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Objective: To compare the short-term clinical effect between laparoscopic distal pancreatectomy (LDP) and open distal pancreatectomy (ODP). Methods: We performed a retrospective study on 161 patients who underwent pancreatectomy between September 2017 to December 2018 in the Department of Pancreatic and Gastric Surgery, Cancer Hospital of Chinese Academy of Medical Sciences. According to the mode of operation, the patients were divided into the LDP group ( n =43) and the ODP group ( n =118). To compare the short-term clinical effect and safety between the LDP group and the ODP group, the preoperative clinical data, intraoperative related index, postoperative complication, postoperative recovery index, preoperative and postoperative inflammatory index were analyzed. Results: The preoperative clinical characteristics between the LDP group and the ODP group were not statistically different ( P >0.05). The intraoperative blood loss in LDP group was (194.19±241.83) ml, significantly less than (315.17±295.94) ml in ODP group ( P <0.05), and the postoperative exhaust time in LDP group was (3.00±0.72) days, significantly shorter than (4.05±0.97) days in OPD group ( P <0.001). The time to get out of bed in LDP group was (3.14±1.01) days, significantly shorter than (3.55±1.05) days in OPD group ( P <0.05). The postoperative eating time in LDP group was (3.88±1.61) days, significantly shorter than (5.11±1.56) days in ODP group ( P <0.001). The time of the drainage tube removal in LDP group was (8.44±1.93) days, significantly shorter than (9.82±3.70) days in ODP group ( P <0.05). The postoperative hospital stay in LDP group was (9.65±3.57) days, significantly shorter than (11.99±6.57) days in ODP group ( P <0.05). The mean operation time in LDP group was (168.65±55.45) min, shorter than (171.23±65.61) min in ODP group, but without significant difference ( P >0.05). The incidences of non-pancreatic fistula-related complications in LDP group and ODP group were 16.3% and 11.0%, respectively, without statistical significance ( P >0.05). The incidences of pancreatic fistula in LDP group and ODP group were 16.3% and 19.5%, respectively, without statistical significance ( P >0.05). The total incidences of complications in LDP group and ODP group were 32.6% and 30.5%, respectively, without statistical significance ( P >0.05). The preoperative and postoperative inflammatory indexes between these two groups were not statistically different ( P >0.05). Conclusions: Compared with ODP, LDP has the advantages of less intraoperative blood loss, faster postoperative recovery, shorter postoperative hospital stays, without increased postoperative complications and prolonged operation time. LDP is a safe and feasible operation method, and its short-term clinical effect is better than that of ODP.

Objective: To identify the feasibility and efficacy of indocyanine green (ICG) used in laparoscopic gastrectomy for advanced gastric cancer patients. Methods: From December 2018 to August 2019, the clinical data of 82 patients preoperatively diagnosed as advanced gastric cancer undergoing laparoscopic radical gastrectomy were retrospectively analyzed. These patients were divided into ICG group( n =38) and a historical control group (non-ICG group, n =44). The number of retrieved lymph nodes, operation time, blood loss, hospital stay, fever time, evacuation time and complications were compared between these two groups. Results: The operation time [(172.8±45.8) min vs (162.6±45.7) min], blood loss [(80.1±91.9) ml vs (78.6±89.8) ml], hospital stay [(7.0±2.0) d vs (7.5±2.4) d], fever time [(2.3±1.2) d vs (2.9±1.9) d], evacuation time [(3.4±0.8) d vs (3.4±1.1) d] and incidence of complications (5.3% vs 9.1%) were not significantly different between the ICG and historical control groups ( P >0.05). The number of retrieved lymph nodes in ICG group was significantly increased compared with that of the historical control group (46.5 vs 33.0, P =0.005). Conclusions: The ICG method applied in lymph node dissection of laparoscopic radical gastrectomy is safe. Moreover, ICG might elevate the efficiency of regional lymph node dissection.

Objective: To analyze the outcomes of simultaneous liver resection for patients who have primary colorectal cancer with synchronous hepatic metastases to see if there is any advantage for doing so., Methods: We retrospectively analyzed the medical records (1999 - 2009) of 53 consecutive patients with synchronously recognized primary colorectal carcinoma and hepatic metastases who underwent simultaneous (40 patients) or two-stage (13 patients) colonic and hepatic resections performed at our hospital., Results: There was no thirty-day mortality in both groups. The two groups had significant differences in mean operation duration [(212.9 ± 72.3) min vs. (326.5 ± 140.2) min, P = 0.014], mean blood loss [(337.5 ± 298.0) ml vs. (594.6 ± 430.5) ml, P = 0.020], post-operative hospital stay [(16.2 ± 8.1) day vs. (25.8 ± 8.5) day, P = 0.001]. The incidence rates of post-operative complications were 25.0% (10/40) and 53.8% (7/13), respectively, in the two groups (P = 0.053). The 1-, 3-, 5-year survival rates in the simultaneous resection group were 95.0%, 57.0% and 37.4%, respectively, with a median overall survival of 40.0 months and median disease-free survival of 14.0 months. The 1-, 3-, 5-year survival rates in the two-stage resection group were 92.3%, 58.7% and 36.7%, respectively, with a median overall survival of 38.0 months and median disease-free survival of 13.0 months. There were no significant differences between the two groups in respect of their survivals (P > 0.05)., Conclusions: Simultaneous colectomy and hepatectomy are safe and efficient for colorectal cancer patients who have synchronous colorectal liver metastases, with less complications and blood loss, and shorter hospital stay compared with the two-stage resection.

Objective: To improve the resection rate and increase operation safety for large centrally located liver tumors., Methods: Clinical data from 133 patients with large centrally located liver tumors confirmed by surgery were analyzed retrospectively. Selective and timely regional hepatic vascular occlusion was used during the operation procedure., Results: The resection rate was 100%. Perioperative death occurred in one patient. During operations, Forty-four patients underwent regional hepatic inflow occlusion ranging from 12 to 33 minutes. Twenty-three patients underwent left and right inflow occlusion, respectively, ranging from 8 to 50 minutes. One patient had right half-hepatic vascular exclusion for 40 minutes. The blood loss of 132 patients was (665 ± 424) ml (one patient experienced diffuse blood oozing and died in the next day). Among them, the blood loss of patients with liver cirrhosis was (723 ± 479) ml. On the contrary, those without liver cirrhosis was (458 ± 223) ml (P < 0.01). Liver function in 92.4% (122/132) patients recovered to Child-Pugh A within one week. No liver failure occurred. After operation, 3 patients presented ascites. Among them, two patients had liver cirrhosis and hepatocellular jaundice, one patient was accepted for transcatheter arterial chemoembolization preoperatively. Four patients had biliary fistula, one patient had gastroparesis, one patient had thrombus in the superior mesenteric vein and portal vein, and five patients had right pleural effusion. The 1-, 3- and 5-year survival rates of 112 patients were 89.1%, 57.7% and 36.9%, respectively., Conclusions: Selective and timely regional hepatic vascular occlusion is useful for the resection of large centrally located liver tumors. This kind of procedure can effectively control the blood loss during the operation and shorten the ischemic reperfusion time, beneficial for protecting the liver cell function. This procedure is a safe hepatic flow occlusion method.

Objective: To investigate the resection technique for small hepatocellular carcinoma (SHCC) in special sites and discuss their outcome., Methods: Clinicopathological data of 30 patients with SHCC in special sites undergone liver resection were reviewed. There were 29 cases of hepatocellular carcinoma and 1 case of cholangiocarcinoma, confirmed by pathology. The tumor was close to the first porta hepatis in 8 cases, colse to the second porta hepatis in 15 cases, and close to the third porta hepatis in 7 cases. Twenty-five patients had one lesion, 4 patients had two and the other had three. The tumor diameter was (2.7 ± 1.2) cm., Results: No perioperative death occurred. The operation time was (279 ± 101) min, the mean intraoperative blood loss was 566 ml, and the postoperative hospitalization was (10.5 ± 2.7) days. The 1- and 3-year survival rates were 100% and 83.3%, respectively, and the 1- and 3-year disease free survival rates were 85.0% and 41.3%, respectively., Conclusion: Although the surgery for SHCC in special sites is quite difficult and risky, surgical treatment is still safe with good perioperative management and is an effective treatment of SHCC in special sites.

Objective: To analyze the characteristics of hormone receptor status in Chinese females with breast cancer., Methods: The clinicopathological data of 5758 female breast cancer patients surgically treated in our breast cancer center from Jan. 1997 to Oct. 2008 were retrospectively analyzed., Results: The positive rates of estrogen receptor (ER) and progesterone receptor (PR) were 64.1% and 70.2%, respectively. The ER positive rate was significantly higher in elderly, post-menopausal females with a smaller tumor and well-differentiated histology (P < 0.05), while the PR positive rate was significantly correlated with only histological differentiation and tumor size (P < 0.05). The ER and PR positive rates were significantly higher in the patients with lymph node metastasis than that in those without (P < 0.05). Multivariate analysis showed that the histological differentiation, T stage, N stage and menopause status were significantly correlated with ER positive rate, while histological differentiation, T stage and N stage were significantly correlated with PR positive rate., Conclusion: Our results show that the ER positive rate of breast cancer in Chinese women is lower than that in western high incidence areas. The ER positive rate is significantly correlated with age, histological differentiation, tumor size, and menopause status. The PR positive rate is correlated only with histological differentiation and tumor size. Interestingly, the ER and PR positive rates are significantly higher in the patients with axillary lymph node metastases than that in those without. However, further study is needed to verify this special phenomenon.