中华外科杂志最新文献

{"title":"[Clinical application of improved treatment of the free margin of the leaflet in aortic root remodeling procedure].","authors":"X J Luo, S Y Wang, J T Qiu, X S Li, P Zhang, Y T Wang, C T Yu","doi":"10.3760/cma.j.cn112139-20240816-00377","DOIUrl":"10.3760/cma.j.cn112139-20240816-00377","url":null,"abstract":"<p><p><b>Objective:</b> To investigate the feasibility and clinical outcome of estimating the target length of the free margin of the leaflet by diameter of the prosthesis graft used to reconstruct the aortic root during the modified root remodeling procedure. <b>Methods:</b> This is a retrospective case series study. The clinical data of 11 patients with aortic root aneurysm who underwent modified aortic root remodeling procedure with external sub-valvular ring from July 2021 to May 2024 at Department of Cardiovascular Surgery, Fuwai Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College were analyzed. The age of the patients was (42.3±14.4) years (range:23 to 61 years), including 9 males and 2 females. The aortic valve of all patients was tri-leaflet configuration. Marfan syndrome was diagnosed in 3 cases. The diameter of the prosthesis graft was determined according to the Lansac group's criteria based on the diameter of the aortic annulus, and a graft ring of the same diameter was used as the external sub-valvular ring. The free margin of the leaflet was treated with central plication according to the standard of \"target length of free margin of the leaflet=the diameter of the selected graft+3 to 5 mm\". The surgical results and postoperative aortic valve closure function were observed. <b>Results:</b> All 11 patients successfully completed the operation without in-hospital death or complications. The graft with a diameter of 28 mm were used in 7 cases, 26 mm in 3 cases, and 30 mm in 1 case. 4 patients required central plication of the free margin of 3 leaflets, 2 patients required treatment of 2 leaflets, 3 patients required treatment of 1 leaflet, and 2 patients did not need treatment of the free margin of the leaflets. The functional status of aortic valve closure was significantly improved in all patients after surgery, and the degree of residual aortic regurgitation was not more than mild. After reconstruction of the aortic root, the measured effective height was (8.8±1.3) mm (range:7 to 11 mm) and the measured coaptation length was (5.2±0.9) mm (range:4 to 7 mm). All patients were re-examined 3 months after surgery. Echocardiography showed that the degree of aortic regurgitation was mild or lower, and the left ventricular end-diastolic diameter was (49.4±6.1) mm (range: 36 to 56 mm), which was smaller than that before the operation ((58.5±7.0) mm (range: 47 to 72 mm)). Eight patients were followed up for more than 6 months, and 5 patients were followed up for more than 1 year. The degree of aortic regurgitation in these patients was mild or below. <b>Conclusions:</b> The method based on the diameter of the selected prosthesis graft to deal with the length of the free margin of the leaflet can be effectively used in the modified aortic root remodeling procedure with external sub-valvular ring. The early postoperative results are satisfactory<b>.</b></p>","PeriodicalId":60685,"journal":{"name":"中华外科杂志","volume":"63 7","pages":"618-623"},"PeriodicalIF":0.0,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144181039","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":"[Feasibility of appropriately extending the surgical interval after neoadjuvant immunotherapy combined with chemotherapy for esophageal squamous cell carcinoma].","authors":"J Y Geng, T Mu, H Zhao, J W Zhang, X Y Chen, W H Weng, X Z Sui, Y Li, X Wang","doi":"10.3760/cma.j.cn112139-20241121-00523","DOIUrl":"10.3760/cma.j.cn112139-20241121-00523","url":null,"abstract":"<p><p><b>Objective:</b> To investigate the impact of the interval between neoadjuvant immunotherapy combined with chemotherapy(nICT) and surgery on pathological outcomes and prognosis in patients. <b>Methods:</b> This is a retrospective cohort study. A total of 115 patients with locally advanced esophageal squamous cell carcinoma who underwent nICT followed by sequential surgery at Department of Thoracic Surgery, Peking University People's Hospital or Department of Thoracic Surgery, the First Affiliated Hospital of Zhengzhou University from January 2020 to April 2024 were included. Among them, 99 were male and 16 were female, with an age of (<i>M</i>(IQR)) 65 (11) years (range:45 to 81 years). All patients received 2 to 6 cycles of paclitaxel plus platinum-based doublet chemotherapy combined with PD-1 immune checkpoint inhibitors. The resectability of tumors was assessed based on CT scans of the chest and abdomen, and surgical approaches included Sweet surgery, Mckeown surgery, and Ivor-Lewis surgery. Patients were divided into a short-interval group (4 to <6 weeks) and a long-interval group (6 to 12 weeks) based on the interval between neoadjuvant immunochemotherapy and surgery. General patient data, surgical details, pathological response, and prognosis were collected and analyzed. Data comparisons were performed using independent sample <i>t</i>-test, Mann-Whitney <i>U</i> test, <i>χ²</i> test, or Fisher's exact test. Multivariate logistic regression analysis was used to identify independent factors influencing pathological complete response (pCR). Survival analysis was conducted using the Kaplan-Meier method and Log-rank test. <b>Results:</b> There were no significant differences in baseline characteristics, neoadjuvant treatment details, surgical outcomes, or postoperative complications between the long-interval group and the short-interval group (all <i>P</i>>0.05). Multivariate Logistic regression analysis revealed that, among clinical factors, interval between neoadjuvant immunochemotherapy and surgery was significantly associated with pCR (long-interval group <i>vs</i>. short-interval group: <i>OR</i>=4.14, 95%<i>CI</i>:1.63 to 10.50, <i>P</i>=0.003). The pCR rate was higher in the long-interval group (43.6% <i>vs.</i> 17.1%, <i>χ</i>²=6.48,<i>P</i>=0.011). Survival analysis showed no significant differences in overall survival (<i>P</i>=0.094) or disease-free survival (<i>P</i>=0.840) between the two groups. <b>Conclusion:</b> Appropriately extending the surgical interval after neoadjuvant immunochemotherapy maybe lead to a higher pCR rate, without increasing surgical difficulty or damaging prognosis.</p>","PeriodicalId":60685,"journal":{"name":"中华外科杂志","volume":"63 7","pages":"597-604"},"PeriodicalIF":0.0,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144183009","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":"[Immunotherapy: progress and challenges of a revolutionary treatment for gastric cancer].","authors":"A N Shi, Y B Zhou, G H Wang","doi":"10.3760/cma.j.cn112139-20250310-00120","DOIUrl":"10.3760/cma.j.cn112139-20250310-00120","url":null,"abstract":"<p><p>Gastric cancer is a common malignant tumor, ranking fifth in incidence and mortality among all malignancies globally. The lack of early symptoms or the non-specific nature of symptoms means that most patients are diagnosed at an advanced stage. The unique high heterogeneity of gastric cancer largely limits the effectiveness of traditional therapies, resulting in poor prognosis for patients. In recent years, immunotherapy has emerged as a new treatment option for advanced gastric cancer. The immunotherapy era has driven gastric cancer treatment towards more personalized and precise directions. There have been many new research advances in the fields of immune checkpoint inhibitors, chimeric antigen receptor T-cell (CAR-T) therapy, and cancer vaccines. However, there are also many challenges and difficulties. It is hoped that this review will provide ideas and suggestions for the in-depth exploration of immunotherapy for gastric cancer.</p>","PeriodicalId":60685,"journal":{"name":"中华外科杂志","volume":"63 7","pages":"563-567"},"PeriodicalIF":0.0,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144183617","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Progress of individualized precision therapy for peritoneal metastasis in gastric cancer].","authors":"J H Zhao, Y Q Yang, R Ma, C Z Zhang, Z C Hong, Z N Wang","doi":"10.3760/cma.j.cn112139-20250313-00127","DOIUrl":"10.3760/cma.j.cn112139-20250313-00127","url":null,"abstract":"<p><p>Peritoneal metastasis represents the most aggressive form of gastric cancer metastasis and serves as a primary contributor to poor prognosis. Conventional therapeutic approaches offer limited survival benefits, making the development of novel treatment strategies an urgent medical priority. With advancements in molecular medicine and sociomedical sciences, contemporary cancer management is evolving towards individualized precision medicine. This transition has given rise to a plethora of innovative therapeutic strategies, including molecular typing-driven targeted therapy, immunotherapy, and locally targeted technology. These strategies emphasize the construction of a precise and individualized therapeutic framework through the integration of genomics, imaging genomics, and artificial intelligence-assisted decision-making, which promotes the continuous improvement of treatment strategies for peritoneal metastasis of gastric cancer. This article provides a comprehensive analysis of the prevailing individualized treatment modalities from the standpoint of precision medicine, offering novel perspectives on the management of peritoneal metastasis in gastric cancer.</p>","PeriodicalId":60685,"journal":{"name":"中华外科杂志","volume":"63 7","pages":"552-557"},"PeriodicalIF":0.0,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144180328","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":"[Current status and trends of perioperative immunotherapy for gastric cancer].","authors":"Y F Zhu, J K Hu","doi":"10.3760/cma.j.cn112139-20250315-00132","DOIUrl":"10.3760/cma.j.cn112139-20250315-00132","url":null,"abstract":"<p><p>In recent years,immunotherapy,particularly immune checkpoint inhibitors,has been widely used in the treatment of both solid and non-solid tumors,and it has become an important component of comprehensive gastric cancer treatment. The clinical application of immunotherapy in gastric cancer has gradually expanded from first-line treatment for advanced gastric cancer to perioperative treatment for resectable locally advanced gastric cancer. The use of immunotherapy combined with chemotherapy,targeted therapy,and other treatment modalities in the perioperative management of gastric cancer has injected new vitality into perioperative treatment strategies,establishing a novel model for comprehensive perioperative gastric cancer treatment. However,the application of immunotherapy in gastric cancer treatment still faces challenges such as limited high-level evidence for perioperative use,drug resistance,and adverse effects. In the future,efforts should focus on conducting high-level evidence-based clinical research on perioperative immunotherapy for gastric cancer,exploring and optimizing combined immunotherapy regimens,and delving into the molecular biological mechanisms of the tumor immune microenvironment in gastric cancer. By leveraging artificial intelligence and big data platform technologies,further optimization of screening strategies for potential beneficiaries should be pursued,and personalized precision treatment should be employed to address and overcome the challenges faced by immunotherapy in gastric cancer.</p>","PeriodicalId":60685,"journal":{"name":"中华外科杂志","volume":"63 7","pages":"575-580"},"PeriodicalIF":0.0,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144183072","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 impact of neoadjuvant immunotherapy on postoperative complications and short-term efficacy in patients with advanced gastric cancer].","authors":"A N Shi, Y B Zhou, G H Wang","doi":"10.3760/cma.j.cn112139-20250310-00121","DOIUrl":"10.3760/cma.j.cn112139-20250310-00121","url":null,"abstract":"<p><p><b>Objective:</b> To investigate the impact of neoadjuvant immunotherapy on intra-treatment complications, postoperative complications,and short-term efficacy in patients with advanced gastric cancer. <b>Methods:</b> This is a retrospective cohort study. Clinical and pathological data were collected from 103 patients with advanced gastric cancer who underwent neoadjuvant therapy and subsequent surgical treatment at the Department of Gastrointestinal Surgery, Affiliated Tongji Hospital,Tongji Medical College,Huazhong University of Science and Technology,between January 2021 and December 2024. Among the patients,70 were male and 33 were female;the age was (58±10)years(range: 29 to 79 years). Patients were divided into two groups based on the neoadjuvant treatment regimen: the chemotherapy-alone group (56 patients) and the immunotherapy plus chemotherapy group(47 patients). There was no statistical significance in the differences of age, gender distribution, tumor location and abdominal surgery history between the two groups (all <i>P</i>>0.05). Comparisons between the two groups were performed using Welch's <i>t</i>-test,<i>χ²</i> test or Fisher's exact probability test,respectively. <b>Results:</b> No statistically significant differences were observed in the incidence of adverse events during neoadjuvant therapy between the two groups (44.7%(21/47) <i>vs.</i> 60.7% (34/56),<i>P</i>>0.05). There were also no statistically significant differences in R0 resection rates (97.9%(46/47) <i>vs.</i> 91.1%(51/56)) and hospitalization costs for surgery((91 759±24 572) yuan <i>vs.</i> (96 873±17 367) yuan) between the two groups (both <i>P</i>>0.05). Additionally,the overall postoperative complication rates between the two groups were not significantly different (29.8%(14/47) <i>vs.</i> 26.8%(15/56) ,<i>χ</i>²=0.114，<i>P</i>>0.05).In terms of short-term efficacy,the proportion of responders(tumor regression grade 0 and 1) was significantly higher in the immunotherapy plus chemotherapy group compared to the chemotherapy-alone group (36.2%(17/47) <i>vs.</i> 14.3%(8/56), <i>χ²</i>=6.658, <i>P</i>=0.010). <b>Conclusions:</b> Neoadjuvant immunotherapy combined with chemotherapy does not increase the incidence of adverse events,surgical resection difficulty,or postoperative complications compared to chemotherapy alone. In terms of short-term efficacy,the addition of immunotherapy shows better performance in tumor regression grade compared to chemotherapy alone.</p>","PeriodicalId":60685,"journal":{"name":"中华外科杂志","volume":"63 7","pages":"581-586"},"PeriodicalIF":0.0,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144182871","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 analysis of splenic circulation control technology applied in minimally invasive radical resection of pancreatic neck and body cancer].","authors":"Q C Zhu, Z Jin, W W Jin, Y P Mou, Y C Zhou, C Lu","doi":"10.3760/cma.j.cn112139-20250424-00217","DOIUrl":"https://doi.org/10.3760/cma.j.cn112139-20250424-00217","url":null,"abstract":"<p><p><b>Objective:</b> To evaluate the effectiveness of splenic circulation control technology in minimally invasive radical resection surgery for pancreatic neck/body cancer. <b>Methods:</b> This is a retrospective case series study. Retrospective analysis of clinical data of 12 patients who underwent laparoscopic or robotic radical resection for pancreatic neck/body cancer at the Department of Gastrointestinal and Pancreatic Surgery,Zhejiang Provincial People's Hospital between January 2024 and January 2025. There were 7 males and 5 females,with mean age of 68 years (range: 52 to 79 years). Clinical data including preoperative,intra-operative and postoperative outcomes were analyzed. Postoperative follow-up was conducted via outpatient visits and telephone interviews,with the follow-up ending on April 1,2025. <b>Results:</b> All 12 patients underwent minimally invasive radical resection of pancreatic neck/body cancer using splenic circulation control technology,consisted of 3 laparoscopic and 9 robotic procedures. The mean operative time was 185 minutes (range: 140 to 315 minutes),and the average blood loss was 100 ml (range: 30 to 300 ml). Two cases involved combined organ resection.There was no conversion to open surgery. Postoperative complications were observed in 2 patients. One patient developed grade B pancreatic leakage,managed by ultrasound-guided puncture.The patient was discharged with drainage tube. The other patient experienced chylous leakage,recovered with conservative treatment. No delayed gastric emptying,hemorrhage or reoperations were observed. The median postoperative hospital stay was 13 days (range: 8 to 20 days). <b>Conclusion:</b> The splenic circulation control technique is simple and safe,and shows certain application prospects in minimally invasive radical resection of pancreatic neck and body cancer.</p>","PeriodicalId":60685,"journal":{"name":"中华外科杂志","volume":"63 8","pages":"728-732"},"PeriodicalIF":0.0,"publicationDate":"2025-06-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144487257","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":"[Several issues to consider in surgical intervention for severe acute pancreatitis in the era of minimally invasive techniques].","authors":"B Sun, G Q Li","doi":"10.3760/cma.j.cn112139-20250218-00082","DOIUrl":"https://doi.org/10.3760/cma.j.cn112139-20250218-00082","url":null,"abstract":"<p><p>Severe acute pancreatitis (SAP) has a mortality rate of up to 30%. Infected pancreatic necrosis (IPN) is a serious complication of acute pancreatitis with high mortality with poor prognosis. With the rapid development of the concept of minimally invasive surgery,the \"step-up\" treatment strategy with minimally invasive techniques as the core has improved the prognosis of SAP patients,and surgical intervention is extremely key in this process. This article focuses on the surgical intervention strategies of SAP in the era of minimally invasive surgery,including the application of surgical rescue,the selection of the timing and method in surgical intervention,the early prediction and diagnosis of IPN,and the treatment of residual infection, so as to provide reference for the clinical treatment of SAP. The key to reduce the mortality of SAP patients is to establish an integrated comprehensive treatment platform and properly grasp the timing and method of surgical intervention.</p>","PeriodicalId":60685,"journal":{"name":"中华外科杂志","volume":"63 8","pages":"660-665"},"PeriodicalIF":0.0,"publicationDate":"2025-06-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144487266","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 clinical features and risk factors for severe acute pancreatitis complicated with biliary system diseases].","authors":"Q Y Li, Y Luo, H Chen, R Kong, Y W Wang, G Q Li, Y Q Song, X Zheng, J J Li, J W Wu, D X Ju, B Sun","doi":"10.3760/cma.j.cn112139-20250217-00080","DOIUrl":"https://doi.org/10.3760/cma.j.cn112139-20250217-00080","url":null,"abstract":"&lt;p&gt;&lt;p&gt;&lt;b&gt;Objective:&lt;/b&gt; To explore the clinical characteristics of biliary system diseases complicated by severe acute pancreatitis(SAP) and the risk factors. &lt;b&gt;Methods:&lt;/b&gt; This is a retrospective cohort study. A retrospective analysis was conducted on the clinical data of 159 SAP patients admitted to the Department of Pancreatic and Biliary Surgery,the First Affiliated Hospital of Harbin Medical University from January 2019 to October 2024. There were 105 male cases, 54 female cases;aged (42.3±10.8)years (range:20 to 71 years). Grouping was performed according to the presence or absence of concurrent acute acalculous cholecystitis (AAC) and biliary stricture. There were 58 cases in the AAC group,including 40 males and 18 females;aged (43.8±10.6) years (range:28 to 71 years);101 cases in the non-AAC group,including 64 males and 37 females;aged (41.5±10.8) years (range:20 to 64 years);there were statistically significant differences between the two groups in terms of admission total bilirubin,Balthazar-CTSI score,fasting time,and the proportions of concurrent shock and sepsis (all &lt;i&gt;P&lt;/i&gt;&lt;0.05);the time from onset of SAP to diagnosis of AAC(&lt;i&gt;M&lt;/i&gt; (IQR)) was 10.5 (13.3) days (range: 3 to 34 days). There were 15 cases in the biliary stricture group,including 13 males and 2 females;age (46.5±10.0) years (range:33 to 63 years);141 cases in the non-biliary stricture group,including 89 males and 52 females;age (41.9±10.8) years (range: 20 to 71 years); there were statistically significant differences between the two groups in the proportions of infected pancreatic necrosis,pancreatic head necrosis,and lower extremity venous thrombosis (all &lt;i&gt;P&lt;/i&gt;&lt;0.05);the time from the onset of SAP to the diagnosis of biliary stenosis in patients with biliary stenosis was 2.0 (3.0) months (range: 1 to 19 months). Univariate analysis was performed using independent sample &lt;i&gt;t&lt;/i&gt;-test, Mann-Whitney &lt;i&gt;U&lt;/i&gt; test,&lt;i&gt;χ&lt;sup&gt;2&lt;/sup&gt;&lt;/i&gt; test,or Fisher's exact probability method,and variables with &lt;i&gt;P&lt;/i&gt;&lt;0.05 in univariate analysis were included in multivariate logistic regression analysis. The receiver operating characteristic (ROC) curve was used to analyze the diagnostic and predictive value of the multivariate logistic regression model for AAC and biliary stricture. &lt;b&gt;Results:&lt;/b&gt; There were statistically significant differences in fasting time,Balthazar-CTSI score,admission total bilirubin,and the proportions of concurrent shock and sepsis between the AAC group and non-AAC group (&lt;i&gt;P&lt;/i&gt;&lt;0.05). Multivariate logistic analysis showed that admission total bilirubin (&lt;i&gt;OR&lt;/i&gt;=1.033,95%&lt;i&gt;CI&lt;/i&gt;; 1.010 to 1.058,&lt;i&gt;P&lt;/i&gt;=0.004),Balthazar-CTSI score (&lt;i&gt;OR&lt;/i&gt;=1.276,95%&lt;i&gt;CI&lt;/i&gt;: 1.036 to 1.572,&lt;i&gt;P&lt;/i&gt;=0.022),fasting time (&lt;i&gt;OR&lt;/i&gt;=1.127,95%&lt;i&gt;CI&lt;/i&gt;: 1.044 to 1.216,&lt;i&gt;P&lt;/i&gt;=0.002), and sepsis (&lt;i&gt;OR&lt;/i&gt;=4.033, 95%&lt;i&gt;CI&lt;/i&gt;; 1.419 to 11.462, &lt;i&gt;P&lt;/i&gt;=0.009) were independent risk factors for AAC complicated by SAP. The area under the curve (AUC) of the ROC curve","PeriodicalId":60685,"journal":{"name":"中华外科杂志","volume":"63 8","pages":"713-720"},"PeriodicalIF":0.0,"publicationDate":"2025-06-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144487254","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":"[Current situation and development trends of minimally invasive surgical procedures in the treatment of pancreatic tumors].","authors":"X J Guo, R Y Qin","doi":"10.3760/cma.j.cn112139-20250224-00090","DOIUrl":"https://doi.org/10.3760/cma.j.cn112139-20250224-00090","url":null,"abstract":"<p><p>With the rapid development of modern medical technology,minimally invasive surgical procedures are playing an increasingly important role in the field of pancreatic tumor treatment. This article systematically expounds on the application status of minimally invasive surgical procedures,including robotic surgery and laparoscopic surgery,in the treatment of pancreatic tumors. Through in-depth analysis of various surgical procedures such as pancreatoduodenectomy,distal pancreatectomy,local pancreatic resection,middle pancreatectomy and duodenum-preserving pancreatic head resection,combined with a large amount of high-quality randomized controlled trial research data in the past decade,it systematically discusses the advantages and limitations of minimally invasive surgery compared with traditional open surgery. It also explores the challenges faced by minimally invasive pancreatic surgery in aspects such as high technical difficulty of surgical operations,complex management of postoperative complications and evaluation of oncological radicality. Moreover,it comprehensively looks ahead to the development trends such as the refinement and innovation of future technologies,strengthened multidisciplinary collaboration,and the application of artificial intelligence and big data,aiming to provide references for the clinical practice and research of pancreatic surgery.</p>","PeriodicalId":60685,"journal":{"name":"中华外科杂志","volume":"63 8","pages":"672-676"},"PeriodicalIF":0.0,"publicationDate":"2025-06-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144487258","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}