ObjectiveTo summarized the clinical experience on laparoscopic radical surgery in patients with advanced distal gastric cancer. MethodsThe clinical data of 26 patients with advanced distant gastric cancer undergoing laparoscopic gastrectomy were retrospectively analyzed. ResultsLaparoscopic distal gastrectomy was performed successfully in all patients. The operation time was (283.2±27.6) min (270-450 min) and the blood loss was (178.4±67.4) ml (80-350 ml). The time of gastrointestinal function recovery was (2.8±1.2) d (2-4 d), out of bed activity time was (1.5±0.4) d (1-3 d) and liquid diet feeding was (3.5±1.4) d (3-4 d). The hospital stay was (10.0±2.6) d (7-13 d). The number of harvested lymph nodes was 11 to 34 (17.8±7.3). The distance from proximal surgical margin to tumor was (7.0±2.1) cm (5-12 cm) and the distance from distal surgical margin to tumor was (5.5±1.8) cm (4-8 cm), thus surgical margins were negative in all samples. All patients were followed up for 3-48 months (mean 18.5 months), two patients with poorly differentiated adenocarcinoma died of extensive metastasis in 13 and 18 months, respectively, and other patients survived well. ConclusionsLaparoscopic radical gastrectomy with D2 lymphadenectomy for advanced gastric cancer is safe and feasible. However, the advantage of laparoscopic technique over the conventional open surgery requires further study.
Objective To detect expression of miR-106a-5p in gastric cancer cells and gastric cancer tissue, and to analyze relationship between it’s expression with clinicopathologic characteristics, and in addition, to analyze its target genes and enriched pathway with bioinformatics method. Methods The expressions of miR-106a-5p in the different differentiation of gastric cancer cells AGS (well differentiation), MKN-28 (middle differentiation), HGC-27 (undifferentiation), MGC-803 (low differentiation), BGC-823 (low differentiation), MKN-45 (middle differentiation) and SGC-7901 (middle differentiation), the normal gastric mucosal epithelial cells GES-1, and the gastric cancer tissue and the corresponding adjacent tissue were detected by the real-time fluorescent quantitative PCR. Furthermore, the target genes of miR-106a-5p were predicted by using more than three softwares affiliated to mirWALK web database and the signal pathways of target genes were enriched by DAVID 6.7 software. Results The expressions of miR-106a-5p in the different differentiation degree of the gastric cancer cells (AGS, SGC-7901, MKN-45, MGC-803, BGC-823, and HGC-27) were up-regulated except the MKN-28 cell line as compared with the normal gastric mucosa cell line GES-1 (P<0.010 orP<0.001), and the expression of miR-106a-5p in the gastric cancer tissue was also up-regulated as compared with the corresponding adjacent tissue, the expression of miR-106a-5p in the gastric cancer tissue was associated with the lymph node metastasis or the invasion depth. The results of the bioinformatics analysis showed that the target genes of miR-106a-5p were enriched in the multiple signaling pathways associated with the cancer. Conclusion miR-106a-5p is a molecular marker of high expression in gastric cancer and a potential cancer gene associated with lymph node metastasis and invasion depth.
ObjectiveTo compare the efficacy and safety in the treatment of malignant gastric outlet obstruction between gastrojejunostomy (GJ) and self-expandable metallic stent (SEMS) placement.MethodsThe relevant literatures of efficacy and safety of GJ and SEMS placement in the treatment of malignant gastric outlet obstruction were searched in the PubMed, Embase, Cochrane Library, Web of Science, Clinical Trial, VIP, CNKI, Wanfang Data databases. The data were extracted and evaluated by the RevMan 5.3 software.ResultsA total of 12 articles with 1 505 patients were included, of which 620 underwent the GJ (GJ group) and 885 underwent the SEMS placement (SEMS group); 3 RCTs, 9 non-RCTs. The meta-analysis results showed: the length of hospital stay [MD=5.83, 95%CI (4.24, 7.42), P<0.000 01] and time of postoperative recovery diet [MD=3.41, 95%CI (1.79, 5.03), P<0.000 1] of the SEMS group were significantly shorter than those of the GJ group; Although the incidence of complications of the GJ group was significantly higher than that of the SEMS group [OR=1.85, 95%CI (1.27, 2.70), P=0.001], the technical success rate [OR=2.72, 95%CI (1.13, 6.53), P=0.03] and clinical success rate [OR=1.86, 95%CI (1.35, 2.57), P=0.000 2] were higher and the survival time was longer [MD=38.31, 95%CI (28.98, 47.64), P<0.000 01] of the GJ group as compared with the SEMS group.ConclusionsSEMS placement is more effective in recovering dietary capacity, length of hospital stay, and incidence of complications, while GJ is more effective in survival time, technical success rate, and clinical success rate. In clinical practice, we could choose different surgical method according to patient situation.