Objective To explore the safety, effectiveness, operation mode and clinical value of the laparoscopic colorectal resection. Methods The clinical data and experiences of laparoscopic resection for 18 cases with colorectal neoplasm from Jun. 2007 to Mar. 2008 were studied retrospectively. Results Among 18 cases, there were 5 cases of rectal cancer, 6 cases of sigmoid colon carcinoma, 2 cases of sigmoid colonic polyp, 2 cases of descending colon carcinoma, 2 cases of ascending colon carcinoma and 1 case of ascending colonic lipoma. Fifteen cases of laparoscopic colorectal resection were performed successfully, including Dixon procedure 4 cases, Miles operation 1 case, radical resection of sigmoid colon 5 cases, palliative resection of sigmoid colon 2 cases, left hemicolectomy 2 cases and right hemicolectomy 1 case. Three cases converted to laparotomy due to adiposity or advanced status of local disease. Average intraoperative blood loss was 110 ml. The average number of lymph nodes dissected was 13.5. It took about 40 hours to restore intestinal function. The average time of hospitalization was 9 days. No one died during operation and no complications such as anastomotic leakage and postoperative hemorrhage occurred. Conclusion Laparoscopic resection for colorectal neoplasms possesses less trauma and rapid postoperative recovery. Laparoscopic colorectal surgery is safe and effective with skill and indication.
Objective To explore a new method for the treatment of refractory recurrent liver cancer. Methods The treatment process and effect of a patient with refractory recurrent liver cancer who received complete remission (CR) treated with second-line targeted drug regorafenib combined with camrelizumab in the Department of Hepatobiliary and Pancreatic Surgery of Dongguan Hospital Affiliated to Southern Medical University were retrospectively analyzed and summarized. Results In the previous 3 years, the patient underwent radical ablation, resection of recurrent cancer in the middle lobe of the liver, ablation of recurrent cancer in S2 and S8 segments of the liver, and multidisciplinary treatment with the first-line targeted drug lenvatinib, extensive intrahepatic recurrence and metastasis still occurred. Finally, the patient was treated with the second-line targeted drug regorafenib combined with camrelizumab for systemic treatment. All the intrahepatic lesions were liquefied and necrotic, and most of them were significantly reduced or disappeared, AFP decreased from the highest peak of 20 867.00 μg/L to normal. The therapeutic effect of CR was evaluated and remained stable for more than 12 months. There were no obvious toxic and side effects. The patient had a good quality of life and insisted on working normally. Conclusion The second-line targeted drug regorafenib combined with new immunotherapy may still have curative effect on refractory recurrent liver cancer after various comprehensive treatment failures, and even obtain the hope and opportunity of long-term tumor-free survival.
ObjectiveTo evaluate the role and value of multidisciplinary team (MDT) in the decision-making for the treatment of elderly patients with large hepatocellular carcinoma (HCC) with multiple organ dysfunction. MethodThe clinicopathologic data of an elderly patient with large HCC with multiple organ dysfunction admitted to Dongguan Hospital of Southern Medical University were analyzed retrospectively. ResultsThe patient was an 82 years old male patient with asthmatic bronchitis, long-term hormone use, severe pulmonary ventilation dysfunction, moderate pericardial effusion, hypertension, and poor liver function compensation. After MDT discussion including 10 departments and full communication with the patient and his families, the open hepatectomy for hepatic S5 and S4b and cholecystectomy were proposed to perform. The operation process was smooth, and the patient was discharged on the 15th day after the operation without any complications. After discharge, lenvatinib was taken and thymosin alpha for injection was injected. At present, the patient’s quality of life was better, and there was no tumor recurrence or metastasis. ConclusionsFor the elderly patients with large HCC with severe cardiopulmonary dysfunction, the risk of treatment is higher. By MDT mode, the optimum treatment scheme for patient could be formulated to ensure efficient and accurate diagnosis and ensure high-quality treatment process, so as to maximally benefit patient.
The precise anatomical division of liver segments is the foundation of liver surgery, while the anatomical division of the S9 segment of liver is a further precise division of the caudate lobe of the liver. This article retrospectively analyzed and summarized the precise minimally invasive ablation and follow-up results of four representative lesions of the S9 segment of liver, including primary liver cancer, recurrent liver cancer, metastatic liver cancer, and focal liver hyperplasia, treated at Affiliated Dongguan Hospital of Southern Medical University. The aim of this study is to explore the minimally invasive ablation effect of lesions located at the S9 segment of liver under CT guidance.
ObjectiveTo summarize the comprehensive multidisciplinary team (MDT) treatment and holistic scientific management approach in a case of hepatocellular carcinoma (HCC) in S7+S9 segments with prostatic metastasis. MethodsA retrospective analysis was conducted on the clinical data and follow-up outcomes of a patient with HCC in S7+S9 segments who developed prostatic metastasis during treatment, admitted to the Tenth Affiliated Hospital of Southern Medical University (Dongguan People’s Hospital of Guangdong Province). ResultsDue to the complexity of the patient’s condition, an MDT discussion was held upon initial admission. It was concluded that the HCC diagnosis was clear, with lesions confined to the liver (S7+S9 segments) and a tumor diameter less than 3 cm, making surgical resection or ablation therapy the preferred options. However, the patient declined liver transplantation and surgical resection. Therefore, CT-guided microwave ablation (MWA) was performed on the primary HCC lesions in segments S7 and S9b. Prior to subsequent treatments for recurrent disease, MDT discussions were held again, and treatments were tailored to the discussion outcomes while respecting the patient’s wishes. Over time, the patient underwent CT-guided liver puncture MWA, re-ablation for recurrent tumors, transarterial chemoembolization (TACE), stereotactic body radiation therapy (SBRT), targeted therapy, and immunotherapy. Following this comprehensive MDT treatment plan, the patient had survived for over 78 months, with no evidence of active tumor lesions in the liver, prostate, or other parts of the body. Alpha-fetoprotein levels and liver function remained normal, and the patient’s quality of life was good. ConclusionComprehensive MDT treatment incorporates various technologies and approaches, along with holistic scientific management, can yield favorable outcomes for patients with complex and challenging HCC.