Robotic anatomical resection for hepatocellular carcinoma located within segment 7 using the Glissonean approach.

Worldwide use of robotic-assisted hepatectomy has increased dramatically over the past two decades. The role of robotic liver surgery is still controversial, especially with respect to its long-term oncological outcomes in treating early-stage hepatocellular carcinoma (HCC). The Glissonean approach is a fundamental technique for anatomical resection using open and laparoscopic liver surgery.

AEG-1 is associated with hypoxia-induced hepatocellular carcinoma chemoresistance via regulating PI3K/AKT/HIF-1alpha/MDR-1 pathway.

Hypoxia is a common characteristic of hepatocellular carcinoma (HCC) associated with reduced response to chemotherapy, thus increasing the probability of tumor recurrence. Astrocyte elevated gene-1 (AEG-1) has been involved in a wide array of cancer progression including proliferation, chemoresistance, angiogenesis and metastasis, but its effect on HCC chemoresistance induced by hypoxia is unclear. In this study, expression of AEG-1 and multiple drug resistance (MDR-1) were examined in HCC using immunohistochemical staining and RT-PCR.

Effect of the PA-MSHA vaccine on septic serum-induced inflammatory response.

Sepsis is defined as a complex clinical syndrome caused by a serious infection followed by an amplified and deregulated inflammatory response. The complex syndrome is associated with a high rate of morbidity and mortality, despite substantial clinical advances. A vaccine derived from the outer membrane proteins of the Gram-negative bacteria Pseudomonas aeruginosa (PA-MSHA) has been demonstrated to exhibit immune modulatory properties.

Adiponectin (ADIPOQ) rs2241766 G/T polymorphism is associated with risk of cancer: evidence from a meta-analysis.

Associations between adiponectin (ADIPOQ) genetic polymorphisms (rs2241766 G/T and rs266729 G/C) and cancer risk have been extensively studied in the past decade, while conflicting results were reported. Therefore, this study would explore the associations by using a meta-analysis. The databases of Medline, Embase, and Wangfang were retrieved, and the latest updated time was 1 August 2012.

Meta-analyses of the associations between four common TGF-β1 genetic polymorphisms and risk of colorectal tumor.

The associations between four common genetic polymorphisms of transforming growth factor-β1 (TGF-β1 -509 C > T, +869 T > C, +915 G > C, and -800 G > A) and risk of colorectal tumor (including adenoma and cancer) have been widely studied. To date, no conclusions could be available because of controversial results reported. Thus, we conducted a meta-analysis to further assess the associations.

Null-margin bisegmentectomy VII-VIII for hepatocellular carcinoma in cirrhotic patients.

Background/aims: Preservation of functional liver parenchyma should be a priority in hepatic surgery to avoid postoperative liver failure and enhance the opportunity to perform repeat resection in case of tumor recurrence.

Methodology: A tumor localized in segments VII, VIII and adhering to or compressing the middle hepatic vein sometimes indicates a need to perform bisegmentectomy VII-VIII without surgical margin. From June 2006 to June 2011, fourteen patients with such a tumor underwent null-margin bisegmentectomy VII-VIII in our hospital.

CYP1B1 Leu432Val polymorphism and colorectal cancer risk among Caucasians: a meta-analysis.

Studies investigating the association between cytochrome P450 1B1 (CYP1B1) Leu432Val (432 C/G, rs1056836) polymorphism and colorectal cancer (CRC) risk report conflicting results. The aim of this study was to quantitatively summarize the evidence for such a relationship. Two investigators independently searched the Medline, Embase, China National Knowledge Infrastructure, and Chinese Biomedicine Databases.

Null-margin mesohepatectomy for centrally located hepatocellular carcinoma in cirrhotic patients.

Background/aims: Anatomic mesohepatectomy is often anatomically restricted by the hilar structure and, therefore, difficult to perform with an adequate resection margin. Especially, in the case of a tumor which is in contact without infiltration with the critical intrahepatic vessels, mesohepatectomy has to be performed without a surgical margin.

Methodology: From January 2005 to December 2009, thirty-seven patients with centrally located HCC underwent anatomic mesohepatectomy without resection margin in our hospital.

Paclitaxel ameliorates fibrosis in hepatic stellate cells via inhibition of TGF-beta/Smad activity.

Aim: To investigated if paclitaxel can attenuate hepatic fibrosis in rat hepatic stellate cells (RHSCs).

Methods: RHSCs were cultured in vitro and randomly assigned to four groups: normal control group (treated only with Dulbecco's Modified Eagle's Medium), Taxol group (200 nmol/L paclitaxel was added to the cell culture), transforming growth factor (TGF)-beta group (5 ng/mL recombinant human TGF-beta1 was added to the cell culture), and TGF-beta + Taxol group. TGF-beta signaling cascade and status of various extracellular matrix proteins were evaluated by real time reverse transcriptase polymerase chain reaction and Western blotting.

[Study on correlation of JAK/STAT signal pathway with progression and prognosis in hepatocellular carcinoma].

Aim: To investigate the expression of JAK/STAT signal pathway in human hepatocellular carcinoma, and to evaluate its clinical significance in the progression and prognosis in hepatocellular carcinoma.

Methods: 196 patients with hepatocellular carcinoma were examined for the expression of JAK-1 protein and STAT-3 protein by SABC immunohistochemistry.

Results: The positive expression rates of JAK-1 protein and STAT-3 protein in patients with hepatocellular carcinoma were significantly higher than those in 20 cases of normal liver tissue (P=0.

Anatomic mesohepatectomy with extrahepatic control of hepatic veins.

Background/aims: Intraoperative bleeding remains a major concern during mesohepatectomy because of doubled area of cut surface and proximity to important intrahepatic vascular structures. Preliminary extrahepatic exposure and looping of the main hepatic veins with the possibility of clamping them in association with total or partial vascular inflow occlusion, can lead to substantially reducing intraoperative bleeding.

Methodology: From January 2003 to July 2008, preliminary exposure and looping of the main hepatic veins was performed in 67 patients undergoing mesohepatectomy.

[Application of damage control surgery in serious pediatric abdominal surgery].

Objective: Damage control surgery (DCS) deals with the complex surgical problems by stages. This study investigated the application of DCS in serious pediatric abdominal surgery.

Methods: The clinical data of 49 children with serious abdominal diseases (age: 4 months to 10 years) were retrospectively studied.

Anatomic resection of segment VIII of liver for hepatocellular carcinoma in cirrhotic patients based on an intrahepatic Glissonian approach.

Background: Isolated segmentectomy VIII is a technically demanding operative procedure and is reported only rarely. To our knowledge, no reports on anatomic segmentectomy based on an intrahepatic approach have been described. For cirrhotic patients with hepatocellular carcinoma (HCC) limited to segment VIII, this is a parenchyma-preserving hepatectomy that can be tolerated.

Overexpression of polo-like kinase1 predicts a poor prognosis in hepatocellular carcinoma patients.

Aim: To elucidate the role of overexpressed polo-like kinase1 (PLK1) in hepatocellular carcinoma (HCC).

Methods: We prospectively collected clinicopathological, immunohistochemical and semi-quantitative reverse transcription-polymerase chain reaction (RT-PCR) data from 135 HCC patients undergoing successful hepatectomy. The correlations between PLK1 mRNA expression and clinicopathologic variables were analyzed by Mann-Whitney U test.

Intrahepatic Glissonian access for mesohepatectomy in cirrhotic patients.

Background/aims: For treatment of centrally located hepatocellular carcinoma (HCC), mesohepatectomy is a technically demanding procedure. The technique of an intrahepatic access to Glissonian pedicles achieves a safe inflow blood control of the liver segments to be resected and allows the anatomical removal of the tumor-bearing segment(s). No reports have mentioned the use of an intrahepatic access for mesohepatectomy in cirrhotic livers.

[Highly-selective regional vascular exclusion for large liver tumor resection].

Objective: To evaluate the highly-selective regional vascular exclusion in the risk hepatectomy for liver tumor.

Methods: Short hepatic veins were ligated and divided followed by the dissection, and isolation of the inflow and outflow vessels of the tumor-bearing lobe, which were completely devascularized after the occlusion of these vessels. The blood loss volume, postoperative recovering situation of the liver function and the incidence of complication were observed in 68 cases.

[Laparoscopic partial gastrectomy: Analysis of 18 procedures].

Objective: To explore the laparoscopic partial gastrectomy and the indications.

Methods: Eighteen patients who underwent laparoscopic partial gastrectomy from August 2005 to May 2006 were analyzed retrospectively.

Results: Sixteen patients (including 6 with gastric cancer, 9 with duodenal ulcer, and 1 with gastric multiple polyps) underwent laparoscopic partial gastrectomy.

Bisegmentectomy VII-VIII for hepatocellular carcinoma in cirrhotic livers.

Background/aims: Preservation of nontumorous liver parenchyma should be a priority in hepatic surgery in order to avoid the risk of life-threatening liver failure and maximize the possibility of repeat resection.

Methodology: A tumor localized in segments VII, VIII and infiltrating the main trunk of the superior right hepatic vein usually indicates a need to perform a right hepatectomy. With the presence of a stout inferior right hepatic vein, bisegmentectomy VII, VIII can be carried out without the risk of hepatic congestion in the remaining segment VI.

Surgical treatment of primary duodenal adenocarcinoma.

Background/aims: Our purpose was to review the outcome of the patients with primary duodenal adenocarcinoma and determine factors influencing survival.

Methodology: Over a 10-year period, 43 patients with this disease were identified. Data were analyzed to assess the outcomes of treatment and predictors of survival.

Anterior approach for complete isolated caudate lobectomy.

Background/aims: Complete isolated caudate lobectomy is a technique-demanding procedure that entails the surgeon's judgement and precise knowledge of liver anatomy.

Methodology: All consecutive patients who underwent complete isolated caudate lobectomy were studied. En bloc excisions combined with adjacent hepatic parenchyma (as part of extended hepatectomies) or wedge excisions of the caudate lobe were excluded.