1.A case report of laparoscopic anatomical resection of the right posterior segment and right anterior dorsal subsegment of the liver guided by intraoperative ultrasound combined with positive ICG fluorescence navigation(with video)
Xingchao SONG ; Xiao MA ; Weibin YANG ; Anzhi XU ; Qiuyu SONG
Chinese Journal of General Surgery 2025;34(6):1219-1227
Background and Aims:Laparoscopic anatomical liver segmentectomy has been widely applied in the surgical treatment of hepatic tumors due to its safety,feasibility,and effectiveness.The combination of indocyanine green(ICG)fluorescence-guided positive staining and intraoperative laparoscopic ultrasound has become an important technique for precision liver resection,particularly in accurately delineating hepatic segment/subsegment boundaries and achieving negative surgical margins.This study reports a case of anatomical resection of the right posterior segment and the dorsal subsegment of the right anterior segment of the liver,guided by laparoscopic ultrasound combined with ICG positive staining,to evaluate its clinical feasibility and outcomes.Methods:A retrospective analysis was conducted on an elderly female patient with a hepatic space-occupying lesion who underwent laparoscopic anatomical resection of the right posterior segment and right anterior dorsal subsegment using intraoperative ultrasound combined with ICG fluorescence-guided positive staining.Results:Preoperative three-dimensional reconstruction revealed that the tumor was located in the right posterior segment and right anterior dorsal subsegment.Intraoperatively,under laparoscopic ultrasound guidance,the anterior-ventral branch of the right portal vein was punctured and injected with ICG to achieve precise staining of the right anterior-ventral subsegment.The resection was performed along the fluorescent boundary,enabling accurate anatomical removal of the targeted liver segments.Intraoperative blood loss was approximately 100 mL without transfusion.Pathology confirmed a moderately differentiated small-duct type intrahepatic cholangiocarcinoma with negative margins(R0 resection).The patient recovered well and was discharged on postoperative day 19.Follow-up CT at 6 months showed no evidence of recurrence.Conclusion:During anatomical resection of the right posterior segment and right anterior dorsal subsegment of the liver,laparoscopic ultrasound combined with ICG fluorescence-guided positive staining can accurately define segmental boundaries,enhance surgical safety,and ensure complete tumor resection,thus offering significant value in achieving R0 resection.
2.A case report of laparoscopic anatomical resection of the right posterior segment and right anterior dorsal subsegment of the liver guided by intraoperative ultrasound combined with positive ICG fluorescence navigation(with video)
Xingchao SONG ; Xiao MA ; Weibin YANG ; Anzhi XU ; Qiuyu SONG
Chinese Journal of General Surgery 2025;34(6):1219-1227
Background and Aims:Laparoscopic anatomical liver segmentectomy has been widely applied in the surgical treatment of hepatic tumors due to its safety,feasibility,and effectiveness.The combination of indocyanine green(ICG)fluorescence-guided positive staining and intraoperative laparoscopic ultrasound has become an important technique for precision liver resection,particularly in accurately delineating hepatic segment/subsegment boundaries and achieving negative surgical margins.This study reports a case of anatomical resection of the right posterior segment and the dorsal subsegment of the right anterior segment of the liver,guided by laparoscopic ultrasound combined with ICG positive staining,to evaluate its clinical feasibility and outcomes.Methods:A retrospective analysis was conducted on an elderly female patient with a hepatic space-occupying lesion who underwent laparoscopic anatomical resection of the right posterior segment and right anterior dorsal subsegment using intraoperative ultrasound combined with ICG fluorescence-guided positive staining.Results:Preoperative three-dimensional reconstruction revealed that the tumor was located in the right posterior segment and right anterior dorsal subsegment.Intraoperatively,under laparoscopic ultrasound guidance,the anterior-ventral branch of the right portal vein was punctured and injected with ICG to achieve precise staining of the right anterior-ventral subsegment.The resection was performed along the fluorescent boundary,enabling accurate anatomical removal of the targeted liver segments.Intraoperative blood loss was approximately 100 mL without transfusion.Pathology confirmed a moderately differentiated small-duct type intrahepatic cholangiocarcinoma with negative margins(R0 resection).The patient recovered well and was discharged on postoperative day 19.Follow-up CT at 6 months showed no evidence of recurrence.Conclusion:During anatomical resection of the right posterior segment and right anterior dorsal subsegment of the liver,laparoscopic ultrasound combined with ICG fluorescence-guided positive staining can accurately define segmental boundaries,enhance surgical safety,and ensure complete tumor resection,thus offering significant value in achieving R0 resection.
3.Expression and clinical significance of FAM83H-AS1 in breast cancer based on bioinformatics analysis
Na LI ; Jun YUAN ; Anzhi ZHANG ; Chuling HU ; Maoyi XU
China Modern Doctor 2024;62(9):1-6,21
Objective To analyze the expression and clinical treatment and prognosis assessment significance of FAM83H-AS1 in breast cancer by bioinformatics analysis.Methods The expression of FAM83H-AS1 in various cancer types was analyzed in the Cancer Genome Atlas(TCGA)database by R language.Additionally the expression in breast cancer was examined by Gene Expression Profiling Interactive Analysis(GEPIA)online database.Survival data were downloaded from TCGA to analyze the correlation between FAM83H-AS1 expression levels and prognosis among breast cancer patients.GEPIA and Kaplan-Meier Plotter were used for dual verification.Clinical information was obtained from TCGA for further analysis on the relationship between FAM83H-AS1 and clinical characteristics.And the relationship between FAM83H-AS1 and tumor microenvironment,immunodetection point-related genes and tumor mutation burden(TMB)was analyzed using R language.Gene set enrichment analysis(GSEA)was performed.Results The expression of FAM83H-AS1 was abnormal in many cancers,particularly exhibiting a significant increase in breast cancer.High expression of FAM83H-AS1 is associated with significantly reduced overall survival in breast cancer patients.Furthermore,the expression level of FAM83H-AS1 varies among breast cancer patients with different clinical stages.FAM83H-AS1 exhibits negative correlation with stromal cell score and immune cell score in breast cancer samples,and correlated with immune detection point-related gene.TMB radar map results suggest that the expression of FAM83H-AS1 in breast cancer is positively correlated with tumor mutational burden.GSEA revealed a positive correlation between the expression of FAM83H-AS1 and the function of mismatch repair.Conclusion FAM83H-AS1 is highly expressed in breast cancer,and is related to poor prognosis.Its expression correlates with clinicopathological stage,tumor microenvironment and TMB of breast cancer patients.Furthermore,FAM83H-AS1 exhibits associations with certain immune checkpoint-related genes and mismatch repair genes.These findings provide a important theoretical basis for clinical treatment,prognosis prediction and development of gene-target drugs.

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