中华胃肠外科杂志最新文献

{"title":"[Clinical application of intraperitoneal chemotherapy ports in patients with gastric cancer and peritoneal metastases].","authors":"Z Zhang, S Lu, Y P Guo, F Bian, Y K Xu, X D Mo, H X Luo, X Y Tang, M Shi, J Zhang, C Yan, Y Chen, Z G Zhu","doi":"10.3760/cma.j.cn441530-20250319-00108","DOIUrl":"https://doi.org/10.3760/cma.j.cn441530-20250319-00108","url":null,"abstract":"<p><p><b>Objective:</b> To evaluate the clinical value and safety of an intraperitoneal chemotherapy port technique in patients with gastric cancer and peritoneal metastases undergoing intraperitoneal chemotherapy. <b>Methods:</b> This was a retrospective, descriptive case analysis. From November 2022 to October 2024, patients diagnosed with gastric cancer and peritoneal metastases at Wuxi Branch of Ruijin Hospital, Shanghai Jiao Tong University School of Medicine with an expected survival >3 months, underwent laparoscopic exploration combined with implantation of an intraperitoneal chemotherapy port [PORT-A-CATH II system (Model 21-4055-24)] implantation. The procedure was as follows: (1) after laparoscopic exploration, a 4-cm skin incision was made at a predetermined site and a subcutaneous pocket created by dissecting to the muscle fascia and removing subcutaneous fat as needed to position the port septum 0.5-1.0 cm from the skin surface; (2) under direct laparoscopic visualization, the abdominal cavity was punctured and a guidewire inserted, followed by an 8.5 Fr sheath, through which a catheter with three trimmed side holes was placed after removal of the sheath; (3) the catheter length in the abdominal cavity was adjusted to 25-30 cm and the catheter trimmed, and connected to the port base, ensuring it extended beyond the connector's visible hole; (4) the whole port was placed within the subcutaneous pocket, and non-absorbable sutures used to create a double purse-string suture at the catheter's abdominal entry, forming an anti-reflux ring; (5) non-absorbable sutures were used to securely fix the port to the fascia through its four base holes and the exposed catheter segments on the fascia sutured and buried; (6) patency was confirmed by injecting saline and followed by intermittent skin closure provided there was no bleeding; and (7) the catheter tip was positioned in the pelvic cavity under laparoscopic guidance. Postoperatively, the patients underwent normothermic intraperitoneal and systemic treatment. The port infusion protocol involved disinfecting the skin (>10 cm diameter) around the port, confirming the puncture site, inserting a Huber needle vertically at 90° to the port base, infusing 100 mL saline to ensure patency, followed by continuous infusion of 1000 mL paclitaxel solution, and sealing with 20 mL saline before removing the needle. No saline flushing was required between chemotherapy infusions. The primary outcomes were the incidence and management of complications post-port implantation. <b>Results:</b> The study cohort comprised 225 patients with gastric cancer and peritoneal metastases. Using standardized port implantation and postoperative puncture procedures, the complication rate during follow-up was 14.2% (32/225), including effusion in 14 patients (6.2%), port infection in 10 (4.4%), incision dehiscence in four (1.8%), port inversion in two (0.9%), hematoma in one (0.4%), and catheter rupture in one (0.4%). Seventy-f","PeriodicalId":23959,"journal":{"name":"中华胃肠外科杂志","volume":"28 5","pages":"521-527"},"PeriodicalIF":0.0,"publicationDate":"2025-05-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144128945","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 age cut-off and prognosis of early-onset gastric cancer in young patients].","authors":"J Lu, C B Lv, L Y Tong, J Chen, J N Wu, F L Liu","doi":"10.3760/cma.j.cn441530-20241023-00349","DOIUrl":"https://doi.org/10.3760/cma.j.cn441530-20241023-00349","url":null,"abstract":"&lt;p&gt;&lt;p&gt;&lt;b&gt;Objective:&lt;/b&gt; To explore the optimal age cutoff for diagnosis and the prognosis of early-onset gastric cancer in young patients. &lt;b&gt;Methods:&lt;/b&gt; Clinicopathological data of patients with gastric adenocarcinoma aged ≤45 years who had undergone radical gastrectomy in the Department of Gastric Surgery, Fudan University Shanghai Cancer Center from January 2013 to December 2018 were retrospectively collected. Patients with distant metastases, other malignant tumors, combined organ resection, gastric stump cancer, positive margin, and incomplete clinical or follow-up data were excluded. X-tile software analysis of the actual overall survival of the collected cases yielded an optimal cut-off of 32 years. Accordingly, the enrolled cases were divided into an early-onset young group (age ≤32 years) and young adult group (age &gt;32 years). Clinicopathological characteristics, long-term survival, and postoperative recurrence were compared between the two groups. Univariate and multivariate analyses were performed using the Cox proportional hazards model to identify the factors affecting the prognosis of young patients with gastric cancer. &lt;b&gt;Results:&lt;/b&gt; The study cohort comprised 462 patients, including 256 (55.4%) women, 419 (90.7%) with middle and lower gastric cancers, and 343 (74.2%) with poorly differentiated tumors. There were 101 patients in the early-onset young group and 361 in the young adult group. These groups did not differ significantly in terms of sex, body mass index, tumor location, tumor size, surgical procedure, neurovascular invasion, or tumor stage (all &lt;i&gt;P&lt;/i&gt;&gt;0.05). The proportion of patients with poorly differentiated tumors in the early-onset young group was significantly higher than that in the young adult group (89.1%[90/101] vs. 70.1%[253/361], χ&lt;sup&gt;2&lt;/sup&gt;=15.26, &lt;i&gt;P&lt;/i&gt;&lt;0.001). All study patients completed 5 years of follow-up, the median duration of which was 101 months (61-133 months). Death or tumor recurrence occurred in 151 patients (32.7%), in 118 of whom the sites of recurrence and metastasis could be identified, 38 in the early-onset young group and 80 in the young adult group. Fifty-five (46.6%) patients developed peritoneal metastases and 40 (33.9%) hematogenous metastases. In the early-onset young group, 20 patients developed peritoneal metastases, 11 hematogenous metastases, five distant lymph node metastases, and two local recurrence. In the young adult group, 35 patients developed peritoneal metastases, 29 hematogenous metastases, six local recurrences, and 10 distant lymph node metastases. The 5-year overall survival and disease-free survival rates were significantly higher in the young adult group than in the early-onset young group (73.7% vs. 57.4%, &lt;i&gt;P&lt;/i&gt;=0.002 and 70.6% vs. 55.4%, &lt;i&gt;P&lt;/i&gt;=0.004, respectively). Cox multivariate analysis showed that age &gt;32 years (HR=0.63, 95%CI: 0.43-0.90, &lt;i&gt;P&lt;/i&gt;=0.012) was an independent protective factor for overall survival, whereas later N stage (HR=1.67, 9","PeriodicalId":23959,"journal":{"name":"中华胃肠外科杂志","volume":"28 4","pages":"400-407"},"PeriodicalIF":0.0,"publicationDate":"2025-04-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144015123","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":"[Efficacy of a fascia-locking circular continuous suture ostomy technique in parastomal hernia prevention].","authors":"H T Ma, X F Zhu, Y Wang, E L Jiang, W D Xiao, Y Qiu","doi":"10.3760/cma.j.cn441530-20241022-00348","DOIUrl":"https://doi.org/10.3760/cma.j.cn441530-20241022-00348","url":null,"abstract":"<p><p><b>Objective:</b> To evaluate the feasibility and preventive efficacy of a fascia- locking circular continuous suture ostomy technique in reducing parastomal hernia incidence. <b>Methods:</b> This technique was applied to patients undergoing permanent colostomy following radical rectal cancer resection. Surgical steps included: (1) A circular incision was made 1-2 cm medial to the intersection of the lateral margin of the rectus abdominis muscle and the line connecting the umbilicus to the left anterior superior iliac spine. Subcutaneous tissues were dissected vertically to expose the anterior rectus sheath, followed by blunt separation of the rectus abdominis after longitudinal incision of the sheath. The posterior rectus sheath and peritoneum were similarly incised. (2) Eight equidistant interrupted sutures (anchoring knots) were placed through the anterior rectus sheath, partial rectus abdominis, posterior rectus sheath, and peritoneum. (3) The terminal colon was exteriorized, and continuous sutures were applied to secure the anchoring knots and seromuscular layers of the bowel between knots, forming a circular locking mechanism by tying the terminal suture to the initial knot's tail. (3) The skin and seromuscular layers of the bowel margin were intermittently sutured (8-12 stitches) to achieve mucosal eversion. <b>Results:</b> From February to October 2023, 13 patients (11 males, 2 females; age: 67 ± 10 years; BMI: 23.8 ± 4.0 kg/m²) underwent this technique at the Second Affiliated Hospital of Army Medical University. Mean stoma creation time was 15.7 ± 3.0 minutes. During a follow-up of 14.6 ± 3.1 months, physical examinations and abdominal CT scans identified parastomal hernias in 2 male patients at 10 and 7 months postoperatively. Only one patient experienced a Clavien-Dindo grade ≥Ⅲ complication, which resolved with treatment. No stoma-related complications (e.g., infection, stenosis, or prolapse) occurred in any patient. <b>Conclusion:</b> The fascia-locking circular continuous suture ostomy technique is safe and feasible, demonstrating potential efficacy in preventing parastomal hernia following colostomy.</p>","PeriodicalId":23959,"journal":{"name":"中华胃肠外科杂志","volume":"28 4","pages":"408-411"},"PeriodicalIF":0.0,"publicationDate":"2025-04-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144013361","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":"[Prevention of ileostomy-related complications and management of anal preservation surgery for rectal cancer].","authors":"X H Hu, X Yin, Z M Zhao, B K Li, G Y Wang","doi":"10.3760/cma.j.cn441530-20250207-00050","DOIUrl":"https://doi.org/10.3760/cma.j.cn441530-20250207-00050","url":null,"abstract":"<p><p>Protective ileostomy is an important bridging procedure in low anterior resection for rectal cancer, aimed at preventing severe anastomotic complications. It has been shown to significantly reduce the risk of pelvic infections resulting from anastomotic leakage. However, whether ileostomy plays a positive clinical role in preventing anastomotic leaks remains a subject of considerable debate. The procedure for creating a protective ileostomy is relatively simple and convenient, making it a commonly used approach in clinical practice. Nevertheless, as a traumatic surgical procedure, ileostomy itself may lead to a range of complications. Therefore, it is crucial to comprehensively understand the potential complications associated with ileostomy, develop optimized management strategies, and carefully select appropriate patients for preventive ileostomy, as these steps hold significant clinical value. This article provides a systematic review of the types, development, and application of preventive ileostomy, as well as the management and prevention strategies for common complications. The aim is to offer valuable guidance to clinical surgeons in optimizing stoma management and minimizing complications in rectal cancer sphincter-preserving surgery.</p>","PeriodicalId":23959,"journal":{"name":"中华胃肠外科杂志","volume":"28 4","pages":"432-440"},"PeriodicalIF":0.0,"publicationDate":"2025-04-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144018919","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":"[Assessment criteria and treatment strategies for complications of radical surgery for colorectal cancer].","authors":"C L Xin, Y Yang, Z T Zhang","doi":"10.3760/cma.j.cn441530-20250211-00053","DOIUrl":"https://doi.org/10.3760/cma.j.cn441530-20250211-00053","url":null,"abstract":"<p><p>Surgical radical operation remains the cornerstone of colorectal cancer treatment, continuously evolving through technological advancements. Emerging innovative technologies, including neoadjuvant chemoradiotherapy with immunotherapy, robot-assisted surgery, and transanal total mesorectal excision, present promising treatment strategies. While these technological innovations bring benefits for patients, they simultaneously introduce potential challenges. This review summarizes the application of novel surgical technologies and therapeutic approaches in colorectal cancer management, synthesizing diagnostic and treatment methodologies for postoperative complications to inform standardized clinical practice.</p>","PeriodicalId":23959,"journal":{"name":"中华胃肠外科杂志","volume":"28 4","pages":"341-345"},"PeriodicalIF":0.0,"publicationDate":"2025-04-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144019278","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":"[Management of anastomotic complications of laparoscopic and robotic-assisted colorectal cancer surgery].","authors":"Y Q Xie, F H Han","doi":"10.3760/cma.j.cn441530-20250203-00043","DOIUrl":"https://doi.org/10.3760/cma.j.cn441530-20250203-00043","url":null,"abstract":"<p><p>In recent years, with the advancement of preoperative assessment techniques, neoadjuvant therapies, and surgical techniques, the anastomosis level in laparoscopic and robotic-assisted colorectal cancer surgery has been lowered, and the sphincter preservation rate has increased. However, anastomosis-related complications remain a significant factor affecting surgical procedures and postoperative functional recovery, and they significantly impact patient prognosis. This article evaluates anastomosis quality based on multiple criteria and focuses on the causes, clinical manifestations, and prevention-treatment methods of three common complications: anastomotic leakage, stenosis, and bleeding. It aims to provide references for clinicians to better prevent and manage these complications, improve prognosis, and enhance patients' quality of life.</p>","PeriodicalId":23959,"journal":{"name":"中华胃肠外科杂志","volume":"28 4","pages":"353-361"},"PeriodicalIF":0.0,"publicationDate":"2025-04-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144018823","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":"[Exploration of gasless laparoscopic gastric cancer surgery].","authors":"Y M Wang, Y W Xue","doi":"10.3760/cma.j.cn441530-20241211-00402","DOIUrl":"https://doi.org/10.3760/cma.j.cn441530-20241211-00402","url":null,"abstract":"<p><p>Laparoscopic technology has been widely used in the surgical treatment of gastric cancer, but the operating space inside the abdominal cavity is mostly created by CO₂ artificial pneumoperitoneum. There is a paradoxical result of CO₂ artificial pneumoperitoneum, which may increase the risk of complications in elderly patients with poor cardiopulmonary function. Therefore, people have been trying non pneumoperitoneum techniques. This article focuses on the establishment of CO₂ pneumoperitoneum as the core technology of minimally invasive abdominal surgery in laparoscopic minimally invasive techniques both domestically and internationally over the years, as well as the complications caused by CO₂ artificial pneumoperitoneum. It explores the use of \"no pneumoperitoneum\" in minimally invasive abdominal surgery and summarizes the exploration of the author's center in this field. The article also looks forward to the prospects of this technology.</p>","PeriodicalId":23959,"journal":{"name":"中华胃肠外科杂志","volume":"28 4","pages":"417-420"},"PeriodicalIF":0.0,"publicationDate":"2025-04-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144056512","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":"[Endoscopic submucosal dissection of gastrointestinal polyps with a novel plasma radio frequency generator and a disposable mucosal incision knife: A prospective, multicenter, non-inferiority, randomized, controlled clinical trial].","authors":"B H Song, G J Shi, X Y Xu, J X Xu, L Feng, J G Xu, P H Zhou, M Y Cai","doi":"10.3760/cma.j.cn441530-20241025-00353","DOIUrl":"10.3760/cma.j.cn441530-20241025-00353","url":null,"abstract":"&lt;p&gt;&lt;p&gt;&lt;b&gt;Objective:&lt;/b&gt; To evaluate the efficacy and safety of a new plasma radiofrequency generator and a disposable mucosal incision knife for endoscopic submucosal dissection (ESD) of gastrointestinal lesions. &lt;b&gt;Methods:&lt;/b&gt; This study is a prospective, randomized, non-inferiority multicenter study (Chinese Clinical Trial Registry No.: ChiCTR2000041394). The inclusion criteria for cases are as follows: (1) being able to understand and voluntarily participate in this clinical trial, and voluntarily signing the informed consent form; (2) being 18-70 years old, regardless of gender; (3) having a gastrointestinal lesion and meeting the endoscopic treatment conditions for the indications of endoscopic submucosal dissection (ESD). The exclusion criteria are: (1) meeting the contraindications for ESD; (2) having a surgical contraindication due to coagulation dysfunction or still taking anticoagulants 1 week before surgery; (3) having coagulation dysfunction, that is, the prothrombin time is prolonged by more than 3 seconds (more than 5 seconds in patients with liver disease), or the activated partial thromboplastin time is prolonged by more than 10 seconds, and the platelet count is &lt; 70×10⁹/L; (4) having severe cardiopulmonary insufficiency and being unable to tolerate the surgery; (5) being a reproductive-aged woman with a positive blood or urine pregnancy test or a lactating woman; (6) the investigator deems that there are other factors that are not suitable for inclusion or affect the subject's participation. Patients who underwent ESD treatment for gastrointestinal lesions from March 2019 to April 2023 at the Endoscopy Center of Zhongshan Hospital Affiliated to Fudan University, the Department of Gastroenterology of Minhang District Central Hospital in Shanghai, and the Department of Gastroenterology of Quzhou People's Hospital were prospectively included. The experimental group used a new plasma radiofrequency therapy instrument and a disposable mucosal incision knife, while the control group used a high-frequency electrosurgical system and a disposable mucosal incision knife. The primary efficacy indicator was the &lt;i&gt;en bloc&lt;/i&gt; resection success rate, the secondary efficacy indicators included the coagulation success rate, and the operation stability of the plasma radiofrequency therapy instrument and the disposable mucosal incision knife; the safety indicators included the incidence of intraoperative bleeding, intraoperative perforation, and postoperative complications. &lt;b&gt;Results:&lt;/b&gt; The study cohort comprised 194 patients, 95 in the experimental group and 99 in the control group. Analysis of the full set showed rates of &lt;i&gt;en bloc&lt;/i&gt; resection of 97.89% (93/95) and 96.97% (96/99) in the experimental and control groups, respectively; the difference being 0.53% (-5.58%, 6.64%). Analysis of the compliance set showed rates of en bloc resection of 97.83% (90/92) and 96.88% (93/96) in the experimental and control groups, respectively; the dif","PeriodicalId":23959,"journal":{"name":"中华胃肠外科杂志","volume":"28 4","pages":"384-391"},"PeriodicalIF":0.0,"publicationDate":"2025-04-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144030070","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":"[Intraoperative complications and management strategies for colorectal cancer in single- incision laparoscopic and robotic-assisted surgery].","authors":"Z J Song, R Zhao","doi":"10.3760/cma.j.cn441530-20250204-00047","DOIUrl":"https://doi.org/10.3760/cma.j.cn441530-20250204-00047","url":null,"abstract":"<p><p>With the rapid development of surgical techniques and the deepening of minimally invasive concepts, single-incision laparoscopic surgery (SILS) and robot-assisted surgery (RAS) are gaining increasing attention in the field of colorectal cancer treatment as representatives of modern surgery's move towards more minimally invasive and precise approaches. While these technologies offer advantages such as reduced trauma, less pain, and faster recovery, they also introduce unique challenges. The high technical demands of SILS, along with the lack of force feedback in robotic systems, can easily lead to unexpected injuries of blood vessels, tissues, or organs. Inappropriate handling can increase the complexity of the surgery and affect clinical outcomes. Timely identification and swift, correct responses can prevent severe consequences for patients. Based on over a decade of experience by our team in treating colorectal cancer with SILS and RAS, and incorporating the latest research advancements both domestically and internationally, this article discusses common intraoperative incidents, management strategies, and preventive measures associated with SILS and RAS. It aims to provide valuable references for surgeons performing these procedures, enhancing their capability to manage intraoperative challenges effectively.</p>","PeriodicalId":23959,"journal":{"name":"中华胃肠外科杂志","volume":"28 4","pages":"362-367"},"PeriodicalIF":0.0,"publicationDate":"2025-04-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144050620","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 study of the \"two-winged\" retraction technique in laparoscopic complete mesocolic resection for the left hemicolon].","authors":"L F Xie, J Jia, Q W Chen, J B Hou, Y Liu, Y Y Wu, X Y Li","doi":"10.3760/cma.j.cn441530-20240724-00256","DOIUrl":"https://doi.org/10.3760/cma.j.cn441530-20240724-00256","url":null,"abstract":"<p><p><b>Objective:</b> To explore the application value of the \"Dual-Wing\" traction technique in the medial & head lateral laparoscopic left hemicolectomy with radical resection. <b>Methods:</b> The \"Dual-Wing \" traction technique is based on the theory of mesenteric anatomy. The assistant lifts the proper mesentery of the digestive tract to be resected or the adjacent mesenteric tissue connected to it,thereby elevating the target organ and its mesentery as a whole away from the mesenteric bed. By utilizing the tension transmission between the proper mesenteries of adjacent organs to create counter-tension,the surgeon's operative actions are always maintained along the line of maximum counter-tension.After incising the mesenteric fusion line,this technique assists the surgeon in entering the fusion plane. A descriptive case series study method was adopted to retrospectively analyze the clinical and pathological data of 37 colorectal cancer patients who underwent laparoscopic left hemicolectomy with the \"Dual-Wing\" traction technique via a medial and cephalad approach, performed by the Department of Gastrointestinal Surgery at Dongjie Campus of the First Hospital of Quanzhou, Fujian Medical University, from May 2023 to November 2023. <b>Results:</b> All patients successfully underwent laparoscopic left hemicolectomy via the medial & head lateral approach using the \"Dual-Wing\" traction technique.The surgery adhered to the principles of total mesocolic excision and safely mobilized the left colon and its mesentery from the correct anatomical plane. In the entire group of patients,there were 14 males and 23 females; the mean operative time was 94.1±18.3 minutes; the mean intraoperative blood loss was 9.8±5.4 ml; the mean number of lymph nodes dissected was 18.1±3.9; the mean number of positive lymph nodes was 1.4±1.6; the pathological specimen resection margin grading was Grade A in 29 cases, Grade B in 8 cases, and no Grade C cases; the tumor TNM staging was Stage I in 3 cases, Stage IIA in 7 cases, Stage IIB in 6 cases, Stage IIIA in 2 cases, Stage IIIB in 15 cases, and Stage IIIC in 4 cases; the mean time to first flatus postoperatively was 35.7±7.5 hours; the mean length of hospital stay was 9.1±1.7 days. There were no intraoperative injuries to the pancreas or spleen. Postoperative complications occurred in 3 cases. No anastomotic leakage was observed in the entire group, and there were no deaths following the surgery. <b>Conclusion:</b> The application of the \"Dual-Wing\" traction technique to establish a stable surgical scenario can significantly reduce the demands on the assistant. It is conducive to maintaining mesenteric tension and fully exposing the surgical field. It also allows for the rapid identification and maintenance of the correct anatomical plane. For colorectal cancer patients, the surgery is safe and feasible, with satisfactory short-term therapeutic effects.</p>","PeriodicalId":23959,"journal":{"name":"中华胃肠外科杂志","volume":"28 4","pages":"412-416"},"PeriodicalIF":0.0,"publicationDate":"2025-04-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144016841","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}