中华胃肠外科杂志最新文献

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[Intraperitoneal chemotherapy for gastric cancer with peritoneal metastasis: Experience from Singapore]. 【腹腔化疗治疗胃癌伴腹膜转移:新加坡经验】。
中华胃肠外科杂志 Pub Date : 2025-05-25 DOI: 10.3760/cma.j.cn441530-20250410-00151
C H U A N Tan, K A I A N N Chia, B O K Y A N So
{"title":"[Intraperitoneal chemotherapy for gastric cancer with peritoneal metastasis: Experience from Singapore].","authors":"C H U A N Tan, K A I A N N Chia, B O K Y A N So","doi":"10.3760/cma.j.cn441530-20250410-00151","DOIUrl":"https://doi.org/10.3760/cma.j.cn441530-20250410-00151","url":null,"abstract":"<p><p>Systemic chemotherapy currently remains the standard treatment for gastric cancer with peritoneal metastasis (GCPM). However, the plasma-peritoneum barrier significantly limits drug penetration into the peritoneal cavity, resulting in the poor prognosis for GCPM patients. In Singapore, intraperitoneal chemotherapy has been demonstrated as a safe and effective approach for GCPM treatment following the implementation of various modalities including pressurized intraperitoneal aerosol chemotherapy (PIPAC), catheter-based intraperitoneal (IP) chemotherapy and conventional hyperthermic intraperitoneal chemotherapy (HIPEC). This article reviews the evolution of intraperitoneal chemotherapy in Singapore and highlights several important clinical trials. Looking forward, the bidirectional approach combining intraperitoneal and systemic chemotherapy will be further refined through the integration of novel drug combinations, optimization of delivery techniques, and expansion of clinical research.</p>","PeriodicalId":23959,"journal":{"name":"中华胃肠外科杂志","volume":"28 5","pages":"493-496"},"PeriodicalIF":0.0,"publicationDate":"2025-05-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144128731","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
[Clinical value of medical imaging artificial intelligence in the diagnosis and treatment of peritoneal metastasis in gastrointestinal cancers]. [医学影像人工智能在胃肠道肿瘤腹膜转移诊治中的临床价值]。
中华胃肠外科杂志 Pub Date : 2025-05-25 DOI: 10.3760/cma.j.cn441530-20250301-00075
M J Fang, D Dong, J Tian
{"title":"[Clinical value of medical imaging artificial intelligence in the diagnosis and treatment of peritoneal metastasis in gastrointestinal cancers].","authors":"M J Fang, D Dong, J Tian","doi":"10.3760/cma.j.cn441530-20250301-00075","DOIUrl":"https://doi.org/10.3760/cma.j.cn441530-20250301-00075","url":null,"abstract":"<p><p>Peritoneal metastasis is a key factor in the poor prognosis of advanced gastrointestinal cancer patients. Traditional radiological diagnostic faces challenges such as insufficient sensitivity. Through technologies like radiomics and deep learning, artificial intelligence can deeply analyze the tumor heterogeneity and microenvironment features in medical images, revealing markers of peritoneal metastasis and constructing high-precision predictive models. These technologies have demonstrated advantages in tasks such as predicting peritoneal metastasis, assessing the risk of peritoneal recurrence, and identifying small metastatic foci during surgery. This paper summarizes the representative progress and application prospects of medical imaging artificial intelligence in the diagnosis and treatment of peritoneal metastasis, and discusses potential development directions such as multimodal data fusion and large model. The integration of medical imaging artificial intelligence with clinical practice is expected to advance personalized and precision medicine in the diagnosis and treatment of peritoneal metastasis in gastrointestinal cancers.</p>","PeriodicalId":23959,"journal":{"name":"中华胃肠外科杂志","volume":"28 5","pages":"473-480"},"PeriodicalIF":0.0,"publicationDate":"2025-05-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144127686","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
[Reflections on the current state of diagnosis and treatment for peritoneal metastasis in colorectal cancer]. 【结直肠癌腹膜转移的诊治现状思考】。
中华胃肠外科杂志 Pub Date : 2025-05-25 DOI: 10.3760/cma.j.cn441530-20250308-00090
J Wang, X G He, Y T Hu, L F Sun, K F Ding
{"title":"[Reflections on the current state of diagnosis and treatment for peritoneal metastasis in colorectal cancer].","authors":"J Wang, X G He, Y T Hu, L F Sun, K F Ding","doi":"10.3760/cma.j.cn441530-20250308-00090","DOIUrl":"https://doi.org/10.3760/cma.j.cn441530-20250308-00090","url":null,"abstract":"<p><p>Peritoneal metastasis of colorectal cancer is the second most common metastatic pattern after liver metastasis, clinically common and associated with a poor prognosis. Refractory subtypes such as mucinous adenocarcinoma, signet-ring cell carcinoma, and BRAF V600E-mutated colorectal cancers account for a relatively high proportion in peritoneal metastasis. While previous diagnosis and treatment faced significant challenges, recent advances in new technologies and evolving therapeutic concepts have achieved progress in management. Many patients with colorectal cancer peritoneal metastasis have obtained favorable treatment outcomes, though numerous challenges persist. This article provides an in-depth analysis of current status and advancements in the diagnosis and treatment of colorectal cancer peritoneal metastasis, examines existing clinical difficulties and unresolved issues, and explores the application of advanced technologies in clinical practice. Through promoting individualized, precise, and standardized treatment concepts, we aim to enhance survival benefits for more patients.</p>","PeriodicalId":23959,"journal":{"name":"中华胃肠外科杂志","volume":"28 5","pages":"465-472"},"PeriodicalIF":0.0,"publicationDate":"2025-05-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144128841","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
[Normothermic intraperitoneal and systemic treatment (NIPS) for gastric cancer with peritoneal metastasis: Japanese experience]. 胃癌伴腹膜转移的常温腹腔及全身治疗(NIPS):日本经验。
中华胃肠外科杂志 Pub Date : 2025-05-25 DOI: 10.3760/cma.j.cn441530-20250319-00109
S Z E Joji, S H D Hironori, K B J Hironori
{"title":"[Normothermic intraperitoneal and systemic treatment (NIPS) for gastric cancer with peritoneal metastasis: Japanese experience].","authors":"S Z E Joji, S H D Hironori, K B J Hironori","doi":"10.3760/cma.j.cn441530-20250319-00109","DOIUrl":"https://doi.org/10.3760/cma.j.cn441530-20250319-00109","url":null,"abstract":"<p><p>Despite advances in targeted therapies, the prognosis for patients with peritoneal metastases (PM) from gastric cancer remains poor, due to the \"blood-peritoneal barrier,\" which limits delivery of systemically administered drugs to peritoneal lesions. Intraperitoneal (IP) administration of paclitaxel (PTX) offers pharmacokinetic advantages by enhancing drug retention and infiltration in peritoneal lesions. Normothermic intraperitoneal and systemic chemotherapy (NIPS), developed in Japan two decades ago, combines repeated IP infusion of PTX via an intraperitoneal access port with systemic chemotherapy, and is currently regarded as one of the most effective treatment modalities for managing PM from gastric cancer. This review provides an overview of the theoretical rationale and clinical outcomes associated with this treatment strategy.</p>","PeriodicalId":23959,"journal":{"name":"中华胃肠外科杂志","volume":"28 5","pages":"487-492"},"PeriodicalIF":0.0,"publicationDate":"2025-05-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144128831","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
[Integrated diagnosis and treatment of peritoneal metastasis in gastric cancer]. [胃癌腹膜转移的综合诊治]。
中华胃肠外科杂志 Pub Date : 2025-05-25 DOI: 10.3760/cma.j.cn441530-20250301-00076
B W Li, P Gao, K Feng, G T Wu, T J Tongjia, Z N Wang
{"title":"[Integrated diagnosis and treatment of peritoneal metastasis in gastric cancer].","authors":"B W Li, P Gao, K Feng, G T Wu, T J Tongjia, Z N Wang","doi":"10.3760/cma.j.cn441530-20250301-00076","DOIUrl":"https://doi.org/10.3760/cma.j.cn441530-20250301-00076","url":null,"abstract":"<p><p>The high incidence and mortality rates of gastric cancer pose a significant burden on human health and public health systems. Peritoneal metastasis is one of the main routes of metastasis in gastric cancer, and patients with this condition have poor prognosis. With advancements in medicine and sociology, the concept of integrated medicine emerged in the late 1980s. It emphasizes treating patients as holistic entities, integrating various medical fields multidimensionally, and combining medicine with other fields. This article organizes the management of gastric cancer peritoneal metastasis around the core concept of \"Prevention, Screening, Diagnosis, Treatment, and Rehabilitation\": Prevention relies on standardized tumor-free surgical techniques and intraoperative interventions. Screening involves early detection of peritoneal metastasis through integrated technologies. Diagnosis combines multiple methods, including laparoscopic exploration with cytological and histopathological examination, imaging studies, peritoneal fluid cytology, and artificial intelligence. Treatment encompasses comprehensive strategies such as intraperitoneal and systemic chemotherapy, cytoreductive surgery combined with hyperthermic intraperitoneal chemotherapy, pressurized intraperitoneal aerosolized chemotherapy, dendritic cell vaccines combined with nivolumab, and supportive care for managing ascites, malignant bowel obstruction, and nutritional support. This integrated medical perspective offers new insights into the management of gastric cancer peritoneal metastasis.</p>","PeriodicalId":23959,"journal":{"name":"中华胃肠外科杂志","volume":"28 5","pages":"455-464"},"PeriodicalIF":0.0,"publicationDate":"2025-05-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144128483","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
[Short-term effects and safety outcomes of the combination of tislelizumab and neoadjuvant chemotherapy in the perioperative treatment of locally advanced gastric cancer]. [替利单抗联合新辅助化疗局部进展期胃癌围手术期的短期疗效及安全性结局]。
中华胃肠外科杂志 Pub Date : 2025-05-25 DOI: 10.3760/cma.j.cn441530-20250304-00081
Y W Chen, Y H Gao, Y S Zhao, X D Zhao, L Li, H Cui, H Zhang, C X Long, Z Qiao
{"title":"[Short-term effects and safety outcomes of the combination of tislelizumab and neoadjuvant chemotherapy in the perioperative treatment of locally advanced gastric cancer].","authors":"Y W Chen, Y H Gao, Y S Zhao, X D Zhao, L Li, H Cui, H Zhang, C X Long, Z Qiao","doi":"10.3760/cma.j.cn441530-20250304-00081","DOIUrl":"https://doi.org/10.3760/cma.j.cn441530-20250304-00081","url":null,"abstract":"<p><p><b>Objective:</b> In this study, we aimed to investigate the short-term efficacy and safety of perioperative administration of the PD-1 inhibitor tislelizumab combined with the SOX regimen (oxaliplatin plus S-1) in patients with locally advanced gastric cancer, and to identify factors influencing therapeutic outcomes. <b>Methods:</b> In this retrospective cohort study, we analyzed clinical data of 166 patients who had undergone perioperative therapy and D2 radical gastrectomy in the Department of General Surgery, First Medical Center of Chinese PLA General Hospital between September 2021 and September 2023. The cohort comprised 140 men and 26 women, of median age 62 years (range: 30-75). The patients were allocated to two groups: 62 receiving tislelizumab plus SOX (combination therapy group), and 104 SOX alone (chemotherapy-only group). Primary outcomes included pathological complete response rate, treatment-related adverse events, and complications of surgery. Secondary outcomes comprised major pathological response rate, tumor regression grade (Grades 1-2 denoting favorable response, Grade 3 moderate, and Grades 4-5 poor response), R0 resection rate, and short-term survival outcomes (1-year disease-free and overall survivals). Risk factors associated with pCR in the combination group were also analyzed. <b>Results:</b> The combination therapy group exhibited significantly higher rates of pCR (25.8% vs. 8.7%, χ<sup>2</sup>=8.93, <i>P</i>=0.003) and Grade 1 tumor regression (25.8% vs. 16.3%, χ<sup>2</sup>=15.32, <i>P</i>=0.001) than the chemotherapy-only group. There were no statistically significant differences in major pathological response rates (41.9% vs. 39.4%), R0 resection rates (96.8% vs. 97.1%,), treatment- related adverse events (48.4% vs. 42.3%,), surgical complications (9.7% vs. 12.5%), 1-year disease-free survival (82.3% vs. 78.8%), or 1-year overall survival (93.5% vs. 91.3%), There were no statistically significant differences (all <i>P</i>>0.05). Multivariate logistic analysis identified neural invasion as an independent risk factor for reduced pCR in the combination group (OR=0.10, 95%CI:0.01-0.85,<i>P</i>=0.035). <b>Conclusions:</b> Perioperative tislelizumab combined with SOX chemotherapy improves pathological response rates in patients with locally advanced gastric cancer and has favorable short-term efficacy and safety profiles. Neural invasion may diminish the therapeutic efficacy of immunotherapy.</p>","PeriodicalId":23959,"journal":{"name":"中华胃肠外科杂志","volume":"28 5","pages":"536-543"},"PeriodicalIF":0.0,"publicationDate":"2025-05-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144128796","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
[Study on the impact of ultrasound-guided bedside hyperthermic intraperitoneal chemotherapy after laparoscopic gastric cancer surgery on the prognosis of patients with positive peritoneal lavage fluid cytology]. [超声引导下腹腔镜胃癌术后床边热腹腔化疗对腹膜灌洗液细胞学阳性患者预后影响的研究]。
中华胃肠外科杂志 Pub Date : 2025-05-25 DOI: 10.3760/cma.j.cn441530-20240920-00324
L Y Tong, J Lu, C B Lv, L S Cai, Y H Wu
{"title":"[Study on the impact of ultrasound-guided bedside hyperthermic intraperitoneal chemotherapy after laparoscopic gastric cancer surgery on the prognosis of patients with positive peritoneal lavage fluid cytology].","authors":"L Y Tong, J Lu, C B Lv, L S Cai, Y H Wu","doi":"10.3760/cma.j.cn441530-20240920-00324","DOIUrl":"https://doi.org/10.3760/cma.j.cn441530-20240920-00324","url":null,"abstract":"&lt;p&gt;&lt;p&gt;&lt;b&gt;Objective:&lt;/b&gt; To investigate the impact of bedside ultrasound-guided hyperthermic intraperitoneal chemotherapy (HIPEC) after laparoscopic gastric cancer surgery on the prognosis of patients with only positive peritoneal lavage cytology (CY+) and no other distant metastases. &lt;b&gt;Methods:&lt;/b&gt; The clinicopathological data of 49 patients with only positive peritoneal lavage cytology who underwent laparoscopic gastrectomy and D2 lymph node dissection from December 2017 to December 2022 were retrospectively analyzed. The patients were divided into the HIPEC group (27 cases) and the non-HIPEC group (22 cases) based on whether they received postoperative bedside ultrasound-guided HIPEC. The patterns of postoperative recurrence and metastasis and the 3-year survival rates were compared between the two groups. Univariate and multivariate analyses using the Cox proportional hazards model were conducted to determine the prognostic factors. &lt;b&gt;Results:&lt;/b&gt; There was no statistically significant difference in all baseline clinicopathological data between the two groups (&lt;i&gt;P&lt;/i&gt;&gt;0.05); the median follow-up time for all patients was 31 months (ranging from 13 to 73 months), and the overall recurrence rate for all patients was 55.1% (27/49). Among them, 12 cases (24.5%) had peritoneal metastasis, 7 cases (14.3%) had hematogenous recurrence, 5 cases (10.2%) had distant lymph node metastasis, and 3 cases (6.1%) had local recurrence. The overall recurrence rates of patients in the HIPEC group and the non-HIPEC group were 51.8% (14/27) and 59.1% (13/22), respectively. There was no statistically significant difference (χ&lt;sup&gt;2&lt;/sup&gt;=0.26, &lt;i&gt;P&lt;/i&gt;=0.612). The peritoneal metastasis rate of patients in the HIPEC group was 18.5% (5/27), which was lower than that of the non-HIPEC group at 31.8% (7/22). However, there was no statistically significant difference (χ&lt;sup&gt;2&lt;/sup&gt;=1.16, &lt;i&gt;P&lt;/i&gt;=0.282). The proportions of local recurrence, hematogenous metastasis, and distant lymph node metastasis were comparable between the two groups (all &lt;i&gt;P&lt;/i&gt;&gt;0.05). The cumulative 3-year recurrence rates of the two groups were similar (70.7% vs. 71.3%, &lt;i&gt;P&lt;/i&gt;=0.266). In the HIPEC group, the 3-year overall survival rate was 61.1%, which was significantly higher than that of the non-HIPEC group (31.5%). The difference was statistically significant (&lt;i&gt;P&lt;/i&gt;=0.014). The disease-free progression survival rates of the two groups were 29.3% and 28.7% respectively, and there was no statistically significant difference between them (&lt;i&gt;P&lt;/i&gt;=0.266). Cox multivariate analysis showed that no postoperative HIPEC (HR=5.21, 95%CI:1.90-14.31, &lt;i&gt;P&lt;/i&gt;=0.001), poor tumor differentiation (HR=3.78, 95%CI:1.07-13.26, &lt;i&gt;P&lt;/i&gt;=0.038), and later N stage (HR=6.18, 95%CI:1.39-7.59, &lt;i&gt;P&lt;/i&gt;=0.017) were independent risk factors for the overall survival rate after surgery (&lt;i&gt;P&lt;/i&gt;&lt;0.05). Later N stage (HR=3.67, 95%CI:1.07-12.55, &lt;i&gt;P&lt;/i&gt;=0.038) was an independent risk factor for the disease-free pr","PeriodicalId":23959,"journal":{"name":"中华胃肠外科杂志","volume":"28 5","pages":"528-535"},"PeriodicalIF":0.0,"publicationDate":"2025-05-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144128803","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
[Research progress on peritoneal metastasis of gastric cancer in the era of immunotherapy]. [免疫治疗时代胃癌腹膜转移研究进展]。
中华胃肠外科杂志 Pub Date : 2025-05-25 DOI: 10.3760/cma.j.cn441530-20241008-00032
J Q Yang, K W Jiang, S Wang
{"title":"[Research progress on peritoneal metastasis of gastric cancer in the era of immunotherapy].","authors":"J Q Yang, K W Jiang, S Wang","doi":"10.3760/cma.j.cn441530-20241008-00032","DOIUrl":"https://doi.org/10.3760/cma.j.cn441530-20241008-00032","url":null,"abstract":"<p><p>Peritoneal metastasis is a common form of metastasis and recurrence in advanced gastric cancer. In recent years, immunotherapy has shown promising applications in the treatment of various malignancies, including gastric cancer. Given the limited efficacy of conventional treatment modalities, such as surgery and chemotherapy, in managing gastric cancer peritoneal metastasis, immunotherapy has garnered increasing attention and recognition among researchers worldwide. However, the application of immunotherapy in gastric cancer peritoneal metastasis still faces significant challenges, including the immunosuppressive tumor microenvironment, drug delivery barriers, and tumor resistance. This review aims to summarize the immunological mechanisms underlying gastric cancer peritoneal metastasis and discuss the latest advances in immunotherapy from both domestic and international studies, with the goal of providing insights for the development of novel immunotherapeutic agents and the optimization of treatment strategies for patients.</p>","PeriodicalId":23959,"journal":{"name":"中华胃肠外科杂志","volume":"28 5","pages":"557-563"},"PeriodicalIF":0.0,"publicationDate":"2025-05-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144128845","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
[Clinical study on endoscopic resection of giant submucosal tumors in the esophagus or gastric cardia]. 【食管贲门粘膜下肿物内镜切除的临床研究】。
中华胃肠外科杂志 Pub Date : 2025-05-25 DOI: 10.3760/cma.j.cn441530-20250303-00079
Z Q Li, Y Wang, S L Lin, P H Zhou, P T Gao
{"title":"[Clinical study on endoscopic resection of giant submucosal tumors in the esophagus or gastric cardia].","authors":"Z Q Li, Y Wang, S L Lin, P H Zhou, P T Gao","doi":"10.3760/cma.j.cn441530-20250303-00079","DOIUrl":"https://doi.org/10.3760/cma.j.cn441530-20250303-00079","url":null,"abstract":"<p><p><b>Objective:</b> Endoscopic resection of giant submucosal tumors (SMTs) in the esophagus and gastric cardia is challenging. The aim of this study was to investigate the safety and efficacy of various endoscopic procedures for resection of esophageal or gastric cardia SMTs with longitudinal diameter ≥7 cm and/or transverse diameter ≥3.5 cm. <b>Methods:</b> In this retrospective cohort study, we analyzed data of 109 patients with giant esophageal/cardia SMTs originating in the muscularis propria who had undergone endoscopic resection in Zhongshan Hospital from July 2017 to February 2022. Inclusion criteria were as follows: (1) SMT diameter ≥7 cm longitudinally or ≥3.5 cm transversely; (2) presence of symptoms requiring intervention; and (3) tumor originating in the muscularis propria. Exclusion criteria included severe comorbidities, coagulation disorders, prior surgery, or tumor adjacent to vital organs precluding endoscopic treatment. The primary outcomes were en bloc and piecemeal resection rates, whereas secondary outcomes comprised adverse events and long-term survival. <b>Results:</b> Among the 109 patients who had successfully undergone endoscopic resection, the median tumor diameters were 7.5 (4.0-15.0) cm, and 4.5 (1.5-7.0) cm. Submucosal tunneling endoscopic resection, endoscopic full-thickness resection, and endoscopic submucosal excavation were performed on 77, 22, and 10 patients, respectively. The median duration of the procedures was 90 (30-300) minutes. The overall en bloc resection rate was 78.9% (86/109), and piecemeal resection rate 21.1% (23/109). Major adverse events occurred in 12.8% of patients (14/109), comprising pneumothorax or pleural effusion (<i>n</i>=12), esophageal-pleural fistula (<i>n</i>=3), severe delayed bleeding (<i>n</i>=1), tunnel infection with abdominal abscess (<i>n</i>=1), pulmonary abscess (<i>n</i>=1), abdominal abscess (<i>n</i>=1), and postoperative esophageal stricture (<i>n</i>=1). During a median follow-up period of 33.6 (15.4-70.4) months, no tumor recurrences or metastases were detected. Multivariate analysis revealed that transverse diameter ≥4.5 cm was an independent risk factor for piecemeal resection (OR=6.016, 95%CI: 2.180-16.597, <i>P</i><0.001); longitudinal diameter ≥9.0 cm (OR=2.728, 95%CI: 1.005-7.405, <i>P</i>=0.049) and transverse diameter ≥4.5 cm (OR=2.942, 95%CI: 1.099-7.874, <i>P</i>=0.032) were independent risk factors for prolonged operation time; and longitudinal diameter ≥9.0 cm (OR=5.040, 95%CI: 1.425-17.828, <i>P</i>=0.012) and piecemeal resection (OR=6.280, 95%CI: 1.741-22.656, <i>P</i>=0.005) were independent risk factors for major adverse events. <b>Conclusion:</b> Endoscopic resection is a safe and effective treatment modality for giant esophageal or gastric cardia SMTs of longitudinal diameter ≥9.0 cm and transverse diameter ≥4.5 cm.</p>","PeriodicalId":23959,"journal":{"name":"中华胃肠外科杂志","volume":"28 5","pages":"544-550"},"PeriodicalIF":0.0,"publicationDate":"2025-05-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144128948","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
[Expert consensus on the diagnosis and treatment of colorectal cancer peritoneal metastasis (2025 edition)]. 【大肠癌腹膜转移诊治专家共识(2025版)】。
中华胃肠外科杂志 Pub Date : 2025-05-25 DOI: 10.3760/cma.j.cn441530-20250303-00077
{"title":"[Expert consensus on the diagnosis and treatment of colorectal cancer peritoneal metastasis (2025 edition)].","authors":"","doi":"10.3760/cma.j.cn441530-20250303-00077","DOIUrl":"https://doi.org/10.3760/cma.j.cn441530-20250303-00077","url":null,"abstract":"<p><p>Colorectal cancer (CRC) is one of the most common malignant tumors in China, ranking second in morbidity and fourth in mortality. Metastasis and recurrence are the leading causes of patient death, and the peritoneum is a frequent site of metastasis in CRC, second only to liver and lung metastases. However, the prognosis of peritoneal metastasis is much worse than hepatic and pulmonary metastasis. CRC peritoneal metastasis is challenging early diagnosis, presents with severe symptoms, and has a poor prognosis. It is crucial to emphasize standardized diagnosis and treatment for CRC peritoneal metastasis to improve patients' outcome and enhance their quality of life. This consensus, based on evidence-based medical evidence, revised the \"Chinese Expert Consensus on the Diagnosis and Treatment of Colorectal Cancer Peritoneal Metastasis (2022 edition)\" and reached a preliminary consensus on the definition, diagnosis, treatment, and prevention of CRC peritoneal metastasis, with the aim of guiding and standardizing the diagnosis and treatment of CRC peritoneal metastasis, developing reasonable and effective comprehensive treatment plans, prolonging survival time and improving quality of life for CRC peritoneal metastasis patients, thereby raising the overall level of diagnosis and treatment for CRC in China.</p>","PeriodicalId":23959,"journal":{"name":"中华胃肠外科杂志","volume":"28 5","pages":"441-449"},"PeriodicalIF":0.0,"publicationDate":"2025-05-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144127729","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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