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Benefits of minimally invasive surgery in the treatment of gastric cancer

World Journal of Gastroenterology 2022年第30期28卷 4227-4230页

作者： Simone Sibio Francesca La Rovere Sara Di Carlo department of surgery P.Valdoni Unit of Oncologic and Minimally Invasive SurgerySapienza University of RomeUmberto I University HospitalRome 00161Italy minimally invasive surgery Unit Department of SurgeryTor Vergata UniversityRome 00133Italy

We read with great interest the article that retrospectively analyzed 814 patients with primary gastric cancer,who underwent minimally invasive R0 gastrectomy between 2009 and 2014 by grouping them in laparoscopic vs robotic *** results of the study highlighted that age,American Society of Anesthesiologists status,gastrectomy type and pathological T and N status were the main prognostic factors of minimally invasive gastrectomy and showed how the robotic approach may improve long-term outcomes of advanced gastric *** to most of the current literature,robotic surgery is associated with a statistically longer operating time when compared to open and laparoscopic surgery;however,looking at the adequacy of resection,defined by negative surgical margins and number of lymph nodes removed,it seems that robotic surgery gives better results in terms of the 5-year overall survival and recurrencefree *** robotic approach to gastric cancer surgery aims to overcome the difficulties and technical limitations of laparoscopy in major *** threedimensional vision,articulation of the instruments and good ergonomics for the surgeon allow for accurate and precise movements which facilitate the complex steps of surgery such as lymph node dissection,esophagus-jejunal anastomosis packaging and reproducing the technical accuracy of open *** the literature,as well as the analyzed study,offers us countless data regarding the short-term oncological results of robotic surgery in the treatment of gastric cancer,satisfactory data on long-term follow-up are lacking,so future studies are necessary.

关键词： Gastric cancer Robotic gastrectomy Laparoscopy D2 lymphadenectomy Long-term outcomes Morbidity

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Has the open surgical approach in colorectal cancer really become uncommon?

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World Journal of Gastrointestinal surgery 2024年第6期16卷 1485-1492页

作者： Maria Cariati Giuseppe Brisinda Maria Michela Chiarello department of surgery Azienda Sanitaria Provinciale di CrotoneCrotone 88900Italy Abdominal and Endocrine Metabolic Medical and Surgical Sciences Fondazione Policlinico Universitario A Gemelli IRCCSRome 00168Italy department of surgery Azienda Sanitaria Provinciale di CosenzaCosenza 87100Italy

Colorectal cancer is the third most common cancer in the *** is man-datory to treat patients with colorectal *** colorectal cancer be treated in laparoscopy?Scientific literature has validated the oncological quality of laparo-scopic approach for the treatment of patients with colorectal *** non-inferiority trials with good remote control have answered positively to this long-debated *** as 1994,first publications demonstrated technical feasibility and compliance with oncological imperatives and,as far as short-term outcomes are concerned,there is no difference in terms of mortality and post-operative morbidity between open and minimally invasive surgical approaches,but only longer operating times at the beginning of the ***,from 2007 onwards,long-term results were published that demonstrated the ab-sence of a significant difference regarding overall survival,disease-free survival,quality of life,local and distant recurrence rates between open and minimally in-vasive *** this editorial,we aim to summarize the clinical and technical aspects which,even today,make the use of open surgery relevant and necessary in the treatment of patients with colorectal cancer.

关键词： Colorectal cancer Laparoscopy Laparoscopic colorectal resection Bowel obstruction Bowel perforation Advanced colorectal cancer

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Inferior pancreaticoduodenal artery pseudoaneurysm in a patient with calculous cholecystitis: A case report

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World Journal of Clinical Cases 2019年第18期7卷 2851-2856页

作者： Qiao-Dong Xu Song-Gang Gu Jia-Hong Liang Shao-Dong Zheng Zhi-Hua Lin Pei-Dong Zhang Jiang Yan department of Biliary-Pancreatic minimally invasive surgery The First Affiliated Hospital of Shantou University Medical College

BACKGROUND Pancreaticoduodenal artery (PDA) aneurysms are extremely rare. The complicated clinical presentations and high incidence of rupture make it difficult to diagnose and treat. PDA pseudoaneurysms often rupture into the gastrointestinal tract and result in life-threatening gastrointestinal hemorrhage. CASE SUMMARY A 69-year-old man was admitted to our hospital due to right upward abdominal pain. A computed tomography (CT) scan demonstrated acute cholecystitis and cholecystolithiasis. Percutaneous gallbladder drainage was performed subsequently. He was discharged after 3 d and readmitted to hospital for cholecystectomy as arranged 1 mo later. A repeat CT scan revealed an emerging enhancing mass between the pancreatic head and the descending duodenum. Then, he suffered hematochezia and hemorrhagic shock suddenly. Emergency percutaneous angiogram was performed and selective catheterization of the superior mesenteric artery demonstrated a pseudoaneurysm in the inferior PDA. Coil embolization was performed and his clinical condition improved quickly after embolization and blood transfusion. He underwent laparoscopic cholecystectomy and was discharged from hospital after surgery under satisfactory conditions. CONCLUSION PDA pseudoaneurysms are uncommon. Acute haemorrhage is a severe complication of pseudoaneurysm with high mortality which clinicians should pay attention to.

关键词： Calculous cholecystitis Inferior pancreaticoduodenal artery pseudoaneurysm Gastrointestinal haemorrhage Coil embolization Case report

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Is appendoscope a new option for the treatment of acute appendicitis?

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World Journal of Gastroenterology 2024年第28期30卷 3386-3392页

作者： Shu-Jiong Feng Yi-Feng Zhou Jian-Feng Yang Hong-Zhang Shen Guang-Xing Cui Xiao-Feng Zhang department of Gastroenterology Affiliated Hangzhou First People’s HospitalSchool of MedicineWestlake UniversityHangzhou 310000Zhejiang ProvinceChina department of Gastroenterology Key Laboratory of Integrated Traditional Chinese and Western Medicine for Biliary and Pancreatic Diseases of Zhejiang ProvinceHangzhou 310000Zhejiang ProvinceChina department of Gastroenterology Hangzhou Institute of Digestive DiseasesHangzhou 310000Zhejiang ProvinceChina

Acute appendicitis is a common surgical *** is commonly caused by obstruction of the appendiceal lumen due to fecaliths,tumors,or lymphoid *** over a century,appendectomy has been the primary treatment for acute *** Groves performed the first open appendectomy in *** 1983,Kurt Semm completed the first laparoscopic appendectomy,heralding a new era in ***,appendectomy is associated with certain complications and a rate of negative *** have suggested controversy over the impact of appendectomy on the development of inflammatory bowel disease and Parkinson’s disease,but an increasing number of studies indicate a possible positive correlation between appendectomy and colorectal cancer,gallstones,and cardiovascular *** the recognition that the appendix is not a vestigial organ and the advancement of endoscopic technology,Liu proposed the endoscopic retrograde appendicitis *** is an effective minimally invasive alternative for treating uncomplicated acute *** team has developed an appendoscope with a disposable digital imaging system operated through the biopsy channel of a colonoscope and successfully applied it in the treatment of *** article provides an overview of the progress in endoscopic treatment for acute appendicitis and offers a new perspective on the future direction of appendiceal disease treatment.

关键词： Acute appendicitis Endoscopic technology Endoscopic retrograde appendicitis therapy Appendoscope Appendiceal disease treatment

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Bioinspired 4D Printing Shape-Memory Polyurethane Rhinoplasty Prosthesis for Dynamic Aesthetic Adjustment

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Journal of Bionic Engineering 2024年第3期21卷 1397-1411页

作者： Jiaqi Liu Guiwei Li He Liu Jincheng Wang Hui Wang Xue Gao Qingping Liu Chenyu Wang department of Plastic and Reconstructive surgery The First Hospital of Jilin UniversityChangchun130021China department of Orthopaedics The Second Hospital of Jilin UniversityChangchun130041China Key Laboratory of Bionic Engineering(Ministry of Education) Jilin UniversityChangchun130022China

The disparity between the postoperative outcomes of rhinoplasty and the expected results frequently necessitates secondary or multiple surgeries as a compensatory measure,greatly diminishing patient ***,there is renewed optimism for addressing these challenges through the innovative realm of Four-Dimensional(4D)*** groundbreaking technology enables three-dimensional objects with shape-memory properties to undergo predictable transformations under specific external ***,implants crafted using 4D printing offer significant potential for dynamic *** by worms in our research,we harnessed 4D printing to fabricate a Shape-Memory Polyurethane(SMPU)for use as a nasal augmentation *** choice of SMPU was guided by its Glass Transition Temperature(Tg),which falls within the acceptable temperature range for the human *** attribute allowed for temperature-responsive intraoperative self-deformation and postoperative *** chosen animal model for experimentation was *** into account the anatomical structure of the rabbit nose,we designed and produced nasal augmentation prostheses with superior *** prostheses were then surgically implanted in a minimally invasive manner into the rabbit ***,they exhibited successful temperature-controlled in-surgery self-deformation according to the predetermined shape and non-invasive remodeling within a mere 9 days *** histological evaluations confirmed the practical viability of these prostheses in a living *** research findings posit that worm-inspired 4D-printed SMPU nasal prostheses hold significant promise for achieving dynamic aesthetic adjustments.

关键词： 4D printing Shape memory polyurethane Rhinoplasty Self-deformation Dynamic aesthetic adjustment

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Natural orifice transluminal endoscopic wedge hepatic resection with a water-jet hybrid knife in a non-survival porcine model

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World Journal of Gastroenterology 2011年第7期17卷 926-931页

作者： Hong Shi Sheng-Jun Jiang Bin Li Deng-Ke Fu Pei Xin Yong-Guang Wang Institute of minimally invasive Medicine Tongji University Shanghai200092 China department of minimally invasive Sur-gery Beijing Chuiyangliu Hospital Beijing 100022 China

AIM: To explore the feasibility of a water-jet hybrid knife to facilitate wedge hepatic resection using a natural orifice transluminal endoscopic surgery (NOTES) approach in a non-survival porcine model. METHODS: The Erbe Jet2 water-jet system allows a needleless, tissue-selective hydro-dissection with a pre-selected pressure. Using this system, wedge hepatic resection was performed through three natural routes (trans-anal, trans-vaginal and trans-umbilical) in three female pigs weighing 35 kg under general anesthesia. Entry into the peritoneal cavity was via a 15-mm incision using a hook knife. The targeted liver segment was marked by an APC probe, followed by wedge hepatic resection performed using a water-jet hybrid knife with the aid of a 4-mm transparent distance soft cap mounted onto the tip of the endoscope for holding up the desired plane. The exposed vascular and ductal structures were clipped with Endoclips. Hemostasis was applied to the bleeding cut edges of the liver parenchyma by electrocautery. After the procedure, the incision site was left open, and the animal was euthanized followed by necropsy. RESULTS: Using the Erbe Jet2 water-jet system, trans-anal and trans-vaginal wedge hepatic resection was successfully performed in two pigs without laparoscopic assistance. Trans-umbilical attempt failed due to an unstable operating platform. The incision for peritoneal entry took 1 min, and about 2 h was spent on excision of the liver tissue. The intra-operative blood loss ranged from 100 to 250 mL. Microscopically, the hydro-dissections were relatively precise and gentle, preserving most vessels. CONCLUSION: The Erbe Jet2 water-jet system can safely accomplish non-anatomic wedge hepatic resection in NOTES, which deserves further studies to shorten the dissection time.

关键词： Natural orifice transluminal endoscopic surgery Hepatic resection Water-jet Hybrid knife Triangulation

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Endoscopic submucosal dissection and endoscopic mucosal resection for esophageal and gastric lesions:A comparison of procedures

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Laparoscopic, Endoscopic and Robotic surgery 2024年第2期7卷 66-71页

作者： Gustav Holm Schæbel Andreas Weise Mucha Charlotte Egeland Michael Patrick Achiam department of surgery and Transplantation Copenhagen University Hospital RigshospitaletBlegdamsvej 92100 CopenhagenDenmark

Objective Esophageal and gastric lesions are effectively managed with minimally invasive upper endoscopic procedures such as endoscopic mucosa resection(EMR)and endoscopic submucosal dissection(ESD),offering patients alternatives to invasive *** ESD is well established in Eastern Asia,its adoption in Denmark for superficial esophageal cancer is *** study presents real-world data on the feasibility,safety,and hospitalization duration associated with ESD and EMR for esophageal and gastric *** A retrospective analysis was conducted on patients who underwent ESD or EMR at a specialized center in Denmark from October 2016 to June *** on treatment,indication,lesion location,hospitalization duration,procedure duration,specimen size,complications,recurrence,and one-year overall survival were *** comparisons utilized the Mann-Whitney U test,independent sample median test,and chi-squared *** The study included 130 patients(144 procedures):72 underwent ESD and 58 underwent *** with EMR,ESD resulted in greater percentages of en bloc and R0 resections(98.8%vs.64.1%,p<0.001;and 83.9%vs.23.8%,p<0.001),greater complication rates(28.7%vs.3.1%,p<0.001)and longer procedure times(119.5 min vs.37.0 min,p<0.001).The ESD procedure time significantly decreased over time(p=0.01).The local recurrence rates were 14.5%for ESD and 23.8%for EMR(p=0.767).The one-year overall survival rates were similar between the groups(95.8%vs.94.8%,p=0.553).Conclusion Both ESD and EMR are safe and viable for treating esophageal and gastric *** offers advantages but requires more time and *** findings support the literature,emphasizing the importance of considering patient-specific factors and surgeon proficiency in selecting the appropriate procedure.

关键词： Endoscopic submucosal dissection Endoscopic mucosa resection Gastroesophageal cancer Real-world data

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Complete mesocolic excision and central vascular ligation in colorectal cancer in the era of minimally invasive surgery

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World Journal of Clinical Cases 2021年第25期9卷 7297-7305页

作者： Marzia Franceschilli Sara Di Carlo Danilo Vinci Bruno Sensi Leandro Siragusa Vittoria Bellato Roberto Caronna Piero Rossi Giuseppe Cavallaro Andrea Guida Simone Sibio department of surgery Minimally Invasive UnitTor Vergata University of RomeRome 00133Italy department of Surgical Sciences Unit of Pancreatic and Biliary SurgerySapienza University of RomeRome 00161Italy department of surgery P Valdoni Unit of Oncologic and Minimally Invasive SurgerySapienza University of RomeRome 00161Italy

Since the 19th century,appropriate lymphadenectomy has been considered a cornerstone of oncologic surgery and one of the most important prognostic *** approach can be applied to any surgery for gastrointestinal *** surgery for colon and rectal cancer,an adequate portion of the mesentery is removed together with the segment of bowel affected by the *** adequate number of lymph nodes to be removed is standardized and reported by several *** is mandatory to determine the appropriate extent of lymphadenectomy and to balance its oncological benefits with the increased morbidity associated with its execution in cancer *** review focuses on the concept of“complete mesenteric excision(CME)with central vascular ligation(CVL),”a radical lymphadenectomy for colorectal cancer that has gained increasing interest in recent *** aim of this study was to evaluate the evolution of this approach over the years,its potential oncologic benefits and potential risks,and the improvements offered by laparoscopic *** advantages of CME are improved local-relapse rates due to complete removal of the intact mesocolic fascia and improved distance recurrence rates due to ligation of vessels at their origin(CVL)which guarantees removal of a larger number of lymph *** development and worldwide diffusion of laparoscopic techniques minimized postoperative trauma in oncologic surgery,providing the same oncologic results as open *** has been widely applied to colorectal cancer surgery;however,CME entails a technical complexity that can limit its wide minimally-invasive application. This review analyzesresults of these procedures in terms of oncological outcomes, technical feasibilityand complexity, especially within the context of minimally invasive surgery.

关键词： Complete mesenteric excision Central vascular ligation Colorectal cancer Lymphadenectomy Laparoscopy minimally invasive surgery

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Quality of life after pancreatic surgery

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World Journal of Gastroenterology 2024年第8期30卷 943-955页

作者： Shi-Zhen Li Ting-Ting Zhen Yi Wu Min Wang Ting-Ting Qin Hang Zhang Ren-Yi Qin department of Biliary-Pancreatic surgery Affiliated Tongji HospitalTongji Medical CollegeHuazhong University of Science and TechnologyWuhan 430030Hubei ProvinceChina

BACKGROUND Pancreatic surgery is challenging owing to the anatomical characteristics of the *** attention has been paid to changes in quality of life(QOL)after pancreatic *** To summarize and analyze current research results on QOL after pancreatic *** A systematic search of the literature available on PubMed and EMBASE was performed in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses *** studies were identified by screening the references of retrieved *** on patients’QOL after pancreatic surgery published after January 1,2012,were *** included prospective and retrospective studies on patients'QOL after several types of pancreatic *** results of these primary studies were summarized *** A total of 45 articles were included in the study,of which 13 were related to pancreaticoduodenectomy(PD),seven to duodenum-preserving pancreatic head resection(DPPHR),nine to distal pancreatectomy(DP),two to central pancre-atectomy(CP),and 14 to total pancreatectomy(TP).Some studies showed that 3-6 months were needed for QOL recovery after PD,whereas others showed that 6-12 months was more *** TP and PD had similar influences on QOL,patients needed longer to recover to preoperative or baseline levels after *** QOL was better after DPPHR than ***,the superiority of the QOL between patients who underwent CP and PD remains *** decrease in exocrine and endocrine functions postoperatively was the main factor affecting the *** invasive surgery could improve patients’QOL in the early Core Tip:This review summarizes and analyzes current research results on quality of life(QOL)after pancreatic *** article covers the discussion and analysis of the QOL of various pancreatic *** kind of surgical procedure has better QOL is *** long-term benefits on QOL of minimally invasive su

关键词： Quality of life Pancreaticoduodenectomy Duodenum-preserving pancreatic head resection Distal pancreatectomy Central pancreatectomy Total pancreatectomy

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Management and Outcome of Urethral Strictures at Two Tertiary Health Facilities in Cameroon

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Open Journal of Urology 2024年第8期14卷 435-446页

作者： Martin Divine Mokake Divine Enoru Eyongeta Ekani Mahamat Ekani Diana Nunga Theophile Chunteng Nana Ntungwetape Ngwane Mwambo Nalova Elroy Patrick Weledji Chichom Alain Mefire Marcellin Ngowe Ngowe department of surgery and Specialties Faculty of Health Sciences University of Buea Buea Cameroon department of surgery Regional Hospital Buea Buea Cameroon department of surgery Regional Hospital Limbe Limbe Cameroon department of surgery Douala General Hospital Douala Cameroon

Introduction and Objectives: Urethral stricture is a reduction in the caliber of the urethral lumen impeding the outflow of urine. It predominantly affects males. The disease burden is severe in our milieu where access to specialized care is limited. Our goal was therefore to assess the management and outcome of male urethral stricture at two tertiary hospitals in Douala, Cameroon. Materials and Methods: This was a hospital-based retrospective study of patients managed for urethral stricture over 5 years (January 1st, 2017 to December 31st, 2021) at the Douala General and Laquintinie Hospitals. Data on sociodemographic, clinical, paraclinical, and treatment options were extracted using pre-structured forms. Data was analyzed using Statistical Package for Social Sciences (SPSS) version 28. Statistical significance was set at p-value Results: We exploited 130 medical records. The mean age of patients was 46.5 years. Dysuria and weak urine stream were the major presenting complaints (63.8% and 23.8% respectively). The etiology of urethral stricture was iatrogenic in 42.3% of cases. The strictures were mostly single (89.8%), and the bulbar urethra was most affected (46.9%). 28 patients had urinary tract infections and the most frequently isolated germ was E. coli in 29.6%. Direct visual internal urethrotomy (DVIU) was performed in 42.3% of cases. surgery, especially excision and primary anastomosis (EPA) was done in 28.5% of cases. Major complications were wound infection, acute kidney injury (AKI), and urethrocutaneous fistulae affecting 3.1, 2.3, and 1.5% of cases respectively. The recurrence rate was 17% with a mortality rate of 0.08%. Conclusion: Urethral stricture is common in our adult male population. The cause is mainly iatrogenic and the bulbar urethra is most affected. minimally invasive and open reconstruction are frequently used treatment options with significant recurrence rates in the long term.

关键词： Urethral Stricture Management Outcomes

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