1.Comparison between curved and unipedicular approach vertebroplasty for treatment of osteoporotic vertebral compression fractures
Rui ZHONG ; Wei JIANG ; Sen XIONG ; Yihao LIU ; Runsheng WANG ; Keya MAO
Chinese Journal of Trauma 2018;34(2):102-108
Objective To evaluate the safety and effectiveness of a curved vertebroplasty (CVP) compared with traditional unipedicular approach vertebroplasty (UVP) in treating osteoporotic vertebral compression fractures (OVCF).Methods This was a retrospective case control study on the clinical data of 77 OVCF patients (12 males,65 females;aged 55-86 years,mean 70.8 years) admitted between July 2013 and December 2016.There were 6 injured vertebrae at T1 10,73 at T11 L2,and 12 at L3 5.The patients were divided into CVP group (36 patients,44 vertebrae) and UVP group (41 patients,47 vertebrae) with no significant difference in baseline clinical variables.Intraoperative and postoperative complications including neurovascular injury were recorded.Operation duration,fluoroscopy frequency,volume of cement per level,cement leakage rate per level treated,cement distribution,and refracture rate were compared between the two groups.Preoperative and postoperative visual analog scale (VAS) and Oswestry disability index (ODI) were compared both within the group and between the groups.Results No severe complications related to puncture were observed.No significant difference was observed for operation duration,fluoroscopy frequency,and cement leakage rate per level treated between the two groups (P > 0.05).Compared with UVP group,CVP group had larger volume of cement per level [(5.0 ± 1.4) ml vs.(4.3 ± 1.6) ml],more uniform cement distribution (none vs.10 cases),and lower refracture rate (0 vs.10%) (P < 0.05).The two groups were followed up for 6-49 months (mean,25.9 months).Significant improvements on the VAS and ODI were noted within each group (P <0.01),but there was no significant difference between the two groups (P > 0.05).Conclusions Both CVP and UVP are safe and effective treatments for OVCF.Compared with UVP,CVP entails more uniform cement distribution and lower refracture rate.
2.Efficacy analysis on laparoscopic simultaneous resection of primary colorectal cancer and liver metastases
Dexiang ZHU ; Guodong HE ; Yihao MAO ; Ye WEI ; Li REN ; Qi LIN ; Xiaoying WANG ; Jianmin XU
Chinese Journal of Gastrointestinal Surgery 2020;23(6):584-588
Objective:To investigate the short-term outcomes of laparoscopic simultaneous resection of primary colorectal cancer and liver metastases in patients with resectable synchronous colorectal liver metastases (SCRLM).Methods:A descriptive case series study was performed. Clinicopathological data of patients with SCRLM who underwent laparoscopic simultaneous resection of colorectal cancer and liver metastases in Zhongshan Hospital between December 2015 and September 2018 were retrieved from a prospective colorectal cancer database. Perioperative presentations and short-term outcomes were analyzed.Results:A total of 53 patients were enrolled with average age of(61.7±11.3) years. Among them, 32 were male (60.4%) and 21 were female (39.6%). Twenty-five patients (47.2%) were American Society of Anesthesiologists (ASA) grade I and 28 (52.8%) were grade II. All the patients completed laparoscopic simultaneous resection without conversion. The average operation time was (320.2±114.5) min. The estimated blood loss was 150.0 (45.0-2000.0) ml, and only 2 cases (3.8%) received intraoperative transfusion. Postoperative pathologic results revealed that the average primary tumor size was (5.4±1.9) cm; 4 cases (7.5%) were T1-2 stage and 48 cases (90.6%) were T3-4 stage; 40 patients (75.5%) had lymph node metastasis; 19 (35.8%) had vascular involvement; 24 (45.3%) had neural invasion. The median number of liver metastases was 1.0 (1-8), and the average size of largest liver metastases was (3.0±1.9) cm. The median margin of liver metastases was 1.0 (0.1-3.5) cm, and only 1 case was R1 resection. The average time to the first postoperative flatus was (67.9±28.9) h, and the average time to the liquid diet was (107.0±33.8) h. The average postoperative indwelling catheterization time was (85.6±56.4) h. The average postoperative hospital stay was (9.2±4.4) d, and the average cost was (82±26) thousand RMB. No death within postoperative 30-day was found. The morbidity of postoperative complication was 32.1% (17/53) and 3 patients developed grade III to IV complications which were improved by conservative treatment. The median follow-up period was 23.2 months. During follow-up, 19 patients (35.8%) developed recurrence or metastasis, and 4 (7.5%) died. The 1- and 2-year disease-free survival (DFS) rates were 68% and 47% respectively, and the 1- and 2-year overall survival rates were 95% and 86% respectively.Conclusions:Laparoscopic simultaneous resection of primary colorectal cancer and liver metastases is safe and feasible in selected patients with SCRLM. Postoperative intestinal function recovery is enhanced, and morbidity and oncological outcomes are acceptable.
3.Efficacy analysis on laparoscopic simultaneous resection of primary colorectal cancer and liver metastases
Dexiang ZHU ; Guodong HE ; Yihao MAO ; Ye WEI ; Li REN ; Qi LIN ; Xiaoying WANG ; Jianmin XU
Chinese Journal of Gastrointestinal Surgery 2020;23(6):584-588
Objective:To investigate the short-term outcomes of laparoscopic simultaneous resection of primary colorectal cancer and liver metastases in patients with resectable synchronous colorectal liver metastases (SCRLM).Methods:A descriptive case series study was performed. Clinicopathological data of patients with SCRLM who underwent laparoscopic simultaneous resection of colorectal cancer and liver metastases in Zhongshan Hospital between December 2015 and September 2018 were retrieved from a prospective colorectal cancer database. Perioperative presentations and short-term outcomes were analyzed.Results:A total of 53 patients were enrolled with average age of(61.7±11.3) years. Among them, 32 were male (60.4%) and 21 were female (39.6%). Twenty-five patients (47.2%) were American Society of Anesthesiologists (ASA) grade I and 28 (52.8%) were grade II. All the patients completed laparoscopic simultaneous resection without conversion. The average operation time was (320.2±114.5) min. The estimated blood loss was 150.0 (45.0-2000.0) ml, and only 2 cases (3.8%) received intraoperative transfusion. Postoperative pathologic results revealed that the average primary tumor size was (5.4±1.9) cm; 4 cases (7.5%) were T1-2 stage and 48 cases (90.6%) were T3-4 stage; 40 patients (75.5%) had lymph node metastasis; 19 (35.8%) had vascular involvement; 24 (45.3%) had neural invasion. The median number of liver metastases was 1.0 (1-8), and the average size of largest liver metastases was (3.0±1.9) cm. The median margin of liver metastases was 1.0 (0.1-3.5) cm, and only 1 case was R1 resection. The average time to the first postoperative flatus was (67.9±28.9) h, and the average time to the liquid diet was (107.0±33.8) h. The average postoperative indwelling catheterization time was (85.6±56.4) h. The average postoperative hospital stay was (9.2±4.4) d, and the average cost was (82±26) thousand RMB. No death within postoperative 30-day was found. The morbidity of postoperative complication was 32.1% (17/53) and 3 patients developed grade III to IV complications which were improved by conservative treatment. The median follow-up period was 23.2 months. During follow-up, 19 patients (35.8%) developed recurrence or metastasis, and 4 (7.5%) died. The 1- and 2-year disease-free survival (DFS) rates were 68% and 47% respectively, and the 1- and 2-year overall survival rates were 95% and 86% respectively.Conclusions:Laparoscopic simultaneous resection of primary colorectal cancer and liver metastases is safe and feasible in selected patients with SCRLM. Postoperative intestinal function recovery is enhanced, and morbidity and oncological outcomes are acceptable.
4.Research progress in delivery systems of mesenchymal stem cells carrying paclitaxel
Yihao PEI ; Siyao CHEN ; Yuyin SU ; Yiming MAO ; Ben LI
Military Medical Sciences 2024;48(9):708-714
Mesenchymal stem cells have emerged as a promising cell therapy for anti-tumor research due to their homing properties,low immunogenicity,anti-angiogenic activity,anti-inflammatory properties,and paracrine effects.Paclitaxel has been clinically used for over thirty years in the treatment of various tumors such as ovarian cancer,lung cancer,and breast cancer.However,the broad-spectrum anti-tumor properties of paclitaxel are not possessed by the aforementioned cell therapies.Moreover,its adverse reactions,including peripheral neuropathy,bone marrow suppression,and gastrointestinal reactions,have long plagued cancer patients.In recent years,many studies have focused on combining cell therapy with chemotherapy to achieve better treatment outcomes,giving rise to a new drug delivery system that utilizes mesenchymal stem cells as carriers for delivering chemotherapeutic drugs.This review summarizes the research progress in MSC-based drug delivery systems for paclitaxel.
5.Current status and progress of robotic colorectal cancer surgery in the era of artificial intelli-gence
Yihao MAO ; Qingyang FENG ; Jianmin XU
Chinese Journal of Digestive Surgery 2024;23(4):573-578
Robotic colorectal cancer surgery has rapidly evolved and matured in recent years, with a significant increase in the volume of surgeries and a continuous diversification of surgical types. Increasing high-level evidence indicates that robotic colorectal cancer surgeries, particularly robotic rectal cancer surgeries, significantly accelerate postoperative recovery, reduce the incidence of complica-tions, enhance postoperative quality of life, and decrease rate of positive circumferential resection margins, thereby improving the radical cure rate of the tumor. In recent years, with the rapid develop-ment of medical artificial intelligence (AI) technologies, early explorations such as AI-enhanced surgery and AI autonomous robotic surgeries have also emerged. The authors summarize the develop-ment history, current status, and the application of AI technology in robotic colorectal cancer surgeries.