35 results on '"Xiao Wu"'
Search Results
2. Partial splenectomy using a laparoscopic bipolar radiofrequency device: A case report
- Author
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Weidong Wang, Jing Ma, Xiao-wu Chen, Jie Lin, Zhi-qiang Wu, and Qing-Bo Liu
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medicine.medical_specialty ,Biopsy ,medicine.medical_treatment ,Splenectomy ,Blood Loss, Surgical ,Case Report ,Catheter ablation ,Splenic Neoplasm ,Asymptomatic ,Lymphangioma ,medicine ,Humans ,Bipolar radiofrequency ,Laparoscopy ,medicine.diagnostic_test ,business.industry ,Splenic Neoplasms ,Gastroenterology ,Equipment Design ,General Medicine ,Middle Aged ,medicine.disease ,Surgery ,Treatment Outcome ,Catheter Ablation ,Female ,medicine.symptom ,Tomography, X-Ray Computed ,business - Abstract
We report a 51-year-old female patient with a solitary lymphangioma located in the upper splenic pole which was managed successfully with laparoscopic partial splenectomy. Surgery lasted 170 min and did not require blood transfusions. The patient recovered well post-operatively and was asymptomatic at the 3-mo follow-up. She had a normal platelet count and no recurrence on ultrasonography or computed tomography. Laparoscopic partial splenectomy is a safe, minimally invasive technique for the treatment of solitary splenic lymphangiomas in the splenic pole. We performed the procedure using the Habib(TM) 4X device. This laparoscopic bipolar radiofrequency device ensured a "bloodless" splenic parenchymal resection.
- Published
- 2015
3. Resection of a cholangiocarcinoma via laparoscopic hepatopancreato- duodenectomy: a case report
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Yi-ping Zhu, Erik Matro, Miao-Zun Zhang, Jia-Fei Yan, Wei-Wei Jin, Xiao-Wu Xu, Ren-Chao Zhang, Ke Chen, Yi-Ping Mou, Yu-Cheng Zhou, and Harsha Ajoodhea
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Laparoscopic surgery ,Male ,medicine.medical_specialty ,Cholangiopancreatography, Magnetic Resonance ,medicine.medical_treatment ,Case Report ,Bile Duct Neoplasm ,digestive system ,Pancreaticoduodenectomy ,Cholangiocarcinoma ,Duodenectomy ,Medicine ,Hepatectomy ,Humans ,Neoplasm Invasiveness ,Laparoscopy ,medicine.diagnostic_test ,business.industry ,Stomach ,Gastroenterology ,General Medicine ,Middle Aged ,digestive system diseases ,Surgery ,medicine.anatomical_structure ,Bile Ducts, Intrahepatic ,Treatment Outcome ,Bile Duct Neoplasms ,Duodenum ,business ,Tomography, X-Ray Computed - Abstract
Some laterally advanced cholangiocarcinomas behave as ductal spread or local invasion, and hepatopancreatoduodenectomy (HPD) may be performed for R0 resection. To date, there have been no reports of laparoscopic HPD (LHPD) in the English literature. We report the first case of LHPD for the resection of a Bismuth IIIa cholangiocarcinoma invading the duodenum. The patient underwent laparoscopic pancreaticoduodenectomy and right hemihepatectomy. Child's approach was used for the reconstruction. The patient recovered well with bile leakage from the 2(nd) postoperative day and was discharged on the 16(th) postoperative day with a drainage tube in place which was removed 2 wk after discharge. Postoperative pathology revealed a well-differentiated cholangiocarcinoma and the margin of liver parenchyma, pancreas and stomach was negative for metastases. The results suggest that LHPD is a feasible and safe procedure when performed in highly specialized centers and in suitable patients with cholangiocarcinoma.
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- 2014
4. Intracorporeal esophagojejunostomy after totally laparoscopic total gastrectomy: A single-center 7-year experience
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Chen, Ke, primary, Pan, Yu, additional, Cai, Jia-Qin, additional, Xu, Xiao-Wu, additional, Wu, Di, additional, Yan, Jia-Fei, additional, Chen, Rong-Gao, additional, He, Yang, additional, and Mou, Yi-Ping, additional
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- 2016
- Full Text
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5. Adjuvant sorafenib after heptectomy for Barcelona Clinic Liver Cancer-stage C hepatocellular carcinoma patients
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Xia, Feng, primary, Wu, Li-Li, additional, Lau, Wan-Yee, additional, Huan, Hong-Bo, additional, Wen, Xu-Dong, additional, Ma, Kuan-Sheng, additional, Li, Xiao-Wu, additional, and Bie, Ping, additional
- Published
- 2016
- Full Text
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6. Successful interventional radiological management of postoperative complications of laparoscopic distal pancreatectomy
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Hong-Jie Hu, Ren-Biao Chen, Yi-ping Zhu, Bin Li, Erik Matro, Xiao-Wu Xu, Yi-ping Mou, and Jun-Jun Ni
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Male ,medicine.medical_specialty ,Abdominal Abscess ,medicine.medical_treatment ,Anastomotic Leak ,Case Report ,Radiography, Interventional ,Pseudoaneurysm ,Pancreatectomy ,Postoperative Complications ,Sepsis ,medicine ,Humans ,Laparoscopy ,medicine.diagnostic_test ,business.industry ,General surgery ,Gastroenterology ,Interventional radiology ,General Medicine ,Middle Aged ,medicine.disease ,Embolization, Therapeutic ,Surgery ,Pancreatic Neoplasms ,Treatment Outcome ,Radiological weapon ,Drainage ,Complication ,business ,Distal pancreatectomy ,Tomography, X-Ray Computed ,Aneurysm, False - Abstract
During the past decade, laparoscopic distal pancreatectomy (LDP) has gained increasing acceptance in the surgical community as a viable treatment option for distal pancreatic lesions. However, the possible complication of post-LDP pancreatic leakage remains a challenge, because it may lead to a series of events resulting in intraperitoneal abscess formation, sepsis, pseudoaneurysm formation, and occasional fatal hemorrhage. Dealing with these complications is extremely difficult and not much experience has been reported to date. We report a case involving the aforementioned post-LDP complications successfully managed by interventional radiological techniques while avoiding reoperation. We conclude that these management options are attractive, safe and minimally invasive alternatives to standard protocols.
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- 2013
7. Laparoscopic distal pancreatectomy is as safe and feasible as open procedure: a meta-analysis
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Xiao-Wu Xu, Yi-ping Zhu, Kun Xie, Yi-Ping Mou, Ke Chen, and Jia-Fei Yan
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medicine.medical_specialty ,medicine.diagnostic_test ,Brief Article ,business.industry ,medicine.medical_treatment ,Mortality rate ,Gastroenterology ,General Medicine ,medicine.disease ,Random effects model ,Surgery ,Pancreatic Neoplasms ,Pancreatic Fistula ,Pancreatectomy ,Pancreatic fistula ,Meta-analysis ,Relative risk ,Anesthesia ,medicine ,Humans ,Laparoscopy ,business ,Distal pancreatectomy - Abstract
AIM: To evaluate the feasibility and safety of laparoscopic distal pancreatectomy (LDP) compared with open distal pancreatectomy (ODP). METHODS: Meta-analysis was performed using the databases, including PubMed, the Cochrane Central Register of Controlled Trials, Web of Science and BIOSIS Previews. Articles should contain quantitative data of the comparison of LDP and ODP. Each article was reviewed by two authors. Indices of operative time, spleen-preserving rate, time to fluid intake, ratio of malignant tumors, postoperative hospital stay, incidence rate of pancreatic fistula and overall morbidity rate were analyzed. RESULTS: Nine articles with 1341 patients who underwent pancreatectomy met the inclusion criteria. LDP was performed in 501 (37.4%) patients, while ODP was performed in 840 (62.6%) patients. There were significant differences in the operative time, time to fluid intake, postoperative hospital stay and spleen-preserving rate between LDP and ODP. There was no difference between the two groups in pancreatic fistula rate [random effects model, risk ratio (RR) 0.996 (0.663, 1.494), P = 0.983, I2 = 28.4%] and overall morbidity rate [random effects model, RR 0.81 (0.596, 1.101), P = 0.178, I2 = 55.6%]. CONCLUSION: LDP has the advantages of shorter hospital stay and operative time, more rapid recovery and higher spleen-preserving rate as compared with ODP.
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- 2011
8. Laparoscopic wedge resection of synchronous gastric intraepithelial neoplasia and stromal tumor: a case report
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Xiao-Wu Xu, Ke Chen, Kun Xie, Wei Zhou, Yi-Ping Mou, and Yu-Cheng Zhou
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medicine.medical_specialty ,Gastrointestinal Stromal Tumors ,Case Report ,Neoplasms, Multiple Primary ,Stomach Neoplasms ,Gastroscopy ,medicine ,Humans ,Stromal tumor ,Laparoscopy ,neoplasms ,Neoplasm Staging ,Intraepithelial neoplasia ,GiST ,medicine.diagnostic_test ,business.industry ,Stomach ,Carcinoma in situ ,Gastroenterology ,Laparoscopic wedge resection ,General Medicine ,Middle Aged ,medicine.disease ,digestive system diseases ,Surgery ,Gastric Intraepithelial Neoplasia ,medicine.anatomical_structure ,Treatment Outcome ,Female ,business ,Tomography, X-Ray Computed ,Carcinoma in Situ - Abstract
Synchronous occurrence of epithelial neoplasia and gastrointestinal stromal tumor (GIST) in the stomach is uncommon. Only rare cases have been reported in the literature. We present here a 60-year-old female case of synchronous occurrence of gastric high-level intraepithelial neoplasia and GIST with the features of 22 similar cases and detailed information reported in the English-language literature summarized. In the present patient, epithelial neoplasia and GIST were removed en bloc by laparoscopic wedge resection. To the best of our knowledge, this is the first reported case treated by laparoscopic wedge resection.
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- 2010
9. Efficiency and safety of radiofrequency-assisted hepatectomy for hepatocellular carcinoma with cirrhosis: A single-center retrospective cohort study
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Zhang, Fan, primary, Yan, Jun, additional, Feng, Xiao-Bin, additional, Xia, Feng, additional, Li, Xiao-Wu, additional, Ma, Kuan-Sheng, additional, and Bie, Ping, additional
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- 2015
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10. Partial splenectomy using a laparoscopic bipolar radiofrequency device: A case report
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Wang, Wei-Dong, primary, Lin, Jie, additional, Wu, Zhi-Qiang, additional, Liu, Qing-Bo, additional, Ma, Jing, additional, and Chen, Xiao-Wu, additional
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- 2015
- Full Text
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11. Protective effects of terminal ileostomy against bacterial translocation in a rat model of intestinal ischemia/reperfusion injury
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Lin, Zhi-Liang, primary, Yu, Wen-Kui, additional, Tan, Shan-Jun, additional, Duan, Kai-Peng, additional, Dong, Yi, additional, Bai, Xiao-Wu, additional, Xu, Lin, additional, and Li, Ning, additional
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- 2014
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12. Fever as a first manifestation of advanced gastric adenosquamous carcinoma: A case report
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Harsha Ajoodhea, Wei-Wei Jin, Yong-Tao He, Yi-Ping Mou, Ren-Chao Zhang, Ke Chen, and Xiao-Wu Xu
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Male ,Poor prognosis ,medicine.medical_specialty ,Time Factors ,Fever ,Gastric Adenosquamous Carcinoma ,Biopsy ,medicine.medical_treatment ,Case Report ,Carcinoma, Adenosquamous ,Refractory ,Gastrectomy ,Stomach Neoplasms ,Gastroscopy ,medicine ,Humans ,Laparoscopy ,Aged ,Neoplasm Staging ,Chemotherapy ,medicine.diagnostic_test ,business.industry ,Gastroenterology ,Cancer ,Chemoradiotherapy, Adjuvant ,General Medicine ,medicine.disease ,Surgery ,Treatment Outcome ,Lymph Node Excision ,Tomography, X-Ray Computed ,business - Abstract
Gastric adenosquamous carcinoma (ASC) is a rare type of gastric cancer. It is a mixed neoplasm, consisting of glandular cells and squamous cells. It is often diagnosed at an advanced stage, thus carrying a poor prognosis. We describe a case of a 73-year-old male, who presented with refractory fever and an intra-abdominal mass on imaging. He underwent a laparoscopic exploration followed by a successful totally laparoscopic total gastrectomy with D2 lymphadenectomy for gastric cancer. Postoperative pathology revealed primary gastric ASC (T4aN0M0). The patient received adjuvant radiotherapy and chemotherapy with S1 and is alive 20 mo after surgery without recurrence. This is the first case of advanced gastric ASC with fever as the initial presentation treated with totally laparoscopic total gastrectomy reported in the English literature.
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- 2014
13. Systematic review and meta-analysis of laparoscopy-assisted and open total gastrectomy for gastric cancer
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Yi-Ping Mou, Yu Pan, Xiao-Wu Xu, Ke Chen, Di Wu, and Ren-Chao Zhang
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medicine.medical_specialty ,Lymphatic metastasis ,Time Factors ,medicine.medical_treatment ,Treatment outcome ,Postoperative Complications ,Gastrectomy ,Risk Factors ,Stomach Neoplasms ,Humans ,Medicine ,Laparoscopy ,Chi-Square Distribution ,medicine.diagnostic_test ,business.industry ,digestive, oral, and skin physiology ,Gastroenterology ,Cancer ,General Medicine ,Length of Stay ,medicine.disease ,digestive system diseases ,Surgery ,Treatment Outcome ,Lymphatic Metastasis ,Meta-analysis ,Neoplasm Recurrence, Local ,business ,Chi-squared distribution ,Meta-Analysis - Abstract
To evaluate the safety and efficacy of laparoscopy-assisted total gastrectomy (LATG) and open total gastrectomy (OTG) for gastric cancer.A comprehensive search of PubMed, Cochrane Library, Web of Science and BIOSIS Previews was performed to identify studies that compared LATG and OTG. The following factors were checked: operating time, blood loss, harvested lymph nodes, flatus time, hospital stay, mortality and morbidity. Data synthesis and statistical analysis were carried out using RevMan 5.1 software.Nine studies with 1221 participants were included (436 LATG and 785 OTG). Compared to OTG, LATG involved a longer operating time [weighted mean difference (WMD) = 57.68 min, 95%CI: 30.48-84.88; P0.001]; less blood loss [standard mean difference (SMD) = -1.71; 95%CI: -2.48 - -0.49; P0.001]; earlier time to flatus (WMD= -0.76 d; 95%CI: -1.22 - -0.30; P0.001); shorter hospital stay (WMD = -2.67 d; 95%CI: -3.96 - -1.38, P0.001); and a decrease in medical complications (RR = 0.41, 95%CI: 0.19-0.90, P = 0.03). The number of harvested lymph nodes, mortality, surgical complications, cancer recurrence rate and long-term survival rate of patients undergoing LATG were similar to those in patients undergoing OTG.Despite a longer operation, LATG can be performed safely in experienced surgical centers with a shorter hospital stay and fewer complications than open surgery.
- Published
- 2013
14. Laparoscopicvsopen distal pancreatectomy for solid pseudopapillary tumor of the pancreas
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Ke Chen, Ren-Chao Zhang, Harsha Ajoodhea, Jia-Fei Yan, Yi-Ping Mou, and Xiao-Wu Xu
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Adult ,Male ,Laparoscopic surgery ,medicine.medical_specialty ,Time Factors ,Blood transfusion ,Brief Article ,medicine.medical_treatment ,Blood Loss, Surgical ,Young Adult ,Pancreatectomy ,Pancreatic tumor ,medicine ,Humans ,Blood Transfusion ,Laparoscopy ,Retrospective Studies ,Chi-Square Distribution ,medicine.diagnostic_test ,business.industry ,Gastroenterology ,Retrospective cohort study ,Recovery of Function ,General Medicine ,Length of Stay ,Middle Aged ,medicine.disease ,Carcinoma, Papillary ,Surgery ,Pancreatic Neoplasms ,Treatment Outcome ,Pancreatic fistula ,Female ,business ,Chi-squared distribution - Abstract
AIM: To compare short- and long-term outcomes of laparoscopic vs open distal pancreatectomy for solid pseudopapillary tumor (SPT) of the pancreas. METHODS: This retrospective study included 28 patients who underwent distal pancreatectomy for SPT of the pancreas between 1998 and 2012. The patients were divided into two groups based on the surgical approach: the laparoscopic surgery group and the open surgery group. The patients’ demographic data, operative results, pathological reports, hospital courses, morbidity and mortality, and follow-up data were compared between the two groups. RESULTS: Fifteen patients with SPT of the pancreas underwent laparoscopic distal pancreatectomy (LDP), and 13 underwent open distal pancreatectomy (ODP). Baseline characteristics were similar between the two groups except for a female predominance in the LDP group (100.0% vs 69.2%, P = 0.035). Mortality, morbidity (33.3% vs 38.5%, P = 1.000), pancreatic fistula rates (26.7% vs 30.8%, P = 0.728), and reoperation rates (0.0% vs 7.7%, P = 0.464) were similar in the two groups. There were no significant differences in the operating time (171 min vs 178 min, P = 0.755) between the two groups. The intraoperative blood loss (149 mL vs 580 mL, P = 0.002), transfusion requirement (6.7% vs 46.2%, P = 0.029), first flatus time (1.9 d vs 3.5 d, P = 0.000), diet start time (2.3 d vs 4.9 d, P = 0.000), and postoperative hospital stay (8.1 d vs 12.8 d, P = 0.029) were significantly less in the LDP group than in the ODP group. All patients had negative surgical margins at final pathology. There were no significant differences in number of lymph nodes harvested (4.6 vs 6.4, P = 0.549) between the two groups. The median follow-up was 33 (3-100) mo for the LDP group and 45 (17-127) mo for the ODP group. All patients were alive with one recurrence. CONCLUSION: LDP for SPT has short-term benefits compared with ODP. Long-term outcomes of LDP are similar to those of ODP.
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- 2013
15. Laparoscopic transduodenal local resection of periampullary neuroendocrine tumor: A case report
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Yi-Ping Mou, Yu-Cheng Zhou, Harsha Ajoodhea, Xiao-Wu Xu, Ke Chen, Ren-Chao Zhang, and Di Wu
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Adult ,Laparoscopic surgery ,Ampulla of Vater ,medicine.medical_specialty ,Time Factors ,medicine.medical_treatment ,Common Bile Duct Neoplasms ,Case Report ,Neuroendocrine tumors ,Endosonography ,Duodenal Neoplasms ,Submucosa ,Gastroscopy ,medicine ,Humans ,Ampulla ,Laparoscopy ,Duodenal Neoplasm ,medicine.diagnostic_test ,business.industry ,Gastroenterology ,General Medicine ,medicine.disease ,Surgery ,Major duodenal papilla ,Neuroendocrine Tumors ,Treatment Outcome ,medicine.anatomical_structure ,Female ,Neoplasm Grading ,Tomography, X-Ray Computed ,business - Abstract
Studies on laparoscopic transduodenal local resection have not been readily available. Only three cases have been reported in the English-language literature. We describe herein a case of 25-year-old woman with periampullary neuroendocrine tumor (NET). Endoscopic ultrasonography revealed a duodenal papilla mass originated from the submucosa and close to the ampulla. The periampullary tumor was successfully managed with laparoscopic transduodenal local resection without any procedure-related complications. Pathological examination showed a NET (Grade 2) with negative margin. The patient was followed up for six months without signs of recurrence. This case suggests that laparoscopic transduodenal local resection is a feasible procedure in selected patients with periampullary tumor.
- Published
- 2013
16. Laparoscopic resection of synchronous intraductal papillary mucinous neoplasms: A case report
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Xu, Xiao-Wu, primary
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- 2012
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17. Laparoscopic resection of synchronous intraductal papillary mucinous neoplasms: A case report
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Ke Chen, Yi-Ping Mou, Jie Wang, Xiao-Wu Xu, Rong-Hua Li, Ren-Chao Zhang, and Wei Zhou
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Pathology ,medicine.medical_specialty ,endocrine system diseases ,Cholangiopancreatography, Magnetic Resonance ,Biopsy ,medicine.medical_treatment ,Tail of pancreas ,Case Report ,Neoplasms, Multiple Primary ,Pancreatectomy ,medicine ,Hepatectomy ,Humans ,Aged ,Pancreatic duct ,Magnetic resonance cholangiopancreatography ,Intraductal papillary mucinous neoplasm ,medicine.diagnostic_test ,business.industry ,Liver Neoplasms ,Gastroenterology ,General Medicine ,medicine.disease ,Pancreatic Neoplasms ,Treatment Outcome ,medicine.anatomical_structure ,Female ,Laparoscopy ,Mucinous Tumor ,Neoplasms, Cystic, Mucinous, and Serous ,Tomography, X-Ray Computed ,business ,Pancreas ,Carcinoma, Pancreatic Ductal - Abstract
We describe herein a 68-year-old woman who was diagnosed with a quite rare entity of intraductal papillary mucinous neoplasms (IPMNs) occurring simultaneously in the left lateral lobe of liver and the tail of pancreas. Abdominal computed tomography and magnetic resonance cholangiopancreatography showed a cystic dilatation of the pancreatic duct in the pancreatic tail, which suggested an IPMN, and multiple intrahepatic duct stones in the left lateral lobe. The patient underwent a laparoscopic left lateral hepatolobectomy and spleen-preserving distal pancreatectomy. Intra-operative finding of massive mucin in the dilated bile duct implied an intraductal mucinous tumor in the liver. The diagnosis of synchronous IPMNs in the liver and pancreas was confirmed by pathological examination. The patient was followed up for 6 mo without signs of recurrence. Although several cases of IPMN of liver without any pancreatic association have been reported, the simultaneous occurrence of IPMNs in the liver and pancreas is very rare. To the best of our knowledge, it is the first reported case treated by laparoscopic resection.
- Published
- 2012
18. Conversion to sirolimus immunosuppression in liver transplantation recipients with hepatocellular carcinoma: Report of an initial experience
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Yi-Feng He, Shuang-Jian Qiu, Yao Yu, Yong-sheng Xiao, Zheng Wang, Jian Zhou, Yu-qi Wang, Zhao-You Tang, Zhi-Quan Wu, Jia Fan, Jian Sun, and Xiao-wu Huang
- Subjects
Adult ,Male ,medicine.medical_specialty ,Carcinoma, Hepatocellular ,medicine.medical_treatment ,Liver transplantation ,Gastroenterology ,Tacrolimus ,Internal medicine ,medicine ,Carcinoma ,Humans ,Transplantation, Homologous ,Renal Insufficiency ,Neoplasm Metastasis ,Adaptor Proteins, Signal Transducing ,Retrospective Studies ,Sirolimus ,Transplantation ,business.industry ,Calcineurin ,Incidence ,Liver Neoplasms ,Immunosuppression ,General Medicine ,Middle Aged ,Phosphoproteins ,medicine.disease ,humanities ,Liver Transplantation ,Surgery ,surgical procedures, operative ,Hepatocellular carcinoma ,Prednisolone ,Female ,Neoplasm Recurrence, Local ,business ,Rapid Communication ,Immunosuppressive Agents ,medicine.drug - Abstract
AIM: To report a retrospective analysis of preliminary results of 36 patients who received sirolimus (SRL, Rapamune®, rapamycin) in a consecutive cohort of 248 liver allograft recipients. METHODS: Thirty-six liver transplant patients with hepatocellular carcinoma (HCC) who were switched to SRL-based immunosuppression therapy from tacrolimus were enrolled in this study. The patients who were diagnosed as advanced HCC before orthotopic liver transplantation (OLT) were divided into group A (n = 11), those who were found to have HCC recurrence and/or metastasis after OLT were assigned to group B (n = 18), and those who developed renal insufficiency caused by calcineurin inhibitor (CNI) were assigned to group C (n = 7) after OLT. RESULTS: The patients were followed up for a median of 10.4 mo (range, 3.8-19.1 mo) after conversion to SRL therapy and 12.3 mo (range, 5.1-34.4 mo) after OLT. Three patients developed mild acute cellular rejection 2 wk after initiating SRL therapy, which was fully reversed after prednisolone pulse therapy. In group A, only 1 patient was found to have HCC recurrence and metastasis 12 mo after OLT. In group B, 66.7% (12/18) patients (2 with progressive tumor, 7 with stable tumor and 3 without tumor) were still alive due to conversing to SRL and/or resection for HCC recurrence at the end of a median follow-up of 6.8 mo post conversion and 10.7 mo posttransplant. In group C, no HCC recurrence was demonstrated in 7 patients, and renal function became normal after SRL therapy. Thrombocytopenia (n = 2), anemia (n = 8), and oral aphthous ulcers (n = 7) found in our cohort were easily manageable. CONCLUSION: The conversion to SRL-based immunosuppression may inhibit the recurrence and metastasis of HCC and improve CNI-induced renal insufficiency in OLT patients with HCC.
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- 2006
19. Association of hTcf-4 gene expression and mutation with clinicopathological characteristics of hepatocellular carcinoma
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Xin-Da Zhou, Ying Jiang, Yin-Kun Liu, Xin Wu, and Xiao-Wu Huang
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Adult ,Male ,Liver Cancer ,Silver Staining ,Carcinoma, Hepatocellular ,Adolescent ,Biology ,medicine.disease_cause ,Polymerase Chain Reaction ,Metastasis ,Exon ,Gene expression ,medicine ,Humans ,RNA, Messenger ,neoplasms ,Gene ,Polymorphism, Single-Stranded Conformational ,Aged ,Liver Neoplasms ,Gastroenterology ,Wnt signaling pathway ,General Medicine ,Middle Aged ,medicine.disease ,Molecular biology ,digestive system diseases ,Gene Expression Regulation, Neoplastic ,Liver ,Hepatocellular carcinoma ,Catenin ,Mutation ,Female ,TCF Transcription Factors ,Carcinogenesis ,Transcription Factor 7-Like 2 Protein ,Transcription Factors - Abstract
Hepatocellular carcinoma(HCC) is a significant health problem in China. But the molecular mechanisms of HCC remains unclear. APC/beta-Catenin/Tcf signaling pathway, also known as Wnt pathway, plays a critical role in the development and oncogenesis. As little is known about the alteration of human T-cell transcription factor-4 (hTcf-4) gene in HCC, it is of interest to study the expression and mutation of hTcf-4 gene in HCC and the relationship between hTcf-4 gene and progression of HCC.Reverse transcription-polymerase chain reaction (RT-PCR) method was used to detect the expression of hTcf-4 mRNA in 32 HCC and para-cancerous tissues and 5 normal liver tissues. PCR-single strand conformation polymorphism (PCR-SSCP) method was used to detect the mutation of hTcf-4 exons 1, 4, 9 and 15 in HCC. The correlation of expression and mutation of the hTcf-4 gene with clinicopathological characteristics of HCC was also analyzed.RT-PCR showed that the expression rate of hTcf-4 mRNA in HCC, para-cancerous tissues and normal liver tissues was 90.6 %, 71.9 % and 80 %, respectively. The gene expression level in tumor was 0.71+/-0.13, much higher than that in para-cancerous liver 0.29+/-0.05 and normal liver 0.26+/-0.05 (P0.001), although there was no significant difference in gene expression level between para-cancerous tissues and normal liver (P0.05). Furthermore, hTcf-4 gene expression was closely associated with tumor capsule status and intrahepatic metastasis of HCC. On SSCP, 2 of 32 cases of HCC (6.25 %) displayed characteristic mutational mobility shifts in exon 15 of the hTcf-4 gene. No abnormal shifting bands were observed in para-cancerous tissues.The high expression level of hTcf-4 in HCC, especially in tumors with metastasis, suggests that the over-expression of hTcf-4 gene may be closely associated with development and progression of HCC, but the mutation of this gene seemed to play less important role in this respect.
- Published
- 2002
20. Coexpression of MYC and BCL-2 predicts prognosis in primary gastrointestinal diffuse large B-cell lymphoma.
- Author
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Xia B, Zhang L, Guo SQ, Li XW, Qu FL, Zhao HF, Zhang LY, Sun BC, You J, and Zhang YZ
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- Adult, Aged, Biomarkers, Tumor genetics, Case-Control Studies, Chi-Square Distribution, China, Disease-Free Survival, Female, Gastrointestinal Neoplasms genetics, Gastrointestinal Neoplasms mortality, Gastrointestinal Neoplasms pathology, Gastrointestinal Neoplasms therapy, Hospitals, University, Humans, Immunohistochemistry, Kaplan-Meier Estimate, Lymphoma, Large B-Cell, Diffuse genetics, Lymphoma, Large B-Cell, Diffuse mortality, Lymphoma, Large B-Cell, Diffuse pathology, Lymphoma, Large B-Cell, Diffuse therapy, Male, Middle Aged, Multivariate Analysis, Neoplasm Staging, Predictive Value of Tests, Proportional Hazards Models, Proto-Oncogene Proteins c-bcl-2 genetics, Proto-Oncogene Proteins c-myc genetics, RNA, Messenger analysis, Real-Time Polymerase Chain Reaction, Risk Factors, Time Factors, Treatment Outcome, Young Adult, Biomarkers, Tumor analysis, Gastrointestinal Neoplasms chemistry, Lymphoma, Large B-Cell, Diffuse chemistry, Proto-Oncogene Proteins c-bcl-2 analysis, Proto-Oncogene Proteins c-myc analysis
- Abstract
Aim: To investigate whether MYC and BCL-2 coexpression has prognostic significance in primary gastrointestinal diffuse large B-cell lymphoma (PGI-DLBCL) patients, and explore its associations with patients' clinical parameters., Methods: Fresh and paraffin-embedded tumor tissue samples from 60 PGI-DLBCL patients who had undergone surgery at the Tianjin Medical University Cancer Institute and Hospital from January 2005 to May 2010 were obtained, and 30 lymphoid tissue samples from reactive lymph nodes of age- and sex-matched patients represented control samples. Staging and diagnostic procedures were conducted according to the Lugano staging system. All patients had been treated with three therapeutic modalities: surgery, chemotherapy, or radiotherapy. Expression of MYC and BCL-2 were detected at both protein and mRNA levels by immunohistochemistry and real-time RT-PCR., Results: Positive expression levels of MYC and BCL-2 proteins were detected in 35% and 45% of patients, respectively. MYC+/BCL-2+ protein was present in 30% of patients. MYC and BCL-2 protein levels were correlated with high MYC and BCL-2 mRNA expression, respectively (both P<0.05). We found that advanced-stage disease (at IIE-IV) was associated with MYC and BCL-2 coexpression levels (P<0.05). In addition, MYC+/BCL-2+ patients had more difficulty in achieving complete remission than others (P<0.05). Presence of MYC protein expression only affected overall survival and progression-free survival (PFS) when BCL-2 protein was coexpressed. The adverse prognostic impact of MYC+/BCL-2+ protein on PFS remained significant (P<0.05) even after adjusting for age, Lugano stage, international prognostic index, and BCL-2 protein expression in a multivariable model., Conclusion: MYC+/BCL-2+ patients have worse chemotherapy response and poorer prognosis than patients who only express one of the two proteins, suggesting that assessment of MYC and BCL-2 expression by immunohistochemistry has clinical significance in predicting clinical outcomes of PGI-DLBCL patients.
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- 2015
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21. Resection of a cholangiocarcinoma via laparoscopic hepatopancreato- duodenectomy: a case report.
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Zhang MZ, Xu XW, Mou YP, Yan JF, Zhu YP, Zhang RC, Zhou YC, Chen K, Jin WW, Matro E, and Ajoodhea H
- Subjects
- Bile Duct Neoplasms pathology, Bile Ducts, Intrahepatic pathology, Cholangiocarcinoma pathology, Cholangiopancreatography, Magnetic Resonance, Humans, Male, Middle Aged, Neoplasm Invasiveness, Tomography, X-Ray Computed, Treatment Outcome, Bile Duct Neoplasms surgery, Bile Ducts, Intrahepatic surgery, Cholangiocarcinoma surgery, Hepatectomy methods, Laparoscopy methods, Pancreaticoduodenectomy methods
- Abstract
Some laterally advanced cholangiocarcinomas behave as ductal spread or local invasion, and hepatopancreatoduodenectomy (HPD) may be performed for R0 resection. To date, there have been no reports of laparoscopic HPD (LHPD) in the English literature. We report the first case of LHPD for the resection of a Bismuth IIIa cholangiocarcinoma invading the duodenum. The patient underwent laparoscopic pancreaticoduodenectomy and right hemihepatectomy. Child's approach was used for the reconstruction. The patient recovered well with bile leakage from the 2(nd) postoperative day and was discharged on the 16(th) postoperative day with a drainage tube in place which was removed 2 wk after discharge. Postoperative pathology revealed a well-differentiated cholangiocarcinoma and the margin of liver parenchyma, pancreas and stomach was negative for metastases. The results suggest that LHPD is a feasible and safe procedure when performed in highly specialized centers and in suitable patients with cholangiocarcinoma.
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- 2014
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22. Totally laparoscopic gastrectomy for gastric cancer: a systematic review and meta-analysis of outcomes compared with open surgery.
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Chen K, Pan Y, Cai JQ, Xu XW, Wu D, and Mou YP
- Subjects
- Blood Loss, Surgical prevention & control, Chi-Square Distribution, Gastrectomy adverse effects, Gastrectomy mortality, Humans, Laparoscopy adverse effects, Laparoscopy mortality, Neoplasm Recurrence, Local, Odds Ratio, Postoperative Complications etiology, Risk Assessment, Risk Factors, Stomach Neoplasms mortality, Stomach Neoplasms pathology, Time Factors, Treatment Outcome, Gastrectomy methods, Laparoscopy methods, Stomach Neoplasms surgery
- Abstract
Aim: To systematically review the surgical outcomes of totally laparoscopic gastrectomy (TLG) vs open gastrectomy (OG) for gastric cancer., Methods: A systematic search of PubMed, Embase, Cochrane Library, and Web of Science was conducted. All original studies comparing TLG with OG were included for critical appraisal. Data synthesis and statistical analysis were carried out using RevMan 5.1 software., Results: One RCT and 13 observational studies involving 1532 patients were included (721 TLG and 811 OG). TLG was associated with longer operation time [weighted mean difference (WMD) = 58.04 min, 95%CI: 37.77-78.32, P < 0.001], less blood loss [WMD = -167.57 min, 95%CI: -208.79-(-126.34), P < 0.001], shorter hospital stay [WMD = -3.75 d, 95%CI: -4.88-(-2.63), P < 0.001] and fewer postoperative complications (RR = 0.71, 95%CI: 0.58-0.86, P < 0.001). The number of harvested lymph nodes, surgical margin, mortality and cancer recurrence rate were similar between the two groups., Conclusion: TLG may be a technically safe, feasible and favorable approach in terms of better cosmesis, less blood loss and faster recovery compared with OG.
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- 2014
- Full Text
- View/download PDF
23. Laparoscopic spleen-preserving distal pancreatectomy for pancreatic neoplasms: a retrospective study.
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Yan JF, Xu XW, Jin WW, Huang CJ, Chen K, Zhang RC, Harsha A, and Mou YP
- Subjects
- Adult, Aged, Blood Loss, Surgical, China, Feasibility Studies, Female, Humans, Length of Stay, Ligation, Male, Middle Aged, Neoplasm Staging, Operative Time, Pancreatectomy adverse effects, Pancreatic Neoplasms pathology, Postoperative Complications etiology, Retrospective Studies, Splenic Artery surgery, Splenic Vein surgery, Time Factors, Treatment Outcome, Laparoscopy adverse effects, Organ Sparing Treatments adverse effects, Pancreatectomy methods, Pancreatic Neoplasms surgery
- Abstract
Aim: To describe the clinical characteristics, technical procedures, and outcomes of patients undergoing laparoscopic spleen-preserving distal pancreatectomy (LSPDP) for benign and malignant pancreatic neoplasms., Methods: The clinical data of 38 patients who underwent LSPDP in the Sir Run Run Shaw Hospital between January 2003 and August 2013 were analyzed retrospectively. Surgical techniques for LSPDP included preservation of the splenic artery and vein (Kimura's technique) and ligation of the splenic pedicle with preservation of the short gastric vessels (Warshaw's technique)., Results: There were no conversions to open surgery in the 38 patients. Splenic vessels were conserved during spleen-preserving pancreatectomy, except in two patients who underwent resection of the splenic vessels and preservation only of the short gastric vessels. The mean operation time was 123.2 ± 52.4 min, the mean intraoperative blood loss was 78.2 ± 39.5 mL, and the mean postoperative hospital stay was 7.6 ± 2.9 d. The overall rate of postoperative complications was 18.4% (7/38), and the rate of clinical pancreatic fistula was 13.2% (5/38). All postoperative complications were treated conservatively. The postoperative pathological diagnoses were 22 cases of benign pancreatic disease and 16 cases of borderline or low-grade malignant lesions. During a median follow-up of 38 mo (range: 5-133 mo), no recurrence was observed., Conclusion: LSPDP is a safe, feasible and effective procedure for the treatment of benign and low-grade malignant tumors of the distal pancreas.
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- 2014
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24. Fever as a first manifestation of advanced gastric adenosquamous carcinoma: a case report.
- Author
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Ajoodhea H, Zhang RC, Xu XW, Jin WW, Chen K, He YT, and Mou YP
- Subjects
- Aged, Biopsy, Carcinoma, Adenosquamous pathology, Carcinoma, Adenosquamous therapy, Chemoradiotherapy, Adjuvant, Gastrectomy methods, Gastroscopy, Humans, Laparoscopy, Lymph Node Excision, Male, Neoplasm Staging, Stomach Neoplasms pathology, Stomach Neoplasms therapy, Time Factors, Tomography, X-Ray Computed, Treatment Outcome, Carcinoma, Adenosquamous complications, Fever etiology, Stomach Neoplasms complications
- Abstract
Gastric adenosquamous carcinoma (ASC) is a rare type of gastric cancer. It is a mixed neoplasm, consisting of glandular cells and squamous cells. It is often diagnosed at an advanced stage, thus carrying a poor prognosis. We describe a case of a 73-year-old male, who presented with refractory fever and an intra-abdominal mass on imaging. He underwent a laparoscopic exploration followed by a successful totally laparoscopic total gastrectomy with D2 lymphadenectomy for gastric cancer. Postoperative pathology revealed primary gastric ASC (T4aN0M0). The patient received adjuvant radiotherapy and chemotherapy with S1 and is alive 20 mo after surgery without recurrence. This is the first case of advanced gastric ASC with fever as the initial presentation treated with totally laparoscopic total gastrectomy reported in the English literature.
- Published
- 2014
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- View/download PDF
25. Liver resection in hepatitis B related-hepatocellular carcinoma: clinical outcomes and safety in elderly patients.
- Author
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Wang HQ, Yang J, Yan LN, Zhang XW, and Yang JY
- Subjects
- Adult, Age Factors, Aged, Comorbidity, Female, Hepatectomy adverse effects, Hepatitis B Surface Antigens blood, Hepatitis B e Antigens blood, Humans, Male, Middle Aged, Postoperative Complications, Retrospective Studies, Treatment Outcome, Carcinoma, Hepatocellular complications, Carcinoma, Hepatocellular surgery, Hepatectomy methods, Hepatitis B complications, Hepatitis B surgery, Liver Neoplasms complications, Liver Neoplasms surgery
- Abstract
Aim: To compare the morbidity and mortality in young and elderly hepatocellular carcinoma (HCC) patients undergoing liver resection., Methods: We retrospectively enrolled 1543 consecutive hepatitis B (HBV)-related HCC patients undergoing elective hepatic resection in our cohort, including 207 elderly patients (≥ 65 years) and 1336 younger patients (< 65 years). Patient characteristics and clinical outcomes after liver resection were compared between the two groups., Results: Elderly patients had more preoperative comorbidities and lower alanine aminotransferase and aspartate aminotransferase levels. Positive rates for hepatitis B surface antigen (P < 0.001), hepatitis B e antigen (P < 0.001) and HBV DNA (P = 0.017) were more common in younger patients. Overall complications and their severity classified using the Clavien system were similar in the two groups (33.3% vs 29.6%, P = 0.271). Elderly patients had a higher rate of postoperative cardiovascular complications (3.9% vs 0.6%, P = 0.001), neurological complications (2.9% vs 0.4%, P < 0.001) and mortality (3.4% vs 1.2%, P = 0.035), and had more hospital stay requirement (13 d vs 12 d , P < 0.001) and more intensive care unit stay (36.7% vs 27.8%, P = 0.008) compared with younger patients. However, postoperative hepatic insufficiency was more common in the younger group (7.7% vs 3.4%, P = 0.024)., Conclusion: Hepatectomy can be safely performed in elderly patients. Age should not be regarded as a contraindication to liver resection with expected higher complication and mortality rates.
- Published
- 2014
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26. Successful interventional radiological management of postoperative complications of laparoscopic distal pancreatectomy.
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Zhu YP, Ni JJ, Chen RB, Matro E, Xu XW, Li B, Hu HJ, and Mou YP
- Subjects
- Abdominal Abscess diagnostic imaging, Abdominal Abscess etiology, Abdominal Abscess therapy, Anastomotic Leak diagnostic imaging, Anastomotic Leak etiology, Anastomotic Leak therapy, Aneurysm, False diagnostic imaging, Aneurysm, False etiology, Aneurysm, False therapy, Humans, Male, Middle Aged, Pancreatectomy methods, Postoperative Complications diagnostic imaging, Postoperative Complications etiology, Sepsis diagnostic imaging, Sepsis etiology, Sepsis therapy, Tomography, X-Ray Computed, Treatment Outcome, Drainage methods, Embolization, Therapeutic methods, Laparoscopy adverse effects, Pancreatectomy adverse effects, Pancreatic Neoplasms surgery, Postoperative Complications therapy, Radiography, Interventional
- Abstract
During the past decade, laparoscopic distal pancreatectomy (LDP) has gained increasing acceptance in the surgical community as a viable treatment option for distal pancreatic lesions. However, the possible complication of post-LDP pancreatic leakage remains a challenge, because it may lead to a series of events resulting in intraperitoneal abscess formation, sepsis, pseudoaneurysm formation, and occasional fatal hemorrhage. Dealing with these complications is extremely difficult and not much experience has been reported to date. We report a case involving the aforementioned post-LDP complications successfully managed by interventional radiological techniques while avoiding reoperation. We conclude that these management options are attractive, safe and minimally invasive alternatives to standard protocols., (© 2013 Baishideng Publishing Group Co., Limited. All rights reserved.)
- Published
- 2013
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27. Laparoscopic transduodenal local resection of periampullary neuroendocrine tumor: a case report.
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Zhang RC, Xu XW, Wu D, Zhou YC, Ajoodhea H, Chen K, and Mou YP
- Subjects
- Adult, Ampulla of Vater pathology, Common Bile Duct Neoplasms pathology, Duodenal Neoplasms pathology, Endosonography, Female, Gastroscopy, Humans, Neoplasm Grading, Neuroendocrine Tumors pathology, Time Factors, Tomography, X-Ray Computed, Treatment Outcome, Ampulla of Vater surgery, Common Bile Duct Neoplasms surgery, Duodenal Neoplasms surgery, Laparoscopy, Neuroendocrine Tumors surgery
- Abstract
Studies on laparoscopic transduodenal local resection have not been readily available. Only three cases have been reported in the English-language literature. We describe herein a case of 25-year-old woman with periampullary neuroendocrine tumor (NET). Endoscopic ultrasonography revealed a duodenal papilla mass originated from the submucosa and close to the ampulla. The periampullary tumor was successfully managed with laparoscopic transduodenal local resection without any procedure-related complications. Pathological examination showed a NET (Grade 2) with negative margin. The patient was followed up for six months without signs of recurrence. This case suggests that laparoscopic transduodenal local resection is a feasible procedure in selected patients with periampullary tumor.
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- 2013
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28. Laparoscopic vs open distal pancreatectomy for solid pseudopapillary tumor of the pancreas.
- Author
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Zhang RC, Yan JF, Xu XW, Chen K, Ajoodhea H, and Mou YP
- Subjects
- Adult, Blood Loss, Surgical prevention & control, Blood Transfusion, Carcinoma, Papillary mortality, Chi-Square Distribution, Female, Humans, Length of Stay, Male, Middle Aged, Pancreatectomy adverse effects, Pancreatectomy mortality, Pancreatic Neoplasms mortality, Recovery of Function, Retrospective Studies, Time Factors, Treatment Outcome, Young Adult, Carcinoma, Papillary surgery, Laparoscopy adverse effects, Laparoscopy mortality, Pancreatectomy methods, Pancreatic Neoplasms surgery
- Abstract
Aim: To compare short- and long-term outcomes of laparoscopic vs open distal pancreatectomy for solid pseudopapillary tumor (SPT) of the pancreas., Methods: This retrospective study included 28 patients who underwent distal pancreatectomy for SPT of the pancreas between 1998 and 2012. The patients were divided into two groups based on the surgical approach: the laparoscopic surgery group and the open surgery group. The patients' demographic data, operative results, pathological reports, hospital courses, morbidity and mortality, and follow-up data were compared between the two groups., Results: Fifteen patients with SPT of the pancreas underwent laparoscopic distal pancreatectomy (LDP), and 13 underwent open distal pancreatectomy (ODP). Baseline characteristics were similar between the two groups except for a female predominance in the LDP group (100.0% vs 69.2%, P = 0.035). Mortality, morbidity (33.3% vs 38.5%, P = 1.000), pancreatic fistula rates (26.7% vs 30.8%, P = 0.728), and reoperation rates (0.0% vs 7.7%, P = 0.464) were similar in the two groups. There were no significant differences in the operating time (171 min vs 178 min, P = 0.755) between the two groups. The intraoperative blood loss (149 mL vs 580 mL, P = 0.002), transfusion requirement (6.7% vs 46.2%, P = 0.029), first flatus time (1.9 d vs 3.5 d, P = 0.000), diet start time (2.3 d vs 4.9 d, P = 0.000), and postoperative hospital stay (8.1 d vs 12.8 d, P = 0.029) were significantly less in the LDP group than in the ODP group. All patients had negative surgical margins at final pathology. There were no significant differences in number of lymph nodes harvested (4.6 vs 6.4, P = 0.549) between the two groups. The median follow-up was 33 (3-100) mo for the LDP group and 45 (17-127) mo for the ODP group. All patients were alive with one recurrence., Conclusion: LDP for SPT has short-term benefits compared with ODP. Long-term outcomes of LDP are similar to those of ODP.
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- 2013
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- View/download PDF
29. Systematic review and meta-analysis of laparoscopy-assisted and open total gastrectomy for gastric cancer.
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Chen K, Xu XW, Zhang RC, Pan Y, Wu D, and Mou YP
- Subjects
- Chi-Square Distribution, Gastrectomy adverse effects, Gastrectomy mortality, Humans, Length of Stay, Lymphatic Metastasis, Neoplasm Recurrence, Local, Postoperative Complications mortality, Postoperative Complications therapy, Risk Factors, Stomach Neoplasms mortality, Stomach Neoplasms pathology, Time Factors, Treatment Outcome, Gastrectomy methods, Laparoscopy adverse effects, Laparoscopy mortality, Stomach Neoplasms surgery
- Abstract
Aim: To evaluate the safety and efficacy of laparoscopy-assisted total gastrectomy (LATG) and open total gastrectomy (OTG) for gastric cancer., Methods: A comprehensive search of PubMed, Cochrane Library, Web of Science and BIOSIS Previews was performed to identify studies that compared LATG and OTG. The following factors were checked: operating time, blood loss, harvested lymph nodes, flatus time, hospital stay, mortality and morbidity. Data synthesis and statistical analysis were carried out using RevMan 5.1 software., Results: Nine studies with 1221 participants were included (436 LATG and 785 OTG). Compared to OTG, LATG involved a longer operating time [weighted mean difference (WMD) = 57.68 min, 95%CI: 30.48-84.88; P < 0.001]; less blood loss [standard mean difference (SMD) = -1.71; 95%CI: -2.48 - -0.49; P < 0.001]; earlier time to flatus (WMD= -0.76 d; 95%CI: -1.22 - -0.30; P < 0.001); shorter hospital stay (WMD = -2.67 d; 95%CI: -3.96 - -1.38, P < 0.001); and a decrease in medical complications (RR = 0.41, 95%CI: 0.19-0.90, P = 0.03). The number of harvested lymph nodes, mortality, surgical complications, cancer recurrence rate and long-term survival rate of patients undergoing LATG were similar to those in patients undergoing OTG., Conclusion: Despite a longer operation, LATG can be performed safely in experienced surgical centers with a shorter hospital stay and fewer complications than open surgery.
- Published
- 2013
- Full Text
- View/download PDF
30. Case-matched comparison of laparoscopy-assisted and open distal gastrectomy for gastric cancer.
- Author
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Wang W, Chen K, Xu XW, Pan Y, and Mou YP
- Subjects
- Aged, Cell Differentiation, Chi-Square Distribution, Female, Gastrectomy adverse effects, Gastrectomy mortality, Humans, Kaplan-Meier Estimate, Lymph Node Excision, Lymphatic Metastasis, Male, Middle Aged, Neoplasm Staging, Postoperative Complications etiology, Retrospective Studies, Stomach Neoplasms mortality, Stomach Neoplasms pathology, Time Factors, Treatment Outcome, Gastrectomy methods, Laparoscopy adverse effects, Laparoscopy mortality, Stomach Neoplasms surgery
- Abstract
Aim: To compare short- and long-term outcomes of laparoscopy-assisted and open distal gastrectomy for gastric cancer., Methods: A retrospective study was performed by comparing the outcomes of 54 patients who underwent laparoscopy-assisted distal gastrectomy (LADG) with those of 54 patients who underwent open distal gastrectomy (ODG) between October 2004 and October 2007. The patients' demographic data (age and gender), date of surgery, extent of lymphadenectomy, and differentiation and tumor-node-metastasis stage of the tumor were examined. The operative time, intraoperative blood loss, postoperative recovery, complications, pathological findings, and follow-up data were compared between the two groups., Results: The mean operative time was significantly longer in the LADG group than in the ODG group (259.3 ± 46.2 min vs 199.8 ± 40.85 min; P < 0.05), whereas intraoperative blood loss and postoperative complications were significantly lower (160.2 ± 85.9 mL vs 257.8 ± 151.0 mL; 13.0% vs 24.1%, respectively, P < 0.05). In addition, the time to first flatus, time to initiate oral intake, and postoperative hospital stay were significantly shorter in the LADG group than in the ODG group (3.9 ± 1.4 d vs 4.4 ± 1.5 d; 4.6 ± 1.2 d vs 5.6 ± 2.1 d; and 9.5 ± 2.7 d vs 11.1 ± 4.1 d, respectively; P < 0.05). There was no significant difference between the LADG group and ODG group with regard to the number of harvested lymph nodes. The median follow-up was 60 mo (range, 5-97 mo). The 1-, 3-, and 5-year disease-free survival rates were 94.3%, 90.2%, and 76.7%, respectively, in the LADG group and 89.5%, 84.7%, and 82.3%, respectively, in the ODG group. The 1-, 3-, and 5-year overall survival rates were 98.0%, 91.9%, and 81.1%, respectively, in the LADG group and 91.5%, 86.9%, and 82.1%, respectively, in the ODG group. There was no significant difference between the two groups with regard to the survival rate., Conclusion: LADG is suitable and minimally invasive for treating distal gastric cancer and can achieve similar long-term results to ODG.
- Published
- 2013
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31. Laparoscopic distal pancreatectomy is as safe and feasible as open procedure: a meta-analysis.
- Author
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Xie K, Zhu YP, Xu XW, Chen K, Yan JF, and Mou YP
- Subjects
- Humans, Laparoscopy adverse effects, Pancreatectomy adverse effects, Pancreatic Fistula surgery, Pancreatic Neoplasms surgery, Laparoscopy methods, Pancreatectomy methods
- Abstract
Aim: To evaluate the feasibility and safety of laparoscopic distal pancreatectomy (LDP) compared with open distal pancreatectomy (ODP)., Methods: Meta-analysis was performed using the databases, including PubMed, the Cochrane Central Register of Controlled Trials, Web of Science and BIOSIS Previews. Articles should contain quantitative data of the comparison of LDP and ODP. Each article was reviewed by two authors. Indices of operative time, spleen-preserving rate, time to fluid intake, ratio of malignant tumors, postoperative hospital stay, incidence rate of pancreatic fistula and overall morbidity rate were analyzed., Results: Nine articles with 1341 patients who underwent pancreatectomy met the inclusion criteria. LDP was performed in 501 (37.4%) patients, while ODP was performed in 840 (62.6%) patients. There were significant differences in the operative time, time to fluid intake, postoperative hospital stay and spleen-preserving rate between LDP and ODP. There was no difference between the two groups in pancreatic fistula rate [random effects model, risk ratio (RR) 0.996 (0.663, 1.494), P = 0.983, I² = 28.4%] and overall morbidity rate [random effects model, RR 0.81 (0.596, 1.101), P = 0.178, I² = 55.6%]., Conclusion: LDP has the advantages of shorter hospital stay and operative time, more rapid recovery and higher spleen-preserving rate as compared with ODP.
- Published
- 2012
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32. Laparoscopic wedge resection of synchronous gastric intraepithelial neoplasia and stromal tumor: a case report.
- Author
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Mou YP, Xu XW, Xie K, Zhou W, Zhou YC, and Chen K
- Subjects
- Carcinoma in Situ diagnostic imaging, Carcinoma in Situ pathology, Female, Gastrointestinal Stromal Tumors diagnostic imaging, Gastrointestinal Stromal Tumors pathology, Gastroscopy, Humans, Middle Aged, Neoplasm Staging, Stomach Neoplasms diagnostic imaging, Stomach Neoplasms pathology, Tomography, X-Ray Computed, Treatment Outcome, Carcinoma in Situ surgery, Gastrointestinal Stromal Tumors surgery, Laparoscopy, Neoplasms, Multiple Primary, Stomach Neoplasms surgery
- Abstract
Synchronous occurrence of epithelial neoplasia and gastrointestinal stromal tumor (GIST) in the stomach is uncommon. Only rare cases have been reported in the literature. We present here a 60-year-old female case of synchronous occurrence of gastric high-level intraepithelial neoplasia and GIST with the features of 22 similar cases and detailed information reported in the English-language literature summarized. In the present patient, epithelial neoplasia and GIST were removed en bloc by laparoscopic wedge resection. To the best of our knowledge, this is the first reported case treated by laparoscopic wedge resection.
- Published
- 2010
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33. Conversion to sirolimus immunosuppression in liver transplantation recipients with hepatocellular carcinoma: Report of an initial experience.
- Author
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Zhou J, Fan J, Wang Z, Wu ZQ, Qiu SJ, Huang XW, Yu Y, Sun J, Xiao YS, He YF, Wang YQ, and Tang ZY
- Subjects
- Adaptor Proteins, Signal Transducing, Adult, Calcineurin adverse effects, Female, Humans, Incidence, Male, Middle Aged, Neoplasm Metastasis drug therapy, Neoplasm Metastasis prevention & control, Neoplasm Recurrence, Local drug therapy, Neoplasm Recurrence, Local prevention & control, Phosphoproteins adverse effects, Renal Insufficiency chemically induced, Renal Insufficiency drug therapy, Retrospective Studies, Tacrolimus therapeutic use, Transplantation, Transplantation, Homologous, Carcinoma, Hepatocellular drug therapy, Carcinoma, Hepatocellular surgery, Immunosuppressive Agents therapeutic use, Liver Neoplasms drug therapy, Liver Neoplasms surgery, Liver Transplantation, Sirolimus therapeutic use
- Abstract
Aim: To report a retrospective analysis of preliminary results of 36 patients who received sirolimus (SRL, Rapamune, rapamycin) in a consecutive cohort of 248 liver allograft recipients., Methods: Thirty-six liver transplant patients with hepatocellular carcinoma (HCC) who were switched to SRL-based immunosuppression therapy from tacrolimus were enrolled in this study. The patients who were diagnosed as advanced HCC before orthotopic liver transplantation (OLT) were divided into group A (n = 11), those who were found to have HCC recurrence and/or metastasis after OLT were assigned to group B (n = 18), and those who developed renal insufficiency caused by calcineurin inhibitor (CNI) were assigned to group C (n = 7) after OLT., Results: The patients were followed up for a median of 10.4 mo (range, 3.8-19.1 mo) after conversion to SRL therapy and 12.3 mo (range, 5.1-34.4 mo) after OLT. Three patients developed mild acute cellular rejection 2 wk after initiating SRL therapy, which was fully reversed after prednisolone pulse therapy. In group A, only 1 patient was found to have HCC recurrence and metastasis 12 mo after OLT. In group B, 66.7% (12/18) patients (2 with progressive tumor, 7 with stable tumor and 3 without tumor) were still alive due to conversing to SRL and/or resection for HCC recurrence at the end of a median follow-up of 6.8 mo post conversion and 10.7 mo posttransplant. In group C, no HCC recurrence was demonstrated in 7 patients, and renal function became normal after SRL therapy. Thrombocytopenia (n = 2), anemia (n = 8), and oral aphthous ulcers (n = 7) found in our cohort were easily manageable., Conclusion: The conversion to SRL-based immunosuppression may inhibit the recurrence and metastasis of HCC and improve CNI-induced renal insufficiency in OLT patients with HCC.
- Published
- 2006
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- View/download PDF
34. Effects of hepatitis B virus infection on human sperm chromosomes.
- Author
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Huang JM, Huang TH, Qiu HY, Fang XW, Zhuang TG, Liu HX, Wang YH, Deng LZ, and Qiu JW
- Subjects
- Adult, DNA, Viral analysis, Hepatitis B Antigens analysis, Hepatitis B Antigens blood, Hepatitis B Surface Antigens analysis, Hepatitis B Surface Antigens blood, Humans, In Situ Hybridization, Fluorescence, Karyotyping, Male, Reference Values, Semen immunology, Chromosomes, Human genetics, Hepatitis B, Chronic genetics, Spermatozoa virology
- Abstract
Aim: To evaluate the level of sperm chromosome aberrations in male patients with hepatitis B, and to directly detect whether there are HBV DNA integrations in sperm chromosomes of hepatitis B patients., Methods: Sperm chromosomes of 14 tested subjects (5 healthy controls, 9 patients with HBV infection, including 1 with acute hepatitis B, 2 with chronic active hepatitis B, 4 with chronic persistent hepatitis B, 2 chronic HBsAg carriers with no clinical symptoms) were prepared using interspecific in vitro fertilization between zona-free golden hamster ova and human spermatozoa, and the frequencies of aberration spermatozoa were compared between subjects of HBV infection and controls. Fluorescence in situ hybridization (FISH) to sperm chromosome spreads was carried out with biotin-labeled full length HBV DNA probe to detect the specific HBV DNA sequences in the sperm chromosomes., Results: The total frequency of sperm chromosome aberrations in HBV infection group (14.8 %, 33/223) was significantly higher than that in the control group (4.3 %, 5/116). Moreover, the sperm chromosomes in HBV infection patients commonly presented stickiness, clumping, failure to staining, etc, which would affect the analysis of sperm chromosomes. Specific fluorescent signal spots for HBV DNA were seen in sperm chromosomes of one patient with chronic persistent hepatitis. In 9 (9/42) sperm chromosome complements containing fluorescent signal spots, one presented 5 obvious FISH spots, others presented 2 to 4 signals. There was significant difference of fluorescence intensity among the signal spots. The distribution of signal sites among chromosomes was random., Conclusion: HBV infection can bring about mutagenic effects on sperm chromosomes. Integrations of viral DNA into sperm chromosomes which are multisites and nonspecific, can further increase the instability of sperm chromosomes. This study suggested that HBV infection can create extensively hereditary effects by alteration genetic constituent and/or induction chromosome aberrations, as well as the possibility of vertical transmission of HBV via the germ line to the next generation.
- Published
- 2003
- Full Text
- View/download PDF
35. Association of hTcf-4 gene expression and mutation with clinicopathological characteristics of hepatocellular carcinoma.
- Author
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Jiang Y, Zhou XD, Liu YK, Wu X, and Huang XW
- Subjects
- Adolescent, Adult, Aged, Female, Gene Expression Regulation, Neoplastic, Humans, Liver physiology, Male, Middle Aged, Mutation, Polymerase Chain Reaction, Polymorphism, Single-Stranded Conformational, RNA, Messenger analysis, Silver Staining, TCF Transcription Factors, Transcription Factor 7-Like 2 Protein, Carcinoma, Hepatocellular pathology, Carcinoma, Hepatocellular physiopathology, Liver Neoplasms pathology, Liver Neoplasms physiopathology, Transcription Factors genetics
- Abstract
Aim: Hepatocellular carcinoma(HCC) is a significant health problem in China. But the molecular mechanisms of HCC remains unclear. APC/beta-Catenin/Tcf signaling pathway, also known as Wnt pathway, plays a critical role in the development and oncogenesis. As little is known about the alteration of human T-cell transcription factor-4 (hTcf-4) gene in HCC, it is of interest to study the expression and mutation of hTcf-4 gene in HCC and the relationship between hTcf-4 gene and progression of HCC., Methods: Reverse transcription-polymerase chain reaction (RT-PCR) method was used to detect the expression of hTcf-4 mRNA in 32 HCC and para-cancerous tissues and 5 normal liver tissues. PCR-single strand conformation polymorphism (PCR-SSCP) method was used to detect the mutation of hTcf-4 exons 1, 4, 9 and 15 in HCC. The correlation of expression and mutation of the hTcf-4 gene with clinicopathological characteristics of HCC was also analyzed., Results: RT-PCR showed that the expression rate of hTcf-4 mRNA in HCC, para-cancerous tissues and normal liver tissues was 90.6 %, 71.9 % and 80 %, respectively. The gene expression level in tumor was 0.71+/-0.13, much higher than that in para-cancerous liver 0.29+/-0.05 and normal liver 0.26+/-0.05 (P<0.001), although there was no significant difference in gene expression level between para-cancerous tissues and normal liver (P>0.05). Furthermore, hTcf-4 gene expression was closely associated with tumor capsule status and intrahepatic metastasis of HCC. On SSCP, 2 of 32 cases of HCC (6.25 %) displayed characteristic mutational mobility shifts in exon 15 of the hTcf-4 gene. No abnormal shifting bands were observed in para-cancerous tissues., Conclusion: The high expression level of hTcf-4 in HCC, especially in tumors with metastasis, suggests that the over-expression of hTcf-4 gene may be closely associated with development and progression of HCC, but the mutation of this gene seemed to play less important role in this respect.
- Published
- 2002
- Full Text
- View/download PDF
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