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World Journal of Gastrointestinal Oncology 2019年第9期11卷 741-749页

作者： Sara Jamel Karina Tukanova sheraz markar Department Surgery and Cancer Imperial College London

BACKGROUND Oesophageal cancer is the eighth most common cancer *** prognosis of oesophageal cancer patients still remains *** 5-year survival rate rarely exceeds 5%in case of metastatic *** patients may however present with oligometastasis which can be treated with loco-regional *** To assess the current practice regarding the management of patients with oligometastatic oesophageal cancer and identify prognostic factors affecting survival following treatment for *** A systematic search of the literature was performed in Cochrance Library,MEDLINE and EMBASE databases from September 1950 to January *** electronic databases were searched for studies assessing the clinical outcome of *** A total of 14 publications were included,of which 12 studies assessing metachronous oligometastasis and 2 on synchronous *** included articles evaluated the specific outcomes of metastasis,management modality and survival *** majority of the patients presented with oesophageal squamous cell *** median disease free interval(time to recurrence)in patients was 19.6 mo and the overall survival reached 30.8 *** prognostic factors were assessed in eight studies and included time to recurrence20 mm),disease free interval(DFI)<12 mo,extra-pulmonary metastasis,primary tumour pathological stage III/*** Oligometastatic oesophageal cancer in selected patients is amenable to locoregional treatment,and the overall survival of this patient cohort may be improved with patient and tumour-specific treatments.

关键词： Oligometastasis Oesophageal cancer Neoplasm Liver Pulmonary

Point-of-care testing in the diagnosis of gastrointestinal cancers: Current technology and future directions

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World Journal of Gastroenterology 2015年第14期21卷 4111-4120页

作者： Jeremy R Huddy Melody Z Ni sheraz R markar George B Hanna Department of Surgery and Cancer Imperial College LondonSt Mary’s Hospital

Point-of-care(POC) tests enable rapid results and are well established in medical *** advances in analytical techniques have led to a new generation of POC devices that will alter gastrointestinal diagnostic *** review aims to identify current and newtechnologies for the POC diagnosis of gastrointestinal cancer.A structured search of the Embase and Medline databases was *** reporting diagnostic tests for gastrointestinal cancer available as a POC device or containing a description of feasibility for POC application were *** recovered were heterogeneous and therefore results are presented as a narrative *** diagnostic methods were identified(fecal occult blood, fecal proteins, volatile organic compounds, pyruvate kinase isoenzyme type M2, tumour markers and DNA analysis).Fecal occult blood testing has a reported sensitivity of 66%-85% and specificity greater than 95%.The others are at a range of development and clinical *** devices have a proven role in the diagnosis of gastrointestinal *** to their implementation exist and the transition from experimental to clinical medicine is currently *** technologies demonstrate potential to provide accurate POC tests and an ability to diagnose gastrointestinal cancer at an early stage with improved clinical outcome and survival.

关键词： Colorectal cancer Cancer-diagnosis Gastric cancer

Continuous wound infusion of local anaesthetic agents following colorectal surgery:Systematic review and meta-analysis

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World Journal of Gastroenterology 2008年第34期14卷 5301-5305页

作者： Alan Karthikesalingam Stewart R Walsh sheraz R markar Umar Sadat Tjun Y Tang Charles M Malata Department of General Surgery Addenbrooke’s HospitalCambridge University Hospitals NHS Foundation Trust Department of Plastic and Reconstructive Surgery Addenbrooke’s HospitalCambridge University Hospitals Foundation Trust

AIM:To provide a specifi c review and meta-analysis of the available evidence for continuous wound infusion of local anaesthetic agents following midline laparoto-my for major colorectal surgery. METHODS: Medline, Embase, trial registries, conference proceedings and article reference lists were searched to identify randomised, controlled trials of continuous wound infusion of local anaesthetic agents following colorectal surgery. The primary outcomes were opioid consumption, pain visual analogue scores (VASs), return to bowel function and length of hospital stay. Weighted mean difference were calculated for continuous outcomes. RESULTS: Five trials containing 542 laparotomy wounds were eligible for inclusion. There was a sig- nificant decrease in post-operative pain VAS at rest on day 3 (weighted mean difference: -0.43; 95% CI: -0.81 to -0.04; P = 0.03) but not on post-operative day 1 and 2. Local anaesthetic infusion was associated with a signifi cant reduction in pain VAS on movement on all three post-operative days (day 1 weighted mean difference: -1.14; 95% CI: -2.24 to -0.041; P = 0.04, day 2 weighted mean difference: -0.97, 95% CI: -1.91to -0.029; P = 0.04, day 3 weighted mean difference: -0.61; 95% CI: 1.01 to -0.20; P = 0.0038). Local an- aesthetic wound infusion was associated with a signifi - cant decrease in total opioid consumption (weighted mean difference: -40.13; 95% CI: -76.74 to -3.53; P = 0.03). There was no signifi cant decrease in length of stay (weighted mean difference: -20.87; 95% CI: -46.96 to 5.21; P = 0.12) or return of bowel function (weighted mean difference: -9.40; 95% CI: -33.98 to 15.17; P = 0.45). CONCLUSION: The results of this systematic re- view and meta-analysis suggest that local anaesthetic wound infusion following laparotomy for major color- ectal surgery is a promising technique but do not pro- vide conclusive evidence of benefi t. Further research is required including cost-effectiveness analysis.

关键词： Colorectal surgery Laparotomy Local anaesthesia Infusion Wound healing

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急性上消化道出血

英国医学杂志中文版 2019年第7期22卷 411-415页

作者： Emma Sverden sheraz R markar Lars Agreus Jesper Lagergren 龚亮(译) 吴东(校) 无 Upper Gastrointestinal Surgery Department of Molecular Medicine and Surgery Karolinska Institutet Karolinska University Hospital. StockholmSweden Department of Upper Gastrointestinal Surgery South Hospital Stockholm Sweden Department of Surgery and Cancer imperial College London UK Division of Family Medicine and Primary Care Department of Neurobiology Care Sciences and Society Karolinska InstitutetKarolinska University Hospital Stockholm Sweden University of Newcastle Australia School of Cancer and Pharmaceutical Sciences King's College London and Guy' s and St Thomas' NHS Foundation Trust UK 中国医学科学院北京协和医学院北京协和医院消化科

每年,每10万人中就有约100例发生上消化道(食道、胃和十二指肠)出血“。这是一个具有较高病死率的内科急症。2007年英国的一项调査发现,上消化道出血的总病死率为10%。消化性溃疡是上消化道出血最常见的原因(框图1),这一实践指南为上消... 详细信息

每年,每10万人中就有约100例发生上消化道(食道、胃和十二指肠)出血“。这是一个具有较高病死率的内科急症。2007年英国的一项调査发现,上消化道出血的总病死率为10%。消化性溃疡是上消化道出血最常见的原因(框图1),这一实践指南为上消化道出血的初期处理以及消化性溃疡出血的后续管理提供了指导。

关键词：急性上消化道出血消化性溃疡出血十二指肠内科急症后续管理初期处理实践指南病死率