中华外科杂志最新文献

{"title":"[Evaluation of the short-term efficacy of fluorescence thoracoscopy-assisted temporary occlusion of pulmonary arteries and veins in sublobar resection for early-stage non-small cell lung cancer].","authors":"Y Zhao, B You, H Li","doi":"10.3760/cma.j.cn112139-20240717-00346","DOIUrl":"10.3760/cma.j.cn112139-20240717-00346","url":null,"abstract":"<p><p><b>Objective:</b> To investigate the effectiveness and safety of fluorescence thoracoscopy-assisted temporary occlusion of pulmonary arteries and veins during sublobar resection for the treatment of early-stage non-small cell lung cancer (NSCLC). <b>Methods:</b> This is a prospective cohort study. Patients with early-stage NSCLC who underwent fluorescence thoracoscopy-assisted temporary occlusion of pulmonary arteries and veins for sublobar resection in the Department of Thoracic Surgery, Beijing Chaoyang Hospital, Capital Medical University, from January to April 2024 were included. Based on whether the artery or vein was blocked during surgery, the patients were divided into the arterial group and the venous group. The surgical time, intraoperative blood loss, distance from the lesion to the resection margin, and boundary duration were collected and compared between the two groups. Independent sample <i>t</i> test, Mann-Whitney <i>U</i> test, or <i>χ</i>² test was used to compare the data between the two groups. <b>Results:</b> A total of 64 patients were enrolled. There were 25 males and 39 females, aged (57.3±12.1) years (range: 34 to 80 years). The tumor diameter was (9.8±2.9) mm (range: 5 to 16 mm). The distance between the surgical margin and the lesion was (16.5±3.9) mm (range: 10 to 30 mm) and the surgical time was (61.5±13.9) minutes (range: 30 to 120 minutes). Pathological examination of the surgical specimens showed that all margins met pathological requirements. The chest drainage tube retention time (<i>M</i>(IQR)) was 2 (1) days (range: 1 to 7 days), and no serious postoperative complications occurred. The boundary duration for the arterial group (<i>n</i>=23) and venous group (<i>n</i>=41) was (147.9±22.2) seconds (range: 119 to 188 seconds) and (40.9±8.0) seconds (range: 20 to 60 seconds), respectively (<i>t</i>=27.935, <i>P</i><0.01). <b>Conclusion:</b> Fluorescence thoracoscopy-assisted temporary occlusion of pulmonary arteries and veins can effectively and accurately delineate surgical resection boundaries, ensuring sufficient margin width to meet oncological requirements.</p>","PeriodicalId":60685,"journal":{"name":"中华外科杂志","volume":"63 2","pages":"124-129"},"PeriodicalIF":0.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142967531","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":"[New perspective of diagnosis and treatment of hepatocellular carcinoma complicated with portal vein tumor thrombosis].","authors":"S Y Peng, Y H Wang, Y Jin, J T Li","doi":"10.3760/cma.j.cn112139-20240910-00419","DOIUrl":"10.3760/cma.j.cn112139-20240910-00419","url":null,"abstract":"<p><p>Hepatocellular carcinoma (HCC) stands as the predominant type of primary liver cancer, frequently accompanied by portal vein tumor thrombosis (PVTT). PVTT is a harbinger of a grim prognosis, with current treatment modalities falling short of expectations. Delving deeper into the pathophysiology of PVTT, researchers have come to recognize that PVTT and HCC may originate from different clones. Previous clinical investigations have proposed various PVTT classification systems, offering a scientific basis for individualized and precise treatment. The innovative surgical approach of \"thrombectomy first\" is designed to mitigate the risk of tumor spread, thereby enhancing patient outcomes. Moreover, the multidisciplinary and integrated treatment model, including targeted therapy, immunotherapy and radiotherapy, has demonstrated promising efficacy for the treatment of PVTT. With the continuous progress and optimization of PVTT diagnostic technology, classification systems and precision treatment strategies, the prospects for long-term survival in HCC patients with PVTT are poised to see a significant uplift.</p>","PeriodicalId":60685,"journal":{"name":"中华外科杂志","volume":"63 2","pages":"102-106"},"PeriodicalIF":0.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142967538","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 on the groin hernia (2024 edition)].","authors":"","doi":"10.3760/cma.j.cn112139-20241128-00533","DOIUrl":"10.3760/cma.j.cn112139-20241128-00533","url":null,"abstract":"<p><p>In recent years, the diagnosis and treatment of groin hernia have become more mature, and personalized treatment plans for different groin hernias have become more standardized. On the basis of <i>the Guidelines for diagnosis and treatment on the adult groin hernia (2018 edition)</i>, more than 70 experts and scholars in China have discussed the consultation and modified the content of diagnosis and treatment of groin 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, combined with evidence-based medical evaluation standards. The relevant medical institutions and peers in China are requested to carry out the actual clinical reference.</p>","PeriodicalId":60685,"journal":{"name":"中华外科杂志","volume":"63 2","pages":"89-94"},"PeriodicalIF":0.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142967535","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Guidelines for diagnosis and treatment of abdominal wall incision hernia (2024 edition)].","authors":"","doi":"10.3760/cma.j.cn112139-20241128-00534","DOIUrl":"10.3760/cma.j.cn112139-20241128-00534","url":null,"abstract":"<p><p>Incisional hernia is a type of iatrogenic disease, and its clinical treatment is complicated. In recent years, there have been new advances in the diagnosis, surgical methods, and materials science of incisional hernias. On the basis of the <i>Guidelines for diagnosis and treatment of abdominal wall incisional hernia (2018 edition)</i>, more than 70 experts and scholars over the country have discussed the consultation and modified the issues such as complex abdominal wall conditions, loss of domain, principles of incisional hernia treatment, techniques of abdominal wall hernia defects closure, perioperative management, and follow-up in this new edition, combined with evidence-based medical evaluation standards. The relevant medical institutions and peers in China are requested to carry out the actual clinical reference.</p>","PeriodicalId":60685,"journal":{"name":"中华外科杂志","volume":"63 2","pages":"95-101"},"PeriodicalIF":0.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142967533","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 learning curve of 69 cases of robot-assisted resection of retroperitoneal benign tumors].","authors":"H L Liu, L Wang, X Wang, L T Tian, Q S Hao, F B Qiu, B Zhou","doi":"10.3760/cma.j.cn112139-20240918-00428","DOIUrl":"10.3760/cma.j.cn112139-20240918-00428","url":null,"abstract":"&lt;p&gt;&lt;p&gt;&lt;b&gt;Objectives:&lt;/b&gt; To explore the efficacy of robotic-assisted retroperitoneal benign tumor resection and to analyze its learning curve. &lt;b&gt;Methods:&lt;/b&gt; This is a retrospective case series study. The data of patients who underwent robotic-assisted retroperitoneal benign tumor resection from August 2015 to February 2023 at the Department of Retroperitoneal Tumor Surgery was analyzed retrospectively. There were 24 males and 45 females, with an age of (46.3±10.6) years (range: 19 to 76 years). The perioperative data, postoperative pathological results, and follow-up data were recorded. The cumulative sum (CUSUM) method was used to analyze the robotic system setup time and operative time to plot the learning curve. A linear regression model was applied to determine the best-fit curve, selecting the model with the highest R² value. Based on the vertex of the learning curve for surgical time, the patients were divided into a learning group and a mastery group. The general data and perioperative conditions of the two groups were compared. Independent sample &lt;i&gt;t&lt;/i&gt;-tests, Mann-Whitney &lt;i&gt;U&lt;/i&gt; tests, and &lt;i&gt;χ&lt;/i&gt;&lt;sup&gt;2&lt;/sup&gt; tests were used for comparisons. &lt;b&gt;Results:&lt;/b&gt; All 69 patients successfully completed the surgery without intraoperative complications. The diameter of tumors was (49.7±18.6) mm (range: 16 to 131 mm). The setup time for the robotic surgical system was (35.3±9.8) minutes (range: 20 to 61 minutes); the surgical time was (169.2±36.5) minutes (range: 70 to 305 minutes); intraoperative blood loss (&lt;i&gt;M&lt;/i&gt;(IQR)) was 10.0 (15.0) ml (range: 2.0 to 200.0 ml). The tumors in 32 patients (46.4%) were adherent to major blood vessels. All patients were discharged without complications. The follow-up period lasted until February 2024, and no patients required reoperation, readmission, or died due to retroperitoneal benign tumors. There were no severe long-term complications, and no radiological evidence of tumor recurrence was found. The best-fit equation for the learning curve based on surgical time was CUSUM=0.010X³-1.648X²-68.573X-61.091, and the best-fit equation for the learning curve based on robotic system setup time was CUSUM=0.0018X³-0.285X²+10.460X+57.541 (where X represents the number of surgeries). The R² values of 2 learning curve models were 0.953 and 0.957, respectively, and the fit model tests had &lt;i&gt;P&lt;/i&gt;&lt;0.05. The inflection point of the learning curve based on surgical time was the 28th case, which is considered the minimum number of surgeries required to achieve proficiency in robotic-assisted retroperitoneal benign tumor resection. Based on this, the patients were divided into a learning group (cases 1 to 28) and a mastery group (cases 29 to 69). The surgical time for the learning group was significantly longer than that of the mastery group ((194.7±30.0) minutes &lt;i&gt;vs.&lt;/i&gt; (151.9±31.4) minutes, &lt;i&gt;t&lt;/i&gt;=4.126,&lt;i&gt;P&lt;/i&gt;&lt;0.01). No statistically significant differences were found for other parameters (all &lt;i&gt;P&lt;/i&gt;&gt;0.05)","PeriodicalId":60685,"journal":{"name":"中华外科杂志","volume":"63 2","pages":"147-152"},"PeriodicalIF":0.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142967529","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Analysis of the efficacy and influencing factors of immunotherapy in gastric cancer liver metastasic patients].","authors":"T T Lu, Y H Gao, G Zhang, H Y Zhang, Y Liu, Z D Chen, H Q Xi","doi":"10.3760/cma.j.cn112139-20240612-00292","DOIUrl":"10.3760/cma.j.cn112139-20240612-00292","url":null,"abstract":"&lt;p&gt;&lt;p&gt;&lt;b&gt;Objective:&lt;/b&gt; To explore the efficacy and factors affecting the treatment of gastric cancer liver metastasis (GCLM) with immune checkpoint inhibitors (ICI). &lt;b&gt;Methods:&lt;/b&gt; This is a retrospective cohort study. Clinical and pathological data of 588 patients with GCLM treated at the Department of General Surgery, First Medical Center, People's Liberation Army General Hospital, from January 2018 to December 2022 were retrospectively collected. There were 491 males and 97 females, aged (&lt;i&gt;M&lt;/i&gt;(IQR)) 60(14) years (range: 18 to 86 years). Patients were divided into an ICI treatment group (&lt;i&gt;n&lt;/i&gt;=142) and a non-ICI treatment group (&lt;i&gt;n&lt;/i&gt;=446) based on whether they received ICI therapy. Clinical and pathological data between the two groups were compared using the &lt;i&gt;χ&lt;/i&gt;&lt;sup&gt;2&lt;/sup&gt; test or Mann-Whitney &lt;i&gt;U&lt;/i&gt; test. Propensity score matching (PSM) was performed with cT stage, cN stage, surgical treatment, targeted therapy, and biomarkers as covariates, using a 1∶1 nearest neighbor matching method with a caliper value of 0.2. Univariate and multivariate analyses were conducted using Cox proportional hazards regression models, with relevant variables selected through forward stepwise regression. Survival curves were plotted using the Kaplan-Meier method, and group differences were compared using the Log-rank test. Subgroup analysis was conducted to identify potential beneficiary populations for ICI through forest plots. &lt;b&gt;Results:&lt;/b&gt; After PSM, 114 patients were included in each group, and there were no statistically significant differences in the baseline data between the two groups (all &lt;i&gt;P&lt;/i&gt;&gt;0.05). The results of Cox multivariate analysis after PSM showed that cN2-3 stage (&lt;i&gt;HR&lt;/i&gt;=1.348, 95%&lt;i&gt;CI&lt;/i&gt;: 1.091 to 1.665, &lt;i&gt;P&lt;/i&gt;=0.006) and peritoneal metastasis (&lt;i&gt;HR&lt;/i&gt;=1.877, 95%&lt;i&gt;CI&lt;/i&gt;:1.360 to 2.590, &lt;i&gt;P&lt;/i&gt;&lt;0.01) were independent risk factors for survival in GCLM patients; radical surgery (&lt;i&gt;HR&lt;/i&gt;=0.391, 95%&lt;i&gt;CI&lt;/i&gt;: 0.305 to 0.501, &lt;i&gt;P&lt;/i&gt;&lt;0.01), immunotherapy (&lt;i&gt;HR&lt;/i&gt;=0.630, 95%&lt;i&gt;CI&lt;/i&gt;: 0.503 to 0.788, &lt;i&gt;P&lt;/i&gt;&lt;0.01), and deficient DNA mismatch repair (dMMR) or combined positive score (CPS)≥5 (&lt;i&gt;HR&lt;/i&gt;=0.454, 95%&lt;i&gt;CI&lt;/i&gt;: 0.320 to 0.644, &lt;i&gt;P&lt;/i&gt;&lt;0.01) were independent protective factors for survival in GCLM patients. After PSM, the overall survival was 12.4 (13.0) months in the non-immunotherapy group and 17.6 (17.8) months in the immunotherapy group (Log-rank test:&lt;i&gt;P&lt;/i&gt;=0.029). Subgroup analysis showed that female patients, those with primary tumors located in the upper stomach, cN2-3 stage, one liver metastasis, synchronous liver metastasis, receiving targeted therapy, and those with dMMR or CPS≥5 were more likely to benefit from ICI therapy (all &lt;i&gt;P&lt;/i&gt;&lt;0.05). &lt;b&gt;Conclusions:&lt;/b&gt; ICI prolongs overall survival in GCLM patients. Female patients, those with primary tumors located in the upper stomach, cN2-3 stage, one liver metastasis, synchronous liver metastasis, receiving targeted therapy, and those ","PeriodicalId":60685,"journal":{"name":"中华外科杂志","volume":"63 2","pages":"136-146"},"PeriodicalIF":0.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142967571","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 risk factors of diaphragmatic hernia after thoraco-laparoscopic minimally invasive McKeown esophagectomy].","authors":"Z H Li, W L Ding, K L Lyu, B K Sun, K Q Dong, M B Wang, P Su, Z Z Tian","doi":"10.3760/cma.j.cn112139-20240805-00364","DOIUrl":"10.3760/cma.j.cn112139-20240805-00364","url":null,"abstract":"<p><p><b>Objective:</b> To explore the related risk factors of diaphragmatic hernia after thoraco-laparoscopic minimally invasive Mckeown esophagectomy (MIME). <b>Methods:</b> This is a retrospective controlled study. A retrospective analysis was conducted on the clinical data of patients who underwent MIME at the Department of Thoracic Surgery, Fourth Hospital of Hebei Medical University, from January 2016 to December 2023. A total of 619 patients were included. There were 423 males and 196 females, aged (63.7±7.6) years (range: 37 to 87 years). The diagnosis of diaphragmatic hernia after MIME was made based on clinical symptoms and CT scans. Patients were divided into two groups: the diaphragmatic hernia group (<i>n</i>=16) and the non-diaphragmatic hernia group (<i>n</i>=603). Clinical data, including age, gender, body mass index (BMI), smoking history, tumor location (upper, middle, and lower thoracic esophagus), preoperative neoadjuvant therapy history, and tumor staging, were collected and analyzed. A BMI of 25 kg/m² and age of 65 years were used as cutoff values. The <i>χ</i>² test and Fisher's exact test were used to compare the data between the two groups, and Logistic regression was employed for risk factor analysis. The diaphragmatic hernia group and non-diaphragmatic hernia group were matched in a 1∶3 ratio with a caliper value of 0.02 by propensity score matching. Kaplan-Meier method was used for survival analysis and compared using the log-rank test for between-group differences. <b>Results:</b> The proportion of patients with diaphragmatic hernia after MIME who underwent surgical treatment was 6/16. Statistically significant differences were observed between the diaphragmatic hernia group and the non-diaphragmatic hernia group in terms of age (<i>χ</i>²=16.057, <i>P</i><0.01), BMI (<i>χ</i>²=16.057, <i>P</i><0.01), and tumor location (<i>χ</i>²=12.048, <i>P</i>=0.002). Multivariate logistic regression analysis revealed that age ≥65 years (<i>OR</i>=1.236, <i>P</i>=0.023) and BMI<25 kg/m² (<i>OR</i>=0.810, <i>P</i><0.01) were independent risk factors for the development of diaphragmatic hernia after MIME. Survival analysis showed no significant difference in long-term survival between patients with and without diaphragmatic hernia after MIME (<i>P</i>=0.187), and whether patients with diaphragmatic hernia underwent surgery was not associated with long-term prognosis (<i>P</i>=0.560). <b>Conclusion:</b> Patients with BMI<25 kg/m² and age ≥65 years are independent risk factors for diaphragmatic hernia after MIME. The occurrence of diaphragmatic hernia is not associated with prognosis, and whether patients with diaphragmatic hernia undergo surgery does not affect the prognosis.</p>","PeriodicalId":60685,"journal":{"name":"中华外科杂志","volume":"63 2","pages":"130-135"},"PeriodicalIF":0.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142967568","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":"[The significance and advancements of circulating tumor DNA in the diagnosis and treatment of operable non-small cell lung cancer].","authors":"Z F Li, Y He, K Z Chen","doi":"10.3760/cma.j.cn112139-20240627-00315","DOIUrl":"10.3760/cma.j.cn112139-20240627-00315","url":null,"abstract":"<p><p>Non-small cell lung cancer, characterized by high incidence and mortality rates, significantly threatens human health. Precisely assessing patient prognosis and implementing adaptive treatment strategies have emerged as pivotal issues in contemporary thoracic oncology. Postoperative minimal residual disease (MRD) detection through liquid biopsy has demonstrated substantial potential. Circulating tumor DNA (ctDNA) enables real-time dynamic monitoring of tumor alterations. With advancements in ctDNA detection technologies, ctDNA has become a core method for MRD assessment. In the context of postoperative surveillance, ctDNA detection facilitates more accurate prognostic stratification and early prediction of tumor recurrence. Regarding therapeutic interventions, ctDNA detection can predict the efficacy of neoadjuvant and adjuvant therapies. In the future, further elucidating the value of assessing ctDNA status in predicting patient prognosis and guiding drug therapies will contribute to the advancement of precision medicine and adaptive treatments.</p>","PeriodicalId":60685,"journal":{"name":"中华外科杂志","volume":"63 2","pages":"171-176"},"PeriodicalIF":0.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142967578","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":"[The application of full-thickness advancement flap of upper abdominal wall in breast-conserving surgery for lower quadrant breast cancer].","authors":"B Zhang, K T Zhang, Y Wang, C S Yue, R Cheng, M L Zhu, S Guan","doi":"10.3760/cma.j.cn112139-20240424-00205","DOIUrl":"10.3760/cma.j.cn112139-20240424-00205","url":null,"abstract":"<p><p><b>Objective:</b> To explore the application of full-thickness advancement flap of upper abdominal wall in breast-conserving surgery for lower quadrant breast cancer. <b>Methods:</b> This is a retrospective case series study. The clinic data of 25 lower quadrant breast cancer patients who underwent a breast-conserving surgery with advancement flap of full-thickness of upper abdominal wall at the Breast Center, Beijing Tongren Hospital, Capital Medical University, from June 2022 to September 2023 were analyzed retrospectively. All patients were female, aged (47.6±5.8) years (range: 38 to 57 years). Tumor staging included stageⅠ in 8 cases, stageⅡA in 13 cases, stageⅡB in 4 cases. The subcutaneous fat thickness of the upper abdominal walls and the volume of wide local excision of the tumor were measured and recorded. The operation time of repairing the breast, the duration of retention of postoperative drainage tubes, postoperative complications, and cosmetic results were recorded. <b>Results:</b> The subcutaneous fat thickness in the upper abdominal walls was (1.7±0.2) cm (range: 1.3 to 2.2 cm), the excision volume of breast-conserving surgery was (70.8±13.6) mm³ (range: 49 to 97 mm³), the operation time of repairing the breast was (55.4±5.1) minutes (range: 45 to 65 minutes) and the retention time of the drainage tube was (7.4±0.8) days (range: 6 to 9 days). Cosmetic results: excellent in 12 cases (48.0%), good in 9 cases (36.0%) and fair in 4 cases (16.0%). There was 1 case of postoperative seroma in the donor area, which healed after repositioning the negative pressure drain. <b>Conclusion:</b> In breast-conserving surgery for lower quadrant breast cancer, using a full-thickness abdominal wall advancement flap to repair breast defects is a simple and effective tumor reconstructive technique, yielding good results in achieving postoperative symmetry of the lower quadrant of the breast.</p>","PeriodicalId":60685,"journal":{"name":"中华外科杂志","volume":"63 2","pages":"153-158"},"PeriodicalIF":0.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142967575","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":"[Branched and fenestrated endovascular aortic repair in complex aortic diseases: innovative progress and clinical application].","authors":"L Cao, Y Y Ge, W Guo","doi":"10.3760/cma.j.cn112139-20240922-00436","DOIUrl":"10.3760/cma.j.cn112139-20240922-00436","url":null,"abstract":"<p><p>Recently, significant progress has been made in the field of endovascular repair of complex aortic disease involving the major branches (aortic arch disease and complex abdominal aortic aneurysms). Open surgery was considered the \"gold standard\" for the treatment of these complicated aortic diseases, but was challenged by the huge surgical trauma and high risk of post-operative complications. However, the rapid development of branched and fenestrated endografts has provided an alternative safe and effective minimally invasive treatment for patients who cannot tolerate open surgery. Preliminary evidence has also shown that branched and fenestrated endografts have achieved significant technical success rates and clinical outcomes and have gradually become an important direction of innovation and development for endovascular repair of complex aortic disease. Nevertheless, both branched and fenestrated endografts are currently in the early stages of experience and a series of high-quality research studies are needed in the future to further compare them with open surgery and within different endovascular techniques.</p>","PeriodicalId":60685,"journal":{"name":"中华外科杂志","volume":"63 1","pages":"45-50"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142848556","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}