中华胃肠外科杂志最新文献

{"title":"[Phages in human health and gut microbiota transplantation therapy].","authors":"Y F Jin, W J Wen, T Zuo","doi":"10.3760/cma.j.cn441530-20241130-00387","DOIUrl":"10.3760/cma.j.cn441530-20241130-00387","url":null,"abstract":"<p><p>Phages, prokaryotic viruses widely present in the human, are a crucial component of the gut microbiome. They play a significant role in human health and the development of diseases. Emerging evidence indicates that phages can interact with bacteria to affect their abundance, metabolism, and antibiotic resistance, thereby influencing the balance of the gut microbiota. In addition, phages also contribute to the gut immune response, and can become dysregulated in a range of immune-related diseases. Gut phages also carry important roles in fecal microbiota transplantation (FMT) for disease treatment. Phages can target specific bacterial members and communities, thereby reduce the risk of bacterial infections or the presence of bacteria, and maintain the stability of the gut microbiome. However, gut phageome research is still in its infancy and additional basic and clinical researches are required to evaluate its species composition, mechanisms of pathogenicity or protection, as well as its efficacy and safety.</p>","PeriodicalId":23959,"journal":{"name":"中华胃肠外科杂志","volume":"28 3","pages":"261-265"},"PeriodicalIF":0.0,"publicationDate":"2025-03-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143693581","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}

{"title":"[Analysis of the application of single-port laparoscopic appendectomy without holder assistance in patients with complicated appendicitis].","authors":"H R Lv, Y X Li, P Guo, S L Wang, C L Wang, L M Guo, L Guo, J Y Liu, W Q Wang, X Y Fan, Z Y Li","doi":"10.3760/cma.j.cn441530-20240507-00165","DOIUrl":"10.3760/cma.j.cn441530-20240507-00165","url":null,"abstract":"&lt;p&gt;&lt;p&gt;&lt;b&gt;Objective:&lt;/b&gt; The aim of this study was to explore the risk factors that affect implementation of the innovative technique of single-incision laparoscopic appendectomy (solo-SLA) without assistance in patients with complicated appendicitis, the goal being improving surgical success rates and reducing the incidence of complications. &lt;b&gt;Methods:&lt;/b&gt; This was an observational study. Indications for solo-SLA surgery were as follows: (1) computed tomography or ultrasound findings suggestive of acute appendicitis, accompanied by a high white blood cell count and C-reactive protein concentration; (2) disease course exceeding 72 hours, standard anti-infection treatment ineffective, inflammatory reaction not localized, surgery mainly aimed at abscess drainage, and the appendix removed if indicated intraoperatively; (3) acute onset stabilized for more than 3 months after conservative treatment; and (4) recurrent chronic appendicitis. Relative contraindications comprised: (1) cardiopulmonary insufficiency, extremely high risk for general anesthesia for laparoscopic surgery; (2) severe coagulation dysfunction; and (3) imaging findings suggestive of formation of a peri-appendiceal abscess, stable after anti-infection treatment, and a tendency for the inflammatory reaction to localize. We retrospectively collected clinical data of 106 patients with complicated appendicitis who had undergone solo-SLA in the Department of Emergency Surgery, Peking University People's Hospital from February to October 2023. Preoperative computed tomography showed appendiceal fecaliths, blurring of the tissue surrounding fat, intra- and extra-luminal gas and exudate, peri-appendiceal abscess, ascites, and intestinal obstruction by appendicitis. The study cohort comprised 53 male and 53 female patients aged (41.4±17.4) years. The median body mass index was (24.2±3.6) kg/m&lt;sup&gt;2&lt;/sup&gt; and median preoperative body temperature (37.3±0.9)℃ Appendicitis had been present for &gt;3 days in 21 of the patients (19.8%) and the maximum diameter of the appendix was (12.4±3.8) mm. The efficacy of the surgery was assessed and logistic regression analysis used to explore the factors affecting the duration of the procedure. The relationship between the maximum diameter of the appendix and duration of surgery was non-linear and was explored using a logistic regression model with restricted cubic spline (RCS). &lt;b&gt;Results:&lt;/b&gt; Only one patient required conversion to open surgery; all the other patients successfully completed solo-SLA with a median intraoperative blood loss of 10 (1-100) ml and a surgical time of (65.4±31.7) minutes. Pain scores on postoperative Day 1 and 7 were (3.4±3.2) points and (1.5±1.7) points, respectively. There were no significant postoperative complications .The postoperative hospital stay was (3.5±1.5) days and the interval to resuming normal activities 14 (2-40) days. According to univariate and multivariate analyses, disease course &gt;3 days (OR=5.19, 95%CI: 1.59-16.","PeriodicalId":23959,"journal":{"name":"中华胃肠外科杂志","volume":"28 3","pages":"314-319"},"PeriodicalIF":0.0,"publicationDate":"2025-03-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143693557","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}

{"title":"[Surgical problems and considerations in conversion treatment of stage IV gastric cancer].","authors":"Y J Shu, J W Mei, P Dong","doi":"10.3760/cma.j.cn441530-20240818-00289","DOIUrl":"10.3760/cma.j.cn441530-20240818-00289","url":null,"abstract":"<p><p>The prognosis of stage IV gastric cancer is extremely poor. Due to the diversificationof treatment methods and the rise and popularizationof multidisciplinary treatment(MDT), the conversion therapy for stage IV gastric cancer has been recognized by more and more surgeons, which brings hope to patients with stage IV gastric cancer,. However, stage IV gastric cancer has various forms of metastasis, and the effect of conversion therapy and the prognosis of patients depend on the site of tumor metastasis and the systemic tumor load. Our team has long applied MDT diagnosis and treatment mode to patients with stage IV gastric cancer, performing R0 surgical resection for patients with tumor down staging or distant metastasis control after conversion. We would like to share our team's experiences and some controversial hot topics, focal points and difficult problems.</p>","PeriodicalId":23959,"journal":{"name":"中华胃肠外科杂志","volume":"28 3","pages":"330-337"},"PeriodicalIF":0.0,"publicationDate":"2025-03-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143692992","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}

{"title":"[Development of a nomogram for predicting pathological complete response after neoadjuvant chemoradiotherapy in patients with locally advanced rectal cancer].","authors":"R X Tian, X H Hu, H C Liu, P Cheng, J Y Li, M D L Bao, L M Zhao, Z X Zheng","doi":"10.3760/cma.j.cn441530-20250106-00012","DOIUrl":"10.3760/cma.j.cn441530-20250106-00012","url":null,"abstract":"<p><p><b>Objective:</b> To construct and validate a predictive model for pathological complete response (pCR) in patients with locally advanced rectal cancer (LARC) after neoadjuvant chemoradiotherapy. <b>Methods:</b> This retrospective observational study included 595 patients with stage T2-4 and (or) N+M0 LARC diagnosed in the Cancer Hospital of Chinese Academy of Medical Sciences and the Fourth Hospital of Hebei Medical University who had no metastases, tolerated neoadjuvant therapy, completed neoadjuvant therapy, and had undergone radical surgery after neoadjuvant therapy. The training set comprised 299 patients admitted to the Cancer Hospital of Chinese Academy of Medical Sciences from 2013 to 2018, the internal validation set 155 patients admitted from 2019 to 2023, and the external validation set 141 patients admitted to the Fourth Hospital of Hebei Medical University from 2013 to 2021. They were divided into pCR group and non-pCR groups according to postoperative pathology. Among the 299 patients in the training set, 247 were in the non-PCR and 52 in the pCR group; among the 155 patients verified internally, 113 were in the non-PCR and 42 in the pCR group; and among the 141 patients validated externally, 132 were in the non-pCR and nine in the pCR group. Logistic regression was used for univariate and multifactorial analysis to explore the factors associated with pCR and construct a nomogram prediction model. Receiver operating characteristic curves, calibration curves, and decision curve analysis (DCA) were used to validate the performance of the predictive model. <b>Results:</b> Univariate and multivariate logistic regression analysis showed that carbohydrate antigen 19-9 (<i>P</i>=0.040, OR=0.97, 95%CI: 0.93-0.99), neutrophil count (<i>P</i><0.001, OR=0.66, 95%CI: 0.52-0.84), tumor T stage: Stage IV (<i>P</i>=0.011, OR=0.22, 95%CI: 0.07-0.70), tumor N stage: Stage I (<i>P</i>=0.003, OR=0.22,95%CI:0.08-0.60), Stage II (<i>P</i><0.001, OR=0.03, 95%CI: 0.01-0.09) and involvement of mesorectal fascia (<i>P</i>=0.004, OR=0.09, 95%CI: 0.02-0.47) were independent predictors of pCR. In the training set, the area under the receiver operating characteristic curve of the model was 0.92 (95%CI: 0.87-0.96), whereas in the internal and external validation sets, the AUCs were 0.78 and 0.81, respectively. The calibration curve showed that the prediction model had good prediction efficiency in both the training and verification sets. Decision curve analysis showed that the net benefit of the model was largest when the threshold probability was in the range of 5.2% to 89.7% (in the internal and external validation sets, the threshold probabilities were in the range of 15.7% to 92.3% and 2.2% to 84.1%, respectively). <b>Conclusion:</b> The nomogram model constructed in this study showed efficacy in predicting whether patients with LARC will achieve pCR after receiving neoadjuvant chemoradiotherapy.</p>","PeriodicalId":23959,"journal":{"name":"中华胃肠外科杂志","volume":"28 3","pages":"304-313"},"PeriodicalIF":0.0,"publicationDate":"2025-03-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143693565","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}

{"title":"[Challenges and progress in in the clinical application of fecal microbiota transplantation].","authors":"Y Xu, C Ye, N Li, Q Y Chen","doi":"10.3760/cma.j.cn441530-20241224-00420","DOIUrl":"10.3760/cma.j.cn441530-20241224-00420","url":null,"abstract":"<p><p>With the deepening understanding of the role of gut microbiota in human health and disease, fecal microbiota transplantation has gained widespread attention as an emerging therapeutic approach in recent years. This technique involves the transplantation of microbial communities from the feces of healthy donors into patients to reconstruct or improve the gut microbiota structure, thereby achieving therapeutic goals. Fecal microbiota transplantation has become an effective method for treating recurrent or refractory <i>Clostridium difficile</i> infections and has shown good therapeutic effects and safety in clinical trials for various gastrointestinal diseases, including inflammatory bowel disease, irritable bowel syndrome, slow transit constipation, and chronic diarrhea. Moreover, its application has been extended to research in metabolic diseases and neurological disorders, which are not directly related to the gut. However, the clinical efficacy of fecal microbiota transplantation still needs improvement, and there are many challenges regarding specific application strategies that remain to be addressed. This article discusses the current progress and challenges of fecal microbiota transplantation strategies and reviews cutting-edge interventional methods such as small intestine microbiota intervention and bacteriophage therapy, aiming to provide reference for further research in fecal microbiota transplantation.</p>","PeriodicalId":23959,"journal":{"name":"中华胃肠外科杂志","volume":"28 3","pages":"266-273"},"PeriodicalIF":0.0,"publicationDate":"2025-03-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143693560","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}

{"title":"[Consensus of Chinese experts on gut microbiota and fecal microbiota transplantation in inflammatory bowel disease (2025 edition)].","authors":"","doi":"10.3760/cma.j.cn441530-20241224-00422","DOIUrl":"10.3760/cma.j.cn441530-20241224-00422","url":null,"abstract":"<p><p>In recent years, significant progress has been made in the clinical and basic research on fecal microbiota transplantation (FMT) for the treatment of inflammatory bowel disease (IBD). With the continuous application of new microbiota-based diagnostic and therapeutic concepts in clinical practice, it is imperative to standardize the diagnostic and therapeutic processes of FMT for IBD and provide consensus recommendations based on the latest evidence from evidence-based medicine for clinical practitioners. Organized by the Chinese Society for Parenteral and Enteral Nutrition of the Chinese Medical Association, the Gut Microbiota and FMT Committee of the Chinese Society for Human Health Sciences, and the Gut Microbiota Committee of the Shanghai Preventive Medicine Association, and with reference to the latest international consensus and relevant research advancements, this consensus integrates the clinical practice experience of domestic experts to establish the \"Consensus of Chinese experts on gut microbiota and fecal microbiota transplantation in inflammatory bowel disease (2025 edition)\". This consensus provides 29 recommendations focusing on the selection of FMT indications, gut microbiota analysis, donor selection and quality control for IBD transplantation, considerations during the transplantation period, selection of transplantation routes and dosages, management of FMT-related complications, and future research directions, aiming to offer standardized guidance for the clinical application of FMT in the treatment of IBD.</p>","PeriodicalId":23959,"journal":{"name":"中华胃肠外科杂志","volume":"28 3","pages":"225-235"},"PeriodicalIF":0.0,"publicationDate":"2025-03-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143693563","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}

{"title":"[Guidelines for diagnosis and treatment of abdominal wall incision hernia (2025 edition)].","authors":"","doi":"10.3760/cma.j.cn441530-20250217-00061","DOIUrl":"10.3760/cma.j.cn441530-20250217-00061","url":null,"abstract":"<p><p>Incisional hernia is a type of iatrogenic disease, and its clinical treatment is complicated. In recent years, there have been new advances in the diagnosis, surgical methods, and materials science of incisional hernias. Based on the <i>Guidelines for Diagnosis and Treatment of Abdominal Wall Incisional Hernia (2018 Edition)</i>, more than 70 domestic experts have evaluated related publications using standards of evidenced-based medicine. Issues such as complex abdominal wall status, loss of domain, principles of incisional hernia treatment, techniques of abdominal wall hernia defects closure, perioperative management, and follow-up have been modified in the 2025 edition for the reference of clinicians.</p>","PeriodicalId":23959,"journal":{"name":"中华胃肠外科杂志","volume":"28 3","pages":"236-245"},"PeriodicalIF":0.0,"publicationDate":"2025-03-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143693572","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}

{"title":"[Revisiting the embryonic origin of Denonvilliers' fascia based on female structure].","authors":"X D Wang","doi":"10.3760/cma.j.cn441530-20240606-00200","DOIUrl":"10.3760/cma.j.cn441530-20240606-00200","url":null,"abstract":"<p><p>There has been significant controversy over the existence of Denonvilliers' fascia in women. To verify and explore whether women have Denonvilliers' fascia equivalent to men, and its impact and significance on rectal cancer surgery, we conducted observation and research based on previous views, combined with adult female pelvic specimens and surgical video data. No independent and intact fascial structures similar to Denonvilliers' fascia was found in the rectovaginal space. We believe that there may not be an independent fascial structure equivalent to the male Denonvilliers' fascia between the female rectum and vagina. The Denonvilliers' fascia may be an organ and tissue related to gender and regulated by sex hormones during development (i.e., the male Denonvilliers' fascia may be an undeveloped vagina).</p>","PeriodicalId":23959,"journal":{"name":"中华胃肠外科杂志","volume":"28 3","pages":"320-322"},"PeriodicalIF":0.0,"publicationDate":"2025-03-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143693585","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}

{"title":"[A case report of IgG4-related diffuse sclerosing mesenteric panniculitis].","authors":"X Zhou, H P Wang, K Song, H Li","doi":"10.3760/cma.j.cn441530-20240727-00262","DOIUrl":"10.3760/cma.j.cn441530-20240727-00262","url":null,"abstract":"","PeriodicalId":23959,"journal":{"name":"中华胃肠外科杂志","volume":"28 3","pages":"327-329"},"PeriodicalIF":0.0,"publicationDate":"2025-03-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143693555","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}

{"title":"[Chinese expert consensus on function-preserving gastrectomy for gastric cancer(2025 edition)].","authors":"","doi":"10.3760/cma.j.cn441530-20250106-00011","DOIUrl":"10.3760/cma.j.cn441530-20250106-00011","url":null,"abstract":"&lt;p&gt;&lt;p&gt;With the advancement of surgical treatment for gastric cancer surgery, the preservation of gastric function to reduce the post-operative impacts on patients' quality of life, while ensuring effective surgical outcomes, have become both patients' expectations and the pursuit of surgeons. The emergence of the concept of function-preserving gastrectomy (FPG) marks the entry of surgical treatment of gastric cancer into a more personalized and precise era. The \"Chinese expert consensus on function - preserving gastrectomy for gastric cancer(2021 edition)\" was the first systematic effort to define FPG, outlining its indications and surgical approaches. In recent years, with the rapid development of surgical technologies, such as functional visualization, lymph node tracing, vascular navigation, and multi-omics imaging artificial intelligence (AI), the concept and practice of FPG have continued to evolve. Therefore, led by the the Gastrointestinal Surgery Branch, Surgery Branch, Chinese Medical Association (CMA) with Chinese Society of Surgical Oncology of Chinese Medical Doctor Association (CMDA), Chinese Society of Upper Gastrointestinal Surgeon of CMDA, Stomach and Intestines Committee of Chinese Anticancer Association, and the Gastric Cancer Committee of the Chinese Anticancer Association, a group of experts has come together to update and refine the consensus based on domestic and international literature, as well as recent researches and clinical practice. The definition of FPG remains consistent with the 2021 edition, emphasizing the goal of achieving radical resection for early gastric cancer while minimizing the scope of surgery, selecting appropriate reconstruction methods, and preserving as much gastric function as possible. The main surgical techniques include those that reduce the extent of surgery (such as pylorus-preserving gastrectomy, segmental gastrectomy, local gastric resection, and endoscopic resection), proximal gastrectomy (PG), and distal gastrectomy with vagus nerve preservation. After PG, the surgical reconstruction of the digestive tract involves procedures such as anastomosis between the distal remnant stomach and esophagus, esophagus-tube stomach anastomosis, double tract reconstruction (DTR), interposition jejunostomy, side to side gastroesophagostomy (SOFY), and double flap gastroesophagostomy (Kamikawa anastomosis). In recent years, new anti-reflux techniques have emerged, such as the tube-shaped stomach \"Giraffe anastomosis\", modified SOFY anastomosis, single flap gastroesophagostomy, arch-shaped anastomosis, and tunnel anastomosis. Functional assessment after FPG primarily includes evaluating remnant gastric function, function-related complications, post-operative nutritional status, and quality of life. This updated consensus is expected to standardize the practice of FPG, provide more personalized surgical treatment options for patients with gastric cancer, and further improve their post-operative quality of lif","PeriodicalId":23959,"journal":{"name":"中华胃肠外科杂志","volume":"28 2","pages":"109-120"},"PeriodicalIF":0.0,"publicationDate":"2025-02-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143459751","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}