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World Journal of Gastroenterology 2014年第42期20卷 15674-15681页

作者： Calogero Iacono Andrea Ruzzenente Luca Bortolasi Alfredo Guglielmi Department of surgery Division of General Surgery "A" Unit of Hepato-Biliary-Pancreatic Surgery University of Verona Medical School "GB Rossi" University Hospital

Central pancreatectomy(CP) is a parenchyma-sparing surgical procedure. The aims are to clarify the history and the development of CP and to give credits to those from whom it came. Ehrhardt, in 1908, described segmental neck resection(SNR) followed, in 1910, by Finney without reconstructive part. In 1950 Honjyo described two cases of SNR combined with gastrectomy for gastric cancer infiltrating the neck of the pancreas. Guillemin and Bessot(1957) and Letton and Wilson(1959) dealt only with the reconstructive aspect of CP. Dagradi and Serio, in 1982, performed the first CP including the resective and reconstructive aspects. Subsequently Iacono has validated it with functional endocrine and exocrine tests and popularized it worldwide. In 2003, Baca and Bokan performed laparoscopic CP and, In 2004, Giulianotti et al performed a robotic assisted CP. CP is performed worldwide either by open surgery or by using minimally-invasive or robotic approaches. This confirms that the operation does not belong to whom introduced it but to everyone who carries out it; however credit must be given to those from whom it came.

关键词： Pancreatic history Pancreatic surgery Central pancreatectomy Conservative pancreatectomy

Application of enhanced recovery after gastric cancer surgery: An updated meta-analysis

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World Journal of Gastroenterology 2018年第14期24卷 1562-1578页

作者： Liu-Hua Wang Ren-Fei Zhu Cheng Gao Shou-Lin Wang Li-Zong Shen division of Gastrointestinal surgery Department of General Surgery First Affiliated Hospital Nanjing Medical University Department of general surgery Yizheng People’s Hospital School of Public Health Nanjing Medical University

AIM To provide an updated assessment of the safety and efficacy of enhanced recovery after surgery(ERAS) protocols in elective gastric cancer(GC) *** Pub Med, Medline, EMBASE, World Health Organization International Trial Register, and Cochrane Library were searched up to June 2017 for all available randomized controlled trials(RCTs) comparing ERAS protocols and standard care(SC) in GC surgery. Thirteen RCTs, with a total of 1092 participants, were analyzed in this study, of whom 545 underwent ERAS protocols and 547 received SC *** No significant difference was observed between ERAS and control groups regarding total complications(P = 0.88), mortality(P = 0.50) and reoperation(P = 0.49). The incidence of pulmonary infection was significantly reduced(P = 0.03) following gastrectomy. However, the readmission rate after GC surgery nearly tripled under ERAS(P = 0.009). ERAS protocols significantly decreased the length of postoperative hospital stay(P < 0.00001) and medical costs(P < 0.00001), and accelerated bowel function recovery, as measured by earlier time to the first flatus(P = 0.0004) and the first defecation(P < 0.0001). Moreover, ERAS protocols were associated with a lower level of serum inflammatory response, higher serum albumin, and superior shortterm quality of life(QOL).CONCLUSION Collectively, ERAS results in accelerated convalescence, reduction of surgical stress and medical costs, improved nutritional status, and better QOL for GC patients. However, high-quality multicenter RCTs with large samples and long-term follow-up are needed to more precisely evaluate ERAS in radical gastrectomy.

关键词： Enhanced recovery after surgery Safety Gastric cancer Efficacy Meta-analysis

Perforated duodenal ulcer:An unusual manifestation of allergic eosinophilic gastroenteritis

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World Journal of Gastroenterology 2015年第44期21卷 12709-12712页

作者： Kevin M Riggle Ghassan Wahbeh Elizabeth M Williams Kimberly J Riehle Department of general surgery University of Washington Seattle division of Gastroenterology Seattle Children’s Hospital Seattle division of Pathology Seattle Children’s Hospital Seattle division of Pediatric general and Thoracic surgery Seattle Children’s Hospital

Spontaneous perforation of a duodenal ulcer secondary to allergic eosinophilic gastroenteritis(EGE) has not been previously reported. We present such a case in a teenager who presented with peritonitis. After exploration and operative repair of his ulcer, he continued to experience intermittent abdominal pain, and further evaluation revealed eosinophilic gastroenteritis in the setting of multiple food allergies. His EGE resolved after adhering to a restrictive diet. Both duodenal ulcers and EGE are very rarely seen in pediatric patients. EGE has a variable presentation depending on the layer(s) of bowel wall affected and the segment of the gastrointestinal tract that is involved. Once diagnosed, it may respond to dietary changes in patients with recognized food allergies, or to steroids in patients in whom an underlying cause is not identified. Our case highlights the need to keep EGE in the differential diagnosis when treating pediatric patients with duodenal ulcers. The epidemiology, pathophysiology, and treatment of EGE are also discussed, along with a review of the current literature.

关键词： Pediatric Duodenal ulcer Eosinophilic Gastroenteri

Diagnosis and management of glandular papilloma of lung:A case report

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World Journal of Clinical Cases 2020年第6期8卷 1104-1115页

作者： Chien-Wei Wu Ann Chen Tsai-Wang Huang Department of surgery Tri-Service General HospitalTaipei 114Taiwan Department of Pathology Tri-Service General HospitalTaipei 114Taiwan division of Thoracic surgery Department of SurgeryTri-Service General HospitalTaipei 114Taiwan

BACKGROUND Solitary respiratory papilloma is a rare epithelial tumor that can be categorizedinto multiple subtypes depending on tumor location,histological presentationand *** glandular type is the rarest,with only 30 cases available withinthe ***,information on its identification and treatment is *** thisreport,we discuss the diagnostic strategy and management of glandularpapilloma,along with a review of the *** SUMMARY We describe a male 44-year-old nonsmoker who presented with a persistentcough and recurrent pneumonia,which he had experienced for over 2 *** pulmonary nodule with an endobronchial lesion was found via computedtomography of the *** a biopsy was obtained,no definite diagnosiscould be *** papilloma of the lung was confirmed via videoassistedthoracoscopic anatomic resection of the right lower lobe of the *** remained disease-free after 6 mo follow *** Minimally invasive surgery is feasible for the surgical resection of endobronchialglandular *** rare,glandular papilloma should be consideredin patients with infection or endobronchial lesions.

关键词： Papilloma Lung Treatment Minimal invasive surgery Diagnosis Case report

Critical evaluation of contemporary management in a new Pelvic Exenteration Unit: The first 25 consecutive cases

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World Journal of Gastrointestinal Oncology 2017年第5期9卷 218-227页

作者： Min Hoe Chew Yu-Ting Yeh Ee-Lin Toh Stephen Aditya Sumarli Ghee Kheng Chew Lui Shiong Lee Mann Hong Tan Tiffany Priyanthi Hennedige Shin Yi Ng Say Kiat Lee Tze Tec Chong Hairil Rizal Abdullah Terence Lin Hon Goh Mohamed Zulfikar Rasheed Kok Chai Tan Choong Leong Tang Department of Colorectal surgery Singapore General Hospital Department of Obstetrics and Gynaecology Singapore General Hospital Department of Urology Singapore General Hospital Department of Orthopaedic surgery Singapore General Hospital division of Oncological Imaging National Cancer Centre Singapore Department of Anaesthesiology Singapore General Hospital Vascular surgery Singapore General Hospital Department of Plastic Reconstructive and Aesthetic SurgerySingapore General Hospital

To critically appraise short-term outcomes in patients treated in a new Pelvic Exenteration (PE) Unit. METHODSThis retrospective observational study was conducted by analysing prospectively collected data for the first 25 patients (16 males, 9 females) who underwent PE for advanced pelvic tumours in our PE Unit between January 2012 and October 2016. Data evaluated included age, co-morbidities, American Society of Anesthesiologists (ASA) score, Eastern Cooperative Oncology Group (ECOG) status, preoperative adjuvant treatment, intra-operative blood loss, procedural duration, perioperative adverse event, lengths of intensive care unit (ICU) stay and hospital stay, and oncological outcome. Quantitative data were summarized as percentage or median and range, and statistically assessed by the χ2 test or Fisher’s exact test, as applicable. RESULTSAll 25 patients received comprehensive preoperative assessment via our dedicated multidisciplinary team approach. Long-course neoadjuvant chemoradiotherapy was provided, if indicated. The median age of the patients was 61.9-year-old. The median ASA and ECOG scores were 2 and 0, respectively. The indications for PE were locally invasive rectal adenocarcinoma (n = 13), advanced colonic adenocarcinoma (n = 5), recurrent cervical carcinoma (n = 3) and malignant sacral chordoma (n = 3). The procedures comprised 10 total PEs, 4 anterior PEs, 7 posterior PEs and 4 isolated lateral PEs. The median follow-up period was 17.6 mo. The median operative time was 11.5 h. The median volume of blood loss was 3306 mL, and the median volume of red cell transfusion was 1475 mL. The median lengths of ICU stay and of hospital stay were 1 d and 21 d, respectively. There was no case of mortality related to surgery. There were a total of 20 surgical morbidities, which occurred in 12 patients. The majority of the complications were grade 2 Clavien-Dindo. Only 2 patients experienced grade 3 Clavien-Dindo complications, and both required procedura

关键词： Colorectal cancer Advanced pelvic tumour Sacrectomy Oncological outcome Pelvic exenteration Chordoma

Machine learning in solid organ transplantation:Charting the evolving landscape

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World Journal of Transplantation 2025年第1期15卷 165-177页

作者： Badi Rawashdeh Haneen Al-abdallat Emre Arpali Beje Thomas Ty B Dunn Matthew Cooper division of Transplant surgery Medical College of WisconsinMilwaukeeWI 53202United States Department of Medicine Jordan University HospitalAmman 11263Jordan Department of Nephrology Medical College of WisconsinMilwaukeeWI 53226United States

BACKGROUND Machine learning(ML),a major branch of artificial intelligence,has not only demonstrated the potential to significantly improve numerous sectors of healthcare but has also made significant contributions to the field of solid organ *** provides revolutionary opportunities in areas such as donorrecipient matching,post-transplant monitoring,and patient care by automatically analyzing large amounts of data,identifying patterns,and forecasting *** To conduct a comprehensive bibliometric analysis of publications on the use of ML in transplantation to understand current research trends and their *** On July 18,a thorough search strategy was used with the Web of Science *** and transplantation-related keywords were *** the aid of the VOS viewer application,the identified articles were subjected to bibliometric variable analysis in order to determine publication counts,citation counts,contributing countries,and institutions,among other *** Of the 529 articles that were first identified,427 were deemed relevant for bibliometric analysis.A surge in publications was observed over the last four years,especially after 2018,signifying growing interest in this *** 209 publications,the United States emerged as the top ***,the"Journal of Heart and Lung Transplantation"and the"American Journal of Transplantation"emerged as the leading journals,publishing the highest number of relevant *** keyword searches revealed that patient survival,mortality,outcomes,allocation,and risk assessment were significant themes of *** The growing body of pertinent publications highlights ML's growing presence in the field of solid organ *** bibliometric analysis highlights the growing importance of ML in transplant research and highlights its exciting potential to change medical practices and enhance patient *** collaboration between signific

关键词： Machine learning Artificial Intelligence Solid organ transplantation Bibliometric analysis

surgery for metastatic pancreatic neuroendocrine tumors: a narrative review

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Hepatobiliary surgery and Nutrition 2023年第1期12卷 69-83页

作者： Jelani K.Williams Jason L.Schwarz Xavier M.Keutgen division of general surgery and Surgical Oncology Department of SurgeryUniversity of Chicago MedicineChicagoILUSA

Background and Objective:Pancreatic neuroendocrine tumors(PanNETs)are derived from the islet cells of the pancreas and have been increasing in *** of these tumors are nonfunctional although some can secrete hormones and lead to hormone-specific clinical *** is the mainstay of treatment for localized tumors,however,surgical resection is controversial in metastatic *** narrative review seeks to summarize the current literature surrounding surgery,specifically in the controversial area of metastatic PanNETs,review current treatment paradigms,and understand the benefits of surgery in this group of ***:Authors searched PubMed using the terms“surgery pancreatic neuroendocrine tumor”,“metastatic neuroendocrine tumor”,and“liver debulking neuroendocrine tumor”from January 1990 to June *** English language publications were *** Content and Findings:There is no consensus among the leading specialty organizations regarding surgery for metastatic *** considering surgery for metastatic PanNETs,tumor grade and morphology,location of the primary tumor,extra-hepatic or extra-abdominal disease,as well as liver tumor burden and metastatic distribution should be *** the liver is the most common site of metastasis and liver failure is the most common cause of death in patients with hepatic metastases,attention is centered here on debulking and other ablative *** transplantation is rarely used for hepatic metastases but could be beneficial in a small subset of *** studies have demonstrated improvement in survival and symptoms after surgery for metastatic disease,but the lack of prospective randomized control trials significantly limits analysis of surgical benefits in patients with metastatic ***:surgery is the standard of care for localized PanNETs,while it remains controversial in metastatic *** studies have shown a survival and symptomatic be

关键词： Pancreatic neuroendocrine tumors(PanNETs) liver tumor burden hepatic metastasis liver debulking DOTATATE

Relationship between intralobar pulmonary sequestration and type A aortic dissection:A case report

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World Journal of Clinical Cases 2023年第15期11卷 3658-3663页

作者： Yi-Jie Wang Ying-Yi Chen Gang-Hua Lin Department of surgery Tri Service General HospitalNational Defense Medical CenterTaipei 114Taiwan division of Thoracic surgery Department of SurgeryTri-Service General HospitalNational Defense Medical CenterTaipei 114Taiwan division of general surgery Department of SurgeryTri-Service General HospitalNational Defense Medical CenterTaipei 114Taiwan

BACKGROUND Pulmonary sequestrations often lead to serious complications such as infections,tuberculosis,fatal hemoptysis,cardiovascular problems,and even malignant degeneration,but it is rarely documented with medium and large vessel vasculitis,which is likely to result in acute aortic *** SUMMARY A 44-year-old man with a history of acute Stanford type A aortic dissection status post-reconstructive surgery five years *** contrast-enhanced computed tomography of the chest at that time had also revealed an intralobar pulmonary sequestration in the left lower lung region,and the angiography also presented perivascular changes with mild mural thickening and wall enhancement,which indicated mild *** intralobar pulmonary sequestration in the left lower lung region was long-term unprocessed,which was probably associated with his intermittent chest tightness since no specific medical findings were detected but only positive sputum culture with mycobacterium avium-intracellular complex and *** performed uniportal video-assisted thoracoscopic surgery with wedge resection of the left lower *** over the parietal pleura,engorgement of the bronchus due to a moderate amount of mucus,and firm adhesion of the lesion to the thoracic aorta were histopathologically *** We hypothesized that a long-term pulmonary sequestration-related bacterial or fungal infection can result in focal infectious aortitis gradually,which may threateningly aggravate the formation of aortic dissection.

关键词： Intralobar pulmonary sequestration Acute aortic dissection Medium and large vessel vasculitis Infection Case report

Repair of a giant inguinoscrotal hernia with herniation of the ileum and sigmoid colon:A case report

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World Journal of Clinical Cases 2023年第2期11卷 401-407页

作者： Shih-Hung Liu Ching-Hen Yen Hsu-Ping Tseng Je-Ming Hu Ching-Han Chang Ta-Wei Pu Department of surgery Tri-Service General HospitalNational Defense Medical CenterTaipei 11490Taiwan division of Urological surgery Department of SurgerySongshan BranchTri-Service General HospitalNational Defense Medical CenterTaipei 10581Taiwan division of Colon and Rectal surgery Department of SurgeryTri-Service General HospitalNational Defense Medical CenterTaipei 11490Taiwan Department of surgery Kaohsiung Armed Forces General HospitalKaohsiung 802Taiwan division of Colon and Rectal surgery Department of SurgerySongshan BranchTri-Service General HospitalNational Defense Medical CenterTaipei 10581Taiwan

BACKGROUND Giant inguinoscrotal hernias are huge inguinal hernias that extend below the midpoint of the inner thigh in the standing *** inguinoscrotal hernias are rare in developed countries because of their better medical resources and early ***,they can develop in patients who refuse surgery or ignore their *** is inevitable because strangulation and organ perforation can occur,leading to peritonitis and *** surgical approaches include open abdominal and inguinal approaches or a combination of *** SUMMARY We present the case of a 73-year-old man who visited our emergency department with a huge mass in his left scrotum and septic *** computed tomography revealed a large left inguinoscrotal hernia that contained small bowel loops and the *** surgical intervention was performed immediately because intestinal strangulation was highly *** operative repair was performed using a combination of mini-exploratory laparotomy and the inguinal *** incarcerated organs,which included the ileum and sigmoid colon,had relatively good intestinal perfusion without perforation or ischemic *** were successfully reduced into the abdomen,and bowel resection was not necessary.A tension-free prosthetic mesh was used for the hernia *** weeks after the initial surgery,and with adequate antimicrobial therapy,the patient recovered and was discharged from our *** evidence of hernia relapse was noted during the outpatient follow-up examination 3 mo after *** Emergency surgery involving combined mini-exploratory laparotomy and the inguinal approach should be performed for serious incarcerated giant inguinoscrotal hernias.

关键词： Inguinal hernia Ileum Sigmoid colon Sepsis Hernia repair Case report

Development of minimally invasive techniques for management of medically-complicated obesity

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World Journal of Gastroenterology 2014年第37期20卷 13424-13445页

作者： Farzin Rashti Ekta Gupta Suzan Ebrahimi Timothy R Shope Timothy R Koch Christopher J Gostout Section of Gastroenterology and Hepatology MedStar-Washington Hospital Center and Georgetown University Schoolof Medicine Department of surgery MedStar-Washington Hospital CenterCenter for Advanced Laparoscopic and Bariatric Surgery division of Gastroenterology and Hepatology Mayo Medical School

The field of bariatric surgery has been rapidly growing and evolving over the past several decades. During the period that obesity has become a worldwide epidemic, new interventions have been developed to combat this complex disorder. The development of new laparoscopic and minimally invasive treatments for medically-complicated obesity has made it essential that gastrointestinal physicians obtain a thorough understanding of past developments and possible future directions in bariatrics. New laparoscopic advancements provide patients and practitioners with a variety of options that have an improved safety profile and better efficacy without open, invasive surgery. The mechanisms of weight loss after bariatric surgery are complex and may in part be related to altered release of regulatory peptide hormones from the gut. Endoscopic techniques designed to mimic the effects of bariatric surgery and endolumenal inter-ventions performed entirely through the gastrointestinal tract offer potential advantages. Several of these new techniques have demonstrated promising, preliminary results. We outline herein historical and current trends in the development of bariatric surgery and its transition to safer and more minimally invasive procedures designed to induce weight loss.

关键词： Obesity bariatrics bariatric surgery Weight loss Endoscopy