中华胃肠外科杂志最新文献

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[Research progress of colonic electrical stimulation in the treatment of chronic constipation]. 【结肠电刺激治疗慢性便秘研究进展】。
中华胃肠外科杂志 Pub Date : 2024-12-25 DOI: 10.3760/cma.j.cn441530-20240316-00102
M D Cai, Y Y Lu, J L Wang
{"title":"[Research progress of colonic electrical stimulation in the treatment of chronic constipation].","authors":"M D Cai, Y Y Lu, J L Wang","doi":"10.3760/cma.j.cn441530-20240316-00102","DOIUrl":"https://doi.org/10.3760/cma.j.cn441530-20240316-00102","url":null,"abstract":"<p><p>Chronic constipation refers to a reduction in the frequency of bowel movements and difficulty in defecation lasting for more than 6 months, with a comprehensive incidence rate of 15% in the population. Chronic constipation is a significant health concern that greatly affects the quality of life of patients and results in substantial healthcare resource consumption. Current common treatment strategies include lifestyle modifications, pharmacological therapy, biofeedback therapy, enemas, and surgical procedures, but the effectiveness of these approaches remains limited. Colonic electrical stimulation therapy is a newly proposed treatment strategy in recent years, which involves the application of external electrical current to correct abnormal physiological activities related to defecation. This article provides an overview of the mechanisms, efficacy, and factors influencing the use of colonic electrical stimulation in the treatment of chronic constipation, as well as a summary of the advantages of colonic electrical stimulation and possible challenges for future development.</p>","PeriodicalId":23959,"journal":{"name":"中华胃肠外科杂志","volume":"27 12","pages":"1293-1300"},"PeriodicalIF":0.0,"publicationDate":"2024-12-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142878142","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
[Significance of disorders of brain-gut interaction in the diagnosis and management of refractory constipation]. 脑肠相互作用紊乱在难治性便秘诊断和治疗中的意义。
中华胃肠外科杂志 Pub Date : 2024-12-25 DOI: 10.3760/cma.j.cn441530-20240328-00113
B W Tian, T Jin, X Su, X Z Li, Z F Zhao
{"title":"[Significance of disorders of brain-gut interaction in the diagnosis and management of refractory constipation].","authors":"B W Tian, T Jin, X Su, X Z Li, Z F Zhao","doi":"10.3760/cma.j.cn441530-20240328-00113","DOIUrl":"https://doi.org/10.3760/cma.j.cn441530-20240328-00113","url":null,"abstract":"<p><p>Chronic constipation is a common digestive disease that affects people's quality of life, with complex causes and difficult treatment. Nearly half of the patients with chronic constipation do not achieve satisfactory treatment results, which is referred to as refractory constipation.Current clinical strategies for addressing refractory constipation have predominantly focused on the mitigation of intestinal symptoms. However, emerging evidence suggests that the pathogenesis and progression of refractory constipation are multifactorial and highly intricate, and that strategies targeted solely at symptom relief may be insufficient to yield optimal therapeutic outcomes. Based on the concept of disorders of brain gut interaction disorder (DBGI) proposed by Rome IV, we found that DBGI may play a key role in patients with refractory constipation. From the perspective of DBGI, this review synthesized the contemporary insights into the pathological mechanisms underlying refractory constipation, as well as diagnostic and therapeutic strategies focusing on four aspects: the central nervous system, the peripheral nervous system, the endocrine system, and the intestinal environment.</p>","PeriodicalId":23959,"journal":{"name":"中华胃肠外科杂志","volume":"27 12","pages":"1301-1308"},"PeriodicalIF":0.0,"publicationDate":"2024-12-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142878152","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
[A rare case report of Lynch Syndrome associated colon cancer]. [Lynch综合征合并结肠癌1例报道]。
中华胃肠外科杂志 Pub Date : 2024-12-25 DOI: 10.3760/cma.j.cn441530-20240111-00022
H Y Jing, D Sha, X L Zhu
{"title":"[A rare case report of Lynch Syndrome associated colon cancer].","authors":"H Y Jing, D Sha, X L Zhu","doi":"10.3760/cma.j.cn441530-20240111-00022","DOIUrl":"10.3760/cma.j.cn441530-20240111-00022","url":null,"abstract":"","PeriodicalId":23959,"journal":{"name":"中华胃肠外科杂志","volume":"27 12","pages":"1290-1292"},"PeriodicalIF":0.0,"publicationDate":"2024-12-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142877957","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
[Comparison of effect of different medial boundaries in laparoscopic right hemicolectomy: a meta-analysis]. [不同内侧边界在腹腔镜右半结肠切除术中的效果比较:meta分析]。
中华胃肠外科杂志 Pub Date : 2024-12-25 DOI: 10.3760/cma.j.cn441530-20240116-00029
F Gao, B Han, Y H Zhang, H Y Zhao, H Wang, M S Guo
{"title":"[Comparison of effect of different medial boundaries in laparoscopic right hemicolectomy: a meta-analysis].","authors":"F Gao, B Han, Y H Zhang, H Y Zhao, H Wang, M S Guo","doi":"10.3760/cma.j.cn441530-20240116-00029","DOIUrl":"10.3760/cma.j.cn441530-20240116-00029","url":null,"abstract":"<p><p><b>Objective:</b> To investigate and compare the clinical efficacy and prognosis of D3 lymphadenectomy/complete mesocolic excision in treatment of right colon cancer with different medial boundaries. <b>Methods:</b> We searched The Cochrane Library, Pubmed, Embase, CBM, VIP, CNKI, and WanFang data bases for superior mesenteric artery (SMA)-oriented and superior mesenteric vein (SMV)-oriented D3 lymphadenectomy/complete mesocolic excision from inception to December, 2023. The resultant data were submitted to meta-analysis using RevMan 5.3 software. <b>Results:</b> In total, we identified nine eligible studies involving 2467 patients. The SMA group had 982 patients and the SMV group had 1 485 patients. Meta-analysis revealed no significant differences in intraoperative bleeding volume, postoperative time to passage of flatus, or postoperative drainage volume between the two studied approaches. The durations of surgery and of postoperative hospital stay were both significantly longer in the SMA than SMV group (weighted mean difference [WMD]=17.70, 95%CI: 6.90-28.50, <i>P</i>=0.001; WMD=0.40, 95%CI: 0.07-0.72, <i>P</i>=0.020, respectively). Furthermore, the rate of postoperative complications was greater in the SMA than SMV group. For example, the incidences of postoperative chyle leakage and diarrhea were significantly higher in the SMA than SMV group, (OR=1.25, 95%CI: 1.01-1.54, <i>P</i> = 0.040; OR=3.60, 95%CI: 2.39-5.41, <i>P</i> < 0.001; OR=2.13, 95%CI: 1.10-4.11, <i>P</i> = 0.020, respectively). In terms of oncological efficacy, the total number of lymph nodes dissected and the number of positive lymph nodes in the SMA group were significantly higher than in the SMV group (WMD=2.76, 95%CI:1.22-4.31, <i>P <</i> 0.001, WMD=0.59, 95%CI: 0.06-1.12, <i>P</i> = 0.030). <b>Conclusion:</b> Laparoscopic surgery for right colon cancer, using the left margin of the SMA as the medial boundary for dissection is associated with a higher risk of postoperative complications, such as chyle leakage and diarrhea, than is using the superior mesenteric vein as the medial boundary. The durations of surgery and postoperative hospital stay are longer. SMA left margin dissection has significant oncological advantages, including a higher total number of harvested lymph nodes and of positive lymph nodes.</p>","PeriodicalId":23959,"journal":{"name":"中华胃肠外科杂志","volume":"27 12","pages":"1276-1283"},"PeriodicalIF":0.0,"publicationDate":"2024-12-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142878023","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
[Surgical treatment for intractable constipation: selection of procedure and perioperative management]. 顽固性便秘的手术治疗:手术方式的选择及围手术期的处理。
中华胃肠外科杂志 Pub Date : 2024-12-25 DOI: 10.3760/cma.j.cn441530-20241010-00335
J Jiang
{"title":"[Surgical treatment for intractable constipation: selection of procedure and perioperative management].","authors":"J Jiang","doi":"10.3760/cma.j.cn441530-20241010-00335","DOIUrl":"https://doi.org/10.3760/cma.j.cn441530-20241010-00335","url":null,"abstract":"<p><p>When chronic constipation develops to the stage of intractable constipation, the symptoms of constipation in patients are severe and persistent, and drug treatment is often ineffective, so surgical treatment is often considered. The clinical manifestations of patients with intractable constipation are variable, and the underlying pathophysiological changes involve various abnormal and dysfunctional anatomical structure of colorectal and pelvic floor, which are different. For the surgical treatment of intractable constipation, accurate preoperative classification diagnosis is very important, and it is necessary to formulate an exact and effective surgical plan to avoid untargeted empirical treatment. The key to maintain long-term good results after surgery is to carry out comprehensive and scientific preoperative evaluation and the correct choice of individual operation. In recent years, thanks to the progress of basic research and clinical diagnosis and treatment of intractable constipation, as well as the improvement of minimally invasive surgical techniques and perioperative management, the safety and effectiveness of surgical treatment have been significantly improved. Based on the research progress at home and abroad and the authors' clinical experience, this paper focuses on the contents of preoperative accurate assessment, scientific selection of surgical methods and perioperative intestinal microecological therapy, so as to provide references for clinical practice in the same field.</p>","PeriodicalId":23959,"journal":{"name":"中华胃肠外科杂志","volume":"27 12","pages":"1243-1247"},"PeriodicalIF":0.0,"publicationDate":"2024-12-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142878171","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
[Surgical treatment for slow transit constipation: total colectomy and subtotal colectomy]. 慢传输型便秘的手术治疗:全结肠切除术和次全结肠切除术。
中华胃肠外科杂志 Pub Date : 2024-12-25 DOI: 10.3760/cma.j.cn441530-20241114-00372
M Guo, W D Tong
{"title":"[Surgical treatment for slow transit constipation: total colectomy and subtotal colectomy].","authors":"M Guo, W D Tong","doi":"10.3760/cma.j.cn441530-20241114-00372","DOIUrl":"https://doi.org/10.3760/cma.j.cn441530-20241114-00372","url":null,"abstract":"<p><p>Although the surgical treatment of slow transit constipation (STC) has been around for over a century, the choice of surgical method is still controversial. Specifically, the two most widely used operations in the world are total colectomy ileorectostomy (TC-IRA) and subtotal colectomy. Subtotal colectomy offers many methods for anastomosis, including ileocecal and cecorectal anastomoses and so on. Cecorectal anastomosis can be divided into two types: isoperistaltic anastomosis and antiperistaltic anastomosis. It is generally believed that total colectomy provides definitive effects but results in more severe postoperative diarrhea, while subtotal colectomy may reduce postoperative diarrhea but potentially increase the risk of constipation recurrence. Most studies of these surgical methods are retrospective small-sample studies with low-quality evidence. This is also one of the reasons for the lack of STC gold standard surgery in clinical practice. This paper discusses the selection of surgical methods for intractable slow transit constipation (STC) based on a review of literature published within the past 10 years, as well as our team's extensive 33-year experience in diagnosing and treating constipation surgically.</p>","PeriodicalId":23959,"journal":{"name":"中华胃肠外科杂志","volume":"27 12","pages":"1248-1253"},"PeriodicalIF":0.0,"publicationDate":"2024-12-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142878180","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
[Modified endoscopic mucosal resection for the treatment of early gastrointestinal lesions]. 【改良内镜下粘膜切除术治疗早期胃肠道病变】。
中华胃肠外科杂志 Pub Date : 2024-12-25 DOI: 10.3760/cma.j.cn441530-20241022-00347
W F Chen, W H Wu, X P Zhang, W W Fan
{"title":"[Modified endoscopic mucosal resection for the treatment of early gastrointestinal lesions].","authors":"W F Chen, W H Wu, X P Zhang, W W Fan","doi":"10.3760/cma.j.cn441530-20241022-00347","DOIUrl":"https://doi.org/10.3760/cma.j.cn441530-20241022-00347","url":null,"abstract":"<p><p><b>Objective:</b> To evaluate the clinical efficacy of modified endoscopic mucosal resection (EMR) in the management of early gastrointestinal lesions. <b>Methods:</b> Upon endoscopic identification of the lesion, normal saline is injected into the submucosa to establish a fluid cushion, which elevates the lesion's mucosa. Methylene blue may also be applied to improve visualization of the relationship between the submucosa and muscular layer. A snare with a tip diameter of 2-3 mm is utilized to circumferentially incise the mucosal layer at the lesion's edge, forming a circular groove. The snare is anchored within this groove, allowing for complete resection of the lesion in a single step. The procedure involves a slow and alternating technique of electrosurgical cutting and coagulation to minimize bleeding risks, while upward tension on the snare during cutting reduces perforation risks. Direct coagulation of exposed blood vessels is performed using the snare tip, and hemostatic clips are applied to larger defects; nylon sutures may be utilized for substantial wounds. <b>Results:</b> Between June 2015 and April 2024, modified EMR was performed on 65 patients with early gastrointestinal lesions at Dongguan Children's Hospital, Guangdong Medical University. The mean operative time was (15.2 ± 3.1) minutes, with a complete resection rate of 100% and negative margins confirmed. Postoperative complications included one case each of delayed bleeding and electrosurgical syndrome. The average cost of consumables was (1887.2±187.6) yuan. Follow-up colonoscopies at 3 and 6 months postoperatively indicated no recurrences. <b>Conclusions:</b> Modified EMR demonstrates a short operative time, high safety and efficacy, and reduced material costs in the treatment of early gastrointestinal mucosal lesions.</p>","PeriodicalId":23959,"journal":{"name":"中华胃肠外科杂志","volume":"27 12","pages":"1284-1287"},"PeriodicalIF":0.0,"publicationDate":"2024-12-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142878108","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
[Several problems needing attention in the diagnosis and treatment of common perianal benign diseases]. 【常见肛周良性疾病诊治应注意的几个问题】。
中华胃肠外科杂志 Pub Date : 2024-12-25 DOI: 10.3760/cma.j.cn441530-20241012-00339
F Gao, C F Gao
{"title":"[Several problems needing attention in the diagnosis and treatment of common perianal benign diseases].","authors":"F Gao, C F Gao","doi":"10.3760/cma.j.cn441530-20241012-00339","DOIUrl":"https://doi.org/10.3760/cma.j.cn441530-20241012-00339","url":null,"abstract":"<p><p>Hemorrhoids, anal fissure, anal fistula and perianal abscess are the most common benign diseases around the anus, which obviously affect people's life and work, and need to be well diagnosed and treated. Based on damage control, the treatment principle is to eliminate relevant disease symptoms and protect the anal function at the same time. Perianal benign diseases are common and frequently occurring, which can be diagnosed and treated in many non-specialist hospitals. Therefore, there is great heterogeneity in the level of diagnosis and treatment, and related complications may occur due to iatrogenic factors such as the selection of treatment strategies, resulting in certain medical risks and subsequent passive treatment. Conservative treatment of internal hemorrhoids at degree I-II and acute anal fissure can achieve good results; internal hemorrhoids at degree III-IV, external hemorrhoids, anal fistula and perianal abscess can only be cured by surgery. The surgeon should pay attention to the protection of anal pad tissue and sphincter function to prevent serious complications such as postoperative anal stenosis and defecation dysfunction. It is imperative to accurately evaluate the specific clinical characteristics of each patient, formulate individualized treatment plans, and combine multiple treatment approaches.</p>","PeriodicalId":23959,"journal":{"name":"中华胃肠外科杂志","volume":"27 12","pages":"1213-1220"},"PeriodicalIF":0.0,"publicationDate":"2024-12-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142878147","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
[Chinese expert consensus on pelvic floor biofeedback for anorectal dysfunction (2024 edition)]. [中国专家共识盆底生物反馈治疗肛肠功能障碍(2024版)]。
中华胃肠外科杂志 Pub Date : 2024-12-25 DOI: 10.3760/cma.j.cn441530-20240719-00252
{"title":"[Chinese expert consensus on pelvic floor biofeedback for anorectal dysfunction (2024 edition)].","authors":"","doi":"10.3760/cma.j.cn441530-20240719-00252","DOIUrl":"https://doi.org/10.3760/cma.j.cn441530-20240719-00252","url":null,"abstract":"<p><p>Pelvic floor biofeedback is a major non-surgical treatment for anorectal dysfunction and has been recommended in several foreign guidelines. There is no consensus on the clinical practice of pelvic floor biofeedback in China currently. There are controversies in indications, contraindications and formulation of protocols. Launched by Pelvic Floor Medicine Specialty Committee of World Federation of Chinese Medicine Societies and Anorectal Branch of Chinese Medical Doctor Association, Chinese experts on this field were convened to write the Chinese expert consensus on pelvic floor biofeedback for anorectal dysfunction based on relevant references and combined the latest evidence and experts' clinical experience. This consensus recommends that before the use of pelvic floor biofeedback therapy, the patient's condition and pelvic floor function should be fully evaluated, and the guiding role of doctors and pelvic floor therapists should be emphasized to guide the standardized use of pelvic floor biofeedback therapy.</p>","PeriodicalId":23959,"journal":{"name":"中华胃肠外科杂志","volume":"27 12","pages":"1202-1212"},"PeriodicalIF":0.0,"publicationDate":"2024-12-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142877965","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
[Advances and considerations for surgical treatment of horseshoe anal fistulas]. [马蹄形肛瘘手术治疗的进展及注意事项]。
中华胃肠外科杂志 Pub Date : 2024-12-25 DOI: 10.3760/cma.j.cn441530-20240927-00329
S H Zhan, L Dai, L Y Fan, B L Yang, P Zhu
{"title":"[Advances and considerations for surgical treatment of horseshoe anal fistulas].","authors":"S H Zhan, L Dai, L Y Fan, B L Yang, P Zhu","doi":"10.3760/cma.j.cn441530-20240927-00329","DOIUrl":"https://doi.org/10.3760/cma.j.cn441530-20240927-00329","url":null,"abstract":"<p><p>Horseshoe anal fistula is one of the most challenging subtypes of complex anal fistulas, closely related to the failure of anal fistula surgery and postoperative recurrence. Accurate preoperative assessment, correct classification, and appropriate surgical plans are crucial for improving treatment efficacy. This article primarily explores the clinical classification of horseshoe anal fistulas and the applicability of mainstream surgical techniques in different types of horseshoe anal fistulas, focusing on their cure rates, recurrence rates, and fecal continence, to assist surgeons to make reasonable surgical plans when treating horseshoe anal fistulas.</p>","PeriodicalId":23959,"journal":{"name":"中华胃肠外科杂志","volume":"27 12","pages":"1227-1237"},"PeriodicalIF":0.0,"publicationDate":"2024-12-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142877961","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
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