the renal resection group was 3 cm?3 cm?2 cm.8 of hydronephrosis,2 of renal tuberculosis,4 of renal atrophied.Adrenal tumor resection group included 8 cases;the average tumor volume was 4 cm?5 cm?6 cm. Results Simple hand-assisted laparoscopic resection of the tumors was performed successfully in 36 cases without any complication such as injury of intestines and other important abdominal viscera except 1 case who underwent open surgery.The mean operative time of nephrectomy was 145 min,and that of adrenal giant tumor resection was 125 min.The mean blood loss was 110 ml.The patients recovered well and were discharged 7 to 8 days after operation.Follow-up lasted 3 months to 5 years after operation.Of the 37 cases,35 survived healthily;2 with renal carcinoma died (1 died of cerebrovascular accident 2 years after operation and the other died of brain and pulmonary metastasis 3 years after operation). Conclusions Simple hand-assisted laparoscopic resection of renal and adrenal giant tumor has the advantages of easier performance,shortened operative time and faster recovery from operation.Thus,this technique is worthy of popularization.

Objective To investigate the utility of virtual endoscopy ultrasound Fly-Thru in the diagnosis of obstructive bile duct diseases.Methods One-hundred patients with obstructed bile duct diseases underwent Fly-Thru examination.All Fly-Thru images were reviewed by two radiologists with different experience.The capabilities of Fly-Thru for bile duct obstructive degree evaluation and distinguishing malignant lesion from benign one were assessed respectively.Results The accuracy and sensitivity of Fly-Thru image in obstruction degree evaluation were 70.59％ and 89.2％ (95％CI 74.6％-96.9％).The diagnosis accuracy of 2DUS for lesion characteristics increased from 80％ to 84％,accompany with Fly-Thru images,especially for lesions in common bile duct from 77.2％ to 86.0％ (x2 =14.399,P =0.001).Conclusions The virtual endoscopy ultrasound Fly-Thru is only partly capable to display the obstructed degree of some bile ducts,but it can improve the diagnostic accuracy of common bile duct diseases.

Aim To evaluate the short-term biocompatibility of a newkind of prosthetic nucleus-Evergel, which is made from the modifiedpolyvinyl alcohol hydrogel. Methods According to China national standardGB/T16886 documents, the toxicity of Evergel prosthetic nucleus materialwas investigated by the cytotoxicity test, sensitization test, haemolysis test,Ames test, mice marrow micronucleus test and chromosome aberration test ofmammalian cell in vitro. Results This material had no cytoxicity, no sen-sitivity, no obvious haemolysis, and no mutagencity in Ames test, micemarrow micronucleus test and chromosome aberration test of mammalian cellin vitro. Conclusion The Evergel prosthetic nucleus has a good biocom-patibility and can be used clinically.

Objective To study the feasibility,efficacy and safety of ultrasound-guided percutaneous radiofrequency ablation (RFA) in the treatment of hepatocellular carcinoma (HCC) in the caudate lobe.Methods From November 2006 to June 2017,31 patients with 31 HCCs located in the caudate lobe were treated with percutaneous RFA at the First Affiliated Hospital of Sun Yat-sen University.The treatment efficacy,complications,and the local tumor progression (LTP),disease-free survival (DFS) and overall survival (OS) rates were analyzed.Results Residual tumors were detected in 5 patients after the first treatment.Complete necrosis was achieved in all the patients after the second treatment.The mean number of ablation sessions was 1.16±0.37.At a follow-up period which ranged from 3 to 65 months,19 patients had died,10 patients were still alive,and 2 patients were lost to follow-up.The 1-,2-,3-,and 5-years OS rates were 78.4％,48.5％,12.1％ and 12.1％,respectively.On follow-up,9 caudate lobe HCC lesions were detected to have LTP.The 1-,2-,and 3-years LTP rates were 21.5％,41.6％ and 41.6％,respectively;while the 1-,2-,and 3-years DFS rates were 22.3％,11.2％ and 11.2％,respectively.Ablationrelated complications were detected in 4 patients.Conclusions Ultrasound-guided percutaneous RFA was safe and effective for patients with HCC in the caudate lobe.These patients should be followed-up closely to detect LTP.

Objective To investigate the beneficial role of synbiotics in the intestinal microbiota of patients with chronic functional constipation (CFC).Methods According to the inclusion and exclusion criteria,6 patients with CFC were enrolled with their fresh fecal samples collected,after a continuous treatment of one month their fresh fecal samples collected again.Meanwhile,6 healthy volunteers were enrolled as the control group with their fresh fecal samples collected.All samples were transported with ice and stored in -80 ℃ refrigerator,and were analyzed by metagenomics sequencing.Results After 4 weeks of symbiotic treatment,the intestinal microbiota had changed in species in patients with CFC.Bacteria of Escherichia_ coli,Clostridium_ sp._ SS2/1 and Clostridium_ sp._ 7_ 3_ 54FAA,which were rich in the people with constipation,decreased in abundance after the treatment.Bacteria of Lactobacillus_ oris and Bifidobacterium _ animalis,which were rich in the healthy people,increased in content after the treatment.Bacteria of Veillonella_ parvula,Veillonella_ sp._ 6_ 1_ 27,Veillonella_ sp._ 3 _ 1_ 44 which were rich in the healthy people,decreased in content after the treatment.LEfSe analysis showed that Parabacteroides distaso nis,Escherichia_ coli and Enterobacter-cloacae were the specific species of the three groups respectively.Conclusion Synbiotics can change the intestinal microbiota showing therapeutic effect,thus can be used as a novel clinical treatment method.

Objective To prepare ultrasound(US)responsive nanodroplets(NDs)simultaneously loaded with anticancer drug Sorafenib(SF)and Doxorubicin(DOX),and to characterize its ultrasound responsibility in vitro and in vivo.Methods The SF/DOX NDs were prepared using the thin-film hydration method.The particle diameter,Zeta potential and drug-encapsulation efficiency were characterized.The acoustic droplets vaporization activity was monitored by in vitro ultrasound imaging and light microscope. The cavitation effect was monitored by in vitro ultrasound imaging and transmission electron microscopy. Results SF/DOX NDs were round in shape,the mean diameter and Zeta potential of SF/DOX NDs was (498 ± 67.34)nm,-(38.87 ± 3.78)mV,respectively.The entrapment efficiency of SF and DOX was (58.14±2.93)%,(51.23±4.11)%,respectively.SF/DOX NDs underwent a phase transition into bubbles and could be continuously imaged for more than 25 min in vitro,and afterward therapeutic ultrasound pulse induced inertial cavitation and substantially enhanced treatment.Conclusions US-responsible SF/DOX NDs are prepared using thin-film hydration mehtod,it can enhance ultrasonic echo in vitro and release anticancer drug by the aid of US exposure,which possesses greater researching and applicating value.

Objective:To summarize the patient profiles and therapeutic efficacies of ABO-incompatible living-related kidney transplantations at 19 domestic transplant centers and provide rationales for clinical application of ABOi-KT.Methods:Clinical cases of ABO-incompatible/compatible kidney transplantation (ABOi-KT/ABOc-KT) from December 2006 to December 2009 were collected. Then, statistical analyses were conducted from the aspects of tissue matching, perioperative managements, complications and survival rates of renal allograft or recipients.Results:Clinical data of 342 ABOi-KT and 779 ABOc-KT indicated that (1) no inter-group differences existed in age, body mass index (BMI), donor-recipient relationship or waiting time of pre-operative dialysis; (2) ABO blood type: blood type O recipients had the longest waiting list and transplantations from blood type A to blood type O accounted for the largest proportion; (3) HLA matching: no statistical significance existed in mismatch rate or positive rate of PRA I/II between two types of surgery; (4) CD20 should be properly used on the basis of different phrases; (5) hemorrhage was a common complication during an early postoperative period and microthrombosis appeared later; (6) no difference existed in postoperative incidence of complications or survival rate of renal allograft and recipients at 1/3/5/10 years between ABOi-KT and ABOc-KT. The acute rejection rate and serum creatinine levels of ABOi-KT recipients were comparable to those of ABOc-KT recipients within 1 year.Conclusions:ABOi-KT is both safe and effective so that it may be applied at all transplant centers as needed.

OBJECTIVE: To investigate the long-term outcome of laparoscope-assisted transanal total mesorectal excision (taTME) for rectal cancer. METHODS: Clinicopathological data of 29 patients with mid-low rectal cancer undergoing laparoscope-assisted taTME at Department of Gastrointestinal Surgery, the First Affiliated Hospital of Guangzhou Medical University from May 2010 to December 2015 were collected for the retrospective case-series study. All the operations were performed with transabdominal and transanal procedure simultaneously or sequentially. Perioperative presentations, pathological examinations, and oncologic outcomes were retrospectively analyzed. Long-term recurrence, metastasis and survival were assessed during follow-up. Outpatient clinic and telephone survey were used for follow-up. The follow-up time ended in December 2018. The overall survival (OS) rate and disease-free survival (DFS) rate were calculated by the Kaplan-Meier method. RESULTS: The average intra-operative blood loss was (75.9±9.5) ml (range,20 to 200). The average operating time was (223.6±4.1) minutes (range, 165 to 280). The average number of harvested lymph node was 22.3±2.0. The average length of pathological specimen was (13.1±0.6) cm. The average distal resection margin was (2.9±0.2) cm. 89.7% (26/29) of specimens was complete and 10.3% (3/29) near complete. Two cases (6.9%) had positive cutting circumferential margin. Median follow-up was 56 (range, 22 to 91) months. Local recurrence rate, distant metastasis rate, 3-year OS rate, 3-year DFS rate, 5-year OS rate, 5-year DFS rate were 10.3% (3/29), 20.7%(6/29), 96.6%, 83.2%, 87.6% and 79.6%, respectively. No incisional hernia or adhesive intestinal obstruction was found. CONCLUSION Long-term outcomes of mid-low rectal cancer patients undergoing laparoscope-assisted taTME are satisfactory.
Humans ; Laparoscopes ; Neoplasm Recurrence, Local ; Rectal Neoplasms ; surgery ; Rectum ; Retrospective Studies ; Transanal Endoscopic Surgery