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Chinese Medical Journal 2022年第21期135卷 2599-2601页

作者： Haifeng Wan Tian Lan Ting Duan Kunlin Xie Jiwei Huang Jiayin Yang Yong Zeng Li Jiang Hong Wu Department of Liver Transplantation Center West China Hospital of Sichuan UniversityChengduSichuan 610041China Department of Radiology West China Hospital of Sichuan UniversityChengduSichuan 610041China Department of Liver Surgery West China Hospital of Sichuan UniversityChengduSichuan 610041China

With technological advances in Laparoscopic hepatectomy and new navigation devices,such as flexible Laparoscopic ultrasound probes,indocyanine green(ICG)-fluorescent imaging and three-dimensional imaging,Laparoscopic segmentectomy(LS),which maximizes the preservation of the functional hepatic reserve and the possibility for future repeat hepatectomy while ensuring adequate surgical margins,has become a feasible alternative to hemihepatectomy for addressing hepatocellular carcinoma(HCC).

关键词： hepatectomy Laparoscopic advances

Bleeding control during complex Laparoscopic surgeries of the spleen:current status and challenges

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Chinese Medical Journal 2022年第24期135卷 2938-2940页

作者： Nan You Jing Li Lu Zheng Department of Hepatobiliary Surgery The Second Affiliated HospitalThird Military Medical University(Army Medical University)Chongqing 400037China

Severe intra-operative bleeding has limited the application of complex Laparoscopic splenectomy(LS),including Laparoscopic total splenectomy(LTS)and Laparoscopic partial splenectomy(LPS).Therefore,reducing bleeding ri... 详细信息

关键词： Laparoscopic spleen bleeding

Laparoscopic pancreaticoduodenectomy: From “standard” to “extended”

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Hepatobiliary & Pancreatic Diseases International 2023年第2期22卷 113-114页

作者： Zhe Yang Ze-Kuan Li Shu-Sen Zheng Department of Hepatobiliary and Pancreatic Surgery Department of Liver TransplantationShulan(Hangzhou)HospitalZhejiang Shuren University School of MedicineHangzhou 310022China Zhejiang University School of Medicine Hangzhou 310000China

Pancreatic cancer is one of the most desperate malignances worldwide with approximately 470 0 0 0 deaths per year, and the 5-year survival rate is only 11% [1]. Pancreaticoduodenectomy(PD) is the standard treatment for pancreatic head and periampullary lesions [2]. PD is often either described as “standard PD” or “extended PD”(e.g., “PD with portal vein resection, additional organ resection or arterial resection”) [3].

关键词： Laparoscopic arterial lesions

Development and validation of a preoperative nomogram for predicting positive surgical margins after Laparoscopic radical prostatectomy

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Chinese Medical Journal 2019年第8期132卷 928-934页

作者： Xiao-Jun Tian Zhao-Lun Wang Geng Li Shuang-Jie Cao Hao-Ran Cui Zong-Han Li Zhuo Liu Bo-Lun Li Lu-Lin Ma Shen-Rong Zhuang Qi-Yan Xiao Department of Urology Peking University Third HospitalBeijing 100191China Peking University First Medical School Peking University First HospitalBeijing 100034China Peking University Second Medical School Peking University People's HospitalBeijing 100044China Institute of Biomedical English Peking University Health Science CenterBeijing 100191China Key Laboratory of Carcinogenesis and Translational Research(Ministry of Education) Peking University Cancer Hospital and InstituteBeijing 100142China

Background:Positive surgical margins are independent risk factor for biochemical recurrence,local recurrence,and distant metastasis after radical prostatectomy.However,limited predictive tools are available.This study aimed to develop and validate a preoperative nomogram for predicting positive surgical margins after Laparoscopic radical prostatectomy(LRP).Methods:From January 2010 to March 2016,a total of 418 patients who underwent LRP without receiving neoadjuvant therapy at Peking University Third Hospital were retrospectively involved in this study.Clinical and pathological results of each patient were collected for further analysis.Univariable and multivariable logistic regression(backward stepwise method)were used for the nomogram development.The concordance index(CI),calibration curve analysis and decision curve analysis were used to evaluate the performance of our model.Results:Of 418 patients involved in this study,142 patients(34.0%)had a positive surgical margin on final pathology.Based on the backward selection,four variables were included in the final multivariable regression model,including the percentage of positive cores in preoperative biopsy,clinical stage,free prostate specific antigen(fPSA)/total PSA(tPSA),and age.A nomogram was developed using these four variables.The concordance index(C-index)of the nomogram was 0.722 in the development cohort and 0.700 in the bootstrap validations.The bias-corrected calibration plot showed a limited departure from the ideal line with a mean absolute error of 2.0%.In decision curve analyses,the nomogram showed net benefits in the range from 0.2 to 0.7.Conclusion:A nomogram to predict positive surgical margins after LRP was developed and validated,which could help urologists plan surgical procedures.

关键词： Prostate cancer Positive surgical margins Laparoscopic radical prostatectomy Nomogram

Feasibility and safety of single-incision Laparoscopic cholecystectomy versus conventional Laparoscopic cholecystectomy in an ambulatory setting

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Hepatobiliary & Pancreatic Diseases International 2019年第3期18卷 273-277页

作者： Jun-Wen Qu Cheng Xin Gui-Yang Wang Zhi-Qing Yuan Ke-Wei Li Department of Biliary-Pancreatic Surgery Renji Hospital School of Medicine Shanghai Jiao Tong University

Background: Single-incision Laparoscopic surgery has emerged as an alternative to conventional Laparoscopic cholecystectomy(LC) in the clinical setting. Limited information is available on the possibility of performing single-incision Laparoscopic surgery as an ambulatory procedure. This study aimed to determine the feasibility and safety of single-incision Laparoscopic cholecystectomy(SILC) versus conventional LC in an ambulatory setting. Methods: Ninety-one patients were randomized to SILC( n = 49) or LC( n = 42). The success rate, operative duration, blood loss, hospital stay, gallbladder perforation, drainage, delayed discharge, readmission, total cost, complications, pain score, vomiting, and cosmetic satisfaction of the two groups were then compared. Results: There were significant differences in the operative time(46.89 ± 10.03 min in SILC vs. 37.24 ± 10.23 min in LC;P 0.05). Conclusions: Ambulatory SILC is safe and feasible for selected patients. The advantages of SILC as compared with LC are improved cosmetic satisfaction and lower total costs.

关键词： Ambulatory Single incision Laparoscopic cholecystectomy Feasibility Safety

Application of robot-assisted Laparoscopic pelvic exenteration in treating gynecologic malignancies

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Chinese Medical Journal 2019年第8期132卷 976-979页

作者： Qi-Yu Yang Jun-Ying Tang Department of Gynecology The First Affiliated Hospital of Chongqing Medical UniversityChongqing 400000China.

Introduction Pelvic exenteration(PE)refers to the en bloc resection of the involved pelvic organs along with pelvic reconstruction so as to enhance the survival rate for tumor patients.First reported by Brunschwig in 1948,[1]PE has thereafter been utilized to treat rectal cancer,bladder cancer,prostate cancer,and cervical cancer as a curative or palliative treatment for advanced or recurrent malignancies.It is critical to carry out surgical resection of all the involved tumor lesions so as to prolong the overall survival(OS)of patients;nonetheless,such medical manipulation will induce various complications.For patients undergoing radiotherapy in the initial treatment,the increased tissue fragility,together with inflammation,has become trouble intraoperatively.

关键词： gynecologic malignancies robot-assisted Laparoscopic pelvic exenteration Pelvic exenteration(PE)

Laparoscopic combined with thoracoscopic transdiaphragmatic hepatectomy for hepatitis B-related hepatocellular carcinoma located in segment VII or VIII

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Hepatobiliary & Pancreatic Diseases International 2020年第3期19卷 291-294页

作者： Yu Zhu Zhen-Yu Li Chun-Guo Wang Zhe-Ping Fang Wei-Dong Jia Fa-Biao Zhang School of Medicine Shandong UniversityJinan 250012China Division of Liver Surgery The First Affiliated Hospital of USTCDivision of Life Sciences and MedicineUniversity of Science and Technology of ChinaHefei 230001China Department of Hepatobiliary Surgery Taizhou Hospital of Zhejiang ProvinceWenzhou Medical UniversityTaizhou 317000China

Laparoscopic hepatectomy(LH)is considered a safe and effective method of treating liver cancer because of its relatively low level of trauma,bleeding,pain,and short hospital stay as compared with traditional open surgery[1].However,this is not ideal for tumors located in segment VII or VIII of the liver as these tumors are difficult to be exposed during laparoscopy,and the conversion rate is relatively high[2].Although it has been reported that the thoracoscopic transdiaphragmatic segment VII or VIII hepatectomy can obtain better visual field and operation space[3]。

关键词： hepatectomy Laparoscopic bleeding

对比经肛全直肠系膜切除术与腹腔镜全直肠系膜切除术:一项多中心III期随机临床试验(TaLaR试验)方案

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Gastroenterology Report 2021年第1期9卷 71-76,I0002页

作者： Liang Kang Ziwei Zeng Shuangling Luo Hong Zhang Quan Wang Mingyang Ren Miao Wu Weidong Tong Qing Xu Yi Xiao Aiwen Wu Yuan-Guang Chen Bo Feng Zhanlong Shen Liang Huang Xingwei Zhang Minhua Zheng Jian-Ping Wang Department of Colorectal Surgery The Sixth Affiliated Hospital of Sun Yat-sen UniversityGuangzhouGuangdongP.R.China Guangdong Institute of Gastroenterology The Sixth Affiliated Hospital of Sun Yatsen UniversityGuangzhouGuangdongP.R.China Guangdong Provincial Key Laboratory of Colorectal and Pelvic Floor Diseases The Sixth Affiliated Hospital of Sun Yat-sen UniversityGuangzhouGuangdongP.R.China Department of Colorectal Surgery Shengjing Hospital of China Medical UniversityShenyangLiaoningP.R.China Department of Gastrointestinal Surgery The First Hospital of Jilin UniversityChangchunJilinP.R.China Department of Gastrointestinal Surgery The Affiliated Nanchong Central Hospital of North Sichuan Medical CollegeNanchongSichuanP.R.China Department of Gastrointestinal Surgery The Second People’s Hospital of YibinYibinSichuanP.R.China Department of General Surgery Daping HospitalArmy Medical universityChongqingP.R.China Department of Gastrointestinal Surgery Renji HospitalSchool of MedicineShanghai Jiao Tong UniversityShanghaiP.R.China Department of General Surgery Peking Union Medical College HospitalPeking Union Medical College and Chinese Academy of Medical SciencesBeijingP.R.China Department of Gastrointestinal Surgery Peking University Cancer HospitalBeijingP.R.China Department of Gastrointestinal Surgery The First Affiliated Hospital of Guangzhou Medical UniversityGuangzhouGuangdongP.R.China Ruijin Hospital Shanghai Jiaotong University School of Medicine ShanghaiP.R.China Department of Gastrointestinal Surgery Peking University People’s HospitalBeijingP.R.China

背景:全直肠系膜切除术是直肠癌治疗的标准手术方法。经肛全直肠系膜切除术(taTME)是治疗低位直肠癌的新术式。既往研究表明,与腹腔镜全直肠系膜切除术(lapTME)相比,taTME应用于低位直肠癌患者可提供更高质量的手术标本,但其长期肿瘤学... 详细信息

背景:全直肠系膜切除术是直肠癌治疗的标准手术方法。经肛全直肠系膜切除术(taTME)是治疗低位直肠癌的新术式。既往研究表明,与腹腔镜全直肠系膜切除术(lapTME)相比,taTME应用于低位直肠癌患者可提供更高质量的手术标本,但其长期肿瘤学结果仍需进一步观察。因此,我们设计了这个非劣效性临床试验(TaLaR试验),比较taTME与lapTME治疗直肠癌的短期和长期结果。方法/设计:TaLaR试验是一项多中心III期随机对照试验。研究对象为经磁共振成像、直肠指检或结肠镜检查被诊断为位于腹膜反折以下的直肠癌,若肿瘤分期≤cT3N2直接手术,若>cT3N2则先行新辅助治疗。通过计算,本研究需纳入1,114例患者(每组557例)。纳入病例随机分配到taTME或lapTME组。本研究的主要终点是3年无病生存率(DFS)和5年总生存率(OS)。次要终点包括手术标本质量、围手术期结果、骨盆和肛门功能以及生活质量。讨论:我们认为,TaLaR试验将阐明taTME是否可以达到与lapTME相似的肿瘤学结果,以及是否可改善直肠癌患者的手术标本质量及恢复情况。

关键词： transanal total mesorectal excision total mesorectal excision Laparoscopic rectal cancer surgery

Surgical outcomes of hand-assisted Laparoscopic liver resection vs. open liver resection: A retrospective propensity scorematched cohort study

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Chinese Journal of Cancer Research 2019年第5期31卷 818-824页

作者： Shengtao Lin Fan Wu Liming Wang Yunhe Liu Yiling Zheng Tana Siqin Weiqi Rong Jianxiong Wu Department of Hepatobiliary Surgery National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital Chinese Academy of Medical Sciences and Peking Union Medical College

Objective: Hand-assisted Laparoscopic liver resection has the advantages of open and Laparoscopic surgeries.There is still lack of comparison of surgical outcomes between hand-assistied Laparoscopic liver resection(HALLR)and open liver resection(OLR). This study compared the surgical outcomes of the two approaches between wellmatched patient cohorts.Methods: Patients who received liver resection during January 2014 and October 2017 in Cancer Hospital,Chinese Academy of Medical Sciences and Peking Union Medical College were included in this retrospective study. Propensity score matching(PSM) was performed to reduce selection bias between the two groups. Operation and short-term surgical outcomes were compared between the well matched groups.Results: During this period, 232 patients with a median age of 55.1 years old received OLR, while 49 patients with a median age of 54.7 years old received HALLR. Compared with HALLR group, OLR group has a higher proportion in male patients(190/232, 81.9% vs. 34/49, 69.4%, P=0.048) and lower albumin(43.2±4.5 vs. 44.8±3.7,P=0.020). After PSM, 49 patients from each group were included in the following analysis. Two groups were well balanced in their baseline characteristics, liver functions, preoperative treatments, abdominal surgery history, and surgical difficulty. None perioperative mortality was observed in both groups. Operation time and postoperative complications were similar in two groups(P=0.935, P=0.056). The HALLR group showed less bleeding amount(177.8±217.1 mL vs. 283.1±225.0 mL, P=0.003) and shorter postoperative stay period(6.9±2.2 d vs. 9.0±3.5 d,P=0.001).Conclusions: We demonstrated that hand-assisted Laparoscopic surgery is feasible and safe for liver resection,including some difficult cases. HALLR can provide better bleeding control and faster recovery after surgery.

关键词： Surgical outcomes hand-assisted Laparoscopic surgery liver resection

Successful Laparoscopic management of ovarian cyst torsion in the third trimester

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Chinese Medical Journal 2021年第3期134卷 375-377页

作者： Rui-Xi Zhan Xiao-Fang Lyu Ling Yin Yang-Yang Shi Ying-Dong He Department of Obstetrics and Gynecology Peking University First HospitalBeijing 100034China Department of Obstetrics and Gynecology Hebei Province Shi Jia Zhuang Maternity and Child Healthcare HospitalShijiazhuangHebei 050000China

.To the Editor:With the advancement of Laparoscopic techniques,minimally invasive surgery is more widely applied in various conditions.The guidelines,published by the Society of American Gastrointestinal Endoscopic Surgeons(SAGES)in 2017,considered that Laparoscopic surgery could be safely performed at any stage of pregnancy,although best in mid-term.[1]Since 2004,our team has carried out more than 150 Laparoscopic procedures in pregnant patients who wanted to preserve their pregnancy.However,only six of these cases were in the late-term.Here we report a case of right ovarian cyst torsion successfully treated by Laparoscopic oophorocystectomy in a patient at 35 weeks gestation.Following this operation,a healthy female of 3000 g was delivered at 40^(+2)weeks gestation.

关键词： Laparoscopic surgery pregnancy