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Silva RDM, Araújo LHV, Cardoso TDS, Franco SLI, Gurgel HJ, Cerqueira PHL, Carvalho LS, Novais LGES, Gonçalves JLDS, de Sousa LA, Albuquerque RDS, Dutra MD, Ferreira TTA, da Silveira JA, Silva MAM, Monteiro FDDO, Teixeira PPM. A Single-Port, Multiple-Access, Custom-Made Device Used in Laparoscopically Assisted Cryptorchidectomy in Standing Horses-A Preliminary Study. Animals (Basel) 2024; 14:1091. [PMID: 38612330 PMCID: PMC11011124 DOI: 10.3390/ani14071091] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2024] [Revised: 03/20/2024] [Accepted: 03/27/2024] [Indexed: 04/14/2024] Open
Abstract
This study evaluates a new multiport device with single access to the abdominal cavity produced with routine hospital supplies that could be applied to laparoscopically assisted cryptorchidectomy in standing horses. Initially, the new device was evaluated on five cadavers of bovine fetuses (n = 5), placed assisted in a minilaparotomy performed in the flank region. Subsequently, the device was evaluated in four cryptorchid horses treated during the hospital routine. During the evaluation of the new device, the possibilities of exploring the abdominal cavity, inspection, and intra-abdominal manipulation with two Babcock forceps were verified. The possibilities were described, and surgical time data were recorded and analyzed using descriptive statistics. In the cadavers, a wide exploration of the abdominal cavity was possible, with a laparoscopic inspection through the right paralumbar fossa and manipulation of intra-abdominal structures with Babcock forceps inserted by the new device. In cryptorchid horses, laparoscopically assisted cryptorchidectomy with a new device was feasible in two patients, and in the others, it allowed the diagnosis of adhesions and ectopic locations in the inguinal region of testicles retained in the cavity. Therefore, the new device was efficient in exploring the inguinal region of cryptorchid horses in the standing position. The present study is preliminary and can support future studies that aim to improve the developed prototype.
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Affiliation(s)
- Rafaela das Mercês Silva
- Institute of Veterinary Medicine, Pará Federal University, Belém 68740-970, Brazil; (R.d.M.S.); (L.H.V.A.); (T.d.S.C.); (S.L.I.F.); (H.J.G.); (P.H.L.C.); (L.S.C.); (L.G.e.S.N.); (J.L.d.S.G.); (L.A.d.S.); (R.d.S.A.); (M.D.D.); (T.T.A.F.); (J.A.d.S.); (P.P.M.T.)
| | - Luiz Henrique Vilela Araújo
- Institute of Veterinary Medicine, Pará Federal University, Belém 68740-970, Brazil; (R.d.M.S.); (L.H.V.A.); (T.d.S.C.); (S.L.I.F.); (H.J.G.); (P.H.L.C.); (L.S.C.); (L.G.e.S.N.); (J.L.d.S.G.); (L.A.d.S.); (R.d.S.A.); (M.D.D.); (T.T.A.F.); (J.A.d.S.); (P.P.M.T.)
| | - Thiago da Silva Cardoso
- Institute of Veterinary Medicine, Pará Federal University, Belém 68740-970, Brazil; (R.d.M.S.); (L.H.V.A.); (T.d.S.C.); (S.L.I.F.); (H.J.G.); (P.H.L.C.); (L.S.C.); (L.G.e.S.N.); (J.L.d.S.G.); (L.A.d.S.); (R.d.S.A.); (M.D.D.); (T.T.A.F.); (J.A.d.S.); (P.P.M.T.)
| | - Stephany Lorrane Ishida Franco
- Institute of Veterinary Medicine, Pará Federal University, Belém 68740-970, Brazil; (R.d.M.S.); (L.H.V.A.); (T.d.S.C.); (S.L.I.F.); (H.J.G.); (P.H.L.C.); (L.S.C.); (L.G.e.S.N.); (J.L.d.S.G.); (L.A.d.S.); (R.d.S.A.); (M.D.D.); (T.T.A.F.); (J.A.d.S.); (P.P.M.T.)
| | - Heytor Jales Gurgel
- Institute of Veterinary Medicine, Pará Federal University, Belém 68740-970, Brazil; (R.d.M.S.); (L.H.V.A.); (T.d.S.C.); (S.L.I.F.); (H.J.G.); (P.H.L.C.); (L.S.C.); (L.G.e.S.N.); (J.L.d.S.G.); (L.A.d.S.); (R.d.S.A.); (M.D.D.); (T.T.A.F.); (J.A.d.S.); (P.P.M.T.)
| | - Pedro Henrique Lira Cerqueira
- Institute of Veterinary Medicine, Pará Federal University, Belém 68740-970, Brazil; (R.d.M.S.); (L.H.V.A.); (T.d.S.C.); (S.L.I.F.); (H.J.G.); (P.H.L.C.); (L.S.C.); (L.G.e.S.N.); (J.L.d.S.G.); (L.A.d.S.); (R.d.S.A.); (M.D.D.); (T.T.A.F.); (J.A.d.S.); (P.P.M.T.)
| | - Lucas Santos Carvalho
- Institute of Veterinary Medicine, Pará Federal University, Belém 68740-970, Brazil; (R.d.M.S.); (L.H.V.A.); (T.d.S.C.); (S.L.I.F.); (H.J.G.); (P.H.L.C.); (L.S.C.); (L.G.e.S.N.); (J.L.d.S.G.); (L.A.d.S.); (R.d.S.A.); (M.D.D.); (T.T.A.F.); (J.A.d.S.); (P.P.M.T.)
| | - Luis Gustavo e Silva Novais
- Institute of Veterinary Medicine, Pará Federal University, Belém 68740-970, Brazil; (R.d.M.S.); (L.H.V.A.); (T.d.S.C.); (S.L.I.F.); (H.J.G.); (P.H.L.C.); (L.S.C.); (L.G.e.S.N.); (J.L.d.S.G.); (L.A.d.S.); (R.d.S.A.); (M.D.D.); (T.T.A.F.); (J.A.d.S.); (P.P.M.T.)
| | - José Leandro da Silva Gonçalves
- Institute of Veterinary Medicine, Pará Federal University, Belém 68740-970, Brazil; (R.d.M.S.); (L.H.V.A.); (T.d.S.C.); (S.L.I.F.); (H.J.G.); (P.H.L.C.); (L.S.C.); (L.G.e.S.N.); (J.L.d.S.G.); (L.A.d.S.); (R.d.S.A.); (M.D.D.); (T.T.A.F.); (J.A.d.S.); (P.P.M.T.)
| | - Loise Araújo de Sousa
- Institute of Veterinary Medicine, Pará Federal University, Belém 68740-970, Brazil; (R.d.M.S.); (L.H.V.A.); (T.d.S.C.); (S.L.I.F.); (H.J.G.); (P.H.L.C.); (L.S.C.); (L.G.e.S.N.); (J.L.d.S.G.); (L.A.d.S.); (R.d.S.A.); (M.D.D.); (T.T.A.F.); (J.A.d.S.); (P.P.M.T.)
| | - Rodrigo dos Santos Albuquerque
- Institute of Veterinary Medicine, Pará Federal University, Belém 68740-970, Brazil; (R.d.M.S.); (L.H.V.A.); (T.d.S.C.); (S.L.I.F.); (H.J.G.); (P.H.L.C.); (L.S.C.); (L.G.e.S.N.); (J.L.d.S.G.); (L.A.d.S.); (R.d.S.A.); (M.D.D.); (T.T.A.F.); (J.A.d.S.); (P.P.M.T.)
| | - Marcos Duarte Dutra
- Institute of Veterinary Medicine, Pará Federal University, Belém 68740-970, Brazil; (R.d.M.S.); (L.H.V.A.); (T.d.S.C.); (S.L.I.F.); (H.J.G.); (P.H.L.C.); (L.S.C.); (L.G.e.S.N.); (J.L.d.S.G.); (L.A.d.S.); (R.d.S.A.); (M.D.D.); (T.T.A.F.); (J.A.d.S.); (P.P.M.T.)
| | - Tatiane Teles Albernaz Ferreira
- Institute of Veterinary Medicine, Pará Federal University, Belém 68740-970, Brazil; (R.d.M.S.); (L.H.V.A.); (T.d.S.C.); (S.L.I.F.); (H.J.G.); (P.H.L.C.); (L.S.C.); (L.G.e.S.N.); (J.L.d.S.G.); (L.A.d.S.); (R.d.S.A.); (M.D.D.); (T.T.A.F.); (J.A.d.S.); (P.P.M.T.)
| | - José Alcides da Silveira
- Institute of Veterinary Medicine, Pará Federal University, Belém 68740-970, Brazil; (R.d.M.S.); (L.H.V.A.); (T.d.S.C.); (S.L.I.F.); (H.J.G.); (P.H.L.C.); (L.S.C.); (L.G.e.S.N.); (J.L.d.S.G.); (L.A.d.S.); (R.d.S.A.); (M.D.D.); (T.T.A.F.); (J.A.d.S.); (P.P.M.T.)
| | | | | | - Pedro Paulo Maia Teixeira
- Institute of Veterinary Medicine, Pará Federal University, Belém 68740-970, Brazil; (R.d.M.S.); (L.H.V.A.); (T.d.S.C.); (S.L.I.F.); (H.J.G.); (P.H.L.C.); (L.S.C.); (L.G.e.S.N.); (J.L.d.S.G.); (L.A.d.S.); (R.d.S.A.); (M.D.D.); (T.T.A.F.); (J.A.d.S.); (P.P.M.T.)
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Zhu Y, Zhang J, Ji Z, Liu W, Li M, Xia E, Zhang J, Wang J. Ultrasound Evaluation of Pelvic Floor Function after Transumbilical Laparoscopic Single-Site Total Hysterectomy Using Deep Learning Algorithm. COMPUTATIONAL AND MATHEMATICAL METHODS IN MEDICINE 2022; 2022:1116332. [PMID: 35991136 PMCID: PMC9385360 DOI: 10.1155/2022/1116332] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/02/2022] [Revised: 07/06/2022] [Accepted: 07/15/2022] [Indexed: 11/18/2022]
Abstract
This study was aimed at investigating the ultrasound based on deep learning algorithm to evaluate the rehabilitation effect of transumbilical laparoscopic single-site total hysterectomy on pelvic floor function in patients. The bilinear convolutional neural network (BCNN) structure was constructed in the ultrasound imaging system. The spatial transformer network (STN) was used to preserve image information. Two algorithms, BCNN-R and BCNN-S, were proposed to remove sensitive information after ultrasonic image processing, and then, subtle features of the image were identified and classified. 80 patients undergoing transumbilical laparoscopic single-site total hysterectomy in hospital were randomly divided into a control group and a treatment group, with 40 cases in each group. In the control group, conventional ultrasound was used to assess the image of pelvic floor function in patients undergoing laparoendoscopic single-site surgery (LESS); in the observation group, ultrasound based on deep learning algorithm was used. The postoperative incision pain score, average postoperative anus exhaust time, average hospital stay, and postoperative satisfaction of the two groups were evaluated, respectively. The highest accuracy of constructed network BCNN-S was 88.98%; the highest recall rate of BCNN-R was 88.51%; the highest accuracy rate of BCNN-R was 97.34%. The operation time, intraoperative blood loss, and exhaust time were similar between the two groups, and the difference had no statistical significance (P > 0.05). The numerical rating scale (NRS) scores were compared, the observation group had less pain, the difference between the two groups had statistical significance (P < 0.05), and the postoperative recovery was good. The BCNN based on deep learning can realize the imaging of the uterus by ultrasound and realize the evaluation of pelvic floor function, and the probability of pelvic floor dysfunction is small, which is worthy of clinical promotion.
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Affiliation(s)
- Yan Zhu
- Department of Obstetrics and Gynecology, The Yancheng Clinical College of Xuzhou Medical University, The First People's Hospital of Yancheng, Yancheng, 224001 Jiangsu, China
| | - Jiamiao Zhang
- Department of Obstetrics and Gynecology, The Yancheng Clinical College of Xuzhou Medical University, The First People's Hospital of Yancheng, Yancheng, 224001 Jiangsu, China
| | - Zhonglei Ji
- Department of Obstetrics and Gynecology, The Yancheng Clinical College of Xuzhou Medical University, The First People's Hospital of Yancheng, Yancheng, 224001 Jiangsu, China
| | - Wen Liu
- Department of Obstetrics and Gynecology, The Yancheng Clinical College of Xuzhou Medical University, The First People's Hospital of Yancheng, Yancheng, 224001 Jiangsu, China
| | - Mingyue Li
- Department of Obstetrics and Gynecology, The Yancheng Clinical College of Xuzhou Medical University, The First People's Hospital of Yancheng, Yancheng, 224001 Jiangsu, China
| | - Enhui Xia
- Department of Ultrasound, The Yancheng Clinical College of Xuzhou Medical University, The First People's Hospital of Yancheng, Yancheng, 224001 Jiangsu, China
| | - Jing Zhang
- Department of Obstetrics and Gynecology, The Yancheng Clinical College of Xuzhou Medical University, The First People's Hospital of Yancheng, Yancheng, 224001 Jiangsu, China
| | - Jianqing Wang
- Department of Obstetrics and Gynecology, The Yancheng Clinical College of Xuzhou Medical University, The First People's Hospital of Yancheng, Yancheng, 224001 Jiangsu, China
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Tuoheti Z, Han L, Mulati G. Laparo-endoscopic single-site surgery vs conventional laparoscopic surgery for endometrial cancer: A systematic review and meta-analysis. Medicine (Baltimore) 2021; 100:e24908. [PMID: 33761649 PMCID: PMC9281911 DOI: 10.1097/md.0000000000024908] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/16/2020] [Revised: 01/24/2021] [Accepted: 01/30/2021] [Indexed: 01/05/2023] Open
Abstract
OBJECTIVE To systematically review and evaluate the safety, advantages and clinical application value of laparo-endoscopic single-site surgery (LESS) for endometrial cancer by comparing it with conventional laparoscopic surgery (CLS). METHODS We conducted a systematic review of the published literature comparing LESS with CLS in the treatment of endometrial cancer. English databases including PubMed, Embase, Ovid, and the Cochrane Library and Chinese databases including Chinese National Knowledge Infrastructure, Wanfang and China Biology Medicine were searched for eligible observational studies up to July 10, 2019. We then evaluated the quality of the selected comparative studies before performing a meta-analysis using the RevMan 5.3 software. The complications, surgical time, blood loss during surgery, postoperative length of hospital stay and number of lymph nodes removed during surgery were compared between the 2 surgical approaches. RESULTS Four studies with 234 patients were finally included in this meta-analysis. We found that there was no statistically significant difference in complications between the 2 surgical approaches [odds ratio (OR): 0.63, 95% confidence interval (CI): 0.18-2.21, P = .47, I2 = 0%]. There was no statistically significant difference in blood loss between the 2 surgical approaches [mean difference (MD): -61.81, 95% CI: -130.87 to -7.25, P = .08, I2 = 74%]. There was no statistically significant difference in surgical time between the 2 surgical approaches (MD: -11.51, 95% CI: -40.19 to 17.16, P = .43, I2 = 81%). There was also no statistically significant difference in postoperative length of hospital stay between the 2 surgical approaches (MD: -0.56, 95% CI: -1.25 to -0.13, P = .11, I2 = 72%). Both pelvic and paraaortic lymph nodes can be removed with either of the 2 procedures. There were no statistically significant differences in the number of paraaortic lymph nodes and total lymph nodes removed during surgery between the 2 surgical approaches [(MD: -0.11, 95% CI: -3.12 to 2.91, P = .29, I2 = 11%) and (MD: -0.53, 95% CI (-3.22 to 2.16), P = .70, I2 = 83%)]. However, patients treated with LESS had more pelvic lymph nodes removed during surgery than those treated with CLS (MD: 3.33, 95% CI: 1.05-5.62, P = .004, I2 = 32%). CONCLUSION Compared with CLS, LESS did not reduce the incidence of complications or shorten postoperative hospital stay. Nor did it increase surgical time or the amount of bleeding during surgery. LESS can remove lymph nodes and ease postoperative pain in the same way as CLS. However, LESS improves cosmesis by leaving a single small scar.
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Michener CM, Lampert E, Yao M, Harnegie MP, Chalif J, Chambers LM. Meta-analysis of Laparoendoscopic Single-site and Vaginal Natural Orifice Transluminal Endoscopic Hysterectomy Compared with Multiport Hysterectomy: Real Benefits or Diminishing Returns? J Minim Invasive Gynecol 2020; 28:698-709.e1. [PMID: 33346073 DOI: 10.1016/j.jmig.2020.11.029] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2020] [Revised: 11/16/2020] [Accepted: 11/25/2020] [Indexed: 02/07/2023]
Abstract
OBJECTIVE Because minimally invasive hysterectomy has become increasingly performed by gynecologic surgeons, strategies to further improve outcomes have emerged, including innovations in surgical approach. We sought to evaluate the intraoperative and perioperative outcomes and success rates of laparoendoscopic single-site surgery (LESS) and vaginal natural orifice transluminal endoscopic surgery (vNOTES) hysterectomy in comparison with those of conventional multiport laparoscopic (MPL) hysterectomy. DATA SOURCES A librarian-led search of PubMed, Scopus, CINAHL, Embase, Web of Science, and the Cochrane Central Register of Controlled Trials was performed for case-control, retrospective cohort, and randomized controlled trials through May 2020. METHODS OF STUDY SELECTION The inclusion criterion was publications comparing LESS or vNOTES hysterectomy with conventional MPL hysterectomy for the management of benign or malignant gynecologic disease. Four authors reviewed the abstracts and selected studies for full-text review. The manuscripts were reviewed, separately, by 2 authors for final inclusion and assessment of bias using either the risk-of-bias assessment tool or the Newcastle-Ottawa scale. Any disagreement was resolved by discussion with, or arbitration by, a third reviewer. The titles of 2259 articles were screened, and 108 articles were chosen for abstract screening. Full-text screening resulted in 29 studies eligible for inclusion. TABULATION, INTEGRATION, AND RESULTS Extracted data were placed into REDCap (Vanderbilt University, Nashville, TN), and MPL hysterectomy was compared with single-port hysterectomy using meta-analysis models. The outcomes included estimated blood loss (EBL); operative (OP) time; transfusion; length of hospital stay (LOS); conversion to laparotomy; visual analog scale pain scores at 12 hours, 24 hours, and 48 hours; any complications; and 7 subcategories of complications. Random-effects models were built for continuous outcomes and binary outcomes, and the results are reported as standardized mean difference (SMD) or odds ratio (OR) and their corresponding 95% confidence intervals, respectively. Meta-analysis could not be performed for vNOTES vs MPL, given that only 3 studies met the eligibility criteria. When LESS and MPL were compared, there was a shorter OP time for MPL (SMD = -0.2577, p <.001) and lower rate of transfusion (OR = 0.1697, p <.001), without a significant difference in EBL (SMD = -0.0243, p = .689). There was a nonsignificant trend toward higher risk of conversion to laparotomy in the MPL group (OR = 2.5871, p = .078). Pain scores were no different 12 or 24 hours postoperatively but were significantly higher at 48 hours postoperatively (SMD = 0.1861, p = .035) in the MPL group. There were no differences in overall or individual complications between the LESS and MPL groups. In the vNOTES comparison, 2 studies demonstrated shorter OP times, with reduced LOS and no difference in complications. CONCLUSION In this meta-analysis, we identified that LESS hysterectomy has comparable and low overall rates of complications and conversion to laparotomy compared with MPL. Notably, the OP time seems longer, and the pain scores at 48 hours may be lower with LESS hysterectomy than with MPL hysterectomy. Limited data suggest that vNOTES hysterectomy may have shorter OP times and improved EBL, transfusion rates, LOS, and pain scores compared with MPL hysterectomy, but further study is needed. There remains a deficit in high-quality data to understand the differences in cosmesis among these surgical approaches. The quality of data for this analysis seems to be low to moderate.
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Affiliation(s)
- Chad M Michener
- Division of Gynecologic Oncology (Drs. Michener and Chambers).
| | - Erika Lampert
- Department of Obstetrics and Gynecology (Drs. Lampert and Chalif) Obstetrics, Gynecology and Women's Health Institute
| | - Meng Yao
- Department of Quantitative Health Sciences (Mr. Yao)
| | - Mary Pat Harnegie
- Department of Library Services (Ms. Harnegie), Cleveland Clinic, Cleveland, Ohio
| | - Julia Chalif
- Department of Obstetrics and Gynecology (Drs. Lampert and Chalif) Obstetrics, Gynecology and Women's Health Institute
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LA Russa M, Liakou C, Burbos N. Ultra-minimally invasive approaches for endometrial cancer treatment: review of the literature. Minerva Med 2020; 112:31-46. [PMID: 33205639 DOI: 10.23736/s0026-4806.20.07073-1] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
INTRODUCTION We conducted a systematic review to evaluate the outcomes and role of ultra-minimally invasive surgical approaches for treatment of women diagnosed with endometrial cancer. Although, there is no agreed definition of the term "ultraminimal," we considered the hysteroscopic surgery, single-port surgery, mini/microlaparoscopy and percutaneous laparoscopy as surgical approaches that would best fit this description. EVIDENCE ACQUISITION The current systematic review was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) Guidelines. We performed a literature search using MEDLINE (PubMed), EMBASE and Cochrane Library databases for English-language studies published before August 1, 2020. We used the following keywords including "endometrial cancer," "endometrial malignancy," "fertility-sparing or preserving," "hysteroscopy," "hysteroscopic resection," "dilatation and curettage," "ultra-minimally invasive surgery," "progestin therapy," "hormone therapy," "single port," "single-site," "minilaparoscopy," "microlaparoscopy," "percutaneous" and "3 mm laparoscopy." EVIDENCE SYNTHESIS A total of 21 studies, reporting on 229 patients were included. 219 (95.6%) of the patients were premenopausal. Among premenopausal women, complete disease response was reported in 186 (84.9%) patients. The complete response rate was 77.1% in patients who underwent focal or extensive endometrial resection, 90.9% in patients who had the two-step approach and 88.9% in the group of patients treated with the three-step technique. Among 98 women who wished and attempted to conceive, 65 (66.3%) women became pregnant. Recurrent disease was diagnosed in 26 of 219 (11.9%) patients. No surgical complications were reported. In 10 postmenopausal patients that underwent hysteroscopic resection, no recurrences were detected after 5 years of follow-up. We identified 11 studies that reported on the use single-port laparoscopic surgery and included a total of 447 patients. The rate of intraoperative and postoperative complications was 2.6% and 5.2%, respectively. The majority of the studies did not report on the duration of follow-up or oncological outcomes. Ten studies, including 296 patients, investigated the role of single-port robotic-assisted laparoscopy. The overall rate of intraoperative and postoperative complications was 1.0% and 7.1%, respectively. Two studies, including 38 patients, reported on the role of minilaparoscopy. None of these cases required conversion to laparotomy. Data on overall survival in the cohort of patients that underwent minilaparoscopy were not reported. We found only one publication reporting on the use of percutaneous laparoscopy. This prospective study included 30 patients. No complication was reported, and with a median follow-up time of 14 months (range 12-36) no recurrences were diagnosed. CONCLUSIONS Several ultra-minimally invasive surgical techniques have been developed and implemented in selected patients with endometrial cancer. The results of this review support the feasibility and perioperative safety of these approaches, while long-term outcomes are not adequately studied. However, further work is required in standardization of the techniques, in determining the learning curve of the operator and establishing their oncological safety.
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Affiliation(s)
- Mariaclelia LA Russa
- Department of Gynecological Oncology, Norfolk and Norwich University Hospital, Norwich, UK -
| | - Chrysoula Liakou
- Department of Gynecological Oncology, Norfolk and Norwich University Hospital, Norwich, UK
| | - Nikolaos Burbos
- Department of Gynecological Oncology, Norfolk and Norwich University Hospital, Norwich, UK
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Aberrantly enhanced melanoma-associated antigen (MAGE)-A3 expression facilitates cervical cancer cell proliferation and metastasis via actuating Wnt signaling pathway. Biomed Pharmacother 2019; 122:109710. [PMID: 31918280 DOI: 10.1016/j.biopha.2019.109710] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2019] [Revised: 11/23/2019] [Accepted: 11/25/2019] [Indexed: 12/28/2022] Open
Abstract
BACKGROUND The over-expression of melanoma-associated antigen (MAGE)-A3 in cervical cancer (CC) has been observed in our previous study, suggesting that it possibly take a vital role during the development and metastasis of CC. The present study aimed to investigate the biological function of MAGE-A3 in the progression of CC and explore how it executes its roles. METHODS The mRNA expression of MAGE-A3 in End1/E6E7 and CC cell lines (HeLa, SiHa and C33A) was measured by real-time quantitative reverse transcription PCR (qRT-PCR). Loss- and gain-of-function methods were used to assess the effect of MAGE-A3 on the proliferative, migratory and invasive abilities of HeLa and SiHa cells. Western blot was performed to measure the expression levels of proteins related to epithelial-mesenchymal transition (EMT) and proteins in the Wnt signaling pathway. In vivo tumorigenesis assay was conducted to evaluate the effect of MAGE-A3 on tumor growth. RESULTS MAGE-A3 expression was significantly up-regulated in CC cell lines (HeLa, SiHa and C33A) compared with that in End1/E6E7 cell line. Knockdown of MAGE-A3 could significantly suppress migration, invasion and proliferation in HeLa cells; whereas, overexpression of MAGE-A3 in SiHa cells presented the opposite results. Moreover, knockdown of MAGE-A3 presented a suppressive effect on the activation of EMT and Wnt signaling pathway in HeLa cells, whilst up-regulation of MAGE-A3 exhibited the opponent outcomes in SiHa cells. Through in vivo tumorigenesis assay, we further verified that MAGE-A3 acted as a facilitator in tumor growth. CONCLUSIONS MAGE-A3 is overexpressed in CC cells and possibly facilitates the viability and motility of CC cells via modulating EMT and Wnt signaling. This study implied that MAGE-A3 might be a potential therapeutic target as well as a prognosis predictor for patients with CC.
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Lin C, Ying Z, Xiao Rong Q, Sijing C, Ling M, Xi Biao J. LESS with Suture Suspension for Early-Stage Adnexa Cancer Staging. JSLS 2019; 23:JSLS.2019.00024. [PMID: 31595144 PMCID: PMC6764791 DOI: 10.4293/jsls.2019.00024] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/03/2022] Open
Abstract
Background and Objective: Laparoendoscopic single-site surgery has been used in treating gynecologic diseases including early-stage cervical and endometrial cancer, but less so in early-stage adnexal cancer. We aimed to demonstrate the use of laparoendoscopic single-site surgery with suture suspension for staging of early-stage ovarian/fallopian-tube cancer and describe the study results. Methods: Seven patients with early-stage adnexal cancer underwent staging surgery via laparoendoscopic single-site surgery at West China Second University Hospital of Sichuan University from November 2017 to September 2018. Results: All cases were successfully staged via this technique. Two patients underwent the high-level para-aortic lymphadenectomy up to the infrarenal vein, and four patients underwent para-aortic lymphadenectomy at the level of the inframesenteric artery; one patient underwent the para-aortic lymph node sampling. The operation time was 305–365 minutes. The estimated intraoperative blood loss was 50–200 mL. No intra-operative complications occurred; one patient developed pneumonia 48 hours postoperation. The number of pelvic and para-aortic nodes was 15–39 and 1–18, respectively. Pain scores 12 and 24 hours postsurgery were 2–3 and 1–2 with the use of butorphanol tartrate, respectively. On 4–14 months followup, the umbilical incision had good cosmesis; no umbilical hernia or vaginal dehiscence and no neoplasm recurrence were noted. Conclusion: Laparoendoscopic single-site surgery may be a feasible and safe technique for staging early-stage ovarian/tubal cancer. This approach has some advantages included providing easier access to the upper abdominal regions when performing high-level infrarenal para-aortic lymphadenectomy; the 2-cm elastic incision favors fast specimen extraction and colpotomy are avoided. However, the long-term oncologic outcomes need to be further investigated.
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Affiliation(s)
- Chen Lin
- Department of Gynecologic Oncology, West China Second Hospital, Sichuan University, Sichuan, China
| | - Zheng Ying
- Department of Gynecologic Oncology, West China Second Hospital, Sichuan University, Sichuan, China
| | - Qi Xiao Rong
- Department of Gynecologic Oncology, West China Second Hospital, Sichuan University, Sichuan, China
| | - Chen Sijing
- Department of Gynecologic Oncology, West China Second Hospital, Sichuan University, Sichuan, China
| | - Min Ling
- Department of Gynecologic Oncology, West China Second Hospital, Sichuan University, Sichuan, China
| | - Jia Xi Biao
- Department of Gynecologic Oncology, West China Second Hospital, Sichuan University, Sichuan, China
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Dong DH, Zhu HY, Luo Y, Zhang HK, Xiang JX, Xue F, Wu RQ, Lv Y. Miniature magnetically anchored and controlled camera system for trocar-less laparoscopy. World J Gastroenterol 2017; 23:2168-2174. [PMID: 28405144 PMCID: PMC5374128 DOI: 10.3748/wjg.v23.i12.2168] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/28/2016] [Revised: 01/17/2017] [Accepted: 02/17/2017] [Indexed: 02/06/2023] Open
Abstract
AIM To design a miniature magnetically anchored and controlled camera system to reduce the number of trocars which are required for laparoscopy.
METHODS The system consists of a miniature magnetically anchored camera with a 30° downward angle, an external magnetically anchored unit, and a vision output device. The camera weighs 12 g, measures Φ10.5 mm × 55 mm and has two magnets, a vision model, a light source, and a metal hexagonal nut. To test the prototype, the camera was inserted through a 12-mm conventional trocar in an ex vivo real liver laparoscopic training system. A trocar-less laparoscopic cholecystectomy was performed 6 times using a 12-mm and a 5-mm conventional trocar. In addition, the same procedure was performed in four canine models.
RESULTS Both procedures were successfully performed using only two conventional laparoscopic trocars. The cholecystectomy was completed without any major complication in 42 min (38-45 min) in vitro and in 50 min (45-53 min) using an animal model. This camera was anchored and controlled by an external unit magnetically anchored on the abdominal wall. The camera could generate excellent image. with no instrument collisions.
CONCLUSION The camera system we designed provides excellent optics and can be easily maneuvered. The number of conventional trocars is reduced without adding technical difficulties.
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