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Zhou YM, Zang YW, Li ZY, Zhou MW, Wang ZH, Chen ZY, Ding JH, Xiang JB. Conformal sphincteric resection for ultra-low rectal cancer located below the dentate line: A pilot report. Colorectal Dis 2023; 25:2414-2422. [PMID: 37908184 DOI: 10.1111/codi.16776] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/07/2023] [Revised: 05/15/2023] [Accepted: 09/14/2023] [Indexed: 11/02/2023]
Abstract
AIM Sphincter-sparing surgery can be achieved in most cases of low rectal cancer with the development of intersphincteric resection. However, abdominoperineal resection is still inevitable for patients with tumours located below the dentate line. To address this, we have developed a procedure called conformal sphincteric resection (CSR) in which the corresponding part of the subcutaneous portion of the external anal sphincter and the perianal skin on the tumour side is removed to achieve a safe distal resection margin and lateral resection margin while the dentate line and the internal anal sphincter on the tumour-free side are preserved as much as possible, to achieve sphincter preservation without compromising oncological safety and functional acceptability, and to render tumour location no longer a contraindication for sphincter-sparing surgery. This is the first study to describe the concept, indication and surgical procedure of CSR and to report its preliminary surgical, oncological and functional results. METHODS This is a retrospective, single-centre, single-arm pilot study conducted at Huashan Hospital, Fudan University. Demographic, clinicopathological, oncological and functional follow-up data were collected from 20 consecutive patients with rectal tumours located below the dentate line who underwent laparoscopic CSR by the same surgical team from June 2018 to March 2022. RESULTS The mean distance of the tumour's lower edge from the anal verge was 13.1 ± 6.0 mm. The mean distal resection margin was 10.6 ± 4.3 mm. All circumferential resection margins were negative. There were no instances of perioperative mortality. The complication rate was 25% but all were Clavien-Dindo Grade I. Among the 20 cases, 17 were diagnosed with adenocarcinoma, one with squamous cell carcinoma and two with adenoma featuring high-grade intraepithelial neoplasia. Pathological TNM staging revealed two, seven, five, five and one case(s) in Stages 0, I, II, III and IV, respectively. The median follow-up period was 20 months (interquartile range 22 months), with no withdrawals. The overall and disease-free survival rates were both 95%. The mean Wexner incontinence score and low anterior resection syndrome score recorded 18 months following diverting ileostomy closure were 6.3 ± 3.8 and 27.3 ± 3.6, respectively. CONCLUSIONS This study has proposed the CSR procedure for the first time, which is a technically feasible, oncologically safe and functionally acceptable procedure for carefully selected patients with rectal tumours located below the dentate line.
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Affiliation(s)
- Yi-Ming Zhou
- Department of General Surgery, Huashan Hospital, Fudan University, Shanghai, China
| | - Yi-Wen Zang
- Department of General Surgery, Huashan Hospital, Fudan University, Shanghai, China
| | - Zhen-Yang Li
- Department of General Surgery, Huashan Hospital, Fudan University, Shanghai, China
| | - Min-Wei Zhou
- Department of General Surgery, Huashan Hospital, Fudan University, Shanghai, China
| | - Zi-Hao Wang
- Department of General Surgery, Huashan Hospital, Fudan University, Shanghai, China
| | - Zong-You Chen
- Department of General Surgery, Huashan Hospital, Fudan University, Shanghai, China
| | - Jian-Hua Ding
- Department of Colorectal Surgery, Characteristic Medical Centre of PLA Rocket Force, Beijing, China
| | - Jian-Bin Xiang
- Department of General Surgery, Huashan Hospital, Fudan University, Shanghai, China
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Zhou MW, Li ZY, Gu XD, Zhou YM, Zang YW, Yang Y, Wang ZH, Chen ZY, Xiang JB. [Impact of surgical treatment for locally recurrent rectal cancer on the quality of life of patients]. Zhonghua Wei Chang Wai Ke Za Zhi 2021; 24:352-358. [PMID: 33878825 DOI: 10.3760/cma.j.cn.441530-20201204-00645] [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] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Objective: To investigate the impact of surgical treatment on quality of life in patients with locally recurrent rectal cancer (LRRC). Methods: A descriptive case series study was performed. The complete clinical data of 62 patients who met the diagnostic criteria of LRRC and treated by surgical procedures in Huashan Hospital of Fudan University from January 2012 to November 2019 were analyzed retrospectively. All the patients were followed up at least 12 months. Assessments of urinary function, sexual function, mobility function of lower limb and quality of life were documented. Patients with distant metastasis and surgical history of the urinary system were excluded. According to the criteria of Memorial Sloan Kettering Cancer Center (MSKCC), recurrence were divided into central (n=27), anterior (n=20), posterior (n=7), and lateral (n=8) subtypes. Baseline characteristics, surgical procedures and short-term complications were analyzed. International prostate symptom score (IPSS) and grade of voiding dysfunction were used to evaluate the urinary function. Higher score of IPSS and higher grade of voiding dysfunction indicated worse voiding function. Sexual function for both genders was assessed preoperatively and postoperatively. International index of erectile function-5 (IIEF-5) was used for assessment of male patients and higher score indicated better function. Female sexual function index (FSFI) was used in females and higher score indicated better function. Short-form health survey with 36 items (SF-36), yielding an 8-scale profile of functional health (physical functioning, role-physical, bodily pain, general health, vitality, social functioning, emotional health and mental health) was used to evaluate the quality of life. The higher score indicated the better quality of life. Results: All the operations of 62 patients completed successfully and R0 resection rate was 88.7% (55/62). Postoperative surgical complications occurred in 16 cases (25.8%), including 3 patients of Clavien-Dindo classification III. At postoperative 3-month, 42 patients without ileum cystectomy or ureterostomy suffered from different grade of voiding dysfunction. IPSS increased significantly after the surgery (before surgery: 12.36±4.75, after surgery: 18.40±4.77, t=-9.128, P<0.001). There was no significant difference among the subtypes (P>0.05). At postoperative 12-month, IIEF-5 decreased from 14 (0~25) to 9 (0~19) in males (Z=-5.174, P<0.001) and FSFI deceased from 8.4 (2.0-27.0) to 2.0 (2.0-18.4) in females (Z=-3.522, P<0.001). Scores of physical functioning and role-physical decreased significantly [physical functioning: before surgery 70 (35-85), after surgery 65 (30-80), Z=-3.685, P<0.001; role-physical: before surgery 50 (0-50), after surgery 25(0-75), Z=-4.065, P<0.001], while those of social functioning role-emotional and mental health increased significantly after the surgery [social functioning: before surgery 44 (22-78), after surgery 56 (0-89), Z=-3.509, P<0.001; role-emotional: before surgery 17 (0-100), after surgery 33 (0-100), Z=-2.439, P=0.015; mental health: before surgery 40 (36-76), after surgery 52 (24-80), Z=-3.395, P<0.001]. All surgical procedures decreased the voiding function of LRRC patients and the sexual function of male patients (all P<0.01). However, only total pelvic exenteration and posterior pelvic exenteration decreased FSFI in female patients [before surgery: 8.4 (2.0-27.0) after surgery: 2.0 (2.0-18.4), Z=-2.810, P=0.005]. Conclusions: Multi-visceral resection in LRRC patients may damage voiding and sexual function. However, successful and effective surgical treatment can improve the psychosocial health of LRRC patients.
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Affiliation(s)
- M W Zhou
- Department of General Surgery, Huashan Hospital, Fudan University, Shanghai 200040, China
| | - Z Y Li
- Department of General Surgery, Huashan Hospital, Fudan University, Shanghai 200040, China
| | - X D Gu
- Department of General Surgery, Huashan Hospital, Fudan University, Shanghai 200040, China
| | - Y M Zhou
- Department of General Surgery, Huashan Hospital, Fudan University, Shanghai 200040, China
| | - Y W Zang
- Department of General Surgery, Huashan Hospital, Fudan University, Shanghai 200040, China
| | - Y Yang
- Department of General Surgery, Huashan Hospital, Fudan University, Shanghai 200040, China
| | - Z H Wang
- Department of General Surgery, Huashan Hospital, Fudan University, Shanghai 200040, China
| | - Z Y Chen
- Department of General Surgery, Huashan Hospital, Fudan University, Shanghai 200040, China
| | - J B Xiang
- Department of General Surgery, Huashan Hospital, Fudan University, Shanghai 200040, China
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Zang YW, Li ZY, Gu XD, Zhou YM, Yang Y, Zhou MW, Wang ZH, Guo YJ, Chen ZY, Xiang JB. [Analysis of technical feasibility and safety of robot-assisted subtotal intersphincteric resection for ultra-low rectal cancer]. Zhonghua Wei Chang Wai Ke Za Zhi 2020; 23:405-407. [PMID: 32306610 DOI: 10.3760/cma.j.cn.441530-20190314-00092] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
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Huang WH, Zhou MW, Zhu YF, Xiang JB, Li ZY, Wang ZH, Zhou YM, Yang Y, Chen ZY, Gu XD. The Role Of Hepatic Stellate Cells In Promoting Liver Metastasis Of Colorectal Carcinoma. Onco Targets Ther 2019; 12:7573-7580. [PMID: 31571908 PMCID: PMC6754330 DOI: 10.2147/ott.s214409] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2019] [Accepted: 08/31/2019] [Indexed: 01/16/2023] Open
Abstract
Purpose Colorectal cancer (CRC) is the most common malignancy in the gastrointestinal tract. The liver is the most common location of CRC metastases, which are the main causes of CRC-related death. However, the mechanisms underlying metastasis of CRC to the liver have not been characterized, resulting in therapeutic challenges. Methods The effects of hepatic stellate cells (HSCs) on T cells were evaluated using in vitro mixed lymphocyte reactions (MLRs) and cytokine production assays. HSC-induced CT26 cell migration and proliferation were evaluated in vitro and in vivo. Results HSCs induced T cell hypo-responsiveness, promoted T cell apoptosis, and induced regulatory T cell expansion in vitro. IL-2 and IL-4 were significantly lower in MLRs incubated with HSCs. Supernatants of MLRs with HSCs promoted CT26 cell proliferation and migration. Furthermore, the presence of HSCs increased the number of liver metastases and promoted proliferation of liver metastatic tumor cells in vivo. Conclusion HSCs may contribute to an immunosuppressive liver microenvironment, resulting in a favorable environment for the colonization of CRC cells in the liver. These findings highlight a potential strategy for treatment of CRC liver metastases.
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Affiliation(s)
- Wen-Hai Huang
- Department of General Surgery, Huashan Hospital, Fudan University, Shanghai 200040, People's Republic of China
| | - Min-Wei Zhou
- Department of General Surgery, Huashan Hospital, Fudan University, Shanghai 200040, People's Republic of China
| | - Yan-Feng Zhu
- Department of Nursing, Huashan Hospital, Fudan University, Shanghai 200040, People's Republic of China
| | - Jian-Bin Xiang
- Department of General Surgery, Huashan Hospital, Fudan University, Shanghai 200040, People's Republic of China
| | - Zhen-Yang Li
- Department of General Surgery, Huashan Hospital, Fudan University, Shanghai 200040, People's Republic of China
| | - Zi-Hao Wang
- Department of General Surgery, Huashan Hospital, Fudan University, Shanghai 200040, People's Republic of China
| | - Yi-Ming Zhou
- Department of General Surgery, Huashan Hospital, Fudan University, Shanghai 200040, People's Republic of China
| | - Yi Yang
- Department of General Surgery, Huashan Hospital, Fudan University, Shanghai 200040, People's Republic of China
| | - Zong-You Chen
- Department of General Surgery, Huashan Hospital, Fudan University, Shanghai 200040, People's Republic of China
| | - Xiao-Dong Gu
- Department of General Surgery, Huashan Hospital, Fudan University, Shanghai 200040, People's Republic of China
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Zhou MW, Huang XY, Chen ZY, Li ZY, Zhou YM, Yang Y, Wang ZH, Xiang JB, Gu XD. Intraoperative monitoring of pelvic autonomic nerves during laparoscopic low anterior resection of rectal cancer. Cancer Manag Res 2018; 11:411-417. [PMID: 30643466 PMCID: PMC6317465 DOI: 10.2147/cmar.s182181] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/16/2023] Open
Abstract
Background Some patients with low rectal cancer experience anorectal and urogenital dysfunctions after surgery, which can influence the long-term quality of life. In this study, we aimed to protect nerve function in such scenarios by performing intraoperative monitoring of pelvic autonomic nerves (IMPAN). Patients and methods We retrospectively investigated a series of 87 patients undergoing laparoscopic low anterior resection of rectal cancer. Nerve-sparing was evaluated both visually and electrophysiologically. IMPAN was performed by stimulating the pelvic autonomic nerves under processed electromyography of the internal anal sphincter. Urination, defecation, sexual function, and the quality of life were evaluated using validated and standardized questionnaires preoperatively and at follow-up, 12 months after surgery. Results Among a total of 87 patients (53 male and 34 female patients), IMPAN with simultaneous electromyography of the internal anal sphincter was performed in 58 (66.7%) patients. Bilateral positive IMPAN results for both measurements, indicating successfully confirmed pelvic autonomic nerve preservation, were obtained in 45 (51.7%) patients. No significant difference was found in terms of urogenital and anorectal functions between preoperative and postoperative patients with bilateral positive IMPAN (P>0.05). Compared to preoperative patients with IMPAN (unilateral) or without IMPAN, these patients exhibited higher International Prostate Symptom Score, a lower International Index of Erectile Function-5, and a lower Female Sexual Function Index score at 12 months postoperatively (P<0.05). Conclusion IMPAN is an appropriate method with which to laparoscopically protect nerve function.
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Affiliation(s)
- Min-Wei Zhou
- Department of General Surgery, Huashan Hospital, Fudan University, Shanghai, People's Republic of China, ;
| | - Xiao-Yun Huang
- Department of Electromyogram, Huashan Hospital, Fudan University, Shanghai, People's Republic of China
| | - Zong-You Chen
- Department of General Surgery, Huashan Hospital, Fudan University, Shanghai, People's Republic of China, ;
| | - Zhen-Yang Li
- Department of General Surgery, Huashan Hospital, Fudan University, Shanghai, People's Republic of China, ;
| | - Yi-Ming Zhou
- Department of General Surgery, Huashan Hospital, Fudan University, Shanghai, People's Republic of China, ;
| | - Yi Yang
- Department of General Surgery, Huashan Hospital, Fudan University, Shanghai, People's Republic of China, ;
| | - Zi-Hao Wang
- Department of General Surgery, Huashan Hospital, Fudan University, Shanghai, People's Republic of China, ;
| | - Jian-Bin Xiang
- Department of General Surgery, Huashan Hospital, Fudan University, Shanghai, People's Republic of China, ;
| | - Xiao-Dong Gu
- Department of General Surgery, Huashan Hospital, Fudan University, Shanghai, People's Republic of China, ;
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Yang Y, Ma WW, Zhou MW, Chen ZY, Xiang JB, Li ZY, Sun B, Gu XD. Application of cryoablation to treat peritoneal carcinomatosis from gastric cancer in a rabbit model. Cryobiology 2018; 85:12-16. [PMID: 30392742 DOI: 10.1016/j.cryobiol.2018.10.263] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2018] [Revised: 10/25/2018] [Accepted: 10/26/2018] [Indexed: 11/29/2022]
Abstract
OBJECTIVES Peritoneal carcinomatosis is one of the causes of death in patients with advanced gastric cancer. We assumed that cryoablation could be applied as adjuvant therapy to control peritoneal carcinomatosis from gastric cancer. METHODS We investigated the feasibility of cryoablation technique in rabbit model using a novel cryoablation balloon probe. The cryozones were harvested 7 days after cryoablation for histological evaluation. The levels of cytokines in the peripheral blood of rabbits were also detected. RESULTS The results demonstrated that cryoablation could be applied in a rabbit model of peritoneal carcinomatosis from gastric cancer. Seven days after cryoablation, necrotic tumor cells could be seen the cryozones. Higher level of IFN-γ was observed. The level of IL-10 was decreased after treatment. CONCLUSIONS The findings provided the experimental basis for the future application of cryoablation in patients.
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Affiliation(s)
- Yi Yang
- Department of General Surgery, Huashan Hospital, Fudan University, 12 Wulumuqi Middle Road, Shanghai, 200040, China
| | - Wei-Wei Ma
- Department of Nursing, Huashan Hospital, Fudan University, 12 Wulumuqi Middle Road, Shanghai, 200040, China
| | - Min-Wei Zhou
- Department of General Surgery, Huashan Hospital, Fudan University, 12 Wulumuqi Middle Road, Shanghai, 200040, China
| | - Zong-You Chen
- Department of General Surgery, Huashan Hospital, Fudan University, 12 Wulumuqi Middle Road, Shanghai, 200040, China
| | - Jian-Bin Xiang
- Department of General Surgery, Huashan Hospital, Fudan University, 12 Wulumuqi Middle Road, Shanghai, 200040, China
| | - Zhen-Yang Li
- Department of General Surgery, Huashan Hospital, Fudan University, 12 Wulumuqi Middle Road, Shanghai, 200040, China
| | - Bo Sun
- Department of Gastric Cancer and Soft Tissue Sarcoma, Shanghai Cancer Center, Fudan University, 270 Dongan Road, Shanghai, 200032, China.
| | - Xiao-Dong Gu
- Department of General Surgery, Huashan Hospital, Fudan University, 12 Wulumuqi Middle Road, Shanghai, 200040, China.
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Wu L, Yin JH, Guan YY, Liu HL, Shen HL, Wang XJ, Han BH, Zhou MW, Gu XD. A long noncoding RNA MAP3K1-2 promotes proliferation and invasion in gastric cancer. Onco Targets Ther 2018; 11:4631-4639. [PMID: 30122954 PMCID: PMC6086095 DOI: 10.2147/ott.s168819] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022] Open
Abstract
Background Long noncoding RNAs (lncRNAs) have been implicated in several human cancers. The expression profile and underlying mechanism of the lncRNA MAP3K1-2 in gastric cancer (GC) are poorly understood. Methods Sixty-one patients with GC were recruited from Shanghai Baoshan Luo Dian Hospital (Shanghai, China). Tumor tissues and paired normal tissues (5 cm adjacent to the tumor) were obtained. Expression of lncRNA MAP3K1-2 in GC cell lines was examined using quantitative real-time polymerase chain reaction. Protein expression was detected using Western blot. Cell cycle analysis was assessed using flow cytometry. Cell proliferation was assessed using soft agar assays, and cell invasion was assessed using Transwell assays. Results The expression level of lncRNA MAP3K1-2 was upregulated in GC cells and markedly higher in poorly differentiated cell lines. Silencing treatment of lncRNA MAP3K1-2 significantly inhibited cell proliferation and invasion in GC. In addition, knockdown of lncRNA MAP3K1-2 significantly inhibited the function of important genes in the MAPK signaling pathway. Higher expression of lncRNA MAP3K1-2 was often associated with poorer prognosis in patients with GC. Conclusions lncRNA MAP3K1-2 is a critical effector in GC tumorigenesis and progression, representing novel therapeutic targets. High lncRNA MAP3K1-2 expression may serve as a novel independent prognostic marker for predicting the outcome of GC.
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Affiliation(s)
- Lei Wu
- Department of General Surgery, Shanghai Baoshan Luo Dian Hospital, Shanghai 201908, China
| | - Jia-Huan Yin
- Department of General Surgery, Shanghai Baoshan Luo Dian Hospital, Shanghai 201908, China
| | - Yu-Yu Guan
- Department of General Surgery, Shanghai Baoshan Luo Dian Hospital, Shanghai 201908, China
| | - Hai-Long Liu
- Department of General Surgery, Shanghai Baoshan Luo Dian Hospital, Shanghai 201908, China
| | - Hai-Long Shen
- Department of General Surgery, Shanghai Baoshan Luo Dian Hospital, Shanghai 201908, China
| | - Xiao-Jie Wang
- Department of General Surgery, Shanghai Baoshan Luo Dian Hospital, Shanghai 201908, China
| | - Bao-Hua Han
- Department of General Surgery, Shanghai Baoshan Luo Dian Hospital, Shanghai 201908, China
| | - Min-Wei Zhou
- Department of General Surgery, Huashan Hospital, Fudan University, Shanghai 200040, China, ;
| | - Xiao-Dong Gu
- Department of General Surgery, Huashan Hospital, Fudan University, Shanghai 200040, China, ;
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He LY, Chen ML, Wang WW, Balde AI, Li Z, Cai Z, Han S, Lei ST, Zhou MW, Zhang GQ. The analysis of clinicopathologic predictors of lymph node metastasis and postoperative recurrence in patients with papillary thyroid microcarcinoma from Guangdong Province, China-a multicenter retrospective study. Int J Clin Exp Pathol 2017; 10:9735-9743. [PMID: 31966856 PMCID: PMC6966002] [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] [Subscribe] [Scholar Register] [Received: 04/08/2017] [Accepted: 07/13/2017] [Indexed: 06/10/2023]
Abstract
PURPOSE Currently the extent of lymph node dissection (LND) for papillary thyroid microcarcinoma (PTMC) remains controversial. The present study aims to investigate the clinicopathologic predictors of lymph node metastasis (LNM) and prognosis in PTMC patients from Guangdong to enable appropriate treatment and follow-up. METHODS Data including demographics, tumor size, multifocality, extrathyroidal extension (ETE) and concomitant thyroiditis were collected from 374 untreated PTMC patients from Guangdong, China. Univariate and multivariate analyses were performed to identify clinicopathologic predictors of LNM and prognostic indicators in PTMC patients with LNM. RESULTS During the follow-up period of 120 months, recurrence was significantly higher in patients with LNM than in patients without LNM (P<0.05). Age <45 years, larger tumor (>5 mm) and multifocality were predictors of LNM; age <45 years, larger tumor size and absence of concomitant thyroiditis were associated with central LNM (CLNM); male sex, ETE and multifocality were correlated with lateral LNM (LLNM) (P<0.05). There was no difference in recurrence between patients with CLNM and LLNM (P>0.05). LNM in PTMC primarily influenced disease-free survival. Age >45 years and male sex were risk factors of recurrence in PTMC patients with LNM. Male patients with CLNM and older patients with LLNM exhibited worse prognosis (P<0.05). CONCLUSIONS PTMC easily metastasizes to cervical lymph nodes, which significantly influences prognosis. Prophylactic LND is recommended in PTMC patients from Guangdong, China, who have a high risk of CLNM and/or LLNM. More aggressive postoperative treatment and more frequent follow-up could be considered for older and/or male PTMC patients with LNM.
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Affiliation(s)
- Lin-Yun He
- Department of General Surgery, Zhujiang Hospital, Southern Medical UniversityGuangzhou 510280, Guangdong Province, China
| | - Miao-Liang Chen
- Department of General Surgery, Zhujiang Hospital, Southern Medical UniversityGuangzhou 510280, Guangdong Province, China
| | - Wei-Wei Wang
- Department of General Surgery, Zhujiang Hospital, Southern Medical UniversityGuangzhou 510280, Guangdong Province, China
| | - Alpha Ibrahima Balde
- Department of General Surgery, Zhujiang Hospital, Southern Medical UniversityGuangzhou 510280, Guangdong Province, China
| | - Zhou Li
- Department of General Surgery, Zhujiang Hospital, Southern Medical UniversityGuangzhou 510280, Guangdong Province, China
| | - Zhai Cai
- Department of General Surgery, Zhujiang Hospital, Southern Medical UniversityGuangzhou 510280, Guangdong Province, China
| | - Shuai Han
- Department of General Surgery, Zhujiang Hospital, Southern Medical UniversityGuangzhou 510280, Guangdong Province, China
| | - Shang-Tong Lei
- Department of General Surgery, Nanfang Hospital, Southern Medical UniversityGuangzhou 510515, Guangdong Province, China
| | - Min-Wei Zhou
- Guangzhou Military General HospitalGuangzhou 510010, Guangdong Province, China
| | - Gang-Qing Zhang
- Guangdong No. 2 Provincial People’s HospitalGuangzhou 510317, Guangdong Province, China
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Zhou MW, Wang ZH, Chen ZY, Xiang JB, Gu XD. Advantages of Early Preventive Ileostomy Closure after Total Mesorectal Excision Surgery for Rectal Cancer: An Institutional Retrospective Study of 123 Consecutive Patients. Dig Surg 2016; 34:305-311. [PMID: 27941329 DOI: 10.1159/000452676] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/15/2016] [Accepted: 10/17/2016] [Indexed: 12/10/2022]
Abstract
BACKGROUND/AIM Preventive ileostomy is frequently constructed to minimizethe consequences of anastomotic leakage after resection of rectal cancer. There is no consensus regarding the best timing for temporary stoma closure after proctectomy for rectal cancer. This retrospective study sought to determine whether the timing of stoma closure influenced postoperative outcomes. METHODS Subjects were 123 patients with rectal cancer undergoing laparoscopic or open total mesorectal excision surgery with preventive ileostomy from 2012 to 2015. They were divided into 2 groups according the timing of stoma closure: the standard group who had closure within 90 (60-120) days (n = 78) and the late group who had closure after 180 (150-210) days (n = 45). RESULTS There was no significant difference in operative time, operative blood loss or postoperative complications between the 2 groups. Timing of postoperative fasting and length of hospital stay was similar in both groups. Adjuvant chemotherapy was not a risk factor for postoperative complications after stoma closure. CONCLUSIONS There was no significant difference between different timings of temporary stoma closure in relation to postoperative complications. Delayed stoma closure showed no benefit in prevention of morbidity. Early closure is safe and can provide better quality of life for patients.
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Affiliation(s)
- Min-Wei Zhou
- Department of General Surgery, Huashan Hospital, Fudan University, Shanghai, China
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Zhou MW, Gu XD, Xiang JB, Chen ZY. Clinical safety and outcomes of laparoscopic surgery versus open surgery for palliative resection of primary tumors in patients with stage IV colorectal cancer: a meta-analysis. Surg Endosc 2015; 30:1902-10. [DOI: 10.1007/s00464-015-4409-1] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2015] [Accepted: 07/02/2015] [Indexed: 01/22/2023]
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Lai R, Tian Y, An J, Zhou MW, Zou G, Li W. A comparative study on morphology and immunohistochemistry of rhabdomyosarcoma and embryonal skeletal muscles. Chin Med J (Engl) 1997; 110:392-6. [PMID: 9594310] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023] Open
Abstract
OBJECTIVE To investigate the histologic and histogenetic relationship between various types of rhabdomyosarcomas (RMS) and embryonal skeletal muscle (ESM) for further understanding of the histogenesis, classification and pattern of differentiation of RMS. METHODS Fifty cases of variant types of RMS and 20 cases of ESM at different gestational ages were available. All specimens were stained with HE, PAS, Van Gieson, Masson, phosphotungstic acid hematoxilin and with antibodies for the demonstration of vimentin, desmin, HHF-35 and myoglobin by ABC method. RESULTS The results showed that the order of positive expression and the intensity of positive reaction of the different immunohistochemical staining were consistent with the degree of differentiation of the tumor and the development of the ESM. It is obvious that each type of RMS is composed of tumor cells in different degree of differentiation and is derived from primitive mesodermal cells which are capable of potential differentiation towards mature skeletal muscles. CONCLUSIONS Based on the results of this study, an ideal histologic classification of RMS should reflect not only the cell morphology and histologic structures but also the degree of differentiation of the tumor cells.
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Affiliation(s)
- R Lai
- Guangzhou General Hospital of PLA, China
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Zhu SX, Zhou MW. Iliac periosteal graft with vascular pedicle in the treatment of avascular necrosis of the femoral head. Experimental study and clinical application. Chin Med J (Engl) 1992; 105:849-55. [PMID: 1291204] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022] Open
Abstract
From March 1983 to June 1987, 6 patients with avascular necrosis of the femoral head were treated with vascular pedicled iliac periosteum graft. Follow-up for 3 to 7.5 years showed satisfactory results. The patients experienced no hip pain, could walk freely, and resumed work after the treatment. X-ray films showed that the original defect of the femoral head was filled up and its outline was clear and smooth. The bone density of the femoral head and neck normalized. The experimental study indicated that the vascularized periosteum improves the blood supply and initiates the revascularization and osteogenesis of the femoral head. The authors conclude that the technique is suitable for the treatment of avascular necrosis of the femoral head of Stage II and III.
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Affiliation(s)
- S X Zhu
- Department of Orthopedics, General Hospital, PLA, Beijing
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