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Dai YS, Gao W, Hu HJ, Jin YW, Li FY. Laparoscopic Left Hepatectomy for Intrahepatic Cholangiocarcinoma. Ann Surg Oncol 2024; 31:3059-3061. [PMID: 38280962 DOI: 10.1245/s10434-024-14905-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2023] [Accepted: 12/29/2023] [Indexed: 01/29/2024]
Abstract
BACKGROUND Minimally invasive surgery for intrahepatic cholangiocarcinoma (ICC) remains challenging, especially in advanced patients. PATIENT AND METHOD A 66-year-old male was diagnosed with stage II ICC after a comprehensive evaluation and was scheduled for laparoscopic exploration and left hepatectomy. RESULTS The pure laparoscopic left hepatectomy was completed in 240 min, employing a no-touch en bloc technique and lymphadenectomy skeletonization. The patient was discharged 6 days after the operation without any complications and received gemcitabine and cisplatin treatment postoperatively. There was no recurrence during 14 months of follow-up. CONCLUSIONS Our experience demonstrates that when utilizing the no-touch en bloc technique, standardized lymphadenectomy through skeletonization, and effective control of bleeding, surgeons with extensive expertise in laparoscopic hepatectomy can achieve results comparable to open surgery.
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Affiliation(s)
- Yu-Shi Dai
- Department of Biliary Surgery, West China Hospital of Sichuan University, Chengdu, Sichuan Province, China
| | - Wei Gao
- Management Center, General Practice Center, West China Hospital, Sichuan University, Chengdu, China
| | - Hai-Jie Hu
- Department of Biliary Surgery, West China Hospital of Sichuan University, Chengdu, Sichuan Province, China
| | - Yan-Wen Jin
- Department of Biliary Surgery, West China Hospital of Sichuan University, Chengdu, Sichuan Province, China.
| | - Fu-Yu Li
- Department of Biliary Surgery, West China Hospital of Sichuan University, Chengdu, Sichuan Province, China.
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Yang SQ, Wang JK, Ma WJ, Liu F, Zou RQ, Dai YS, Lv TR, Li FY, Hu HJ. Prognostic Significance of Tumor Necrosis in Patients with Gallbladder Carcinoma Undergoing Curative-Intent Resection. Ann Surg Oncol 2024; 31:125-132. [PMID: 37884700 DOI: 10.1245/s10434-023-14421-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2023] [Accepted: 09/25/2023] [Indexed: 10/28/2023]
Abstract
BACKGROUND Tumor necrosis has been indicated to correlate with dismal survival outcomes of a variety of solid tumors. However, the significance and prognostic value of tumor necrosis remain unclear in gallbladder carcinoma. The aim of this research is to explore the relationships between necrosis with long-term survival and tumor-related biological characteristics of patients with gallbladder carcinoma. PATIENTS AND METHODS Patients with gallbladder carcinoma who accepted curative-intent resection in West China Hospital of Sichuan University (China) between January 2010 and December 2021 were retrospectively analyzed. Tumor necrosis was determined by staining the patient's original tissue sections with hematoxylin and eosin. Based on the presence of tumor necrosis, the pathologic features and survival outcomes were compared. RESULTS This study enrolled 213 patients with gallbladder carcinoma who underwent curative-intent surgery, of whom 89 had tumor necrosis. Comparative analyses indicated that patients with tumor necrosis had more aggressive clinicopathological features, such as larger tumor size (p = 0.002), poorer tumor differentiation (p = 0.029), more frequent vascular invasion (p < 0.001), presence of lymph node metastasis (p = 0.014), and higher tumor status (p = 0.01), and experienced poorer survival. Univariate and multivariate analyses revealed that tumor necrosis was an independent prognostic factor for overall survival (multivariate: HR 1.651, p = 0.026) and disease-free survival (multivariate: HR 1.589, p = 0.040). CONCLUSIONS Tumor necrosis can be considered as an independent predictive factor for overall survival and disease-free survival among individuals with gallbladder carcinoma, which was a valuable pathologic parameter.
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Affiliation(s)
- Si-Qi Yang
- Division of Biliary Tract Surgery, Department of General Surgery, West China Hospital, Sichuan University, Chengdu, Sichuan Province, China
| | - Jun-Ke Wang
- Division of Biliary Tract Surgery, Department of General Surgery, West China Hospital, Sichuan University, Chengdu, Sichuan Province, China
| | - Wen-Jie Ma
- Division of Biliary Tract Surgery, Department of General Surgery, West China Hospital, Sichuan University, Chengdu, Sichuan Province, China
| | - Fei Liu
- Division of Biliary Tract Surgery, Department of General Surgery, West China Hospital, Sichuan University, Chengdu, Sichuan Province, China
| | - Rui-Qi Zou
- Division of Biliary Tract Surgery, Department of General Surgery, West China Hospital, Sichuan University, Chengdu, Sichuan Province, China
| | - Yu-Shi Dai
- Division of Biliary Tract Surgery, Department of General Surgery, West China Hospital, Sichuan University, Chengdu, Sichuan Province, China
| | - Tian-Run Lv
- Division of Biliary Tract Surgery, Department of General Surgery, West China Hospital, Sichuan University, Chengdu, Sichuan Province, China
| | - Fu-Yu Li
- Division of Biliary Tract Surgery, Department of General Surgery, West China Hospital, Sichuan University, Chengdu, Sichuan Province, China.
| | - Hai-Jie Hu
- Division of Biliary Tract Surgery, Department of General Surgery, West China Hospital, Sichuan University, Chengdu, Sichuan Province, China.
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Yang SQ, Zou RQ, Dai YS, Li FY, Hu HJ. Comparison of the upfront surgery and neoadjuvant therapy in resectable and borderline resectable pancreatic cancer: an updated systematic review and meta-analysis. Updates Surg 2024; 76:1-15. [PMID: 37639177 DOI: 10.1007/s13304-023-01626-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2023] [Accepted: 08/02/2023] [Indexed: 08/29/2023]
Abstract
Pancreatic cancer is a malignant disease with a dismal prognosis. While neoadjuvant therapy has shown promise in the treatment of pancreatic cancer, its role remains a subject of controversy among physicians. We aimed to evaluate the benefits of neoadjuvant therapy in patients with resectable and borderline resectable pancreatic cancer. Eligible studies were identified from MEDLINE, Embase, Cochrane Library, and Web of Science. Studies comparing neoadjuvant therapy with upfront surgery (with or without adjuvant therapy) in resectable and borderline resectable pancreatic cancer were included. The primary endpoint assessed was overall survival. A total of 10,022 studies were identified, and the meta-analysis finally enrolled 50 revealed studies. The meta-analysis suggested that neoadjuvant therapy significantly improved the overall survival (HR 0.74, p < 0.001) and recurrence-free survival (HR 0.75, p = 0.006) compared to the upfront surgery approach. Furthermore, neoadjuvant therapy leads to favorable postoperative outcomes, with an enhanced R0 resection rate (OR 1.90, p < 0.001) and reduced lymph node metastasis (OR 0.36, p < 0.001) and perineural invasion (OR 0.42, p < 0.001), although it is associated with a reduced resection rate (OR 0.42, p < 0.001). In addition, patients treated with neoadjuvant therapy experience superior survival benefits compared to those undergoing adjuvant therapy (HR 0.87, p = 0.019). These results are further corroborated by the subgroup analysis of randomized controlled trials. Neoadjuvant therapy has the potential to provide survival benefits and improve postoperative long-term outcomes for patients with resectable and borderline resectable pancreatic cancer. However, to validate and reinforce these findings, further well-designed and large trials are required.
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Affiliation(s)
- Si-Qi Yang
- Division of Biliary Tract Surgery, Department of General Surgery, West China Hospital, Sichuan University, Chengdu, Sichuan Province, China
| | - Rui-Qi Zou
- Division of Biliary Tract Surgery, Department of General Surgery, West China Hospital, Sichuan University, Chengdu, Sichuan Province, China
| | - Yu-Shi Dai
- Division of Biliary Tract Surgery, Department of General Surgery, West China Hospital, Sichuan University, Chengdu, Sichuan Province, China
| | - Fu-Yu Li
- Division of Biliary Tract Surgery, Department of General Surgery, West China Hospital, Sichuan University, Chengdu, Sichuan Province, China.
| | - Hai-Jie Hu
- Division of Biliary Tract Surgery, Department of General Surgery, West China Hospital, Sichuan University, Chengdu, Sichuan Province, China.
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Chen JM, Chen M, Ren XC, Chen WC, Wang N, Li JW. [Research progress of metal micro-battery dressings in wound repair]. Zhonghua Shao Shang Yu Chuang Mian Xiu Fu Za Zhi 2023; 39:596-600. [PMID: 37805778 DOI: 10.3760/cma.j.cn501225-20220926-00416] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Subscribe] [Scholar Register] [Indexed: 10/09/2023]
Abstract
To develop the dressings that can both inhibit bacterial infection and actively promote healing is of great importance for wound repair and the development of medical technology. Electrical stimulation has multiple roles in wound healing, including hemostasis, antibacterial, anti-inflammatory, guidance of cell migration, promotion of re-epithelialization, and proliferation of cells. Metal micro-battery can provide a stable source of electrical stimulation energy without an external power source. Thus, the integration of metal micro-battery with medical dressings opens up new opportunities for the wireless application of electrical stimulation in wound repair. In this review, the mechanism of the effect of electrical stimulation on wound healing is systematically presented, then recent advances in metal micro-battery dressings, including preparation methods, antibacterial performance, and healing properties are mainly introduced, and the current challenges and prospects of metal micro-battery dressings are also provided.
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Affiliation(s)
- J M Chen
- College of Textile & Clothing, Qingdao University, Institute of Nonwovens and Industrial Textile Innovation, Qingdao 266071, China
| | - M Chen
- College of Textile & Clothing, Qingdao University, Institute of Nonwovens and Industrial Textile Innovation, Qingdao 266071, China
| | - X C Ren
- College of Textile & Clothing, Qingdao University, Institute of Nonwovens and Industrial Textile Innovation, Qingdao 266071, China
| | - W C Chen
- College of Textile & Clothing, Qingdao University, Institute of Nonwovens and Industrial Textile Innovation, Qingdao 266071, China
| | - N Wang
- College of Textile & Clothing, Qingdao University, Institute of Nonwovens and Industrial Textile Innovation, Qingdao 266071, China
| | - J W Li
- College of Textile & Clothing, Qingdao University, Institute of Nonwovens and Industrial Textile Innovation, Qingdao 266071, China
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Li Q, Gao J, Zhang J, Huang Z, Wang S, Song B, Wang Q, Zhou W. Treatment of high-phosphorus load wastewater by column packed with non-burning compound filler/gravel/ceramsite: evaluation of performance and microorganism community. Environ Sci Pollut Res Int 2023; 30:67730-67741. [PMID: 37118390 DOI: 10.1007/s11356-023-26487-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/17/2022] [Accepted: 03/13/2023] [Indexed: 05/25/2023]
Abstract
Cost-effective and environmental-friendly substrates are essential for the constructed wetlands (CWs). In this study, the column test was used to explore the differences in pollutant purification performance, microbial community structure and abundance between non-burning compound filler and conventional CWs substrates (i.e. gravel and ceramsite) at low temperature (0-15℃). It was found that the maximum phosphorus removal efficiency of compound filler (99%) was better than gravel (18%) and ceramsite (21%). Besides, the proportion of aerobic heterotrophic bacteria capable of ammonium oxidation, nitrification and denitrification (i.e. Pseudomonas, Acinetobacter, and Acetoanaerobium) was enhanced by compound filler, which has an excellent potential for nitrogen removal in the subsequent purification process. These results demonstrated that the self-made non-burning compound filler was a potential substrate for CWs, which was of great significance for the resource utilization of solid wastes such as polyaluminum chloride residue.
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Affiliation(s)
- Qiang Li
- School of Ecology and Environment, Zhengzhou University, Zhengzhou, 450001, China
- College of Chemistry, Zhengzhou University, Zhengzhou, 450001, China
| | - Jingqing Gao
- School of Ecology and Environment, Zhengzhou University, Zhengzhou, 450001, China.
- Key Laboratory of Water Management and Water Security for Yellow River, Basin, Ministry of Water Resources (Under Construction), Zhengzhou, 450001, China.
| | - Jingshen Zhang
- College of Chemistry, Zhengzhou University, Zhengzhou, 450001, China
| | - Zhenzhen Huang
- School of Ecology and Environment, Zhengzhou University, Zhengzhou, 450001, China
- Faculty of Environmental and Municipal Engineering, Henan Province Key Laboratory of Water Pollution Control and Rehabilitation Technology, Henan University of Urban Construction, Pingdingshan, 467036, China
| | - Shilong Wang
- School of Ecology and Environment, Zhengzhou University, Zhengzhou, 450001, China
| | - Bozhen Song
- School of Ecology and Environment, Zhengzhou University, Zhengzhou, 450001, China
| | - Qiaojian Wang
- School of Ecology and Environment, Zhengzhou University, Zhengzhou, 450001, China
| | - Wanglin Zhou
- CSCEC Xinjiang Construction&Engineering (Group) Co.,Ltd, Xian, 710000, China
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Lv TR, Hu HJ, Liu F, Ma WJ, Jin YW, Li FY. The significance of peri-neural invasion in patients with gallbladder carcinoma after curative surgery: a 10 year experience in China. Updates Surg 2023:10.1007/s13304-023-01519-2. [PMID: 37099122 DOI: 10.1007/s13304-023-01519-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2023] [Accepted: 04/17/2023] [Indexed: 04/27/2023]
Abstract
The significance of peri-neural invasion (PNI) in patients with gallbladder carcinoma (GBC) after curative surgery remains unknown. Current study was performed to evaluate the significance of PNI in resected GBC patients in terms of tumor-related biological features and long-term survival. Patients with GBC between September 2010 and September 2020 were reviewed and analyzed. SPSS 25.0 software were used for statistical analysis. A total of 324 resected GBC patients were identified (No. PNI: 64). An elevated preoperative Ca19.9 level (P = 0.001), obstructive jaundice (P = 0.001), liver invasion (P < 0.0001), lymph-vascular invasion (P < 0.0001), lymph-node metastasis (P < 0.0001), and poor or moderate differentiation status (P = 0.036) were more frequently detected in patients with PNI. Major hepatectomy (P = 0.019), bile duct resection (P < 0.0001), combined multi-visceral resections (P = 0.001), and combined major vascular resections and reconstructions (P = 0.002) were also more frequently detected. However, a significantly lower R0 rate (P < 0.0001) was acquired in patients with PNI. Patients with PNI were generally more advanced disease and shared a much worse prognosis even after matching. PNI was an independent prognostic factor of disease-free survival as well as an independent predictor of early recurrence. Postoperative adjuvant chemotherapy has brought an obvious survival benefit in resected GBC patients with PNI. PNI could be regarded as an indicator of worse prognosis and could serve as an independent predictor of early recurrence. Postoperative adjuvant chemotherapy was correlated with an improved survival for resected GBC patients with PNI. Upcoming multicenter studies covering various races are warranted for further validation.
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Affiliation(s)
- Tian-Run Lv
- Division of Biliary Tract Surgery, Department of General Surgery, West China Hospital, Sichuan University, Chengdu, 610041, Sichuan, China
| | - Hai-Jie Hu
- Division of Biliary Tract Surgery, Department of General Surgery, West China Hospital, Sichuan University, Chengdu, 610041, Sichuan, China
| | - Fei Liu
- Division of Biliary Tract Surgery, Department of General Surgery, West China Hospital, Sichuan University, Chengdu, 610041, Sichuan, China
| | - Wen-Jie Ma
- Division of Biliary Tract Surgery, Department of General Surgery, West China Hospital, Sichuan University, Chengdu, 610041, Sichuan, China
| | - Yan-Wen Jin
- Division of Biliary Tract Surgery, Department of General Surgery, West China Hospital, Sichuan University, Chengdu, 610041, Sichuan, China
| | - Fu-Yu Li
- Division of Biliary Tract Surgery, Department of General Surgery, West China Hospital, Sichuan University, Chengdu, 610041, Sichuan, China.
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Lv TR, Wang JK, Hu HJ, Ma WJ, Li FY. The Significance of Tumor Locations in Patients with Gallbladder Carcinoma After Curative-Intent Resection. J Gastrointest Surg 2023:10.1007/s11605-023-05665-1. [PMID: 37095334 DOI: 10.1007/s11605-023-05665-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/06/2023] [Accepted: 03/13/2023] [Indexed: 04/26/2023]
Abstract
OBJECTIVE To evaluate the significance of tumor locations in patients with resected gallbladder carcinoma (GBC) and to supply the indication of extra-hepatic bile duct resection (EHBDR) according to tumor locations. METHODS Patients with resected GBC from 2010 to 2020 in our hospital were retrospectively analyzed. Comparative analyses and a meta-analysis were performed according to different tumor locations (body/fundus/neck/cystic duct). RESULTS Article: A total of 259 patients were identified (neck: 71; cystic: 29; body: 51; fundus: 108). Patients with proximal tumors (neck/cystic duct) were often in a more advanced stage and had more aggressive tumor biological features as well as a worse prognosis compared with those with distal tumors (fundus/body). Moreover, the observation was even more obvious between cystic duct and non-cystic duct tumors. Cystic duct tumor was an independent prognostic factor for overall survival (P = 0.01). EHBDR provided no survival advantage even in those with cystic duct tumor. META-ANALYSIS With our own cohort incorporated, five studies with 204 patients with proximal tumors and 5167 patients with distal tumors were identified. Pooled results revealed that proximal tumors indicated worse tumor biological features and prognosis versus distal tumors. CONCLUSION Proximal GBC had more aggressive tumor biological features, and a worse prognosis versus distal GBC and cystic duct tumor can be regarded as an independent prognostic factor. EHBDR had no obvious survival advantage even in those with cystic duct tumor and was even harmful in those with distal tumors. Upcoming more powerful well-designed studies are required for further validation.
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Affiliation(s)
- Tian-Run Lv
- Department of Biliary Surgery, West China Hospital, Sichuan University, Chengdu, 610041, Sichuan Province, China
| | - Jun-Ke Wang
- Department of Biliary Surgery, West China Hospital, Sichuan University, Chengdu, 610041, Sichuan Province, China
| | - Hai-Jie Hu
- Department of Biliary Surgery, West China Hospital, Sichuan University, Chengdu, 610041, Sichuan Province, China
| | - Wen-Jie Ma
- Department of Biliary Surgery, West China Hospital, Sichuan University, Chengdu, 610041, Sichuan Province, China
| | - Fu-Yu Li
- Department of Biliary Surgery, West China Hospital, Sichuan University, Chengdu, 610041, Sichuan Province, China.
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