Single incision laparoscopic anterior resection for cancer using a 'QuadiPort Access System®'

BACKGROUND: Single incision laparoscopic surgery (SILS) is developing rapidly and different devices are already available. However there is limited data in the literature about single port laparoscopic colorectal surgery. AIMS: We report the first case of a single incision laparoscopic anterior resection for cancer using the device 'QuadiPort Access System?'. METHODS: A 66 year old female affected by adenocarcinoma of the rectosigmoid junction underwent a radical single incision laparoscopic anterior resection performed by an experienced laparoscopic team. RESULTS: The preoperative staging was T2N0M0. The total operative time was 135 min. Length of hospital stay was 6 days. The length of the specimen was 27 cm and 21 nodes were isolated. The pathological examination showed adenocarcinoma staged T3N2MX; G2. There was no postoperative morbidity and at the 6 month follow-up, the patient presented in well condition with no complications and free from cancer. CONCLUSION: Single incision laparoscopic anterior resection for locally advanced high rectal cancer seems to be feasible and the 'QuadiPort Access System?' seems to be a valid device. To evaluate outcomes and costeffectiveness of SILS versus the standard laparoscopic colorectal surgery multicenter prospective randomised trials are necessary and the 'QuadiPort Access System?' could prove to be the device of choice

Complement system network in cell physiology and in human diseases

The complement system is a multi-functional system representing the first line host defense against pathogens in innate immune response, through three different pathways. Impairment of its function, consisting in deficiency or excessive deregulated activation, may lead to severe systemic infections or autoimmune disorders. These diseases may be inherited or acquired. Despite many diagnostic tools are currently available, ranging from traditional, such as hemolytic or ELISA based assays, to innovative ones, like next generation sequencing techniques, these diseases are often not recognized. As for therapeutic aspects, strategies based on the use of targeted drugs are now widespread. The aim of this review is to present an updated overview of complement system pathophysiology, clinical implications of its dysfunction and to summarize diagnostic and therapeutic approaches

The Use of Barbed Suture for Intracorporeal Mechanical Anastomosis During a Totally Laparoscopic Right Colectomy: Is It Safe? A Retrospective Nonrandomized Comparative Multicenter Study

Background. A totally laparoscopic right colectomy could be perceived as a more challenging procedure over a laparoscopic-assisted right colectomy owing to the difficulty of intracorporeal anastomosis and the closure of the enterotomy. The aim of this study is to evaluate the safety and efficacy of the barbed auto-locking absorbable suture for the closure of an anastomotic stapler-access enterotomy during a totally laparoscopic right colectomy. Methods. From January 2010 to April 2016, data from patients who had undergone a laparoscopic right colectomy in 2 different departments of 2 institutions (the Department of General and Minimally Invasive Surgery, San Camillo Hospital in Trento and the Department of Surgical Specialties and Nephrology, University Federico II in Naples) were retrospectively analyzed. We compared the data of patients in whom the stapler-access enterotomy was closed through a conventional absorbable suture (Group A), with the data of patients in whom a stapler-access enterotomy was closed through a V-Loc 180 suture (Group B). Biometric features and intraoperative and postoperative data were collected and analyzed. Results. The 2 groups (Group A: 40 patients; Group B: 40 patients) were comparable for biometric features and postoperative outcomes. The anastomosing time was lower in Group B. A statistically significant difference was noted in the mean operative time between Groups A and B (Group A = 134.92 ± 34.17; Group B = 120.92 ± 23.27, P =.035). Only one anastomotic leakage per group was recorded, each treated with an anastomosis redo. During the reoperations, we find in both groups an intact stapler-access enterotomy. Conclusion. On retrospective analysis, barbed suture appears to be safe and efficient for closure of the stapler-access enterotomy during totally laparoscopic right colectomy

The Mixing Ratio and Filling-Amount Affect the Tissue Browning and Antioxidant Properties of Fresh-Cut Baby Leaf Lettuce (Lactuca sativa L.) and Rocket (Eruca sativa Mill.) Grown in Floating Growing Systems

Different types of baby leaf vegetables (BLV) are often mixed and packaged as salad mixes. This work has evaluated the effects of BLV mixing ratios (100% lettuce ‘Lollo Bionda’, 100 LB; 75% lettuce + 25% rocket, 75 LB; 50% lettuce + 50% rocket, 50 LB) and the weight filling amount (125 g filling amount, 125F; 250 g, 250F) on the antioxidant properties and browning potential (BP) of lettuce and rocket baby leaves during storage for 9 days at 4 °C in the dark. The samples were packaged in thermos-sealed bags previously prepared using polypropylene film. The results showed that the 50 LB mix had preserved high amounts of chlorophylls and internal nutrients on d9, regardless of the filling amount. No visible browning symptoms were detected in the 50 LB samples. The 50 LB × 125F mix was found to be the most efficient strategy to maintain the antioxidant property of BLV. Thus, the optimisation of the mixing ratio and its combination with an appropriate filling amount could represent an effective postharvest practice

Laparascopic colon resection for cancer: Evidence based results

About 90-92% of patients with carcinoma of the colon are treated surgically. For other surgeons, laparoscopic surgery for the treatment of malignancies remains controversial because of concerns about the adequacy of lymphadenectomy, the extent of resection, early findings of port-site metastasis and the lack of data on long-term results. In our experience, there are no differences between the laparoscopic and laparotomic techniques, and only advantages if the laparoscopic technique is use correctly. We essentially agree with the good results of many studies published in the last ten years, but we are extremely confident that it is necessary to have a good learning curve and a high-volume cases hospital to obtain good results through a laparoscopic approach. So laparoscopic colorectal surgery should be performed only by surgeons who have completed training in this approach and who perform the procedure often enough to maintain a good level of competence

New ATCA, ALMA and VISIR observations of the candidate LBV SK-67266 (S61): the nebular mass from modelling 3D density distributions

We present new observations of the nebula around the Magellanic candidate Luminous Blue Variable S61. These comprise high-resolution data acquired with the Australia Telescope Compact Array (ATCA), the Atacama Large Millimetre/Submillimetre Array (ALMA), and VISIR at the Very Large Telescope (VLT). The nebula was detected only in the radio, up to 17 GHz. The 17 GHz ATCA map, with 0.8 arcsec resolution, allowed a morphological comparison with the H$\alpha$ Hubble Space Telescope image. The radio nebula resembles a spherical shell, as in the optical. The spectral index map indicates that the radio emission is due to free-free transitions in the ionised, optically thin gas, but there are hints of inhomogeneities. We present our new public code RHOCUBE to model 3D density distributions, and determine via Bayesian inference the nebula's geometric parameters. We applied the code to model the electron density distribution in the S61 nebula. We found that different distributions fit the data, but all of them converge to the same ionised mass, ~0.1 $\rm M\odot$, which is an order of magnitude smaller than previous estimates. We show how the nebula models can be used to derive the mass-loss history with high-temporal resolution. The nebula was probably formed through stellar winds, rather than eruptions. From the ALMA and VISIR non-detections, plus the derived extinction map, we deduce that the infrared emission observed by space telescopes must arise from extended, diffuse dust within the ionised region.Comment: 17 pages, 9 figures. Authors list corrected. In press in MNRAS. RHOCUBE code available online ( https://github.com/rnikutta/rhocube

Altered signaling through IL-12 receptor in children with very high serum IgE levels

An alteration of Th1/Th2 homeostasis may lead to diseases in humans. In this study, we investigated whether an impaired IL-12R signaling occurred in children with elevated serum IgE levels divided on the basis of the IgE levels (group A: >2000 kU/l; group B: <2000 kU/l). We evaluated the integrity of the IL-12R signaling through the analysis of phosphorylation/activation of STAT4, and mRNA expression and membrane assembly of the receptor chains. At a functional level, a proliferative defect of lymphocytes from group A patients was observed. In these patients, an abnormal IL-12R signaling was documented, and this finding was associated with abnormal expression of the IL-12Rb2 chain. Our data indicate that in patients with very high IgE levels the generation of Th1 response is impaired, and that this abnormality associates with abnormal IL-12R signaling