Gang Wang

Nanjing Medical University, Nanjing, Jiangsu Sheng, China

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Publications (7)5.68 Total impact

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    ABSTRACT: To compare the short-term clinical outcomes of laparoscopic and da Vince robotic radical gastrectomy for gastric cancer and evaluate the safety and efficacy of robotic system.
    05/2014; 17(5):461-4.
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    ABSTRACT: To evaluate the safety, feasibility, and efficacy of robotic gastrectomy for gastric cancer using da Vinci surgical system. A total of 120 patients who underwent robotic gastrectomy using da Vinci surgical system for gastric cancer from May 2010 to April 2012. Data regarding surgical and early oncological outcomes were systematically collected in a specific database for statistical analysis. There were 74 males and 46 females, with a mean age of 58.5 (22-80) years old. The type of robotic operation included 62 distal subtotal gastrectomies, 35 total gastrectomies, and 23 proximal gastrectomies. Reconstruction of the alimentary tract was achieved using extracorporeal method through a minilaparotomy in 55 cases, and intracorporeal robot-sewn anastomosis in 65 cases. There was 1 conversion (0.9%). The operative time was (245±50) min and the docking time (17±5) min. The blood loss was (70±45) ml. The number of harvested lymph nodes was 22.5±10.7. The resection margins were negative in all surgical specimens. The postoperative pathological stage consisted of stage I B in 24 cases, stage II in 28, stage III A in 47, and stage III B in 21. Six patients (5%) developed postoperative complication including 1 case of duodenal stump leakage, 2 cases of esophagus-gastric leakage, 1 case of small bowel obstruction, 1 case of delayed gastric empting, and 1 case of abdominal bleeding. All the complications were cured by reoperation or conservative therapy, and there were no postoperative 30-day deaths. The postoperative hospital stay was (6.3±2.6) days. Robotic gastrectomy for the treatment of gastric cancer is a feasible and safe procedure, and is advantageous in terms of lymphadenectomy and alimentary tract reconstruction.
    Zhonghua wei chang wai ke za zhi = Chinese journal of gastrointestinal surgery 08/2012; 15(8):801-3.
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    ABSTRACT: To summarize the clinical experience of transanal specimen extraction and introduce how to achieve the rectum reconstruction in robotic rectal cancer surgery. Clinical data of 15 cases undergoing rectal cancer resection with the da Vinci robotic system in Jinglin Hospital between February 2012 and May 2012 were analyzed retrospectively. There were 9 males and 6 females with a mean age of (61.5±9.2) years old. All the cases underwent robotic surgery successfully without intraoperative conversion. The average operative time was (154.7±10.6) min with minimal blood loss (17.3±6.5) ml. The time to first flatus was (2.3±0.8) days postoperatively. The postoperative hospital stay was (3.3±0.6) days. The mean number of lymph node harvested from the surgical specimen was (15.0±1.2). All the resection margins were negative. All the patients had postoperative follow-up ranging from 4 to 8 weeks. There were no postoperative infection, anastomotic leak, incision hernia, or short-term deaths. da Vinci robotic system greatly reduces the difficulty of the rectal cancer surgery with its unique light source system and flexible equipment operation.
    Zhonghua wei chang wai ke za zhi = Chinese journal of gastrointestinal surgery 08/2012; 15(8):807-9.
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    ABSTRACT: It has been demonstrated that colon operation combined with fast-track (FT) surgery and laparoscopic technique can shorten the length of hospital stay, accelerate recovery of intestinal function, and reduce the occurrence of post-operative complications. However, there are no reports regarding the combined effects of FT colon operation and laparoscopic technique on humoral inflammatory cellular immunity. This was a prospective, controlled study. One hundred sixty-three colon cancer patients underwent the traditional protocol and open operation (traditional open group, n=42), the traditional protocol and laparoscopic operation (traditional laparoscopic group, n=40), the FT protocol and open operation (FT open group, n=41), or the FT protocol and laparoscopic operation (FT laparoscopic group, n=40). Blood samples were taken prior to operation as well as on days 1, 3, and 5 after operation. The number of lymphocyte subpopulations was determined by flow cytometry, and serum interleukin-6 and C-reactive protein levels were measured. Post-operative hospital stay, post-operative morbidity, readmission rate, and in-hospital mortality were recorded. Compared with open operation, laparoscopic colon operation effectively inhibited the release of post-operative inflammatory factors and yielded good protection via post-operative cell immunity. FT surgery had a better protective role with respect to the post-operative immune system compared with traditional peri-operative care. Inflammatory reactions, based on interleukin-6 and C-reactive protein levels, were less intense following FT laparoscopic operation compared to FT open operation; however, there were no differences in specific immunity (CD3+ and CD4+ counts, and the CD4+/CD8+ ratio) during these two types of surgical procedures. Post-operative hospital stay in patients randomized to the FT laparoscopic group was significantly shorter than in the other three treatment groups (P<0.01). Post-operative complications in patients who underwent FT laparoscopic treatment were less than in the other three treatment groups (P<0.05). There were no significant differences between the four treatment groups regarding readmission rate and in-hospital mortality. The laparoscopic technique and FT surgery rehabilitation program effectively inhibited release of post-operative inflammatory factors with a reduction in peri-operative trauma and stress, which together played a protective role on the post-operative immune system. Combining two treatment measures during colon operation produced better protective effects via the immune system. The beneficial clinical effects support that the better-preserved post-operative immune system may also contribute to the improvement of post-operative results in FT laparoscopic patients.
    Journal of Gastrointestinal Surgery 05/2012; 16(7):1379-88. · 2.36 Impact Factor
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    ABSTRACT: Background/Aims: Fast track (FT) rehabilitation programmes have demonstrated advantages over traditional perioperative care after open colonic surgery; however, their contribution in recovery after laparoscopic colonic surgery is not clearly defined. This study was conducted to estimate the value of FT rehabilitation programme in laparoscopic colonic resections. Methodology: This is a randomized prospective controlled clinical trial. Ninety-nine consecutive patients underwent elective laparoscopic colonic resection between February 2008 and March 2009. Forty-nine patients received FT multimodal rehabilitation programme as FT group and 50 patients underwent traditional perioperative care as non-FT group. Postoperative hospital stay, return of gastrointestinal function, postoperative complications were recorded. Results: Postoperative hospital stay was shorter in the FT group, a median duration of 4.0 days versus 5.0 days in the non-FT group (p<0.01). Gastrointestinal functional recovery occurred 1 day earlier in FT group (passage of flatus after 2.0 days vs. 3.0 days, p<0.01). There were no significant differences in complications within 30 postoperative days (12% in FT group vs. 20% in non-FT group, p=0.295). Conclusions: When applied after laparoscopic colonic surgery, FT rehabilitation programme is feasible, safe and may lead to accelerated functional recovery and reductions in postoperative hospital stay.
    Hepato-gastroenterology 02/2012; 59(119). · 0.77 Impact Factor
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    ABSTRACT: To compare the fast-track rehabilitation program and conventional care for patients after resection of colorectal cancer. One hundred and six consecutive patients who underwent fast-track rehabilitation program were encouraged to have early oral feeding and movement for early discharge, while 104 consecutive patients underwent conventional care after resection of colorectal cancer. Their gastrointestinal functions, postoperative complications and hospital stay time were recorded. The restoration time of gastrointestinal functions in the patients was significantly faster after fast-track rehabilitation program than after conventional care (2.1 d vs 3.2 d, P<0.01). The percentage of patients who developed complications was significantly lower 30 d after fast-track rehabilitation program than after conventional care (13.2% vs 26.9%, P<0.05). Also, the percentage of patients who had general complications was significantly lower 30 d after fast-track rehabilitation program than after conventional care (6.6% vs 15.4%, P<0.05). The postoperative hospital stay time of the patients was shorter after fast-track rehabilitation program than after conventional care (5 d vs 7 d, P<0.01). No significant difference was observed in the re-admission rate 30 d after fast-track rehabilitation program and conventional care (3.8% vs 8.7%). The fast-track rehabilitation program can significantly decrease the complications and shorten the time of postoperative hospital stay of patients after resection colorectal cancer.
    World Journal of Gastroenterology 02/2011; 17(5):671-6. · 2.55 Impact Factor
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    ABSTRACT: To investigate the efficacy and safety of fast-track surgery(FTS) in patients with colorectal cancer. One hundred and sixteen patients with colorectal cancer underwent colorectal operation between June 2006 and May 2008. FTS procedures were used in these patients during the study period. Data were retrospectively analyzed pertaining to post-operative hospital stay and operative complications. The median postoperative hospital stay was (5.6+/-5.4)(range 1-54) d. Fourteen patients(12.1%) had postoperative complications, in which the rate of anastomotic leakage and wound infection was 1.7% and 2.6% respectively. 30-day readmission rate was 1.7%, and the 30-day mortality was 0.9%. Fast-track surgery is feasible in an unselected patient population undergoing elective colorectal cancer resection without compromising surgical outcomes.
    Zhonghua wei chang wai ke za zhi = Chinese journal of gastrointestinal surgery 05/2010; 13(5):342-5.

Publication Stats

43 Citations
5.68 Total Impact Points

Institutions

  • 2012
    • Nanjing Medical University
      • Department of General Surgery
      Nanjing, Jiangsu Sheng, China
  • 2010–2012
    • Nanjing University
      • School of Medicine
      Nan-ching, Jiangsu Sheng, China