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Hepatobiliary & Pancreatic Diseases International 2022年第4期21卷 387-391页

作者： Mario Spaggiari Kiara A Tulla Gabriela Aguiluz Pierpaolo Di Cocco Lola Castro Gil Enrico Benedetti Ivo G Tzvetanov Pier Cristoforo Giulianotti division of Transplantation Department of SurgeryUniversity of Illinois at ChicagoChicagoILUSA division of General Minimally Invasiveand Robotic SurgeryDepartment of SurgeryUniversity of Illinois at ChicagoChicagoILUSA

Surgical resection remains the only definitive treatment for colorectal liver metastasis(CRLM). However, only a minority of cases are deemed resectable at the time of diagnosis. Systemic chemotherapy along with hepatic artery infusion(HAI) is an effective and safe regional chemotherapy modality for the downstaging of patients with isolated unresectable CRLM [1].

关键词： chemotherapy liver artery treatment metastasis

Is fascial closure required for a 12-mm trocar?A comparative study on trocar site hernia with long-term follow up

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World Journal of Clinical Cases 2023年第2期11卷 357-365页

作者： Santi Krittiyanitsakun Chawisa Nampoolsuksan Thikhamporn Tawantanakorn Tharathorn Suwatthanarak Nicha Srisuworanan Voraboot Taweerutchana Thammawat Parakonthun Chainarong Phalanusitthepha Jirawat Swangsri Thawatchai Akaraviputh Asada Methasate Vitoon Chinswangwatanakul Atthaphorn Trakarnsanga minimally invasive Surgery Unit Department of SurgeryFaculty of Medicine Siriraj HospitalMahidol UniversityBangkok 10700Thailand

BACKGROUND Despite the infrequency of trocar site hernias(TSHs),fascial closure continues to be recommended for their prevention when using a≥10-mm trocar.AIM To identify the necessity of fascial closure for a 12-mm nonbladed trocar incision in minimally invasive colorectal surgeries.METHODS Between July 2010 and December 2018,all patients who underwent minimally invasive colorectal surgery at the minimally invasive Surgery Unit of Siriraj Hospital were retrospectively reviewed.All patients underwent cross-sectional imaging for TSH assessment.Clinicopathological characteristics were recorded.Incidence rates of TSH and postoperative results were analyzed.RESULTS Of the 254 patients included,70(111 ports)were in the fascial closure(closed)group and 184(279 ports)were in the nonfascial closure(open)group.The median follow up duration was 43 mo.During follow up,three patients in the open group developed TSHs,whereas none in the closed group developed the condition(1.1%vs 0%,P=0.561).All TSHs occurred in the right lower abdomen.Patients whose drains were placed through the same incision had higher rates of TSHs compared with those without the drain.The open group had a significantly shorter operative time and lower blood loss than the closed group.CONCLUSION Routine performance of fascial closure when using a 12-mm nonbladed trocar may not be needed.However,further prospective studies with cross-sectional imaging follow-up and larger sample size are needed to confirm this finding.

关键词： Trocar site hernia Port site hernia Fascial closure Laparoscopic colorectal surgery Nonbladed trocar

Benefits of minimally invasive surgery in the treatment of gastric cancer

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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 procedures.The 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 cancer.According 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 survival.The robotic approach to gastric cancer surgery aims to overcome the difficulties and technical limitations of laparoscopy in major surgery.The 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 surgery.If 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

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

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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 period.Management of CRLM is best achieved via a multidisciplinary approach and the diagnostic and therapeutic decision-making process is complex.In order to optimize patients’survival and quality of life,there are several unsolved challenges which must be overcome.These primarily include a timely diagnosis and the identification of reliable prognostic factors.Furthermore,to allow optimal treatment options,a precision-medicine,personalized approach is required.The widespread digitalization of healthcare generates a vast amount of data and together with accessible high-performance computing,artificial intelligence(AI)technologies can be applied.By increasing diagnostic accuracy,reducing timings and costs,the application of AI could help mitigate the current shortcomings in CRLM management.In this review we explore the available evidence of the possible role of AI in all phases of the CRLM natural history.Radiomics analysis and convolutional neural networks(CNN)which combine computed tomography(CT)images with clinical data have been developed to predict CRLM development in CRC patients.AI 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 air.The 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 patterns.ML 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 chemotherapy.Despite the initial enthusiasm and the accumulating evidence,AI technologies’role in healthcare and CRLM management is not yet full

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

纳米材料助力合成生物学的生物医学应用（英文）

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Science China Materials 2024年

作者：雷琪赵一帆刘双语肖雅方杨芳郭伟圣顾宁 Department of minimally invasive Interventional Radiology School of Biomedical Engineering & The Second Affiliated Hospital Guangzhou Medical University State Key Laboratory of Digital Medical Engineering Jiangsu Key Laboratory for Biomaterials and Devices School of Biological Science and Medical Engineering Southeast University Cardiovascular Disease Research Center Nanjing Drum Tower Hospital Affiliated Hospital of Medical School Medical School Nanjing University

合成生物学是借助基因工具改造活细胞和生物体的学科,其经历了蓬勃发展阶段,在生物医学领域得到广泛应用,包括新型生物传感器和生物材料设计,以及最新临床治疗药物和疫苗的开发.纳米材料具有独特的物理、化学和生物特性,在拓展合成生物...

合成生物学是借助基因工具改造活细胞和生物体的学科,其经历了蓬勃发展阶段,在生物医学领域得到广泛应用,包括新型生物传感器和生物材料设计,以及最新临床治疗药物和疫苗的开发.纳米材料具有独特的物理、化学和生物特性,在拓展合成生物学的生物医学应用场景上具有巨大的潜力,可以提高治疗剂的生产效率,并增强改造生物体的功能.在此,我们简要概述了纳米材料应用于合成生物学领域的最新进展,主要涵盖纳米材料作为递送载体、信号转导器和功能增强剂的角色及其制备过程和性能特点.本综述首先强调了纳米材料作为基因载体的最新成果,包括有机、无机和仿生递送系统;其次,回顾了纳米材料介导的刺激响应型基因表达调控的研究;第三,总结了在可编程的杂化生物活性材料方面的开创性工作,包括纳米材料/细菌杂合系统和纳米材料/哺乳动物细胞杂合系统;最后,讨论了该领域当前面临的挑战,并从个人观点展望了未来的发展前景.

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Comment on:“Completion pancreatectomy or a pancreas-preserving procedure during relaparotomy for pancreatic fistula after pancreatoduodenectomy:a multicentre cohort study and meta-analysis”

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Hepatobiliary Surgery and Nutrition 2022年第1期11卷 94-96页

作者： Régis Souche Jean-Michel Fabre Department of Oncologic and minimally invasive Digestive Surgery Hospital Saint EloiUniversity Hospital of MontpellierMontpellierFrance

We read with great interest the recently published article of Groen et al.from the Dutch Pancreatic Cancer Group(1)appeared on British Journal of Surgery.The authors compared salvage completion pancreatectomy with a pancreas-preserving procedure in patients undergoing relaparotomy for severe pancreatic fistula after pancreatoduodenectomy(PD).This retrospective multi center cohort study included patients who underwent relaparotomy for pancreatic fistula after PD from 2005-2018 and provided a systematic review with a meta-analysis on postoperative death.In the literature,large retrospective studies dedicated to this question are rare and no randomized study is available to date.

关键词： pancreas fistula

The application of indocyanine green in guiding prostate cancer treatment

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Asian Journal of Urology 2023年第1期10卷 1-8页

作者： Donghua Xie Di Gu Ming Lei Cong Cai Wen Zhong Defeng Qi Wenqi Wu Guohua Zeng Yongda Liu Department of Urology Minimally Invasive Surgery CenterThe First Affiliated Hospital of Guangzhou Medical UniversityGuangdong Key Laboratory of UrologyGuangzhouChina

Objective:Indocyanine green(ICG)with near-infrared fluorescence absorption is approved by the United States Food and Drug Administration for clinical applications in angiography,blood flow evaluation,and liver function assessment.It has strong optical absorption in the near-infrared region,where light can penetrate deepest into biological tissue.We sought to review its value in guiding prostate cancer treatment.Methods:All related literature at PubMed from January 2000 to December 2020 were reviewed.Results:Multiple preclinical studies have demonstrated the usefulness of ICG in identifying prostate cancer by using different engineering techniques.Clinical studies have demonstrated the usefulness of ICG in guiding sentinel node dissection during radical prostatectomy,and possible better preservation of neurovascular bundle by identifying landmark prostatic arteries.New techniques such as adding fluorescein in additional to ICG were tested in a limited number of patients with encouraging result.In addition,the use of the ICG was shown to be safe.Even though there are encouraging results,it does not carry sufficient sensitivity and specificity in replacing extended pelvic lymph node dissection during radical prostatectomy.Conclusion:Multiple preclinical and clinical studies have shown the usefulness of ICG in identifying and guiding treatment for prostate cancer.Larger randomized prospective studies are warranted to further test its usefulness and find new modified approaches.

关键词： Indocyanine green Intraoperative imaging Prostate cancer Sentinel lymph node dissection Neurovascular bundle

Effect of hepatic artery resection and reconstruction on the prognosis of patients with advanced hilar cholangiocarcinoma

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World Journal of Gastrointestinal Oncology 2022年第4期14卷 887-896页

作者： Yuan-Ming Li Zhi-Xin Bie Run-Qi Guo Bin Li Cheng-En Wang Fei Yan minimally invasive Tumor Therapies Center Beijing HospitalNational Center of GerontologyInstitute of Geriatric MedicineChinese Academy of Medical SciencesBeijing 100730China

BACKGROUND Hilar cholangiocarcinoma(HC)is a good adaptation certificate of hepatic arterectomy,and hepatic arterectomy is conductive to the radical resection of cholangiocarcinoma,which simplifies the operation and helps with a combined resection of the peripheral portal tissue.With continuous development of surgical techniques,especially microsurgical technique,vascular invasion is no longer a contraindication to surgery in the past 10 years.However,hepatic artery reconstruction after hepatic arterectomy has been performed to treat liver tumor in many centers with better results,but it is rarely applied in advanced HC.AIM To determine the prognosis of patients with advanced HC after hepatic artery resection and reconstruction.METHODS A total of 98 patients with HC who underwent radical operation in our hospital were selected for this retrospective analysis.According to whether the patients underwent hepatic artery resection and reconstruction or not,they were divided into reconstruction(n=40)and control(n=58)groups.The traumatic indices,surgical resection margin,liver function tests before and after the operation,and surgical complications were compared between the two groups.RESULTS Operation time,blood loss,hospital stay,and gastrointestinal function recovery time were higher in the reconstruction group than in the control group(P0.05),but was higher in the reconstruction group(P0.05).Two-year survival rate(42.50%vs 39.66%)and two-year survival time(22.0 mo vs 23.0 mo)were similar between the groups(P>0.05).CONCLU

关键词： Advanced stage Hilar cholangiocarcinoma Hepatic artery resection Reconstruction Radical surgery

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 42.The first cadaveric graft allocated was a large-for-size graft.LT was performed with a piggyback side-to-side cavocaval anastomosis.At 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

Sustained release of hydrogen sulfide from anisotropic ferrofluid hydrogel for the repair of spinal cord injury

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Bioactive Materials 2023年第5期23卷 118-128页

作者： Ruofei Wang Xia-Xiao Wu Zhenming Tian Tian Hu Chaoyang Cai Guan-Ping Wu Gang-Biao Jiang Bin Liu Department of Spine Surgery The Third Affiliated Hospital of Sun Yat-Sen UniversityGuangzhou510630China Guangdong Provincial Center for Quality Control of minimally invasive Spine Surgery Guangzhou510630China Guangdong Provincial Center for Engineering and Technology Research of minimally invasive Spine Surgery Guangzhou510630China Key Laboratory for Biobased Materials and Energy of Ministry of Education College of Materials and EnergySouth China Agricultural UniversityGuangzhou510642China

Spinal cord injury(SCI)results in massive neuronal death,axonal disruption,and cascading inflammatory response,which causes further damage to impaired neurons.The survived neurons with damaged function fail to form effective neuronal circuits.It is mainly caused by the neuroinflammatory microenvironment at injury sites and regenerated axons without guidance.To address this challenge,a ferrofluid hydrogel(FFH)was prepared with Ferric tetrasulfide(Fe3S4),carboxymethyl chitosan,and gold.Its internal structural particles can be oriented in a magnetic field to acquire anisotropy.Moreover,Fe3S4 can release hydrogen sulfide(H2S)with anti-inflammatory effects under acidic conditions.Regarding in vitro experiments,0.01g/ml Fe3S4 FFH significantly reduced the inflammatory factors produced by LPS-induced BV2 cells.Oriented and longer axons of the induced neural stem cells loaded on anisotropic FFH were observed.In vivo experiments showed that FFH reduced the activated microglia/macrophage and the expression of pro-inflammatory factors in SCI rats through the NF-κB pathway.Moreover,it significantly promoted directional axonal regrowth and functional recovery after SCI.Given the critical role of inhibition of neuroinflammation and directional axonal growth,anisotropic Fe3S4 FFH is a promising alternative for the treatment of SCI.

关键词： Spinal cord injury Anisotropic Ferrofluid Hydrogen sulfide