Mine disaster survivor’s pelvic floor hernia treated with laparoscopic surgery and a perineal approach: A case report

BACKGROUND

A pelvic floor hernia is defined as a pelvic floor defect through which the intraabdominal viscera may protrude. It is an infrequent complication following abdominoperineal surgeries. This type of hernia requires surgical repair by conventional or reconstructive techniques. The main treatments could be transabdominal, transperineal or a combination.

CASE SUMMARY

In this article, we present the case of a recurrent perineal incisional hernia, postresection of the left side of the pelvis, testis and lower limbs resulting from a mine disaster 18 years ago. Combined laparoscopic surgery with a perineal approach was performed. The pelvic floor defect was repaired by a biological mesh and one pedicle skin flap. No signs of recurrence were indicated during the 2 years of follow-up.

CONCLUSION

The combination of laparoscopic surgery with a perineal approach was effective. The use of the biological mesh and pedicle skin flap to restructure the pelvic floor was effective.

[Short-term efficacy of da Vinci robotic surgical system on rectal cancer in 101 patients]

OBJECTIVE

To investigate the feasibility and safety of da Vinci robotic surgical system in rectal cancer radical operation, and to summarize its short-term efficacy and clinical experience.

METHODS

Data of 101 cases undergoing da Vinci robotic surgical system for rectal cancer radical operation from March 2010 to September 2012 were retrospectively analyzed. Evaluation was focused on operative procedure, complication, recovery and pathology.

RESULTS

All the 101 cases underwent operation successfully and safely without conversion to open procedure. Rectal cancer radical operation with da Vinci robotic surgical system included 73 low anterior resections and 28 abdominoperineal resections. The average operative time was (210.3±47.2) min. The average blood lose was (60.5±28.7) ml without transfusion. Lymphadenectomy harvest was 17.3±5.4. Passage of first flatus was (2.7±0.7) d. Distal margin was (5.3±2.3) cm without residual cancer cells. The complication rate was 6.9%, including anastomotic leakage(n=2), perineum incision infection(n=2), pulmonary infection (n=2), urinary retention (n=1). There was no postoperative death. The mean follow-up time was(12.9±8.0) months. No local recurrence was found except 2 cases with distant metastasis.

CONCLUSION

Application of da Vinci robotic surgical system in rectal cancer radical operation is safe and patients recover quickly The short-term efficacy is satisfactory.

Effect of thymosin alpha-1 on subpopulations of Th1, Th2, Th17, and regulatory T cells (Tregs) in vitro

Thymosin alpha 1 (Tα1) has been shown to have beneficial effects on numerous immune system parameters, but little is known about the effects of Tα1 on patients with gastric carcinoma. The objective of this study was to determine the effect of Tα1 on subpopulations of Th1, Th2, Th17, and regulatory T cells (Tregs) in vitro, and to evaluate its efficacy as an immunoregulatory factor in patients with gastric carcinoma. We compared the effect of Tα1 on the frequency of CD4+ and CD8+ T cells, especially the CD4+CD25+Foxp3+ Tregs in peripheral blood mononuclear cells (PBMCs) from gastric carcinoma patients (N = 35) and healthy donors (N = 22). We also analyzed the changes in the proliferation of PBMCs in response to treatment with Tα1, and examined the production of Th1, Th2, and Th17 cytokines by PBMCs and tumor-infiltrating lymphocytes. The treatment of PBMCs from gastric cancer patients, with Tα1 (50 µg/mL) alone increased the percentage of CD4+CD25+Foxp3+ (suppressive antitumor-specific Tregs) from 1.68 ± 0.697 to 2.19 ± 0.795% (P < 0.05). Our results indicate that Tα1 increases the percentage of Tregs and IL-1β, TNF-α, and IL-6 in vitro.

Laparoscopy-assisted resection for gastric stump cancer and gastric stump recurrent cancer: a report of 15 cases

OBJECTIVE

This study was designed to investigate the technical methods and clinical therapeutic effects of laparoscopy-assisted resection of gastric stump cancer (GSC).

METHODS

Laparoscopy-assisted resection was performed on 15 patients with GSC. The approach, method, difficult points, and techniques of the operation were analyzed, and its clinical therapeutic effect was evaluated.

RESULTS

With the help of laparoscopy, D2 radical resection of gastric stump was performed on 12 patients, and palliative gastric stump resection was performed on two patients. There was one case of conversion from laparoscopic surgery to open surgery. Roux-en-Y gastric bypass was performed in all cases to reconstruct the alimentary tract. The mean operative time for laparoscopy-assisted resection was 205 ± 25 min. The mean intraoperative blood loss volume was 110 ± 40 ml. The mean number of lymph nodes removed was 18 ± 5. A gastric tube was not placed in the patients after surgery. The mean time for the recovery of intestinal function was 2.5 ± 1 days, the mean duration of postoperative liquid diet was 2.5 ± 1 days, and the mean time for the recovery of ambulatory activity was 3 ± 0.5 days. There was one case of postoperative infection of the incision site. The follow-up time was 6-40 months, with 1 case of death due to liver metastasis, 1 case of death due to peritoneal metastasis, 1 case of death due to complications from lupus erythematosus, and survival for the remaining 12 cases.

CONCLUSIONS

Laparoscopy-assisted resection of GSC is technically feasible; determination of the short- and long-term efficacies will require a larger and comparative sample study.

Modeling of configurations and third-order nonlinear optical properties of C36 and C34X2 (X=B,N)

Using the ab initio method, the geometrical structures of C(36) and the X (B,N)-doped isomers C(34)X(2) have been optimized. On the basis of the optimized structures, then, the third-order nonlinear optical polarizabilities gamma in the different optical processes of the third-harmonic generation, electric-field induced second-harmonic generation and degenerate four-wave mixing, and two-photon absorption (TPA) cross sections delta are calculated by using TDB3LYP method coupled with the sum-over-states method. The calculated results show that the one-photon allowed excitation process dominate the two-photon excitation process for C(36)-D(6h), whereas the two-photon allowed excitation process dominate the one-photon excitation process for C(36)-D(2d) and C(34)X(2) (B,N). It is found that the largest resonant TPA peaks of dopant fullerenes have a blueshift and the TPA cross sections have an enhancement compared with those of the parent fullerenes of isomers C(36)-D(6h) and C(36)-D(2d).