BACKGROUND Gastric cancer surgery has advanced with minimally invasive techniques.This study compares outcomes between single-incision laparoscopic surgery plus one port(SILS+1)and conventional laparoscopic surgery(CL...BACKGROUND Gastric cancer surgery has advanced with minimally invasive techniques.This study compares outcomes between single-incision laparoscopic surgery plus one port(SILS+1)and conventional laparoscopic surgery(CLS)in treating gastric cancer.AIM To explore the curative effect of SILS+1 and CLS on gastric cancer and their influences on prognosis.METHODS A total of 93 patients with gastric cancer undergoing radical gastrectomy in the hospital were retrospectively analyzed between September 2019 and September 2022.According to different surgical methods,they were divided into SILS+1 group(n=56)and CLS group(n=37).The perioperative indexes,pain degree[visual analogue scale(VAS)]and stress response[C-reactive protein(CRP),white blood cell count(WBC)]in the two groups were compared.The postoperative complications,recurrence rate and mortality at 1 year after surgery were recorded.RESULTS Intraoperative blood loss was significantly lower in the SILS+1 group(76.53±8.12 mL)compared to the CLS group(108.67±12.34 mL,P<0.001),and the total incision length was also significantly shorter in the SILS+1 group(5.29±1.01 cm vs 9.45±2.34 cm,P<0.001).SILS+1 patients experienced faster recovery,with shorter times to first flatus(1.94±0.43 days vs 3.23±0.88 days,P<0.001)and ambulation(2.76±0.58 days vs 4.10±0.97 days,P<0.001).Postoperative pain,as measured by VAS scores,was significantly lower in the SILS+1 group on postoperative days 1,2,and 3(P<0.001).Additionally,stress markers(CRP and WBC)were significantly lower in the SILS+1 group on the first postoperative day(CRP:6.41±1.63 mg/L vs 7.82±1.88 mg/L,P<0.001;WBC:6.34±1.50×109/L vs 7.09±1.61×109/L,P=0.024).The complication rate in the SILS+1 group was also significantly lower than in the CLS group(8.93%vs 27.03%,P=0.020).However,there was no significant difference in recurrence rates between the two groups after one year(3.57%vs 8.11%,P>0.05).CONCLUSION SILS+1 and CLS have the comparable lymph node clearance effect in patients with gastric cancer.However,SILS+1 is more beneficial to reduce intraoperative blood loss,relieve pain,alleviate stress response,reduce the incidence of complications and promote rapid postoperative recovery.展开更多
BACKGROUND Clinical prognosis often worsens due to high recurrence rates following radical surgery for colon cancer.The examination of high-risk recurrence factors post-surgery provides critical insights for disease e...BACKGROUND Clinical prognosis often worsens due to high recurrence rates following radical surgery for colon cancer.The examination of high-risk recurrence factors post-surgery provides critical insights for disease evaluation and treatment planning.AIM To explore the relationship between metastasis-associated factor-1 in colon cancer(MACC1)and vacuolar ATP synthase(V-ATPase)expression in colon cancer tissues,and recurrence rate in patients undergoing radical colon cancer surgery.METHODS We selected 104 patients treated with radical colon cancer surgery at our hospital from January 2018 to June 2021.Immunohistochemical staining was utilized to assess the expression levels of MACC1 and V-ATPase in these patients.RESULTS The rates of MACC1 and V-ATPase positivity were 64.42%and 67.31%,respe-ctively,in colon cancer tissues,which were significantly higher than in paracan-cerous tissues(P<0.05).Among patients with TNM stage III,medium to low differentiation,and lymph node metastasis,the positive rates of MACC1 and V-ATPase were significantly elevated in comparison to patients with TNM stage I-II,high differentiation,and no lymph node metastasis(P<0.05).The rate of MACC1 positivity was 76.67%in patients with tumor diameters>5 cm,notably higher than in patients with tumor diameters≤5 cm(P<0.05).We observed a positive correlation between MACC1 and V-ATPase expression(rs=0.797,P<0.05).The positive rates of MACC1 and V-ATPase were significantly higher in patients with recurrence compared to those without(P<0.05).Logistic regression analysis revealed TNM stage,lymph node metastasis,MACC1 expression,and V-ATPase expression as risk factors for postoperative colon cancer recurrence(OR=6.322,3.435,2.683,and 2.421;P<0.05).CONCLUSION The upregulated expression of MACC1 and V-ATPase in colon cancer patients appears to correlate with clinicopathological features and post-radical surgery recurrence.展开更多
文摘BACKGROUND Gastric cancer surgery has advanced with minimally invasive techniques.This study compares outcomes between single-incision laparoscopic surgery plus one port(SILS+1)and conventional laparoscopic surgery(CLS)in treating gastric cancer.AIM To explore the curative effect of SILS+1 and CLS on gastric cancer and their influences on prognosis.METHODS A total of 93 patients with gastric cancer undergoing radical gastrectomy in the hospital were retrospectively analyzed between September 2019 and September 2022.According to different surgical methods,they were divided into SILS+1 group(n=56)and CLS group(n=37).The perioperative indexes,pain degree[visual analogue scale(VAS)]and stress response[C-reactive protein(CRP),white blood cell count(WBC)]in the two groups were compared.The postoperative complications,recurrence rate and mortality at 1 year after surgery were recorded.RESULTS Intraoperative blood loss was significantly lower in the SILS+1 group(76.53±8.12 mL)compared to the CLS group(108.67±12.34 mL,P<0.001),and the total incision length was also significantly shorter in the SILS+1 group(5.29±1.01 cm vs 9.45±2.34 cm,P<0.001).SILS+1 patients experienced faster recovery,with shorter times to first flatus(1.94±0.43 days vs 3.23±0.88 days,P<0.001)and ambulation(2.76±0.58 days vs 4.10±0.97 days,P<0.001).Postoperative pain,as measured by VAS scores,was significantly lower in the SILS+1 group on postoperative days 1,2,and 3(P<0.001).Additionally,stress markers(CRP and WBC)were significantly lower in the SILS+1 group on the first postoperative day(CRP:6.41±1.63 mg/L vs 7.82±1.88 mg/L,P<0.001;WBC:6.34±1.50×109/L vs 7.09±1.61×109/L,P=0.024).The complication rate in the SILS+1 group was also significantly lower than in the CLS group(8.93%vs 27.03%,P=0.020).However,there was no significant difference in recurrence rates between the two groups after one year(3.57%vs 8.11%,P>0.05).CONCLUSION SILS+1 and CLS have the comparable lymph node clearance effect in patients with gastric cancer.However,SILS+1 is more beneficial to reduce intraoperative blood loss,relieve pain,alleviate stress response,reduce the incidence of complications and promote rapid postoperative recovery.
基金The study was reviewed and approved by the Institutional Review Board of The First Affiliated Hospital of Gannan Medical College,No.20141219.
文摘BACKGROUND Clinical prognosis often worsens due to high recurrence rates following radical surgery for colon cancer.The examination of high-risk recurrence factors post-surgery provides critical insights for disease evaluation and treatment planning.AIM To explore the relationship between metastasis-associated factor-1 in colon cancer(MACC1)and vacuolar ATP synthase(V-ATPase)expression in colon cancer tissues,and recurrence rate in patients undergoing radical colon cancer surgery.METHODS We selected 104 patients treated with radical colon cancer surgery at our hospital from January 2018 to June 2021.Immunohistochemical staining was utilized to assess the expression levels of MACC1 and V-ATPase in these patients.RESULTS The rates of MACC1 and V-ATPase positivity were 64.42%and 67.31%,respe-ctively,in colon cancer tissues,which were significantly higher than in paracan-cerous tissues(P<0.05).Among patients with TNM stage III,medium to low differentiation,and lymph node metastasis,the positive rates of MACC1 and V-ATPase were significantly elevated in comparison to patients with TNM stage I-II,high differentiation,and no lymph node metastasis(P<0.05).The rate of MACC1 positivity was 76.67%in patients with tumor diameters>5 cm,notably higher than in patients with tumor diameters≤5 cm(P<0.05).We observed a positive correlation between MACC1 and V-ATPase expression(rs=0.797,P<0.05).The positive rates of MACC1 and V-ATPase were significantly higher in patients with recurrence compared to those without(P<0.05).Logistic regression analysis revealed TNM stage,lymph node metastasis,MACC1 expression,and V-ATPase expression as risk factors for postoperative colon cancer recurrence(OR=6.322,3.435,2.683,and 2.421;P<0.05).CONCLUSION The upregulated expression of MACC1 and V-ATPase in colon cancer patients appears to correlate with clinicopathological features and post-radical surgery recurrence.
