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Artificial intelligence in the diagnosis and management of colorectal cancer liver metastases

World Journal of Gastroenterology 2022年第1期28卷 108-122页

作者： Gianluca Rompianesi Francesca Pegoraro Carlo DL Ceresa Roberto Montalti Roberto Ivan Troisi division of Hepato-Bilio-Pancreatic Minimally Invasive and Robotic SurgeryDepartment of Clinical Medicine and SurgeryFederico II University HospitalNaples 80125Italy Department of Hepato-Pancreato-Biliary surgery Oxford University Hospitals NHS Foundation TrustOxford OX39ESUnited Kingdom division of Hepato-Bilio-Pancreatic Minimally Invasive and Robotic SurgeryDepartment of Public HealthFederico II University HospitalNaples 80125Italy

Colorectal cancer(CRC)is the third most common malignancy worldwide,with approximately 50%of patients developing colorectal cancer liver metastasis(CRLM)during the follow-up *** of CRLM is best achieved via a multidisciplinary approach and the diagnostic and therapeutic decision-making process is *** order to optimize patients’survival and quality of life,there are several unsolved challenges which must be *** primarily include a timely diagnosis and the identification of reliable prognostic ***,to allow optimal treatment options,a precision-medicine,personalized approach is *** widespread digitalization of healthcare generates a vast amount of data and together with accessible high-performance computing,artificial intelligence(AI)technologies can be *** increasing diagnostic accuracy,reducing timings and costs,the application of AI could help mitigate the current shortcomings in CRLM *** this review we explore the available evidence of the possible role of AI in all phases of the CRLM natural *** analysis and convolutional neural networks(CNN)which combine computed tomography(CT)images with clinical data have been developed to predict CRLM development in CRC *** models have also proven themselves to perform similarly or better than expert radiologists in detecting CRLM on CT and magnetic resonance scans or identifying them from the noninvasive analysis of patients’exhaled *** application of AI and machine learning(ML)in diagnosing CRLM has also been extended to histopathological examination in order to rapidly and accurately identify CRLM tissue and its different histopathological growth *** and CNN have shown good accuracy in predicting response to chemotherapy,early local tumor progression after ablation treatment,and patient survival after surgical treatment or *** the initial enthusiasm and the accumulating evidence,AI technologies’role i

关键词： Colorectal cancer Liver metastases Artificial intelligence Machine learning Deep learning Neural networks Radiomics

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Sengstaken-Blakemore tubes:a rescue system during liver transplantation

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Hepatobiliary surgery and Nutrition 2022年第1期11卷 171-172页

作者： Antonio Cubisino Fabrizio Panaro division of General Minimally Invasive and Robotic SurgeryUniversity of Illinois at ChicagoChicagoILUSA division of HBP surgery and Transplantation Department of SurgeryHôpital Saint EloiCHU-MontpellierMontpellierFrance

A 52-year-old woman has undergone liver transplantation(LT)owing to fulminant viral hepatitis,MELD *** first cadaveric graft allocated was a large-for-size *** was performed with a piggyback side-to-side cavocaval *** the end of the procedure,the removal of the abdominal retractor produced,due to a narrow ribcage,a caval compression with liver congestion because of a reduced caval outflow.

关键词： liver anastomosis graft

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Screening pre-bariatric surgery patients for esophageal disease with esophageal capsule endoscopy

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World Journal of Gastroenterology 2013年第37期19卷 6188-6192页

作者： Ashish Shah Erica Boettcher Marianne Fahmy Thomas Savides Santiago Horgan Garth R Jacobsen Bryan J Sandler Michael Sedrak Denise Kalmaz Department of Gastroenterology University of California San Diego Department of minimally invasive surgery University of California San Diego

AIM:To determine if esophageal capsule endoscopy(ECE)is an adequate diagnostic alternative to esophagogastroduodenoscopy(EGD)in pre-bariatric surgery ***:We conducted a prospective pilot study to assess the diagnostic accuracy of ECE(PillCam ESO2,Given Imaging)vs conventional EGD in pre-bariatric surgery *** who were scheduled for bariatric surgery and referred for pre-operative EGD were prospectively *** patients underwent ECE followed by standard *** experienced gastroenterologists blinded to the patient’s history and the findings of the EGD reviewed the ECE and documented their *** gold standard was the findings on ***:Ten patients with an average body mass index of 50 kg/m2were enrolled and completed the *** identified 11 of 14(79%)positive esophageal/gastroesophageal junction(GEJ)findings and 14of 17(82%)combined esophageal and gastric findings identified on ***’s exact test was used to compare the findings and no significant difference was found between ECE and EGD(P=0.64 for esophageal/GEJ and P=0.66 for combined esophageal and gastric findings respectively).Of the positive esophageal/GEJ findings,ECE failed to identify the following:hiatal hernia in two patients,mild esophagitis in two patients,and mild Schatzki ring in two *** was able to identify the entire esophagus in 100%,gastric cardia in0%,gastric body in 100%,gastric antrum in 70%,pylorus in 60%,and duodenum in 0%.CONCLUSION:There were no significant differences in the likelihood of identifying a positive finding using ECE compared with EGD in preoperative evaluation of bariatric patients.

关键词： Capsule endoscopy bariatric Moderate sedation Esophagogastroduodenoscopy Esophageal capsule endoscopy

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Liver transplantation and sleeve gastrectomy in the medically complicated obese: New challenges on the horizon

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World Journal of Hepatology 2015年第21期7卷 2315-2318页

作者： Diego C Reino Keri E Weigle Erik P Dutson Adam S Bodzin Keri E Lunsford Ronald W Busuttil division of Liver and Pancreas Transplantation Department of Surgery University of California Los Angeles division of minimally invasive and bariatric surgery Department of Surgery University of California Los Angeles

In the last 30 years, operative, technical and medical advances have made liver transplantation(LT) a lifesaving therapy that is used worldwide today. Global industrialization has been a contributor to morbid obesity and this has brought about the metabolic syndrome along with many downstream complications of such. Non-alcoholic steatohepatitis(NASH) has become a recognized hepatic manifestation of the metabolic syndrome and NASH cirrhosis is predicted to be the primary indication for LT in the United States by 2025. Several case series and database reviews have begun analyzing the efficacy of weight reduction surgery in the LT recipient. These data have reasonably demonstrated that weight reduction surgery in the LT recipient is a feasible endeavor. However, several questions have been raised regarding the type of weight reduction surgery, timing of surgery in relation to LT, patient and allograft survival and post-LT maintenance of weight loss to name a few. We look forward to a time when weight reduction surgery will work to improve the technical conduct of LT, improve perioperative benchmarks such as blood transfusions, intensive care unit length of stay and help to prevent recurrence of NASH cirrhosis in the medically complicated obese patient. In the meantime, well-designed prospective clinical trials that focus on the issues highlighted will help guide us in the care of these complicated patients who will soon account for the majority of the patients in our clinics.

关键词： Non-alcoholic steatohepatitis cirrhosis Liver tran

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Outcomes of robotic vs laparoscopic hepatectomy:A systematic review and meta-analysis

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World Journal of Gastroenterology 2015年第27期21卷 8441-8451页

作者： Roberto Montalti Giammauro Berardi Alberto Patriti Marco Vivarelli Roberto Ivan Troisi Department of General and Hepato-Biliary surgery Liver Transplantation Service Ghent University Hospital and Medical School Department of Gastroenterology and Transplantation surgery Polytechnic University of Marche-Ospedali Riuniti division of General Minimally Invasive and Robotic Surgery General Hospital of Spoleto

AIM: To perform a systematic review and metaanalysis on robotic-assisted vs laparoscopic liver ***: A systematic literature search was performed using Pub Med, Scopus and the Cochrane Library Central. Participants of any age and sex, who underwent robotic or laparoscopic liver resection were considered following these criteria:(1) studies comparing robotic and laparoscopic liver resection;(2) studies reporting at least one perioperative outcome; and(3) if more than one study was reported by the same institute, only the most recent was included. The primary outcome measures were set for estimated blood loss, operative time, conversion rate, R1 resection rate, morbidity and mortality rates, hospital stay and major hepatectomy ***: A total of 7 articles, published between 2010 and 2014, fulfilled the selection criteria. The laparoscopic approach was associated with a significant reduction in blood loss and lower operative time(MD = 83.96, 95%CI: 10.51-157.41, P = 0.03; MD = 68.43, 95%CI: 39.22-97.65, P < 0.00001, respectively). No differences were found with respect to conversion rate, R1 resection rate, morbidity and hospital ***: Laparoscopic liver resection resulted in reduced blood loss and shorter surgical times compared to robotic liver resections. There was no difference in conversion rate, R1 resection rate, morbidity and length of postoperative stay.

关键词： Laparoscopic liver resections Robotic liverresections Outcome Systematic review Meta-analysis

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Conduit necrosis following esophagectomy: An up-to-date literature review

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World Journal of Gastrointestinal surgery 2019年第3期11卷 155-168页

作者： Antonios Athanasiou Mairead Hennessy Eleftherios Spartalis Benjamin H L Tan Ewen A Griffiths Department of Upper GI Bariatric and Minimally Invasive Surgery St.James' University Hospital Leeds Teaching Hospitals NHS Trust Department of Anaesthesia University Hospital of Waterford Laboratory of Experimental surgery and Surgical Research University of Athens Medical School Department of Upper Gastrointestinal surgery University Hospitals Birmingham NHS Foundation Trust

Esophageal conduit ischaemia and necrosis is an uncommon but devastating complication of esophagectomy and remains one of the most challenging issues in surgical practice. The incidence, time interval to develop symptoms, and clinical presentation are highly variable with no predictable pattern. Evidence comes from case reports and case series rather than randomized controlled *** describe the issues surrounding conduit necrosis affecting the stomach,jejunum and colon as an esophageal replacement and the advantages,disadvantages and challenges of each type of reconstruction. Diagnosis is challenging for the most experienced surgeon. Upper gastrointestinal endoscopy and computed tomography thorax with both oral and intravenous contrast is the gold standard. Management, either conservative or interventional is also a difficult decision. Management options include conservative treatment and more aggressive treatments such as stent insertion, surgical debridement and repair of the esophagus using jejunum, colon or a musculocutaneous flap. In spite of recent advances in surgical techniques, there is no reliable strategy to manage esophageal conduit necrosis. Our review covers the pathophysiology and clinical significance of esophageal necrosis while highlighting current techniques of prevention, diagnosis and treatment of this life-threatening condition.

关键词： Esophagectomy Esophageal cancers Esophagogastric anastomosis

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Review of 500 single incision laparoscopic colorectalsurgery cases-Lessons learned

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World Journal of Gastroenterology 2016年第2期22卷 659-667页

作者： Deborah S Keller Juan R Flores-Gonzalez Sergio Ibarra Eric M Haas Colorectal Surgical Associates HoustonTX 77054United States division of Colon and Rectal surgery Houston Methodist HospitalThe University of Texas Medical School at HoustonHoustonTX 77054United States division of minimally invasive surgery Department of SurgeryThe University of Texas Medical School at HoustonHoustonTX 77054United States

Single incision laparoscopic surgery(SILS) is a minimally invasive platform with specific benefits over traditional multiport laparoscopic surgery. The safety and feasibility of SILS has been proven, and the applications continue to grow with experience. After 500 cases at a high-volume, single-institution, we were able to standardize instrumentation and operative steps, as well as develop adaptations in technique to help overcome technical and ergonomic challenges. These technical adaptations have allowed the successful application of SILS to technically difficult patient populations, such as pelvic cases, inflammatory bowel disease cases, and high body mass index patients. This review is a frame of reference for the application and wider integration of the single incision laparoscopic platform in colorectal surgery.

关键词： Laparoscopic colectomy minimally invasivecolorectal surgery Single-incision laparoscopic surgery

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Systematic review of diagnostic tools for peritoneal metastasis in gastric cancer-staging laparoscopy and its alternatives

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World Journal of Gastrointestinal surgery 2023年第10期15卷 2280-2293页

作者： Si Ying Adelina Ho Kon Voi Tay Lee Kong Chian School of Medicine Singapore 308232Singapore Upper GI and bariatric division General SurgeryTan Tock Seng HospitalSingapore 308433Singapore Upper GI and bariatric division General SurgeryWoodlands HealthSingapore 768024Singapore

BACKGROUND Gastric cancer is one of the leading causes of cancer burden and mortality,often resulting in peritoneal metastasis in advanced stages with negative survival *** laparoscopy has become standard practice for suspected cases before a definitive gastrectomy or *** systematic review aims to compare the efficacy of other diagnostic modalities instead of staging laparoscopy as the alternatives are able to reduce cost and invasive staging ***,a radiomic model based on computed tomography and positron emission tomography(PET)has also emerged as another method to predict peritoneal *** To determine if the efficacy of computed tomography,magnetic resonance imaging and PET is comparable with staging *** Articles comparing computed tomography,PET,magnetic resonance imaging,and radiomic models based on computed tomography and PET to staging laparoscopies were filtered out from the Cochrane Library,EMBASE,PubMed,Web of Science,and Reference Citations Analysis(https://***/).In the search for studies comparing computed tomography(CT)to staging laparoscopy,five retrospective studies and three prospective studies were ***,five retrospective studies and two prospective studies were also included for papers comparing CT to PET *** one retrospective study and one prospective study were found to be suitable for papers comparing CT to magnetic resonance imaging *** Staging laparoscopy outperformed computed tomography in all measured aspects,namely sensitivity,specificity,positive predictive value and negative predictive *** resonance imaging and PET produced mixed results,with the former shown to be only marginally better than computed *** performed slightly better than PET in most measured domains,except in specificity and true negative *** speculate that this may be due to the limited F-fluorodeoxyglucose uptake in small peri

关键词： Gastric cancer Peritoneal metastases Computed tomography Positron emission tomography Magnetic resonance imaging Staging laparoscopy

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Resolution of acute gastroenteritis symptoms in children and adults treated with a novel polyphenol-based prebiotic

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World Journal of Gastroenterology 2014年第34期20卷 12301-12307页

作者： Telma Noguera Robert Wotring Chris R Melville Kara Hargraves Jochen Kumm John M Morton Instituto Centroamericano de Investigación Clínica Managua 050-008-4Nicaragua Greenteaspoon Inc StanfordCA 94305United States Department of Biology Stanford UniversityStanfordCA 94305United States bariatric and minimally invasive surgery Stanford School of MedicineStanfordCA 94305United States

AIM: To test efficacy and durability of a polyphenol-based prebiotic treatment for acute gastroenteritis in a 300 patient double-blinded clinical study.

关键词： Prebiotic Gastroenteritis Diarrhea Rotavirus Infant Mortality Dehydration Heartburn Polyphenol Aliva Greenteaspoon

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Endoluminal surgery

Endoluminal Surgery

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第五届中国中西医结合围手术期医学研讨会

作者： Bradley J.Needleman FACS Associate Professor of surgery Director Bariatric Surgery Program Center for Minimally Invasive Surgery The Ohio State University

Endoluminal surgery·Operating within the lumen -Gastric operations·GERD·bariatric·Other-pancreatic pseudocysts -Transgastric operations·NOTES

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