中华胃肠外科杂志最新文献

{"title":"[Surgical treatment of ulcerative colitis: a 10-year retrospective analysis at a surgical referral center].","authors":"S Li, F Zhu, Abudourexiti Waresi, Z Y Wang, M F Chen, Y Z Guo, Z R Yang, Y Zhou, J F Gong","doi":"10.3760/cma.j.cn441530-20240928-00330","DOIUrl":"10.3760/cma.j.cn441530-20240928-00330","url":null,"abstract":"<p><p><b>Objective:</b> To investigate the clinical characteristics, postoperative complications, and risk factors for pouchitis in surgical patients with ulcerative colitis (UC). <b>Methods:</b> This was a retrospective observational study. The clinical data of 336 UC patients who had undergone surgical treatment at the Inflammatory Bowel Disease Center of the Department of General Surgery, Jinling Hospital Affiliated to Nanjing University Medical School from February 2014 to February 2024 were enrolled. The study patients were stratified into 2014-2019 (<i>n</i> = 158) and 2020-2024 groups (<i>n</i> = 178), these being the periods before and after biologics were covered for treatment of UC by national insurance in China in 2020. Clinical characteristics and surgical complications were analyzed and compared between the 2014-2019 and 2020-2024 groups. Multivariable logistic regression was performed to identify the risk factors associated with pouchitis in UC patients undergoing total proctocolectomy with ileal pouch-anal anastomosis (TPC-IPAA). <b>Results:</b> The study cohort comprised 336 UC patients, 193 (57.4%) of whom were men. The median preoperative disease course was 48.0 months and the mean age at colectomy was 46.4±15.4 years. TPC-IPAA had been performed on 275 patients (81.8%), 129 in the 2014-2019 group and 146 in the 2020-2024 group. Sixty-one patients had undergone total or subtotal colectomy, 29 in the 2014-2019 group and 32 in the 2020-2024 group. 262 (78.0%) UC patients underwent surgery due to medical refractory. Ninety-nine (29.5%) had used biopharmaceuticals within 2 months prior to surgery, 63 (18.8%) of them having received infliximab. A smaller proportion of patients had undergone surgery for UC that was refractory to medications in the 2020-2024 group than in the 2014-2019 group (73.0% [130/178] vs. 83.5% [132/158], χ²=5.384, <i>P</i>=0.020), the patients were older at colectomy (48.0±15.4 years vs. 44.6±15.2 years, <i>t</i>=-2.008, <i>P</i>=0.045), the body mass index was higher (20.2±3.1 kg/m² vs. 19.4±3.2 kg/m², <i>t</i>=-2.201, <i>P</i>=0.028), the Mayo score prior to surgery was lower (<i>M</i>[<i>Q</i>₁, <i>Q</i>₃]: 11.0 [9.2, 12.0 points] vs. 12.0 [11.0, 12.0) points, <i>Z</i>=-4.242, <i>P</i>=0.001), the rate of Charlson Comorbidity Index ≥ 3 scores was higher (27.0% [48/178] vs. 17.1% [27/158], χ²=5.384, <i>P</i>=0.020), a greater percentage of patients had received biologics prior to surgery (41.0% [73/178) vs. 16.5% [26/158], χ²=24.285, <i>P</i><0.001), and intraoperative blood loss was greater (<i>M</i>[<i>Q</i>₁, <i>Q</i>₃]: 100.0 [100.0, 150.0] ml vs. 50.0 [30.0, 100.0] ml, <i>Z</i>=-7.054, <i>P</i><0.001) despite the operation time being shorter (253.8±74.6 minutes vs. 315.2±96.8 minutes, <i>t</i>=6.265, <i>P</i><0.001). Among the 275 patients undergoing TPC-IPAA, 95 (34.6%) had early complications (within 30 d","PeriodicalId":23959,"journal":{"name":"中华胃肠外科杂志","volume":"28 4","pages":"374-383"},"PeriodicalIF":0.0,"publicationDate":"2025-04-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144037429","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":"[Laparoscopic and robotic ultralow sphincter-saving operation and intersphincteric resection for rectal cancer:prevention and management for major complications].","authors":"P Chi, S H Huang","doi":"10.3760/cma.j.cn441530-20250217-00060","DOIUrl":"https://doi.org/10.3760/cma.j.cn441530-20250217-00060","url":null,"abstract":"<p><p>In laparoscopic and robot-assisted ultra-low sphincter-saving surgeries for rectal cancer, preserving sexual function, preventing anastomotic leakage, anastomotic stricture, and low anterior resection syndrome (LARS) is critical to ensuring a good postoperative quality of life. The primary strategy for preventing postoperative sexual dysfunction is the meticulous preservation of the autonomic nerves, particularly the neurovascular bundles in the prostate area, guided by precise anatomical dissection. Partial preservation of the Denonvilliers fascia during total mesorectal excision (TME) not only helps protect the anterior mesorectum but also safeguards the neurovascular bundles. To prevent anastomotic leakage, it is essential to achieve clear oncologic margins, ensure a robust blood supply to both the proximal and distal margins, maintain a tension-free anastomosis, and avoid thermal or radiation injury whenever possible. In elderly patients with metabolic diseases, persistent descending mesocolon, or those undergoing neoadjuvant chemoradiotherapy, selective preservation of the left colic artery may be considered. Additionally, reinforcing the anastomosis with sutures at the 'dog-ear' site, closing the pelvic peritoneum, and placing a transanal tube for drainage are beneficial strategies. Early identification of anastomotic leakage and timely intervention to ensure drainage can prevent delayed leakage, strictures, and the structural sequelae of anastomotic failure. To minimize fecal dysfunction, selective exemption from radiotherapy may be beneficial for mid-to-high rectal cancer, while for low rectal cancer, reconstruction of J-pouch reservoirs, end-to-side anastomosis, and transverse coloplasty can help reduce the incidence of severe low anterior resection syndrome. Additionally, for low rectal cancer following neoadjuvant therapy, a selective rectum-preserving strategy that avoids major surgery can effectively prevent these complications.</p>","PeriodicalId":23959,"journal":{"name":"中华胃肠外科杂志","volume":"28 4","pages":"346-352"},"PeriodicalIF":0.0,"publicationDate":"2025-04-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143988404","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 and quality of life in laparoscopic right hemicolectomy with different extent of lymph node dissection].","authors":"X Zhao, Y Zhang, S Xu, H Zhang","doi":"10.3760/cma.j.cn441530-20240702-00230","DOIUrl":"https://doi.org/10.3760/cma.j.cn441530-20240702-00230","url":null,"abstract":"<p><p><b>Objective:</b> To investigate the efficacy of laparoscopic right hemicolectomy using the left edge of the superior mesenteric artery (SMA) as the medial boundary for lymph node dissection, and its impact on patients' quality of life. <b>Methods:</b> Patients were included who had been clearly diagnosed with primary right colon cancer (located in the ileocecal region, ascending colon, and hepatic flexure of the colon) through endoscopic histopathological examination, were aged 80 years or younger, had completed laparoscopic complete mesocolic excision plus D3 radical resection for right colon cancer, and had complete quality of life assessments and follow-up records.A retrospective cohort study method was used. Clinical data of patients undergoing laparoscopic right hemicolectomy at Shengjing Hospital of China Medical University from January 2018 to December 2022 were collected.Based on the different medial boundaries of lymph node dissection, patients were divided into an arterial group (bounded by the left edge of the SMA, 119 cases) and a venous group (bounded by the left edge of the superior mesenteric vein, 89 cases).There were no statistically significant differences in baseline characteristics between the two groups (all <i>P</i>>0.05), and use theQuality of Life Questionnaire for Colorectal Cancer - 38 (QLQ-CR38) and the Diarrhea Assessment Scale(DAS)to evaluate the quality of life and diarrhea of patients one month, three months, and six months after surgery. <b>Results:</b> Compared with the venous group, more lymph nodes were dissected at the third station than in the arterial group (4.2±2.0 vs. 3.3±1.6, <i>t</i>=3.320, <i>P</i><0.001). Additionally, the rates of positive lymph nodes at the third station (10.9% [13/119] vs. 3.4% [3/89], χ² =2.007, <i>P</i>=0.038) and the rates of positive lymph nodes at the third station among patients with Stage III disease (32.5% [13/40] vs. 8.6% [3/35], χ²=2.507, <i>P</i>=0.012) were both significantly higher in the arterial group. These differences are all statistically significant (<i>P</i><0.05). There were no significant differences in the other perioperative data assessed between the two groups (all <i>P</i><0.05). Application of generalized estimating equation analysis showed statistically significant differences between the two groups in terms of timing of gastrointestinal issues (<i>P</i>=0.024) and defecation problems (<i>P</i><0.001). Further simple effects analysis of each of the assessed variables revealed that, one month after surgery, patients in the venous group had significantly less severe gastrointestinal symptoms (<i>M</i> [<i>Q</i>₁, <i>Q</i>₃]: 9 [7,13] vs. 11 [9,13], <i>Z</i>=2.416, <i>P</i>=0.016) and defecation dysfunction (<i>M</i> [<i>Q</i>₁, <i>Q</i>₃]: 13 [8,14] vs. 19 [16,22], <i>Z</i>=8.813, <i>P</i><0.001) compared with the arterial group; these differences are all statistically significant (all ","PeriodicalId":23959,"journal":{"name":"中华胃肠外科杂志","volume":"28 4","pages":"392-399"},"PeriodicalIF":0.0,"publicationDate":"2025-04-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144053933","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":"[Characteristics and management of perioperative complications in laparoscopic surgery for colorectal cancer patients aged over 85 years].","authors":"G B Li, X Zhang, X Y Qiu, C T Wang, L Xu, B Z Niu, G N Zhang, J Y Lu, B Wu, Y Xiao, G L Lin","doi":"10.3760/cma.j.cn441530-20240718-00251","DOIUrl":"10.3760/cma.j.cn441530-20240718-00251","url":null,"abstract":"<p><p><b>Objective:</b> To analyze the types and characteristics of post-operative complications in colorectal cancer patients aged over 85 years undergoing laparoscopic surgery, and to summarize peri-operative management strategies. <b>Methods:</b> This was an observational study. Inclusion criteria: pathologically confirmed adenocarcinoma; tumor located in ileocecum, ascending colon, transverse colon, descending colon, sigmoid colon, or rectum; undergoing laparoscopic radical resection for colorectal cancer; complete clinical data. Exclusion criteria included distant metastasis, synchronous resection of multiple primary cancers, simultaneous liver metastasis surgery, and follow-up duration <1 month. A retrospective analysis was conducted on 191 patients of colorectal cancer patients aged over 85 years who underwent laparoscopic radical surgery in the General Surgery Department at Peking Union Medical College Hospital from January 2019 to January 2024. Among 191 patients, 107 patients (56.0%) had colon cancer and 84 (44.0%) rectal cancer. All patients received \"home-based prehabilitation\" and post-operative \"enhanced recovery after surgery\" protocols. Patient characteristics, peri-operative complication types, treatments, and outcomes were analyzed. <b>Results:</b> Post-operative complications occurred in 97 patients (50.8%), including 53 colon cancer patients (54.6%) and 44 rectal cancer patients (45.4%). Comorbidities existed in 88 patients (90.7%), with 93 patients (95.9%) classified as ASA II-III pre-operatively and 86 (88.7%) having nutritional risks. Surgical procedures included Dixon procedure (38 patients, 39.2%), right hemicolectomy (33 patients, 34.0%), sigmoidectomy (10 patients, 10.3%), and 17 patients (17.5%) received prophylactic stomas. Complication types comprised non-anastomotic infections (38 patients, 19.9%), intestinal flora disorder (26 patients, 13.6%), anastomotic/wound/stoma-related complications (16 patients, 8.4%), thrombotic/hemorrhagic events (6 patients, 3.1%), and others (11 patients, 5.8%). By Clavien-Dindo classification: Grade I (12 patients, 6.3%), Grade II (69 patients, 36.1%), Grade III (12 patients, 6.3%), and Grade IV (4 patients, 2.1%). Except for 5 patients (2.6%) requiring unplanned re-operation, all complications resolved with conservative treatment. The median duration of post-operative hospitalization was 9.5 days (7-13). <b>Conclusion:</b> Non-anastomotic infections and intestinal flora disorder constitute predominant complications after laparoscopic surgery in colorectal cancer patients aged over 85 years, mostly manageable with conservative treatment. Strengthened peri-operative management incorporating pre-operative prehabilitation and post-operative enhanced recovery after surgery protocols is crucial for patients aged over 85 years.</p>","PeriodicalId":23959,"journal":{"name":"中华胃肠外科杂志","volume":"28 4","pages":"368-373"},"PeriodicalIF":0.0,"publicationDate":"2025-04-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144037438","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 endoscopic intermuscular dissection in the treatment of rectal tumors].","authors":"S H Liao, S L Huang","doi":"10.3760/cma.j.cn441530-20240909-00309","DOIUrl":"https://doi.org/10.3760/cma.j.cn441530-20240909-00309","url":null,"abstract":"<p><p>Rectal tumors, as a common type of gastrointestinal tumor, can be treated through various methods, including endoscopic resection, surgical resection, and radiotherapy. With the in-depth research in the mechanisms of tumors development and the increasing patient demands for quality of life , endoscopic treatment has rapidly advanced due to its advantages of being minimally invasive, promoting faster recovery, and reducing costs. Endoscopic submucosal dissection (ESD), a well-established therapeutic technique, has been widely used for the treatment of precancerous lesions and early-stage tumors in the gastrointestinal tract, as well as for the resection of submucosal tumors such as rectal neuroendocrine tumor. However, ESD faces challenges when dealing with lesions accompanied by severe fibrosis or potential deep submucosal infiltration, leading to difficulties in dissection and the risk of positive vertical margins, which increases the risk of tumor recurrence. The emergence of endoscopic intermuscular dissection (EID) provides a novel approach to address these issues. By dissecting between the inner circular and outer longitudinal muscle layers of the muscularis propria, EID achieves the complete resection of the mucosa, submucosa, and inner circular muscle layer without compromising the integrity of the intestinal wall, thereby resolving the issue of positive vertical margins in histopathological evaluation. The clinical application of EID is still in its early stages. This article reviews the literature to summarize the development and clinical applications of EID technology, providing strategies insights for the minimally invasive endoscopic treatment of rectal tumors.</p>","PeriodicalId":23959,"journal":{"name":"中华胃肠外科杂志","volume":"28 4","pages":"426-431"},"PeriodicalIF":0.0,"publicationDate":"2025-04-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144034428","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":"[Whole-course management of abdominal opening with enteroatmospheric fistula].","authors":"W D Zhong, G Hu, Z G Zhao, Z Wang, J C Liu, W Li, L L Dai, L X Pu, S R Wang, Y F Shen, X X Xue, G Y Shao","doi":"10.3760/cma.j.cn441530-20240215-00065","DOIUrl":"10.3760/cma.j.cn441530-20240215-00065","url":null,"abstract":"<p><p>Severe intra-abdominal infections are life-threatening conditions and a significant challenge for surgeons. This article presents a case of an elderly patient with a severe intra-abdominal infection complicated by an anastomotic leak. This patient had experienced prolonged sepsis and multiple surgical traumas. Upon admission to our department, exploratory surgery revealed extensive bowel edema and adhesions, an anastomotic leak, and abdominal contamination with infection. In accordance with the principles of damage control surgery, the anastomotic leak was exteriorized, the abdomen was left open, and continuous intra-abdominal lavage with dual-lumen catheters was implemented to effectively control the infection. Negative pressure wound therapy was used to manage the open abdomen, and a negative pressure-assisted drainage device was used to manage the enteroatmospheric fistula. After granulation of the abdominal wound, split-thickness skin grafting was performed. The enteroatmospheric fistula was converted into an enterocutaneous fistula. A 3D-printed stoma baseplate was used to manage the digestive fistula. Concurrently, enhanced parenteral and enteral nutritional support was provided. Six months later, the patient successfully underwent definitive fistula resection and abdominal wall defect repair.</p>","PeriodicalId":23959,"journal":{"name":"中华胃肠外科杂志","volume":"28 3","pages":"323-326"},"PeriodicalIF":0.0,"publicationDate":"2025-03-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143693385","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 inguinal hernia (2025 edition)].","authors":"","doi":"10.3760/cma.j.cn441530-20250217-00062","DOIUrl":"10.3760/cma.j.cn441530-20250217-00062","url":null,"abstract":"<p><p>In recent years, the diagnosis and treatment of inguinal hernia have become mature, and personalized treatment plans for different inguinal hernias have become more standardized. Based on <i>the Guidelines for Diagnosis and Treatment on the Adult Inguinal Hernia (2012 & 2014 Edition)</i>, more than 70 domestic experts have evaluated related publications using standards of evidenced-based medicine. Major modifications include diagnosis and treatment of inguinal hernia in children and adolescents, diagnosis and treatment of scrotal hernia, management of hernia related complications, and postoperative education and follow-up in this new edition, for the reference of clinicians.</p>","PeriodicalId":23959,"journal":{"name":"中华胃肠外科杂志","volume":"28 3","pages":"246-253"},"PeriodicalIF":0.0,"publicationDate":"2025-03-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143693575","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":"[How close is fecal microbiota transplantation to moving to precision medicine?]","authors":"X J Wang, D Zhao, Y H Qin, L T Yu, Z Cao, W H Liu, B Yang, N Li, Q Y Chen, H L Qin","doi":"10.3760/cma.j.cn441530-20241220-00415","DOIUrl":"10.3760/cma.j.cn441530-20241220-00415","url":null,"abstract":"<p><p>Fecal microbiota transplantation (FMT) has the potential to rebuild the intestinal microbiome of patients, which can influence the disease course, alleviate symptoms, or even cure the disease. It is seen as a promising breakthrough for treating major chronic diseases that are difficult to manage. Currently, FMT therapy has been clinically studied for over 80 diseases and has led to significant breakthroughs. However, there are still four main challenges: (1) identifying the effective characteristics of donor microbiota and ensuring precise matching between donors and recipients; (2) understanding the pathways and molecular mechanisms by which key FMT bacteria and metabolites improve disease outcomes; (3) studying strain interactions and colonization mechanisms to restore intestinal microbiota balance; and (4) refining the precision of microbiome and functional microbiota transplantation. To address these clinical challenges, this article reviews the latest research both domestically and internationally, outlines the response patterns of FMT therapy, examines the reasons behind FMT failure, and explores future directions for the development of FMT. The aim is to accelerate the scientific and precise advancement of FMT technology in China.</p>","PeriodicalId":23959,"journal":{"name":"中华胃肠外科杂志","volume":"28 3","pages":"254-260"},"PeriodicalIF":0.0,"publicationDate":"2025-03-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143693578","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":"[Evaluation of the efficacy and safety of multi-center fecal microbiota transplantation for treatment of functional constipation: A retrospective real-world study].","authors":"L Li, L Wang, G G Guo, Y H Fan, J G Shi, X G Yuan, X S Dong, L Liu, N Li, Q Y Chen","doi":"10.3760/cma.j.cn441530-20250102-00001","DOIUrl":"10.3760/cma.j.cn441530-20250102-00001","url":null,"abstract":"<p><p><b>Objective:</b> To evaluate the efficacy and safety of fecal microbiota transplantation (FMT) for treating functional constipation, analyze the incidence of, and factors that influence, adverse events, and provide scientific evidence for optimizing FMT treatment. <b>Methods:</b> This retrospective, multicenter, single-arm, pre-post real-world study included 1529 patients with functional constipation from four clinical centers. Eligibility criteria comprised meeting the diagnostic criteria for functional constipation, having undergone at least one FMT treatment, complete pre- and post-treatment data available, and age ≥18 years. Patients who had received other interventions affecting gut function within 1 month before treatment and those with severe organic diseases or immune deficiencies were excluded. Applying the above criteria yielded 1529 eligible patients with functional constipation from four medical centers (1405 from the Shanghai Tenth People's Hospital Affiliated to Tongji University, 20 from the Central Hospital of Wuhan, 67 from the Shanxi Bethune Hospital and 37 from the Longgang District People's Hospital of Shenzhen). The study cohort comprised 746 male (48.8%) and 783 female patients (51.2%) of mean age (51.4 ± 17.4) years, mean body mass index (26.4 ± 4.9) kg/m², and mean duration of disease (15.0 ± 8.3) years. The primary outcomes were the incidence, types, and severity of adverse reactions during treatment, and their impact on patients' quality of life. Secondary outcomes included: (1) the efficacy of FMT in treating constipation. This was assessed based on changes in Patient Assessment of Constipation Symptoms (PAC-SYM) scores, where higher score indicates worse symptom. (2) Subjective satisfaction, evaluated through questionnaires or rating scales, reflecting patients' acceptance of and satisfaction with the treatment, with scores ranging from 1 to 5, where higher scores indicated greater satisfaction. Paired t-tests and Wilcoxon signed-rank tests were used to evaluate changes in symptom scores and biochemical indicators before and after treatment. Logistic regression was performed to analyze factors influencing adverse events, and subgroup analyses to explored differences in efficacy between patient groups. <b>Results:</b> In this cohort of 1529 patients with functional constipation, adverse reactions were primarily mild to moderate (1048/1529,68.5%). They comprised fever in 54 patients (3.5%), dizziness or fatigue in 218 (14.3%), throat discomfort in 806 (52.7%), nausea and vomiting in 166 (10.9%), and abdominal distension or pain in 415 (27.1%). According to multivariate logistic regression analysis, PAC-SYM scores were associated with the rate of adverse reactions, higher scores indicating a lower risk (OR = 0.958, 95% CI: 0.923-0.993, <i>P</i>=0.021). Among the 1529 patients, 274 (17.9%) underwent two or more treatment courses. After one treatment course, the patients' PAC-SYM scores decreased from (37.7 ± 3.2) pr","PeriodicalId":23959,"journal":{"name":"中华胃肠外科杂志","volume":"28 3","pages":"288-295"},"PeriodicalIF":0.0,"publicationDate":"2025-03-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143693568","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":"[Fecal microbiota transplantation for the treatment of intestinal disorders: An analysis of treatment of 15 000 patients].","authors":"H L Tian, L Wang, C L Ma, B Yang, L Li, C Ye, D Zhao, Z L Lin, J Q Cui, Y K Liu, W Y Zhu, S L Zhou, N Li, Q Y Chen","doi":"10.3760/cma.j.cn441530-20250114-00025","DOIUrl":"10.3760/cma.j.cn441530-20250114-00025","url":null,"abstract":"<p><p><b>Objective:</b> To examine the long-term efficacy and complications of fecal microbiota transplantation (FMT) for the treatment of diseases related to intestinal dysbiosis. <b>Methods:</b> This was a retrospective descriptive study. Relevant data were collected from the records of 15 000 patients who had undergone FMT and been followed up for more than 3 months during the period from May 2017 to September 2024. The patient cohort comprised 3746 male and 11 254 female patients aged (45.3±12.2) years. The inclusion criterion was meeting the indications for FMT. Application of this criterion yielded 8258 patients with constipation, 684 with Clostridium difficile infection, 1730 with chronic diarrhea, 510 with inflammatory bowel disease, 432 with radiation enteritis, 1940 with irritable bowel syndrome, 365 with autism, 870 with postoperative gastrointestinal dysfunction, and 211 with neurodegenerative diseases. The three routes of delivering FMT comprised infusion of an enterobacterial solution through a nasoenteric tube into the jejunum for 6 consecutive days (upper gastrointestinal FMT group, 11 125 patients), oral intake of enterobacterial capsules for 6 consecutive days (oral capsule FMT, 3597 patients), and a single injection of a bacterial solution into the colon via colonoscopy (lower gastrointestinal FMT group, 278 patients). Other treatments were discontinued during the treatment and follow-up period and administration of other medications was not recommended unless absolutely necessary. The primary outcomes were the efficacy of FMT after 3, 12 and 36 months of treatment, and improvement in chronic constipation, C. difficile infection, chronic diarrhea, inflammatory bowel disease, radiation enteritis, irritable bowel syndrome, post-surgery gastrointestinal dysfunction, and autism. Other outcomes included the occurrence of short-term (within 2 weeks after treatment) and long-term (within 36 months after treatment) adverse reactions. <b>Results:</b> At 3, 12 and 36 months after treatment, the overall rates of effectiveness of treatment were 71.8% (10 763/15 000), 64.4% (7600/11 808) and 58.8% (3659/6218), respectively. Specifically, the rates of clinical improvement were 70.3% (5805/8258), 62.6% (3970/6345), and 56.5% (1894/3352), respectively, for constipation; 85.8% (587/684), 72.3% (408/564), and 67.3% (218/324), respectively, for C.difficile infection; 81.0% (1401/1730), 78.1% (1198/1534), and 72.3% (633/876), respectively, for chronic diarrhea; 64.3% (328/510), 52.3% (249/476), and 46.6 % (97/208), respectively, for inflammatory bowel disease; 77.3% (334/432), 65.4% (212/324), and 53.6% (82/153), respectively, for radiculitis; 70.6% (1370/1940), 64.5% (939/1456), and 60.4% (475/786), respectively, for irritable bowel syndrome; 75.3% (275/365), 70.0% (201/287), and 63.6% (112/176), respectively, for autism; 65.3% (568/870), 54.3% (355/654), and 46.5% (114/245), respectively, for post-surgical gastrointestinal dysfunction; and 45.0%","PeriodicalId":23959,"journal":{"name":"中华胃肠外科杂志","volume":"28 3","pages":"296-303"},"PeriodicalIF":0.0,"publicationDate":"2025-03-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143693570","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}