检索结果-南通市图书馆

Superiority of laparoscopic rectal surgery:Towards a new era

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 Gastrointestinal Surgery 2011年第10期3卷 142-146页

作者： yosuke fukunaga Department of Gastroenterological Surgery Cancer Institute Hospital

While laparoscopic colon surgery has been established to some degree over this decade,laparoscopic rectal surgery is not standard yet because of the difficulty of making a clear surgical field,the lack of precise anatomy of the pelvis,immature procedures of rectal transaction and so on.On the other hand,maintaining a clear surgical field via the magnified laparoscopy may allow easier mobilization of the rectum as far as the levetor muscle level and may result less blood loss and less invasiveness.However,some unique techniques to keep a clear surgical field and knowledge about anatomy of the pelvis are required to achieve the above superior operative outcomes.This review article discusses how to keep a clear operative field,removing normally existing abdominal structures,and how to transact the rectum and restore the discontinuity based on anatomical investigations.According to this review,laparoscopic rectal surgery will become a powerful modality to accomplish a more precise procedure which has been technically impossible so far,actually entering a new era.

关键词： Laparoscopic surgery Rectum Anatomy Plane Reconstruction Double stapling technique Anal preservation

Recurrent colorectal cancer after endoscopic resectionwhen additional surgery was recommended

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 2016年第7期22卷 2336-2341页

作者： Yukiko Takatsu yosuke fukunaga Shunsuke Hamasaki Atsushi Ogura Jun Nagata Toshiya Nagasaki,Takashi Akiyoshi Tsuyoshi Konishi Yoshiya Fujimoto Satoshi Nagayama Masashi Ueno Department of Gastroenterological Surgery Cancer Institute HospitalJapanese Foundation for Cancer ResearchTokyo 135-8550Japan

AIM: To evaluate the type of recurrence after endoscopic resection in colorectal cancer patients and whether rescue was possible by salvage operation.METHODS: Among 4972 patients who underwent surgical resection at our institution for primary or recurrent colorectal cancers from January 2005 to February 2015, we experienced eight recurrent colorectal cancers after endoscopic resection when additional surgical resection was recommended.RESULTS: The recurrence patterns were: intramural local recurrence(five cases), regional lymph node recurrence(three cases), and associated with simultaneous distant metastasis(three cases). Among five cases with lymphatic invasion observed histologically in endoscopic resected specimens, four cases recurred with lymph node metastasis or distant metastasis. All cases were treated laparoscopically and curative surgery was achieved in six cases. Among four cases located in the rectum, three cases achieved preservation of the anus. Postoperative complications occurred in two cases(enteritis).CONCLUSION: For high-risk submucosal invasive colorectal cancers after endoscopic resection, additional surgical resection with lymphadenectomy is recommended, particularly in cases with lymphovascular invasion.

关键词： Colorectal neoplasms Colorectal surgery Laparoscopy Endoscopy Recurrence

在线全文

维普期刊数据库

学校读者我要写书评

暂无评论

4K时代中日胃肠微创外科交流与协作

中华消化外科杂志 2020年第11期19卷 1151-1153页

作者：福长洋介癌研有明医院消化中心普通外科日本东京135-8550

随着腹腔镜设备光学技术的发展,手术画面的质量获得较大提高,从而推动了日本胃肠肿瘤微创手术质量迅速提高。2017年《中华消化外科杂志》编辑委员会组织中国和日本的胃肠外科学专家成功举办“4K时代中日胃肠微创手术标准解读交流会”,... 详细信息

随着腹腔镜设备光学技术的发展,手术画面的质量获得较大提高,从而推动了日本胃肠肿瘤微创手术质量迅速提高。2017年《中华消化外科杂志》编辑委员会组织中国和日本的胃肠外科学专家成功举办“4K时代中日胃肠微创手术标准解读交流会”,希望通过会议交流、推广、普及中国与日本在腹腔镜胃肠微创手术领域的医疗技术。通过参加会议,笔者团队展示4K腹腔镜保留自主神经的胃肠肿瘤根治术等手术方式,介绍日本内镜外科学会腹腔镜技术认定制度,并与中国外科医师在手术技术要点和肿瘤学质量方面进行深入探讨,由此进一步推进中日胃肠微创外科交流与协作。

关键词：胃肿瘤肠肿瘤 4K分辨率交流腹腔镜检查

Angle of covered self-expandable metallic stents after placement is a risk factor for recurrent biliary obstruction

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 Hepatology 2022年第5期14卷 992-1005页

作者： Kojiro Tanoue Hirotsugu Maruyama Yuki Ishikawa-Kakiya yosuke Kinoshita Kappei Hayashi Masafumi Yamamura Masaki Ominami Yuji Nadatani Shusei fukunaga Koji Otani Shuhei Hosomi Fumio Tanaka Noriko Kamata Yasuaki Nagami Koichi Taira Toshio Watanabe Yasuhiro Fujiwara Department of Gastroenterology Osaka City University Graduate School of MedicineOsaka 545-8585Japan

BACKGROUND Studies have shown that covered self-expandable metallic stents(CSEMS)with a low axial forces after placement can cause early recurrent biliary obstruction(RBO)due to precipitating sludge formation.AIM To ascertain whether the angle of CSEMS after placement is a risk factor for RBO in unresectable distal malignant biliary obstruction(MBO).METHODS Between January 2010 and March 2019,261 consecutive patients underwent selfexpandable metallic stent insertion by endoscopic retrograde cholangiopancreatography at our facility,and 87 patients were included in this study.We evaluated the risk factors for RBO,including the angle of CSEMS after placement as the primary outcome.We measured the obtuse angle of CSEMS after placement on an abdominal radiograph using the SYNAPSE PACS system.We also evaluated technical and functional success,adverse events,time to RBO(TRBO),non-RBO rate,survival time,cause of RBO,and reintervention procedure as secondary outcomes.RESULTS We divided the patients into two cohorts based on the presence or absence of RBO.The angle of CSEMS after placement(per 1°and per 10°)was evaluated using the multivariate Cox proportional hazard analysis,which was an independent risk factor for RBO in unresectable distal MBO[hazard ratio,0.97 and 0.71;95%confidence interval(CI):0.94-0.99 and 0.54-0.92;P=0.01 and 0.01,respectively].For early diagnosis of RBO,the cut-off value of the angle of CSEMS after placement using the receiver operating characteristic curve was 130°[sensitivity,50.0%;specificity 85.5%;area under the curve 0.70(95%CI:0.57-0.84)].TRBO in the<130°angle group was significantly shorter than that in the≥130°angle group(P<0.01).CONCLUSION This study suggests that the angle of the CSEMS after placement for unresectable distal MBO is a risk factor for RBO.These novel results provide pertinent information for future stent management.

关键词： Covered self-expandable metallic stents Recurrent biliary obstruction Malignant biliary obstruction Endoscopic retrograde cholangiopancreatography Angle Axial force