检索结果-南通市图书馆

The Chengdu system for recurrent hepatocellular carcinoma: A step in the right direction

在线全文

维普期刊数据库

学校读者我要写书评

暂无评论

hepatobiliary Surgery and Nutrition 2019年第3期8卷 298-300页

作者： Simon Erridge mikael h.sodergren Department of Surgery and Cancer Imperial College LondonLondonUK

Liver cancer is the fourth leading cause of cancer-related death worldwide.hepatocellular carcinoma(hCC),the most prevalent cause of primary liver cancer,is observed highest in the Far East,South-Eastern Asia and East Africa(1).In most endemic regions this is secondary to the prevalence of specific risk factors including chronic hepatitis B virus(hBV)infection,hepatitis C virus(hCV)infection and aflatoxin-exposure(1,2).The development of hBV vaccination and programmes to reduce hBV transmission has reduced the risk of hCC in high-risk Asian countries(1).Global incidence of hCC however continues to rise and major contributory factors to this are alcohol misuse and the obesity epidemic,resulting in non-alcoholic fatty liver disease,in Western nations(1,2).

关键词： Liver Eastern alcohol

No difference in mortality among ALPPS,two-staged hepatectomy,and portal vein embolization/ligation:A systematic review by updated traditional and network meta-analyses

在线全文

维普期刊数据库

学校读者我要写书评

暂无评论

hepatobiliary & Pancreatic Diseases International 2020年第5期19卷 411-419页

作者： Paschalis Gavriilidis Robert P Sutcliffe Keith J Roberts Madhava Pai Duncan Spalding Nagy habib Long R Jiao mikael h sodergren Department of hepatopanceaticobiliary Surgery Imperial College Healthcare NHS TrustHammersmith HospitalLondon W120HSUK Department of hepato-Pancreato-Biliary and Liver Transplant Surgery Queen Elizabeth University Hospitals Birmingham NHS Foundation TrustBirmingham B152THUK

Background:There is an ongoing debate on the feasibility,safety,and oncological efficacy of the associating liver partition and portal vein ligation for staged hepatectomy(ALPPS)technique.The aim of this study was to compare ALPPS,two-staged hepatectomy(TSh),and portal vein embolization(PVE)/ligation(PVL)using updated traditional meta-analysis and network meta-analysis(NMA).Data sources:Electronic databases were used in a systematic literature search.Updated traditional metaanalysis and NMA were performed and compared.Mortality and major morbidity were selected as primary outcomes.Results:Nineteen studies including 1200 patients were selected from the pool of 436 studies.Of these patients,315(31%)and 702(69%)underwent ALPPS and portal vein occlusion(PVO),respectively.Ninetyday mortality based on updated traditional meta-analysis,subgroup analysis of the randomized controlled trials(RCTs),and both Bayesian and frequentist NMA did not demonstrate significant differences between the ALPPS cohort and the PVE,PVL,and TSh cohorts.Moreover,analysis of RCTs did not demonstrate significant differences of major morbidity between the ALPPS and PVO cohorts.The ALPPS cohort demonstrated significantly more favorable outcomes in hypertrophy parameters,time to operation,definitive hepatectomy,and R0 margins rates compared with the PVO cohort.In contrast,1-year disease-free survival was significantly higher in the PVO cohort compared to the ALPPS cohort.Conclusions:This study is the first to use updated traditional meta-analysis and both Bayesian and frequentist NMA and demonstrated no significant differences in 90-day mortality between the ALPPS and other hepatic hypertrophy approaches.Furthermore,two high quality RCTs including 147 patients demonstrated no significant differences in major morbidity between the ALPPS and PVO cohorts.

关键词： ALPPS hepatectomy Portal vein embolization Portal vein ligation Network meta-analysis

Natural orifice translumenal endoscopic surgery applications in clinical practice

维普期刊数据库

同方期刊数据库评论

在线全文

学校读者我要写书评

暂无评论

World Journal of Gastrointestinal Endoscopy 2012年第3期4卷 65-74页

作者： Ross S Coomber mikael h sodergren James Clark Julian Teare Ara Darzi Division of Surgery Department of Surgery and CancerImperial College LondonSt.Mary's Hospital

To review natural orifice translumenal endoscopic surgery (NOTES) applications in clinical practice and assess the evidence base for each application as reported in the literature.An electronic literature search was performed.Inclusion criteria were publications relating to NOTES applications in humans.For each type of operation the highest level of evidence available for clinical NOTES publications was evaluated.Morbidity and short-term operative outcomes were compared with gold standard published evidence where available.Finally,registered trials recruiting patients for NOTES applications were identified.human NOTES publications with the highest level of evidence in each application are identified.There were no RCTs in the literature to date.The strongest evidence came in the form of large,multi-centre trials with 300-500 patients.The results are encouraging,comparable with gold standard techniques on morbidity and mortality.While short-term operative outcomes were also simi-lar when compared to the gold standard techniques,other than improved cosmesis little else can definitely be concluded as a clear benefit of a NOTES procedure.The most common procedures are cholecystectomy,appendicectomy and peritoneoscopy mainly performed via transvaginal access.It is evident that morbidity appears to be higher when the transgastric route is used.The safety profile of hybrid NOTES transvaginal procedures is beginning to be confirmed as is evident from the large number of procedures presented in this review.A number of authors have presented work on pure NOTES procedures but the results are inconsistent and thus the vast majority of NOTES procedures worldwide are performed in a hybrid fashion with a variable amount of laparoscopy.This review of the clinical applications of NOTES summarises the growing evidence behind this surgical discipline and highlights NOTES procedures with an acceptable safety profile.

关键词： Natural orifice translumenal endoscopic surgery humans Clinical practice

Laparoscopic vs open approach to resection of hepatocellular carcinoma in patients with known cirrhosis:Systematic review and meta-analysis

在线全文

维普期刊数据库

学校读者我要写书评

暂无评论

World Journal of Gastroenterology 2014年第25期20卷 8274-8281页

作者： Ahmed Twaij Philip h Pucher mikael h sodergren Tamara Gall Ara Darzi Long R Jiao Department of Surgery and Cancer QEQM BuildingSt Mary’s HospitalImperial CollegeLondon W2 1NY United Kingdom Department of Surgery Hammersmith HospitalImperial College LondonLondon SW7 2AZUnited Kingdom

AIM: To review the currently available literature comparing laparoscopic to open resection of hepatocellular carcinoma(hCC) in patients with known liver cirrhosis.METhODS: A literature search of MEDLINE, EMBASE, and Cochrane databases was conducted. The search terms used included(laparoscopic OR laparoscopy) AND(hepatic or liver) AND(surgery or resection) AND "hepatocellular carcinoma" AND(cirrhosis or cirrhotic). Furthermore, to widen the search, we also used the "related articles" section. Studies reporting a comparison of outcomes and methods of open vs laparoscopic hepatic resection for hCC in patients with liver cirrhosis were included. Meta-analysis of results was performed using a random effects model to compute relative risk(RR) and for dichotomous variablesand standard mean differences(SMD) for continuous variables.RESULTS: A total of 420 patients from 4 cohort studies were included in final analysis. Patients undergoing laparoscopic procedures had statistically less blood loss compared to the open cohort, SMD of-1.01(95%CI:-1.23-0.79), P h a reduced risk of transfusion, RR = 0.19(95%CI: 0.09-0.38), P hieved following a laparoscopic approach, SMD of 0.34(95%CI: 0.08-0.60), P = 0.011. No significant difference was noted between laparoscopic and open resection operative times, SMD of-0.15(95%CI: 0.35-0.05), P = 0.142. The overall RR of suffering from postoperative morbidity is 0.25 in favour of the open surgery cohort(95%CI: 0.17-0.37), P had significantly shorter length of stays in hospital compared to the open cohort, SMD of-0.53(95%CI:-0.73 to-0.32), P his review suggests that laparoscopic resection of hepatocellular carcinoma in patients with cirrhosis is safe and may provide improved patient outcomes when compared to the open technique.

关键词： Laparoscopic hepatocellular carcinoma Cirrhosis he