中华胃肠外科杂志最新文献

{"title":"[Peripheral blood cell count composite score as a prognostic factor in patients with colorectal cancer].","authors":"P Y Guo, X H Hu, B K Li, T Lu, J M Liu, C Y Wang, W B Niu, G Y Wang, B Yu","doi":"10.3760/cma.j.cn441530-20231029-00151","DOIUrl":"10.3760/cma.j.cn441530-20231029-00151","url":null,"abstract":"<p><p><b>Objective:</b> To develop a prognostic prediction model for patients with colorectal cancer based on a peripheral blood cell composite score (PBCS) system. <b>Methods:</b> This retrospective observational study included patients who had primary colorectal cancer without distant metastasis, who did not undergo radiotherapy or chemotherapy before surgery, who did not receive leukocyte or platelet-raising therapy within 1 month before surgery, and whose postoperative pathology confirmed colorectal adenocarcinoma with complete tumor resection. Patients with severe anemia, infection, or hematologic diseases before surgery, as well as those with severe heart, lung, or other important organ diseases or concurrent malignant tumors, were excluded. In total, 1021 patients with colorectal cancer who underwent surgical treatment in the Department of Gastrointestinal Surgery of the Fourth Hospital of Hebei Medical University from April 2018 to April 2020 were retrospectively included as the training set (766 patients) and the internal validation set (255 patients). Additionally, using the same criteria, 215 patients with colorectal cancer who underwent surgical treatment in another treatment group from March 2015 to December 2020 were selected as the external validation set. The \"surv_cutpoint\" function in R software was used to analyze the optimal cut-off values of neutrophils, lymphocytes, and platelets, and a PBCS system was established based on the optimal cut-off values. The scoring rules of the PBCS system were as follows: Neutrophils and platelets below the optimal cut-off value = 1 point, otherwise 0 points; Lymphocytes above the optimal cut-off value = 1 point, otherwise 0 points. The scores of the three cell types were added together to obtain the PBCS. Univariate and multivariate Cox regression analyses were performed to explore the correlation between patients' clinicopathological features and prognosis, and a nomogram was constructed based on the Cox regression analysis to predict patients' prognosis. The accuracy of the nomogram prediction model was validated using the C-index, calibration curve, and decision curve analysis. <b>Results:</b> The optimal cut-off values for neutrophils, lymphocytes, and platelets were 4.40×10<sup>9</sup>/L, 1.41×10<sup>9</sup>/L, and 355×10<sup>9</sup>/L, respectively. The patients were divided into high and low groups according to the optimal cut-off values of these cells. Survival curve analysis showed that a high lymphocyte count (training set: <i>P</i>=0.042, internal validation: <i>P</i>=0.010, external validation: <i>P</i>=0.029), low neutrophil count (training set: <i>P</i>=0.035, internal validation: <i>P</i>=0.001, external validation: <i>P</i>=0.024), and low platelet count (training set: <i>P</i>=0.041, internal validation: <i>P</i>=0.030, external validation: <i>P</i>=0.024) were associated with prolonged overall survival (OS), with statistically significant differences in all cases. Survival a","PeriodicalId":23959,"journal":{"name":"中华胃肠外科杂志","volume":"27 9","pages":"953-965"},"PeriodicalIF":0.0,"publicationDate":"2024-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142308674","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":"[Research progress on the distribution patterns and surgical dissection of central lymph nodes in left-sided colon cancer].","authors":"Y D Bao, Z D Gao","doi":"10.3760/cma.j.cn441530-20240711-00243","DOIUrl":"10.3760/cma.j.cn441530-20240711-00243","url":null,"abstract":"<p><p>Lymphatic metastasis is one of the main pathways of colorectal cancer spread and also a crucial factor in patient long-term prognosis. Lymph node dissection in the possible tumor drainage area, particularly the central group of lymph nodes at the root of the tumor-associated supplying artery, is a key and challenging aspect of surgical techniques. Currently, the patterns of lymphatic drainage and the distribution of central lymph nodes in left-sided colon cancer are not well illustrated, and there is no consensus on the necessity and extent of central lymph node dissection. This has led to significant variability in the extent of lymph node dissection among different surgeons in clinical practice, a lack of quality control standards for surgical procedures, and impacts on postoperative treatment strategy and long-term outcomes. Moreover, current research on lymphatic drainage and metastasis is primarily based on traditional anatomy, whereas individualized, precise approaches to lymph node dissection have not been realized. The application of preoperative and intraoperative lymph node imaging techniques based on functional anatomy in colorectal cancer patients is still under exploration.</p>","PeriodicalId":23959,"journal":{"name":"中华胃肠外科杂志","volume":"27 9","pages":"914-918"},"PeriodicalIF":0.0,"publicationDate":"2024-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142308675","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 of multiple primary hepatoid adenocarcinoma in the intestine].","authors":"L F Xie, J Jia, Y Liu, X Y Li","doi":"10.3760/cma.j.cn441530-20240105-00008","DOIUrl":"10.3760/cma.j.cn441530-20240105-00008","url":null,"abstract":"","PeriodicalId":23959,"journal":{"name":"中华胃肠外科杂志","volume":"27 6","pages":"639-641"},"PeriodicalIF":0.0,"publicationDate":"2024-06-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141432913","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":"[Application of D-type stoma repair in parastomal hernia after permanent sigmoidostomy].","authors":"Y Y Fu, J J Zhou, C K Zhang, L H Sun, W Wang, J Ren, L H Wang, D Tang, Y Ma, D R Wang","doi":"10.3760/cma.j.cn441530-20230831-00078","DOIUrl":"10.3760/cma.j.cn441530-20230831-00078","url":null,"abstract":"","PeriodicalId":23959,"journal":{"name":"中华胃肠外科杂志","volume":"27 6","pages":"621-624"},"PeriodicalIF":0.0,"publicationDate":"2024-06-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141432915","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":"[Report on the application of endoscopic intermuscular dissection for diagnostic resection of early rectal cancer].","authors":"D J Fan, L Y Huang, J W Qi, Q N Wu, X H Kong, C J Li","doi":"10.3760/cma.j.cn441530-20240314-00098","DOIUrl":"10.3760/cma.j.cn441530-20240314-00098","url":null,"abstract":"<p><p><b>Objective:</b> This report presents the initial outcomes of endoscopic intermuscular dissection (EID), a novel technique introduced by our team for the diagnostic resection of early rectal cancer, focusing on the postoperative status of the vertical margins. <b>Methods:</b> On January 26, 2024, a patient with early rectal cancer (cT1-2N0M0) underwent Endoscopic Intermuscular Dissection. The EID procedure consists of six steps: (1) mucosal incision; (2) submucosal dissection; (3) superficial muscular layer incision; (4) intermuscular dissection; (5) complete tumor removal; (6) wound management. <b>Results:</b> The patient was a 70-year-old male with rectal cancer (cT1-2N0M0). The tumor was located on the left anterior wall of the rectum, approximately 9 cm from the anal margin, and measured 20mm in size. The dissection rate was 2.68 mm²/minute, and the total duration of the surgery was 109 minutes. The patient was successfully discharged on the fifth day after surgery. Pathological examination of the post-endoscopic surgery specimen revealed pT1b, with negative vertical margins. Follow-up after more than one month showed good recovery with no complications such as bleeding, perforation, infection, or stricture occurring. Colonoscopy indicated the presence of a granulation tissue suggestive of inflammation. <b>Conclusion:</b> Endoscopic Intermuscular Dissection for the diagnostic resection of early rectal cancer is potentially safe and may achieve negative vertical margins.</p>","PeriodicalId":23959,"journal":{"name":"中华胃肠外科杂志","volume":"27 6","pages":"630-633"},"PeriodicalIF":0.0,"publicationDate":"2024-06-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141432969","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":"[Clinical application of modified abdominal transverse incision in colorectal cancer surger].","authors":"X C Ge, Z Q Li, J H Zhang, Q Xin","doi":"10.3760/cma.j.cn441530-20231206-00046","DOIUrl":"10.3760/cma.j.cn441530-20231206-00046","url":null,"abstract":"","PeriodicalId":23959,"journal":{"name":"中华胃肠外科杂志","volume":"27 6","pages":"625-627"},"PeriodicalIF":0.0,"publicationDate":"2024-06-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141432961","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":"[Multivariate analysis and construction and validation of a nomogram model from data of 1610 patients with non-tumor-related anastomotic stenosis after rectal cancer surgery].","authors":"K M Qiu, W Jian, J X Zheng, M Y Feng, X M Liu, D S Lu, J Yan","doi":"10.3760/cma.j.cn441530-20230926-00112","DOIUrl":"10.3760/cma.j.cn441530-20230926-00112","url":null,"abstract":"&lt;p&gt;&lt;p&gt;&lt;b&gt;Objective:&lt;/b&gt; To assess the risk factors affecting development of non-tumor- related anastomotic stenosis after rectal cancer and to construct a nomogram prediction model. &lt;b&gt;Methods:&lt;/b&gt; This was a retrospective study of data of patients who had undergone excision with one-stage intestinal anastomosis for rectal cancer between January 2003 and September 2018 in Nanfang Hospital of Southern Medical University. The exclusion criteria were as follows: (1) pathological examination of the operative specimen revealed residual tumor on the incision margin of the anastomosis; (2) pathological examination of postoperative colonoscopy specimens revealed tumor recurrence at the anastomotic stenosis, or postoperative imaging evaluation and tumor marker monitoring indicated tumor recurrence; (3) follow-up time &lt;3 months; and (4) simultaneous multiple primary cancers. Univariate analysis using the χ&lt;sup&gt;2&lt;/sup&gt; or Fisher's exact test was performed to assess the study patients' baseline characteristics and variables such as tumor-related factors and surgical approach (&lt;i&gt;P&lt;/i&gt;&lt;0.05). Multivariate analysis using binary logistic regression was then performed to identify independent risk factors for development of non-tumor-related anastomotic stenosis after rectal cancer. Finally, a nomogram model for predicting non-tumor-related anastomotic stenosis after rectal cancer surgery was constructed using R software. The reliability and accuracy of this prediction model was evaluated using internal validation and calculation of the area under the curve of the model's receiver characteristic curve (ROC). &lt;b&gt;Results:&lt;/b&gt; The study cohort comprised 1,610 patients, including 1,008 men and 602 women of median age 59 (50, 67) years and median body mass index 22.4 (20.2, 24.5) kg/m². Non-tumor-related anastomotic stenosis developed in 121 (7.5%) of these patients. The incidence of non-tumor-related anastomotic stenosis in patients who had undergone neoadjuvant chemotherapy, neoadjuvant radiotherapy, and surgery alone was 11.2% (10/89), 26.4% (47/178), and 4.8% (64/1,343), respectively. Neoadjuvant treatment (neoadjuvant chemotherapy: OR=2.455, 95%CI: 1.148-5.253, &lt;i&gt;P&lt;/i&gt;=0.021; neoadjuvant chemoradiotherapy, OR=3.882, 95%CI: 2.425-6.216, &lt;i&gt;P&lt;/i&gt;&lt;0.001), anastomotic leakage (OR=7.960, 95%CI: 4.550-13.926, &lt;i&gt;P&lt;/i&gt;&lt;0.001), open laparotomy (OR=3.412, 95%CI: 1.772-6.571, &lt;i&gt;P&lt;/i&gt;&lt;0.001), and tumor location (distance of tumor from the anal verge 5-10 cm: OR=2.381, 95%CI:1.227-4.691, &lt;i&gt;P&lt;/i&gt;&lt;0.001; distance of tumor from the anal verge &lt;5 cm: OR=5.985,95% CI: 3.039-11.787, &lt;i&gt;P&lt;/i&gt;&lt;0.001) were identified as independent risk factors for non-tumor-related anastomotic stenosis. Thereafter, a nomogram prediction model incorporating the four identified risk factors for development of anastomotic stenosis after rectal cancer was developed. The area under the curve of the model ROC was 0.815 (0.773-0.857, &lt;i&gt;P&lt;/i&gt;&lt;0.001), and the C-index of the predictive model was 0.815, in","PeriodicalId":23959,"journal":{"name":"中华胃肠外科杂志","volume":"27 6","pages":"600-607"},"PeriodicalIF":0.0,"publicationDate":"2024-06-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141432965","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":"[Intraperitoneal chemotherapy for colorectal cancer peritoneal metastasis].","authors":"J W Ye, H B Hu, R Luo, H M Wang, R K Huang, L L Chu, H Wang","doi":"10.3760/cma.j.cn441530-20230522-00177","DOIUrl":"10.3760/cma.j.cn441530-20230522-00177","url":null,"abstract":"<p><p>Peritoneal metastasis is one of the common site of colorectal cancer metastasis and associated with a poor prognosis. The core strategy for colorectal cancer peritoneal metastasis primarily revolves around a comprehensive treatment approach with cytoreductive surgery and systemic chemotherapy as the mainstay, supplemented by intraperitoneal chemotherapy. As an important supplement to treatment, intraperitoneal chemotherapy has broad application prospects. The main modalities are hyperthermic intraperitoneal chemotherapy (HIPEC), neoadjuvant intraperitoneal and systemic chemotherapy (NIPS), early postoperative intraperitoneal chemotherapy (EPIC), sequential postoperative intraperitoneal chemotherapy (SPIC), normothermic intraperitoneal chemotherapy (NIPEC) and pressurized intraperitoneal aerosol chemotherapy (PIPAC). To promote the standardized application of intraperitoneal chemotherapy, further research on the mechanisms underlying peritoneal metastasis of colorectal cancer, selection of effective intraperitoneal chemotherapy agents, determination of optimal timing and administration protocols, exploration of the feasibility of sequential intraperitoneal chemotherapy and conduction of valuable basic and clinical research are currently needed. This paper will review the development and origins of intraperitoneal chemotherapy, treatment modalities, as well as the current application status and prospects of various treatment approaches in the context of peritoneal metastasis of colorectal cancer.</p>","PeriodicalId":23959,"journal":{"name":"中华胃肠外科杂志","volume":"27 6","pages":"646-652"},"PeriodicalIF":0.0,"publicationDate":"2024-06-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141432964","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":"[Emphasis on awareness of early-onset colorectal cancer].","authors":"Y T Hu, Q Xiao, K F Ding, S Zheng","doi":"10.3760/cma.j.cn441530-20240305-00086","DOIUrl":"10.3760/cma.j.cn441530-20240305-00086","url":null,"abstract":"<p><p>The incidence and mortality rates of early-onset colorectal cancer (EOCRC) among people under 50 years old are showing an upward trend. Although traditional epidemiological studies have conducted relatively deep research and screened out environmental factors related to EOCRC, our understanding of the causes, mechanisms, and treatment of this disease is still far from sufficient. In this review, we clarify the current progress of EOCRC, with a particular focus on epidemiology, screening status, clinical symptoms, and prognosis. This provides new evidence for secondary prevention, including precision screening, and offers new ideas for improving the diagnosis and treatment of EOCRC.</p>","PeriodicalId":23959,"journal":{"name":"中华胃肠外科杂志","volume":"27 5","pages":"430-435"},"PeriodicalIF":0.0,"publicationDate":"2024-05-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141080980","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":"[Progress of circulating tumor DNA methylation for gastric cancer screening and management].","authors":"Q X Cao, L Yan, N Y Hou, J F Chen, S Yu, H J Lu, Z J Dan, M H Pang","doi":"10.3760/cma.j.cn441530-20230710-00001","DOIUrl":"10.3760/cma.j.cn441530-20230710-00001","url":null,"abstract":"<p><p>Circulating tumor DNA (ctDNA) is cell-free DNA released by tumors or circulating tumor cells, containing abundant tumor-specific information that can serve as biomarkers for cancer early screening, monitoring, prognosis, and prediction of treatment response. This is particularly attractive in the field of gastric cancer, where high-quality screening, monitoring, and prediction methods are currently lacking. Gastric cancer exhibits significant tumor heterogeneity, with large differences in genetic and epigenetic characteristics among different subgroups. Methylated ctDNA has high sensitivity and specificity, which can help clarify tumor genotyping and facilitate the formulation of precise diagnostic and therapeutic strategies. Furthermore, numerous studies have confirmed the unique advantages of methylated DNA in predicting treatment response, adjuvant therapy, and drug resistance assessment, which may be used in the future to enhance the efficacy of chemotherapy regimens and improve patient chemotherapeutic response, and even treat multidrug resistance. However, there are several challenges associated with methylated ctDNA, such as low sensitivity and specificity at single-target sites, limited association between some gastric cancer subtypes and ctDNA, off-target risks, and the lack of large-scale and high-quality clinical research evidence. This review mainly summarizes current research on the methylation status of ctDNA in gastric cancer and connects these findings to early screening, recurrence monitoring, and potential treatment opportunities for gastric cancer. With advances in technology and the deepening of interdisciplinary research, ctDNA detection will reveal more disease information and become an essential foundation for gastric cancer research and precision medicine treatment.</p>","PeriodicalId":23959,"journal":{"name":"中华胃肠外科杂志","volume":"27 5","pages":"535-544"},"PeriodicalIF":0.0,"publicationDate":"2024-05-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141081347","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}