中华消化外科杂志最新文献

{"title":"A multicenter prospective study on incidence and risk factors of postoperative pancreatic fistula after radical gastrectomy: a report of 2 089 cases","authors":"Zhaoqing Tang, Gang Zhao, L. Zang, Ziyu Li, W. Zang, Zhengrong Li, J. Qu, Su Yan, C. Zheng, G. Ji, Linghua Zhu, Yongliang Zhao, Jian Zhang, Hua Huang, Ying-xue Hao, L. Fan, Hongtao Xu, Yong Li, Li Yang, Wu Song, Jiaming Zhu, Wenbin Zhang, Minzhe Li, Fenglin Liu","doi":"10.3760/CMA.J.ISSN.1673-9752.2020.01.011","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1673-9752.2020.01.011","url":null,"abstract":"Objective \u0000To investigate the incidence of postoperative pancreatic fistula (POPF) and its risk factors after radical gastrectomy. \u0000 \u0000 \u0000Methods \u0000The prospective study was conducted. The clinicopathological data of 2 089 patients who underwent radical gastrectomy in 22 medical centers between December 2017 and November 2018 were collected, including 380 in the Zhongshan Hospital of Fudan University, 351 in the Renji Hospital of Shanghai Jiaotong University School of Medicine, 130 in the Ruijin Hospital of Shanghai Jiaotong University School of Medicine, 139 in the Peking University Cancer Hospital, 128 in the Fujian Provincial Cancer Hospital, 114 in the First Hospital Affiliated to Army Medical University, 104 in the First Affiliated Hospital of Nanchang University, 104 in the Affiliated Hospital of Qinghai University, 103 in the Weifang People′s Hospital, 102 in the Fujian Medical University Union Hospital, 99 in the First Affiliated Hospital of Air Force Medical University, 97 in the Sir Run Run Shaw Hospital Affiliated to Zhejiang University School of Medicine, 60 in the Hangzhou First People′s Hospital Affiliated to Zhejiang University School of Medicine, 48 in the Fudan University Shanghai Cancer Center, 29 in the First Affiliated Hospital of Xi′an Jiaotong University, 26 in the Lishui Municipal Central Hospital, 26 in the Guangdong Provincial People′s Hospital, 23 in the Jiangsu Province Hospital, 13 in the First Affiliated Hospital of Sun Yat-Sen University, 7 in the Second Hospital of Jilin University, 4 in the First Affiliated Hospital of Xinjiang Medical University, 2 in the Beijing Chao-Yang Hospital of Capital Medical University. Observation indicators: (1) the incidence of POPF after radical gastrectomy; (2) treatment of grade B POPF after radical gastrectomy; (3) analysis of clinicopathological data; (4) analysis of surgical data; (5) risk factors for grade B POPF after radical gastrectomy. Measurement data with normal distribution were represented as Mean±SD, and comparison between groups was analyzed using ANOVA. Count data were described as absolute numbers or percentages, and comparison between groups was analyzed using the chi-square test. Univariate analysis was conducted using the t test or chi-square test based on data excluding missing data of clinico-pathological and surgical data. Multivariate analysis was conducted using the Logistic regression model based on factors with P<0.20 in univariate analysis. \u0000 \u0000 \u0000Results \u0000There were 2 089 patients screened for eligibility, including 1 512 males, 576 females and 1 without sex information, aged (62±11)years. The body mass index (BMI) was (23±3)kg/m2. (1) The incidence of POPF after radical gastrectomy: the total incidence rate of POPF in the 2 089 patients was 20.728%(433/2 089). The incidence rates of biochemical fistula, grade B pancreatic fistula, and grade C pancreatic fistula were 19.627%(410/2 089), 1.101%(23/2 089), 0, respectively. (2) Treatment of grade B POPF after rad","PeriodicalId":36400,"journal":{"name":"中华消化外科杂志","volume":"19 1","pages":"63-71"},"PeriodicalIF":0.0,"publicationDate":"2020-01-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41716322","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 value of parallel and cross-to-overlap anastomosis method in three-dimensional laparoscopic radical resection of right hemicolon cancer","authors":"Junwei Bai, Chao Zhang, Zhi-kai Wang, Hui Zhang, Yi Xie, Chunbo Zhang","doi":"10.3760/CMA.J.ISSN.1673-9752.2020.01.015","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1673-9752.2020.01.015","url":null,"abstract":"Objective \u0000To investigate the application value of parallel and cross-to-overlap anastomosis method (PCOA) in three-dimensional (3D) laparoscopic radical resection of right hemicolon cancer. \u0000 \u0000 \u0000Methods \u0000The retrospective cross-sectional study was conducted. The clinicopathological data of 138 patients who underwent 3D laparoscopic radical resection of right hemicolon cancer at Henan Provincial People′s Hospital between July 2016 and July 2019 were collected. There were 83 males and 55 females, aged from 30 to 76 years, with a median age of 64 years. All the 138 patients with right hemicolon tumors were diagnosed as malignant tumors by enteroscopy and pathological examination before operation. The lymph node dissection and radical resection of right hemicolon cancer were performed according to the 9th edition of Japanese General Rules for Cancer of Colon, Rectum and Anus of the Japanese Colorectal Cancer Association. Observation indicators: (1) surgical situations; (2) postoperative conditions; (3) follow-up. Follow-up was conducted by outpatient examination or telephone interview to detect survival of patients and tumor recurrence and metastasis up to September 2019. Measurement data with normal distribution were represented as Mean±SD. Measurement data with skewed distribution were represented as M (range). Count data were represented as percentages or absolute numbers. \u0000 \u0000 \u0000Results \u0000(1) Surgical situations: all the 138 patients underwent 3D laparoscopic radical resection of right hemicolon cancer using PCOA to reconstruct digestive tracts, without conversion to open surgery. The operation time, time for PCOA, and volume of intraoperative blood loss was (151.0±54.0)minutes, (20.1±2.0)minutes, and (60±21)mL. (2) Postoperative situations: the time to first flatus, time to semi-liquid food intake, length of auxiliary incision, and incidence rate of postoperative complications were (2.5±0.4)days, (4.0±1.3)days, (3.0±0.2)cm, and 3.62%(5/138), respectively. Of the 5 patients with postoperative complications, 1 patient with intestinal obstruction was cured after conservative treatment including gastrointestinal decompression and nutritional support, 1 patient with anastomotic leakage was cured after conservative treatment including gastrointestinal decompression, local patency drainage, infection control and nutritional support, 1 patient with ascites and abdominal infection was cured after computed tomography-guided percutaneous catheter drainage, 1 patient with incisional infection was cured by controlling infection, strengthening dressing changes, local irrigation and drainage, 1 patient with pulmonary infection was cured after anti-infective treatment.The number of lymph nodes dissected after surgery, duration of postoperative hospital stay, and hospital expenses were 19±8, (7.2±4.1)days, and (4.8±1.4)×104 yuan. All the 138 patients were confirmed as colonic adenocarcinoma by postoperative pathological examination, including 27 cases of poorly di","PeriodicalId":36400,"journal":{"name":"中华消化外科杂志","volume":"19 1","pages":"93-98"},"PeriodicalIF":0.0,"publicationDate":"2020-01-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49589259","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 to promote the standardization of colorectal cancer surgical practice based upon the data analysis of Chinese Colorectal Cancer Surgery Database","authors":"H. Yao","doi":"10.3760/CMA.J.ISSN.1673-9752.2020.01.009","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1673-9752.2020.01.009","url":null,"abstract":"China has the largest group of patients with colorectal cancer in the world, however, there are few international guidelines for the diagnosis and treatment of colorectal cancer from China, or research of high-level evidence in China. In recent years, colorectal surgery has developed rapidly in China, and great progress has been made both in clinical practice and in clinical research. But there are still many imbalances and under-regulations. In 2018, Chinese Society of Colorectal Surgery led the establishment of Chinese Colorectal Cancer Surgery Database (CCCD). The retrospective and prospective data collection coming from CCCD showed that the standardization of colorectal cancer surgery and data management needed to be improved, and the awareness of clinical research needed to be further improved. Therefore, how to carry out good clinical research and obtain high-level evidence based upon CCCD will be the great challenge for colorectal surgery in China. \u0000 \u0000 \u0000Key words: \u0000Colorectal neoplasms; Standardization; Registry database; Data collection; Clinical research","PeriodicalId":36400,"journal":{"name":"中华消化外科杂志","volume":"19 1","pages":"55-58"},"PeriodicalIF":0.0,"publicationDate":"2020-01-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44015673","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":"Enlightenment and reflection of laparoscopic radical cholecystectomy","authors":"Lei Zhang","doi":"10.3760/CMA.J.ISSN.1673-9752.2020.01.007","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1673-9752.2020.01.007","url":null,"abstract":"Gallbladder cancer is a biliary malignant disease with difficulty in early diagnosis, high malignancy and poor prognosis. Radical resection is the most effective approach to improve the prognosis of patients. With the update of minimally invasive devices and the accumulation of surgeon experience, laparoscopic surgery has achieved satisfactory results in the treatment of malignant tumors of the digestive tract, but there is still controversy in its application in gallbladder cancer treatment, mainly due to lack of reliable evidence for improved survival outcomes. The current studies indicated that laparoscopic surgery could benefit some patients with early gallbladder cancer in perioperative period and survival. For advanced gallbladder cancer, although there is still no consensus on the resection extent, laparoscopic staging can prevent patients from unnecessary expanded resection. The minimally invasive process of radical cholecystectomy needs to be promoted through a high-quality diagnosis and treatment process. Only in this way can there be practical clinical evidence to guide the best clinical practice. \u0000 \u0000 \u0000Key words: \u0000Bile duct neoplasms; Treatment; Ra-dical cholecystectomy; Laparoscopy","PeriodicalId":36400,"journal":{"name":"中华消化外科杂志","volume":"19 1","pages":"46-49"},"PeriodicalIF":0.0,"publicationDate":"2020-01-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49613662","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 value of multidisciplinary team model in normatively carrying out transanal total mesorectal excision","authors":"Zhanlong Shen, Y. Ye, M. Yin, Z. Gao, Jian Cao, Long Zhao","doi":"10.3760/CMA.J.ISSN.1673-9752.2020.01.010","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1673-9752.2020.01.010","url":null,"abstract":"With certain advantages of superior surgical fields and better chances for anus reservation, transanal total mesorectal excision (TaTME) is a novel surgical approach for low rectal cancer. Guidelines recommend multidisciplinary team (MDT) work as a clinical routine for standardized treatment of rectal cancer. Indication of TaTME depends on multidisciplinary discussion including preoperative staging, prediction of recurrence risks. Standardized preoperative evaluation by MDT and decisions after MDT discussion are the guarantee for the stan-dardized implementation and reasonable promotion of TaTME. Meanwhile, as a procedure for improving local efficacy of rectal cancer, TaTME could save a part of patients with low rectal cancer the trouble of neoadjuvant chemoradiotherapy based on accurate staging by radiologists. That might upgrade status of colorectal surgeons in the MDT and contribute to optimize both curative effects and health economics. \u0000 \u0000 \u0000Key words: \u0000Rectal neoplasms; Transanal total mesorectal excision; Multidisciplinary team; Surgery; Standardization; Diagnosis; Treatment; Model","PeriodicalId":36400,"journal":{"name":"中华消化外科杂志","volume":"19 1","pages":"59-62"},"PeriodicalIF":0.0,"publicationDate":"2020-01-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"70016912","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":"Enlightenment and reflection of splenic hilar lymph node dissection for advanced proximal gastric cancer","authors":"Chang-ming Huang","doi":"10.3760/CMA.J.ISSN.1673-9752.2020.01.008","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1673-9752.2020.01.008","url":null,"abstract":"Splenic hilar lymph node (LN) is the difficulty and focus of perigastric LN dissection during radical gastrectomy for advanced proximal gastric cancer (APGC). Although the new edition of Japanese Gastric Cancer Treatment Guidelines excluded the splenic hilar LN from the D2 lymphadenectomy in patients with APGC, there are still few high-level evidences. Meanwhile, the guideline recommends that splenectomy is still necessary for patients with APGC involving the greater curvature. With the support of increasing evidences, the spleen-preserving splenic hilar LN dissection has been recognized by more and more scholars. Additionally, the technique of laparoscopy provides a new method for splenic hilar LN dissection. Our center proposed a new technique named Huang′s three-step maneuver for laparoscopic spleen-preserving splenic hilar lymphadenectomy, which not only reduces the difficulty of operation, but also makes the technique easier to popularize and with a significance of minimally invasive effect. During the clinical practice, the dissection of LNs behind the splenic portal vessels is also one of the controversies. Therefore, the difficult technique of splenic hilar LN dissection not only requires us to make a technical exploration, but also requires us to explore precise indications, in order to avoid unnecessary operation in patients who do not require dissection of the No.10 LNs and to avoid missing the opportunity for radical surgery in high-risk patients because of the difficult techniques. \u0000 \u0000 \u0000Key words: \u0000Gastric neoplasms; Surgical procedure, operative; Splenic hilar lymph node; Lymphadenectomy; Laparoscopy","PeriodicalId":36400,"journal":{"name":"中华消化外科杂志","volume":"19 1","pages":"50-54"},"PeriodicalIF":0.0,"publicationDate":"2020-01-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47403875","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":"Role of surgeons in the medical model of treating patients infected with COVID-19 in makeshift hospitals","authors":"Jian Chen, M. Yang, Q. Lu","doi":"10.3760/cma.j.issn.1673-9752.2020.03.008","DOIUrl":"https://doi.org/10.3760/cma.j.issn.1673-9752.2020.03.008","url":null,"abstract":"Since the outbreak of Corona Virus Disease 2019 (COVID-19) in December 2019, the number of new confirmed cases in Wuhan has been increasing, and medical resources are in short supply Under this grim situation, makeshift hospitals have been used to treat patients with mild symptoms and achieved the largest capacity Under the model of concentrated admission in makeshift hospitals with limited medical resources, the frontline surgeons adopt strict disease observation and treatment strategies, actively carry out psychological counseling for patients, and organize multidisciplinary teams to deal with chronic and emergency surgical diseases of patients with COVID-19 Combined with their own clinical practices, the authors summarize a series of clinical experiences for the treatment of patients with COVID-19 Copyright © 2020 by the Chinese Medical Association","PeriodicalId":36400,"journal":{"name":"中华消化外科杂志","volume":"19 1","pages":"256-258"},"PeriodicalIF":0.0,"publicationDate":"2020-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"70016960","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":"Perioperative management strategies for surgical patients during the COVID-19 outbreak","authors":"W. Guo, J. Yuan, Tao-Ran Fu","doi":"10.3760/cma.j.issn.1673-9752.2020.03.009","DOIUrl":"https://doi.org/10.3760/cma.j.issn.1673-9752.2020.03.009","url":null,"abstract":"At present, the prevention and control situation of epidemics of Corona Virus Disease 2019 (COVID-19) is still serious, medical institutions should provide quality and safe routine medical services while doing their best in the prevention and control of this disease The purpose of this article is to suggest a way to give quality and safe medical services to patients who need surgical treatment, especially to those who need emergency surgical treatment, with strict classified managements and standard precaution during perioperative period With those suggestions, we may reduce the incidence of nosocomial infection and contribute to the prevention and control of COVID-19 Copyright © 2020 by the Chinese Medical Association","PeriodicalId":36400,"journal":{"name":"中华消化外科杂志","volume":"19 1","pages":"259-261"},"PeriodicalIF":0.0,"publicationDate":"2020-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"70016971","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":"Strategies for general surgery related issues in the treatment of critically ill patients diagnosed with COVID-19","authors":"J. Lu, S. Li, C. Zhang, T. Lin, Y. Zhou, Q. Wang, L. Guo, D. Li, Q. Guo, F. Liu, Xuehao Wang, T. Wang, J. Han, H. Deng, Q. Shi, L. Fan","doi":"10.3760/cma.j.cn115610-20200313-00168","DOIUrl":"https://doi.org/10.3760/cma.j.cn115610-20200313-00168","url":null,"abstract":"In order to improve the cure rate of critically ill patients in Wuhan epidemic area and reduce the fatality rate, the state have dispatched medical staffs from the whole country to support Wuhan and treat critically ill patients in dedicated facilities A medical team from the First Affiliated Hospital of Xi'an Jiaotong University, consisting of 133 medical staffs major in critical care medicine, respiralogy, infection, cardiology, and general surgery, entirely took over the critical care unit of the East Hospital of the Renmin Hospital of Wuhan University, and formed a multidisciplinary collaboration team with local medical staffs to treat patients together Up to March 13th in 2020, the author's medical team has admitted a total of 109 patients, of which 48 had been discharged up on recovery Critically ill patients with Corona Virus Disease 2019 mainly have elder age, comorbidities, complicated conditions, and difficult diagnosis and treatment The author and the author's team combined with clinical practice, share experience and strategies of general surgery related issues in the treatment of critically ill patients, providing reference for collegues in general surgery Copyright © 2020 by the Chinese Medical Association","PeriodicalId":36400,"journal":{"name":"中华消化外科杂志","volume":"19 1","pages":"352-355"},"PeriodicalIF":0.0,"publicationDate":"2020-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"70011354","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":"Out-of-hospital management strategies for gastric cancer patients during the COVID-19 outbreak","authors":"K. Xue, Zhemin Li, Z. Wu, Shuangxi Li, Y. Jia, R. Miao, C. Yan, Yan Wang, X. Ying, Y. Zhang, J. Ji","doi":"10.3760/cma.j.issn.1673-9752.2020.03.004","DOIUrl":"https://doi.org/10.3760/cma.j.issn.1673-9752.2020.03.004","url":null,"abstract":"Since the outbreak of Corona Virus Disease 2019 occurred in December 2019, the reduction of population mobility has curbed the spread of the epidemic to some extent but also prolonged the waiting time for the treatment of patients with gastric cancer Based on fully understanding the different staging characteristics of gastric cancer, clinical departments should develop reasonable out-of-hospital management strategies On one hand, reasonable communication channels should be established to allow patients to receive adequate guidance out of the hospital On the other hand, shared decisions with patients should be made to adjust treatment strategies, and education on viral prevention should be implemented to minimize the impact of the epidemic on tumor treatment Copyright © 2020 by the Chinese Medical Association","PeriodicalId":36400,"journal":{"name":"中华消化外科杂志","volume":"19 1","pages":"239-243"},"PeriodicalIF":0.0,"publicationDate":"2020-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"70016923","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}