Objective To study the expression of inducible nitric oxide synthase (iNOS)，endothelial nitric oxide synthase (eNOS) and vascular endothelial growth factor (VEGF) in human gastric cancer and their relationship with tumor angiogenesis and to investigate the interaction of NOS and VEGF in gastric cancer. Methods The expression and distribution of VEGF, iNOS and eNOS in 34 gastric cancer specimens were detected with immunohistochemistry. Microvessel density (MVD) was counted with FⅧRAg immune specific staining. Results The expression rates of iNOS, eNOS and VEGF in 34 gastric cancers were 73.5%, 82.4% and 91.2% respectively. The expression of VEGF had a significant positive relation with iNOS, but not with eNOS. The MVDs of VEGF or iNOS positive gastric cancers were obviously higher than those of VEGF or iNOS negative gastric cancers. There was no significant difference between the MVDs of eNOS positive gastric cancers and eNOS negative ones. Conclusion MVD increases with increase of expression of VEGF and iNOS in gastric cancer. It is indicated that VEGF and iNOS can promote gastric cancer angiogenesis. VEGF and iNOS have a significant positive correlation, which suggests that in human gastric cancer, iNOS plays an important role in the production and action of VEGF.
Objective To study whether carbon dioxide used to establish pneumoperitoneum has an influence on port-site and intraperitoneal implantation and metastasis of tumor cells. Methods R15 hepatic cancer cells were injected into 30 Wistar rats’ peritoneal cavities 1 hour before operation, then the 30 Wistar rats were randomly divided into 3 groups: gasless group, helium group and carbon dioxide group. The suspension was exposed to the gas environment for 2 hours, all animals were killed after 28 days and the port-site and intraperitoneal implantation and metastasis of tumor cells were examined. Results On port-site, intestinal serous coat, mesentery, greater omentum and diaphragm, the weights of tumor cells, in carbon dioxide group were (326.7±230.3) mg， （626.2±215.9） mg，（476.2±204.8） mg，（2 536.5±906.7） mg and （384.5±149.9） mg respectively； in helium group were (235.6±107.3) mg， （414.2±148.4） mg, （261.8±92.6） mg, （1 633.4±247.3） mg and（220.0±57.9） mg； in gasless group were (145.0±42.4) mg， （221.5±108.2） mg， （212.5±109.6） mg, （797.5±335.9） mg and 113.0 mg.The weights of carbon dioxide group showed a significant increase, compared with helium group and gasless group (P＜0.05). The weights of helium group were greater than gasless group，but there was no significance in statistics (Pgt;0.05). Conclusion The insufflation of carbon dioxide promotes intraperitoneal tumor implantation and growth compared with helium and gaslessness in a rat model.
Objective To investigate the preventive measures for bleeding in laparoscopic hepatectomy. Methods The candidates for laparoscopic hepatectomy were 22 patients with live lesions， including 5 patients with primary liver cancer， 16 patients with liver hemangioma， and 1 patient with metastatic liver cancer. The tumors locatedthe left lateral lobe in 15 cases， caudate lobe in 1 case， segmentⅣin 2 cases， and segmentⅥ in 4 cases. The meandiameter of tumors was 4cm （2-10cm）. The surgical approaches included the left lateral lobectomy （15 cases）， leftlateral lobectomy of caudate （1 case）， and nonanatomic and wedge resection were performed in 6 cases. Results Twenty-two cases underwent laparoscopic liver resection， there were no conversion to open and operative death. The mean operative time was 115min （65-142min）， the mean blood loss was 450mL （270-780mL）， the mean length of hospital stay after operation was 6.5 days （3-11 days）. Conclusion Control liver section hemorrhage is a key technique in laparoscopic hepatectomy.
Objective To approach the indications， techniques features， and efficacy of laparoscopic hepatectomy for liver tumor. Methods The clinical data and follow-up results of 61 patients who received laparoscopic hepatectomy at our institute from January， 2007 to December， 2012 were retrospectively analyzed. Results Of the 61 patients， 16 cases were with primary liver cancer， 1 case with liver adenocarcinoma， 2 cases with metastatic liver cancer， 31 cases with hepatic hemangioma， and 11 cases with other benign liver diseases （including hepatocellular adenoma， focal nodular hyperplasia， hepatic cysts， and mucinous cystadenoma）. The average tumor diameter was 5.6 cm （2-15 cm）. The surgical approaches includes laparoscopic hepatic left lateral lobectomy （42 cases）， right posterior lobectomy （2 cases）， hepatectomy of segmentⅥ （3 cases）， hepatectomy of segmentsⅦ/Ⅷ， Ⅳa， and caudate lobe （one respectively）. Non-anntomic and wedge resection were performed on 11 patients. The mean operating time， blood loss， postoperative hospital stay， and postoperative complication rate were （124±65） min （50-200min）， （251±145） mL （50-1 000mL），（7.3±3.6） d （4-11d）， and 16.3% （10/61）， respectively. In 19 cases with malignant liver lesions， 15 cases were followed up mean for 26 months （1-48 months）. One of them died in 1 year after operation for multiple organ dysfunction， others were survival. Conclusions Experienced laparoscopic surgery doctors selected appropriate cases， used proper blood inflow oclussion and liver resction methods， and cared for tumor-free principle， the laparoscopic hepatectomy for malignant and benign tumors of liver could be safe and effective to carry out.