Objective To summarize the application and progress of common autologous organ transplantation (AOT) techniques. Method A literature review and summary of previous and recent studies on common AOT was performed, including autologous liver transplantation, autologous kidney transplantation and intestinal autotransplantation techniques. Results AOT solved the issues of bleeding that cannot be controlled by in vivo resection of lesions, difficulties in vascular reconstruction, and the inability to radically resect lesions, and extended the indications for treatment of partially diseased conditions. Conclusions The AOT technique has an ameliorating effect on the tight donor situation in China, providing more potential donors. And the application of the AOT technique effectively avoids the usage of postoperative immunosuppressive drugs and the progression of lesions due to waiting for allogeneic organ transplantation. However, the clinical benefit in malignant tumors remains to be further investigated.
We reviewed the clinical studies on drug therapy for gallbladder cancer and expounded on the current situation of conversion therapy for gallbladder cancer. Gallbladder cancer was usually diagnosed late, with high malignancy, low surgical resection rate, and poor prognosis. With the development of conversion therapy, systemic therapy combined with radical resection had effectively improved the surgical resection rate and prognosis of gallbladder cancer patients. At present, most of the published conversion therapies for gallbladder cancer were mainly retrospective researches, lacking large multicenter prospective research, and the treatment plan was still based on chemotherapy, lacking the research of targeted therapy in combination with immunotherapy. It is expected that more high-quality clinical trials can be made first-line recommendations for the conversion therapy of gallbladder cancer.
Objective
To explore the influencing factors for pulmonary infection after radical resection of colon cancer.
Methods
A cohort study included 56 patients who underwent radical resection of colon cancer in People’s Hospital of Daye City from Oct. 2014 to Oct. 2016 were followed-up prospectively, to observe the occurrence of pulmonary infection, and collectting the related factors for pulmonary infection in addition.
Results
The clinical data of 53 patients were finalized and the clinical data of these patients were complete. Among them, 13 patients suffered from pulmonary infection after radical resection of colon cancer, and 40 patients had no obvious exacerbation and no complicated pulmonary infection. Results of logistic regression showed that, value of forced expiratory volume in1 second/forced vital capacity (OR=1.174, P=0.033), operative time (OR=1.638, P=0.012), levels of postoperative copeptin (OR=1.328, P=0.032), and procalcitonin (OR=1.465, P=0.042) were risk factors for pulmonary infection after radical resection of colon cancer. Receiver operating characteristic curve (ROC) showed that, operative time was 6.207-hour, postoperative copeptin level was 10.420 pmol/L, and the postoperative procalcitonin level was 3.676 ng/mL, which had the best predictive effect on predicting pulmonary infection after radical resection of colon cancer.
Conclusions
Value of forced expiratory volume in 1 second/forced vital capacity, operative time, levels of copeptin and procalcitonin after operation are the independent influencing factors for pulmonary infection after radical resection of colon cancer, and it has best prognostic outcome when the operative time is 6.207-hour, postoperative copeptin level is 10.420 pmol/L, and the postoperative procalcitonin level is 3.676 ng/mL.
ObjectiveTo evaluate the influence of clinical, pathological and treatment factors on the prognosis of thymic carcinoma patient accepted surgical treatment.MethodsRetrospective analysis was performed on 38 patients with thymic carcinoma undergoing surgical treatment between January 2008 and December 2017. The association between the prognostic factors including age, sex, thymectomy, radical resection, pathological type, TNM stage, Masaoka-Koga stage, tumor size, and survival was assessed using the Kaplan-Meier method.ResultsThe 5-year overall survival rate of our cohort was 51.9%. Kaplan-Meier univariate survival analysis showed that radical resection (P=0.003), TNM stage (P=0.038), Masaoka-Koga stage (P=0.033), and tumor size (P=0.030) were related to the prognosis of patients with thymic carcinoma. Radical resection was also validated as an independent prognostic factor in multivariate Cox analysis (P=0.009, hazard ratio 2.31, 95%CI 1.23-4.33).ConclusionRadical surgical treatment could improve the prognosis of patients with resectable thymic carcinoma.
Objective To compare the differences in postoperative pulmonary function and quality of life between synchronous and combined mediastinoscopy with laparoscopic radical resection of esophageal cancer, providing evidence for selecting the optimal surgical approach. Methods A retrospective analysis was conducted on patients who underwent minimally invasive mediastinoscopic esophagectomy at Huaihe Hospital of Henan University from January 2023 to January 2025. Patients were divided into two groups based on surgical approach: the synchronized laparoscopic inflatable mediastinoscopy (SPIMSLE) group and the inflatable video-assisted mediastinoscopic transhiatal esophagectomy (IVMTE) group. Propensity score matching (1 : 1) was applied to balance baseline characteristics. Perioperative indicators, pulmonary function (FEV1, FVC, FEV1/FVC ratio), postoperative complications, pain levels (NRS score), and quality of life were statistically analyzed. Results A total of 173 patients were enrolled, including 110 males, 63 females with a mean age of (62.5±6.2) years. After matching, each group comprised 80 patients. No significant differences were observed in gender, age, tumor location, or clinical stage (all P>0.05). The SPIMSLE group demonstrated superior outcomes: shorter operative time [(100.32±15.28) vs. (134.53±16.43) min, P<0.001], less intraoperative blood loss [(40.13±12.73) mL vs. (69.45±12.34) mL, P<0.001), and shorter postoperative hospitalization [(10.50±2.00) d vs. (12.50±2.50) d, P<0.001]. At 1-6 months postoperatively, the SPIMSLE group showed faster recovery in pulmonary function (FEV1, FVC, FEV1/FVC ratio, P<0.05), lower complication rates (16.25% vs. 40%, P<0.001), reduced pain (NRS score, P<0.05), and improved quality of life (P<0.05). No significant difference was noted in lymph node dissection (P>0.05). All patients were followed up until June 2025, with no recurrence, metastasis, or mortality among the 160 cases. Conclusion Compared to IVMTE, SPIMSLE offers shorter operative time, reduced blood loss, faster pulmonary recovery, fewer complications, milder pain, and better quality of life, demonstrating significant clinical advantages.
ObjectiveTo investigate the feasibility, safety and clinical effect of total laparoscopic radical resection of hilar cholangiocarcinoma.MethodsRetrospectively summarized the 14 patients with hilar cholangiocarcinoma, who underwent total laparoscopic radical resection of hilar cholangiocarcinoma in the Affiliated Hospital of Xuzhou Medical University from April 2016 to June 2018. Collected the clinical data of those patients, including 7 cases of Bismuth type Ⅰ, 5 cases of Bismuth type Ⅱ, and 2 cases of Bismuth type Ⅲb.ResultsTotal laparoscopic radical resection of hilar cholangiocarcinoma were performed successfully in all 14 patients. The operative time was 190–400 min (median time of 285 min) and the amount of intraoperative blood loss was 100–500 mL (median amount of 175 mL). There was no death case during the perioperative period. Postoperative pathological results showed that all cases accorded with bile duct adenocarcinoma, resection margins of them were negative, amount of lymph node was detected 6–15 per case (median amount of 8 per case), and 3 patients were inspected with peritumoral lymph node metastasis. Two patients were combined with postoperative bile leakage, one of whom was complicated with an abdominal infection, and both were cured and discharged after conservative treatment. All patients were followed-up regularly within 3–24 months (median followed-up period of 16 months). One of them recurred within 12 months after the operation. The remaining patients have survived well so far.ConclusionUnder the operation of the experienced surgeon, total laparoscopic radical resection of hilar cholangiocarcinoma is safe, feasible and effective in the short term.
Esophageal carcinoma is one of the most common malignant tumor, a serious threat to human health. In the early and middle esophageal carcinoma patients, surgery is the only expected treatment to cure esophageal carcinoma. Traditional surgery of esophageal cancer needs thoracotomy and laparotomy, which has great trauma and high incidence of complications. So surgeons are looking for a minimally invasive surgical methods alternative to traditional esophagectomy. Video-mediastinoscopy is used to free middle and upper esophagus, as a minimally invasive surgical method, it is used in radical resection of esophageal cancer gradually. This article reviews the recent progress and the related research results in the application of mediastinoscopy in the radical resection of esophageal cancer. It is found that mediastinoscopy assisted the radical resection of esophageal cancer is a safe and feasible operation. It provides a feasible treatment option for early and middle stage esophageal cancer patients with pulmonary insufficiency who can not be resected by thoracoscopy.
ObjectiveTo evaluate the curative effect of laparoscopic assisted and open D2 radical resection in treatment of advanced gastric cancer.
MethodsThe clinical data of 76 cases performed by laparoscopic assisted D2 radical resection (laparoscopic group) and 104 cases performed by open operation (open group) from October 2010 to October 2012 in our center were retrospective analized.Operation related index, postoperative recovery, and extent of radical resection of tumor of 2 groups were compared.
ResultsThe operative time of the laparoscopic group[(192.5±14.8) min]was longer than that open group[(171.5±16.5) min, P < 0.05].But the blood loss, postoperative drainage, length of incision, and hospital stay of the laparoscopic group were significantly less or shorter than those of open group (P < 0.05).There were no significant difference in postoperative complications and extent of radical resection of tumor between the 2 groups (P > 0.05).There were no residual tumor in distal margin and operatiive death case in both 2 groups.
ConclusionComparing with open operation, the laparoscopic assisted surgery for advanced gastric cancer could achieve the same clinical outcomes, and obvious advantage of minimal invasion.
ObjectiveTo explore the risk factors of perioperative severe complications (Clavien-Dindo grade Ⅲ and above) after laparoscopic radical resection of colorectal cancer (CRC). MethodsThe clinicopathologic data of CRC patients who met the inclusion and exclusion criteria treated in the Shaanxi Provincial People’s Hospital from January 2018 to December 2020 were retrospectively analyzed. The univariate and multivariate logistic analyses were used to explore the risk factors of perioperative severe complications after the laparoscopic radical resection of CRC. ResultsAtotal of 170 eligible patients were included in this study, and the postoperative complications occurred in 45 patients, 24 of whom were severe complications. The univariate analysis results showed that the age (P<0.001), body mass index (BMI, P=0.047), age adjusted Charlson complication index (aCCI) score (P=0.002), American Association of Anesthesiologists (ASA) classification (P<0.001), prognostic nutritional index (PNI, P=0.011), preoperative anemia (P=0.011), operation numbers of surgeon (P=0.003), and operation time (P=0.026) were related to the perioperative severe complications in the patients underwent the laparoscopic radical resection of CRC. The statistic indexes of univariate analysis (P<0.05) combined with indexes of clinical significance were included in the multivariate analysis, the results showed that the ASA classification Ⅲ– Ⅳ (OR=3.536, P=0.027), BMI ≥25 kg/m2 (OR=3.228, P=0.031), preoperative anemia (OR=2.876, P=0.049), operation numbers of surgeon <300 (OR=0.324, P=0.046), and the operation time ≥300 min (OR=3.480, P=0.020) increased the probability of perioperative severe complications in the patients underwent the laparoscopic radical resection of CRC. ConclusionsThe results of this study suggest that clinicians should pay attention to the perioperative management of patients with CRC, such as adequately evaluating the preoperative status of patients by ASA classification, PNI, and aCCI to adjust the malnutrition of patients; after operation, the patients with BMI ≥25 kg/m2 and operation time more than 300 min should be paid more attention. At the same time, the surgeon should continuously accumulate the operation numbers and improve the operation proficiency so as to reduce the occurrence of perioperative severe complications after laparoscopic radical resection of CRC.
Objective
To investigate the strategy of treatment and prevention of hemorrhage after radical resection of hilar cholangiocarcinoma.
Method
Reviewing the related literatures at home and abroad in recent years, to summarize the progress of treatment and prevention of hemorrhage after radical resection of hilar cholangiocarcinoma.
Results
We should clear the postoperative bleeding time, extent, cause, and location, to help the clinician to choose the appropriate timing of intervention and treatment. The patients with early hemorrhage and mild degree hemorrhage could be treated conservatively. If patients with severe hemorrhage and hemodynamic disorders, surgical intervention must be decisive. Patients with late hemorrhage would have serious consequences, and these patients should receive interventional or surgical treatment as early as possible.
Conclusions
For patients with hilar cholangiocarcinoma after radical resection, doctors need to do accurate preoperative evaluation, meticulous operation, and intensive management after operation, to reduce the incidence of hemorrhage after radical resection of hilar cholangiocarcinoma. If the postoperative hemorrhage occurs, the cause, location, time, and degree of hemorrhage should be clearly defined to facilitate clinicians to make rapid clinical decisions and to develop treatment programs.
