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Detection of cervical metastatic lymph nodes in papillary thyroid carcinoma by Fourier transform infrared spectroscopy

A previous study demonstrated that Fourier transform infrared (FTIR) spectroscopy can distinguish thyroid cancer from benign thyroid lesions. The aim of this study was to explore the use of FTIR for identifying metastatic lymph nodes of papillary thyroid cancer in vitro, and distinguishing between metastatic and non‐metastatic tissue.

Chemical ablation of the gallbladder: clinical application and long-term observations.

BackgroundWe investigated whether minicholecystostomy followed by chemical ablation of the gallbladder could be used as a alternative to cholecystectomy in patients at high risk for complications of surgery.MethodsFrom January 1990 through January 2003, 34 patients at high risk underwent minicholecystostomy. Six weeks after the operation, microwave irradiation was provided to burn the mucosa of the cystic duct at locations at 3, 6, 9, and 12 o’clock around the orifice. Each location was treated eight times at 50 mA for 10 sec. Then chemical ablation of the gallbladder was performed by infusing 95% ethanol into the gallbladder cavity for 30 min. For each sclerosis course, the procedure was repeated every 4 h for a total of eight times. Approximately 2 weeks later, the drainage tube was removed from the gallbladder after cholecystography showed that no cavity other than the lumen of the tube remained in the gallbladder.ResultsPatients tolerated the procedure well and were followed with ultrasonography for 2–14 years (mean, 9). Twenty-nine patients had no complications or side effects, and five patients developed a 1.5- to 3- cm mucocele in the gallbladder. The long-term success rate of sclerotherapy was 85.3% (29/34). No recurrent cholecystitis, new stone or formation, canceration were encountered at the site of the gallbladder.ConclusionsMinicholecystostomy followed by chemical ablation of the gallbladder was a safe, effective, and simple procedure for treating high-risk patients with acute cholecystitis and/or cholelithiasis.

Healing Process of the Guinea Pig Common Bile Duct after End-to-End Anastomosis: Pathological Evaluation after 6 Months

Background: The healing process of an injured bile duct is always associated with stricture formation, the specific mechanism of which remains unclear. Our objective in this study was to establish a guinea pig common bile duct end-to-end anastomosis (EEA) model after total transection of the common bile duct and to assess the postoperative healing process after 6 months. Materials and Methods: Thirty-two male guinea pigs were randomly divided into 4 groups with or without operation (a control group without operation and 3 groups examined 2, 3 and 6 months after biliary EEA reconstruction, respectively). Histological, immunohistochemical (proliferating cell nuclear antigen, α-smooth muscle actin, h-caldesmon, and Bcl-2 expression) and ultrastructural characteristics were examined and evaluated. Results: Myofibroblasts (MFBs) were differentiated from smooth muscle cells by α-SMA and h-caldesmon staining. Gross inspection of operated bile ducts revealed coarctation formation at the anastomotic stoma. Histological and immunohistochemical examinations showed significant inflammatory reaction, the presence of MFBs, epithelial proliferation and glandular element hyperplasia. Bcl-2 expression decreased in groups 2 and 3, indicating an epithelial self-protecting mechanism. Conclusions: A guinea pig common bile duct EEA model was successfully established. Glandular elements, bile duct epithelial cells and MFBs all played crucial roles in the bile duct healing process. It seems important to elucidate the pathomechanisms of these components for restoring bile duct physiological function.

Laparoscopic treatment for suspected gallbladder cancer confined to the wall: a 10-year study from a single institution

Objective Although laparoscopic treatment of gallbladder cancer (GBC) has been explored in the last decade, long-term results are still rare. This study evaluates long-term results of intended laparoscopic treatment for suspected GBC confined to the gallbladder wall, based on our experience over 10 years. Methods Between August 2006 and December 2015, 164 patients with suspected GBC confined to the wall were enrolled in the protocol for laparoscopic surgery. The process for GBC treatment was analyzed to evaluate the feasibility of computed tomography (CT) and/or magnetic resonance imaging (MRI) combined with frozen-section examination in identifying GBC confined to the wall. Of 159 patients who underwent the intended laparoscopic radical treatment, 47 with pathologically proven GBC were investigated to determine the safety and oncologic outcomes of a laparoscopic approach to GBC. Results Among the 164 patients, 5 patients avoided further radical surgery because of unresectable disease and 12 were converted to open surgery; in the remaining 147 patients, totally laparoscopic treatment was successfully accomplished. Extended cholecystectomy was performed in 37 patients and simple cholecystectomy in 10. The T stages based on final pathology were Tis (n=6), T1a (n=2), T1b (n=9), T2 (n=26), and T3 (n=4). Recurrence was detected in 11 patients over a median follow-up of 51 months. The disease-specific 5-year survival rate of these 47 patients was 68.8%, and rose to 85% for patients with a normal cancer antigen 19-9 (CA19-9) level. Conclusions The favorable long-term outcomes demonstrate the feasibility of combined CT/MRI and frozen-section examination in the selection of patients with GBC confined to the gallbladder wall, confirm the oncologic safety of laparoscopic treatment in selected GBC patients, and favor measurement of preoperative CA19-9 in the selection of GBCs suitable for laparoscopic treatment.