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25 November 2019, Volume 24 Issue 06 Previous Issue    Next Issue

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Risk factors for lymph node posterior right recurrent laryngeal nerve metastasis of papillary thyroid carcinoma HOU Jianzhong, ZHANG Yingchao, DENG Xianzhao, GUO Bomin, KANG Jie, FAN Youben, WU Bo 2019, 24 (06):  507-511.  DOI: 10.16139/j.1007-9610.2019.06.008 Abstract ( 477 )   PDF (463KB) ( 80 )   Objective To investigate the risk factors for lymph node posterior right recurrent laryngeal nerve (LN-prRLN) metastasis of papillary thyroid carcinoma (PTC). Methods Clinicopathologic data of 424 patients with PTC who had right or bilateral thyroidectomy were analyzed retrospectively between January 2014 and August 2019 in our department. Risk factors for LN-prRLN metastasis were analyzed by χ2 test and Logistic regression model. Results LN-prRLN metastasis had been detected in 96 (22.64%) patients. Univariate analysis showed that the factors including age, tumor diameter, capsular invasion and right Ⅵa lymph node metastasis were significantly related with LN-prRLN metastasis (all P<0.001). It was shown by Logistic regression analysis that 3 factors of tumor diameter 1 cm and larger, capsular invasion and right Ⅵa lymph node metastasis were independent risk factors for LN-prRLN metastasis (all P≤0.001). Conclusions The rate of LN-prRLN metastasis was 22.64% in this study. It should be paid more attention to LN-prRLN dissection when tumor diameter 1 cm and larger, capsular invasion and right Ⅵa lymph node metastasis were found in PTC patients. References | Related Articles | Metrics

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3-dimentional digital technique in single-site endoscopic parathyroidectomy CHEN Lingxie, XUAN Ming, DING Hao, ZHANG Yongchang, CHEN Cheng, KUANG Jie, YAN Jiqi, QIU Weihua, TAN Jian 2019, 24 (06):  512-516.  DOI: 10.16139/j.1007-9610.2019.06.009 Abstract ( 387 )   PDF (834KB) ( 42 )   Objective To evaluate the feasibility using 3-dimentional (3D) virtual model in digital surgery design of trans-areola single-site endoscopic parathyroidectomy (TASSEP) based on principle of precise surgery. Methods A retrospective analysis was performed on the clinical data of 12 patients with primary hyperparathyroidism (PHPT) who received TASSEP from April 2017 to December 2018. All patients had preoperative localization with ultrathin CT scan to build 3D virtual models for precise surgical design. Parathyroid hormone and blood calcium were detected preoperatively and postoperatively. The complications were recorded after surgery. Cosmetic and biochemical results were followed up. Results TASSEP was completed in all 12 patients successfully according to the preoperative digital surgery without conversion to open surgery. No complication was present after surgery. The surgical time was (97.1±30.3) min with blood loss (18.7±2.8) mL and cosmetic satisfactory median score 8 (7-10). The parathyroid hormone and serum calcium levels were normal at 6 month postoperative follow-up without recurrence. Conclusions 3D virtual model for digital surgery design of PHPT would be used for safety and efficiency of surgery and cosmetic outcomes. References | Related Articles | Metrics

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Efficacy of transjugular intrahepatic portosystemic shunt in treatment of portal hypertension: A comparison of Viatorr stent and covered stent combined with bare (metal) stent BAO Yingjun, GU Junpeng, ZHANG Haixiao, ZHU Diwen, REN Weixin 2019, 24 (06):  517-521.  DOI: 10.16139/j.1007-9610.2019.06.010 Abstract ( 498 )   PDF (613KB) ( 44 )   Objective To compare shunt patency and hepatic encephalopathy rates following transjugular intrahepatic portosystemic shunt (TIPS) creation between Viatorr and covered stent combined with bare(metal) stent as combined stent. Methods From May 2014 to September 2017, the patients with cirrhosis and portal hypertension in our center had TIPS creation including 46 cases in Viatorr stent group and 79 cases in covered stent combined with bare(metal) stent. Portal venous pressure before and after TIPS creation, shunt patency and hepatic encephalopathy rates were compared between two groups. Results There was no significant difference in portal venous pressure before and after TIPS creation between Viatorr stent group and covered stent combined with bare(metal) stent. After 12 months of follow-up, patency rate was 97.8% in Viatorr stent group and 83.5% in covered stent combined with bare(metal) stent. Hepatic encephalopathy rate was 4.3% in Viatorr stent group and 11.4% in covered stent combined with bare(metal) stent. Conclusions TIPS creation with Viatorr stent improves short-term shunt patency rate. However, there was no statistical difference in hepatic encephalopathy rate between use Viatorr stent and combined stent graft. References | Related Articles | Metrics

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Tauroursodeoxycholic acid prevents gallbladder stone formation in high-fat fed mice LU Qifan, JIANG Zhaoyan, WANG Qihan, ZHAO Gang, HU Hai 2019, 24 (06):  522-529.  DOI: 10.16139/j.1007-9610.2019.06.011 Abstract ( 339 )   PDF (1264KB) ( 155 )   Objective To investigate the effect of tauroursodeoxycholic acid (TUDCA) on prevention of cholesterol gallstones formation in high-fat fed mice. Methods Thirty SPF grade male c57bl/6 mice were randomly divided into lithogenic diet (LD) group and TUDCA group. The mice in TUDCA group were fed 5g TUDCA/1 000 g LD. After 8 weeks of feeding, serum, gallbladder, liver and small intestine were collected and the formation of gallstones or crystals in gallbladder was examined. Composition of intestinal microbiota was examined. Gallbladder bile lipid composition, serum lipid and liver lipid in mice were detected. Expression of genes involved in bile acid and lipid metabolism of liver and small intestine was detected by quantitative real-time PCR. Results Cholesterol gallstones with cholesterol crystal formed in all mice of LD group (100%). Only cholesterol crystals were found in three mice without any gallstone in TUDCA group. The abundance of intestinal Firmicutes in TUDCA group (0.55%±0.06%) was higher than that in LD group (0.28%±0.02%)（P<0.01), while the abundance of Bacteroides in TUDCA group (0.05%±0.01%) was lower than that in LD group (0.30%±0.01%) (P<0.001). Compared with LD group, the ratio of Firmicutes/Bacteroides in TUDCA group increased by 3.13 times. Serum total cholesterol levels in TUDCA group [(2.36±0.11)mmol/L] decreased compared with that in LD group [(5.79±0.43)mmol/L] (P<0.01). Hepatic total cholesterol levels in TUDCA group [(4.12±0.21) mg/g] decreased significantly compared with that in LD group significantly[(83.17±3.06) mg/g] (P<0.001). mRNA expression level of Abcg5 and Abcg8 in liver of TUDCA group (6.32±0.26, 8.12±0.86) decreased significantly compared with that in LD group（9.48±0.64, 16.76±1.61）(P<0.01). The expression level of Abcb11 (15.74±1.06), Acat2 (2.04±0.02), Cyp27 (36.41±0.77) in the liver of TUDCA group increased compared with those in LD group (3.87±0.71, 1.47±0.09, 28.70±1.09）(P<0.001). Gallbladder cholesterol saturation index in TUDCA group (1.06±0.15) also decreased compared with that in LD group (2.40±0.36) (P<0.01). Conclusions TUDCA might inhibit the absorption and synthesis of lipids in small intestine by improving intestinal microbiota of high-fat fed mice, so as to reduce gallstone formation in the mice. References | Related Articles | Metrics

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Comparative study on short-term results of radical gastrectomy in gastric cancer patients: 3D versus 2D laparoscopy or open surgery QIAN Chen, YANG Feng, XU Yingjie, HE Jun, MAO Qibin, YU Judian, ZHENG Zhi 2019, 24 (06):  530-534.  DOI: 10.16139/j.1007-9610.2019.06.012 Abstract ( 326 )   PDF (463KB) ( 51 )   Objective To compare clinical results in gastric cancer patients with radical gastrectomy among 3D laparoscopy, 2D laparoscopy and open surgery, and study the advantage of 3D laparoscopic radical gastrectomy. Methods Clinical data of 450 patients with gastric cancer in our hospital from January 2013 to January 2018 were analyzed retrospectively including 126 cases in 3D laparoscopy group, 219 cases in 2D laparoscopy group and 105 cases in open surgery group. Surgical parameters, postoperative recovery and morbidity were compared among three groups combined with serum inflammatory factor before surgery and 3 days later. Results Less operative time and less operative blood loss were found in 3D laparoscopy group and 2D laparoscopy group comparing with those in open surgery group. Anal exhaust, ambulation and postoperative hospital stay in 3D laparoscopy group and 2D laparoscopy group were shorter than those in open surgery group (P<0.05). The intraoperative and postoperative parameters in 3D laparoscopy group were better than those in 2D laparoscopy group (P<0.05). There was no difference in the number of lymph node retrieved among three groups (P<0.05). Three days after operation, the levels of serum C-reactive protein (CRP), interleukin-6 and tumor necrosis factor-α in open surgery group were higher than those before operation (P<0.05). The levels of serum CRP in 3D and 2D laparoscopy group were higher than those before operation (P<0.05). The levels of serum inflammatory factors in 3D and 2D laparoscopy group were lower than those in open surgery group (P<0.05). There was lower morbidity in 3D and 2D laparoscopy group than in open surgery group (P<0.05). However, no significant difference in morbidity was present between 3D and 2D laparoscopy group (P>0.05). Conclusions The patients with gastric cancer undergoing laparoscopic radical gastrectomy had faster recovery, less morbidity and mild inflammatory reaction with the most advantage in 3D laparoscopy gastrectomy, the shortest operation time, the least blood loss, the fastest recovery. References | Related Articles | Metrics

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Perioperative efficacy of 3D laparoscopic gastrectomy for advanced gastric cancer YAN Dongyi, ZHANG Shun, YUAN Biao, YANG Yao, CAO Dongliang, JIANG Xiaohua 2019, 24 (06):  535-539.  DOI: 10.16139/j.1007-9610.2019.06.013 Abstract ( 269 )   PDF (495KB) ( 53 )   Objective To investigate the perioperative efficacy of 3D laparoscopic D2 radical gastrectomy in the treatment of advanced gastric cancer. Methods We analyze retrospectively 181 cases with advanced gastric cancer undergoing D2 radical gastrectomy in our department from January 2016 to December 2018 including 87 cases of 3D laparoscopic gastrectomy (3D group) and 94 cases of open gastrectomy (open group). The perioperative data were compared between two groups. Results There was no case in 3D group conversion to open. R0 dissection was gotten all in this study. No perio-perative mortality was found. There was no significant difference in operative time, postoperative hospital stay and postope-rative complications between two groups (P>0.05). The intraoperative blood loss in 3D group (155.06±144.95) mL was significantly less than that in open group (214.47±220.58) mL (P=0.035). Postoperative pass gas time, the time in taking li-quid food and semi-liquid food were all earlier in 3D group than those in open group significantly (P=0.004, P<0.05). No significant difference was present in lymph node dissection between two groups (P>0.05). Conclusions 3D laparoscopic D2 radical gastrectomy could be a safe and feasible surgical type for advanced gastric cancer with quicker recovery and minimal injury. References | Related Articles | Metrics