Benq Medical Center

Nanjing, China

Benq Medical Center

Nanjing, China
SEARCH FILTERS
Time filter
Source Type

Yang C.,Taipei Medical University Hospital | Chu Y.,Chang Gung University | Wu Y.-C.,Chang Gung University | Hsieh M.-J.,Chang Gung University | And 6 more authors.
Surgical Endoscopy and Other Interventional Techniques | Year: 2012

Background: The success of natural orifice transluminal endoscopic surgery (NOTES) depends on an adequate exploration of surgical regions. Currently, limited data are available regarding the optimal position for the NOTES approach for thoracic surgery. This study therefore aimed to evaluate the effectiveness of transoral thoracic exploration in a canine model placed in a lateral decubitus position. Methods: A total of 14 dogs were used in this study. Transoral thoracoscopy was performed using a custommade metal tube via an incision over the vestibular incision with the animal in a supine position. After thoracic exploration, the animal was placed in a lateral decubitus position. The thoracic intervention (surgical lung biopsy, pericardial window creation, and dorsal sympathectomy) was performed by passing a flexible bronchoscope through the lumen of a metal tube. Results: The mean operative time for this procedure was 70 min (range 45-100 min). For 12 dogs, all procedures were completed without major complications. However, for one dog, the exploration of the thoracic cavity was incorrect (the right lower lobe had been misinterpreted as the left lower lobe). Another dog had minor bleeding because of an intercostal artery injury that occurred during sympathectomy. Conclusion: The posterior aspect of the thoracic cavity can be exposed via a transoral approach with the animal in a lateral decubitus position. This approach may be considered as an adjuvant to the supine approach, in which exploration of the posterior thoracic cavity is restricted. © Springer Science+Business Media, LLC 2012.


Liu C.-Y.,Chang Gung University | Chu Y.,Chang Gung University | Wu Y.-C.,Chang Gung University | Yuan H.-C.,Chang Gung University | And 3 more authors.
Surgical Endoscopy and Other Interventional Techniques | Year: 2013

Purpose: Transoral endoscopic surgery has been shown to be feasible and safe in both humans and animal models. The purpose of this study was to evaluate the safety and efficacy of transoral and conventional thoracoscopy for thoracic exploration, surgical lung biopsy, and pericardial window creation. Methods: The animals (n = 20) were randomly assigned to the transoral endoscopic approach group (n = 10) or conventional thoracoscopic approach group (n = 10). Transoral thoracoscopy was performed with a flexible bronchoscope via an incision over the vestibulum oris. In conventional thoracoscopy, access to the thoracic cavity was obtained through a thoracic incision. Surgical outcomes (body weight, operating time, operative complications, and time to resumption of normal diet), physiologic parameters (respiratory rate, body temperature), inflammatory parameters [white blood cell (WBC) counts and C-reactive protein (CRP)], and pulmonary parameters (arterial blood gases) were compared for both procedures. Results: The surgical lung biopsy and pericardial window creation were successfully performed in all animals except one animal in the transoral group. There was no significant difference in operating times between the groups. The increase in WBC in the transoral thoracoscopy group was significantly smaller on postoperative day 1 than in the conventional thoracoscopy group (p = 0.0029). The transoral group had an earlier return to preoperative body temperature (p = 0.041) and respiratory rate (p = 0.045) on day 7. With respect to pulmonary parameters, there was no significant difference in blood pH, pCO2, or PaCO2 between the transoral and transthoracic groups. All animals survived without complications 14 days after surgery. Conclusions: This study demonstrated that the transoral approach was comparable to conventional thoracoscopic surgery for lung biopsy and pericardial window creation in terms of safety and efficacy. © 2013 Springer Science+Business Media New York.


Ko P.-J.,Chang Gung University | Chu Y.,Chang Gung University | Wu Y.-C.,Chang Gung University | Liu C.-Y.,Chang Gung University | And 7 more authors.
Journal of Surgical Research | Year: 2012

Background: The thoracic cavity approach for natural orifice transluminal endoscopic surgery (NOTES) is technically challenging. The aim of this study was to evaluate the feasibility of a transoral endoscopic technique for a surgical lung biopsy and pericardial window creation Methods: Under general anesthesia, a 12 mm incision was made over the vestibulum oris region. Under video guidance, a homemade metallic tube was introduced through the incision, extending along the pre-tracheal space to the substernal space with blunt dissection technique, and used as the entrance into the thoracic cavity. A surgical lung biopsy and a pericardial window creation were performed in 12 canines, using the transoral NOTES technique. Results: The transoral endoscopic surgical lung biopsy and pericardial window creation were successfully completed in 11 of the 12 canines. Intraoperative bleeding and death from an injury to the pulmonary hilum developed in one animal during the electrosurgical excision of lung tissue. Conclusions: Transoral surgical lung biopsy and pericardial window creation in canine models is technically feasible and can be used as a novel experimental platform for studies of NOTES for intra-thoracic surgery. © 2012 Elsevier Inc. All rights reserved.


Wu Y.-C.,Chang Gung University | Yen-Chu Y.,Chang Gung University | Yeh C.-J.,Chang Gung University | Hsieh M.-J.,Chang Gung University | And 7 more authors.
Surgical Innovation | Year: 2014

Background. To date there are no practical platforms for performing natural orifice transluminal endoscopic surgery in the thoracic cavity. This study evaluates the feasibility of transumbilical thoracosopy for lung biopsy and pericardial window creation. Methods. Eleven dogs (6 in the nonsurvival group and 5 in the survival group) were used for this study. A homemade metallic tube was advanced into the abdominal cavity via a 12-mm umbilical incision. The metallic tube was advanced into the thoracic cavity through a subxyphoid diaphragmatic incision under video guidance. Access to the thoracic cavity was achieved by a flexible bronchoscope via the metallic tube. Surgical lung biopsy and pericardial window creation were performed using an electrocautery loop and needle knife. The animals were euthanized 20 minutes after the surgery was complete (nonsurvival group) or 14 days postsurgery (survival group) for necropsy evaluation. Results. Eight pericardial window creations and 21 of 22 preplanned lung biopsies were completed in a median time of 72.18 minutes (range 50-105 minutes). One dog in the nonsurvival group died after tension pneumothorax due to postprocedure massive air leaks. In the survival group, the postoperative period was uneventful in all 5 dogs. Autopsies revealed no signs of vital organ injury and complete healing of the diaphragmatic incision occurred in all animals. Conclusions. The study demonstrated that transumbilical thoracoscopic surgical lung biopsy and pericardial window creation is feasible. The safety and efficacy of the transumbilical approach need to be verified by a more detailed survival study. © The Author(s) 2013.


Liu Y.-H.,Chang Gung University | Yen-Chu,Chang Gung University | Wu Y.-C.,Chang Gung University | Yeh C.-J.,Chang Gung University | And 3 more authors.
Journal of Thoracic and Cardiovascular Surgery | Year: 2011

Background: The present study aimed to evaluate the performance of transtracheal thoracic exploration and pericardial window creation in a canine survival model. Methods: Transthoracic exploration was performed in 14 dogs. Under general anesthesia, after an incision in the right lateral wall of the middle-lower portion of the trachea was made, a 9-mm metal tube was advanced into the thoracic cavity. For thoracic cavity exploration and pericardial window creation, a flexible bronchoscope was introduced through the metal tube into the thoracic cavity. After thoracoscopy, a Dumon stent (Novatech, Grasse, France) was used to cover the tracheal incision site and facilitate healing. Animals were evaluated by endoscopy 1 and 2 weeks later. Animals were humanely killed, and necropsy was performed 2 weeks after the transtracheal natural orifice transluminal endoscopic surgery. Results: Fourteen dogs underwent transtracheal thoracic exploration lasting for an average of 110 minutes (range, 80-150), with 3 perioperative deaths. At 2 weeks after pericardial window creation, endoscopy revealed normal healing of the tracheal incision sites in all 11 surviving animals. Necropsy on the 11 animals at 2 weeks showed 9 adhesions around the pericardial window and 5 adhesions around the tracheal incision region. No mediastinitis or abscesses could be identified. Conclusions: Transtracheal thoracic exploration is technically feasible. Increasing surgical experience together with improvement in endoscopic techniques will further facilitate the development of natural orifice transluminal endoscopic surgery for thoracic diseases. Copyright © 2011 by The American Association for Thoracic Surgery.


Wen C.-T.,Chang Gung University | Chu Y.,Chang Gung University | Yeh C.-J.,Chang Gung University | Liu C.-Y.,Chang Gung University | And 4 more authors.
Journal of Surgical Research | Year: 2013

Background: Transumbilical laparoscopy allows the patient to undergo various surgical procedures associated with abdominal disease. The aim of this study was to evaluate the feasibility and safety of transumbilical thoracic exploration and surgical lung biopsy in a canine survival model. Methods: We performed the procedure in 12 dogs weighting 7.1-9.1 kg. The thoracic cavity was accessed using a metal tube inserted via umbilical and diaphragmatic incisions. After transumbilical thoracoscopy, we resected the predetermined lung lobe with an electrocautery loop. We carried out daily clinical examinations, including determination of respiratory rate and rectal temperature. Laboratory parameters (white blood cell count) and inflammatory parameters, including serum interleukin-6 and C-reactive protein, were measured before surgery and at postoperative days 1, 3, 7, and 14. We performed necropsies 2 wk after surgery. Results: We successfully performed corrected surgical lung biopsies for the predetermined lung lobe in all animals, with a median time of 43.5 min (range, 32-65 min). We observed two perioperative complications: One dog had minor postoperative air leakage and one had hemodynamic collapse because of inadequate ventilation. These animals recovered well without signs of perioperative infection. Necropsies at 2 wk after surgery showed no evidence of mediastinitis or peritonitis. Conclusions: Exposure of the thoracic cavity and surgical lung biopsy via a transumbilical incision is feasible in this canine model of survival. This procedure may have potential advantages over currently used transthoracic thoracoscopy techniques. © 2013 Elsevier Inc. All rights reserved.


Le X.,Benq Medical Center | Yang D.-T.,Benq Medical Center | Zhang H.-H.,Benq Medical Center
Chinese Journal of Tissue Engineering Research | Year: 2015

BACKGROUND: Fluorouracil is a basic chemotherapy drug for gastric cancer, and its drug resistance is commonly seen in clinic. Cancer stem cells have low sensitivity to chemotherapy drugs, which may be an important cause of tumor recurrence and progression following chemotherpay.  OBJECTIVE: To explore the sensitivity of gastric cancer stem cells to 5-fluorouracil and related biology mechanism underlying multidrug resistance.  METHODS: Stem cell marker CD44 and multidrug resistance protein thymidylate synthase in 69 cases of gastric cancer tissues were tested by immunohistochemical staining. The selection strategy was based on the clonal morphology, and gastric cancer stem cells were isolated from human gastric cancer cell line AGS to detect the expression of CD44 and thymidylate synthase and the self renewing ability. Inhibitory concentration 50 (IC50) of 5-fluorouracil in different AGS cell clone was detected using cell counting kit-8.  RESULTS AND CONCLUSION: In 69 cases of gastric cancer tissues, the positive expression rates of thymidylate synthase and CD44were 57% (39/69) and 61% (42/69), respectively, and there was a positive correlation between the expression of CD44 and thymidylate synthase (Kappa=0.41, x2=11.59, P < 0.05). Cloning efficiency of the AGS cell line was 39% (29/69), wherein, vice cloning, secondary cloning, and full clone proportions were 17% (5/29), 69% (20/29), 14% (4/29), respectively. After sub-cloning, the clone was digested using trysin followed by low-density passage; vice clones were unable to passage, secondary clones could only passage a few, and full clones could serially passage. After treatment with different concentrations of 5-fluorouracil, the full clone growth inhibition rate was significantly lower than that of secondary clones and AGS cells (P < 0.05). These findings show that gastric cancer stem cells are less sensitive to 5-fluorouracil, indicating the cells have a resistance to chemotherapy drugs, which may be one of the chemotherapy resistance mechanisms in the clinical treatment of gastric cancer.

Loading Benq Medical Center collaborators
Loading Benq Medical Center collaborators