中华外科杂志最新文献

{"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":"<p><p><b>Objective:</b> To explore the clinical characteristics of biliary system diseases complicated by severe acute pancreatitis(SAP) and the risk factors. <b>Methods:</b> 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 <i>P</i><0.05);the time from onset of SAP to diagnosis of AAC(<i>M</i> (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 <i>P</i><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 <i>t</i>-test, Mann-Whitney <i>U</i> test,<i>χ<sup>2</sup></i> test,or Fisher's exact probability method,and variables with <i>P</i><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. <b>Results:</b> 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 (<i>P</i><0.05). Multivariate logistic analysis showed that admission total bilirubin (<i>OR</i>=1.033,95%<i>CI</i>; 1.010 to 1.058,<i>P</i>=0.004),Balthazar-CTSI score (<i>OR</i>=1.276,95%<i>CI</i>: 1.036 to 1.572,<i>P</i>=0.022),fasting time (<i>OR</i>=1.127,95%<i>CI</i>: 1.044 to 1.216,<i>P</i>=0.002), and sepsis (<i>OR</i>=4.033, 95%<i>CI</i>; 1.419 to 11.462, <i>P</i>=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}

{"title":"[Prognosis and risk factors of different recurrence and metastasis patterns following pancreatectomy].","authors":"B H Yang, K Chen, L Z Xu, J Y Shen, A Q Guo, Y S Liu, Y S Ma, X D Tian, Y M Yang","doi":"10.3760/cma.j.cn112139-20250430-00231","DOIUrl":"https://doi.org/10.3760/cma.j.cn112139-20250430-00231","url":null,"abstract":"&lt;p&gt;&lt;p&gt;&lt;b&gt;Objective:&lt;/b&gt; To elucidate the prognostic differences and risk factors associated with different patterns of recurrence and metastasis following pancreatic cancer (PC) resection. &lt;b&gt;Methods:&lt;/b&gt; This is a retrospective case series study. Clinicopathological data and follow-up information were retrospectively collected from 210 patients who underwent surgery for PC at the Department of Hepatobiliary and Pancreatic Surgery, Peking University First Hospital, between January 2014 and December 2023. There were 114 males and 96 females; the age was (64.5±10.3) years (range: 29 to 89 years). Survival functions based on different times to recurrence and metastasis and different patterns of recurrence and metastasis were estimated using the Kaplan-Meier method, and survival differences among groups were compared using the Log-rank test. Identifying the optimal cutoff for time to postoperative recurrence/metastasis predicting overall survival (OS) in pancreatic cancer patients via the minimum p-value approach. Univariate and multivariate Cox regression analyses were performed to identify independent risk factors affecting OS following pancreatectomy. &lt;b&gt;Results:&lt;/b&gt; A total of 210 patients met the inclusion and exclusion criteria. Among them, 71 patients remained free of recurrence and metastasis, while 139 developed recurrence and metastasis. The patterns included local recurrence (&lt;i&gt;n&lt;/i&gt;=34), liver metastasis (&lt;i&gt;n&lt;/i&gt;=39), lung metastasis (&lt;i&gt;n&lt;/i&gt;=11), peritoneal metastasis (&lt;i&gt;n&lt;/i&gt;=13), multiple sites metastasis (&lt;i&gt;n&lt;/i&gt;=38), bone metastasis (&lt;i&gt;n&lt;/i&gt;=3), and kidney metastasis (&lt;i&gt;n&lt;/i&gt;=1). OS was significantly shorter in the group with postoperative recurrence and metastasis compared to the group without recurrence/metastasis (23.07 month &lt;i&gt;vs&lt;/i&gt;.not reached, &lt;i&gt;P&lt;/i&gt;&lt;0.01). The optimal cut-off time distinguishing early from late recurrence and metastasis was 13 months. There was a significant difference in post-recurrence survival between patients with early and late recurrence and metastasis (16.03 month &lt;i&gt;vs&lt;/i&gt;.52.40 month,&lt;i&gt;P&lt;/i&gt;=0.009). The Kaplan-Meier survival curve showed that different postoperative recurrence and metastasis patterns had different impacts on OS, with lung metastasis showing the best prognosis compared to local recurrence, liver metastasis, peritoneal metastasis, and multiple sites metastasis (&lt;i&gt;P&lt;/i&gt;&lt;0.01). Multivariate Cox analysis revealed that Eastern Cooperative Oncology Group (ECOG) score 1, postoperative carcinoembryonic antigen (CEA)≥15 μg/L, poor tumor differentiation, postoperative local recurrence, liver metastasis, peritoneal metastasis, and multiple sites metastases are independent risk factors for postoperative recurrence and metastasis (all &lt;i&gt;P&lt;/i&gt;&lt;0.05). &lt;b&gt;Conclusions:&lt;/b&gt; Considerable prognostic heterogeneity exists in postoperative PC patients depending on the site and pattern of recurrence or metastasis. Specifically, lung metastasis portends a significantly more favorable prognosis th","PeriodicalId":60685,"journal":{"name":"中华外科杂志","volume":"63 8","pages":"704-712"},"PeriodicalIF":0.0,"publicationDate":"2025-06-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144487264","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 real-time virtual sonography combined with intraductal biliary contrast-enhanced ultrasound in percutaneous transhepatic cholangial drainage].","authors":"H H Wu, J W Yi, Z G Hu, B H Zhou, J F Guan, J L Yan, X Yu, R F Yuan, S B Zou, K Wang","doi":"10.3760/cma.j.cn112139-20241228-00596","DOIUrl":"https://doi.org/10.3760/cma.j.cn112139-20241228-00596","url":null,"abstract":"<p><p><b>Objective:</b> To explore the application value of real-time virtual sonography (RVS) combined with intraductal biliary contrast-enhanced ultrasound (IB-CEUS) in percutaneous transhepatic cholangial drainage (PTCD). <b>Methods:</b> This retrospective cohort study included data from 71 patients who underwent PTCD at the Department of Hepatobiliary and Pancreatic Surgery in the Second Affiliated Hospital of Nanchang University between May 2021 and August 2022. There were 36 male and 35 female patients,aged 35 to 94 years. Based on the guidance modality used,patients were divided into two groups: the RVS combined with IB-CEUS group (<i>n</i>=36) and the digital subtraction angiography (DSA) group (<i>n</i>=35). PTCD was performed under the guidance of RVS combined with IB-CEUS in the RVS+IB-CEUS group,and under conventional DSA fluoroscopic guidance in the DSA group. Two clinicians classified the biliary conditions as either simple or complex based on preoperative ultrasound and CT (or MRI) imaging. Statistical analyses were conducted using independent sample <i>t</i>-tests,rank-sum tests,<i>χ²</i> tests,or Fisher's exact tests,as appropriate. <b>Results:</b> Significant differences were observed between the RVS+IB-CEUS group and the DSA group in terms of the number of punctures (1.0±0.2 <i>vs.</i> 2.2±1.4,<i>t</i>=-5.148,<i>P</i><0.01) and postoperative complication rate(2.8% (1/35) <i>vs.</i> 17.1% (6/36),<i>P</i>=0.049). There were 9 patients with complex biliary conditions in the DSA group and 12 in the RVS+IB-CEUS group. The number of punctures in both the simple and complex subgroups of the RVS+IB-CEUS group(1.0±0.2 and 1.0±0.0) remained lower than that in the corresponding DSA subgroups(2.2±1.6 and 2.4±0.4) (<i>t</i>=-3.606,<i>P</i><0.01;<i>t</i>=-3.959,<i>P</i>=0.002). Moreover,the complication rate in the simple biliary subgroup of the RVS+IB-CEUS group was significantly lower than that of the DSA group(0 (0/24) <i>vs.</i> 19.2% (5/26), <i>P</i>=0.031),whereas no significant difference was found in the complex biliary subgroup (1/12 <i>vs.</i> 1/9,<i>P</i>=0.686). <b>Conclusion:</b> Guided by RVS and IB-CEUS, PTCD can help reduce the number of punctures during surgery and postoperative complications, and patients with complex bile duct conditions can still benefit from PTCD.</p>","PeriodicalId":60685,"journal":{"name":"中华外科杂志","volume":"63 8","pages":"733-738"},"PeriodicalIF":0.0,"publicationDate":"2025-06-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144487255","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":"[Key considerations in the diagnosis and treatment of pancreatic cystic tumors].","authors":"S M Gou, H S Wu","doi":"10.3760/cma.j.cn112139-20250121-00039","DOIUrl":"https://doi.org/10.3760/cma.j.cn112139-20250121-00039","url":null,"abstract":"<p><p>Pancreatic cystic neoplasm (PCN) has multiple pathological types, with an increasing incidence year by year. PCN exhibits strong heterogeneity, and the risk of malignancy and malignant transformation varies significantly among different pathological types. Additionally, pancreatic resection carries high surgical risks, so multiple factors must be considered when making treatment decisions for PCN. Among various pathological types of PCN, intraductal papillary mucinous tumors, mucinous cystic neoplasms, and serous cystic neoplasms share similar imaging characteristics and relatively high incidence rates, but their treatment strategies differ markedly. This article, based on recommendations from domestic and international guidelines, literature reviews, and the author's clinical experience, offers insights and solutions to the challenges in diagnosing and treating these three types of PCN. It emphasizes that it is essential to diagnose as accurately as possible through existing examination methods and MDT discussions; for patients who cannot be definitively diagnosed and have no risk factors, a close follow-up strategy should be adopted, and surgery should not be performed arbitrarily.</p>","PeriodicalId":60685,"journal":{"name":"中华外科杂志","volume":"63 8","pages":"677-681"},"PeriodicalIF":0.0,"publicationDate":"2025-06-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144487262","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":"[Development and validation of a risk prediction model for severe acute pancreatitis induced by hypertriglyceridemia].","authors":"Z Wang, H Z Deng, K X Peng, J D Lu, L Zhang, X L Shi, Y P Peng, K D Xu, Z Wang, G T Lu, G Wang, Z P Lu, F Li, L Wen, F Cao","doi":"10.3760/cma.j.cn112139-20250303-00107","DOIUrl":"https://doi.org/10.3760/cma.j.cn112139-20250303-00107","url":null,"abstract":"<p><p><b>Objective:</b> To investigate the risk factors for patients with hypertriglyceridemia-related acute pancreatitis (HTG-AP) developing into severe acute pancreatitis or experiencing organ failure. <b>Methods:</b> This retrospective cohort study collected clinical data from 2 429 patients diagnosed with acute pancreatitis from five hospitals in China between January 2019 and December 2023 using a pre-designed data collection form. The cohort included 1 516 males and 913 females,with an age of (50.2±16.5)years(range: 11 to 99 years). Among them,353 patients (16.1%) had HTG-AP,while 1 846 (83.9%) had non-HTG-AP. HTG-AP was defined as serum triglyceride levels>500 mg/dl with other etiologies excluded. Intergroup comparisons were performed using <i>t</i>-tests,Mann-Whitney <i>U</i> test or <i>χ²</i> tests,respectively. Univariate and multivariate logistic regression analyses were conducted to assess risk factors for severe acute pancreatitis after adjusting for potential confounders,and a predictive model was developed and validated. <b>Results:</b> Compared with other etiologies,HTG-AP patients had a higher risk of progressing to SAP (<i>OR</i>=1.415,95%<i>CI:</i> 0.866 to 2.312, <i>P</i>=0.017) and organ failure (<i>OR</i>=1.256,95%<i>CI:</i> 1.015 to 1.554, <i>P</i>=0.036). Among HTG-AP patients,risk factors for SAP included body mass index (<i>OR</i>=1.856,95%<i>CI</i>: 1.742 to 1.987, <i>P</i>=0.033),fasting blood glucose (<i>OR</i>=1.128,95%<i>CI:</i> 1.036 to 1.229, <i>P</i>=0.006),white blood cell count(<i>OR</i>=1.162,95%<i>CI</i>: 1.055 to 1.281, <i>P</i>=0.002),and the presence of pleural effusion (<i>OR</i>=13.151,95%<i>CI:</i> 4.330 to 19.946, <i>P</i><0.01). A nomogram prediction model for SAP in HTG-AP was constructed based on these risk factors,demonstrating good discriminative ability with area under the curve values of 0.877 in the training set and 0.894 in the validation set,along with satisfactory calibration. <b>Conclusions:</b> HTG-AP patients are at higher risk of developing SAP and organ failure. The risk prediction model incorporating body mass index,fasting blood glucose,white blood cell count,and pleural effusion shows good predictive value for SAP.</p>","PeriodicalId":60685,"journal":{"name":"中华外科杂志","volume":"63 8","pages":"721-727"},"PeriodicalIF":0.0,"publicationDate":"2025-06-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144487259","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":"[Research advances in perineural invasion of pancreatic cancer].","authors":"G H Xue, G Jin, Y J Zhang, P Cheng","doi":"10.3760/cma.j.cn112139-20241208-00561","DOIUrl":"https://doi.org/10.3760/cma.j.cn112139-20241208-00561","url":null,"abstract":"<p><p>Perineural invasion (PNI) in pancreatic cancer,as an important clinical pathological feature,not only participates in various biological processes such as development,growth,invasion,and metastasis of pancreatic cancer,but also is closely associated with poor prognosis in pancreatic cancer. This article systematically reviews the latest research advancements in the field of PNI in pancreatic cancer,providing a multidimensional analysis of its anatomical basis,cytokine regulatory networks,metabolic reprogramming mechanisms,vesicle-mediated molecular transport,immune-neural interactions,pain-inducing pathomechanism,quantitative assessment frameworks,experimental model construction,cutting-edge technological applications,and innovations in surgical strategies. In the surgical domain,precision techniques combining targeted nerve plexus resection with molecular-targeted probes have significantly improved the R0 resection rate,while surgical navigation strategies based on single-cell spatial transcriptomics offer novel insights for optimizing therapeutic paradigms. Future research should prioritize the discovery of PNI-specific molecular targets,multidimensional exploration of the neural-immune-metabolic axis,and addressing the challenges of integrating interdisciplinary technologies into clinical translation.</p>","PeriodicalId":60685,"journal":{"name":"中华外科杂志","volume":"63 8","pages":"761-766"},"PeriodicalIF":0.0,"publicationDate":"2025-06-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144487265","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 research progress on de-escalation and optimization strategies for the treatment of early-stage breast cancer].","authors":"X P Hao, S Wu, Z F Jiang","doi":"10.3760/cma.j.cn112139-20241012-00459","DOIUrl":"https://doi.org/10.3760/cma.j.cn112139-20241012-00459","url":null,"abstract":"<p><p>With the advancement of precision medicine, the treatment of early-stage breast cancer is gradually moving toward standardized individualization. While ensuring therapeutic efficacy, increasing attention is being given to patients' quality of life. In recent years, as clinical research data on targeted therapies for HER2-positive breast cancer, CDK4/6 inhibitors for hormone receptor-positive breast cancer, and immune checkpoint inhibitors for triple-negative breast cancer have accumulated, the treatment of early-stage breast cancer has become more precise and personalized. Furthermore, the growing body of clinical research on breast-conserving surgery, axillary preservation, and even the omission of primary tumor resection has significantly improved patients' quality of life. These more effective drugs and advanced technologies provide the foundation for de-escalation treatment strategies in early-stage breast cancer, driving the development of a more refined, patient-centered treatment approach.</p>","PeriodicalId":60685,"journal":{"name":"中华外科杂志","volume":"63 8","pages":"682-689"},"PeriodicalIF":0.0,"publicationDate":"2025-06-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144487269","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":"[Expert consensus on advocating the use of graphic surgical records(2025 edition)].","authors":"","doi":"10.3760/cma.j.cn112139-20250423-00216","DOIUrl":"https://doi.org/10.3760/cma.j.cn112139-20250423-00216","url":null,"abstract":"<p><p>Surgical records are the core components of medical documents in clinical centers of surgery. Standardization of surgical records contributes to standardizing surgical procedures, improving the quality of surgery, and ensuring patient safety. To ensure that surgical records more objectively, visually, and comprehensively reflect the actual surgical process, numerous high-level university hospitals' surgical centers have long adhered to the good tradition of documenting surgical records in a \"combination of text and images\" format. Graphic surgical records not only benefit postoperative review and structured data collection but also facilitate the implementation of high-quality clinical research and surgical training. As early as 2015, Group of Operative Surgery, Chinese Society of Surgery, Chinese Medical Association already formulated the \"Expert Consensus on Advocating the use of graphic surgical records\".In recent years, rapid development of information technology has provided technical support for the further promotion of graphical surgical records. After extensive and multiple rounds of professional discussions and investigations, and based on a thorough consideration of relevant national policy requirements, information standards, the 2025 edition of the \"Expert Consensus\" is intended to be revised, aiming to enhance the standardization of graphical surgical records, improve the quality of surgery and training system, as well as clinical researches, thereby contributing to the development of Healthy China.</p>","PeriodicalId":60685,"journal":{"name":"中华外科杂志","volume":"63 8","pages":"653-659"},"PeriodicalIF":0.0,"publicationDate":"2025-06-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144487260","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":"[Implementation of personalized T-cell therapy in the treatment of pancreatic cancer].","authors":"Rienk Offringa, Z B Meng, H K Cai, X Y Shi, H Mei, H S Wu","doi":"10.3760/cma.j.cn112139-20250328-00164","DOIUrl":"https://doi.org/10.3760/cma.j.cn112139-20250328-00164","url":null,"abstract":"<p><p>Pancreatic ductal adenocarcinoma is profoundly treatment-resistant, due to intrinsic properties of the tumor cells and the complex tumor microenvironment. Consequently, surgical resection of the primary tumor is still the only intervention that significantly prolongs patient survival. This points at an urgent need for more effective (neo)adjuvant strategies to increase the fraction of patients eligible to surgery and to counter post-surgery disease recurrence. The advent of single-cell RNA-sequencing has created an opportunity for the development of a highly potent, patient-tailored adjuvant treatment that is based on the infusion of genetically engineered autologous T-cells armed with tumor-reactive T-cell receptors as identified in the patient's own tumor sample.</p>","PeriodicalId":60685,"journal":{"name":"中华外科杂志","volume":"63 8","pages":"666-671"},"PeriodicalIF":0.0,"publicationDate":"2025-06-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144487261","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}